60 research outputs found
Oral candidiasis in Chikungunya viral fever: a case report
Get PDFA 32 year old Indian male patient presented with chief complaints of a high fever, erythema on ear, severe polyarthritic joint pains & swelling, non pitting pedal oedema, facial puffiness and itching for past four days. He had no significant past medical and drug history and was serologically confirmed to have Chikungunya. Oral cavity inspection revealed whitish non erythematous pseudo membranous plaques on the hard palate, buccal surface of cheek and the floor of the mouth which was later microbiologically confirmed as Candidiasis. He tested negative for HIV and had leucopenia with severe CD4 T-lymphocytopenia. This is the first report of an opportunistic infection with CD4 T-lymphocytopaenia in Chikungunya fever
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
Get PDFBackground
Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis.
Methods
A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis).
Results
Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent).
Conclusion
Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified
X-ray studies of the crystalline and nematic phases of 4'-(3,4,5-trifluorophenyl)-4-propylbicyclohexyl
No full textThe crystal and molecular structures of the nematogenic compound 4'-(3,4,5- trifluorophenyl)-4-propylbicyclohexyl (3ccp-fff) were determined by direct methods using single crystal X-ray diffraction data at 293K. The compound (C21H29F3) crystallises in the triclinic system with space group P1 and Z=2. The unit cell dimensions are a=5.3715(14), b=10.559(3), c=16.891(4), =86.331(5), =85.196(6) and =81.938(5). The structure was refined by the least squares method to an R-value of 0.058 for 1398 observed reflections. The fluorine atoms are in the plane of phenyl ring. Both the cyclohexyl groups are found to be in chair conformation and they are coplanar (dihedral angle 0.8). The molecules were found to be in the most extended conformation. Results of the crystal structure analysis were compared with that obtained from molecular modelling and also with that of the related bifluorinated compound (3ccp-ff). An antiparallel imbricated mode of packing of the molecules is found in the crystalline state. Several van der Waals interactions are observed between the neighbouring molecules, suggesting evidence for existence of molecular packings in head-to tail configuration. The average fluctuation length of the molecules within the nematic phase, determined from a small-angle X-ray diffraction study, is found to be about 1.4 times more than molecular length, providing further evidence for the existence of antiparallel associations between neighbouring molecules
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