Isolated pulmonary cavitary mucormycosis in uncontrolled diabetic, diagnosed by fiber-optic bronchoscopy and completely managed medically

Pulmonary mucormycosis is rare life‐threatening infection affecting mostly immunocompromised individuals such as diabetes mellitus, hematological malignancies, chronic renal failure, post transplantation etc. Based on the anatomic site involved, mucormycosis can be one of several forms, such as rhinocerebral, pulmonary, cutaneous, gastrointestinal, disseminated, and uncommon presentations that include endocarditis, osteomyelitis, peritonitis, and renal infection. Pulmonary infection is the most common form of mucormycosis recognized in patients with hematological malignancy and remains the second most common presentation after rhinocerebral infection in diabetic patients. Its presentation in the lungs may mimic cavitary diseases like tuberculosis, mass lesions as in malignancies and non-resolving pneumonias. Here we report a case of isolated pulmonary mucormycosis in an uncontrolled diabetic male patient with a cavitary lesion. Diagnosis was made with a bronchoscopic biopsy and treatment was completely medical with liposomal amphotericin B

An unusual cause of hemoptysis due to leaking subclavian artery pseudoaneurysm secondary to trauma

Pseudoneurysms of the subclavian artery after blunting thoracic trauma presenting with a complication of hemoptysis are rare, most of which occur early, within days of trauma and represent a challenging surgical problem. Only a few scattered case reports are found in the literature. Here, we present the case of a 36-year-old male, with a history of blunt injury to the chest with right clavicular fracture, a few years back, who presented with cough, hemoptysis and shortness of breath of five days duration. On complete evaluation it was found that these complaints were due to a sub clavian artery pseudo aneurysm in the proximal part, which is compressing on the right upper lobe bronchus and blood leaking into the parenchyma and airways producing the symptoms. He was managed conservatively and stabilized. Later aneurysm resection and anastomosis was done electively. The patient is now asymptomatic and healthy

Presentation of pulmonary tuberculosis in diabetics and response to anti-tuberculosis therapy

Background: Diabetes and Tuberculosis are known to be mutually affective. In high tuberculosis and Diabetes burden country like ours, it is essential that we understand all the aspects concerning both these diseases individually and in mutual coexistence, in order to improve the management of this unhealthy partnership.Methods: This is a prospective hospital based observational study, in which 100 patients with coexisting Diabetes and new sputum confirmed pulmonary tuberculosis with no other comorbidities were included. Detailed history, examination and appropriate investigations were done evaluating the clinical and radiological presentation and treatment response in terms of sputum conversion at follow up visits.Results: Predominant symptoms were anorexia, fever and cough with sputum, majority with duration of more than 4 weeks. About half of them had diabetes duration of less than 1 year, most being newly diagnosed. All cases had upper lobe involvement; two thirds of them had lower lung field and multiple lobe involvement. Confluent consolidation, cavitary lesions and fluffy infiltrates were common. 27 of the 100 cases had a delayed sputum conversion. Longer duration of diabetes, maintenance on oral hypoglycaemic drugs alone and uncontrolled diabetes had delayed sputum conversion.Conclusions: Presenting symptoms of tuberculosis in diabetics is more or less similar to that in non-diabetics. Atypical radiological presentation with lower lung field involvement and confluent consolidation mimicking pneumonia is common. Delay in sputum conversion is common in dual disease and is increased with increasing DM duration and poor glycemic control. Better results may be obtained with insulin therapy

Low Leakage and Robust Sub-threshold SRAM Cell using Memristor

This work aims to improve the total power dissipation, leakage currents and stability without disturbing the logic state of SRAM cell with concept called sub-threshold operation. Though, sub-threshold SRAM proves to be advantageous but fails with basic 6T SRAM cell during readability and writability. In this paper we have investigated a non-volatile 6T2M (6 Transistors & 2 Memristors) sub-threshold SRAM cell working at lower supply voltage of VDD=0.3V, where Memristor is used to store the information even at power failures and restores previous data with successful read and write operation overcomes the challenge faced. This paper also proposes a new configuration of non-volatile 6T2M (6 Transistors & 2 Memristors) sub-threshold SRAM cell resulting in improved behaviour in terms of power, stability and leakage current where read and write power has improved by 40% and 90% respectively when compared to 6T2M (conventional) SRAM cell. The proposed 6T2M SRAM cell offers good stability of RSNM=65mV and WSNM=93mV which is much improved at low voltage when compared to conventional basic 6T SRAM cell, and improved leakage current of 4.92nA is achieved as compared

Low Leakage and Robust Sub-threshold SRAM Cell using Memristor

This work aims to improve the total power dissipation, leakage currents and stability without disturbing the logic state of SRAM cell with concept called sub-threshold operation. Though, sub-threshold SRAM proves to be advantageous but fails with basic 6T SRAM cell during readability and writability. In this paper we have investigated a non-volatile 6T2M (6 Transistors & 2 Memristors) sub-threshold SRAM cell working at lower supply voltage of VDD=0.3V, where Memristor is used to store the information even at power failures and restores previous data with successful read and write operation overcomes the challenge faced. This paper also proposes a new configuration of non-volatile 6T2M (6 Transistors & 2 Memristors) sub-threshold SRAM cell resulting in improved behaviour in terms of power, stability and leakage current where read and write power has improved by 40% and 90% respectively when compared to 6T2M (conventional) SRAM cell. The proposed 6T2M SRAM cell offers good stability of RSNM=65mV and WSNM=93mV which is much improved at low voltage when compared to conventional basic 6T SRAM cell, and improved leakage current of 4.92nA is achieved as compared

