Report: Fatal case of disseminated BCG infection in an infant born to a mother taking infliximab for Crohn’s disease

Abstract We present the case of a 28 year old lady with refractory Crohn's Disease treated with infliximab throughout her pregnancy. Her baby was born healthy and received a Bacillus Calmette-Guérin (BCG) vaccine aged 3 months. Soon after this the infant became unwell and died aged 4.5 months. At post-mortem the cause of death was attributed to an unusual complication of the BCG vaccine, known as disseminated BCG. BCG vaccination is contraindicated in individuals who are receiving immunosuppressive drugs. We recommend physicians should exercise caution before such vaccines are used in infants born to mothers taking anti-TNF therapies or other potentially immunosuppressive IgG1 antibodies. © 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved. Case report This case is of a 28 year old Caucasian lady diagnosed with pan-colitis and erythema nodosum secondary to Crohn's Disease (CD) in 2001. She was treated early on with mesalazine and azathioprine at a dose of 2 mg per kg bodyweight but experienced recurrent flare-ups requiring repeated courses of prednisolone with eventual loss of response. In 2004, infliximab 5 mg/kg was commenced with initial good symptomatic benefit but subsequent loss of response. Therefore, in 2006 the dose of infliximab was increased to 10 mg/kg every eight weeks. In 2008 she became pregnant. The pros and cons of continuing infliximab were discussed at length with the patient. Due the severity and corticosteroid refractory nature of her CD, the benefits of maintaining remission with infliximab was felt to outweigh the risks of foetus exposure to the drug. She consented to continue eightweekly infusions of infliximab 10 mg/kg as monotherapy for CD. Her disease remained in remission during pregnancy and in July 2008 she gave birth to a healthy baby boy. The baby was born at 36 + 3 gestation via spontaneous vaginal deliver

Prohepcidin Levels in Refractory Anaemia Caused by Lead Poisoning

Recent research evidence suggests a central role for hepcidin in iron homeostasis. Hepcidin is a hormone synthesized in the liver. Hepcidin is also thought to play a vital role in the pathogenic mechanism of anaemia in patients with inflammation or chronic disease. A 38-year-old female who presented with recurrent abdominal pain was found to have raised urinary porphyrins and a blood lead level of 779 μg/l. Her haemoglobin level was 8.3 g/dl. Her MCV was normal. Serum ferritin, B12 and folate were normal. Her serum prohepcidin level was 2,489 ng/ml (normal <450 ng/ml). To our knowledge, this is the first report of raised prohepcidin levels in a patient with anaemia of chronic disease resulting from lead poisoning

Diversity of phytoplankton in some domestic wastewater-fed urban fish pond ecosystems of the Chota Nagpur Plateau in Bankura, India

Abstract The present limnological investigation is conducted to study the relationship between phytoplankton abundance and five important physicochemical factors in urban wastewater-fed seven fish ponds of Chota Nagpur Plateau area. A total number of 43 phytoplankton taxa representing four classes, namely Cyanophyceae (7), Chlorophyceae (29), Bacillariophyceae (5) and Euglenophyceae (2), are thriving in these ponds which may suggest that different nutrient-rich wastewater supports the diversity and abundance of the phytoplankton. Different values of diversity indices, results of post hoc analysis and rarefaction curve are depicted spatial variations of phytoplankton abundance and physicochemical factors. From the Principal Component Analysis, out of 43 phytoplankton species, 23 important species are extracted. The canonical correspondence analysis presents that most of the phytoplankton species densities are associated with higher values of the physicochemical variables in these ponds. Correspondingly, in the present study, Algal Genus Pollution Index (AGPI) is employed to study the water quality of seven sites. From the AGPI score, it is revealed that Site 4 has probable high organic pollution and Site 2 and Site 3 have moderate organic pollution. Therefore, long-term intensive studies and proper management are necessary to protect these ponds toward eutrophication and degradation, because these ponds not only act as a safeguard of livelihoods but also contribute significantly at local level food and water security and economic prosperity

Light-emitting devices based on Evans blue under alternating-current and direct-current modes: different charge injection mechanisms

Light-emitting devices (LEDs) have been fabricated with a blend of evans blue dye and poly(methylmethacrylate) (PMMA) insulating material. Luminance has been observed under both direct-current (DC) and alternating-current (AC) modes. Different charge injection and operation mechanisms have been shown to be applicable under DC and AC biases. From the current-voltage characteristics under DC voltage, Fowler-Nordheim (FN) tunnelling mechanism and Richardson-Schottky thermionic emission have been found to be applicable in forward and reverse bias directions, respectively. In general, luminance has been observed only in the forward bias direction. Under AC voltage, there has been accumulated hole-assisted electron injection, which has resulted in luminance in both bias directions for all molar concentrations of evans blue, and particularly higher luminance level in the reverse-biased half-cycle. Moderately high-frequency (40 kHz) electroluminescence (EL) has been obtained from these devices

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On measures of technical inefficiency and production uncertainty in stochastic frontier production model with correlated error components

Stochastic frontier model, Efficiency measurement, Hazard function, Skew normal distribution, C11, C14, C23,