Accuracy of Intraocular lens power calculation in pediatric traumatic cataract

PURPOSE

To evaluate the prediction error (PE) in pediatric traumatic cataract surgery involving primary or secondary intraocular lens implantation (IOL) and the factors affecting it.

METHODS

Retrospective data of unilateral traumatic cataract eyes of children aged ≤16 years were collected between February 2019 and March 2022 at a tertiary eye care hospital. Absolute PE was calculated by deducting the target refraction from the observed refraction at 6 weeks postsurgery following suture removal. Simulated PE was calculated in eyes with corneal scar replacing the affected eye keratometry (K) with the K of the fellow eye and standard K (44D) and was then compared with absolute PE.

RESULTS

Fifty children with a mean age of 9.5 years (2-16 years) were included. Mean absolute PE was 1.63 ± 1.8D (0 to 9D). Absolute PE was not affected by the age at surgery, method of biometry, duration of injury, type of cataract surgery, position of IOL, and preoperative keratometry. The absolute PE was affected by axial length (AXL) being <1.5D in AXL of 22.73 ± 0.84 mm, <1.5-2D in AXL of 22.07 ± 0.61 mm, and >2D in AXL of 22.01 ± 0.74 mm (P = 0.039) in univariate analysis. In multivariate analysis, none of the factors affected the absolute PE. In 34 eyes with corneal scar, higher variability in PE was observed. The standard K resulted in greater simulated PE as compared to the affected eye average K in eyes with scar involving the visual axis.

CONCLUSION

Absolute PE following pediatric traumatic cataract was studied. It was higher in shorter AXLs. In corneal scar involving the visual axis, using the fellow eye K yielded lesser simulated PE as compared to standard K.

Remarkably High Separation of Neodymium from Praseodymium by Selective Dissolution from their Oxide Mixture using an Ionic Liquid Containing aβ-Diketone

A simple, efficient, direct and economical method for the mutual separation of Nd and Pr was developed by the selective dissolution of Nd2O3 from their oxide mixtures in an ionic liquid containing 2-thenoyltrifluoroacetone (HTTA) resulting in an unprecedented separation factor (βNd/Pr)>500, which is 277 times more than the thus far reported βNd/Pr values. The proposed mechanism was supported by DFT computations.

In-Situ-Generated Fluoride-Assisted Rapid Dissolution of Uranium Oxides by Ionic Liquids

A quantitative, rapid, endothermic dissolution of U3O8 in C4mim·PF6 (1-alkyl-3-methyl imidazolium hexafluorophosphate) has been achieved within 2 h at 65 °C by in situ generated fluoride ions by pre-equilibrating the ionic liquid with suitable concentrations of nitric acid. The efficiency of the dissolution followed the trend: UO3 > UO2 > U3O8. The fluoride generation was found to increase with the concentration of nitric acid being equilibrated, the water content of the ionic liquid, and also the time of equilibration. The rate of dissolution of U3O8 followed the trend: C4mim·PF6> C6mim·PF6 > C8mim·PF6. The maximum loading observed for the present case was 200 mg mL-1 which is considered to be quite high with an ionic liquid. The effects of different acid pre-equilibration (HClO4, HCl) on F- generation and subsequent dissolution characteristics have also been investigated. The in situ F- generation, as well as U3O8 dissolution, were found to predominantly follow a pseudo-second-order rate kinetics, while the rate constants for U3O8 dissolution were found to be higher than that of F- generation. The dissolved uranium was successfully electrodeposited on a Cu plate, as confirmed by EDXRF, while the formation of UO2 was revealed from the XRD pattern of the deposit.

