A comparative study of ferric carboxymaltose and iron sucrose as a parenteral iron treatment in iron deficiency anaemia during pregnancy

Background: Iron deficiency anemia during pregnancy is a serious global concern specially in developing country, which is preventable with effective measures. In women who cannot tolerate oral iron or have moderate to severe anemia, parenteral iron in the form of iron sucrose or ferric carboxymaltose can be very much useful. This study aimed to compare efficacy and safety of iron sucrose and ferric carboxymaltose in iron deficiency anemia during pregnancy.Methods: This prospective interventional comparative study was conducted during May 2016 to April 2018 at tertiary care hospital and total 100 antenatal women from 28 to 34 weeks of gestation having moderate to severe anemia were included in this study and all women were divided in to 2 groups randomly and were given either iron sucrose or ferric carboxymaltose according to iron requirement. Rise in haemoglobin and serum ferritin were noted and data analysed statistically.Results: The mean rise of haemoglobin with iron sucrose was 1.8 gm% and with ferric carboxymaltose was 2.6 gm%. The mean rise of serum ferritin with iron sucrose was 82.4 ng/ml and with ferric carboxymaltose was 100.9 ng/ml. Other than minimal local reaction one woman had developed severe anaphylactic reaction after receiving iron sucrose.Conclusions: Intravenous ferric carboxymaltose is better and safe molecule than iron sucrose and it has advantage of ability to administer large dose in single sitting which reduce overall cost of therapy.  Hence ferric carboxymaltose is a drug of choice as parenteral iron therapy in iron deficiency anemia during second trimester of pregnancy.

Energy extraction from Janis-Newman-Winicour naked singularity

In general, energy extraction methods such as the Penrose process and the magnetic Penrose process are thought to be reliant on the existence of an ergoregion. Inside an ergoregion, there are negative energy states that allow a particle to extract energy and escape to an observer at infinity. In this paper, we considered the electromagnetic field in the rotating Janis-Newman-Winicour (JNW) spacetime. This concept is feasible because an accretion disc forms an electromagnetic field around compact objects. After that, we briefly examine negative energy orbits and their significance in energy extraction. The ergoregion is absent in a rotating JNW geometry, but we show that the effective ergoregion is there. The change in a negative energy orbit concerning the magnetic field (B), spin parameter (a), and electric charge (Q) is analyzed. We find that the total energy extraction efficiency within this process can be around $60\%$ for the rotating JNW naked singularity.Comment: 11 pages, 18 figure

Naked Singularity as a Possible Source of Ultra-High Energy Cosmic Rays

The source of Ultra-High Energy Cosmic Rays (UHECRs) remains one of the greatest mysteries in astrophysics. Their possible source can be the galactic nuclei, where the ultra-high gravity region plays a crucial role. Cosmic rays are extremely energetic particles that travel through space with energies exceeding $10^{20}eV$, but their origin is still a mystery despite years of studies and observations. In view of this, in this work, we studied the Joshi-Malafarina-Narayan (JMN-1) naked singularity as a natural particle accelerator. We derived the necessary expressions to find center of mass energy when two particles collide. We have obtained results showing that center of mass energy of the two particles will reach to Planck energy scale. This will form a microscopic black hole which will decay in Hawking radiation, having energy on the order of $10^{26} eV$ from the ultra-high gravity region of Sgr A*. These outgoing highly energetic particles from the naked singularity could be the possible sources of UHECRs.Comment: 11 pages, 7 figure

An acquired Bartter syndrome with secondary Sjögren syndrome

Renal tubular involvement in Sjögren's syndrome (SS) often described with renal tubular acidosis, nephrogenic diabetes insipidus, or rarely with Fanconi syndrome. SS presenting with clinical features of Bartter's syndrome or Gitelman's syndrome is rare. We report a case of a female patient who presented an acquired Bartter syndrome with a secondary SS. Our case highlights the fact that hypokalemia with metabolic alkalosis in an adult patient should prompt clinicians to look for common and uncommon conditions. While assessing for abnormal conditions, acquired Bartter syndrome should be considered if a patient has an underlying autoimmune, endocrine, or connective tissue disease

Penile Gangrene with Abscess Formation after Modified Al-Ghorab Shunt for Idiopathic Ischemic Priapism

Penile gangrene is a rare but unfortunate complication of surgical intervention and priapism shunts. The literature regarding penile gangrene following surgical correction of priapism is sparse, the majority of which dates back to thirty to forty years. Here, we present the case of a 60-year-old man who presented with priapism that required operative management with a modified Al-Ghorab shunt and eventually suffered from complete necrosis of the penis with abscess formation in both corpora cavernosa

