Comparison of tympanic and rectal temperature in febrile patients

Objective. To compare tympanic membrane temperature and rectal temperature in febrile pediatric patients.Methods. Sixty febrile children were enrolled as continuous enrollment at initial triage. Two readings of ear temperature were taken in each child with Thermoscan infrared thermometer. Rectal temperature was recorded by a digital electronic thermometer. Comparison of both the techniques was done and co-relation co-efficients calculated. Parental preference for both techniques was assessed.Results. It was observed that mean ear temperature was 38.9±0.90C and that for rectal temperature was 38.8±0.8°C. The correlation coefficient between the two was 0.994 (p < 0.01). Coefficients for both sites were comparable over a wide age range. The difference between readings taken from two ears was not significant. Temperature ranges over which readings were recorded were quite wide for both techniques. Parental preference for tympanic thermometry over rectal thermometry was noticed. Tympanic thermometry utilizes pyro-electric sensors, to detect infra-red rays emitted from the surface of tympanic membrane. Ear temperatures correlates well with rectal temperatures which have long been considered as “core” temperatures. Parents prefer the technique of ear thermometry which is quick (2 sec), safe and non-invasive and patient resistance for this is also less.Conclusion. A non-invasive, non-mucous device which is accurate over a wide range of temperature could be very useful.     

Developing SNPs and STR DNA markers for snub-nosed monkeys (Rhinopithecus roxellana) using next-generation sequencing technology

In this study, we describe a protocol of generating a large number of candidate SNPs and STR loci quickly and cost-efficiently for an endangered species, snub-nosed monkeys (Rhinopithecus roxellana), using next-generation sequencing technology. First, we built a reduced representation library of snub-nosed monkeys through digesting the DNA of four individuals using HaeIII and pooling the 350?C500?bp fragments together. Second, we sequenced the DNA pool using pyrosequencing technology. Third, we analyzed sequencing reads using bioinformatic software. We detected 23 putative SNPs, 10 polymorphic STR loci, and 347 candidate STR loci (number of repeats greater than 9). The markers generated by this study can be used to address questions regarding genetic diversity, population structure, phylogeography, and conservation of this endangered primate.     

High predictive ability of glycated hemoglobin on comparison with oxidative stress markers in assessment of chronic vascular complications in type 2 diabetes mellitus

Objective: To validate the diagnostic utility of oxidative stress markers along with glycated hemoglobin (HbA_1c?) in the assessment of chronic vascular complications in type 2 diabetes mellitus (DM). Methods: Ischemia modified albumin (IMA), advanced oxidation protein products (AOPP) and malondialdehyde (MDA) were measured in 100 type 2 DM (without complications n?=?50, with complications n?=?50) and healthy controls (n?=?50). Diagnostic potential was evaluated by receiver operating characteristic analysis and their relationships to risk variables were analyzed. Results: MDA, IMA and AOPP were significantly increased in diabetics, both with and without complications. Oxidative stress parameters correlated with fasting blood glucose and HbA_1c (independent predictors). Duration of diabetes was an independent predictor for AOPP and MDA. The association of IMA with diabetes duration was lost on multiple regression analysis. Area under the curve, sensitivity and specificity for MDA were 0.795, 84%, 66%; for AOPP, they were 0.762, 82%, 56%; for IMA, they were 0.611, 60%, 52%; and for HbA_1c, they were 0.848, 90%, 70%, respectively. Conclusion: MDA and AOPP could be considered better than IMA in the evaluation of diabetes progression, but MDA is more useful as a diagnostic indicator to detect vascular complications. HbA_1c measurement is of greater value than the oxidative stress markers in the prediction of vascular complications.     