Experimental and Theoretical Insight into the Ionic Liquid-Mediated Complexation of Trivalent Lanthanides with β-Diketone and Its Fluorinated Analogue

A multitechnique approach with theoretical insights has been employed to understand the complexation of trivalent lanthanides with two β-diketones, viz. 1-phenyl-1,3-butanedione (L1) and 4,4,4-trifluoro-1-phenyl-1,3-butanedione (L2), in an ionic liquid (C6mim·NTf2). UV-vis spectral analysis of complexation using Nd3+ revealed the predominance of ML2+ and ML4- species. The stability constants for the PB complexes were higher (β2 ∼ 10.45 ± 0.05, β4 ∼ 15.51 ± 0.05) than those for the TPB (β2 ∼ 7.56 ± 0.05, β4 ∼ 13.19 ± 0.06). The photoluminescence titration using Eu3+ corroborated the same observations with slightly higher stability constants, probably due to the higher ionic potential of Eu3+. The more asymmetric (AL2ML4 ∼ 5.2) Eu-L2 complex was found to contain one water molecule in the primary coordination sphere of Eu3+ with more covalency of the Eu3+-O bond (Ω2L1 = 8.5 × 10-20, Ω4L1 = 1.3 × 10-20) compared to the less asymmetric Eu-L1 complex (AL1ML4 ∼ 3.5) with two water molecules having less Eu-O covalency (Judd-Offelt parameters: Ω2L1 = 7.3 × 10-20, Ω4L1 = 1.0 × 10-20). Liquid-liquid extraction studies involving Nd3+ and Eu3+ revealed the formation of the ML4- complex following an 'anion exchange' mechanism. The shift of the enol peak from 1176 to 1138 cm-1 on the complexation of the β-diketones with Eu3+ was confirmed from the FTIR spectra. 1H NMR titration of the β-diketones with La(NTf2)3 evidenced the participation of α-H of the β-diketones and protons at C2, C4, and C5 positions of the methylimidazolium ring. For the ML2 complex, 4 donor O atoms are suggested to coordinate to the trivalent lanthanides with bond distances of 2.3297-2.411 Å for La-O, 2.206-2.236 Å for Eu-O, and 2.217-2.268 Å for Nd-O, respectively, while for the ML4 complex, 8 donor O atoms were coordinated with bond lengths of 2.506-2.559 Å for La-O, 2.367-2.447 Å for Eu-O, and 2.408-2.476 Å for Nd-O. The Nd3+ ion was higher by 9.7 kcal·mol-1 than that of the La3+ ion for the 1:4 complex. The complexation energy with L1 was quite higher than that with L2 for both 1:2 and 1:4 complexes. Using cyclic voltammetry, the redox behavior of trivalent lanthanides Eu and Gd with β-diketonate in ionic liquid medium was probed and their redox energetic and kinetic parameters were determined.

An 85-Year-Old Man with Fever, Dyspnea, and Dry Cough Diagnosed with Idiopathic Hypereosinophilic Syndrome, Successfully Treated with High-Dose Corticosteroids

BACKGROUND Idiopathic hypereosinophilic syndrome (I-HES) is a rare disease diagnosed as absolute eosinophil count >1500 cells/µl and end-organ involvement attributable to tissue eosinophilia with no secondary cause of underlying eosinophilia. The mean age of presentation for I-HES is 44 years. The skin, lungs, and gastrointestinal (GI) system are most common sites of presenting manifestations, including fatigue, cough, dyspnea, myalgias, angioedema, rash, fever, nausea, and diarrhea. Although cardiac and neurologic symptoms are less common at presentation, they can be life-threatening. CASE REPORT We report the case of an 85-year-old man who presented with fever, malaise, and loss of appetite for 3 weeks, followed by dyspnea and dry cough for 2 weeks. His absolute eosinophil count was 9000 cells/µl, which was not responding to empirical antibiotic therapy, with worsening of symptoms, suggesting a non-infective origin. He was then extensively evaluated to establish underlying an etiology for specific treatment, which was negative for common causes like atypical infections, malignancy, and autoimmune disorders. He was then started on corticosteroid therapy to overcome an exaggerated immune response and reduce inflammation-related injury, to which he responded well. On follow-up, hypereosinophilia was fully cured, with reversal of end-organ involvement including myocarditis and pneumonitis. CONCLUSIONS This report shows that idiopathic HES can present with various clinical features and that accurate diagnosis, excluding known causes of eosinophilia, and early management are essential to prevent long-term organ damage. Our patient responded to prompt treatment with high-dose corticosteroids.

