Necrotizing Fasciitis in a Patient with Diabetes Mellitus

Case presentation: A 46-year-old man was admitted to the emergency department with complaints of fever and skin lesions in the right leg since 3 days before. Moreover, he revealed a history of 5 years of poorly controlled diabetes mellitus despite being on oral medication. On physical examination, he was oriented and the following vital signs were observed: blood pressure: 80/60 mmHg; pulse rate: 90 beats/min; respiratory rate: 18 breaths/min; and oral temperature: 38 °C. Two large erythematous lesions with central necrosis in the upper segment of the right leg were noticed. Further examination revealed crepitation of the same right leg segment. Laboratory findings revealed the following: white blood cell (WBC) count, 17,000/mm3; hemoglobin, 15 g/dl; sodium, 125 meq/l; potassium, 3.8 meq/l; blood glucose, 400 mg/dl; blood urea nitrogen, 45 mg/dl; creatinine, 2.4 mg/dl; and bicarbonate,13 meq/l. Plain X-ray of right leg revealed gas formation in the soft tissues, which was a diagnostic criterion for necrotizing fasciitis (Figure 1). The patient was treated immediately with intravenous fluid, broad spectrum empiric antibiotics (meropenem plus vancomycin), and insulin infusion; moreover, urgent surgical consultation was requested. He underwent emergency debridement within few hours of hospitalization

COVID-19 Associated Mucormycosis::A Review of an Emergent Epidemic Fungal Infection in 3 Era of COVID-19 Pandemic

At a time when the COVID-19's second wave is still picking up in countries like India, a number of reports describe the potential association with a rise in the number of cases of mucormycosis, commonly known as the black fungus. This fungal infection has been around for centuries and affects those people whose immunity has been compromised due to severe health conditions. In this article, we provide a detailed overview of mucormycosis and discuss how COVID-19 could have caused a sudden spike in an otherwise rare disease in countries like India. The article discusses the various symptoms of the disease, class of people most vulnerable to this infection, preventive measures to avoid the disease, and various treatments that exist in clinical practice and research to manage the disease

Electrochemical synthesis, characterization and applications of new types of 1D valve metal oxide nanostructures

