Possible adverse drug reaction to parenteral amino acids in an infant: a case report

A case report of a possible adverse drug reaction to 10% parenteral aminoacid formulation in a 5½ month male patient diagnosed with bronchopulmonary pneumonia with acute respiratory distress syndrome in septic shock, is presented. There was a temporal relationship between the administration of the parenteral amino acid formulation and the onset of the exanthem. This was further evidenced by the regression of the exanthem following the discontinuation of the formulation. The causality assessment of this adverse drug reaction has been done, and the likely causes of this hypersensitivity reaction have been analyzed

Effect of discrete time observations on synchronization in Chua model and applications to data assimilation

Recent studies show indication of the effectiveness of synchronization as a data assimilation tool for small or meso-scale forecast when less number of variables are observed frequently. Our main aim here is to understand the effects of changing observational frequency and observational noise on synchronization and prediction in a low dimensional chaotic system, namely the Chua circuit model. We perform {\it identical twin experiments} in order to study synchronization using discrete-in-time observations generated from independent model run and coupled unidirectionally to the model through $x$, $y$ and $z$ separately. We observe synchrony in a finite range of coupling constant when coupling the x and y variables of the Chua model but not when coupling the z variable. This range of coupling constant decreases with increasing levels of noise in the observations. The Chua system does not show synchrony when the time gap between observations is greater than about one-seventh of the Lyapunov time. Finally, we also note that prediction errors are much larger when noisy observations are used than when using observations without noise.Comment: synchronization, Data assimilation, Chua model, 8 pages, 11 figure

Clinical outcomes after joint surgery in patients on turoctocog alfa pegol (N8-GP) prophylaxis: a post hoc analysis

Introduction Joint damage in haemophilia often requires surgical correction. However, the surgery effect on bleeding rates and other clinical joint outcomes can be unclear. Aim To investigate the effects of joint surgery on joint annualized bleeding rates (JABRs) and physical health outcomes in patients with haemophilia A undergoing N8-GP prophylaxis. Methods Patients in the pathfinder 2 trial received N8-GP prophylaxis, enrolling in the pathfinder 3 trial for indicated surgery. Patients returned to pathfinder two post-surgery, continuing N8-GP prophylaxis until end-of-trial. JABRs were calculated from bleeding across all joints for pre-surgery (immediately before surgery) and post-surgery (to pathfinder 2 study end) periods. Joint-health-related outcomes were derived from patient records. Results Data (41 joint surgeries; n = 30) were analysed statistically using datamining and descriptively. Pre-surgery mean JABR was higher in patients who later were operated than in 146 non-operated patients (p = .004). In operated patients, mean JABR decreased from 1.33 pre-surgery to .37 post-surgery (p = .011). In all but three patients, JABR improved or remained the same post-surgery. In the three patients whose JABR remained at one (all with multiple joint arthropathy), post-surgery bleeds were mostly at non-operated sites. Two of the three patients whose JABR increased post-surgery had undergone surgery for reasons unlikely to improve JABR. Mobility parameters often improved in patients whose JABR remained at zero. Conclusion Patients with haemophilia treated with N8-GP prophylaxis benefit from surgeries. However, this analysis could not differentiate the relative contributions of surgical interventions and prophylactic treatment to the improvement of JABR

Effect of Injectable Platelet-Rich Fibrin with a Nano-Hydroxyapatite Bone Graft on the Treatment of a Grade II Furcation Defect

Background: Periodontal diseases lead to bone loss, crestal defects and even loss of the tooth, which also further makes it difficult to replace the tooth. Autogenous bone grafts are considered the gold standard in bone regenerative procedures. This study aimed to compare and evaluate the bone regenerative effects of i-PRF (Injectable- Platelet-rich fibrin) with a bone graft and a bone graft alone in mandibular grade II furcation defects over a period of 9 months. Method: This was a comparative study of 12 participants, who were randomly selected and grouped into two groups: test and control. Following phase I therapy, both groups were subjected to open flap debridement. In the test group, after debridement, a nano-hydroxyapatite bone graft mixed with i-PRF was inserted, whereas in the control group only a nano-hydroxyapatite bone graft was inserted. The clinical parameters such as plaque index (PI), gingival index (GI), pocket probing depth (PPD), clinical attachment level (CAL), horizontal probing depth (HPD) and vertical probing depth (VPD) were recorded at baseline, 3 months, 6 months and 9 months following the surgery. The bone area fill (BAF) was assessed using intraoral periapical radiographs (IOPARs) taken at baseline and 9 months after surgery. Results: At the baseline, there was no statistically significant difference between the tested parameters. After 9 months all the clinical parameters, PI, GI, PPD, CAL, HPD and VPD as well as radiographic bone fill showed a significant increase in both the groups (p < 0.05) (PI-TGr; CGr–VPD—3.5 ± 0.54 to 0.66 ± 0.51; 3.3 ± 0.81 to 2 ± 0.63/BAF—2.9 ± 0.88 to 5.6 ± 1.10; 3.4 ± 1.39 to 3.9 ± 1.4). On comparison the test group showed better results for each clinical parameter. Conclusion: The results showed increased improvement in clinical conditions in both groups, although better results were seen in the group where i-PRF with a nano-HA bone graft was used in the furcation defect