Septicaemia in pregnancy: a case report

Necrotizing fasciitis (NF) is a rare, life-threatening surgical infection in pregnancy with high rates of morbidity and mortality. It is a severe, potentially fatal infectious disease which rapidly extends from the subcutaneous tissue along the superficial and deep fascia causing vascular occlusion, ischemia, and necrosis of tissues. A 30-year-old gravida 2 para1 living 1 woman, at 32 weeks of gestation with previous caesarean section and recently diagnosed diabetes, hypertension was admitted to our hospital with signs and symptoms of severe sepsis with pruritic black lesions over abdomen and perineum. Patient was in a morbid state in our hospital. During clinical examination, fetal heart sound was not localised suggestive of intrauterine fetal demise (IUFD), with ulcerative lesions over abdomen and vulva. Patient was immediately taken for surgical intervention and was suggestive of ruptured uterus with extrusion of fetus in abdominal cavity with cellulitis of abdominal and vulva. During initial laboratory examinations, diabetes mellitus was diagnosed. Patient was kept on ventilatory support and was vitals were stabilised. Multidisciplinary therapy with immediate aggressive surgical debridement of necrotic tissues, multiple antibiotics, and intensive care monitoring was performed successfully. The patient’s postoperative course was uncomplicated and skin defect healed by second intention of healing. The following case emphasized the potential immunosuppressive role of pregnancy state in conjunction with diabetes mellitus in the development of severe necrotizing soft tissue infections

Negative imaginary potentials in time-dependent quantum molecular scattering

Reflection or wrap around of the wavefunction from the grid edges is often avoided in time-dependent quantum mechanical calculations by using a negative imaginary potential (NIP) near the grid edges. The stability of the various (second-order differencing, split operator, Chebyshev polynomial and short iterative Lanczos) schemes used, in conjunction with the NIP, for time evolution is discussed using collinear (He, H2+) collisions as a test case. It is shown that the difficulties encountered in obtaining converged reaction probability [PR(E)] values at high energies for the system when NIPs are used, are avoided by using a properly chosen damping function externally

Low flow low gradient aortic stenosis: clinical pathways

AbstractAortic stenosis patients with severe LV dysfunction and low cardiac output present with relatively low transvalvular gradients. It is difficult to distinguish them from aortic sclerosis and LV dysfunction with low cardiac output. The former condition is severe AS with LV dysfunction and latter is primarily a contractile dysfunction. Dobutamine stress echocardiogram is key to diagnosis.AS with LV dysfunction associated with preserved contractile reserve benefit from valve replacement and those without contractile reserve needs critical evaluation on a case to case basis. Patients of AS with LV dysfunction with associated coronary artery disease need coronary angiograms to decide regarding need for valve replacement with bypass surgery. A subset of AS patients have low flow, low mean gradients with preserved ejection fraction in whom one must evaluate global hemodynamic load to assess ventriculo-arterial impedence.In this review an approach to the clinical pathways for assessment of low flow, low gradient aortic stenosis has been discussed

Performance Simulation of HF-VHF Mobile Radio Systems in a Tactical Vehicle

A simulation process evolved for evaluating the performance of HF-VHF multi-radio set configuration ina tactical command vehicle is discussed. Algorithms and performance models used in the simulation process arebriefly described. Simulation process is for a specific application in a defined area of deployment under knownoperating situations. Performance simulation also includes an interference simulation model corresponding to thesystem model so that a real world situation is analysed to the practicable extent. Wherever statistical data ormanufacturer's design data is not available, suitable default values are assumed for applicable, battlefield scenarioquoted in the literature. This simulation tool can be extended to many applications (with modification to RFpower of transmitters, receiver sensitivity, frequency separation, distance separation, channel spacing, frequencyrange, communication range, etc. of  tactical vehicles  operating in combinations of   HF-VHF-UHF regions).Defence Science Journal, 2008, 58(6), pp.762-767, DOI:http://dx.doi.org/10.14429/dsj.58.170