Tato disertační práce představuje komplexní výzkum růstu TiO2 nanotrubicových (TNT) vrstev s vysokým poměrem délka/šířka (HAR) a jejich využití v pokročilých světelně-sensorických aplikacích. Výzkumné výstupy dosažené během tohoto doktorského studia zahrnují sérii článků, které se zabývají výzkumem syntézy a charakterizace vrstev HAR TNT na jedné straně a hodnocení výkonu těchto vrstev v různých senzorických modalitách na straně druhé. Počáteční studie se zaměřuje na anodizaci Ti fólií za účelem získání vrstev HAR TNT pomocí speciálně formulované elektrolytu obsahujícího NH4F/H2O/ethylene glycol s přídavkem mléčné kyseliny (LA). Výsledky ukazují, že regulací stáří a složení elektrolytu a použitím dostatečně vysokých potenciálů lze dosáhnout vrstev HAR TNT s vysokým poměrem délka/šířka (přibližně 450) v pozoruhodně krátkých časech anodizace ( 15 minut) ve srovnání s literaturou dostupnou před zahájením této disertační práce. Tento přístup nabízí slibnou cestu k získání robustních vrstev TNT bez dielektrického průrazu, eliminující potřebu řízení dalších procesních parametrů, jako je ohřev nebo ochlazování elektrolytu. Na základě úspěšných výsledků byla v následující práci zkoumána galvanostatická anodizace pro získání vrstev HAR TNT v elektrolytu obsahujícím LA. Bylo zjištěno, že mléčná kyselina účinně předchází dielektrickému průrazu při použití vysokých proudových hustot. Tento nález poukazuje na potenciál galvanostatické anodizace pro výrobu vrstev HAR TNT v podstatně zkrácených časech anodizace při pokojové teplotě. Navazující výzkum v disertační práci se zabývá mikrovlnnou fotoelektrickou vodivostí TNT vrstev s různou tloušťkou (15, 50, 80 a 110 m) při frekvencích X-pásma (~8 GHz) pro aplikace v senzorice a bezdrátové vesmírné komunikaci. Integrace anatasových TNT vrstev s rovinným rezonátorem se rozděleným kroužkem (SRR) umožňuje hodnocení jejich mikrovlnné fotoelektrické vodivosti. Experimentální výsledky odhalily významné variace v rezonanční amplitudě a frekvenčních odezvách TNT vrstev, přičemž TNT vrstvy o tloušťce 80 m vykazovaly nejvyšší citlivost. Byly stanoveny korelace mezi účinností fotoelektrické vodivosti, velikostí krystalitů a tloušťkou vrstev TNT, což podporuje využití optimalizovaných vrstev TNT pro co nejlepší mikrovlnného snímání. Kromě toho práce zkoumá vrstvy TNT na SRR pro detekci viditelného světla. Depozicí CdS tenkých vrstev na TNT vrstvy pomocí technologie depozice atomárních vrstev (ALD) se TNT vrstvy stávají velmi citlivé ve viditelné oblasti spektra, což umožňuje efektivní detekci UV a viditelného světla a detekci světlem indukovaných změn dielektrických vlastností TNT vrstev. Experimentální výsledky souhlasí s teoretickými modely a zdůrazňují výjimečný potenciál senzorů založených na TNT při detekci nebezpečí, monitorování znečištění, analýze materiálů a světelné komunikaci mezi satelity. Celkově tato práce poskytuje komplexní porozumění o růstu HAR TNT vrstev a jejich schopnostem pro pokročilé senzorické aplikace. Získané poznatky z tohoto výzkumu přispějí k rozvoji senzorů založených na nanomateriálech a otevírají nové možnosti jejich využití v různých odvětvích a nových technologiích.This thesis presents a comprehensive investigation of the growth of high-aspect-ratio (HAR) TiO2 nanotube (TNT) layers and their application in advanced light sensing technologies. The research outputs achieved during this Ph.D. study encompass a series of papers that collectively explore the synthesis and characterization of HAR TNT layers on one hand side, and performance evaluation of these layers in various sensing modalities on the other side. The initial study focuses on the successful anodization of Ti foil to obtain HAR TNT layers using a specially formulated electrolyte containing NH4F/H2O/ethylene glycol, with the addition of lactic acid (LA). The results demonstrate that by controlling the electrolyte age and composition, together with the application of sufficiently high potentials, HAR TNT layers with high aspect ratio (of approximately 450) can be achieved within remarkably short anodization times ( 15 minutes) compared to the literature available before the work on this thesis begun. This approach offers a promising pathway to obtain robust TNT layers without dielectric breakdown, eliminating the need for additional process control, such as heating or cooling of the electrolyte. Building up on the successful anodization results, the subsequent investigation explored the galvanostatic anodization for obtaining HAR TNT layers in an LA-containing electrolyte. It was observed that lactic acid effectively prevents dielectric breakdown when high current densities are applied. This finding highlights the potential of galvanostatic anodization to produce HAR TNT layers in significantly reduced anodization times at room temperature. Expanding the research scope, the thesis delves into the microwave photoconductivity of TNT layers with different thicknesses (15, 50, 80, and 110 m) at X-band frequencies (~8 GHz) for applications in sensing and wireless space communication. The integration of anatase TNT layers with a planar split ring resonator (SRR) microwave resonator enables the evaluation of their microwave photoconductivity performance. Experimental results revealed significant variations in the resonant amplitude and frequency responses of the TNT layers, with the 80 m thick TNT layers demonstrating the highest sensitivity. Correlations were established between the photoconductivity efficiency, crystallite size, and thickness of the TNT layers, supporting the development of optimized TNT layers for enhanced microwave sensing capabilities. Furthermore, the thesis explores TNT layers on SRR for visible light detection. By sensitizing the TNT layers to the visible spectral region through the deposition of a CdS coating using Atomic Layer Deposition (ALD), the results demonstrate effective detection of ultraviolet (UV) light, visible (VIS) light and light-induced variations in the dielectric properties of TNT layers. The experimental findings align with theoretical models and highlight the clearly outstanding potential of TNT-based sensors in hazard detection, pollution monitoring, material analysis, and light-based satellite-to-satellite communication. Overall, this thesis provides a comprehensive understanding of HAR TNT layers and their capabilities for advanced sensing applications. The knowledge gained from this research will contribute to the advancement of nanomaterial-based sensors and opens up new possibilities for their utilization in various industries and emerging technologies.

