Cerebral fat embolism syndrome mimicking thrombotic thrombocytopenic purpura in a patient with Hemoglobin SC disease

Case Presentation A 54 year‐old man with hemoglobin SC disease (HbSC) and a history of substance abuse presented to the Emergency Department from a nursing home with two days of progressive weakness, shortness of breath, and lower back pain. He developed a fever, hypoxia, and tachycardia on the day of admission. He did not have any recent changes in medications, and his family as well as the nursing home staff denied any access to illicit drugs

Influence of laser spot size at diffuser plane on the longitudinal spatial coherence function of optical coherence microscopy system

Coherence properties and wavelength of light sources are indispensable for optical coherence microscopy/tomography as they greatly influence the signal to noise ratio, axial resolution, and penetration depth of the system. In the present letter, we investigated the longitudinal spatial coherence properties of the pseudo-thermal light source (PTS) as a function of spot size at the diffuser plane, which is controlled by translating microscope objective lens towards or away from the diffuser plane. The axial resolution of PTS is found to be maximum ~ 13 microns for the beam spot size of 3.5 mm at the diffuser plane. The change in the axial resolution of the system as the spot size is increased at the diffuser plane is further confirmed by performing experiments on standard gauge blocks of height difference of 15 microns. Thus, by appropriately choosing the beam spot size at the diffuser plane, any monochromatic laser light source depending on the biological window can be utilized to obtain high axial-resolution with large penetration depth and speckle-free tomographic images of multilayered biological specimens irrespective of the source temporal coherence length. In addition, PTS could be an attractive alternative light source for achieving high axial-resolution without needing chromatic aberration corrected optics and dispersion-compensation mechanism, unlike conventional setups.Comment: 11 pages, 4 figures. arXiv admin note: text overlap with arXiv:1810.0199

Prevalence of G6PD deficiency versus oxidizing drugs: a survey in the tertiary care hospital

Background: G6PD deficiency is distributed worldwide including India and is involved in accidental hemolysis and anemia by inadvertent use of oxidizing drugs. Awareness of community wise occurrence of G6PD deficiency can help in screening beforehand.Methods: On 150 community wise classified, non-anemic, non- hemolysed (in recent past) visitors of pathological laboratory attached to C U Shah Medical College, Surendranagar, Gujarat, Crayman’s hemoglobin colorimetric kit (item no 700540) was used to estimate normal or below normal status of G6PD.Results: 10 people (6.6% of population) were found deficient – 7 (4 male + 3 female) from Harijan community, 2 (1 male + 1 female) from Rabbari community and 1 (1 male + 0 female) from Lohana community.Conclusions: While applying oxidizing drugs in a person of Harijan community (prevalence 7 out of total 26, i.e. 27%), extra caution is required, esp. if a person otherwise vulnerable (e.g. alcoholic). For other less represented communities, larger stratified sampling is required

Adverse effects of temperature on perinatal and pregnancy outcomes: methodological challenges and knowledge gaps

Evidence linking temperature with adverse perinatal and pregnancy outcomes is emerging. We searched for literature published until 30 January 2023 in PubMed, Web of Science, and reference lists of articles focusing on the outcomes that were most studied like preterm birth, low birth weight, stillbirth, and hypertensive disorders of pregnancy. A review of the literature reveals important gaps in knowledge and several methodological challenges. One important gap is the lack of knowledge of how core body temperature modulates under extreme ambient temperature exposure during pregnancy. We do not know the magnitude of non-modulation of body temperature during pregnancy that is clinically significant, i.e., when the body starts triggering physiologic counterbalances. Furthermore, few studies are conducted in places where extreme temperature conditions are more frequently encountered, such as in South Asia and sub-Saharan Africa. Little is also known about specific cost-effective interventions that can be implemented in vulnerable communities to reduce adverse outcomes. As the threat of global warming looms large, effective interventions are critically necessary to mitigate its effects

