Clinical and laboratory profile of patients with amoebic liver abscess

Context

Amebic liver abscess (ALA) occurs in 3%-9% of the amebiasis cases, with complications seen in 20%-40% of the cases and 2%-18% mortality rate. Successful treatment thus requires the accurate identification of these cases.

Aims and Objectives

We aimed to assess the seropositivity and profile of ALA patients in western Rajasthan.

Materials and Methods

This retrospective study was conducted at a tertiary care center in western Rajasthan from November 2017 to May 2019. Serological diagnosis of ALA was done by detecting immunoglobulin G (IgG) antibodies in the serum of the patients by ELISA. The derangements in laboratory profile (hematological and biochemical parameters) and ultrasonography findings were assessed from the hospital records. Statistical analysis was performed using Mann-Whitney U-test.

Results

Among the total cases (n = 34), 20 were diagnosed as ALA. Twenty-one (61.8%) were positive for anti-amebic IgG antibodies. Among ALA patients, 14 (70%) were >40 years old and only 6 (30%) patients were of age ≤40 years. Male: female ratio was 5.7:1, and ultrasonography records of 15 ALA patients revealed the presence of hepatomegaly (n = 7, 46.7%), pleural effusion (n = 3, 20%), lung collapse (n = 2, 13.3%), and vascular involvement (n = 1, 6.7%). The right lobe of the liver was involved in majority of the patients (n = 12, 80%). Total white blood cell count (P < 0.001), absolute neutrophil count (P = 0.001), total serum bilirubin (P = 0.019), and serum alkaline phosphatase (P = 0.018) were significantly elevated in ALA patients.

Conclusions

Seroprevalence shows that ALA still remains the dominant etiology in liver abscess patients in this region. There are significant derangements in the laboratory profile that require a larger study for corroboration.

Thrombocytopenia in malaria patients from an arid region of Western Rajasthan (India)

Context

The arid climate of Western Rajasthan is challenging for malaria transmission, with the number of cases correlating directly with the annual rainfall pattern. Moreover, >90% of the cases in this region are caused by Plasmodium vivax, which has recently been shown to cause a similar degree of thrombocytopenia as Plasmodium falciparum.

Aims and Objectives

The aim of the study was to determine the degree of thrombocytopenia in malaria patients and its association with different species of malaria in this region with an unstable malaria epidemiology.

Materials and Methods

This retrospective study was conducted on all microbiologically confirmed malaria patients with documented platelet counts from August 2017 to October 2018. Microbiological diagnosis was established by rapid diagnostic tests and peripheral blood film examination. Platelet counts were used to assess the degree of thrombocytopenia.

Results

A total of 130 cases were included in the study, of which 118 (91%) were caused by P. vivax, while the rest 12 (9%) were caused by P. falciparum. Thrombocytopenia was present in 108 (83%) cases, and the mean values of platelets in thrombocytopenic patients with P. vivax and P. falciparum infection were 72600/μL and 48500/μL, respectively. Although P. falciparum infection was significantly associated with severe thrombocytopenia (odds ratio: 4.7, [95% confidence interval 1.3-16.1]), extremely low platelet counts (n = 5) warranting platelet transfusions (n = 1) were seen only in P. vivax cases. Only one patient required platelet transfusions in these patients suggesting good tolerance to thrombocytopenia.

Conclusions

Avoiding unnecessary transfusions in febrile thrombocytopenic patients with an established malaria diagnosis can help in reducing transfusion-transmitted infections.

First-principles study of electronic structure and fermiology of covellite mineral and its B1, B3 phases

We present the first-principles calculations under the framework of density functional theory to explore the Fermi surface and electronic properties of covellite mineral. The correlation effects are considered applying the +U correction in the density functional theory. Lattice parameters are determined and the possibility of pressure induced phase transitions to the hypothetical B1 and B3 crystals is examined. All calculations show impending B18 → B1 and B3 → B1 phase transitions. Using generalized gradient approximation these are found to occur at 7.4 and 6.48 GPa, respectively. Electronic bands structures of the three crystals highlight metallic properties. Two copper atoms situated at distinct locations in covellite exhibit a distinct role. The Fermi surfaces of all phases are presented. The calculations of B18 map out corrugated cylindrical Fermi surface signifying inter-layer interaction mediated by the S(II)-S(II) bond. The +U correction shows anisotropy in the Fermi surface noted in experiment. It also indicates stronger inter-layer interaction. Applying Debye-Slater and the Debye-Grüneisen models the thermal expansion coefficient, heat capacity and entropy are found and their temperature dependence is discussed.