Precession of timelike bound orbits in Kerr spacetime

Astrometric observations of S-stars provide a unique opportunity to probe the nature of Sagittarius-A* (Sgr-A*). In view of this, it has become important to understand the nature and behavior of timelike bound trajectories of particles around a massive central object. It is known now that whereas the Schwarzschild black hole does not allow the negative precession for the S-stars, the naked singularity spacetimes can admit the positive as well as negative precession for the bound timelike orbits. In this context, we study the perihelion precession of a test particle in the Kerr spacetime geometry. Considering some approximations, we investigate whether the timelike bound orbits of a test particle in Kerr spacetime can have negative precession. In this paper, we only consider low eccentric timelike equatorial orbits. With these considerations, we find that in Kerr spacetimes, negative precession of timelike bound orbits is not allowed.Comment: 12 pages, 18 figure

Model of LPG Refrigerator: A Literature Review

This work investigates the result of an experimental study carried out to determine the Coefficient of performance of domestic refrigerator when a propane-butane mixture is liquefied petroleum gas (LPG) which is available and comprises 56.4% butane, 24.4%propane, and 17.2% isobutene. This paper also presented an experimental investigation of COP by the effect of changing capillary tube length, capillary tube inner diameter and capillary coil diameter on the mass flow rate of refrigerant in an adiabatic helical capillary tube. Large amount of electricity supply is not available easily in large part of underdevelopment country like India. It will also prove to be an effective for remote area such as research sites, mines, & deserts where electricity is generally not available. The LPG is cheaper and possesses an environmental free in nature with no ozone depletion potential (ODP). Also LPG is available as a side product in local refineries. The results of the present work indicate the successful use of this propane-butane mixture as an alternative refrigerant to CFCs and HFCs in domestic refrigerator. It would include Experimental setup of working model and detailed observation of the LPG refrigerator and represents its application in refinery, hotel, chemical industries where requirement of LPG is more. Keywords: LPG refrigerator, domestic refrigerator, eco friendly refrigerants, Mixed Refrigerant

In-hospital mortality rate and predictors of 30-day readmission in patients with iron deficiency anemia and diastolic heart failure : a cross-sectional study

Corresponding author: Karthik Gangu MD, Assistant Professor of Clinical Medicine, Department of Medicine, Division of Hospital Medicine, University of Kansas Medical CenterIntroduction: There is currently strong evidence of the adverse effects of anemia on the prognosis of heart failure with reduced ejection fraction. Unfortunately, the data on the effects of anemia on a large sample of patients with diastolic heart failure (DHF) is lacking. In this study, we aimed to evaluate the effect of iron deficiency anemia on DHF readmission rates and its corresponding causes and burdens on the healthcare system. Methods: We utilized 2018 Nationwide readmission data and included patients aged ≥18 years with ICD-10 CM code indicating acute or acute chronic diastolic heart failure and iron deficiency anemia was included in the study. The primary outcome is 30-day readmission rates. Secondary outcomes were mortality rates, common causes of readmission, and healthcare utilization. Independent predictors for readmission were identified using cox regression analysis. Results: The total number of admissions in our study was 795,777. The mean age was 74.4 years (SD=13.7), and 63.54% were females. The 30-day readmission rate in patients with diastolic heart failure and iron deficiency anemia was 18.32 % vs. 16.01% in patients without anemia. The mortality rate at index admission and readmission was 3.62 % (2601) and 5.82 % (737), respectively. The most common cause of readmission was hypertensive heart and kidney disease with heart failure (17.74%). The independent predictors of readmission were age [less than] 85 years, household income [less than] 59000$/per year, Medicare and Medicaid insurance, higher Elixhauser comorbidities score, longer Length of stay during the index admission, discharge to a nursing home, hospital located in a large metropolitan area. The financial burden on healthcare for all the readmission was$837 million for 2018. Conclusion: The 30-day readmission rate in patients with diastolic heart failure and iron deficiency anemia is 18.32% in the year 2018. The mortality rate increased from 3.62 % to 5.82 % with readmission. The financial burden for readmission during that year was $837 million. Future studies are warranted to treat iron deficiency anemia to prevent readmissions in diastolic heart failure.Karthik Gangu MD (Department of Medicine, Division of Hospital Medicine, University of Kansas Medical Center), Aniesh Bobba MBBS (Department of Medicine, Division of Hospital Medicine, John H Stroger Hospital of Cook County), Parth S.Patel MD (University of Missouri Kansas City School of Medicine), Sruthi Vellanki MD (Department of Medicine, Division of Hospital Medicine, Union Hospital), Anup Kumar Trikannad MD (Department of Medicine, Division of Hospital Medicine, Union Hospital), Sanket Basida MBBS (Department of Medicine, Pandit Deendayal Upadhyay Medical College), Sindhu Avula (Department of Cardiovascular Medicine, Division of Interventional Cardiology, University of Kansas Medical Center), Alok Tripathi (Department of Cardiovascular Medicine, Division of Interventional Cardiology, University of Kansas Medical Center)Includes bibliographical references

