Clinical, etiological and laboratory profile of febrile thrombocytopenia and correlation of platelet count with outcome in a South Indian tertiary hospital

Background: Febrile thrombocytopenia is commonly encountered by doctors especially during monsoon and peri-monsoon period, many of these patients have a turbulent cthisse with multi organ dysfunction and might land up in ICU with significant morbidity and mortality. Infections are the commonest causes of thrombocytopenia and they vary with season and geographical location. A systematic approach, carried out with an awareness of causes, clinical presentation and laboratory profile of febrile thrombocytopenia can shorten the duration of investigations and bring out the diagnosis early, reducing morbidity and mortality of patients and reducing burden on hospital resthisces. The objective of the study is to study the underlying etiology, the various clinical presentations, laboratory profile and complications of fever with thrombocytopenia in this community during monsoon period and to correlate thrombocytopenia with outcome, co morbidities and its etiology.Methods: The prospective observational study was conducted in tertiary centre in Kolar between June-December 2017. Patients meeting inclusion and exclusion criteria were grouped into 4 groups based on platelet counts, and correlated with comorbidities, etiology and outcome. Detailed clinical and laboratory examination were done in all patients and p value of <0.05 was considered statistically significant.Results: Among 465 patients were included in the study. Dengue was the most common cause for febrile thrombocytopenia and mortality. Hepatic complications and petechiaes were the most common complications and bleeding manifestations. 135 patients received platelet transfusion but there was no relationship between platelet transfusion and outcome, there were 9 deaths in the study and there was no association between death and platelet count at admission.Conclusions: There was no relation between platelet count on admission and mortality and also there was no relationship between platelet transfusion and outcome. Knowing the clinical presentation, etiology, complications and its monitoring can significantly reduce the morbidity and mortality due to febrile thrombocytopenia

Graphene Based Nanocomposite Electrodes for Energy Storage in Supercapacitors

There is an unmet need to develop high performance energy storage systems (ESS), capable of storing energy from both renewable and non-renewable sources to meet the current energy crisis and depletion of non-renewable sources. Amongst many available ESS, supercapacitors (ECs) are the most promising because they exhibit a high charge/discharge rate and power density, along with a long cycle life. A novel use of atomically thin carbon allotropes like graphene, carbon nanotubes (CNTs) and electrically conducting polymers (ECPs) such as polypyrrole (PPy) have been studied as high performance conducting electrodes in supercapacitor application. A novel templated sustainable nanocomposite electrode has been fabricated using cellulose extracted from Cladophora c. aegagropila algae as a component of the assembled supercapacitor device which later has been transitioned to a unique template-less freestanding nanocomposite supercapacitor electrode[1]. The specific capacitance of polypyrrole-graphene-cellulose nanocomposite as calculated from the cyclic voltammetry curve is 91.5 F g-1 at the scan rate 50 m Vs-1 in the presence of 1M NaCl electrolyte. The open circuit voltage of the device with polypyrrole -graphene-cellulose electrode was found to be around 225 m V and that of the polypyrrole -cellulose device is only 53 m V without the presence of graphene in the nanocomposite electrode. Understanding the fundamentals by fabricating template nanocomposite electrode led to developing a unique nanocomposite template-less freestanding film which comprises of polypyrrole-graphene-CNT hybrid[2]. Various experiments have been performed using different electrolytes such ascorbic acid, sodium sulfate and sulfuric acid in different scan rates. The specific capacitance of polypyrrole-graphene-CNT nanocomposite with 0.1 wt% of graphene-CNT, as calculated from cyclic voltammetry curve is 450 F g-1 at the scan rate 5 m V s-1. For the first time a nanofibrous membrane has been developed as a separator which acts as an electrolyte reservoir and ionic diffusion membrane. The performance of the fabricated supercapacitor device has been analyzed using a multimeter and compared with a conventional alkaline (1.5 V) battery. Lighting up of 2.2 V light emitting diode has been demonstrated using the fabricated supercapacitor

Significance of APTT as early predictor of bleeding in comparison to thrombocytopenia in dengue virus infection

