Assessment of genetic diversity of Bacillus spp. isolated from eutrophic fish culture pond

The genus Bacillus comprises of a diverse group with a wide range of nutritional requirements and physiological and metabolic diversity. Their role in nutrient cycle is well documented. 16S rDNA sequences do not always allow the species to be discriminated. In this study 40 Bacillus spp. obtained from fish culture pond and 10 culture type strains were analysed for their genomic diversity by PCR-RFLP of intergenic spacer region of 16S-23S and HSP60 genes. TaqI digestion of PCR products amplified by ITS PCR did not render distinctive RFLP patterns. Numerical analysis of ITS PCR-RFLP pattern differentiated the isolates into 11 clusters. Same species were found to be grouped in different clusters. But PstI digested PCR products amplified from HSP60 gene of the isolates showed distinctive RFLP patterns. The dendrogram constructed from HSP60 PCR-RFLP delineated the isolates into 11 clusters also. All the clusters, except cluster I grouped only one type of species. The results showed that Bacillus spp. could be clearly distinguished by PCR-RFLP of HSP60 gene. Therefore, the HSP60 gene is proposed as an additional molecular marker for discrimination of Bacillus group.

Role of oral candidiasis in TB and HIV co-infection: AIDS Clinical Trial Group Protocol A5253

OBJECTIVE

To evaluate the association between oral candidiasis and tuberculosis (TB) in human immunodeficiency virus (HIV) infected individuals in sub-Saharan Africa, and to investigate oral candidiasis as a potential tool for TB case finding.

METHODS

Protocol A5253 was a cross-sectional study designed to improve the diagnosis of pulmonary TB in HIV-infected adults in high TB prevalence countries. Participants received an oral examination to detect oral candidiasis. We estimated the association between TB disease and oral candidiasis using logistic regression, and sensitivity, specificity and predictive values.

RESULTS

Of 454 participants with TB culture results enrolled in African sites, the median age was 33 years, 71% were female and the median CD4 count was 257 cells/mm(3). Fifty-four (12%) had TB disease; the prevalence of oral candidiasis was significantly higher among TB cases (35%) than among non-TB cases (16%, P < 0.001). The odds of having TB was 2.4 times higher among those with oral candidiasis when controlling for CD4 count and antifungals (95%CI 1.2-4.7, P = 0.01). The sensitivity of oral candidiasis as a predictor of TB was 35% (95%CI 22-48) and the specificity 85% (95%CI 81-88).

CONCLUSION

We found a strong association between oral candidiasis and TB disease, independent of CD4 count, suggesting that in resource-limited settings, oral candidiasis may provide clinical evidence for increased risk of TB and contribute to TB case finding.

Understanding the role of nitrogen in plasma-assisted surface modification of magnetic recording media with and without ultrathin carbon overcoats

A novel scheme of pre-surface modification of media using mixed argon-nitrogen plasma is proposed to improve the protection performance of 1.5 nm carbon overcoats (COC) on media produced by a facile pulsed DC sputtering technique. We observe stable and lower friction, higher wear resistance, higher oxidation resistance, and lower surface polarity for the media sample modified in 70%Ar + 30%N2 plasma and possessing 1.5 nm COC as compared to samples prepared using gaseous compositions of 100%Ar and 50%Ar + 50%N2 with 1.5 nm COC. Raman and X-ray photoelectron spectroscopy results suggest that the surface modification process does not affect the microstructure of the grown COC. Instead, the improved tribological, corrosion-resistant and oxidation-resistant characteristics after 70%Ar + 30%N2 plasma-assisted modification can be attributed to, firstly, the enrichment in surface and interfacial bonding, leading to interfacial strength, and secondly, more effective removal of ambient oxygen from the media surface, leading to stronger adhesion of the COC with media, reduction of media corrosion and oxidation, and surface polarity. Moreover, the tribological, corrosion and surface properties of mixed Ar + N2 plasma treated media with 1.5 nm COCs are found to be comparable or better than ~2.7 nm thick conventional COC in commercial media.

