Ligature strangulation causes death due to neck compression without suspension. However, suicidal ligature strangulation is rare. The suicide of a 32-year-old man is presented. After a dispute, the man was found outdoors with a lashing belt around his neck which had been pulled tight with a ratchet. Conjunctival petechiae were found, but hemorrhages in the soft tissues were not observed. The hyoid bone and larynx did not show fractures or hemorrhage. Other injuries as well as signs of defence were not observed. The differentiation between homicidal and suicidal ligature strangulation can be difficult and requires careful investigation and collaboration by police and forensic pathologists.The deterioration of water quality of river Ganga is a huge concern for Govt. of India. Apart from various pollution sources, the religious and ritualistic activities also have a good share in deteriorating Ganga water quality. Thus, the aim of the present study was to evaluate the changes in physico-chemical properties, microbial diversity and role of bacteriophages in controlling bacterial population of Ganga water during mass ritualistic bathing on the occasion of Maha-Kumbh in 2013. The BOD, COD, hardness, TDS and level of various ions significantly increased, while DO decreased in Ganga water during Maha-Kumbh. Ganga water was more affluent in trace elements than Yamuna and their levels further increased during Maha-Kumbh, which was correlated with decreased level of trace elements in the sediment. The bacterial diversity and evenness were increased and correlated with the number of devotees taking a dip at various events. Despite enormous increase in bacterial diversity during mass ritualistic bathing, rated in all cultures, the outcome of the current study will not only be useful for the policy maker of cleaning and conservation of Ganga but also for restoration of other polluted rivers all over the world.Endometriosis is one of the most common medical conditions affecting the women. The study aimed to evaluate the safety and efficacy of robotic-assisted laparoscopic surgery (RAS) versus conventional laparoscopic surgery (LPS) in the treatment of endometriosis. PubMed, Embase, Cochrane and CINAHL databases were searched from January 1995 to March 2019. According to meta-analysis criteria, five comparative studies were selected. A total of 1527 patients were identified. In the meta-analysis, there were no significant differences in blood loss, complication, and hospital stay between RAS and LPS surgeries in the treatment of patients with endometriosis. However, RAS surgery required a higher weighted mean operating time than LPS surgery, 0.54 (95% confidence interval; 0.37 to 0.70; p  less then  0.00001) min. This meta-analysis confirmed that the robotic surgery is safe and feasible in patients affected by endometriosis. We could suggest that RAS is a valid option and might be considered an alternative to LPS especially in advanced cases.Parental rearing behaviours characterised by high levels of rejection and overprotection have been implicated in the development and maintenance of child psychopathology, including paediatric obsessive-compulsive disorder (OCD). The Egna Minnen Beträffande Uppfostran (EMBU) is a commonly used measure of perceived parental rearing. Using confirmatory factor analysis, the factor structure of the EMBU child and parent versions were examined in a sample of children and youth with OCD (n = 176), and their mothers (n = 162). Associations between rearing and clinical correlates of OCD were explored. For parents, a 4-factor model provided the best fit. For children, a higher order model was the best fit. Greater parent and child perceived negative rearing behaviours and lower perceived positive behaviours were associated with greater OCD severity, comorbid symptoms and impairment. The EMBU has a conceptually meaningful factor structure and provides a useful measure for assessing perceived rearing behaviours within paediatric OCD.Early and prompt diagnosis of pyelonephritis is of great importance in children. The aim of this study is to evaluate the diagnostic accuracy of urinary carbohydrate antigen 19-9 (CA19-9) levels for predicting acute pyelonephritis (APN) in children with urinary tract infection (UTI). Patients were allocated into two groups of APN and acute cystitis according to their diagnosis. Urine samples of all patients were collected. Also, complete history was taken, and physical examination, kidney and bladder ultrasonography, 99mTc-dimercaptosuccinic acid renal cortical scintigraphy, and urine analysis and culture were performed. Urinary CA19-9 was measured by an electrochemiluminescence enzyme immunometric kit. In addition, CA19-9 levels were measured in the APN group 2 weeks and 3 months later. A total of 100 children were included in this study (mean age 46 ± 31 months, 16 males and 84 females). CA19-9 levels were significantly greater in the APN group than acute cystitis group (510 ± 328 vs. https://www.selleckchem.com/products/colivelin.html 18.7 ± 18.6 U/ml, P  less then  0.001). During follow-up periods of the APN group, CA19-9 levels decreased to 180 ± 124 U/ml after 2 weeks (P  less then  0.001) and 30 ± 23 U/ml after 3 months (P  less then  0.001). Urinary CA-19-9 had 95.3% sensitivity and 80% specificity for the diagnosis of APN. The area under the curve value of CA19-9 was 0.904 (95% CI 0.831-0.977).Conclusion Urinary CA19-9 level can be used as a reliable biomarker for early detection of APN prior to urine culture confirmation in children with UTI.What is known• Early and prompt diagnosis of pyelonephritis is necessary in children to prevent renal damage.• Acute pyelonephritis can present with vague and nonspecific symptoms in infants and children.What is new• Urinary carbohydrate antigen 19-9 is a reliable biomarker for early detection of acute pyelonephritis prior to urine culture confirmation.• Urinary carbohydrate antigen 19-9 has 95.3% sensitivity and 80% specificity for diagnosis of acute pyelonephritis.Anthropometric indices (AI) have been known to be associated with age at menarche (AAM). The aim of this longitudinal study was to evaluate the changes in AI and its association with AAM in a community-based population in Iran. From among 10,192 women, we included 6818, aged ≥ 10 years, who were post-menarche at the time of entering the study and their AAM ranged between 8 and 18 years. Study subjects were divided into groups by tertiles birth cohort (BC) (born ≤ 1939, 1940-1969, and ≥ 1970) and AAM (≤ 11, 12-15, and ≥ 16 years). Generalized estimating equation analysis was performed to evaluate the association between changes of AI in different BCs with AAM groups. Overall mean of AAM was 13.5 ± 1.4 years. Mean body mass index (BMI) was significantly increased over time more in those with early AAM (≤ 11 years) compared to those with AAM ≥ 16 years; changes in mean BMI of 1.24 kg/m2 (95% CI 0.32, 2.15), 2.61 kg/m2 (95% CI 1.90, 3.33), and 3.99 kg/m2 (95% CI 2.46, 5.51) in BC ≥ 1970, BC (1940-1969), and, BC ≤ 1939, respectively.