SETTING: Intracranial tuberculomas are commonly observed neuroimaging abnormalities in tuberculous meningitis (TBM).OBJECTIVE: To evaluate the predictors and prognostic significance of tuberculomas ...in patients with TBM.DESIGN: In a retrospective follow-up study, contrast-enhanced
magnetic resonance imaging was performed at study inclusion and after 9 months of follow-up. Univariate analysis and multivariate analysis were used to identify predictive factors for tuberculoma. Prognosis (death and severe disability) was assessed using the modified Rankin scale.RESULTS:
At inclusion, 43 of 110 patients had cerebral tuberculomas. Seven patients developed paradoxical tuberculomas. Predictors of tuberculomas were raised cerebrospinal fluid (CSF) protein (>3 g/l) and meningeal enhancement. Multivariate analysis did not show any significant predictors. During
follow-up, the only significant predictor of paradoxical development of tuberculomas was raised CSF protein (>3 g/l). After 9 months of follow-up, 32 patients had died or had severe disability. Survival analysis revealed that patients with tuberculomas and those without tuberculomas had
a similar prognosis.CONCLUSION: Tuberculomas occurred in approximately 39% of the patients with TBM. Significant predictors were meningeal enhancement and raised CSF protein. TBM patients with or without tuberculomas had a similar prognosis.
Abstract
The Tokamak plasma start-up is the first process to have a successful Tokamak plasma discharge. Considering the start-up condition, high electric field and neutral density with the absence ...of flux surfaces an enhanced electron transport to the Plasma-Facing Components (PFC) or the inner vessel wall is expected. Such electron excursion under an applied electric field induces electromagnetic emission, especially in the x-ray region. Such emission is important as it gives vital information about the initial condition of the plasma start-up and the potential for energy loss to the PFC/vessel walls. A Silicon Drift Detector (SDD) based soft x-ray (SX) spectrometer is installed at the ADITYA-U tokamak, operating within the range of 1–30 keV generating a 4 K channel spectrum. The energy calibration, spectra transformation from channel space to the energy space, is a pre-requisite for any spectroscopic measurement. The calibration is performed by natural radioactive sources
241
Am,
109
Cd,
133
Ba, and
55
Fe having micro-curie strength. Two-point and multipoint calibrations are applied to the SDD spectra. The results from the two processes establish that the multipoint calibration works well for the identification of the photon energy due to the realization of the detector linearity for a wider band.
Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome caused by macrophages and cytotoxic T cells with aberrant activation. The primary (genetic) form, which is caused by mutations ...that affect lymphocyte cytotoxicity and immune regulation, is most prevalent in children, whereas the secondary (acquired) form is prevalent in adults. Secondary HLH is commonly caused by infections or cancers, but it can also be caused by autoimmune disorders, in which case it is known as macrophage activation syndrome (MAS; or MAS-HLH). A 25-year-old female presented with a high-grade fever that lasted for two weeks. His laboratory results revealed pancytopenia, neutropenia, hypertriglyceridemia, hypofibrinogenemia, and hyperferritinemia. Based on the clinical presentation and laboratory findings, a provisional diagnosis of HLH has been made. A HLH protocol was utilized to treat the patient. During the course of hospitalization, systemic lupus erythematosus (SLE) was identified as the underlying cause. She improved dramatically after receiving an immunosuppressive regimen of etoposide, cyclosporine, and dexamethasone according to HLH protocol-2004 with individualized modifications. The clinician should be aware that HLH may be the initial manifestation of underlying SLE. Early diagnosis and aggressive, individualized treatment are the key to improving outcomes.
Fasting has a long tradition in most cultures and has many health benefits. Most of the studies are from daytime fasting or intermittent fasting. There is paucity of data from complete fasting (no ...food and fruits, water only). This prospective study is conducted with aims to study impact of complete fasting on clinical and biochemical parameters.
One hundred ten participants of either gender who voluntarily fasted (3-30 days) were included and underwent clinical and biochemical examination before and after fasting.
A total of 110 healthy volunteers (M: 27, F: 83) with mean age 51 ± 16 years (range 18-86) and body mass index 27.1 ± 4.9 kg/m
(16.1-45.2) were studied. They had undergone fast for varying duration between 3-30 days (short fast: 3-7 days = 72; prolong fast: >7 days = 38). There were significant decrease in weight (66.8 ± 11.0 to 64.7 ± 11.1 kg,
< 0.0001), BMI (27.1 ± 4.9 to 26.2 ± 4.9 kg/m
,
< 0.0001), systolic blood pressure (130 ± 17 to 128 ± 15 mmHg,
= 0.012), serum globulin (3.10 ± 0.42 to 3.01 ± 0.41 mg/dl,
= 0.024), and serum high density lipoprotein (48.3 ± 12.2 to 45.7 ± 12.6 mg/dl,
< 0.0001) post fasting. However, significant increase was observed in pulse rate (81 ± 10 to 83 ± 11 beat/min,
= 0.001), fasting plasma glucose (102.9 ± 35.0 to 132.0 ± 42.0 mg/dl,
< 0.0001), serum triglycerides (137.6 ± 68.3 to 149.0 ± 67.1 mg/dl,
= 0.031), very low density lipoprotein (22.0 ± 10.5 to 24.2 ± 11.1 mg/dl,
= 0.010), and serum cortisol levels (13.5 ± 5.9 to 17.2 ± 6.3 μg/dl,
< 0.0001). These changes were more pronounced with prolong fasting, but were not affected by gender.