Reprogramming of glucose metabolism in virus infected cells

Viral infection is a kind of cellular stress that leads to the changes in cellular metabolism. Many metabolic pathways in a host cell such as glycolysis, amino acid and nucleotide synthesis are altered following virus infection. Both oncogenic and non-oncogenic viruses depend on host cell glycolysis for their survival and pathogenesis. Recent studies have shown that the rate of glycolysis plays an important role in oncolysis as well by oncolytic therapeutic viruses. During infection, viral proteins interact with various cellular glycolytic enzymes, and this interaction enhances the catalytic framework of the enzymes subsequently the glycolytic rate of the cell. Increased activity of glycolytic enzymes following their interaction with viral proteins is vital for replication and to counteract the inhibition of glycolysis caused by immune response. In this review, the importance of host cell glycolysis and the modulation of glycolysis by various viruses such as oncogenic, non-oncogenic and oncolytic viruses are presented.

Evaluation of a Phosphinate Functionalized Ionic Liquid for the Separation of Nb and Ta from Nitric Acid Feed Conditions

A 'green' single-step separation process, involving a phosphonium phosphinate functionalized ionic liquid (FIL) in C8mim·NTf2, has been developed for highly encouraging improvements in the mutual separation of Nb and Ta with a maximum separation factor of ∼48 at 2 M nitric acid. The separation factor in C4mim·NTf2 was found to be somewhat lower compared to that seen in C8mim·NTf2. In C8mim·NTf2, the extraction proceeded via the neutral NbOF3(R4P+)(R2POO-) and TaOF3(R4P+)(R2POO-) species predominated by a 'solvation' mechanism at 2 M HNO3, where both the cationic and anionic parts of the FIL took part in the metal ion extraction. However, in the case of C4mim·NTf2, the extraction proceeded via a cation exchange mechanism involving the mono-positive species viz. [NbO(R2POO-)2]+IL, [TaO(R2POO-)2]+IL. Only the phosphinate group of the FIL was directly involved in the binding to the metal ion. The charge neutrality was maintained by the exchange of the C4mim+ ion from the ionic liquid phase to the aqueous phase. The processes were spontaneous, exothermic involving outer sphere complexation. The radiolytic stabilities of the C8mim·NTf2-based solvent systems were poorer than those of the solvents based on C4mim·NTf2. Aqueous solutions of EDTA-guanidine carbonate or DTPA-guanidine carbonate showed promising back extraction ability though three contacts of these organic phases were required for more than 99.99% stripping of the metal ion. The reusability of these solvent systems was evaluated. After four consecutive cycles, a maximum of only 8% reduction in the extraction efficiency of Ta was noticed, while for Nb it was less than 4% for Nb.

A structure and knowledge-based combinatorial approach to engineering universal scFv antibodies against influenza M2 protein

BACKGROUND

The influenza virus enters the host via hemagglutinin protein binding to cell surface sialic acid. Receptor-mediated endocytosis is followed by viral nucleocapsid uncoating for replication aided by the transmembrane viral M2 proton ion channel. M2 ectodomain (M2e) is a potential universal candidate for monoclonal antibody therapy owing to its conserved nature across influenza virus subtypes and its importance in viral propagation.

METHODS

The phage-displayed naive human antibody libraries were screened against the short stretch of the N-terminal 10-mer peptide (SLLTEVETPI) of the M2e. ELISA, BLI, and flow cytometry assays were used to examine scFv binding to M2e epitopes. The scFv crystal structures were determined to examine the nature of the interactions. The potencies of the scFvs against the influenza virus were demonstrated by real-time PCR and confocal microscopy imaging.

RESULTS

The four unique scFv clones were obtained from the scFv phage-display antibody libraries and shown to exhibit binding with the 10-mer conserved part of the M2e and with full-length M2 protein expressed on the HEK293T cells. The crystal structure of scFv AU1 with M2e peptide showed the peptide as a dimer in the parallel beta-sheet conformation bound at the interface of two scFv CDRs. The scFv AU1 significantly restricted the release of H1N1 virus progeny from the infected A549 cells.

CONCLUSION

This structural and biochemical study showcased the binding of antibody scFv molecules with M2e peptide dimer, providing the structural insights for the function effect in terms of recognizing and restricting the release of new viral particles from an infected host cell.

