Manifestation of pernicious anaemia as hyperpigmentation of palms and soles

Vitamin B12 deficiency produces various manifestations involving CNS, heart, skin, blood and female reproductive systems. It is seen most commonly in the older individuals, malabsorptive states (>60% of all cases) and vegetarians. Pernicious anaemia may be confused to Addison’s disease as both may present with similar clinical features. Hereby we report a case of pernicious anaemia presenting with dermatological manifestation in the form of deep pigmentation of both palms of and both soles respectively, cortisol levels normal so Addition’s disease ruled out

Phaeobacterium nitratireducens gen. nov., sp. nov., a phototrophic gammaproteobacterium isolated from a mangrove forest sediment sample

A novel brown-coloured, Gram-negative-staining, rod-shaped, motile, phototrophic, purple sulfur bacterium, designated strain AK40T, was isolated in pure culture from a sediment sample collected from Coringa mangrove forest, India. Strain AK40T contained bacteriochlorophyll a and carotenoids of the rhodopin series as major photosynthetic pigments. Strain AK40T was able to grow photoheterotrophically and could utilize a number of organic substrates. It was unable to grow photoautotrophically and did not utilize sulfide or thiosulfate as electron donors. Thiamine and riboflavin were required for growth. The dominant fatty acids were C12 : 0, C16 : 0, C18 : 1ω7c and summed feature 3 (C16 : 1ω7c and/or iso-C15 : 0 2-OH). The polar lipid profile of strain AK40T was found to contain diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol and eight unidentified lipids. Q-10 was the predominant respiratory quinone. The DNA G+C content of strain AK40T was 65.5 mol%. 16S rRNA gene sequence comparisons indicated that the isolate represented a member of the family Chromatiaceae within the class Gammaproteobacteria. 16S rRNA gene sequence analysis indicated that strain AK40T was closely related to Phaeochromatium fluminis, with 95.2% pairwise sequence similarity to the type strain; sequence similarity to strains of other species of the family was 90.8-94.8%. Based on the sequence comparison data, strain AK40T was positioned distinctly outside the group formed by the genera Phaeochromatium, Marichromatium, Halochromatium, Thiohalocapsa, Rhabdochromatium and Thiorhodovibrio. Distinct morphological, physiological and genotypic differences from previously described taxa supported the classification of this isolate as a representative of a novel species in a new genus, for which the name Phaeobacterium nitratireducens gen. nov., sp. nov. is proposed. The type strain of Phaeobacterium nitratireducens is AK40T ( = JCM 19219T = MTCC 11824T)

Three Dimensional Casson nanofluid Flow with Convective Boundary Layer via Stretching Sheet

The present work examined Casson nanofluid in a three-dimensional boundary layer motion via stretching sheet. The study focuses on analyzing the behavior of a Casson nanofluid, which is one type of non-Newtonian fluid. The study appears to involve solving partial differential equations related to fluid flow, heat transfer, and mass transfer. These PDEs are transformed into ordinary differential equations using standard similarity variables. To solve the ODEs, the researchers employ the Runge-Kutta-Fehlberg (R-K-F) 4th order iterative scheme. It appears that higher values of the Biot number can significantly affect the temperature and concentration profiles in the Casson liquid flow

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

American Journal of Advances in Medical Science Dermatological manifestation of lightning injury

Abstract Lightning is one of the most common naturally occurring global phenomena. Among various types of lightning, cloud to ground discharges possesses the most destructive effects. Lightning injuries are more common in rural or exposed environments than in urban areas. In the present article, a case of Lightning injury causing cutaneous manifestation in the form of superficial burns resembling miniature fern tree (Lichtenberg Figures) is reported

Performance and Emission of VCR-CI Engine with palm kernel and eucalyptus blends

This study aims at complete replacement of conventional diesel fuel by biodiesel. In order to achieve that, palm kernel oil and eucalyptus oil blend has been chosen. Eucalyptus oil was blended with methyl ester of palm kernel oil in 5%, 10% and 15% by volume. Tests were conducted with diesel fuel and blends on a 4 stroke VCR diesel engine for comparative analysis with 220 bar injection pressure and 19:1 compression ratio. All the test fuels were used in computerized 4 stroke single cylinder variable compression ratio engine at five different loads (0, 6, 12, 18 and 24 N m). Present investigation depicts the improved combustion and reduced emissions for the PKO85% + EuO15% blend when compared to diesel at full load conditions