Spontaneous Lung Herniation Leading to Extensive Subcutaneous Emphysema, Pneumothorax, Pneumomediastinum, and Pneumopericardium.

Spontaneous lung herniation is a rare phenomenon in which the lung parenchyma along with the pleural membranes protrudes outside their usual boundaries and can lead to a wide variety of complications. We are reporting a case of a middle-aged male who presented with chronic obstructive pulmonary disease (COPD) exacerbation with severe bouts of cough. Initial computed tomography (CT) chest was unrevealing, but two days later, he developed spontaneous lung herniation, which was initially managed conservatively, but later it progressed to pneumothorax, pneumomediastinum, with striking CT scan images showing extensive subcutaneous emphysema. Blowhole incisions were done on the anterior chest wall which led to ultimate recovery

Study of Violent Asphyxial Death

Background:An increasing death rate as a result of violence constitutes a large group in medico-legal autopsies especially deaths due to asphyxia are one of the most important cause in violent deaths.Method: It was a prospective study of all medico-legal autopsies performed between December 2008 and November 2010 at mortuary of Civil Hospital affiliated with B.J.Medical College, Ahmedabad, Gujarat, India. Out of the total autopsies conducted at the Mortuary of Civil Hospital, Ahmedabad, those where the victim died as a result of violent mechanical interference with respiration like hanging, strangulation, and drowning were included.Results and Conclusion:Incidence of violent asphyxia deaths is 5.63% of total autopsies. Hanging (82.48%) is the most commonly encountered violent asphyxia death. Males are most common victims with male:female ratio 1.69:1. Most commonly involved age group is 21-30 years (128 cases forming 32.99% of total) with 200 victims (51.54%) aged 21-40 years. 312 out of 320 cases (97.5%) of hanging were suicidal and rest 8 (2.5%) were accidental in nature. Homicidal hanging is not recorded in present study. All 12 strangulation cases were of homicide, 32 out of 56 (57.14%) cases of drowning were accidental and remaining 24 (42.86%) were suicidal

Characteristics of Fatal Cases of Pandemic Influenza A (H1N1) from September 2009 to January 2010 in Saurashtra Region, India

Background: India reported first case of 2009 pandemic influenza A (H1N1) virus infection in May, 2009 and Saurashtra region in August, 2009. We describe the characteristics of fatal cases of 2009 influenza A (H1N1) infection reported in Saurashtra region. Methods: From September, 2009 to January, 2010, we observed 71 fatal cases that were infected with 2009 influenza A (H1N1) virus and admitted in different hospitals in Rajkot city. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection; the clinico-epidemiological features were observed and documented. Results: Median age of the deceased (71) was 29 years, and 57.7% were females. Median time observed was 5 days from onset of illness to diagnosis of influenza A (H1N1), and 57.7% were referred from general practitioner (OR=0.42, CI=0.24-0.74). Median hospital stay reported was 3 days. All admitted patients received oseltamivir, but only 16.9% received it within 2 days of onset of illness. The most common symptoms were cough (97.2%), fever (93%), sore throat and shortness of breath. Co-morbid conditions were present in almost half of the patients who ultimately died, the most common of which was pregnancy (OR=0.15, CI=0.04-0.52). Radiological pneumonia was reported in 98% patients. Conclusion: Residing in urban area, delayed referral from general practitioner, presence of co-existing condition, especially pregnancy was responsible for mortality among influenza A (H1N1) infected positive

Effect of music on post-exercise recovery rate in young healthy individuals

Background: Music has been used in exercise classes for many decades. The role of music in increasing the exercise performance is well recognized but there is very little information about effect of music on post-exercise recovery time.Methods: The present study was conducted to see the effect of musical sounds on post-exercise recovery time following moderate exercise with Harvard step test in young healthy volunteers. 30 young healthy volunteers (17 males, 13 females) aged between 17 to 20 years were recruited for the study. Pulse rate, systolic BP, diastolic BP were recorded prior to exercise in lying down position. The participants were subjected to moderate exercise by Harvard step test for 3 minutes on 3 consecutive days. They were allowed to rest in silence on 1st day, rest with hearing slow music on 2nd day and rest with hearing fast music on 3rd day. During the post-exercise relaxation time PR, SBP and DBP were measured immediately and after every 1 min. until the parameters returned to resting values. Data was statistically analysed using ANOVA test and 0.05 level of significance was set prior to the study.Results: The result showed that with slow music, recovery time of pulse rate (5.2 ± 2.1), systolic blood pressure (3.9 ± 1.1) and diastolic blood pressure (3.2 ± 1.7) were significantly faster as compared to both no music and fast music.Conclusion: The study concluded that music hastens post-exercise recovery and slow music has greater relaxation effect than fast or no music.