On the mechanisms of formation of spherical agglomerates

Spherical agglomerates of benzoic acid have been successfully prepared by semi-batch, agitated vessel, drowning-out crystallization in water–ethanol–toluene mixtures. Benzoic acid is dissolved in ethanol, toluene is added and this mixture is fed at constant rate to the agitated crystallizer containing water. The influence of the amount of bridging liquid and the feeding rate on the product particle size distribution, morphology, and mechanical compression characteristics have been investigated. Compression characteristics for single agglomerates are compared with data on bed compression. With increasing amount of bridging liquid the particle size and strength increases and morphology improves. Particle size decreases and the fracture force increases with increasing feeding rate but the morphology remains unchanged. Using toluene as opposed to chloroform as the bridging liquid leads to improved product properties. Experiments have also been performed to reveal the mechanisms of the formation of the agglomerates. The results show that along the course of the process the properties of the particles change gradually but substantially. Particle size and number increases along with increasing feed. The spherical shape does not appear immediately but develops gradually, and is shown to be very much the result of the agitation of the slurry.     

IVC tumor thrombus: an advanced case of rare extraosseous Ewing sarcoma of the adrenal gland

Extraosseous Ewing sarcoma (ES) of the adrenal gland is a rare, aggressive tumor of young adults, with <10 cases reported. We present the radiological findings of an unusual case of adrenal and renal vein tumor thrombosis extending into the inferior vena cava, secondary to ES of the adrenal gland in a 26-year-old female.     

Influence of NOD-like receptor 2 gene polymorphisms on muramyl dipeptide induced pro-inflammatory response in patients with active pulmonary tuberculosis and household contacts

PurposeThe immune response induced by nucleotide-binding oligomerization domain-2(NOD2) is associated with the production of cytokines affected by the host's genetic background. The present study aimed to examine the effects of NOD2; 802C > T, 2105G > A polymorphisms associated with altered cytokine levels in patients with active pulmonary tuberculosis disease, Latent TB subjects (household contacts(HHC) and healthy controls(HC).MethodsGenetic polymorphisms were analyzed by Restriction Fragment Length Polymorphism(RFLP) in 102-PTB patients, 102-HHC, and 132-HC. QuantiFERON-TB Gold In-Tube test was performed to identify latent TB infection in 60-HHC. Estimated their cytokine levels by ELISA in MDP (muramyl dipeptide) stimulated culture supernatants of all the groups. Further, we studied pre-mRNA structures by insilico analysis and relative gene expression by RT-PCR.ResultsRecessive genetic models of NOD2 802C > T SNP with TT genotype and AA genotype of NOD2 2105G > A SNP were significantly associated with increased TB risk in PTB patients and HHC compared with HC. In vitro stimulations were performed with NOD2 ligand MDP in PTB patients and latent TB subjects: QuantiFERON positive household contacts (QFT + ve HHC)and QuantiFERON negative household contacts(QFT-ve HHC). The results showed that reduced TNF-α and enhanced IL-12, IL-1β indicate that these cytokines may play an essential role in the initial maintenance of cell-mediated immunity. Our study demonstrated the correlation between NOD2 polymorphism with IL-1β, TNF-α, IL-12 levels. Insilico analysis represents the pre-mRNA secondary structures affected by NOD2 SNPs. We also observed the difference in m RNA levels in variant and wild genotypes.ConclusionThis finding may lead to the forthcoming development of immunotherapy and may be used as predictive markers to identify high-risk individuals for TB disease.     

Surgical-orthodontic treatment of Class I malocclusion with maxillary vertical excess--a case report

This article describes the treatment of an adult male with vertical maxillary excess, excessive gingival display on smiling, a convex profile, proclined upper and lower incisors, and crowded lower anteriors with severe lip incompetence. The therapy included stages: (1) Pre surgical orthodontics- leveling and aligning of the maxillary and mandibular arch with closure of all extraction spaces. (2) Surgical phase-Lefort I osteotomy for superior maxillary impaction, 5 mm of anterior and 3 mm of posterior impaction ofmaxilla was done. (3) Post surgical orthodontics for finishing and detailing. The treatment lasted 16 months; improved facial esthetics significantly; and resulted in a normal occlusion, overjet, and overbite.