Epistaxis in Visceral Leishmaniasis with Hematological Correlation

Objective. To study the prevalence of epistaxis in visceral leismaniasis and its correlation with hematological profile. Methods. Out of 80 diagnosed cases of visceral leishmaniasis, 19 patients with epistaxis were included in the study. Diagnosis was made by Rk-39 from peripheral smear and LD bodies from bone marrow. Before starting anti-kala-azar treatment, nasal examination findings and hematological profile were noted. Study Design. Prospective cross-sectional hospital-based study. Results. Epistaxis was found in the age group of 7–66 years. Epistaxis was observed in 19 (23.8%) cases. One patient died because of epistaxis and neck hematoma. Conclusion. Epistaxis is a common ENT finding in endemic area of visceral leishmaniasis like our case

Evaluation of prognostic factors in neonatal intestinal obstruction.

INTRODUCTION : Neonatal surgical emergencies cause considerable mortality and morbidity with intestinal obstruction being a common cause. The etiology ranges from Duodenal / Jejunal atresias to Malrotation, Annular pancreas, duplication cyst, volvulous, meconium ileus, pyloric stenosis, Hirschsprungs disease to anorectal anomalies. The mode of presentation can be acute or more chronic with systemic upset due to shock. Neonates, more so than older children, with unrecognized intestinal obstruction deteriorate rapidly, show an increase of associated morbidity and mortality. Early diagnosis depends largely on the prompt detection of Obstructive manifestations and the subsequent accurate interpretation of radiographic findings and other investigations, leading to surgical treatment, which should always be preceded by appropriate resuscitation/ preparation of the neonate. With the advent of neonatal intensive care the prognosis is mainly determined by the coexistence of other major congenital anomalies (eg, cardiac, respiratory, renal), delays in referral or coexisting factors as prematurity ,sepsis, low birth weight, respiratory distress ,operative procedure/ time. This study focuses on etiology, clnical presentation, and operative details and follow up with emphasis on the good and poor prognostic factors affecting the outcome. AIMS : 1. To know the frequency, mode of presentation of the various causes of neonatal intestinal obstruction. 2. To identify the good and poor prognostic factors associated with neonatal intestinal obstruction. 3. To evaluate the various surgical interventions and their outcome. 4. To analyse the relationship between the prognostic factors and outcome post operatively. MATERIALS AND METHODS : Study Design – Retrospective and prospective study evaluating the prognostic factors in neonatal intestinal obstruction. Study Period : December 2004 – December 2009. Study Centre : Department of Paediatric Surgery, Coimbatore Medical College Hospital. INCLUSION CRITERIA - 1. Newborn less than 28 days old. 2. Presenting clinically with vomiting, abdominal distension, failure to pass meconium. EXCLUSION CRITERIA - 1. Babies older than 28 days. 2. Babies diagnosed as cases of Hirschsprungs, Anorectal anomaly, Esophageal atresia. CONCLUSION : 1. Jejunoileal atresias are the commonest cause of neonatal intestinal obstruction. 2. Bilious Vomiting is the cardinal and thecommonest presenting symptom. The next commonest symptom is abdominal distension, followed by failure of passage of meconium seen more in case of distal atresias. Early suspecion is necessary to prevent the morbidity due to late referral. 3. Prenatal Ultrasound diagnosis provides the opportunity for appropriate counseling and for planning the delivery in a tertiary care center with a pediatric surgeon and a neonatal intensive care unit. 4. Low birth weight and prematurity are significant bad prognostic factors associated with considerable early post operative mortality. 5. Complex cardiac defects which pose a high anaesthetic risk is a negative prognostic factor. 6. Longer operative time which indicates complex procedures with adhesiolysis, gross contamination of the abdomen and gangrenous bowel are associated with increased morbidity and mortality signifying their prognostic value. 7. Reoperations and Postoperative sepsis are associated with poorer outcome. 8. Neonates with birth weight >2.5 kgs, term babies, early referrals all add up to the early recovery with minimum length of hospital stay and are of good prognostic value. 9. Surgical interventions per say though not based on the operative findings had major prognostic value shorter surgical endeavours as pyloromyotomy and clean procedures carry good prognosis in contrary to adhesiolysis, tapering enteroplasties and diversion procedures

