Mathematical modelling of and experimental studies in axisymmetrical combustors

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Diagnostic value of computed tomography in the patients of abdominal tuberculosis

Background: Abdominal tuberculosis (ATB) is a rare form of extra-pulmonary tuberculosis which is clinically challenging. It remains difficult to diagnose due to the non-specific presentation, variable anatomical location and lack of sensitive diagnostic tools. To evaluate the diagnostic value of computed tomography (CT) in the patients of abdominal tuberculosis.Methods: This was a retrospective diagnostic study design. The study was conducted among adults aged>18 years of either gender with clinical suspected ATB. The detailed demographic and clinical history was noted on pre-designed proforma. After obtaining the history, the patient was subjected to general physical and systematic examinations. The patients were then subjected to radiological evaluation that included chest X-ray, X-ray of abdomen and CT.Results: A total of 55 clinically suspected adult cases of abdominal tuberculosis were enrolled in the study. 45 (81.8%) were found to be abdominal tuberculosis on final diagnosis. The abdominal tuberculosis was found to be higher in the age groups 21-40 years (64.4%).The abdominal tuberculosis was observed to be higher among female patients (62.2%) than males (37.8%). CT findings showed that the bowel wall thickening & narrowing and dilatation was found in 64.4% patients.Conclusions: ATB is still a diagnosis to consider in individuals presenting with abdominal symptoms in the developing world, particularly in patients from ethnic minorities. Diagnosis can be challenging and requires a multidisciplinary approach with involvement from Radiology, Microbiology, Gastroenterology, Surgery, Infectious Diseases and Respiratory teams

Bacteriocins: Applications in Food Preservation and Therapeutics

The awareness in preventing the use of chemical preservatives for food has increased. Not only this, but the prevalence of antimicrobial resistance in the food-borne pathogens that can cause infections such as food poisoning is also at a rise. This has led in the growing demand for the safe food. The bacteriocins can be used as an effective alternative in food preservation and safety. Bacteriocins are ribosomally synthesized proteins that possess certain inhibitory activities against diverse group of undesirable microorganisms. These are produced by both Gram-positive and Gram-negative bacteria and some of the archaeal species. Bacteriocins are safe for human consumption, since they can be degraded by proteolytic enzymes in the gastrointestinal tract. In this chapter, focus is made on an alternative and safe approach for food preservation and therapeutics through bacteriocins. The applications of different types of bacteriocins in preserving food are mentioned with regard to increased shelf life, additives, and packaging. Not only this, but also bacteriocins benefit in boosting the immune system and possess certain anticancer properties. Bacteriocins can also be used in controlling the antimicrobial resistance in certain food-borne pathogens. They are the future antimicrobial proteins for the food preservation and therapeutics in a cost-effective manner

Physico-Chemical and Microbiological Quality Changes in Cocoa and Whey Protein Enriched Functional Dairy Drink During Storage

Cocoa and whey protein enriched functional dairy drink was subjected to storage studies at refrigeration temperature 4±1°C in the present study. The samples were studied for microbial and physicochemical tests during storage. The results in this study suggest that the product can be stored upto 18 days at 4±1°C. A decrease in pH from 7.01 to 6.49 for whey protein enriched product and from 6.94 to 6.41 in case of cocoa & whey protein enriched product was observed at the end of shelf life. The FFA increased from 0.72 to 1.46 meq./ml at the end of shelf life of 18 days in case of whey protein enriched product and from 1.16 to 2.02 meq./ml in case of cocoa & whey protein enriched product. An increase in the HMF content of the functional drink was recorded from 59.84 to 134.56 µmol/l at the end of 18 days of storage in case of whey protein enriched product and from 1.16 to 2.02 µmol/l in case of cocoa & whey protein enriched product. The total bacterial counts and yeast and mould counts were increased from 3.14 to 6.48 log cfu/ml and 1.14 to 2.10 log cfu/ml respectively in whey protein enriched functional drink. The coliform count was observed to be nil in both the variants of the functional dairy drink of throughout the storage period

Investigation and Management of Bone Mineral Density Following Hematopoietic Cell Transplantation : A Survey of Current Practice by the Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation

Reduced bone mineral density (BMD) is a well-recognized complication of hematopoietic cell transplantation (HCT), with significant drops in BMD occurring within the first 12 months after HCT. Guidance on identifying and managing this complication is available in several published guidelines. In this study, we investigated current practices in the investigation and management of low BMD in centers registered with the European Society for Blood and Marrow Transplantation (EBMT). A questionnaire about bone health was sent to all registered centers, and responses were received from 99 centers in 25 countries (52%) currently registered with the EBMT. Our data highlight considerable heterogeneity in practices across European centers in relation to investigations, management, and use of guidelines. Our data demonstrate the need for better dissemination and implementation of existing guidelines and also for the development of multidisciplinary guidelines with input from all relevant stakeholders. (c) 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.Peer reviewe

Provision of long-term monitoring and late effects services following adult allogeneic haematopoietic stem cell transplant: a survey of UK NHS-based programmes