A laparoscopic management of Swyer syndrome in a woman with pure 46XY gonads and hypoplastic dysgenesis-a rare presentation

Swyer syndrome is also known as complete/pure gonadal dysgenesis & is associated with an absence of testicular differentiation in a phenotypic female with a 46, XY karyotype. A 23-year-old married girl had come with complaints of primary infertility. She was averagely built & nourished. She had well developed secondary sexual characteristics like  breast development,  axillary hairs, and  pubic hairs (Tanners stage 4) secondary to receiving HRT for getting  menses. External genitalia was of female type. Karyotype showed genotype of 46, XY. Magnetic resonance imaging revealed hypoplastic uterus with rudimentary fallopian tubes , and fibrotic gonad like tissue. A diagnosis of Swyer syndrome was made. The patient was started on hormonal replacement therapy. Dysgenetic streak gonads were removed laparoscopically . Pathologic examination revealed seminiferous tubules ,rete testis & epididymis without evidence of malignant transformation. The patient tolerated the procedure well . Thus laparoscopic prophylactic gonadectomy revealed to be an economical ,straightforward and simple procedure in this patient & risk of neoplasia could be prevented. 

Introducing a twist in carbon nanotubes

A simple model based on rotational distortion of carbon atoms between adjacent layers running perpendicular to the tube axis, without altering the hexagonal motifs is proposed for constructing coiled carbon nanotubes

Computational identification and characterization of putative miRNAs in Nasonia species

MicroRNAs are important at post transcriptional regulation in eukaryotes. Nasonia genus is becoming increasingly popular model in present days due to genetic advantages it possesses over Drosophila. Nasonia species are found distributed throughout the world, expect for N. longicornis, and N. giraulti. In this study, we use the sequential method of blasting all known invertebrate miRNA genes against the Nasonia vitripennis, Nasonia longicornis, and Nasonia giraulti genomes. We identify 40, 31 and 29 putative pre-​miRNAs and mature sequences in N. vitripennis, N. giraulti and N. longicornis resp. A cross species comparison of putative miRNA sequences and their statistical characteristics reveals that there are no huge differences between the species, except for few miRNAs which are reported. We also find that the minimal folding energy index for three Nasonia species pre-​miRNA's av. is around -​0.85 ± 0.11. Further, we report that U is predominant at the 5' end of mature sequence, which being a typical characteristic of plant miRNAs. Using MiRanda, we predict nearly 471 potential sites in the N. vitripennis genome. Thus concluding our study to be the beginning of understanding the Nasonia's non coding RNAs and may play an important role in effective pest management in near future

Puerperal Group A Streptococcal sepsis: a case report

Group A Streptococcal (GAS) sepsis in puerperium is one of the recognised causes of maternal mortality. Though the onset is often insidious, it can progress rapidly to a life-threatening invasive infection, toxin-mediated shock, and end-organ failure, even before clinical signs become apparent. We report a case of puerperal GAS sepsis that was successfully managed. 24-years-old para 1 was readmitted to the intensive care unit requiring non-invasive ventilation on postnatal day 6 with clinical and biochemical features of sepsis. Blood culture, episiotomy wound swab, and high vaginal swab grew GAS. Broad-spectrum antibiotics initiated. She developed ascites that progressively increased and needed therapeutic paracentesis. She was discharged after four weeks of hospitalization. Early identification and prompt treatment are the keys to prevent severe morbidity and maternal mortality

Structure and stability of spiro-cyclic water clusters

The structure and stability of spiro-cyclic water clusters containing up to 32 water molecules have been investigated at different levels of theory. Although there exist minima lower in energy than these spiro-cyclic clusters, calculations at the Hartree-Fock level, density functional theory using B3LYP parametrization and second order Møller-Plesset perturbation theory using 6-31G∗ and 6-311++G∗∗ basis sets show that they are stable in their own right. Vibrational frequency calculations and atoms-inmolecules analysis of the electron density map confirm the robustness of these hydrogen bonded clusters