Risk factors and predictors of violence: insights from the emergency department at a level 1 trauma center in the USA

BACKGROUND

This study aimed to assess the risk factors and predictors of violence among patients admitted to a Level 1 trauma center in a single institution.

METHODS

We conducted a retrospective analysis of patients who were admitted with a history of violence between 2012 and 2016.

RESULTS

A total of 9855 trauma patients were admitted, of whom 746 (7.6%) had a history of violence prior to the index admission. Patients who had history of violence were younger and more likely to be males, Black, Hispanic and covered by low-income primary payer in comparison to non-assault trauma patients (P < 0.001 for all). Multivariate logistic regression analysis showed that covariate-adjusted predictors of violence were being Black, male having low-income primary payer, Asian, drug user, alcohol intoxicated and smoker.

CONCLUSIONS

Violence is a major problem among young age subjects with certain demographic, social and ethnic characteristics. Trauma centers should establish violence injury prevention programs for youth and diverse communities.

Modified Nishida's procedure in a case of medial rectus hypoplasia

Introduction: We report a case of large angle exotropia in a child with limitation of adduction in the left eye with a radiological finding of hypoplastic medial rectus. Methods: A 3- year- old male child presented with left eye large angle exotropia, left face turn, -4 adduction limitation and severe amblyopia. Orbital imaging revealed hypoplasia of the medial rectus and intraoperatively a thin medial rectus was noted. The surgical procedure planned was lateral rectus recession combined with Modified Nishida's technique in the left eye. In this technique the superior and inferior recti were transposed medially by inserting non-absorbable sutures in the sclera posteriorly, closer to the upper and lower borders of the medial rectus muscle. Result: There was improvement in adduction of left eye and reduction of original deviation following maximal lateral rectus recession and a modified Nishida's approach. The early and optimal correction of exotropia also improved the compliance to patching with subsequent gain in visual acuity of the amblyopic eye. Conclusion: Modified Nishida's technique has the advantage of no muscle splitting and no tenotomy, remains a less invasive surgical procedure to correct large deviations. The modification of placing the bellies closer to medial rectus augments the effect and further improves adduction in cases with severe limitation of adduction. This technique can thus be considered as a possible surgical approach in young children with large angle exotropia due to hypoplastic medial rectus.

Olfactory and taste dysfunction in coronavirus disease 2019 patients: its prevalence and outcomes

OBJECTIVES

To evaluate the occurrence, clinical course and outcomes of olfactory and gustatory dysfunction in patients with laboratory confirmed coronavirus disease 2019 infection.

METHODS

This is a prospective cross-sectional study of patients diagnosed with coronavirus disease 2019 infection by reverse transcription polymerase chain reaction over two months. The epidemiological and clinical outcomes studied were: age, sex, general symptoms, and olfactory and taste dysfunction.

RESULTS

A total of 410 coronavirus disease 2019 infected patients were included in the study, with 262 males (63.9 per cent) and 148 females (36.1 per cent). Ninety-nine patients (24.1 per cent) reported chemosensory dysfunction, of which 85 patients (20.7 per cent) reported both olfactory and taste dysfunction. Olfactory and taste dysfunction were proportionally more common in females. The mean duration of olfactory and taste dysfunction was 4.9 days, with a range of 2-15 days.

CONCLUSION

Olfactory and taste dysfunction are prevalent symptoms in coronavirus disease 2019 patients. In this study, they were more common in females than males. The occurrence of such dysfunctions is lower in the Indian population than in the European population.

Beta-blockers are associated with incident heart failure: a secondary analysis of the systolic blood pressure intervention (SPRINT) trial

Background

The Systolic Blood Pressure Intervention Trial (SPRINT) evaluated whether a blood pressure (BP) goal of less than 120mmHg versus less than 140mmHg would reduce cardiovascular outcomes in subjects with at least one cardiovascular risk factor and without heart failure. Participating investigators were encouraged to use any antihypertensive medication class with a strong evidence base. The SPRINT trial was halted early due to a lower rate of the composite primary outcome in the 120mmHg group, which was mainly driven by a reduction in heart failure (HF).

Objective

As there is a concern that beta-blocker use may be associated with an excess risk for incident HF in subjects with a normal left ventricular systolic function, we evaluated the association between beta-blocker use and HF. Beta-blockers were compared with other major classes of antihypertensive medications. We also studied the association of antihypertensive class with loop-diuretic initiation.

Methods and results

In the 9,012 subjects, without HF at baseline, the association of beta-blocker exposure and incident HF was examined using time-variant competing risk analysis. Beta-blocker exposure was associated with an increased HF risk (HR 1.18; CI 1.07–1.30; p&lt;0.001) and more frequent and earlier loop diuretic-use compared to other antihypertensive agents (both p&lt;0.01). Sensitivity analyses of propensity-score matched cohorts confirmed a strong association of beta-blocker use and HF. Other major antihypertensive medication classes did not show this association.

Conclusions

Beta-blocker exposure was associated with a higher incidence of HF in hypertensive subjects without HF at baseline.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health

Brain Imaging of Patients with COVID-19: Findings at an Academic Institution during the Height of the Outbreak in New York City

BACKGROUND AND PURPOSE

A large spectrum of neurologic disease has been reported in patients with coronavirus disease 2019 (COVID-19) infection. Our aim was to investigate the yield of neuroimaging in patients with COVID-19 undergoing CT or MR imaging of the brain and to describe associated imaging findings.

MATERIALS AND METHODS

We performed a retrospective cohort study involving 2054 patients with laboratory-confirmed COVID-19 presenting to 2 hospitals in New York City between March 4 and May 9, 2020, of whom 278 (14%) underwent either CT or MR imaging of the brain. All images initially received a formal interpretation from a neuroradiologist within the institution and were subsequently reviewed by 2 neuroradiologists in consensus, with disputes resolved by a third neuroradiologist.

RESULTS

The median age of these patients was 64 years (interquartile range, 50-75 years), and 43% were women. Among imaged patients, 58 (21%) demonstrated acute or subacute neuroimaging findings, the most common including cerebral infarctions (11%), parenchymal hematomas (3.6%), and posterior reversible encephalopathy syndrome (1.1%). Among the 51 patients with MR imaging examinations, 26 (51%) demonstrated acute or subacute findings; notable findings included 6 cases of cranial nerve abnormalities (including 4 patients with olfactory bulb abnormalities) and 3 patients with a microhemorrhage pattern compatible with critical illness-associated microbleeds.

CONCLUSIONS

Our experience confirms the wide range of neurologic imaging findings in patients with COVID-19 and suggests the need for further studies to optimize management for these patients.

Focal Loss for Dense Object Detection

The highest accuracy object detectors to date are based on a two-stage approach popularized by R-CNN, where a classifier is applied to a sparse set of candidate object locations. In contrast, one-stage detectors that are applied over a regular, dense sampling of possible object locations have the potential to be faster and simpler, but have trailed the accuracy of two-stage detectors thus far. In this paper, we investigate why this is the case. We discover that the extreme foreground-background class imbalance encountered during training of dense detectors is the central cause. We propose to address this class imbalance by reshaping the standard cross entropy loss such that it down-weights the loss assigned to well-classified examples. Our novel Focal Loss focuses training on a sparse set of hard examples and prevents the vast number of easy negatives from overwhelming the detector during training. To evaluate the effectiveness of our loss, we design and train a simple dense detector we call RetinaNet. Our results show that when trained with the focal loss, RetinaNet is able to match the speed of previous one-stage detectors while surpassing the accuracy of all existing state-of-the-art two-stage detectors. Code is at: https://github.com/facebookresearch/Detectron.

Focal Loss for Dense Object Detection

The highest accuracy object detectors to date are based on a two-stage approach popularized by R-CNN, where a classifier is applied to a sparse set of candidate object locations. In contrast, one-stage detectors that are applied over a regular, dense sampling of possible object locations have the potential to be faster and simpler, but have trailed the accuracy of two-stage detectors thus far. In this paper, we investigate why this is the case. We discover that the extreme foreground-background class imbalance encountered during training of dense detectors is the central cause. We propose to address this class imbalance by reshaping the standard cross entropy loss such that it down-weights the loss assigned to well-classified examples. Our novel Focal Loss focuses training on a sparse set of hard examples and prevents the vast number of easy negatives from overwhelming the detector during training. To evaluate the effectiveness of our loss, we design and train a simple dense detector we call RetinaNet. Our results show that when trained with the focal loss, RetinaNet is able to match the speed of previous one-stage detectors while surpassing the accuracy of all existing state-of-the-art two-stage detectors. Code is at: https://github.com/facebookresearch/Detectron.

Study of efficacy and safety of modified adjuvant intraperitoneal chemotherapy regimen in carcinoma ovary

OBJECTIVE

It has been demonstrated in few trials that intraperitoneal and intravenous (IP/IV) chemotherapy improves survival in advanced stage ovarian cancer (OC). However, in view of high treatment-related toxicities, various modifications in treatment schedules have been tried. In this study, response and tolerability of IP paclitaxel on day 8 with IV paclitaxel on day 1 and IV cisplatin day 2 in carcinoma ovary were evaluated.

PATIENTS AND METHODS

In this prospective observational study, from March 2013 to December 2015, the efficacy and tolerability of adjuvant IP/IV chemotherapy in optimally cytoreduced Stage III epithelial OC (EOC) patients were assessed.

RESULTS

Totally, sixty patients were enrolled. The median age of patients was 53 years (32-67 years). Out of a total of 360 IP cycles, 316 cycles (88%) were completed. Forty-five patients (76%) received all the 6 cycles by IP route. Eight out of those 45 patients had one or more adjustment including delay or dose reduction. After median follow-up of 22 months, eight patients (14%) had local or systemic recurrence. Median progression-free survival not reached yet. Catheter block was seen in five cases. Two cases had needle displacement and extravasations of drug around the port chamber. Six patients had Grade 3 abdominal pain and cramp. Grade 3/4 leukopenia was experienced by thirty patients (50%), but febrile neutropenia occurred in only 6 (10%) patients. Renal complication present in 4 (7%) patients.

CONCLUSIONS

In Indian patients, adjuvant chemotherapy with day 8 I/P paclitaxel in optimally cytoreduced EOC is associated with comparable survival outcomes, less side effects and high treatment completion rate relative to literature published from Western countries.

Outcome of universal newborn eye screening with wide-field digital retinal image acquisition system: a pilot study

PurposeTo evaluate the outcome of universal newborn eye screening with wide-field digital retinal imaging (WFDRI) system.MethodsIn this pilot study, we examined 1152 apparently healthy newborn infants in the obstetrics and gynecology ward of a civil hospital in Eastern India over 1.5 years. The examination included external eye examination, red reflex test and fundus imaging by WFDRI (RetCam II, Clarity medical system, Pleasanton, CA, USA) by a trained optometrist. The pathologies detected, net monetary gain and skilled manpower saved were documented. The results were compared with three similar studies thus far published in the literature.ResultsOcular abnormality of any kind was seen in 172 (14.93%) babies. Retinal hemorrhage in 153 babies (88.9% of all abnormal findings) was the most common abnormality; it was bilateral in 118 (77.12%) babies and 4 babies had foveal hemorrhage. Other abnormalities included vitreous hemorrhage (n=1), congenital glaucoma (n=2), uveal coloboma (n=2), retinopathy mimicking retinopathy of prematurity (n=2), and cystic fovea (n=3). The retinal hemorrhages resolved spontaneously in all eyes. One baby with congenital glaucoma received surgery and the other was treated medically. The benefits included savings in skilled manpower, a net monetary gain of INR 4.195 million (US$ 62,612) and skilled manpower saving by 319.4 h.ConclusionsThe universal neonatal eye screening using WFDRI detected pathologies that needed immediate care or regular follow up; saved skilled manpower with a net monetary gain. But compared to a red reflex test the benefits were marginal in terms of detecting treatment warranting ocular pathologies.

Epidemiology and resistance pattern of bacterial isolates among cancer patients in a Tertiary Care Oncology Centre in North India

OBJECTIVES

To examine the epidemiology of microbiologically documented bacterial infection and the resistance pattern, among cancer patients undergoing treatment at RGCIRC, Delhi.

DESIGN AND SETTING

Retrospective observational study in which culture reports obtained over 1 year in 2013, were analyzed.