A Comparative Study on the Physicochemical Parameters of Camel and Buffalo Milk

This research work was carried out to compare the various physicochemical parameters of two species, camel and buffalo. Camel milk samples were collected at National Research Centre on Camel, Bikaner and buffaloes milk samples were collected from the surroundings villages of Bikaner. After collection milk samples were brought to the laboratory of NRCC Bikaner and they were analyzed for fat, SNF (Solid Not Fat), protein, lactose, total ash and pH using milk analyzer (Lactoscan). Camel milk had 2.71±0.11 fat, 6.91±0.03 SNF, 2.23±0.02 protein, 3.86±0.02 lactose, 0.79±0.004 total ash and 6.95±0.01 pH while buffalo milk had 8.71±0.82 fat, 8.44±0.19 SNF, 4.11±0.02 protein, 4.46±0.15 lactose, 0.98±0.05 total ash and 7.59±0.02 pH. Fat, SNF, protein and pH of buffalo milk was significantly (P<0.001) higher than camel milk. Lactose and total ash in buffalo milk was also higher than camel milk but at P<0.05 level. So it can be concluded that all the studied parameters were high in buffalo milk than camel milk

Bio-dissolution of metals from activated nodules of Indian Ocean

The biodissolution of valuable metals from ferro-manganese nodules of Indian Ocean in presence of Aspergillus niger is a slow process. In order to improve the kinetics of bioleaching, the sea nodules were activated in high energy attrition mill thereby changing the granulometry and surface charge characteristics of the particles. The zeta potential, particle size distribution and surface area of the activated material were recorded and bioleaching was carried out by A.niger in the pH range 4.0-5.5. The mechano-chemical activation of the mixed particles (≤ 75 µm) of nodules in 10 min reduced almost 86 % material to ≤ 10 µm size with a change in zeta potential from -18 to -34 mV. Bioleaching of metals from the activated nodules was compared with that of the dissolution pattern of metals in presence of A.niger without any pretreatment as well as those under the chemical leaching conditions. The results showed the bio-recovery of more than 95% copper, nickel and cobalt each in 15 days time when the nodules activated for 10 min was leached at 5 % (w/v) pulp density, 4.5 pH and 35 ºC temperature. Bio-leaching of these metals was observed to be similar from the nodules activated for 30 min. The non-activated nodules showed ≥ 89% metal recovery in 25 days under the above conditions. The mechano-chemical activation of sea nodules has thus been found to improve the kinetics of the process and has also resulted in to the availability of wider pH in the range of 4-5 for the processing

Experiences of Female and Male Medical Students With Death, Dying, and Palliative Care: One Size Does Not Fit All

Background: Medical students learn about death, dying, and palliative care (DDPC) through formal curricular offerings and informal clinical experiences; however, the lessons learned in the clinic may be at odds with the formal curriculum. Reflective writing is a means for students to “bracket” their DDPC experiences and reconcile conflicts between the formal and informal curriculum. Objectives: The aim of this study is to compare the level of reflection demonstrated in medical students’ narratives on DDPC with other experiences and to examine the domains of professionalism that students perceive to be prevalent in their DDPC experiences. Methods: Third-year medical students submitted professionalism narratives during their internal medicine clerkship. We identified a subset of narratives related to DDPC (n = 388) and randomly selected control narratives (n = 153). We assessed the level of reflection demonstrated in the narratives using a validated rubric and analyzed the professionalism domains that students identified as relevant to their experience. Results: There was no difference in reflective level between DDPC and control narratives. Within the DDPC group, female students demonstrated higher reflection (2.24 ± 0.71) than male students (2.01 ± 0.77; P < .001). Caring, compassion and communication, and honor and integrity were prominent among DDPC narratives. More females identified caring, compassion, and communication as relevant to their DDPC experiences, whereas more males identified altruism. Conclusion: Males and females have different perceptions of DDPC experiences, and female students appear to be more deeply impacted. These findings can help clinical faculty engage students more effectively with this challenging topic

Effect of Silver Addition on the Ethanol-Sensing Properties of Indium Oxide Nanoparticle Layers: Optical Absorption Study

In2O3 and In2O3:Ag nanoparticle layers have been deposited using a two-step method consisting of chemical capping and dip coating techniques. The result of optical absorption analysis of In2O3:Ag samples shows the presence of Ag2O and Ag in air-annealed and vacuum-annealed samples, respectively. These results have been correlated with the gas sensing properties of these layers towards ethanol and support the proposed mechanism that increase in sensor response on Ag addition is due to the conversion of Ag2O to Ag in the presence of ethanol