Exposure to chlorine affects the extracellular polymeric substance production and cell surface hydrophobicity in biofilm bacteria

Chlorination is a common antifouling method adopted by industrial units to minimize the fouling growth on cooling systems. In the present study, the effect of sodium hypochlorite on extracellular polymeric substance (EPS) production, hydrophobicity, cell adhesion and viability of marine bacteria involved in biofilm formation were assessed in laboratory condition. Two bacterial strains, tentatively identified as Alteromonas sp. and Pseudomonas sp. isolated from the surface of seaweeds were used as test organisms for the present study. The bacterial cultures were treated with sodium hypochlorite at 25% of the minimum inhibitory concentration. Results showed considerable variation in the production of EPS, viable counts, hydrophobicity and adhesion ability of bacteria treated with sodium hypochlorite. In general, the present study indicated that chlorination affects some important characteristics involved in the biofilm formation and thereby reduces the adhesion rate on surfaces.     

Low risk of viral infection after administration of vapor-heated factor VIII concentrate. International Investigator Group

A multicenter prospective study was carried out to evaluate whether a vapor-heated factor VIII concentrate transmitted blood-borne viral infections over a surveillance period of 15 months. Thirty-five patients with hemophilia and von Willebrand disease who had never received any blood components were treated. Twenty-eight were analyzed and found not to have non-A, non-B hepatitis. Sera from 20 of these 28 patients were also tested for the antibody to the hepatitis C virus. None had sero-converted during the follow-up period. None of the patients analyzed developed markers of the hepatitis B virus (n = 17) or the human immunodeficiency virus (n = 31). This vapor-heated factor VIII concentrate carries a low risk of transmitting hepatitis and human immunodeficiency virus infection.     

Subungual malignant melanoma clinically resembling granuloma pyogenicum

A 37-year-old labourer developed longitudinally split dystrophic nail with blackish discolouration in the centre 5 months following blunt trauma to the right thumb nail. Six months later, a well defined exudative erythematous to violaceous nodule developed and this recurred inspite of repeated surgical interventions. Patient had large, firm to hard epitrochlear and axillary lymphadenopathy. Histopathological examination confirmed the diagnosis of malignant melanoma.     

Severe thrombocytopenia is associated with high mortality in systemic lupus erythematosus—analysis from Indian SLE Inception cohort for Research (INSPIRE)

Clinical Rheumatology - Thrombocytopenia in patients with systemic lupus erythematosus (SLE) is associated with higher morbidity and mortality. We report frequency, associations and short-term...     

Olfaction in leprosy

Olfactory test was carried out in 225 cases of Hansen's disease with 75 cases each of lepromatous leprosy (L.L.), borderline leprosy (B.L.) and tuberculoid leprosy (T). Impairment of olfaction was found in 94(41.7%) cases. It was seen in 69.33% cases of L.L., 33.33% cases of B.L. and 22.6% cases of T. Total anosmia was present in 5(6.61%) cases of L.L. only. Males were more affected than the females. Impairment of olfaction was related to the duration of the disease, severity of the nasal condition, and E.N.L. reaction. It was not related to the type of antileprosy drug used.     

Vitamin D and child health in the 21<Superscript>st</Superscript> century

Context  

Vitamin D has emerged as a topic of great interest among researchers. Recent evidence indicates that today the world is facing vitamin D deficiency pandemic. Sensitizing pediatricians to widespread vitamin D deficiency in children and benefits accrued from it’s correction would go a long way as far as clinical practice and public health is concerned.     

