Hypophosphataemia among Severely-malnourished Children: Case Series

Phosphorus is an essential substance in our body, and hypophosphataemia (HP) is well-described in rickets, refeeding syndrome, diabetic ketoacidosis (DKA), and in chronic alcohol-abuse. However, to our knowledge, HP among severely-malnourished children has not been studied in detail, and information on prevalence, severity, and treatment is scarce. Currently, there are only a few published case reports of HP. This case series describes three cases of HP that presented to Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Our first case required mechanical ventilation for respiratory distress associated with severe hypokalaemia (K 1.1 mmol/L) and moderate hypophosphataemia (P 2.1 mg/dL). The second case presented with severe sepsis which was associated with symptomatic hypocalcaemia (Ca 1.68 mmol/L), hypokalaemia (K 1.82 mmol/L), and severe hypophosphataemia (P 0.9 mg/dL). The third case presented with pneumonia and sepsis which were complicated by hypokalaemia (K 2.05 mmol/L) and severe hypophosphataemia (P 1.1 mg/dL). Marked lethargy and severe hypotonia were associated with HP in all of these cases. Manifestations of HP are diverse and can occur in association with other electrolyte imbalances, especially among malnourished children. Malnutrition, combined with sepsis, is one of the major killers of children younger than 5 years of age, and both malnutrition and sepsis can cause HP. It is concluded that the underlying causes of morbidity, including HP, should be actively sought and treated to reduce the mortality of children aged below five years.Key words: Electrolyte imbalance, Hypokalaemia, Hypophosphataemia, Malnutrition, Sepsis, Bangladesh     

Back pain and restricted daily physical activity in the Spanish adult population

Background. Low back pain is a widespread health problem that affects a great part of the Spanish adult population; it also places a constraint on developing activities of daily living. The aim of this paper is to estimate the association between daily physical activity and chronic back pain in Spain. Material and methods. This paper analyses data from the European Health Survey in Spain 2009; it presents a cross sectional epidemiological study designed to assess the health of the Spanish population, in which 22,188 people participated (10,876 men and 11,312 women over 16 years ), representative of the total Spanish population. The variables studied are: back pain indicators obtained from the European Health Status Module and the European Health Care Module included in this survey, and the daily physical activity pattern obtained from the European Module of Health Determinants. Results. The total volume of daily physical activity is similar in healthy people and those who have back pain, but a pattern of low or moderate intensity in people with chronic back pain in the last twelve months (p <0.01) was observed with greater frequency. Conclusions. People with chronic back pain do not show a lower volume of physical activity, but their physical activity pattern is often low or moderate. Developing a vigorous pattern of physical activity should be considered not only as a strategy to prevent this disease, but also as a therapeutic target in these patients.     

A randomised controlled trial comparing completeness of responses of three methods of collecting patient-reported outcome measures in men diagnosed with prostate cancer

Quality of Life Research - The purpose of the study was to compare completeness, timeliness and cost of patient-reported outcome measures (PROMs) collection using telephone, email and post in men...     

Changing epidemiology of infective endocarditis

Infective endocarditis (IE) continues to be a serious infection with a stable incidence rate over time and a persistently high mortality. Population-based studies from France, Netherlands, Sweden, and the United States reported on the epidemiology of this infection. These studies suggest a changing distribution of underlying valvular heart disease in patients with IE, namely a decreasing proportion of patients with rheumatic heart disease and an increasing proportion with underlying prosthetic valves or mitral valve prolapse. There is controversy regarding the change of spectrum of IE-causative organisms. In some geographically defined populations with complete case ascertainment, viridans group streptococci continue to be the most common causative organisms, whereas in passively reported community surveys and in referral-center case series, Staphylococcus aureus is surpassing streptococci as the leading cause for IE.     

Dubin-Johnson syndrome with systemic lupus erythematosus: a case report

Introduction Dubin-Johnson syndrome (DJS) is a rare recessively inherited conjugated hyperbilirubi- nemia caused by deficiency of the canalicular multi-drug resistance/multi-specific organic anionic transporter protein (MDR2/cMOAT). Thus bilirubin is conjugated but inefficiently secreted into bile, which results in accumulation of conjugated and, to some extent, unconjugated bilirubin in blood, leading to hyperbilirubinemia and bilirubinuria. But, the results of liver function tests are no…     

Meta Analysis of Etiology and its Clinical and Radiological Correlation in Cases of Craniomaxillofacial Trauma

Aim

The present study was planned to investigate the etiology of injuries and to analyze correlation between clinical and radiological findings in cases of craniomaxillofacial trauma.