Targeted temperature management in brain protection: An evidence-based review

Targeted temperature management (TTM) for neuroprotection involves maintaining the temperature of the brain at predetermined levels by various techniques. It is aimed at avoiding the harmful effects of hyperthermia on the brain and at exploiting the protective effects of lower tissue temperature. There has been an explosion in the use of TTM for neuroprotection in a variety of clinical scenarios apart from the commonly accepted fields of resuscitation and ischaemic, hypoxic encephalopathy. This review briefly discusses the evidence base for TTM. The focus is on various areas of application for neuroprotection, the practical issues pertaining to TTM implementation, the recent data that support it and the present areas of controversy.

Enhanced tribological, corrosion, and microstructural properties of an ultrathin (<2 nm) silicon nitride/carbon bilayer overcoat for high density magnetic storage

An ultrathin bilayer overcoat of silicon nitride and carbon (SiNx/C) providing low friction, high wear resistance, and high corrosion resistance is proposed for future generation hard disk media. The 16 Å thick SiNx/C overcoat consists of an atomically thin SiNx underlayer (4 Å) and a carbon layer (12 Å), fabricated by reactive magnetron sputtering and filtered cathodic vacuum arc (FCVA), respectively. When compared with monolithic overcoats of FCVA-deposited carbon (16 Å) and sputtered SiNx (16 Å), the SiNx/C bilayer overcoat demonstrated the best tribological performance with a coefficient of friction < 0.2. Despite showing marginally less electrochemical corrosion protection than monolithic SiNx, its ability to protect the magnetic media from corrosion/oxidation was better than that of an ∼27 Å thick commercial hard disk overcoat and 16 Å thick monolithic FCVA-deposited carbon. From X-ray photoelectron spectroscopy and Raman spectroscopy analyses, it was found that the introduction of the 4 Å SiNx underlayer facilitated higher sp(3) hybridization within the carbon layer by acting as a barrier and promoted the formation of strong bonds at the SiNx/C and the SiNx/media interfaces by acting as an adhesion layer. The higher sp(3) carbon content is expected to improve the thermal stability of the overcoat, which is extremely important for future hard disk drives employing heat assisted magnetic recording (HAMR).

Upregulation of transcripts for metabolism in diverse environments is a shared response associated with survival and adaptation of Klebsiella pneumoniae in response to temperature extremes

Klebsiella pneumoniae being ubiquitous in nature encounters wide differences in environmental condition. The organism's abundance in natural water reservoirs exposed to temperature variation forms the basis of its persistence and spread in the soil and other farm produce. In order to investigate the effect of temperature changes on the survival and adaptation of the bacteria, the transcriptional response of K. pneumoniae subjected to low (20 °C) and high (50 °C) temperature shock were executed using Applied Biosystems SOLiD platform. Approximately, 33 and 34% of protein coding genes expressed in response to 20 and 50 °C, respectively, displayed significant up- or downregulation (p < 0.01). Most of the significantly expressed transcripts mapped to metabolism, membrane transport, and cell motility were downregulated at 50 °C, except for protein folding, sorting, and degradation, suggesting that heat stress causes general downregulation of gene expression together with induction of heat shock proteins. While at 20 °C, the transcripts of carbohydrate, lipid, and amino acid metabolism were highly upregulated. Hypothetical proteins as well as canonical heat and cold shock proteins, viz. grpE, clpX, recA, and deaD were upregulated commonly in response to 20 and 50 °C. Significant upregulation of genes encoding ribosomal proteins at 20 and 50 °C possibly suggest their role in the survival of K. pneumoniae cells under low- and high-temperature stress.

Screening for pulmonary tuberculosis in HIV-infected individuals: AIDS Clinical Trials Group Protocol A5253

BACKGROUND

Improved tuberculosis (TB) screening is urgently needed for human immunodeficiency virus (HIV) infected patients.

METHODS

An observational, multi-country, cross-sectional study of HIV-infected patients to compare a standardized diagnostic evaluation (SDE) for TB with standard of care (SOC). SOC evaluations included TB symptom review (current cough, fever, night sweats and/or weight loss), sputum Ziehl-Neelsen staining and chest radiography. SDE screening added extended clinical signs and symptoms and fluorescent microscopy (FM). All participants underwent all evaluations. Mycobacterium tuberculosis on sputum culture was the primary outcome.

RESULTS

A total of 801 participants were enrolled from Botswana, Malawi, South Africa, Zimbabwe, India, Peru and Brazil. The median age was 33 years; 37% were male, and median CD4 count was 275 cells/mm(3). Thirty-one participants (4%) had a positive culture on Löwenstein-Jensen media and 54 (8%) on MGIT. All but one positive culture came from sub-Saharan Africa, where the prevalence of TB was 54/445 (12%). SOC screening had 54% sensitivity (95%CI 40-67) and 76% specificity (95%CI 72-80). Positive and negative predictive values were respectively 24% and 92%. No elements of the SDE improved the predictive values of SOC.

CONCLUSIONS

Symptom-based screening with smear microscopy was insufficiently sensitive. More sensitive diagnostic testing is required for HIV-infected patients.

Clostridium difficile Associated Disease in a Neurointensive Care Unit

Background: Critically ill patients are at high risk for acquiring Clostridium difficile infection. The aim of this study was to investigate the prevalence, severity, and outcome of neurointensive care unit (NICU) acquired Clostridium difficile associated disease (CDAD).

Materials and Methods: Intensive care admission and hospital infection control databases from April 2008 to August 2010 were studied and the case notes reviewed retrospectively. Diarrhea was classified as mild, moderate, or severe based on the frequency and volume. Information on demographics, risk factors for CDAD, presentation, and course of the disease was gathered. Admission diagnosis, days of NICU stay, and incidence of complications were noted.

Results: In the time period studied, 9 out of 2212 patients (prevalence rate 0.4%) admitted to the intensive care unit (ICU) for a total of 10,825 bed days (incidence rate 8.3 per 10,000 bed days) acquired CDAD. Median age was 55 (IQR 20–72) years. The median NICU stay was 26 (IQR 11–103) days. The median duration between ICU admission and development of CDAD was 11 (IQR 3–93) days. Four patients (44%) had moderate CDAD. Concurrent infections occurred in seven (77%) patients. The most frequently prescribed antimicrobials prior to CDAD were cephalosporins (71%). The apparent risk factors in this group included age>65 year (22%) and antibiotics (67%) among others. One patient developed CDAD colitis. Three patients had a perceived delay in discharge from the ICU (1–8 days) due to their infective status. No mortality was ascribed to CDAD.

Conclusion: The prevalence rate (0.4%) and morbidity of CDAD in the unit are low. A larger database is needed to better analyze the associated risk factors in this subgroup of patients. A possible increase in disease burden due to a delay in discharge from the ICU merits further evaluation.

Adverse drug reaction, patent blue V dye and anaesthesia

BACKGROUND AND AIM

Patent blue vital (PBV) dye is used for varied perioperative indications, and has a potential for causing life-threatening allergic reactions. In this retrospective case series study, at a tertiary level neurosciences centre, we analysed the nature, management and outcome of adverse drug reaction to the preoperative use of PBV for marking vertebral level prior to back surgeries.

METHODS

Patients were identified from the theatre and radiology database. Data were collected from the patients' notes retrieved from the medical records division.

RESULTS

Eleven of 1247 (0.88%) patients experienced adverse reactions: 6 (0.48%) patients had minor grade I reactions (urticaria, blue hives, pruritis or generalised rash), 4 (0.32%) had grade II reactions (transient hypotension/bronchospasm/laryngospasm) and grade III reaction (hypotension requiring prolonged vasopressor support) was noted in 1 (0.08%) patient. No mortality was seen. The time of onset (range 10-45 min) frequently coincided with induction of anaesthesia or prone positioning of patient. Seven (63.6%) cases were cancelled or postponed (range 2-63 days). Treatment varied independent of the grade of reaction. Allergy workup (often incomplete) was done for 6 (54%) patients.

CONCLUSION

An awareness of the time of onset and infrequency of life-threatening reactions to patent blue dye may result in better management, less postponement, more complete workup and referral of these events.

Improved neuropsychological and neurological functioning across three antiretroviral regimens in diverse resource-limited settings: AIDS Clinical Trials Group study a5199, the International Neurological Study

BACKGROUND

AIDS Clinical Trials Group (ACTG) A5199 compared the neurological and neuropsychological (NP) effects of 3 antiretroviral regimens in participants infected with human immunodeficiency virus type 1 (HIV-1) in resource-limited settings.

METHODS

Participants from Brazil, India, Malawi, Peru, South Africa, Thailand, and Zimbabwe were randomized to 3 antiretroviral treatment arms: A (lamivudine-zidovudine plus efavirenz, n = 289), B (atazanavir, emtricitabine, and didanosine-EC, n = 293), and C (emtricitabine-tenofovir-disoproxil fumarate plus efavirenz, n = 278) as part of the ACTG PEARLS study (A5175). Standardized neurological and neuropsychological (NP) screening examinations (grooved pegboard, timed gait, semantic verbal fluency, and finger tapping) were administered every 24 weeks from February 2006 to May 2010. Associations with neurological and neuropsychological function were estimated from linear and logistic regression models using generalized estimating equations.

RESULTS

The median weeks on study was 168 (Q1 = 96, Q3 = 192) for the 860 participants. NP test scores improved (P < .05) with the exception of semantic verbal fluency. No differences in neurological and neuropsychological functioning between treatment regimens were detected (P > .10). Significant country effects were noted on all NP tests and neurological outcomes (P < .01).

CONCLUSIONS

The study detected no significant differences in neuropsychological and neurological outcomes between randomized ART regimens. Significant improvement occurred in neurocognitive and neurological functioning over time after initiation of ARTs. The etiology of these improvements is likely multifactorial, reflecting reduced central nervous system HIV infection, better general health, and practice effects. This study suggests that treatment with either of the World Health Organization -recommended first-line antiretroviral regimens in resource-limited settings will improve neuropsychological functioning and reduce neurological dysfunction.

CLINICAL TRIALS REGISTRATION

NCT00096824.

Global guidelines for treatment of tuberculosis among persons living with HIV: unresolved issues

The Revised National Tuberculosis Control Programme (RNTCP) in India uses a fully intermittent thrice-weekly rifampicin-containing regimen for all tuberculosis (TB) patients, including those who are human immunodeficiency virus (HIV) infected, whereas the World Health Organization (WHO) recommends daily anti-tuberculosis treatment at least during the intensive phase. The WHO recommendation was based on the results of a meta-analysis demonstrating increased risk of recurrence and failure among HIV-infected TB patients receiving intermittent TB treatment compared to a daily regimen. Review of the primary evidence indicates limited, low-quality information on intermittency, mostly from observational studies in the pre-antiretroviral treatment (ART) era. Molecular epidemiology in India indicates that most of the recurrences and many of the failures result from exogenous re-infection, suggesting poor infection control and high transmission rather than poor regimen efficacy. Subsequently published studies have shown acceptable treatment outcomes among HIV-infected TB patients receiving intermittent anti-tuberculosis regimens with concomitant ART. Treatment outcomes among HIV-infected TB patients treated under programmatic conditions show low failure rates but high case fatality; death has been associated with lack of ART. The highest priority is therefore to reduce mortality by linking all HIV-infected TB patients to ART. While urgently seeking to reduce death rates among HIV-infected TB patients, given the poor evidence for change and operational advantages of an intermittent regimen, the RNTCP intends to collect the necessary evidence to inform national policy decisions through randomised clinical trials.

Endovascular cooling for severe hyperthermia in cervical spine injury

BACKGROUND

Sustained severe hyperthermia in patients with high cervical spinal cord injuries may have many etiologies, from infection to autonomic dysregulation. When uncontrolled, it has been seen to have a high morbidity and mortality.

METHODS

We present two patients with high cervical spinal cord injury (SCI) who had sustained severe hyperpyrexia, of possible autonomic origin. The temperature stayed above 40°C and was uncontrolled with conventional methods of temperature management.

RESULTS

We employed endovascular cooling for therapeutic normothermia which was successful in effective control of temperature in both the patients. The first patient suffered complications from deep vein thrombosis and pulmonary embolism which may be attributed to the presence of the cooling catheter in spite of chemical and mechanical thromboprophylaxis.

CONCLUSIONS

The use of endovascular cooling in the management of severe life threatening hyperthermia in patients with cervical SCI may be an useful intervention. There must be a high suspicion for the possibility of deep vein thrombosis in this subgroup, however.

Phlebotomy for rapid weaning and extubation in COPD patient with secondary polycythemia and respiratory failure

The increased incidence of ventilator-associated complications in patients with chronic obstructive pulmonary disease (COPD) necessitates rapid weaning and extubation. The presence of secondary polycythemia in this subgroup increases the incidence of stroke and myocardial infarction due to hyperviscosity and tissue hypoxia. We present a 58-year-old male patient of COPD with secondary polycythemia (hematocrit 64%) who had possible hyperviscosity-related complications leading to cardiac arrest after a minor surgical procedure. The patient developed ventilator dependence after recovery. Phlebotomy was done to remove 10% of total blood volume. Symptomatic improvement was dramatic. Improvement in weaning indices like rapid shallow breathing index and PaO₂/PAO₂ was observed facilitating rapid weaning and early extubation. Monitored, acute phlebotomy is safe and cost-effective. It decreases blood volume and viscosity, increases cardiac output and improves exercise tolerance in patients.

Clinical response of newly diagnosed HIV seropositive & seronegative pulmonary tuberculosis patients with the RNTCP Short Course regimen in Pune, India

BACKGROUND & OBJECTIVES

In the Revised National Tuberculosis Control Programme (RNTCP) in India prior to 2005, TB patients were offered standard DOTS regimens without knowledge of HIV status. Consequently such patients did not receive anti-retroviral therapy (ART) and the influence of concomitant HIV infection on the outcome of anti-tuberculosis treatment remained undetermined. This study was conducted to determine the results of treatment of HIV seropositive pulmonary tuberculosis patients with the RNTCP (DOTS) regimens under the programme in comparison with HIV negative patients prior to the availability of free ART in India.

METHODS

Between September 2000 and July 2006, 283 newly diagnosed pulmonary TB patients were enrolled in the study at the TB Outpatient Department at the Talera Hospital in the Pimpri Chinchwad Municipal Corporation area at Pune (Maharashtra): they included 121 HIV seropositive and 162 HIV seronegative patients. They were treated for tuberculosis as per the RNTCP in India. This study was predominantly conducted in the period before the free ART become available in Pune.

RESULTS

At the end of 6 months of anti-TB treatment, 62 per cent of the HIV seropositive and 92 per cent of the HIV negative smear negative patients completed treatment and were asymptomatic; among smear positive patients, 70 per cent of the HIV-seropositive and 81 per cent of HIV seronegative pulmonary TB patients were cured. Considering the results in the smear positive and smear negative cases together, treatment success rates were substantially lower in HIV positive patients than in HIV negative patients, (66% vs 85%). Further, 29 per cent of HIV seropositive and 1 per cent of the HIV seronegative patients expired during treatment. During the entire period of 30 months, including 6 months of treatment and 24 months of follow up, 61 (51%) of 121 HIV positive patients died; correspondingly there were 6 (4%) deaths among HIV negative patients.

INTERPRETATION & CONCLUSIONS

The HIV seropositive TB patients responded poorly to the RNTCP regimens as evidenced by lower success rates with chemotherapy and high mortality rates during treatment and follow up. There is a need to streamline the identification and management of HIV associated TB patients in the programme with provision of ART to achieve high cure rates for TB, reducing mortality rates and ensuring a better quality of life.

Preparation of Ultraviolet Light Emitting ZnO Nanoparticles Via a Novel Synthesis Route

A new synthesis methodology is utilized to prepare ZnO nanoparticles with a narrow size distribution between 2 to 4 nm. The particle growth is found to be reaction time dependent. The dry powders of ZnO nanoparticles show a strong blue-shifted near-band-edge ultraviolet emission, and the size and size distribution of the particles did not exhibit noticeable change during solvent evaporation. Raman spectra show ZnO E22 (TO) phonon mode and other vibration modes that are attributed to the bound acetate group. The CO stretching mode in the Raman spectra is red-shifted to 1401 cm-1, indicating a strong adsorption of the acetate ligands onto ZnO surfaces.

Laterally-current-injected light-emitting diodes based on nanocrystalline-Si/SiO2 superlattice

Laterally electrically-pumped Si light-emitting diodes (LEDs) based on truncated nanocrystalline-Si (nc-Si)/SiO2 quantum wells are fabricated with complementary-metal-semiconductor-oxide (CMOS) process. Visible electroluminescence (EL) can be observed under a reverse bias larger than ~6 V. The light emission would probably originate from the spontaneous hot-carrier relaxations within the conduction and the valance bands when the device is sufficiently reverse-biased. The EL spectral profile is found to be modulated by varying structure parameters of the interdigitated finger electrodes. Up to ~20 times EL intensity enhancement is achieved as compared to vertical-current-injection LED prepared using the same material system. Based on the lateral-current-injection scheme, a Si/SiO2 MQW LED with Fabry-Perot (FP) microcavity and an on-chip waveguided LED that emits at 1.55-µm are proposed.

Etoricoxib-induced life-threatening hyperkalemia and acute kidney dysfunction against the background of telmisartan and a low sodium diet

Drug-induced hyperkalemia is not uncommon and may be life-threatening when presenting acutely in the emergency department. We present a case of severe hyperkalemia precipitated acutely by etoricoxib in a patient who was on telmisartan and a low sodium (potassium chloride-rich) diet. A 75-year-old male with a past medical history of well-controlled diabetes and hypertension was prescribed etoricoxib (90 mg daily) for 3 days for musculoskeletal backache. He had been taking his routine medications including telmisartan and a potassium-rich salt substitute for many years, without any recent change in dosage or quantity. There was evidence of microalbuminurea; however, the renal functions and electrolytes prior to starting etoricoxib were normal. He presented to the emergency department with signs and symptoms of life-threatening hyperkalemia (serum potassium 7.7 mEq/dl), accelerated hypertension, congestive heart failure, pulmonary edema and acute renal failure. Acute medical management and withholding all drugs that could cause hyperkalemia improved his serum potassium levels over 24 h and renal parameters within 5 days. All the other drugs except etoricoxib were restarted under observation over 8 weeks with no recurrence of the acute episode. Non-steroidal analgesics and other COX-2 inhibitors (rofecoxib and celecoxib) have been known to precipitate renal failure and hyperkalemia specially in patients at risk for the same; although not unexpected, this may be the first reported case of life-threatening hyperkalemia precipitated by etoricoxib in a previously stable patient having increased risk of renal failure and hyperkalemia.

Derivation and characterization of embryonic stem-like cells of Indian major carp Catla catla

Embryonic stem (ES)-like cells were derived from mid-blastula stage embryos of a freshwater fish, catla Catla catla, under feeder-free condition and designated as CCES cells. The conditioned media was optimized with 10% foetal bovine serum (FBS), fish embryo extract (FEE) having 100 µg ml(-1) protein concentration, 15 ng ml(-1) basic fibroblast growth factor (bFGF) and basic media containing Leibovitz-15, DMEM with 4·5 g l(-1) glucose and Ham's F12 (LDF) in 2:1:1 ratio using a primary culture of CCES cells. Cells attached to gelatin-coated plates after 24 h of seeding and ES-like colonies were obtained at day 5 onwards. A stable cell culture was obtained after passage 10 and further maintained up to passage 44. These cells were characterized by their typical morphology, high alkaline phosphatase activity, positive expression of cell-surface antigen SSEA-1, transcription factor Oct4, germ cell marker vasa and consistent karyotype up to extended periods. The undifferentiated state was confirmed by their ability to form embryoid bodies and their differentiation potential.

Acute demyelinating encephalomyelitis after anti-venom therapy in Russell's viper bite

INTRODUCTION

Russell's viper is a commonly encountered venomous snake in India. Morbidity and mortality following envenomation and the treatment thereof are frequent. We report a rarely seen complication after a treated Russell's viper bite.

CASE REPORT

A 36-year-old male farmer received 30 vials polyvalent anti-snake venom after a viper bite to his right leg. Improvement in initial hematemesis and circulatory shock was followed by acute renal failure managed with regular hemodialysis. He displayed no abnormalities on neurological examination at admission. Fourth day onwards his neurologic status started deteriorating with development of behavioral abnormalities, hemi-spatial neglect of left upper limb, paralysis of left facial nerve, left upper limb, and right lower limb. Acute disseminated encephalomyelitis was confirmed on magnetic resonance imaging (MRI) of brain with typical spectroscopic characteristics. High dose methyl prednisolone was administered and a rapid recovery followed.

CONCLUSION

Russell's viper bite followed by treatment with antivenom may be complicated by the development of immune complex mediated demyelination and development of acute disseminated encephalomyelitis. MRI spectroscopy helps in early identification of demyelination and in a definite diagnosis. Treatment with corticosteroids was associated with resolution of symptoms in this case.

Phosphor-Free Apple-White LEDs with Embedded Indium-Rich Nanostructures Grown on Strain Relaxed Nano-epitaxy GaN

Phosphor-free apple-white light emitting diodes have been fabricated using a dual stacked InGaN/GaN multiple quantum wells comprising of a lower set of long wavelength emitting indium-rich nanostructures incorporated in multiple quantum wells with an upper set of cyan-green emitting multiple quantum wells. The light-emitting diodes were grown on nano-epitaxially lateral overgrown GaN template formed by regrowth of GaN over SiO(2) film patterned with an anodic aluminum oxide mask with holes of 125 nm diameter and a period of 250 nm. The growth of InGaN/GaN multiple quantum wells on these stress relaxed low defect density templates improves the internal quantum efficiency by 15% for the cyan-green multiple quantum wells. Higher emission intensity with redshift in the PL peak emission wavelength is obtained for the indium-rich nanostructures incorporated in multiple quantum wells. The quantum wells grown on the nano-epitaxially lateral overgrown GaN has a weaker piezoelectric field and hence shows a minimal peak shift with application of higher injection current. An enhancement of external quantum efficiency is achieved for the apple-white light emitting diodes grown on the nano-epitaxially lateral overgrown GaN template based on the light -output power measurement. The improvement in light extraction efficiency, η(extraction,) was found to be 34% for the cyan-green emission peak and 15% from the broad long wavelength emission with optimized lattice period.

Extreme metabolic alkalosis in intensive care

Metabolic alkalosis is a commonly seen imbalance in the intensive care unit (ICU). Extreme metabolic alkalemia, however, is less common. A pH greater than 7.65 may carry a high risk of mortality (up to 80%). We discuss the entity of life threatening metabolic alkalemia by means of two illustrative cases - both with a pH greater than 7.65 on presentation. The cause, modalities of managing and complications of this condition is discussed from the point of view of both the traditional method of Henderson and Hasselbalch and the mathematical model based on physiochemical model described by Stewart. Special mention to the pitfalls in managing patients of metabolic alkalosis with concomitant renal compromise is made.

Refeeding syndrome

We report a case of a fifty-year-old male who was admitted with a three month history of increasing weakness, prostration, decreasing appetite and inability to swallow. The patient was a chronic alcoholic, unemployed, and of very poor socioeconomic background. The patient was initially investigated for upper GI malignancy, Addisons disease, bulbar palsy and other endocrinopathies. Concurrent management was started for severe electrolyte abnormalities and enteral nutritional supplementation was begun. By the fourth day of feeding patient developed severe hypophosphatemia and other life-threatening features suggesting refeeding syndrome. The patient was managed for the manifestations of refeeding syndrome. A final diagnosis of chronic alcoholic malnutrition with refeeding syndrome was made. Refeeding of previously starving patients may lead to a variety of complications including sudden death.

Interference lithographically defined and catalytically etched, large-area silicon nanocones from nanowires

We report a simple and cost effective method for the synthesis of large-area, precisely located silicon nanocones from nanowires. The nanowires were obtained from our interference lithography and catalytic etching (IL-CE) method. We found that porous silicon was formed near the Au catalyst during the fabrication of the nanowires. The porous silicon exhibited enhanced oxidation ability when exposed to atmospheric conditions or in wet oxidation ambient. Very well located nanocones with uniform sharpness resulted when these oxidized nanowires were etched in 10% HF. Nanocones of different heights were obtained by varying the doping concentration of the silicon wafers. We believe this is a novel method of producing large-area, low cost, well defined nanocones from nanowires both in terms of the control of location and shape of the nanocones. A wide range of potential applications of the nanocone array can be found as a master copy for nanoimprinted polymer substrates for possible biomedical research; as a candidate for making sharp probes for scanning probe nanolithography; or as a building block for field emitting tips or photodetectors in electronic/optoelectronic applications.

Measuring Viscoelasticity of Soft Samples Using Atomic Force Microscopy

Relaxation indentation experiments using atomic force microscopy (AFM) are used to obtain viscoelastic material properties of soft samples. The quasilinear viscoelastic (QLV) model formulated by Fung (1972, “Stress Strain History Relations of Soft Tissues in Simple Elongation,” in Biomechanics, Its Foundation and Objectives, Prentice-Hall, Englewood Cliffs, NJ, pp. 181–207) for uniaxial compression data was modified for the indentation test data in this study. Hertz contact mechanics was used for the instantaneous deformation, and a reduced relaxation function based on continuous spectrum is used for the time-dependent part in the model. The modified QLV indentation model presents a novel method to obtain viscoelastic properties from indentation data independent of relaxation times of the test. The major objective of the present study is to develop the QLV indentation model and implement the model on AFM indentation data for 1% agarose gel and a viscoelastic polymer using spherical indenter.

Ofloxacin induced leucopenia in complicated falciparum malaria: a case report

INTRODUCTION

To report a case of ofloxacin-associated leucopoenia, which occurred in a patient of falciparum malaria shortly after administration and resolved following discontinuation of the drug.

CASE PRESENTATION

A 44 year old female was admitted in circulatory shock with a diagnosis of falciparum malaria, suffering from fever, diarrhoea and vomiting. After successful resuscitation she was treated with intravenous ofloxacin for Escherichia coli induced diarrhoea. She developed acute leucopoenia that resolved after discontinuation of the drug.

DISCUSSION

Ofloxacin is a broad-spectrum synthetic fluoroquinolone used for a wide variety of bacterial infections. Because of the temporal relationship between ofloxacin administration and the development of leucopenia in our patient, as well as the relationship between drug withdrawal and improvement in white blood cell count, ofloxacin-associated leucopenia was suspected. This reaction was categorized as probable according to the Naranjo probability scale. We report, for the first time in the English-language literature, a case of Ofloxacin-associated leucopoenia. This association is further supported by the exclusion of other potential causes for this adverse effect.

CONCLUSION

Leucopoenia is a well-recognized adverse effect of several drugs. We report a case of Ofloxacin-associated leucopoenia during treatment of a patient with malaria. Healthcare personnel should be aware of this possible adverse reaction in patients treated with ofloxacin. A high degree of suspicion assumes special importance in this subgroup of critically ill patients with malaria where hematologic aberrations are common.

Dietary supplies of iodine & thiocyanate in the aetiology of endemic goitre in Imphal East district of Manipur, north east India

BACKGROUND & OBJECTIVE

The present investigation was undertaken to study the iodine nutritional status of school children of Imphal east district in Manipur where endemic goitre persists during post-salt iodization phase along with the investigation of the factors responsible for the occurrence of goitre endemicity.

METHODS

A total of 1,286 children (6-12 yr) were clinically examined for goitre from study areas of Imphal east district. A total of 160 urine samples were collected and analyzed to measure urinary iodine and thiocyanate levels. Iodine content was measured in 140 salt samples and 16 drinking water samples.

RESULTS

Overall goitre prevalence was about 30 per cent (grade 1-24.7%; grade 2-5.3%) and median urinary iodine level was 17.25 microg/dl. The mean urinary thiocyanate level was 1.073 +/- 0.39 mg/dl. Iodine/thiocyanate ratio (microg/mg) was in the ranges from 15.65 to 22.34. The mean iodine content in drinking water samples was 2.92 +/- 1.75 microg/l and 97.8 per cent of edible salts had iodine level above 15 ppm at the consumption point.

INTERPRETATION & CONCLUSION

Our findings showed that in spite of no biochemical iodine deficiency, iodine deficiency disorders (IDD) is a serious public health problem in Imphal east district of Manipur. The consumption pattern of certain plant foods containing thiocyanate (or its precursors) was relatively high that interfere with thyroid hormone synthesis resulting in the excretion of more iodine. Thus, the existing dietary supplies of thiocyanate in relation to iodine may be a possible aetiological factor for the persistence of endemic goitre in the study region during post salt iodization period.