Changing trend in bacterial etiology and antibiotic resistance in sepsis of intramural neonates at a tertiary care hospital

Background:

Septicemia is an important cause of neonatal morbidity and mortality. However, organized data on causative organisms and their resistant pattern are scanty from developing countries. The changing trend in causative organisms and their antibiotic resistance is yet to be documented in India. The present study examines the trends in bacterial profile and antibiotic resistance of the organisms causing sepsis in hospitalized neonates.

Materials and Methods:

A retrospective laboratory-based analysis of blood cultures obtained from Neonatal Intensive Care Unit of a tertiary care hospital in New Delhi was done for the period of 1999–2014, divided into five phases.

Results:

A total of 4700 isolates were considered. Over time, Gram-negative organisms have replaced Gram-positives as frequent isolates. Initially, there was predominance of Klebsiella pneumoniae, then of Staphylococcus aureus which recently has been changed with coagulase negative-Staphylococcus and Acinetobacter. Growing resistance against the first and second line of drugs has been noted, including methicillin-resistant S. aureus and vancomycin-resistant Enterococcus.

Conclusion:

The etiological profile of neonatal sepsis has changed tremendously in the past 15 years. High resistance against common drugs necessitates continued surveillance and review of empirical antibiotic policy for neonatal sepsis. These steps are important to effectively curtail the surge of further antibiotic resistance.

Thermoelectric and vibrational properties of Be2C, BeMgC and Mg2C using first-principles method

Transport coefficients are calculated combining first-principles calculations with the Boltzmann transport theory. Electronic states obtained in terms of the k-space eigen-energies from the crystalline orbital program, based on density functional theory, are Fourier transformed and interfaced with the transport equations modeled in the BoltzTraP. The calculations are performed for Be₂C, Mg₂C, and the BeMgC mixed crystal. The Seebeck coefficient, electronic thermal conductivity and the power factor are calculated. Further, the transport coefficients are linked to find the electronic fitness function to compare the performance with other thermoelectric materials. The procedure can also be applied to study the thermoelectric properties of other materials. The vibrational frequencies at the Brillouin zone centre are calculated generating a Hessian matrix from the analytical gradients of the energy with respect to atomic coordinates in the three antifluorite crystals. Moreover, the static, high frequency dielectric constants and Born effective charges are calculated to find splitting in the longitudinal optic and transverse optic modes. Results are compared with the data wherever available in the literature and a very good agreement is found in most cases.

The EFF of Mg₂C. A very good thermoelectric has the EFF above the horizontal lines marked at 300 and 800 K.

Electron Localization Function and Compton Profiles of Cu2O

The nature of bonding in the cubic cuprous oxide is studied by means of the theoretical tools, namely, the electron localization function and Compton profiles. The isotropic Compton profiles together with the anisotropies in the directional Compton profiles are presented. Taking free-atom Compton profiles, the charge-transfer model is also applied. The first-principles calculations based on the GGA are performed, and the self-interaction correction is incorporated, adopting the GGA+U approach. Both types of calculations are performed deploying the linearized augmented plane-wave (LAPW) method. The effect of self-interaction correction on the electron localization function, Compton profiles, and anisotropies is discussed. The electron localization function reveals ionic behavior in the (110) plane and covalent nature in the Cu-O bond intersecting plane. The GGA+U exhibits more covalent nature. The two LAPW calculations of the Compton profiles show better agreement with the available experimental data than the free-atom profiles. Among all of the calculations undertaken, the GGA+U shows the best agreement with the experiment. The GGA+U calculation shows more anisotropic behavior in directional Compton profiles.

Smoking and tuberculosis: an association overlooked

OBJECTIVES

This article discusses the role of smoking as a risk factor for tuberculosis. A review of the evidence that has been documented is presented.

DATA SOURCES

Relevant articles in the medical literature derived from searching the Medline database (1966 to present) with key terms 'smoking' and 'tuberculosis'. The bibliographies of all papers thus located were searched for further relevant articles.

RESULTS

On searching the database, a total of 12 studies were found. A search of the bibliographies yielded four more articles. Sixteen studies published between 1956 to the present were included in this review. The evidence suggests that smoking could be considered as an important risk factor for the development of tuberculosis. Not only does active smoking appear to heighten the chances of contracting pulmonary tuberculosis, smokers also seem to be at an increased risk for extrapulmonary tuberculosis. Exposure to environmental tobacco smoke in children seems to enhance the hazards of acquiring tuberculosis. Increased tuberculin reactivity, in a dose-dependent manner, was recorded in smokers as compared to non-smokers.

CONCLUSIONS

Although an association between smoking and tuberculosis appears evident, prospective studies would help to confirm the evidence and to highlight this noxious association. Nevertheless, smoking should be considered as an important risk factor for tuberculosis.