Invasive pneumococcal infections in children with sickle cell disease in the era of penicillin prophylaxis, antibiotic resistance, and 23-valent pneumococcal polysaccharide vaccination

Rates and severity of pneumococcal infections in children with sickle cell disease were examined before licensure of pneumococcal-conjugated vaccine (PVC). Rates of peak invasive infection rates in 1-year-old children with hemoglobin SS and mortality in those 0 to 10 years of age were 36.5 to 63.4 and 1.4 to 2.8 per 1000 person-years, respectively (>10 and 100 times as frequent as in the general population). Overall, 71% of serotyped isolates (n=80) were PVC serotypes and 71% of nonvaccine serotype strains were penicillin-sensitive. Clinical presentation in children with hemoglobin SS (n=71; more with hypotension) and hemoglobin SC (n=18; more with acute chest syndrome, otitis media) differed. Penicillin nonsusceptibility (38% of isolates) varied between geographic study sites. Penicillin prophylaxis appeared less effective against intermediate and resistant strains. Of all infected children, meningitis developed in 20% and 15% died (hemoglobin SS, n=15 and 11; hemoglobin SC, n=1 each). Factors associated with death included age >4 years (58%), serotype 19F, and not being followed by a hematologist (42% each). The pneumococcal-polysaccharide vaccine was 80.4% effective within 3 years after vaccination (95% CI, 39.7, 93.6). Children with sickle cell disease of all ages may benefit from PVC boosted with polysaccharide vaccination.     

Survey of sleep problems amongst Singapore children in a psychiatric setting

Background Sleep problems are common among children and range from transient ones to chronic problems like snoring, somnambulism and bedwetting. Sleep problems in turn impact on children’s health, learning, school performance, quality of life and are often closely related to mental health problems. Population based surveys have also revealed a strong association between sleep problems and behavioral and emotional symptoms in children. The objectives of our study were to estimate the prevalence of sleep problems in children and adolescents attending psychiatric services in Singapore and to identify the correlates of sleep problems in this population. Methods A total of 490 parents/guardians accompanying their children to the child guidance clinic consented to complete a questionnaire, which was used to collect both sociodemographic data and the frequency of sleep problems. These included sleep starts, confusional arousal, sleep talking, bruxism, sleep walking, sleep terrors, nightmares, sleep paralysis and nocturnal enuresis. Psychiatric diagnosis was determined from case record survey of the participating subjects. Results About 62.2% (95% CI 57.8%–66.6%) of the children suffered from at least one problem. Girls were significantly more likely to suffer from sleep problems when compared with boys (χ² = 8.5, P < 0.005). The significant predictors for sleep problems were gender, diagnosis of developmental disorders and a family history of sleep problems. Conclusions The study highlights the need for child and adolescent psychiatrists to enquire about sleep problems since sleep disturbances of children are frequent and may not be self-reported. This project was supported by an Institutional Block Grant Received from the National Medical Research Council, Singapore     

Alarm settings for the Marquette 8000 pulse oximeter to prevent hyperoxic and hypoxic episodes

OBJECTIVE: To determine safe and appropriate alarm limits for the Marquette 8000 pulse oximeter to prevent hyperoxic and hypoxic episodes in neonates. It is necessary to define these limits for each brand of oximeter because of the variance in nonuser adjustable calibration algorithms used in pulse oximeters. METHODOLOGY: Oxygen saturation values obtained from a Marquette 8000 pulse oximeter (SpO2) were compared with simultaneous arterial blood gas PaO2 values obtained from blood gas analysis, for 322 samples in 24 consecutive neonates (median 30 weeks' gestation). RESULTS: In order to prevent 95% of hyperoxic episodes (PaO2 > 90 mmHg), the upper alarm limit was 95% SpO2. Similarly, to prevent 95% of hypoxic episodes (PaO2 < 40 mmHg), the lower alarm limit was 95% SpO2. A sensitivity lower than 95% had to be accepted to develop an alarm range which prevented both hyperoxic and hypoxic episodes. To maintain PaO2 values between 40 and 90 mmHg, an appropriate alarm range of 94-97% SpO2 (90% sensitivity, 28% specificity) was established. CONCLUSIONS: The relative merits of high sensitivity versus high specificity should be considered when determining appropriate alarm limits. Alarm limits which represent a balance between sensitivity and specificity will minimise false alarms and provide a clinically practical range. It would be useful for this type of information to be available for each brand of oximeter, to assist the user in determining appropriate alarm settings.