Necrotizing Fasciitis in a Patient with Diabetes Mellitus

Case presentation: A 46-year-old man was admitted to the emergency department with complaints of fever and skin lesions in the right leg since 3 days before. Moreover, he revealed a history of 5 years of poorly controlled diabetes mellitus despite being on oral medication. On physical examination, he was oriented and the following vital signs were observed: blood pressure: 80/60 mmHg; pulse rate: 90 beats/min; respiratory rate: 18 breaths/min; and oral temperature: 38 °C. Two large erythematous lesions with central necrosis in the upper segment of the right leg were noticed. Further examination revealed crepitation of the same right leg segment. Laboratory findings revealed the following: white blood cell (WBC) count, 17,000/mm3; hemoglobin, 15 g/dl; sodium, 125 meq/l; potassium, 3.8 meq/l; blood glucose, 400 mg/dl; blood urea nitrogen, 45 mg/dl; creatinine, 2.4 mg/dl; and bicarbonate,13 meq/l. Plain X-ray of right leg revealed gas formation in the soft tissues, which was a diagnostic criterion for necrotizing fasciitis (Figure 1). The patient was treated immediately with intravenous fluid, broad spectrum empiric antibiotics (meropenem plus vancomycin), and insulin infusion; moreover, urgent surgical consultation was requested. He underwent emergency debridement within few hours of hospitalization

Effect of the nursing process using via

Background and aims: Nursing process is performance Standard for nursing cares. According to their conditions and facilities, various centers can choose and implement a nursing process that is more efficient for them. This study was aimed to determine the effect of nursing process the way "accessible care cards" on patientschr('39') satisfaction from care in intensive care units. Methods: This is a cross-sectional interventional study with plan case-control study that was conducted in Golestan hospital in Ahwaz in 2014. Considering the inclusion criteria and available sampling method, a total of 38 controls and 38 cases were selected for the intervention group were evaluated. Data were collected questionnaire made by researcher, which was assess the scientific validity, the content validity method were used validated. As well as its reliability using Cronbachchr('39')s alpha test (α= 0.9) was determined. Intervention was conducted by accessible care cards in nursing process for two weeks and its impact on patient satisfaction was measured. The control group was routine care. The collected data was analyzed by SPSS 19 and statistical tests. Descriptive statistics such as mean, and standard deviation was used. Chi-square test, Mann-whitney and t-test were used to compare groups. Results: Results showed that 28.90% of patients in the control group had great satisfaction of care, while the 97.36% of patients in the intervention group reported nearly excellent satisfaction. The observed difference in patientschr('39') satisfaction with nursing care in both the experimental and control group was statistically significant (P<0.001). Conclusion: Implementation of nursing process, in a manner of available cards led to an increase in patient satisfaction compared with the routine manner and the use of these cards makes the nursing process of a greater degree of mental state, to objectively state, that can help in saving a lot of time for nurses

Vysokofrekvenční koplanární vlnovodový rezonátor s TiO2 nanotrubicemi pro vysoce citlivou ultrafialovou detekci