STUDIES ON THE SYNTHESIS OF SOME NEW 1,2,4- TRIAZOLES DERIVATIVES AND EVALUATION FOR THEIR ANTI-FUNGAL ACTIVITY PROFILES

The synthesis of new heterocyclic compounds has always drawn the attention of medicinal chemist over the years mainly because they possess diverse biological properties. The literature survey on 1,2,4-triazoles revealed that they are endowed with wide variety of biological activities .During the present investigation a series of new 1,2,4-triazole derivatives N-(3-(2-(3- hydrazinyl-3-oxoalkanoyl)hydrazinyl)-5-(phenoxymethyl)-4H-1,2,4-triazol-4-yl)isonicotinamide(6a- 6e)were synthesized by reacting withN-(5-mercapto-3-(phenoxymethyl)-4H-1,2,4-triazol-4- yl)isonicotinamide (5) and aliphatic dicarboxylic acid hydrazides (a-e). The structures of the newly All the compounds synthesised 6a to 6e were evaluated for antifungal activity against Candida albicans and Aspergillus Niger was carried out and MIC values were determined synthesized compounds were estblished by FT-IR, 1H-NMR and MASS spectral analysis. The compound 6a (n=0) was found to be the most potent antifungal agent. Keywords: 1,2,4-triazole derivatives, antifungal, Candida albicans, Aspergillus Nige

DESIGN, SYNTHESIS AND PHARMACOLOGICAL EVALUATION OF NEW SUBSTITUTED THIAZOLIDIN-4- ONE DERIVATIVES

4-thiazolidinones are among t h e most extensively investigated class of organic compounds. Thiazolidin-4-one has been considered as magic moiety, which is a core structure in various synthetic pharmaceuticals displaying a broad spectrum of biological activities.They are widely used as anti-inflammatory, anticonvulsant, analgesic, antimicrobial,anti-HIV,CNS depressant, carcinostatic, antihypertensive and cytotoxic. In view of the wide spectrum activities of condensed 4-thiazolidinones, it was thought worthwhile to undertake the synthesis of heterocyclic systems in which 4-thiazolidinone nucleus is linked to another biologically active moiety.Semicarbazide/Thiosemicarbazide was reacted with b e n z o y l chloride to obtain N-hydrazinocarbonyl benzene-1-carboxamide/N-hydrazinocarbothioylbenzene-1 carboxamide respectively.These were then condensed with various aldehydes to yield the intermediate Schiff bases. Thiazolidin-4-ones were prepared by the reaction of Schiff bases with mercaptoacetic acid in dry benzene by refluxing for 16-18 hours. The purity of the compounds synthesized was established by TLC.The synthesiz ed derivatives were characteriz ed by FT-IR, 1HNMR and Mass spectral analysis. All the derivatives synthesized were screened for their anti-bacterial and antifungal activities using cup-plate method against Bacillus subtilis, Salmonella typhi, Escherichia coli, Staphylococcus aureus, Aspergillus niger and Candida albicans at 100µ g/ml using ciprofloxacin and clotrimazole as reference standard drugs respectively.The compounds belonging to series (3A1-3A6) have shown promising antibacterial and antifungal activity and those belonging to series (3B1-3B6) were moderate compared to standard. The antimicrobial activity data reveals that, the compounds bearing the phenyl carbonyl urea in their structure, were found to be more potent than the phenyl carbonyl thiourea containing derivatives, indicating the influence of oxygen in enhancing the antimicrobial potency. Keywords: Schif bases,Thiazolidin-4-one,Antimicrobia

Low Power Non-Volatile 7T1M Subthreshold SRAM Cell

A new modified 7T1M non-volatile SRAM cell is presented in this paper for low power applications at subthresholdvoltage (very low voltage) simply by connecting the memristor directly with storage node which is acting as storage elementand adding a transistor in between the two storage nodes with feedback connection gives better performance in terms ofaverage delay, read /write operations and RSNM/WSNM. The memristor based circuits are simulated at subthreshold is anew insight and a new effort in technology made with improvement of approximately 61% and 23% of RSNM and WSNMrespectively compared to existing memory cell 7T1M and power dissipation is decreased by 66% whereas read delay andwrite delay obtained is nominal. Moreover, It has also simulated an adjusting 6T2M and conventional 6T at subthresholdvoltage i.e. VDD=0.3V to compare its stability behaviour at lower supply voltage

Dead on arrival in a low-income country: results from a multicenter study in Pakistan

BACKGROUND: This study assessed the characteristics of dead on arrival (DOA) patients in Pakistan. METHODS: Data about the DOA patients were extracted from Pakistan National Emergency Department Surveillance study (Pak-NEDS). This study recruited all ED patients presenting to seven tertiary care hospitals during a four-month period between November 2010 and March 2011. This study included patients who were declared dead-on-arrival by the ED physician. RESULTS: A total of 1,557 DOA patients (7 per 1,000 visits) were included in the Pak-NEDS. Men accounted for two-thirds (64%) of DOA patients. Those aged 20-49 years accounted for about 46% of DOA patients. Nine percent (n = 72) of patients were brought by ambulance, and most patients presented at a public hospital (80%). About 11% of DOA patients had an injury. Factors significantly associated (p \u3c 0.05) with ambulance use were men (adjusted odds ratio [aOR] = 2.72), brought to a private hospital (OR = 2.74), and being injured (aOR = 1.89). Cardiopulmonary resuscitation (CPR) was performed on 6% (n = 42) of patients who received treatment. Those brought to a private hospital were more likely to receive CPR (aOR = 2.81). CONCLUSION: This study noted a higher burden of DOA patients in Pakistan compared to other resourceful settings (about 1 to 2 per 1,000 visits). A large proportion of patients belonging to productive age groups, and the low prevalence of ambulance and CPR use, indicate a need for improving the prehospital care and basic life support training in pakistan

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed