Case Report on Morbidly Obese Patient with Cervical Spine Ankylosing Spondylitis Presenting with Acute Spinal Shock and Complex Airway Management

A 67 year old morbidly obese male presented to the ER with weakness in both lower extremities after a fall at home. The patient sustained a T12/ L1 unstable vertebral fractures and cord compression at the thoracolumbar junction with acute traumatic paraplegia. The patient arrived in the PACU on a backboard and with a cervical collar in place directly from the ER. The review of the patient’s chart revealed that he had a history of hypertension, PE / DVT on coumadin, hypothyroidism, NIDDM, bipolar disorder and cervical spine ankylosing spondylitis of his neck. On physical exam the patient was sleepy, but arousable and unable to move his lower extremities, with loss of bladder and bowel control. There was one 20 G IV in place. The airway exam revealed Mallampati Class 4. The patient was hemodynamically unstable with BP ~80/~40 mm HG; HR ~70’s/min; SpO2 ~86-88%. Resuscitation commenced immediately. The patient was started on face mask @ 10 l/m O2. One liter of normal saline was administered with minimal effect. A phenylephrine infusion was started. The blood pressure improved to SBP of 120’s mm Hg. The O2 saturation increased to 95%. A methylprednisone drip (30mg/kg iv bolus) was started for treatment of his spinal cord injury. For additional IV access, another 20G IV was placed. Two units of FFP were given to normalize the INR of 2.4. After multiple attempts, a right radial arterial catheter was successfully placed. A right internal jugular (RIJ) central venous catheter was inserted under ultrasound guidanc

Soil Heavy Metal Concentration Patterns at Two Speed Zones along the Gaborone- Tlokweng Border Post Highway, Southeast Botswana

Since 1988 Botswana has been experiencing an unprecedented increase in vehicular traffic which is suspected to be having contamination effects on soils along heavily used roads in the country. This study aimed atunderstanding the contamination trends of heavy metals on soils due to vehicular emissions. The soil physicochemistry (bulk density, particle size distribution, pH, electrical conductivity and cation exchange capacity),mineralogy (using x-ray diffraction techniques) and heavy metals (Cd, Pb, Cu and Zn) concentrations were determined for soil samples obtained along the roadside at 2m, 4m, 6m and 100 m of the Gaborone – TlokwengEmigration/Immigration Boarder Post Road, which is one of the busiest in the country. Bulk density of soil samples were from 1.19 to 1.4; and sand, loamy sand and sandy loam textural classes constituted the soil samples. The soil pH was from 5.09 to 8.57; the EC ranged from 6.27 ìS cm-1to 20.3 27 ìS cm-1 and the CEC values were from 10.2 meq100g-1 to 27.2 meq100g-1. Clay minerals were identified in the samples as well as feldspar and quartz. The concentration levels for Pb were from 0 mgkg-1 to 71 mgkg-1; Zn were from 5.23 mgkg-1 to 51.26 mgkg-1 ; Cu werefrom 0.3 mgkg-1 to 18.1 mgkg-1 and Cd 0 mgkg-1 to 2.4 mgkg-1 . The interplay of soil physico-chemistry and mineralogy on heavy metals concentrations is discussed. Although levels of heavy metals concentrations fell below normal ranges, the values obtained were generally higher than those from some developed and developing countries.@JASE

Large tunable image-charge effects in single-molecule junctions

The characteristics of molecular electronic devices are critically determined by metal-organic interfaces, which influence the arrangement of the orbital levels that participate in charge transport. Studies on self-assembled monolayers (SAMs) show (molecule-dependent) level shifts as well as transport-gap renormalization, suggesting that polarization effects in the metal substrate play a key role in the level alignment with respect to the metal's Fermi energy. Here, we provide direct evidence for an electrode-induced gap renormalization in single-molecule junctions. We study charge transport in single porphyrin-type molecules using electrically gateable break junctions. In this set-up, the position of the occupied and unoccupied levels can be followed in situ and with simultaneous mechanical control. When increasing the electrode separation, we observe a substantial increase in the transport gap with level shifts as high as several hundreds of meV for displacements of a few \aa ngstroms. Analysis of this large and tunable gap renormalization with image-charge calculations based on atomic charges obtained from density functional theory confirms and clarifies the dominant role of image-charge effects in single-molecule junctions