Despite international guidelines, optimal delivery models of late effects (LE) services for HSCT patients are unclear from the clinical, organizational and economic viewpoints. To scope current LE service delivery models within the UK NHS (National Health Service), in 2014, we surveyed the 27 adult allogeneic HSCT centres using a 30-question online tool, achieving a 100% response rate. Most LE services were led and delivered by senior physicians (>80% centres). Follow-up was usually provided in a dedicated allograft or LE clinic for the first year (>90% centres), but thereafter attrition meant that only ~50% of patients were followed after 5 years. Most centres (69%) had a standard operating procedure for long-term monitoring but access to a LE Multi-Disciplinary Team was rare (19% centres). Access to medical specialities necessary for LE management was good, but specialist interest in long-term HSCT complications was uncommon. Some screening (endocrinopathy, cardiovascular) was near universal, but other areas were more limited (mammography, cervical smears). Funding of extra staff and investigations were the most commonly perceived barriers to implementation of LE services. This survey shows variation in the long-term follow-up of allogeneic HSCT survivors within the UK NHS and further work is warranted to optimize effective, sustainable and affordable models of LE service delivery among this group

A neonatal presentation of factor V deficiency: A case report

BACKGROUND: Factor V deficiency is a rare autosomal recessive coagulation disorder. Awareness of presenting features and management is important to avoid bleeding complications associated with mortality and neurodisability. CASE PRESENTATION: A 6-day-old Pakistani boy was admitted with bleeding from the left nipple. His parents were first cousins. A coagulation screen showed a prothrombin time of 41 s (control 14 s), a partial thromboplastin time of 132 s (control 33 s) and a normal thrombin time of 15 s (control 14 s). Factor V activity was <0.01 IU/ml. Oral tranexamic acid was started. At 5 weeks of age the child presented with irritability, lethargy and reduced feeding and a drop of hemoglobin to 5.6 g/dl. A cranial computed tomography scan showed a right intra-cerebral bleed extending from the frontal lobe to the parieto-occipital region with shift of the midline to the left. A regime of 20 ml/kg of fresh frozen plasma four times a week was instituted and has prevented further bleeds up to the present age of 21 months. Neurodevelopment remained normal. CONCLUSION: This case illustrates that in an unusually bleeding newborn of consanguineous parents rare severe homozygous bleeding disorders need to be considered. Nipple bleeding may be the first presentation of a congenital bleeding disorder. In cases of factor V deficiency where factor concentrates are not available long term use of fresh frozen plasma can prevent potentially life threatening bleeding

Current Practice in Vitamin D Management in Allogeneic Hematopoietic Stem Cell Transplantation: A Survey by the Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation

Beyond its impact on bone health, numerous studies have investigated the immune-regulatory properties of vitamin D and shown how its deficiency can affect outcomes in allogeneic hematopoietic stem cell transplantation (HSCT), particularly in acute or chronic graft-versus-host disease. This survey, carried out by the Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation (EBMT), describes the current clinical practice discrepancies across the EBMT HSCT programs. We therefore recommend the development of evidence-based guidelines to standardize evaluation criteria and to harmonize the management of vitamin D deficiency in patients undergoing allogeneic HSCT

Metabolic syndrome and cardiovascular disease following hematopoietic cell transplantation: screening and preventive practice recommendations from CIBMTR and EBMT

Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus and all cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with the estimated prevalence of MetS being 31–49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal of reviewing literature and recommend practices appropriate to HCT recipients. Here we deliver consensus recommendations to help clinicians provide screening and preventive care for MetS and cardiovascular disease among HCT recipients. All HCT survivors should be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors

Current incidence, severity, and management of veno-occlusive disease/sinusoidal obstruction syndrome in adult allogeneic HSCT recipients:an EBMT Transplant Complications Working Party study

The current incidence, diagnostic policy, management, and outcome of VOD/SOS at EBMT centers were studied. All centers that had performed allogeneic HSCTs in adult patients within one defined year were invited to the study. Seventy-one centers participated with a total of 2886 allogeneic transplantations and 93 cases of VOD/SOS in 2018. The cumulative incidence of VOD/SOS at day 21 was 1.8% and at day 100 2.4%. Of 67 cases with detailed data, 52 were classical and 15 (22%) late onset (&gt;day 21). According to the EBMT criteria, 65/67 patients had at least two VOD/SOS risk factors. The severity grades were: mild 0, moderate 3, severe 29, very severe 35. Fifty-four patients were treated with defibrotide. VOD/SOS resolved in 58% of the patients, 3/3 with moderate, 22/28 with severe, and 12/33 with very severe grade (p &lt; 0.001). By day 100, 57% of the patients were alive; 3/3 with moderate, 22/29 with severe, and 13/35 with very severe VOD/SOS (p = 0.002). In conclusion, the incidence of VOD/SOS was low. Severe and very severe grades dominated. Very severe grade predicted poor outcome compared to severe grade further supporting the concept of early diagnosis and treatment to avoid a dismal outcome. [Figure not available: see fulltext.]</p