Tubercular prevertebral and epidural abscess presenting as stridor and dysphagia in an infant: A rare presentation of tuberculosis in infancy

Tubercular prevertebral abscess is rare presentation of pott’s spine in infancy. It can lead to life threatening airway obstruction and dysphagia requiring early diagnosis and proper management to prevent consequences. We present a case of 5 month child with tubercular prevertebral and epidural abscess who presented with dysphagia and stridor. Child responded dramatically to anti-tubercular therapy and surgical drainage of abscess. The child is doing well on follow up

Advanced Modeling and Control Strategies for Charging Electric Vehicle Batteries

University of Minnesota M.S.E.E. thesis. October 2019. Major: Electrical Engineering. Advisor: Desineni Subbaram Naidu. 1 computer file (PDF); iv, 72 pages.The research in this master's thesis presents an advanced modeling and control strategy for charging electric vehicle (EV) batteries. The purpose of modeling the battery incorporating the optimal control mechanism is developing a fast-charging system for EVs. The thesis starts with a literature survey to find out the latest EV battery model within an appropriate format of interest. Then, on the selected battery model, it applies the state-dependent Riccati equation (SDRE) technique to develop a closed-loop optimal control strategy. For the purpose of optimization, the battery model aims to track a reference trajectory with a performance index which is minimizing the quadratic error between a reference and an actual trajectory. To harness the unified benefits of optimal and intelligent control systems, the thesis also sheds light upon fuzzy logic by generating a reference trajectory with it. Finally, to determine the correctness of the modeling, MATLAB simulations for a lithium-ion (li-ion) battery have been carried out and they display a satisfactory tracking performance

Naphthalene induced hemolysis in a glucose 6 phosphate dehydrogenase deficient neonate - A case report

Glucose-6-phosphate dehydrogenase (G6PD), a critical enzyme in the hexose monophosphate pathway, is a key component in the antioxidant mechanism of all cells, particularly erythrocytes. Its deficiency may manifest in the neonatal period in the form of severe hyperbilirubinemia. Hemolysis in neonate may occur de novo or be precipitated by stressors such as oxidant drugs or naphthalene. We report a case of 3 days old, G6PD deficient neonate, with naphthalene induced hemolysis, requiring exchange transfusion

Effect of timing of cord clamping on iron stores of infants born to anemic mothers

Objective: To study the effect of timing of cord clamping on the iron stores of infants born to anemic (hemoglobin [Hb] 7-10 g/dl)mothers, and if late clamping leads to polycythemia. Design: Randomized comparative trial. Setting: Tertiary care hospital in ametropolitan city. Participants: Term, healthy, and vaginally delivered neonates without any congenital malformations or birth asphyxia,born to booked anemic (Hb 7-10 g/dl) mothers having no medical or pregnancy-related complications were included in the study.Interventions: The pregnant mothers were randomized into three groups, and their umbilical cords were clamped at 1, 2, and 3 min.Neonatal hematocrit was estimated by the capillary method at 24 h of life, and infant’s (Hb) and ferritin were obtained at 3 monthsof life. Main Outcome Measures: Hematocrit at 24 h of life and serum iron and ferritin levels at 3 months of age. Results: Theoutcome variables significantly associated (p<0.05) with hematocrit were cord clamping time, maternal Hb and cord Hb, and ferritin.That associated with infant’s Hb were cord clamping time and cord Hb and ferritin. Whereas, only cord clamp time was significantlyassociated with infant’s ferritin. None of the neonates had polycythemia, and Hb and ferritin were found to be the highest in those whosecord was clamped at 3 min. Conclusion: In resource-constrained countries, where iron deficiency anemia is a major public healthproblem, delaying the umbilical cord clamping by up to 3 min will reduce the incidence of infantile anemia. It will serve as an additionalcost-effective intervention in anemia control program without any adverse effect of polycythemia

Efficacy of resveratrol encapsulated microsponges delivered by pectin based matrix tablets in rats with acetic acid-induced ulcerative colitis

Objectives: The objective of the present work to encapsulate the resveratrol (RES) inside the chitosan-based microsponges, employing the systematic optimization by 33 Box-Behnken design for the colonic targeting.Significance: Enhanced therapeutic efficacy of RES-loaded microsponges and matrix tablets, vis-a-vis pureRES for ulcerative colitis.Methods: RES-loaded microsponges were prepared employing the systematic optimization by 33 Box-Behnken design for the colonic targeting. The best-optimizedRES-loaded microsponge was compressed in the form of a tablet, employing pectin as a matrix-forming material. The encapsulation of RES inside microsponge was confirmed by XRD, DSC and FT-IR. Further, both RES-loaded microsponges and matrix tablets were evaluated for in vitro release kinetics and further evaluated for in vivo ulcerative colitis animal model.Results: Optimization experiments was obtained as the high value of r2 (particle size = 0.9999; %EE = 0.9652; %CDR = 0.9469) inferred excellent goodness of fit. SEM revealed nearly spherical and porous nature of RES-loaded microsponges. The in vitro release kinetic showed zero-order release for RES-loaded microsponges and Korsmeyer-Peppas model for matrix tablets. The pharmacodynamic studies, in ulcerative colitis rat model, indicated better therapeutic efficacy of drug-loaded microsponges and matrix tablets, vis-a-vis pure RES. Thus, the present study advocates the potential of RES based microsponges delivered by pectin based matrix tablet, in the treatment of various colonic disorders.Conclusion: The present study proved that RES-loaded microsponges and matrix tablets based on chitosan and pectin can be the ideal delivery system for colonic delivery of RES