The clinical Transferability of Raman Micro-Spectroscopic Systems for Cervical Cytopathology

The clinical potential for Raman microscopic systems is well established for early diagnosis via cytology. Although Raman systems offer a complementary diagnostic tool providing molecular information, it is not yet utilised substantially in clinics. A few challenges for the clinical implementation of Raman spectroscopy are system and user variability. In this study, we asked how much variability occurs due to different Raman systems or users. To address these questions, we measured the same set of cells using two different Raman microscopes and by two different users. And classification models were generated using multivariate partial least squares discriminant analysis (PLS-DA) and analysed for clinical implementation. Raman spectra were measured from single exfoliated cells (n=400) from ThinPrep samples with negative cytology (n=10) and high-grade cytology (n=10). Raman spectra were acquired from the same set of cells via two identical HORIBA Jobin Yvon XploRATM systems (Villeneuve d\u27Ascq, France), as well as two different users. The Raman data was subjected to PLS-DA and cross-validated via leave-one-patient out. The study\u27s findings suggest that the data acquired from the two Raman systems are 99% identical. However, the observed classification accuracy for the data obtained by user-1 was 92%, whereas by user-2 was 99%

Deformation of Nanowires and Nanotubes

In this article, we have investigated the consequences of the next to the leading order correction to the effective field theory of nanostructures. This has been done by analyzing the effects of deformed Heisenberg algebra on nanowires and nanotubes. We first deform the Schrodinger equation with cylindrical topology. Then specific solutions to the deformed Schrodinger equation with different boundary conditions are studied. These deformed solutions are used to investigate the consequences of the deformation on the energy of nanowires and nanotubes.Comment: 9 pages, 6 figure

Case Report Haematochezia from a Splenic Artery Pseudoaneurysm Communicating with Transverse Colon: A Case Report and Literature Review

Splenic artery aneurysms (SAA) are the third most common intra-abdominal aneurysm. Complications include invasion into surrounding structures often in association with preexisting pancreatic disease. We describe an 88-year-old female, with no history of pancreatic disease, referred with lower gastrointestinal bleeding. CT angiography showed a splenic artery pseudoaneurysm with associated collection and fistula to the transverse colon at the level of the splenic flexure. The pseudoaneurysm was embolised endovascularly with metallic microcoils. Rectal bleeding ceased. The patient recovered well and follow-up angiography revealed no persistence of the splenic artery pseudoaneurysm. SAA rupture results in 29%-50% mortality. Experienced centres report success with the endovascular approach in haemodynamically unstable patients, as a bridge to surgery, and even on a background of pancreatic disease. This case highlights the importance of prompt CT angiography, if endoscopy fails to identify a cause of gastrointestinal bleeding. Endovascular embolisation provides a safe and effective alternative to surgery, where anatomical considerations and local expertise permit

Streptococcus anginosus bacteremia: a septic IVC thrombus and a large empyema requiring decortication

A previously healthy 39 year old male presented with complaints of cough, fever, abdominal pain and chills. The patient was found to be in active sepsis with hypotension on presentation so was resuscitated while a full septic work-up was ordered. Initial chest X-ray showed only increased broncho-alveolar markings and no consolidations, but blood cultures eventually revealed Streptococcus anginosus bacteremia. Intravenous antibiotics were started and infective endocarditis was ruled out. Computerized tomography scan of the abdomen with contrast revealed findings suggestive of a septic hepatic inferior vena cava thrombus and right lower lung findings suggestive of septic embolization and an empyema. Later on during admission, CT scan of the chest with contrast revealed a moderate-sized empyema of the right lung which eventually required decortication. Discovering such findings concurrently in a single patient is extremely rare, particularly an embolizing septic IVC thrombus with confirmed bacteremia. For this reason it is described in the following case presentatio

Characterisation of Cartilage Damage via Fusing Mid-Infrared, Near-Infrared, and Raman Spectroscopic Data