Fasting results in improvement in anthropometric, physical and biochemical parameters related to physical health. It can be recommended as a mean for improving quality of life.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
We report the first two proven cases of cavitary pulmonary zygomycosis caused by Rhizopus homothallicus. The diagnosis in each case was based on histology, culture of the causal agent, and the ...nucleotide sequence of the D1/D2 region of the 28S ribosomal DNA.
The objective of this paper was to determine the optimum process parameters of an electric discharge machine while machining a new hybrid aluminum metal matrix composite. In this study, a new hybrid ...aluminum metal matrix composite was prepared, with silicon carbide and graphite particles used as reinforcements, with the help of the stir casting method. The selected electric discharge machining parameters in this study were peak current (I), voltage (V), pulse-on time (Ton), and tool material, while the response parameters were material removal rate and surface roughness. To machine the fabricated samples, two different types of tool materials (copper and brass) were used as electric discharge machine electrodes, and each had a diameter (Ø) of 12.0 mm. The optimal settings of the electric discharge machining parameters were determined through experiments planned, conducted, and analyzed using the Taguchi (L18) technique. An analysis of variance and confirmatory tests were used to check the contribution of each machining parameter. It was found that the material removal rate increased with the increase in pulse-on time and pulse current, whereas the material removal rate decreased with the increase in voltage. On the other hand, reduced surface roughness could only be achieved when current, voltage, and pulse duration were low. It was also found that the selected electric discharge machining electrodes had a significant effect on both the material removal rate and the surface roughness.
Objectives
The current COVID-19 pandemic has created a huge impact across the globe. Recent literature has reported the occurrence of varied oral lesions in COVID-19 patients in the form of sporadic ...case reports. This analytical cross-sectional study was carried out to gauge and understand the pattern of oral lesions in qualitative RT-PCR-confirmed COVID-19 patients.
Methods
A cross-sectional study involves a total of 500 qualitative RT-PCR confirmed, hospitalized COVID-19 patients who were meticulously scanned for any hard and soft tissue lesions developing concomitantly with the disease occurrence.
Results
This study included a total of 367 (73.4%) males and 133 (26.6%) female patients with a mean age of 53.46 ± 17.50 years. Almost 51.2% of patients presented with gustatory disturbance, 28% with xerostomia and 15.4% of patients were found to have oral findings like erythema, ulcers, depapillation of tongue. There was a statistically significant correlation between oral manifestations and disease severity (
p
≤ 0.001).
Conclusion
COVID-19 is found to effect oral health with greater probability in patients with severe diseases (SARI) which may be due to disease itself, immune response and lack of motivation for personal hygiene measures.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Objectives
Computed tomography (CT) pulmonary angiography is widely used in patients with suspected pulmonary hypertension (PH). However, the diagnostic and prognostic significance remains unclear. ...The aim of this study was to (a) build a diagnostic CT model and (b) test its prognostic significance.
Methods
Consecutive patients with suspected PH undergoing routine CT pulmonary angiography and right heart catheterisation (RHC) were identified. Axial and reconstructed images were used to derive CT metrics. Multivariate regression analysis was performed in the derivation cohort to identify a diagnostic CT model to predict mPAP ≥ 25 mmHg (the existing ESC guideline definition of PH) and > 20 mmHg (the new threshold proposed at the 6th World Symposium on PH). In the validation cohort, sensitivity, specificity and compromise CT thresholds were identified with receiver operating characteristic (ROC) analysis. The prognostic value of the CT model was assessed using Kaplan-Meier analysis.
Results
Between 2012 and 2016, 491 patients were identified. In the derivation cohort (
n
= 247), a CT model was identified including pulmonary artery diameter, right ventricular outflow tract thickness, septal angle and left ventricular area. In the validation cohort (
n
= 244), the model was diagnostic, with an area under the ROC curve of 0.94/0.91 for mPAP ≥ 25/> 20 mmHg respectively. In the validation cohort, 93 patients died; mean follow-up was 42 months. The diagnostic thresholds for the CT model were prognostic, log rank, all
p
< 0.01.
Discussion
In suspected PH, a diagnostic CT model had diagnostic and prognostic utility.
Key Points
•
Diagnostic CT models have high diagnostic accuracy in a tertiary referral population of with suspected PH.
•
Diagnostic CT models stratify patients by mortality in suspected PH.
Objective
There is controversy about the relation of thyroid functions and body mass index. The present study was aimed to assess the relationship between thyroid function and body mass index in ...Indian school children.
Design
Population survey.
Patients
Data were collected from 25 schools in 19 cities across five different geographical zones of India. Children, who consented, were evaluated for anthropometry and blood tests. Children were categorized as overweight and obese based on standard BMI criteria.
Measurements
Serum samples were analysed for free T3, free T4, TSH and anti‐TPO antibodies.
Results
A total of 13 691 children in the age group of 5–18 years formed the study population. The mean age and mean BMI were 11·9 ± 3·0 years and 18·48 ± 3·89 kg/m2 respectively. Among these, 2119 (15·5%) children were overweight and 536 (3·9%) were obese. Subclinical hypothyroidism was present in 943 (6·9%) children.FT3 and TSH levels increased and FT4 levels decreased with increasing BMI in euthyroid boys and girls. Prevalence of SCH was significantly higher in obese/overweight children (9·0%, vs 6·5%; P = 0·034) as compared with normal BMI children.
Conclusions
Serum FT3 and TSH were positively while FT4 was negatively associated with BMI in apparently healthy euthyroid children.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
PDF
