Chronic Lung inflammation in victims of toxic gas leak at Bhopal

Bronchoalveolar lavage (BAL) studies in 20 patients at Bhopal. 1.3 ± 0.4 yr and 2.7 ± 0.6 yr after toxic gas exposure had revealed that the lower respiratory tract inflammation had progressed from initial macrophage alveolitis to macrophage-neutrophilic alveolitis. The interval between the two lavages was 1.4 ± 0.6 yr. BAL studies in a new group of 14 patients 5.1 ± 1.0 yr after exposure had confirmed chronic inflammation of the lower respiratory tract as evidenced by macrophage-neutrophilic alveolitis in these subjects as well. Clinical. radiographic and pulmonary function abnormalities were persistent in a proportion of subjects in both groups. Fibronectin (FN) levels were estimated in BAL fluid in 41 patients. Elevated FN levels were seen in 12 (29.3%) subjects and nine of these 12 had radiographic abnormalities. Severely exposed subjects (n=30) had significantly higher BAL fibronectin levels compared to normal subjects and mild/moderately exposed subjects. Repeat FN estimations in BAL samples from 10 patients had revealed that five had abnormally high FN including three who had high FN on both occasions. The number of patients showing abnormal decline in pulmonary function was higher in patients with elevated FN than in patients with normal FN. Thus, persisting clinical, roentgenographic and ventilatory abnormalities, as well as macrophageneutrophilic alveolitis alon g with abnormally elevated FN levels in a proportion of subjects, suggest the possibility that lung fibrosis can occur in subjects exposed to toxic gas at Bhopal

Frequency of eosinophilia and risk factors and their association with Toxocara infection in schoolchildren during a health survey in the north of Lima, Peru

During a health survey in a primary school from the district of Carabayllo (North of Lima, Peru), 200 schoolchildren (96 male and 104 female between five to 12 years old) were randomly selected and divided in two groups (as positive or negative group), according to the serologic result of the Toxocara ELISA test from a total population of 646 schoolchildren. All children were analyzed by hematologic tests to determinate the frequency of eosinophilia and leukocytosis. Additionally, all clinical and epidemiological data were also analyzed to determine their association with toxocariasis. From group of children with positive serology, 40% had some type of eosinophilia in contrast to 19% of children with negative serology, and their association was statistically significant (OR = 2.84, p < 0.001). From all signs and symptoms evaluated, only 'dry cough' was more frequent and statistically significant in the positive serology group (OR = 2.79, p < 0.001). Almost all risk factors evaluated were highly frequent and statistically associated to the positive serology. In conclusion, the presence of eosinophilia and the risk factors evaluated in this population were frequently associated to human toxocariasis

Ultrasonographic analysis of the anatomical relationship between femoral vessels in the upper part of thigh in critically ill patients– a cross sectional study

Objective: Femoral vessels are one of the frequently used sites of cannulation in intensive care units. In resource limited settings cannulations are done blindly without ultrasonographic guidance based on a traditional belief that in the upper thigh vein keeps a medial relationship to artery. In this trial we tried to analyse the anatomical relationship of femoral vein to femoral artery using ultrasound in critically ill patients. Methods: This cross sectional study analysed the anatomical relationship of femoral vein to femoral artery at 2cm, 4 cm and 6 cm from the mid inguinal point in both thighs of the patients using ultrasonography. The study was done among patients admitted in a multidisciplinary intensive care unit. Results: Three hundred limbs of one hundred and fifty patients were analysed by ultrasonography. A total of 900 measurements were taken at three different levels of both legs. At 2 cm below the mid inguinal point, in 256 limbs (85.3%) femoral vein was medial to femoral artery (95% Confidence Interval82.82% to 89.14%), at 4 cm below the mid inguinal point, in 210 limbs (70%) femoral vein was postero medial to femoral artery (95% CI64.47% to 75.13%),and at6 cm below the mid inguinal point in 200 limbs(66.7%)femoral vein was posterior to femoral artery(95% CI 61.02% to 71.98%). Conclusion: Femoral vein showed variable relationship to femoral artery in the upper part of the thigh. As the distance increased from mid inguinal point, variation from normal relationship was also found to be increasing

An Unhappy Patient following Successful Sonothrombolysis in Vertebrobasilar Thrombosis: Dilemma with Final Diagnosis

10.1111/j.1552-6569.2010.00509.xJournal of Neuroimaging212e173-e176JNER

Reconciling Tourism Development and Conservation Outcomes Through Marine Spatial Planning for a Saudi Giga-Project in the Red Sea (The Red Sea Project, Vision 2030)

The Red Sea Project (TRSP) is a development that extends over 28,000 km2 along the shores of the Red Sea that will progress to become a sustainable luxury tourism destination on the west coast of the Kingdom of Saudi Arabia. The destination incorporates the Al Wajh lagoon, a pristine 2,081 km2 area that includes 92 islands with valuable habitats (coral reefs, seagrass, and mangroves) and species of global conservation importance. The Red Sea Development Company, responsible for the execution of TRSP, has committed to achieve a net-positive impact on biodiversity while developing the site for sustainable tourism. This requires reaching conservation outcomes superior to those of a “business as usual” scenario for an undeveloped site. After careful optimization of the development plans to explore every opportunity to avoid impacts, we applied marine spatial planning to optimize the conservation of the Al Wajh lagoon in the presence of development. We subsequently tested five conservation scenarios (excluding and including development) using Marxan, a suite of tools designed to identify priority areas for protection on the basis of prescribed conservation objectives. We succeeded in creating a three-layer conservation zoning, achieving conservation outcomes as those possible in the “business as usual” scenario. Subsequently, we designed additional actions to remove existing pressures and generate net positive conservation outcomes. The results demonstrate that careful design and planning could potentially allow coastal development to enhance, rather than jeopardize, conservation. © Copyright © 2020 Chalastani, Manetos, Al-Suwailem, Hale, Vijayan, Pagano, Williamson, Henshaw, Albaseet, Butt, Brainard, Coccossis, Tsoukala and Duarte