Stevens Johnson syndrome following paraquat poisoning: a case report

Paraquat is a herbicidal agent used extensively, mainly in developing countries where there is a high incidence of its poisoning. It causes damage to kidneys, lungs and liver. Reports of mucocutaneous manifestations following paraquat ingestion are rare. Here we describe a case of Stevens-Johnson syndrome(SJS) presenting in a case of paraquat ingestion. A 22 year old male was admitted to our hospital for difficulty in swallowing and micturation since ingestion of 10-15 ml of paraquat 7 days before. He had multiple hemorrhagic crusted erosions over lips and left maxillary area with diffuse erythematous erosions over bilateral buccal mucosa, palate, labial mucosa and urethral mucosa with whitish slough over them. Upper GI endoscopy revealed oral, esophageal and fundal sloughing. Patient was treated with oral corticosteroids and antibiotics which caused complete resolution of skin lesions within 15 days.Paraquat dichloride exerts its toxicity by generation of reactive oxygen species. Skin lesions following topical application of paraquat are common, but very few cases have been reported of the same after oral ingestion. SJS is caused by a variety of drugs and commonly presents with muco-cutaneous tenderness, hemorrhagic erosions and erythematous macules with 90% developing oral, genital and gastrointestinal mucosal involvement. As the oral and genital manifestations in our patient developed the day after paraquat ingestion, possibility of SJS developing due to the same are the highest. Paraquat should not be ruled out as a drug causality if mucocutaneous manifestations of SJS/TEN appear in a patient of paraquat ingestion.

Confocal Laser Scanning Microscopic Evaluation of Sealer Penetration in Root Canals of Teeth with the butterfly and Non-butterfly Effect: An In vitro Study

AIM: The study aimed to investigate the penetration depth of calcium hydroxide-based root canal sealer into buccolingual and mesiodistal aspects of roots with and without the butterfly effect at coronal and middle root sections. METHODS AND MATERIALS: Twenty single-rooted maxillary premolars were decoronated at the cementoenamel junction and viewed under a light microscope and grouped as Group 1 – butterfly (B) and Group 2 – non-butterfly according to the presence or absence of the effect. Canals were prepared till working length followed with copious irrigation. Canals were finally rinsed with 5 ml of 17% ethylenediaminetetraacetic acid solution and activated using EndoActivator followed by obturation using gutta-percha (warm vertical compaction technique) with Sealapex sealer. To provide fluorescence for confocal laser scanning microscopy (CLSM), the Sealapex was mixed with rhodamine B dye. Root sectioning yielded coronal and middle sections. CLSM was used to assess the penetration of the sealer. STATISTICAL ANALYSIS: Shapiro–Wilk test, unpaired “t-test.” RESULTS: Teeth with the butterfly effect had greater mean penetration buccolingually (905.2 μm) than mesiodistally (182.1 μm; p < 0.001). Coronal sections had greater penetration (517.4 μm) compared with the middle (354.6 μm). CONCLUSION: Sealapex sealer exhibited maximum tubular penetration in teeth with butterfly effect in buccolingual direction at the coronal third level

IL RUOLO DEI PUNTI VENDITA COME STRUMENTO DI IMMAGINE DI MARCA NEL MERCATO CINESE

Preeclampsia (PE) and intrauterine growth restriction (IUGR) are major obstetric health problems. Higher levels of T-helper (Th) 1 (proinflammatory) cytokines have been observed in pregnancies complicated with PE and IUGR; this is in contrast to the predominant Th2 (anti-inflammatory) cytokine environment found in uncomplicated pregnancies. Myostatin is best known as a negative regulator of muscle development and reportedly has a role in fat deposition, glucose metabolism, and cytokine modulation (outside the placenta). Myostatin concentrations in plasma and protein expression in placental tissue are significantly higher in women with PE. Expression of myostatin in IUGR and PE-IUGR and the effect of this protein on the cytokine production from the placenta is unknown. In the current study, significant differences were identified in the expression of myostatin in pregnancies complicated with IUGR, PE, and PE with IUGR. Furthermore, cytokine production by first-trimester placental tissues was altered following myostatin treatment.</p

Tracking Target Signal Strengths on a Grid using Sparsity

Multi-target tracking is mainly challenged by the nonlinearity present in the measurement equation, and the difficulty in fast and accurate data association. To overcome these challenges, the present paper introduces a grid-based model in which the state captures target signal strengths on a known spatial grid (TSSG). This model leads to \emph{linear} state and measurement equations, which bypass data association and can afford state estimation via sparsity-aware Kalman filtering (KF). Leveraging the grid-induced sparsity of the novel model, two types of sparsity-cognizant TSSG-KF trackers are developed: one effects sparsity through $\ell_1$-norm regularization, and the other invokes sparsity as an extra measurement. Iterative extended KF and Gauss-Newton algorithms are developed for reduced-complexity tracking, along with accurate error covariance updates for assessing performance of the resultant sparsity-aware state estimators. Based on TSSG state estimates, more informative target position and track estimates can be obtained in a follow-up step, ensuring that track association and position estimation errors do not propagate back into TSSG state estimates. The novel TSSG trackers do not require knowing the number of targets or their signal strengths, and exhibit considerably lower complexity than the benchmark hidden Markov model filter, especially for a large number of targets. Numerical simulations demonstrate that sparsity-cognizant trackers enjoy improved root mean-square error performance at reduced complexity when compared to their sparsity-agnostic counterparts.Comment: Submitted to IEEE Trans. on Signal Processin

Working with Young People Who Offend : An Examination of the Literature Regarding Violence, Substance Misuse and Harmful Sexual Behaviour

This paper presents a review of the recent literature relating to effective practice with young people displaying harmful sexual behaviour (HSB), violence or risky substance misuse. The intention is to build upon and update the 2007 literature review Research and practice in risk assessment and risk management of children and young people engaging in offending behaviour, funded by the Risk Management Authority (RMA) and carried out by the Scottish Centre for Crime and Justice Research (SCCJR)