Mid-infrared spectroscopy (MIR), near-infrared spectroscopy (NIR), and Raman spectroscopy are all well-established analytical techniques in biomedical applications. Since they provide complementary chemical information, we aimed to determine whether combining them amplifies their strengths and mitigates their weaknesses. This study investigates the feasibility of the fusion of MIR, NIR, and Raman spectroscopic data for characterising articular cartilage integrity. Osteochondral specimens from bovine patellae were subjected to mechanical and enzymatic damage, and then MIR, NIR, and Raman data were acquired from the damaged and control specimens. We assessed the capacity of individual spectroscopic methods to classify the samples into damage or control groups using Partial Least Squares Discriminant Analysis (PLS-DA). Multi-block PLS-DA was carried out to assess the potential of data fusion by combining the dataset by applying two-block (MIR and NIR, MIR and Raman, NIR and Raman) and three-block approaches (MIR, NIR, and Raman). The results of the one-block models show a higher classification accuracy for NIR (93%) and MIR (92%) than for Raman (76%) spectroscopy. In contrast, we observed the highest classification efficiency of 94% and 93% for the two-block (MIR and NIR) and three-block models, respectively. The detailed correlative analysis of the spectral features contributing to the discrimination in the three-block models adds considerably more insight into the molecular origin of cartilage damage

Poboljšan postupak sinteze nekih novih 1,3-diaril-2-propen-1-ona koristeći PEG-400 kao reciklirajuće otapalo i njihovo antimikrobno vrednovanje

A simple and convenient route is described for the synthesis of novel hetero 1,3-diaryl-2-propen-1-ones (chalcones) by using recyclable poly PEG-400 as an alternative reaction solvent. The reaction is clean with excellent yield, shorter reaction time and reduces the use of volatile organic compounds (VOCs). All the synthesized compounds were evaluated for their antimicrobial activities against several pathogenic representatives.Opisana je jednostavna i pogodna metoda sinteze novih hetero 1,3-diaril-2-propen-1-ona (kalkona) koristeći poli(etilenglikol) (PEG-400) kao alternativno otapalo. Reakcija je jednoznačna, a uporaba hlapljivih organskih otapala je smanjena. Iskorištenja na produktima su visoka, a reakcijska vremena kraća. Svi sintetizirani spojevi testirani su na antimikrobno djelovanje na nekoliko patogenih mikroorganizama

The Perceptions on Male Circumcision as a Preventive Measure Against HIV Infection and Considerations in Scaling up of the Services: A Qualitative Study Among Police Officers in Dar es Salaam, Tanzania.

\ud In recent randomized controlled trials, male circumcision has been proven to complement the available biomedical interventions in decreasing HIV transmission from infected women to uninfected men. Consequently, Tanzania is striving to scale-up safe medical male circumcision to reduce HIV transmission. However, there is a need to investigate the perceptions of male circumcision in Tanzania using specific populations. The purpose of the present study was to assess the perceptions of male circumcision in a cohort of police officers that also served as a source of volunteers for a phase I/II HIV vaccine (HIVIS-03) trial in Dar es Salaam, Tanzania. In-depth interviews with 24 men and 10 women were conducted. Content analysis informed by the socio-ecological model was used to analyze the data. Informants perceived male circumcision as a health-promoting practice that may prevent HIV transmission and other sexually transmitted infections. They reported male circumcision promotes sexual pleasure, confidence and hygiene or sexual cleanliness. They added that it is a religious ritual and a cultural practice that enhances the recognition of manhood in the community. However, informants were concerned about the cost involved in male circumcision and cleanliness of instruments used in medical and traditional male circumcision. They also expressed confusion about the shame of undergoing circumcision at an advanced age and pain that could emanate after circumcision. The participants advocated for health policies that promote medical male circumcision at childhood, specifically along with the vaccination program. The perceived benefit of male circumcision as a preventive strategy to HIV and other sexually transmitted infections is important. However, there is a need to ensure that male circumcision is conducted under hygienic conditions. Integrating male circumcision service in the routine childhood vaccination program may increase its coverage at early childhood. The findings from this investigation provide contextual understanding that may assist in scaling-up male circumcision in Tanzania.\u