Study Design

An 18 months cross-sectional study was done and 325 patients with maxillofacial fractures were analyzed from January 2013 to June 2014 who reported to the department of oral and maxillofacial surgery, Aligarh, Uttar Pradesh. Data was recorded in a preformed case sheet which included: patient’s demographic data, cause of injury, type of injury, treatment plan.

Results

Out of the 325 patients, 74.4 % were males with a male: female ratio of 2.91:1. The 21–30 year age group was found to be maximum. Road traffic accidents accounted for 71.3 %, followed by fall from height (19 %) and assault (9.5 %). Most commonly involved vehicles were two wheelers followed by public transport. Mandibular fractures (65 %) were most prevalent, followed by zygomaticomaxillary complex (44.27 %), parietal bone (48 %) and orbital fractures (21.3 %). Thirty-seven fractures (7.14 %) were missed clinically which were confirmed later by radiographic technique. Maximum were in cranium region (57 %) followed by mandible (27 %), mid face region (16.21 %). Thirty-three fractures (6.37 %) were overestimated or suspected clinically which could not be confirmed by radiographic technique. Maximum were in mandible (48.5 %) followed by mid face (36.33 %) and cranium (15.15 %).

Conclusion

The idea behind this article is to analyze the various trends and affecting factors and correlation between clinical and radiological findings. A better understanding of the above said would help in future treatment planning and management of facial injuries.

     

Metal oxide QD based ultrasensitive microsphere fluorescent sensor for copper,chromium and iron ions in water

Herein we developed a rapid, cheap, and water-soluble ultra-sensitive ZnO quantum dot (QD) based metal sensor for detecting different hazardous metal ions up to the picomolar range in water. Various spectroscopic and microscopic techniques confirmed the formation of 2.15 ± 0.46 μm of ZnO QD conjugated CMC microspheres (ZCM microspheres) which contain 5.5 ± 0.5 nm fluorescent zinc oxide (ZnO) QDs. Our system, as a promising sensor, exhibited excellent photostability and affinity towards various heavy metal ions. The detection limits were calculated to be 16 pM for Cu²⁺ and 0.18 nM for Cr⁶⁺ ions which are better than previously reported values. The simple fluorescence ‘turn off’ property of our ZCM microsphere sensor system can serve a two-in-one purpose by not only detecting the heavy metals but also quantifying them. Nonetheless, pattern recognition for different heavy metals helped us to detect and identify multiple heavy metal ions. Finally, their practical applications on real samples also demonstrated that the ZCM sensor can be effectively utilized for detection of Cr⁶⁺, Fe³⁺, Cu²⁺ present in the real water samples. This study may inspire future research and design of target fluorescent metal oxide QDs with specific functions.

Herein we developed a rapid, cheap, and water-soluble ultra-sensitive ZnO quantum dot (QD) based metal sensor for detecting different hazardous metal ions up to the picomolar range in water.     

Enhanced ferromagnetism of ZnO@Co/Ni hybrid core@shell nanowires grown by electrochemical deposition method

The hybrid structure of ZnO NWs with the presence of different dopants recently has drawn many interests from researchers due to the possibility to integrate multiple functionalities into one single structure. In this article, we investigated the morphology, crystal structure and ferromagnetism of the ZnO@Co/Ni hybrid core@shell NWs prepared by a facile electrochemical deposition method. The results show that a thin layer of Ni and Co coated on the surface of ZnO NWs (confirmed by XRD, EDS, TEM and Raman scattering) can create a significant improvement of ferromagnetic property in such hybrid core@shell NWs. In which, for the coating time of 10, 15, 20 min, the value of M_s is around 0.67, 0.88 and 2.56 emu g⁻¹ for ZnO@Co NWs, and about 0.013, 0.022 and 0.031 emu g⁻¹ for ZnO@Ni NWs, respectively, in comparison with the number of 0.016 emu g⁻¹ for pure ZnO NWs. Interestingly, we also found the temperature dependence of ferromagnetism of such Co/Ni coated ZnO NWs. These results reveal the possibility to employ such hybrid core@shell NWs for many applications, e.g. spin field effect transistors.

Facile electrochemical synthesis of ZnO@Co and ZnO@Ni hybrid core@shell nanowires with enhanced ferromagnetism.