Prevalence and Correlates of Sustained Hypertension in Adolescents of Rural Wardha,Central India

Objective  

To study the prevalence of hypertension and its determinants among adolescents in rural areas of Wardha.     

Umbilical Signs of Peritoneal Tuberculosis in Children

Objectives  

To report the observation of involvement of the umbilicus with alteration of its morphology in association with peritoneal tuberculosis.     

Renal cortical necrosis and acute kidney injury associated with Plasmodium vivax: a neglected human malaria parasite

Plasmodium vivax is causing increasingly more cases of severe malaria worldwide. There is an urgent need to reexamine the clinical spectrum and burden of P. vivax so that adequate control measures can be implemented against this emerging but neglected disease. Herein, we report a case of renal acute cortical necrosis and acute kidney injury (AKI) associated with P. vivax monoinfection. Her initial serum creatinine was 7.3?mg/dL on admission. Modification of Diet in Renal Disease (MDRD) Study glomerular filtration rate (GFR) value was 7?mL/min/1.73?m² (normal kidney function—GFR above 90?mL/min/1.73?m² and no proteinuria). On follow-up, 5?months later, her SCr. was 2.43?mg/dl with no proteinuria. MDRD GFR value was 24?mL/min/1.73?m² suggesting severe chronic kidney disease (CKD; GFR less than 60 or kidney damage for at least 3?months), stage 4. Our case report highlights the fact that P. vivax malaria is benign by name but not always by nature. AKI associated with P. vivax malaria can lead to CKD. Further studies are needed to determine why P. vivax infections are becoming more severe.     

The benefit of stratification in clinical trials revisited

Stratification is common in clinical trials because it can reduce the variance of the estimated treatment effect. The traditional demonstration of variance reduction relies on the assumption of stratum sizes being fixed quantities. However, in practice, to speed up enrollment, and to obtain a study population with a similar distribution as the overall population, the stratum sizes are allowed to vary. Under the condition that the total sample size is fixed and that the stratum sizes have a multinomial distribution, the criterion changes for achieving a reduction in variance. The relationship between the stratified and unstratified variances is established and shown to be approximately the same for prestratified and post-stratified trials. It is demonstrated why stratification may actually increase the variance compared with no stratification even when the mean square error is reduced on account of stratification. Data from a real clinical trial will be used for illustration. The benefit attributed to stratification needs to be re-examined in light of the findings presented, particularly given its widespread use.     

The opsoclonus–myoclonus syndrome

The opsoclonus–myoclonus syndrome is a rare and distinct neurological disorder characterised by rapid multidirectional conjugate eye movements (opsoclonus), myoclonus and ataxia, along with behavioural changes in adults and irritability in children. Sometimes it is due to a self-limiting presumed para-infectious brainstem encephalitis but it may also represent a non-metastatic manifestation of neuroblastoma in children and small cell carcinoma of the lung in adults. In this article, we will describe the clinical features, diagnosis, pathogenesis and management.     

Severity profile of penetrating ballistic-like brain injury on neurofunctional outcome, blood-brain barrier permeability, and brain edema formation

This study evaluated the injury severity profile of unilateral, frontal penetrating ballistic-like brain injury (PBBI) on neurofunctional outcome, blood-brain barrier (BBB) permeability, and brain edema formation. The degree of injury severity was determined by the delivery of a water-pressure pulse designed to produce a temporary cavity by rapid (<40?ms) expansion of the probe's elastic balloon calibrated to equal 5%, 10%, 12.5%, or 15% of total rat brain volume (control groups consisted of sham surgery or insertion of the probe only). Neurofunctional assessments revealed motor and cognitive deficits related to the degree of injury severity, with the most clear-cut profile of PBBI injury severity depicted by the Morris water maze (MWM) results. A biphasic pattern of BBB leakage was detected in the injured hemisphere at all injury severity levels at 4?h post-injury, and again at 48-72?h post-injury, which remained evident out to 7 days post-PBBI in the 10% and 12.5% PBBI groups. Likewise, significant brain edema was detected in the injured hemisphere by 4?h post-injury and remained elevated out to 7 days post-injury in the 10% and 12.5% PBBI groups. However, following 5% PBBI, significant levels of edema were only detected from 24?h to 48h post-injury. These results identify an injury severity profile of BBB permeability, brain edema, and neurofunctional impairment that provides sensitive and clinically relevant outcome metrics for studying potential therapeutics.     

Single‐Step Magnetic Patterning of Iron Nanoparticles in a Semiconducting Polymer Matrix

Summary: A cost‐effective chemical synthesis and single‐step magnetic patterning of iron nanoparticles (size ≈100 nm) in a semiconducting P3OT polymer matrix is reported wherein Fe nanostructures (≈150 ± 50 nm) are periodically aligned with π‐conjugated P3OT chains to form a nanomagnet‐semiconductor‐nanomagnet (Fe‐π‐Fe) structure. The resultant periodic patterning has been characterized by XRD, SEM and AFM techniques and is attributed to the intrinsic alignment of Fe at the nanometer‐scale level in a conjugated polymer matrix under the influence of a magnetic field. Such a P3OT/Fe matrix may find application in magnetic memory devices.

AFM image in nanometers showing the periodic nanostructuring of P3OT‐Fe matrices when the P3OT‐Fe nanocomposite films were grown under an applied magnetic field.