Extensive Fixed Drug Eruption Due to Diclofenac

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Experimental evaluation of adaptive maximum power point tracking for a standalone photovoltaic system

The adaptability of maximum power point tracking (MPPT) of a solar PV system is important for integration to a microgrid. Depending on what fixed step-size the MPPT controller implements, there is an impact on settling time to reach the maximum power point (MPP) and the steady state operation for conventional tracking techniques. This paper presents experimental results of an adaptive tracking technique based on Perturb and Observe (P&O) and Incremental Conductance (IC) for standalone Photovoltaic (PV) systems under uniform irradiance and partial shading conditions. Analysis and verification of measured and MATLAB/Simulink simulation results have been carried out. The adaptive tracking technique splits the operational region of the solar PV’s power–voltage characteristic curve into four and six operational sectors to understand the MPP response and stability of the technique. By implementing more step-sizes at sector locations based on the distance of the sector from the MPP, the challenges associated with fixed step-size is improved on.The measured and simulation results clearly indicate that the proposed system tracks MPP faster and displays better steady state operation than conventional system. The proposed system’s tracking efficiency is over 10% greater than the conventional system for all techniques. The proposed system has been under partial shading condition has been and it outperforms other techniques with the GMPP achieved in 0.9 s which is better than conventional techniques

A Case of Multiple Myeloma Presenting with Diabetes Insipidus

Multiple myeloma (MM) can present with involvement of the central nervous system in the form of nerve palsy, plasma cell masses or, rarely, with endocrinological effects due to involvement of the pituitary gland. Usually, in such cases, the disease has a rapid progression and poor prognosis. We report a 52-year-old man who was admitted to the Kolkata Medical College, Kolkata, India, in 2016 with a prolonged low-grade fever and hypernatremia. Shortly afterwards, the patient began to complain of increased urinary frequency and drowsiness. The hypernatremia was treated with intranasal desmopressin and free water replacement. Serum protein electrophoresis and an immunofixation study revealed an immunoglobulin G-κ monoclonal band. Magnetic resonance imaging of the pituitary gland revealed the absence of a posterior bright spot and spotty infiltration of the pituitary fossa. A bone marrow biopsy confirmed a diagnosis of cranial diabetes insipidus due to posterior pituitary MM infiltration

Living environment and self assessed morbidity: a questionnaire-based survey

<p>Abstract</p> <p>Background</p> <p>Health complaints have been reported to be higher among the industrial area residents when compared with reference community.</p> <p>Methods</p> <p>Such reports being only a few, a questionnaire survey was conducted in three different areas (Industrial, Residential, Commercial) of Ahmedabad city of India to determine the pattern of morbidity and to do a comparative analysis of different areas within the city.</p> <p>Results</p> <p>A total of 679 families (243 from commercial, 199 from residential and 237 from industrial area) were included in this study. This study revealed that apart from presence of industry in close proximity to residence (99.2%), industrial area residents are having many other disadvantages from the point of view of public health like waste water stagnation (87.4%), problem of cooking smoke (33.2%) and presence of garbage dumps near residence (72.8%). Consequently, problems like coughing, wheezing, eye irritation, skin irritation, jaundice, asthma, and dental caries have been observed to be more common in industrial area. Comparative risk calculated in terms of odds ratio for different such problems have ranged from 1.83 to 6.2 when industrial area was compared with commercial area. Similarly on comparison of industrial area with residential area, odds ratio for different problems have ranged from 1.82 to 11.5.</p> <p>Conclusion</p> <p>This study has pointed out the need of separate planning and implementation of specific upliftment programs for addressing the environmental as well as public health issues of industrial localities.</p

Effectiveness of different methods of health education: A comparative assessment in a scientific conference