RESULTS

13329 cultures were obtained over 1 year in 2013 and were analyzed. 23.6 % samples showed positive culture with majority being gram negative isolates (67.9 %). E. coli was the commonest gram negative isolate (49.4%) followed by klebsella (29.7%) and Staph. aureus was the commonest gram positive isolate. There was high incidence of ESBL in blood and urine (87.2% & 88.5%) and BLBLI were also high (78% & 83.9%). Carbapenem resistance was comparatively low (10%) and colistin sensitivity was quiet high (> 95%).

CONCLUSIONS

Prevalence of MRSA and VRE in our institute is very less, whereas prevalence of ESBLs and BLBLI isolates amongst gram negative infections is around 80%. Gram negative isolates had poor sensitivity to cephalosporins and fluoroquinolones.

Cytological Diagnosis of Primary Thyroid Tuberculosis

Primary thyroid tuberculosis is an extremely rare disease, even in countries where other forms of tuberculosis are abundant. TT has no age bar but usually affects women in fourth and fifth decade. Hereby, we report a case of 16-years-old girl presented with complaint of progressively increasing, painful thyroid swelling. Diagnosis of TT was made on cytology and there was no evidence of involvement of any other organ by tuberculosis. Despite of its rarity, TT is usually misdiagnosed. So, a clinician should always consider this entity in the differential diagnosis of thyroid swelling. Fine needle aspiration cytology is the best diagnostic method and can result in the avoidance of unnecessary thyroid surgeries.

Flow accelerated corrosion study in feeder pipes

The Indian Pressurized Heavy Water Reactor (PHWR) core consists of a number of horizontal channels containing nuclear fuel bundles. Parallel coolant channels are connected to Inlet and Outlet header through feeder pipes. Coolant from Reactor Inlet Header is distributed to the coolant channels and after removing heat combines at Reactor Outlet Header. Due to space constraints the feeder pipes are joined to the channel with one or two elbows close to the end fittings of the coolant channels. The carbon steel feeder pipes carry high temperature fluid at higher velocity and are liable to undergo Flow Accelerated Corrosion (FAC). In the recent inspection it has been found that feeders having double elbow are more susceptible to FAC on the intrados of second elbow. But it was found that in some of the elbows maximum thinning due to FAC was observed on the intrados of the first elbow. Hence to resolve this, effect of first bend orientation with respect of upstream direction has been studied. Two different approaches are used for predicting the FAC rate from calculated value of wall shear stress by CFD. One method is based on evaluating of wear rate using Colburn analogy and the other using an empirical equation between wear rate and shear stress. In Colburn analogy, mass transfer coefficient is evaluated by knowing shear stress and equilibrium concentration. For a case study, wall shear stress obtained from k-∊ turbulence model was compared with k-ω SST turbulence model and no appreciable change in the wall shear stress has been found. Hence for subsequent analysis k-∊ turbulence model was chosen because large mesh size near to the surface (first layer thickness) is permitted due to higher y+ value.

Polymorphism of the IL-8 gene and the risk of ovarian cancer

Ovarian cancer still represents a challenge in gynecological oncology. Most patients are diagnosed in an advanced tumor stage. No specific screening or prevention strategies for ovarian cancer exist as of yet. Interleukin 8 (IL-8) is a pro-inflammatory chemokine known for its angiogenetic activity, and is supposedly responsible for tumor-associated angiogenesis in several malignant tumors. The aim of the study was to investigate the susceptibility of patients with an IL-8 gene polymorphism to developing ovarian cancer. Four single nucleotide polymorphisms (SNPs) (IL-8 -251, IL-8 +781, IL-8 +1633 and IL-8 +2767) of the IL-8 gene were screened, using the PCR method in 268 patients with ovarian cancer and 426 healthy women as a control group. Significant associations were noted in patients with the IL-8 +781 (T/T) genotype (p=0.0048) with increased frequencies of ovarian cancer, while women with the IL-8 +781 (C/C) allele suffer from ovarian cancer significantly less frequently (p=0.0003). Furthermore, the IL-8 +2767 (T/T) genotype is also associated with a higher risk of ovarian cancer (p=0.0177). Our results indicate, for the first time, that IL-8 polymorphism is associated with ovarian cancer.