Bilateral pneumothorax following an acupuncture

Acupuncture is a form of complementary medicine that has been practiced in China for thousands of years. Adverse effect of acupuncture is rarely reported in local literature. This is a case of a patient who developed bilateral pneumothorax following an acupuncture session. A 63-year-old lady with no significant medical illness presented with sudden onset of shortness of breath half an hour following acupuncture and massage session by traditional medicine practitioner. On examination, she was tachypnoiec and there was reduced air entry bilaterally on lung auscultation. Urgent portable chest X-ray was done and it showed bilateral pneumothorax. Bilateral chest tubes were inserted. Patient was discharged well following five days of hospitalization. As acupuncture is gaining popularity among Malaysian population, medical practitioners need to increase their awareness and knowledge regarding the adverse effect of such alternative practice

Critical digital ischemia secondary to ulnar artery thrombosis in suspected antiphospholipid syndrome

Antiphospholipid syndrome (APS) is known to cause critical limb ischemia leading to limb loss or death from arterial occlusion. We reported a 45-year-old woman with critical digital ischemia and was suspected secondary to APS. This woman presented to the Emergency Department (ED) for the third time because of recurrent pain and numbness in the fingertips of her left hand with bluish discoloration of the left little finger. Her ulnar artery became faint on palpation, and her left fifth finger was cool, cyanotic, with prolonged capillary refill time (CRT) and unrecognised signal in SpO2. Angiography and ultrasound showed proximal thrombosis of the ulnar artery. Thrombectomy was performed twice because graft thrombosis had occurred during the first operation. The rheumatology team treated her as APS and administered antiplatelet drugs. We hope this case report will raise awareness among emergency physicians for early recognition and provide optimal treatment

Morel-Lavallee lesion: a forgotten cause of bleeding in trauma

The Morel-Lavallee lesion is a rare soft tissue injury that occurs due to traumatic shearing force on skin surface causing separation of skin and subcutaneous tissue resulting in hematoma. This case report depicts a 22-year-old gentleman who was involved in a motor vehicle accident. He complained of pain and swelling over lower back. He was treated for soft tissue injury and admitted for pain control. One day post-trauma, he complained of increased swelling over the back. His hemoglobin dropped from 12.2g/dL to 10.7g/dL. Diagnosis of Morel-Lavallae lesion was made. Initially no surgical intervention was planned. However, in view of worsening of swelling, bedside aspiration was performed and subsequently a pigtail catheter was inserted to drain the hematoma. In total, 2.05 litre of liquefied hematoma was drained. Thus, Morel-Lavallee lesion is an uncommon soft tissue injury that can cause significant bleeding following trauma

Graphene-deposited photonic crystal fibers for continuous refractive index sensing applications

© 2015 Optical Society of America. We present a pilot demonstration of an optical fiber based refractive index (RI) sensor involving the deposition of graphene onto the surface of a segment of a photonic crystal fiber (PCF) in a fiber-based Mach-Zehnder Interferometer (MZI). The fabrication process is relatively simple and only involves the fusion splicing of a PCF between two single mode fibers. The deposition process relies only on the cold transfer of graphene onto the PCF segment, without the need for further physical or chemical treatment. The graphene overlay modified the sensing scheme of the MZI RI sensor, allowing the sensor to overcome limitations to its detectable RI range due to free spectral range issues. This modification also allows for continuous measurements to be obtained without the need for reference values for the range of RIs studied and brings to light the potential for simultaneous dual parameter sensing. The sensor was able to achieve a RI sensitivity of 9.4 dB/RIU for the RIs of 1.33-1.38 and a sensitivity of 17.5 dB/RIU for the RIs of 1.38-1.43. It also displayed good repeatability and the results obtained were consistent with the modeling

Contact printing of colloidal nanocrystal thin films for hybrid organic/quantum dot optoelectronic devices

Novel thin film optoelectronic devices containing both inorganic colloidal semiconductor quantum dots (QDs) and organic semiconductor thin films have been widely investigated in recent years for a variety of applications. Here, we review one of the most versatile and successful methods developed to integrate these two dissimilar material classes into a functional multilayered device: contact printing of colloidal QD films. Experimental details regarding the contact printing process are outlined, and the key advantages of this QD deposition method over other commonly encountered techniques are discussed. The use of tapping mode atomic force microscopy (AFM) to effectively characterize QD film morphology both on an elastomeric stamp (before contact printing) and as-transferred to the organic semiconductor receiving film (after contact printing) is also described. Finally, we offer suggestions for future efforts directed toward the goal of rapid, continuous QD deposition over larger substrates for the advancement of hybrid optoelectronic thin film devices

The evolution of peripheral nerve treatment for trigeminal neuralgia - peripheral nerve surgery

Trigeminal neuralgia typically presents with a sudden and severe facial pain. Although peripheral nerve injection can produce good pain relief in the treatment of trigeminal neuralgia, their effect may not be permanent. Surgical treatment has always been an alternative for patients who do not respond well to medical treatment or, for those who are severely affected by the side effects of anticonvulsants. Unknown to most young healthcare providers, surgical treatment was the first line treatment at the turn of the 19th century till 1960s. This review narrates the evolution of peripheral nerve treatment for trigeminal neuralgia over the last 150 years