Spontaneous pneumothorax as a manifestation of COVID-19: A case report

Spontaneous pneumothorax (SP) is an uncommon complication of COVID-19, mostly in association with pre-existing lung conditions or under positive pressure ventilation. SP has been reported to occur in approximately 1% of the patients with COVID-19. We report here a case of a 47-year-old non-smoker gentleman without any pre-existing lung disease, who was admitted to our facility with fever, cough and shortness of breath and for 3 days with progressive worsening and chest pain over last 24 hours. Chest radiography revealed the diagnosis of right-sided pneumothorax with widespread patchy infiltrates on the left lung field. He was tested positive for COVID-19 and cultures for secondary bacterial infections were negative. A chest drain was secured and he was given antibiotics, steroid, heparin and remdesivir. However, the patient died within next 2 days due to progressive respiratory failure. This report emphasizes awareness of the possibility of SP as a complication of COVID-19; early identification and treatment of this entity may help decrease the associated mortality and morbidity. In conclusion, the possibility of SP should always be considered in the workup of a patient of SARS-CoV-2 infection having acute shortness of breath with or without chest pain. We would like to highlight this significant, though rare, presentation of COVID-19 and urge clinicians to maintain a high index of suspicion

Cold Bubble Humidification of Oxygen: Old habits die hard

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Relationship between Cervical Vertebral Maturation and Chronological Age: A Mixed Longitudinal Study

The cervical vertebrae have been proposed as a method of determining skeletal maturation.This study aimed to evaluate the relationship between chronologic age and the individual skeletal maturity as assessed by means of the cervical vertebral maturation (CVM) method

Apparently less value of blood pressure among healthy people: is the cuff width responsible?

Blood pressure in normal adults in the present study population in Nepal is found to be less in comparison to that recorded in Framingham study, USA. To find out the cause of variation of blood pressure values, this study was designed. Blood pressures of healthy young subjects were recorded by mercury sphygmomanometer having standard Riva-Rocci cuff. The midarm- circumference of the same subjects were measured by a measuring tape. Blood pressure for male and female subjects was found to be 115/77 mmHg and 107/73 mmHg respectively. Mid-arm-circumferences of male and female volunteers were recorded approximately 25 cm and 23 cm respectively. As per rule, width of the cuff should be 40% of the mid-arm-circumference. Nevertheless, the calculated value of 40% of the mid-arm-circumference was found to be less than 12 cm. The calculated value of 40% of mid-arm-circumference for male and female volunteers was found to be approximately 10 cm and 9 cm respectively in this study population. So, the width of the cuff is relatively more than what it should be, for this study population. This may be the cause of less value of blood pressure in normotensive population in this study. Cuff size should be considered carefully to avoid misinterpretation of borderline hypertensives as normotensives

Stopping power dependence of nitrogen sputtering yields in copper nitride films under swift-ion irradiation: Exciton model approach

Nitrogen sputtering yields as high as 104 atoms/ion, are obtained by irradiating N-rich-Cu3N films (N concentration: 33 ± 2 at.%) with Cu ions at energies in the range 10?42 MeV. The kinetics of N sputtering as a function of ion fluence is determined at several energies (stopping powers) for films deposited on both, glass and silicon substrates. The kinetic curves show that the amount of nitrogen release strongly increases with rising irradiation fluence up to reaching a saturation level at a low remaining nitrogen fraction (5?10%), in which no further nitrogen reduction is observed. The sputtering rate for nitrogen depletion is found to be independent of the substrate and to linearly increase with electronic stopping power (Se). A stopping power (Sth) threshold of ?3.5 keV/nm for nitrogen depletion has been estimated from extrapolation of the data. Experimental kinetic data have been analyzed within a bulk molecular recombination model. The microscopic mechanisms of the nitrogen depletion process are discussed in terms of a non-radiative exciton decay model. In particular, the estimated threshold is related to a minimum exciton density which is required to achieve efficient sputtering rates

of Struma Ovarii: A Rare Ovarian Tumor

Abstract Struma ovarii or monodermal teratoma is a specialized ovarian neoplasm which mainly constitutes mature thyroid tissue. It is a rare tumor which comprises 1% of all ovarian tumors and 2.7% of all dermoid tumors. Thyroid tissue can be observed in 5-15% of dermoid tumors but to designate the tumor as struma ovarii, it must comprise more than 50% of the ovarian tissue. This study was conducted in the Department of Pathology, Manipal Teaching Hospital in Pokhara, Nepal over a period of 10 years (Jan 2006 to Sep 2015. Age, clinical findings, preoperative imaging diagnosis, size and side of the tumor, gross and microscopic findings along with type of surgery performed are included in the study. During this 10 years period, there were 7 cases of struma ovarii with age ranging from 26 to 56 years. 2 cases had tumor on the right and 4 cases had tumor on the left side while 1 case had bilateral struma ovarii. Initial presenting symptom was palpable mass, abdominal pain and vaginal bleeding. The size of the tumor ranged from 4 to 15 cm. The capsule was smooth and cut surface shows multiloculated cyst filled with greenish to pale brown gelatinous thick fluid. Microscopic examination revealed well encapsulated tumor composed entirely of thyroid follicles. Diagnoses of struma ovarii were made in all cases. The preoperative imaging may not exactly give the diagnosis. Clinically, lesser age group was more affected and left side is more commonly involved in our series, in contrary to other literature. Out of 7 cases, bilateral struma ovarii was seen in 1 patient. No malignant features were seen in any of these cases

Financial development and economic growth in an oil-rich economy: The case of Saudi Arabia

© 2014 Elsevier B.V.We investigate the effect of financial development on economic growth in the context of Saudi Arabia, an oil-rich economy. In doing so, we distinguish between the effects of financial development on the oil and non-oil sectors of the economy. Using the Autoregressive Distributed Lag (ARDL) Bounds test technique, we find that financial development has a positive impact on the growth of the non-oil sector. In contrast, its impact on the oil-sector growth and total GDP growth is either negative or insignificant. This suggests that the relationship between financial development and growth may be fundamentally different in resource-dominated economies