Reversible cerebral vasoconstriction syndrome in a young primigravida woman with pre-eclampsia

Reversible cerebral vasoconstriction syndrome (RCVS) is characterised by severe headache and is associated with reversible segmental vasoconstriction of cerebral arteries. Conditions associated with RCVS are commonly pregnancy with or without pre-eclampsia, neurological procedures, head trauma. Thunderclap headache is the chief clinical presentation. Visual disturbances and focal neurological deficits are also frequently encountered. Posterior reversible encephalopathy syndrome and RCVS are often overlapping and hence most cases of RCVS are diagnosed late. We reported a young primigravida who had no comorbidities presenting to the ER with elevated blood pressure and generalised tonic and clonic seizures. Post-delivery her headache persisted and clinically her neurological status started deteriorating. Later she was diagnosed as RCVS. Treatment is based on expert opinion. Nimodipine, nifedipine or verapamil have been used in most patients

A successful and ideal randomized orthogonal additive response model

An innovative additive randomized response technique (RRT) has been put forth in this study. The proposed models characteristics have been researched. Theoretically, it has been demonstrated that under highly realistic circumstances, the recommended additive model is superior to the existing one. RRTs are used to lessen response biases in sensitive research question self-report surveys (e.g., on socially undesirable characteristics). Evidence suggests that they cannot entirely eradicate self-protective response mechanisms. There are RRTs made especially to assess the effectiveness of such tactics in order to solve this issue. Also provided in support of the current study are numerical examples

Linguistic isolation correlates with length of stay and mortality for pediatric oncology patients in California.

OBJECTIVE: To evaluate social drivers of health and how they impact pediatric oncology patients clinical outcomes during pediatric intensive care unit (PICU) admission via correlation with patient ZIP codes. METHODS: Demographic, clinical, and outcome variables from Virtual Pediatric Systems®, LLC for oncology patients (2009-2021) in California PICUs (excluding postoperative) using 3-digit ZIP Codes with social drivers of health variables linguistic isolation, poverty, race/ethnicity, and education abstracted from American Community Survey data for 3-digit ZIP Codes using the Environmental Protection Agencys EJScreen tool. Outcomes of length of stay (LOS), mortality, acuity scores, were compared with social variables. RESULTS: Positive correlation between mortality and minority racial groups (Hispanic/Latino) across ZIP Codes (correlation coefficients of 0.45 (95% CI: 0.22-0.64, p < 0.001) in 2017, 0.50 (95% CI: 0.27-0.68, p < 0.001) in 2018, 0.33 (95% CI: 0.07-0.54, p = 0.013) in 2020, and 0.32 (95% CI: 0.06-0.53, p = 0.018) in 2021). Median PICU length of stay significantly correlated with linguistic isolation (coefficient of 0.42 (95% CI: 0.18-0.61, p = 0.001) in 2021 versus -0.41 (95% CI: -0.61 to -0.16, p = 0.002) in 2019), which included PRISMIII (n = 7417). Mixed effects logistic regression model for other constant variables (PRISMIII, cancer type, race/ethnicity, year), random effect of patient, linguistic isolation (percentage as a continuous value) was significantly associated (95% CI: 1.01-1.06; p = 0.02) with mortality; (OR = 1.03). CONCLUSIONS: Linguistic isolation was correlated with LOS and mortality, however variable year to year

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Insight into the Interaction between Plants and Associated Fluorescent Pseudomonas

Fluorescent Pseudomonas are known for their plant growth promoting and disease protection abilities. In past years, a number of studies have focused on how these bacteria suppress disease and induce resistance. They are known to produce antibiotics and siderophores, promote growth, and induce systemic resistance in the host plant. This bacterium has come out as a model organism for ecological studies going on in rhizosphere and for studying plant-beneficial microbe interaction. This review focuses on the current state of knowledge on biocontrol potential of fluorescent Pseudomonas strains and the mechanisms adopted by them

Technological and economic analysis of electrokinetic remediation of contaminated soil: A global perspective and its application in Indian scenario

