Retained surgical sponge after laparotomy

Erosion of a retained surgical sponge into the intestine is an unusual occurrence and may make its appearance months or years later. The demonstration of a distended bowel by the barium-impregnated mass with multiple polypoidal filling defects in a patient who has undergone previous laparotomy should lead the physician to suspect a retained surgical sponge. Surgical intervention is rewarding.     

Synthesis of new <Emphasis Type="Italic">O</Emphasis>-alkyl and alkyne–azide cycloaddition derivatives of 4′-methoxy licoflavanone: a distinct prenylated flavonoids depicting potent cytotoxic activity

Prenylated flavonoids represent a unique class of naturally occurring compounds and have proved to be an important source of chemically diverse novel metabolites. Nevertheless, they possess wild array of biological activities. 4′-Methoxy licoflavanone is a prenylated flavonoid isolated from stem bark of Erytherina subrossa. Herein, we report the synthesis of O-alkyl analogs (2a–2m) and 1,2,3 triazole conjugate (3–14) of 4′-methoxy licoflavanone by selective modification at C-7 position in the chromane nucleus. In addition, all the derivatives were evaluated for in vitro antiproliferative activity against a panel of cancer cell lines including pancreatic cancer (Mia PaCa-2), prostate cancer (PC-3), and human leukemia (HL-60) cells. The results revealed that some analogs including 2e and 2m exhibited better cytotoxicity effect than parent compound, specifically on Mia PaCa-2 cell lines.     

Controlling room temperature ferromagnetism and band gap in ZnO nanostructured thin films by varying angle of implantation

The defects in the host lattice play a major role in tuning the surface roughness, optical band gap and the room temperature ferromagnetism (RTFM) of ZnO thin films. Herein, we report a novel approach to tailor the band gap and RTFM of a ZnO nanostructure by varying the angle of implantation of 60 keV N ions keeping the ion fluence of 1 × 10¹⁶ ions per cm² and the beam size of 3 mm constant. The implantation was performed by changing the thin films'' orientations at 30°, 60° and 90° with respect to the incident beams. Remarkably, an enhancement of ∼6 times in RTFM, tuning in band gap from 3.27 to 3.21 eV and ∼60% reduction in surface roughness were noticed when the ion implantation was done at 60° to the normal. This novel technique may be suitable for tuning the physical properties of nanostructures for their application in the spintronics, semiconductor and solar cell industries.

The defects in the host lattice play a major role in tuning the surface roughness, optical band gap and the room temperature ferromagnetism of ZnO thin films.     

Factors influencing the provision of oral hygiene care following stroke: an application of the Theory of Planned Behaviour

Objectives: This study aimed to examine “intention to” and “performance of” oral hygiene care to stroke patients using the Theory of Planned Behavior.

Materials and methods: A large scale survey of 13 centers in Malaysia was conducted involving 806 nurses in relation to oral hygiene care intentions and practices. In addition, information on personal and environmental factors was collected.

Results: The response rate was 95.6% (778/806). The domains of the Theory of Planned Behavior were significantly associated with general intention to perform oral hygiene care: attitudes (β?=?0.21, p?p?p?p?<0.01), controlling for other factors. Knowledge scores, training, access to oral hygiene guidelines and kits, as well as working ward type were identified as key factors associated with intention and practice of oral hygiene care.

Conclusion: The Theory of Planned Behavior provides understanding of “intention to” and “performance of” oral hygiene care to stroke patients. Several provider and environmental factors were also associated with intentions and practices. This has implications for understanding and improving the implementation of oral hygiene care in stroke rehabilitation.

• Implications for Rehabilitation

• Oral hygiene care is crucial for stroke patients as it can prevent oral health problems and potentially life threatening events (such as aspiration pneumonia).

• Despite oral hygiene care being relative simple to perform, it is often neglected during stroke rehabilitation.

• A large-scale national survey was conducted to understand “intentions to” and “performance of” oral hygiene care to stroke patients using the Theory of Planned Behavior social cognition model.

• These study findings may have implications and use in promoting oral hygiene care to stroke patients:i) by understanding the pathways and influences to perform oral hygiene care.ii) to conduct health promotion and health education based on behavioral models such as Theory of Planned Behavior.

     

In vivo corneal confocal microscopic analysis in patients with keratoconus

AIM:To quantify corneal ultrastructure using laser scanning in vivo confocal microscopy (IVCM) in patients with keratoconus and control subjects.METHODS: Unscarred corneas of 78 keratoconic subjects without a history of contact lens use and 36 age-matched control subjects were evaluated with slit-lamp examination (SLE), corneal topography and laser scanning IVCM. One eye was randomly chosen for analysis. Anterior and posterior stromal keratocyte, endothelial cell and basal epithelial cell densities and sub-basal nerve structure were evaluated.RESULTS: IVCM qualitatively demonstrated enlarged basal epithelial cells, structural changes in sub-basal and stromal nerve fibers, abnormal stromal keratocytes and keratocyte nuclei, and pleomorphism and enlargement of endothelial cells. Compared with control subjects, significant reductions in basal epithelial cell density (5817±306 cells/mm² vs 4802±508 cells/mm², P<0.001), anterior stromal keratocyte density (800±111 cells/mm² vs 555±115 cells/mm², P<0.001), posterior stromal keratocyte density (333±34 cells/mm² vs 270±47 cells/mm², P<0.001), endothelial cell density (2875±223 cells/mm² vs 2686±265 cells/mm², P<0.001), sub-basal nerve fiber density (31.2±8.4 nerves/mm² vs 18.1±9.2 nerves/mm², P<0.001), sub-basal nerve fiber length (21.4±3.4 mm/mm² vs 16.1±5.1 mm/mm², P<0.001), and sub-basal nerve branch density (median 50.0 (first quartile 31.2 - third quartile 68.7) nerve branches/mm² vs median 25.0 (first quartile 6.2 - third quartile 45.3) nerve branches/mm², P<0.001) were observed in patients with keratoconus.CONCLUSION: Significant microstructural abnormalities were identified in all corneal layers in the eyes of subjects with keratoconus using IVCM. This non-invasive in vivo technique provides an important means to define and follow progress of microstructural changes in patients with keratoconus.     

Molecular Epidemiology of Hospital Outbreak of Middle East Respiratory Syndrome,Riyadh, Saudi Arabia, 2014

We investigated an outbreak of Middle East respiratory syndrome (MERS) at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, during March 29–May 21, 2014. This outbreak involved 45 patients: 8 infected outside KFMC, 13 long-term patients at KFMC, 23 health care workers, and 1 who had an indeterminate source of infection. Sequences of full-length MERS coronavirus (MERS-CoV) from 10 patients and a partial sequence of MERS-CoV from another patient, when compared with other MERS-CoV sequences, demonstrated that this outbreak was part of a larger outbreak that affected multiple health care facilities in Riyadh and possibly arose from a single zoonotic transmission event that occurred in December 2013 (95% highest posterior density interval November 8, 2013–February 10, 2014). This finding suggested continued health care–associated transmission for 5 months. Molecular epidemiology documented multiple external introductions in a seemingly contiguous outbreak and helped support or refute transmission pathways suspected through epidemiologic investigation.     

Kinetics of Serologic Responses to MERS Coronavirus Infection in Humans,South Korea

We investigated the kinetics of serologic responses to Middle East respiratory syndrome coronavirus (MERS-CoV) infection by using virus neutralization and MERS-CoV S1 IgG ELISA tests. In most patients, robust antibody responses developed by the third week of illness. Delayed antibody responses with the neutralization test were associated with more severe disease.