Combining CEEMDAN with PCA for Effective Cardiac Artefact Suppression from Single-Channel EEG

The large signal due to cardiac activity can easily distort the signals originating from the relatively weak electrical activity of the brain, commonly measured as an Electroencephalogram (EEG). The artifact due to cardiac activity in EEG is called cardiac artifact, which contaminates the EEG data and makes interpretation of the EEG difficult for clinicians. Hence it is crucial to remove the cardiac artifact from EEG data. To suppress the cardiac artifact, we propose a novel approach to effectively extract cardiac artifacts from single-channel contaminated EEG data without using reference Electrocardiogram (EKG) data. The proposed methodology uses Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (CEEMDAN) to decompose EEG data contaminated by cardiac activity into the Intrinsic Mode Functions (IMFs). Principal Component Analysis (PCA) is performed on these IMFs to obtain the principal components arranged in the order of decreasing variance. Effective cardiac artifact extraction is achieved by optimizing the signal reconstruction process so that only those principal components that capture the cardiac activity are retained with the constraint that distortion introduced in EEG data should be minimum. The comparison clearly shows that the proposed method outperforms conventionally employed methods like wavelet-based approach

Unresectable Primary Tracheal Synovial Sarcoma

Synovial sarcoma (SS) comprises less than 1% of head and neck cancers, and less than five cases of adult primary tracheal SS have been described. This case describes a patient encountered at a community-based academic hospital, and retrospective chart review was performed for data collection. A woman in her forties presented with shortness of breath due to a superior mediastinal mass found to be an unresectable primary tracheal SS. Primary treatment resorted to curative-intent radiation therapy. Subsequent metastasis required systemic chemotherapy with pazopanib. To the best of our knowledge, this is the first reported case of this nature and adds to understanding the presentation, diagnosis, natural history, and treatment outcomes of primary tracheal SS. This case was exempt from review by the institutional review board and complied with privacy policy standards

Association of plasma fibrinogen and development of complications in type 2 diabetes mellitus

Background: Fibrinogen is a glycoprotein produced by the liver that plays a crucial role in blood clotting. Elevated levels of fibrinogen have been associated with an increased risk of cardio vascular disease, stroke and other chronic conditions. Several studies have investigated the relationship between fibrinogen and diabetes mellitus. Furthermore, fibrinogen has been suggested to play a role in pathogenesis of diabetes and its complications by promoting inflammation and endothelial dysfunction. The aim of the study was done to study association of fibrinogen levels and development of complications of diabetes mellitus. Methods: A cross sectional observational study was conducted at medicine department of Dhiraj Hospital, Vadodara. Total of 114 diabetes mellitus patients were studied. The level of fibrinogen as well as presence of various risk factors like smoking, hypertension, obesity, dyslipidemia and different microvascular and macro-vascular complications were assessed. There were no conflict of interest. Results: Of 114 patients smoking, overweight, hypertension, uncontrolled diabetes and dyslipidemia was reported in 54.4%, 30.7%, 41.2%, 28.1% and 60.5% respectively. Microvascular complication like retinopathy, nephropathy and neuropathy was reported in 34.2%, 40.4% and 21.1% patients respectively. Macrovascular complications like coronary artery disease and stroke was reported in 20.2% and 16.7% patients respectively. Average level of fibrinogen was found higher amongst diabetic patients with microvascular as well as macrovascular complications. Conclusions: Serum fibrinogen level was found to be higher among patients with poor glycemic control, dyslipidemia, hypertension and higher BMI. A positive correlation was found between the level of fibrinogen and various complications of diabetes mellitus.

Evaluation of Cardioprotective Effect of 3,5,3′-Tri-iodo-L-thyronine in Isoproterenol-Induced Cardiotoxicity

T3 (3,5,3′-triiodothyronine) has drawn relatively little attention in relation to cardiovascular (CVS) diseases. The present study was designed to evaluate the cardioprotective action of T3 in isoproterenol-(ISO-) induced cardiac toxicity. Female Wistar rats were exposed with ISO (100 mg/kg, body weight, subcutaneously) for 2 days at the interval of 24 h followed by T3 (3 μg/kg, body weight, orally) treatment for 3 days. Positive control rats received only ISO (100 mg/kg, body weight, subcutaneously) for 2 days at the interval of 24 hrs. Control group animals received normal saline as a vehicle. As expected, ISO-induced significant changes were observed in low-density lipoprotein, total cholesterol, ALT, CK-MB to TCK ratio, and prolongation of QT interval in electrocardiogram, which is toward normalization after T3 treatment. Lower heart weight, upregulation of cardiac myosin heavy chain alpha (MHC-α), and reduced inflammatory cell infiltration, myonecrosis, vacuolar changes, and a trend toward normal cardiac muscle fiber architecture in microscopic examination of cardiac tissue further support the cardioprotective effect of T3

Multi-Mission Automated Task Invocation Subsystem

Multi-Mission Automated Task Invocation Subsystem (MATIS) is software that establishes a distributed data-processing framework for automated generation of instrument data products from a spacecraft mission. Each mission may set up a set of MATIS servers for processing its data products. MATIS embodies lessons learned in experience with prior instrument- data-product-generation software. MATIS is an event-driven workflow manager that interprets project-specific, user-defined rules for managing processes. It executes programs in response to specific events under specific conditions according to the rules. Because requirements of different missions are too diverse to be satisfied by one program, MATIS accommodates plug-in programs. MATIS is flexible in that users can control such processing parameters as how many pipelines to run and on which computing machines to run them. MATIS has a fail-safe capability. At each step, MATIS captures and retains pertinent information needed to complete the step and start the next step. In the event of a restart, this information is retrieved so that processing can be resumed appropriately. At this writing, it is planned to develop a graphical user interface (GUI) for monitoring and controlling a product generation engine in MATIS. The GUI would enable users to schedule multiple processes and manage the data products produced in the processes. Although MATIS was initially designed for instrument data product generation