Numerical and analytical investigation towards performance enhancement of a newly developed rockfall protective cable-net structure

In a previous companion paper, we presented a three-tier modelling of a particular type of rockfall protective cable-net structure (barrier), developed newly in Japan. Therein, we developed a three-dimensional, Finite Element based, nonlinear numerical model having been calibrated/back-calculated and verified with the element- and structure-level physical tests. Moreover, using a very simple, lumped-mass, single-degree-of-freedom, equivalently linear analytical model, a global-displacement-predictive correlation was devised by modifying the basic equation – obtained by combining the principles of conservation of linear momentum and energy – based on the back-analysis of the tests on the numerical model. In this paper, we use the developed models to explore the performance enhancement potential of the structure in terms of (a) the control of global displacement – possibly the major performance criterion for the proposed structure owing to a narrow space available in the targeted site, and (b) the increase in energy dissipation by the existing U-bolt-type Friction-brake Devices – which are identified to have performed weakly when integrated into the structure. A set of parametric investigations have revealed correlations to achieve the first objective in terms of the structure's mass, particularly by manipulating the wire-net's characteristics, and has additionally disclosed the effects of the impacting-block's parameters. Towards achieving the second objective, another set of parametric investigations have led to a proposal of a few innovative improvements in the constitutive behaviour (model) of the studied brake device (dissipator), in addition to an important recommendation of careful handling of the device based on the identified potential flaw

CLOZAPINE INDUCED PARALYTIC ILEUS

Clozapine is an atypical antipsychotic drug used for the treatment of schizophrenia in patient not responding to other antipsychotics. Dry mouth, constipation, loss of accommodation and urinary retention are the common side effects encountered with this drug. Here we are reporting a case of paralytic ileus secondary to clozapin

Iron porphyrin molecules on Cu(001): Influence of adlayers and ligands on the magnetic properties

The structural and magnetic properties of Fe octaethylporphyrin (OEP) molecules on Cu(001) have been investigated by means of density functional theory (DFT) methods and X-ray absorption spectroscopy. The molecules have been adsorbed on the bare metal surface and on an oxygen-covered surface, which shows a $\sqrt{2}\times2\sqrt{2}R45^{\circ}$ reconstruction. In order to allow for a direct comparison between magnetic moments obtained from sum-rule analysis and DFT we calculate the dipolar term $7$, which is also important in view of the magnetic anisotropy of the molecule. The measured X-ray magnetic circular dichroism shows a strong dependence on the photon incidence angle, which we could relate to a huge value of $7$, e.g. on Cu(001) $7$ amounts to -2.07\,\mbo{} for normal incidence leading to a reduction of the effective spin moment $m_s + 7$. Calculations have also been performed to study the influence of possible ligands such as Cl and O atoms on the magnetic properties of the molecule and the interaction between molecule and surface, because the experimental spectra display a clear dependence on the ligand, which is used to stabilize the molecule in the gas phase. Both types of ligands weaken the hybridization between surface and porphyrin molecule and change the magnetic spin state of the molecule, but the changes in the X-ray absorption are clearly related to residual Cl ligands.Comment: 17 figures, full articl

Field-regulated switching of the magnetization of Co-porphyrin on graphene

Differentmagnetic couplingmechanisms have been identified for a fewmonolayers of Co-porphyrin molecules deposited on a graphene-covered Ni(111) single crystal. A relatively strong antiferromagnetic coupling of the first molecular layer via graphene to the Ni crystal in comparison to a weaker intermolecular coupling gives rise to a complex field-dependent response of this hybrid system. By continuously increasing the magnetic field strength, the net magnetization of the molecular system switches from antiparallel to parallel to the field direction at 2.5 T. Utilizing x-ray absorption spectroscopy and x-ray magnetic circular dichroism, the element-specific magnetization and field dependence was probed. The nature of the magnetic couplings is identified by means of density functional theory and orbital-dependent susceptibilities