Globally million hectares of land annually is getting contaminated by heavy metalloids like As, Cd, Cr, Hg, Pb, Co, Cu, Ni, Zn, and Se, with current concentrations in soil above geo-baseline or regulatory standards. The heavy metals are highly toxic, mobile, and persistent and hence require immediate and effective mitigation. There are many available remediation techniques like surface capping, encapsulation, landfilling, soil flushing, soil washing, electrokinetic extraction, stabilization, solidification, vitrification, phytoremediation, and bioremediation which have been evolved to clean up heavy metal-contaminated sites. Nevertheless, all of the technologies have some applicability and limitations making the soil remediation initiative unsustainable. Among the available technologies, electrokinetic remediation (EKR) has been comparatively recognized to mitigate contaminated sites via both in-situ and ex-situ approaches due to its efficiency, suitability for use in low permeability soil, and requirement of low potential gradient. The work critically analyzes the EKR concerning techno, economic, and sustainability aspect for evaluating its application on various substrates and environmental conditions. The current soil contamination status in India is presented and the application of EKR for the heavy metal remediation from soil has been evaluated. The present work summaries a comprehensive and exhaustive review on EKR technology proving its effectiveness for a country like India where the huge amount of waste generated could not be treated due to lack of infrastructure, technology, and economic constraints

Evaluation of pneumatization of the temporal bone with cone beam computed tomography: A radiographic study

Purpose: The temporal bone depicts a variety of pneumatization patterns which are incidental findings but have a great clinical significance for planning surgical procedures in this area. The purpose of the present study was to evaluate the prevalence and incidence of pneumatization of articular tubercle and roof of glenoid fossa. Methods: 520 CBCT scans of 260 patients were evaluated to determine pneumatized articular eminence prevalence and characteristics. Gender, laterality and type of pneumatization were observed for both the left and right sides. Chi-square test was used to evaluate the relationship between pneumatized articular eminence and roof of glenoid fossa and gender and type. The software used for the statistical analysis was SPSS version 21.0 and the p-value < 0.05 were considered to indicate statistical significance. Results: PAT was detected in 180 (34.6%), consisting of 105 (20.2%) unilocular and 75 (14.4%) multilocular. PRGF was observed in 224 (43.1%) patients, consisting of 80 (15.4%) unilocular and 144 (27.7%) multilocular. There was 102(19.6%), 93(17.9%) unilateral PAT and PRGF and 44 (8.5%), 74 (14.2%) bilateral PAT and PRGF respectively. Significant corelation was observed for the distribution of types of PAT according to gender (p-value= 0.001)

Technological and economic analysis of electrokinetic remediation of contaminated soil: A global perspective and its application in Indian scenario

Globally million hectares of land annually is getting contaminated by heavy metalloids like As, Cd, Cr, Hg, Pb, Co, Cu, Ni, Zn, and Se, with current concentrations in soil above geo-baseline or regulatory standards. The heavy metals are highly toxic, mobile, and persistent and hence require immediate and effective mitigation. There are many available remediation techniques like surface capping, encapsulation, landfilling, soil flushing, soil washing, electrokinetic extraction, stabilization, solidification, vitrification, phytoremediation, and bioremediation which have been evolved to clean up heavy metal-contaminated sites. Nevertheless, all of the technologies have some applicability and limitations making the soil remediation initiative unsustainable. Among the available technologies, electrokinetic remediation (EKR) has been comparatively recognized to mitigate contaminated sites via both in-situ and ex-situ approaches due to its efficiency, suitability for use in low permeability soil, and requirement of low potential gradient. The work critically analyzes the EKR concerning techno, economic, and sustainability aspect for evaluating its application on various substrates and environmental conditions. The current soil contamination status in India is presented and the application of EKR for the heavy metal remediation from soil has been evaluated. The present work summaries a comprehensive and exhaustive review on EKR technology proving its effectiveness for a country like India where the huge amount of waste generated could not be treated due to lack of infrastructure, technology, and economic constraints