Background: Dengue is a systemic viral infection transmitted by mosquitoes such as Aedes aegypti or Aedes albopictus. Dengue Fever (DF) is characterized by fever, headache, muscle or joint pain, and rash. The spectrum of dengue virus infection spreads from an undifferentiated fever and dengue fever (DF) to dengue haemorrhagic fever (DHF) with shock. Factors responsible for bleeding manifestations in dengue are vasculopathy, thrombocytopenia, coagulopathy, and disseminated intravascular coagulation (DIC). Coagulopathy results in derangement of activated partial thromboplastin time (APTT) which is an indicator of impending bleeding risk.Methods: A prospective study was conducted from June to December in 2017 in R L Jalappa Hospital. Patients aged above 18 years with febrile thrombocytopenia who are positive for dengue virus serology (NS1Ag and/ or IgM) were included in the study. Serial daily monitoring of platelet count and analysis of APTT levels were done. APTT was considered abnormal if it was more than 33.8s. Patients were followed up for evidence of leaking and bleeding manifestations.Results: Out of 170 patients 28.1% patients had bleeding manifestations. Bleeding signs were seen on clinical examination in 52.37% of patients. capillary leak was found in the form of Pleural effusion in 35.3%, Ascites in 41.2% and Periorbital edema in 31.2% of patients. Elevated APTT levels were seen in 110(64.7%) patients. Among patients with abnormal APTT platelet transfusion was done in 78.9% of patients, and among those with normal APTT levels platelet transfusion was done in 21.1% of patients.Conclusions: Our study showed significant correlation between bleeding manifestations and prolonged APTT levels as well as thrombocytopenia with abnormal APTT levels. Study concluded that 21.1% of platelet transfusions could have been prevented considering prolonged APTT as a predictor of bleeding manifestation, thus saving the resources and reactions due to platelet concentrate transfusion

EASY SEARCHING OF TRAIN DETAILS BY RAILWAY ROUTE OPTIMIZATION SYSTEM

In today’s modern world, travelling had gained a great importance as users travelling in trains have increased a lot. But they feel still not convenient in their journey as they are not satisfied with the features available in the existing system. They expect a system in such a way that they could reach the required destination in shorter period. Our system is designed as a software to make users journey in a more quicker manner. The main aim of this system is to provide users in easy search of train routes to reach the destination as quick as possible in a very clear manner respectively

Fabrication and Experimental Analysis of Axially Oriented Nanofibers

A novel design of a laboratory built axially rotating collector (ARC) having capability to align electrospun nanofibers have been described. A detailed morphological comparison of such nanofibers orientation and their geometry is done using scanning electron microscopy (SEM). For comparison various polymeric solutions were electrospun on conventional static collector as well as ARC. The average diameter of polyvinyl alcohol (PVA) nanofibers was found to be 250 nm while polycaprolactone (PCL) nanofibers were found to be within a range of 600–800 nm. Conducting nanoparticles such as graphene and multi-walled carbon nanotubes (MWNTs) mixed with polymer solutions shown to have a significant influence on the overall geometry of these nanofibers and their diameter distribution. It is evident from the SEM analysis that both graphene and MWNTs in polymer solution play a crucial role in achieving a uniform diameter of nanofibers. Lastly, the formation of the aligned nanofibers using ARC has been mathematically modeled and the electromagnetic field governing the process has been simulated

Flexural behaviour of carbon and glass reinforced hybrid composite pipes

This paper presents a study on the flexural behaviour of hybrid composite pipes reinforced with carbon and glass fibres. The progressive failure of composite pipes in three point bending was modelled numerically by Finite Element Analysis (FEA). The FEA based model was validated against the experimental data. With this developed model, the effects of ply angle, fibre volume fraction and hybridisation have been found. It is shown from the results that the maximum bending loads occur when the ply angle is between 60° and 75° The hybrid composite pipe has comparable failure loads compared to the full carbon fibre composite pipe or the full glass fibre composite pipe

The Role of TNF-α in Mice with Type 1- and 2- Diabetes

Background: Previously, we have demonstrated that short-term treatment of new onset diabetic Non-obese diabetic (NOD) mice, mice that are afflicted with both type 1 (T1D) and type 2 (T2D) diabetes with either Power Mix (PM) regimen or alpha1 antitrypsin (AAT) permanently restores euglycemia, immune tolerance to self-islets and normal insulin signaling. Methodology and Principal Findings: To search for relevant therapeutic targets, we have applied genome wide transcriptional profiling and systems biology oriented bioinformatics analysis to examine the impact of the PM and AAT regimens upon pancreatic lymph node (PLN) and fat, a crucial tissue for insulin dependent glucose disposal, in new onset diabetic non-obese diabetic (NOD) mice. Systems biology analysis identified tumor necrosis factor alpha (TNF-$\alpha$) as the top focus gene hub, as determined by the highest degree of connectivity, in both tissues. In PLNs and fat, TNF-$\alpha$ interacted with 53% and 32% of genes, respectively, associated with reversal of diabetes by previous treatments and was thereby selected as a therapeutic target. Short-term anti-TNF-$\alpha$ treatment ablated a T cell-rich islet-invasive and beta cell-destructive process, thereby enhancing beta cell viability. Indeed anti-TNF-$\alpha$ treatment induces immune tolerance selective to syngeneic beta cells. In addition to these curative effects on T1D anti-TNF-e33254 treatment restored in vivo insulin signaling resulting in restoration of insulin sensitivity. Conclusions: In short, our molecular analysis suggested that PM and AAT both may act in part by quenching a detrimental TNF-$\alpha$ dependent effect in both fat and PLNs. Indeed, short-term anti-TNF-$\alpha$ mAb treatment restored enduring euglycemia, self-tolerance, and normal insulin signaling