Circadian rhythm disruption and Alzheimer’s disease: The dynamics of a vicious cycle

All mammalian cells exhibit circadian rhythm in cellular metabolism and energetics. Autonomous cellular clocks are modulated by various pathways that are essential for robust time keeping. In addition to the canonical transcriptional translational feedback loop, several new pathways of circadian timekeeping - non-transcriptional oscillations, post-translational modifications, epigenetics and cellular signaling in the circadian clock - have been identified. The physiology of circadian rhythm is expansive, and its link to the neurodegeneration is multifactorial. Circadian rhythm disruption is prevelant in contamporary society where light-noise, shift-work, and transmeridian travel are commonplace, and is also reported from the early stages of Alzheimer's disease (AD). Circadian alignment by bright light therapy in conjunction with chronobiotics is beneficial for treating sundowning syndrome and other cognitive symptoms in advanced AD patients. We performed a comprehensive analysis of the clinical and translational reports to review the physiology of the circadian clock, delineate its dysfunction in AD, and unravel the dynamics of the vicious cycle between two pathologies. The review delineates the role of putative targets like clock proteins PER, CLOCK, BMAL1, ROR, and clock-controlled proteins like AVP, SIRT1, FOXO, and PK2 towards future approaches for management of AD. Furthermore, the role of circadian rhythm disruption in aging is delineated

Azelaic acid and Melaleuca alternifolia essential oil co-loaded vesicular carrier for combinational therapy of acne

Aim: Azelaic acid (AzA), a comedolytic, antibacterial, anti-inflammatory anti-melanogenic agent, prescribed against acne vulgaris is safe on skin. Its combination with another widely used anti-acne agent, tea tree oil (EO) whose delivery is limited by volatility, instability and lipophilicity constraints was attempted. Method: Solvent injection was used to prepare AzA-EO integrated ethosomes. Result: Ethosomes were transformed into carbopol hydrogel, which exhibited pseudo-plastic properties with appreciable firmness, work of shear, stickiness and work of adhesion. The hydrogel showed better permeation and retention characteristics vis-a-vis commercial formulation (AzidermTM), when evaluated in Wistar rat skin. Further, ethosome hydrogel composite was better tolerated with no side effects. Conclusion: The findings suggests that the aforementioned strategy could be a potential treatment used for acne management. </jats:p

The burden of stroke and transient ischemic attack in Pakistan: a community-based prevalence study.

BACKGROUND: The burden of cerebrovascular disease in developing countries is rising sharply. The prevalence of established risk factors of stroke is exceptionally high in Pakistan. However, there is limited data on the burden of stroke and transient ischemic attack (TIA) in South Asia. We report the first such study conducted in an urban slum of Karachi, Pakistan. METHODS: Individuals 35 years of age or older were invited for participation in this investigation through simple random sampling. A structured face-to-face interview was conducted using a pre-tested stroke symptom questionnaire in each participant to screen for past stroke or TIA followed by neurological examination of suspected cases. Anthropometric measurements and random blood glucose levels were recorded. Multivariable logistic regression was used to determine the association of vascular risk factors with prevalence of stroke. RESULTS: Five hundred and forty five individuals (49.4% females) participated in the study with a response rate of 90.8%. One hundred and four individuals (19.1%) were observed to have a prior stroke while TIA was found in 53 individuals (9.7%). Overall, 119 individuals (21.8% with 66.4% females) had stroke and/or TIA. Female gender, old age, raised random blood glucose level and use of chewable tobacco were significantly associated with the prevalence of cerebrovascular disease. CONCLUSION: This is the first study demonstrating an alarmingly high life-time prevalence of cerebrovascular disease in Pakistan. Individual and public health interventions in Pakistan to increase awareness about stroke, its prevention and therapy are warranted.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Nanocarriers: more than tour de force for thymoquinone

Introduction: Thymoquinone (TQ), 2-isopropyl-5-methylbenzo-1, 4-quinone, the main active constituent of Nigella sativa (NS) plant, has been proven to be of great therapeutic aid in various in vitro and in vivo conditions. Despite the promising therapeutic activities of TQ, this molecule is not yet in the clinical trials, restricted by its poor biopharmaceutical properties including photo-instability.Area covered: This review compiles the different types of polymeric and lipidic nanocarriers (NCs), encapsulating TQ for their improved oral bioavailability, and augmented in vitro and in vivo efficacy, evidenced on various pathologies. Furthermore, we provide a comprehensive overview of TQ in relation to its encapsulation approaches advancing the delivery and improving the efficacy of TQ.Expert opinion: TQ was first identified in the essential oil of Nigella sativa L. black seed. TQ has not been used in formulations because it is a highly hydrophobic drug having poor aqueous solubility. To deal with the poor physicochemical problems associated with TQ, various NCs encapsulating TQ have been tried in the past. Nevertheless, these NCs could be impending in bringing forth this potential molecule to clinical reality. This will also be beneficial for a large research community including pharmaceutical & biological sciences and translational researchers