ABSTRACT: BACKGROUND: Every individual mode of health education has its own merits, drawbacks as well as their own sphere of effectiveness. A specific mode of communication is more useful in a specific setting on a specific group than others. To search for optimum mode of communication for a specific audience is a major area of research in health education. The issue of imparting health education to a gathering of educated people, representing different fields of knowledge has remained a relatively less lighted aspect of health education research. In this backdrop this study was initiated for making a comparative assessment of different methods of dissemination of health education among educated people. METHODS: A cross-sectional interviewer administered questionnaire survey was conducted involving 142 randomly selected subjects during the last session of a five-day conference having health as main theme when the opinion of the delegates regarding different communication methods was asked for. Collected data was analyzed not only to find out the optimum mode of education dissemination in such a setting but also to find the contribution of different factors in the preferences of the study subjects. RESULTS: The participants opted more (60%) for focused programs of smaller audience (sectional program). In both broad area (main program) and focused area programs (sectional), the participants preferred lectures (62% and 65.7% respectively). Specific topics were preferred both in lectures (67.6%) and symposia (57.7%). In the exhibition, exhibits seemed to be more attractive (62%) than the posters. Qualification has emerged to be a contributing factor in peoples' choice towards sectional programme and also in their affinity to symposia. Increased age was a significant contributor in participants' preference towards specific topics. Physical barriers of communication appeared to be a problem in the main program as well as in the exhibition. Lack of coherence among the speakers was reported (69%) to be a major reason for which symposia was not preferred. CONCLUSION: This study concluded that while planning for health education dissemination in an educated group a focused programme should be formulated in small groups preferably in the form of lectures on specific topics, more so while dealing with participants of higher age group having higher educational qualification

Inhibition of Human Dendritic Cell ER Stress Response Reduces T Cell Alloreactivity Yet Spares Donor Anti-tumor Immunity

Acute graft- vs. -host disease (GVHD) is an important cause of morbidity and death after allogeneic hematopoietic cell transplantation (HCT). We identify a new approach to prevent GVHD that impairs monocyte-derived dendritic cell (moDC) alloactivation of T cells, yet preserves graft- vs.-leukemia (GVL). Exceeding endoplasmic reticulum (ER) capacity results in a spliced form of X-box binding protein-1 (XBP-1s). XBP-1s mediates ER stress and inflammatory responses. We demonstrate that siRNA targeting XBP-1 in moDCs abrogates their stimulation of allogeneic T cells. B-I09, an inositol-requiring enzyme-1α (IRE1α) inhibitor that prevents XBP-1 splicing, reduces human moDC migration, allo-stimulatory potency, and curtails moDC IL-1β, TGFβ, and p40 cytokines, suppressing Th1 and Th17 cell priming. B-I09-treated moDCs reduce responder T cell activation via calcium flux without interfering with regulatory T cell (Treg) function or GVL effects by cytotoxic T lymphocytes (CTL) and NK cells. In a human T cell mediated xenogeneic GVHD model, B-I09 inhibition of XBP-1s reduced target-organ damage and pathogenic Th1 and Th17 cells without impacting donor Tregs or anti-tumor CTL. DC XBP-1s inhibition provides an innovative strategy to prevent GVHD and retain GVL

Programmed death ligand-1 expression on donor T cells drives graft-versus-host disease lethality

Programmed death ligand-1 (PD-L1) interaction with PD-1 induces T cell exhaustion and is a therapeutic target to enhance immune responses against cancer and chronic infections. In murine bone marrow transplant models, PD-L1 expression on host target tissues reduces the incidence of graft-versus-host disease (GVHD). PD-L1 is also expressed on T cells; however, it is unclear whether PD-L1 on this population influences immune function. Here, we examined the effects of PD-L1 modulation of T cell function in GVHD. In patients with severe GVHD, PD-L1 expression was increased on donor T cells. Compared with mice that received WT T cells, GVHD was reduced in animals that received T cells from Pdl1–/– donors. PD-L1–deficient T cells had reduced expression of gut homing receptors, diminished production of inflammatory cytokines, and enhanced rates of apoptosis. Moreover, multiple bioenergetic pathways, including aerobic glycolysis, oxidative phosphorylation, and fatty acid metabolism, were also reduced in T cells lacking PD-L1. Finally, the reduction of acute GVHD lethality in mice that received Pdl1–/– donor cells did not affect graft-versus-leukemia responses. These data demonstrate that PD-L1 selectively enhances T cell–mediated immune responses, suggesting a context-dependent function of the PD-1/PD-L1 axis, and suggest selective inhibition of PD-L1 on donor T cells as a potential strategy to prevent or ameliorate GVHD