Ultraviolet (UV) sensors are a key component in growing applications such as water quality treatment and environmental monitoring, with considerable interest in their miniaturization and enhanced operation. This work presents a passive gold coplanar waveguide split ring resonator integrated with anodic self-organized TiO2 nanotube (TNT) membranes with a thickness of 20 mu m to provide real-time UV detection. The resonator operated as a one-port device to capture the reflection coefficient (S11) signal, with a center frequency of 16 GHz and a notch amplitude of -88 dB. It was experimentally analyzed for its UV sensing capability in the range of 36.5-463 mu W/cm(2). The high-frequency resonator was improved through design choices including the addition of a tapered input transmission line, wire bonding for practical device design, and an interdigitated capacitive ring gap. The high frequency also helped mitigate noise due to water vapor or environmental contaminants. S11 amplitude variation was found through both experiments and modeling to follow a linear trend with UV illumination intensity. The resonator exhibited over 45 +/- 2 dB shift in the resonant amplitude under the highest UV illumination conditions, with a sensitivity of 0.084 dB/mu W cm(-2) and the potential to sense UV intensity as low as 2.7 mu W/cm(2). The presented device enabled a repeatable and accurate microwave response under UV illumination with very high sensitivity, entirely through the use of passive circuit elements.Ultrafialové (UV) senzory jsou klíčovou součástí v rostoucích aplikacích, jako je úprava kvality vody a monitorování životního prostředí, se značným zájmem o jejich miniaturizaci a lepší provoz. Tato práce představuje pasivní zlatý koplanární vlnovodný rezonátor s děleným prstencem integrovaný s anodickými samoorganizovanými nanotrubičkami TiO2 (TNT) membránami o tloušťce 20 um pro zajištění UV detekce v reálném čase. Rezonátor fungoval jako jednoportové zařízení pro zachycení signálu s koeficientem odrazu (S11) se střední frekvencí 16 GHz a amplitudou zářezu -88 dB. Byla experimentálně analyzována na schopnost UV snímání v rozsahu 36,5-463 mu W/cm(2). Vysokofrekvenční rezonátor byl vylepšen prostřednictvím konstrukčních voleb, včetně přidání zúženého vstupního přenosového vedení, propojení vodičů pro praktický design zařízení a interdigitované kapacitní prstencové mezery. Vysoká frekvence také pomohla zmírnit hluk způsobený vodní párou nebo znečištěním životního prostředí. Jak experimenty, tak modelováním bylo zjištěno, že variace amplitudy S11 sleduje lineární trend s intenzitou UV osvětlení. Rezonátor vykazoval více než 45 +/- 2 dB posun v rezonanční amplitudě za podmínek nejvyššího UV osvětlení, s citlivostí 0,084 dB/mu W cm(-2) a potenciálem snímat intenzitu UV záření již od 2,7 mu W/ cm(2). Prezentované zařízení umožnilo opakovatelnou a přesnou mikrovlnnou odezvu pod UV osvětlením s velmi vysokou citlivostí, zcela pomocí pasivních obvodových prvků

TiO2 nanotube layers decorated by titania nanoparticles as anodes for Li-ion microbatteries

In this work, the utilization of TiO2 nanotube (TNT) layers decorated with TiO2 nanoparticles (NPs) as anodes in Li-ion microbatteries is reported for the first time. Such TiO2 NPs decorated TNT layers possess an increased amount of active material and a higher surface area compared with their non-decorated (blank) counterparts. TNT layers decorated with several different amounts of TiO2 NPs were tested by galvanostatic cycling tests. The capacities of the TiO2 NPs decorated TNT layer anodes increase with the amount of NPs decoration due to the enhancement of the capacitive effect. Indeed, an areal capacity of -126 pAh cm(-2) (vs 88 pAh cm(-2) for the non decorated TNT layer) at the 200th cycle has been obtained after optimizing the NPs loading. On the other hand, a too high NPs loading of the TNT layers leads to a reduced areal capacity due to clogging of the nanotube exteriors and a significant decrease in inner diameter of the nanotubes