Gender variations in neonatal and early infant mortality in India and Pakistan: A secondary analysis from the global network maternal newborn health registry

Background: To determine the gender differences in neonatal mortality, stillbirths, and perinatal mortality in south Asia using the Global Network data from the Maternal Newborn Health Registry.Methods: This study is a secondary analysis of prospectively collected data from the three south Asian sites of the Global Network. The maternal and neonatal demographic, clinical characteristics, rates of stillbirths, early neonatal mortality (1-7 days), late neonatal mortality (8-28 days), mortality between 29-42 days and the number of infants hospitalized after birth were compared between the male and female infants.Results: Between 2010 and 2018, 297,509 births [154,790 males (52.03%) and 142,719 females (47.97%)] from two Indian sites and one Pakistani site were included in the analysis [288,859 live births (97.1%) and 8,648 stillbirths (2.9%)]. The neonatal mortality rate was significantly higher in male infants (33.2/1,000 live births) compared to their female counterparts (27.4/1,000, p \u3c 0.001). The rates of stillbirths (31.0 vs. 26.9/1000 births) and early neonatal mortality (27.1 vs 21.6/1000 live births) were also higher in males. However, there were no significant differences in late neonatal mortality (6.3 vs. 5.9/1000 live births) and mortality between 29-42 days (2.1 vs. 1.9/1000 live births) between the two groups. More male infants were hospitalized within 42 days after birth (1.8/1000 vs. 1.3/1000 live births, p \u3c 0.001) than females.Conclusion: The risks of stillbirths, and early neonatal mortality were higher among male infants than their female counterparts. However, there was no gender difference in mortality after 7 days of age. Our results highlight the importance of stratifying neonatal mortality into early and late neonatal period to better understand the impact of gender on neonatal mortality. The information from this study will help in developing strategies and identifying measures that can reduce differences in sex-specific mortality

BALR-6 regulates cell growth and cell survival in B-lymphoblastic leukemia

BackgroundA new class of non-coding RNAs, known as long non-coding RNAs (lncRNAs), has been recently described. These lncRNAs are implicated to play pivotal roles in various molecular processes, including development and oncogenesis. Gene expression profiling of human B-ALL samples showed differential lncRNA expression in samples with particular cytogenetic abnormalities. One of the most promising lncRNAs identified, designated B-ALL associated long RNA-6 (BALR-6), had the highest expression in patient samples carrying the MLL rearrangement, and is the focus of this study.ResultsHere, we performed a series of experiments to define the function of BALR-6, including several novel splice forms that we identified. Functionally, siRNA-mediated knockdown of BALR-6 in human B-ALL cell lines caused reduced cell proliferation and increased cell death. Conversely, overexpression of BALR-6 isoforms in both human and mouse cell lines caused increased proliferation and decreased apoptosis. Overexpression of BALR-6 in murine bone marrow transplantation experiments caused a significant increase in early hematopoietic progenitor populations, suggesting that its dysregulation may cause developmental changes. Notably, the knockdown of BALR-6 resulted in global dysregulation of gene expression. The gene set was enriched for leukemia-associated genes, as well as for the transcriptome regulated by Specificity Protein 1 (SP1). We confirmed changes in the expression of SP1, as well as its known interactor and downstream target CREB1. Luciferase reporter assays demonstrated an enhancement of SP1-mediated transcription in the presence of BALR-6. These data provide a putative mechanism for regulation by BALR-6 in B-ALL.ConclusionsOur findings support a role for the novel lncRNA BALR-6 in promoting cell survival in B-ALL. Furthermore, this lncRNA influences gene expression in B-ALL in a manner consistent with a function in transcriptional regulation. Specifically, our findings suggest that BALR-6 expression regulates the transcriptome downstream of SP1, and that this may underlie the function of BALR-6 in B-ALL