Analysis of humpback whale sounds in shallow waters of the Southeastern Arabian Sea: An indication of breeding habitat.

The primary objective of this work was to present the acoustical identification of humpback whales, detected by using an autonomous ambient noise measurement system, deployed in the shallow waters of the Southeastern Arabian Sea (SEAS) during the period January to May 2011. Seven types of sounds were detected. These were characteristically upsweeps and downsweeps along with harmonics. Sounds produced repeatedly in a specific pattern were referred to as phrases (PQRS and ABC). Repeated phrases in a particular pattern were referred to as themes, and from the spectrographic analysis, two themes (I and II) were identified. The variation in the acoustic characteristics such as fundamental frequency, range, duration of the sound unit, and the structure of the phrases and themes are discussed. Sound units were recorded from mid-January to mid-March, with a peak in February, when the mean SST is ~28°C, and no presence was recorded after mid-March. The temporal and thematic structures strongly determine the functions of the humpback whale song form. Given the use of song in the SEAS, this area is possibly used as an active breeding habitat by humpback whales during the winter season.

Ruptured splenic abscess presenting as peritonitis: a case report.

Incidence of splenic abscess is a rare -0.05-0.7% and rarer still is the rupture of the abscess. We present a patient who presented with features of peritonitis and investigations and emergency laparotomy revealed a ruptured splenic abscess with dense adhesions between spleen and diaphragm, stomach, splenic flexure, kidney and lateral abdominal wall due to perisplenitis. Patient was treated with emergency splenectomy and antibiotics. Patient recovered although after a stormy immediate post operative period due to septicaemia. This case is presented owing to the rarity of presentation.

Parotid fistula due to iatrogenic parotid duct injury.

The most common cause of parotid fistula is trauma, operative complications followed by malignancy and infection. Injury to the duct may be difficult to diagnose unless one has high index of suspicion while operating in the parotid region. Sequelae of inadequate diagnosis and treatment include parotid fistula and sialocele formation which are inconvenient for the patient and difficult to treat. We are reporting a case of parotid fistula due to injury to parotid duct following extensive debridement for necrotising fasciitis of cheek extending to the neck following tooth extraction.

Evaluación y manejo del paciente con accidente isquémico transitorio / Evaluation and management of patients with transitory ischemic accident

El manejo de los pacientes con accidente isquémico transitorio (AIT) en los servicios de urgencia es muy variable, en algunas instituciones todos los pacientes son admitidos al hospital para su evaluación y tratamiento, y en otras se recomienda efectuar la evaluación en el ámbito ambulatorio. Definir el pronóstico a corto plazo y los factores de riesgo para desarrollar un accidente vascular encefálico después de un episodio de AIT nos permite identificar a los grupos de riesgo que necesitan ser admitidos al hospital porque requieren monitorización y evaluación inmediata. En la última década, el manejo de los pacientes con AIT ha sufrido cambios significativos que los médicos de los servicios de urgencia deben conocer e incorporar en sus protocolos de atención. En esta revisión se han actualizado algunos conceptos sobre tópicos específicos relacionados con el manejo de urgencia de pacientes con AIT: 1) La definición de AIT ha sido modificada, 2) Criterios diagnósticos de AIT, 3) Evaluación diagnóstica y tratamiento recomendado para el paciente con AIT, 4) Evaluación de los factores de riesgo que permiten orientar el lugar de manejo y el estudio de los enfermos. Para ilustrar el problema, se presenta el caso clínico de un paciente que consultó en el servicio de urgencia por síntomas neurológicos transitorios que no estaban presentes en el momento de la consulta.

Management of patients with acute transient ischemic attack (TIA) varies widely, with some institutions admitting all patients and others proceeding with outpatient evaluations. Defining the short-term prognosis and risk factors for stroke after TIA may provide guidance in determining which patients need rapid evaluation. In the past few years, the approach to patients with transient ischemic attacks has undergone a transformation. To care for these patients, emergency physicians must understand these changes. They must be comfortable with the diagnosis and treatment of transient ischemic attacks in their emergency department. To this end, we ask and answer the following important questions in this up-to-date review of transient ischemic attacks: 1) How is a transient ischemic attack defined?, 2) Does this patient have a transient ischemic attack?, 3) Once diagnosed, what diagnostic evaluation should be done (and when)?, 4) What treatment should be instituted (and when)? and 5) What is the correct disposition? We submit a case report of a patient who presented to the emergency physician completely asymptomatic with complaints of transient neurologic symptoms.

Tuberculin specific T cell responses in BCG vaccinated children.

The effector mechanisms of BCG protection were examined 5-7 years after vaccination. The in vitro lymphoproliferation, following stimulation with tuberculin, in normal, (A) vaccinated and (B) unvaccinated children and children with tuberculosis (C), were assayed. The mean stimulation index (SI) of lymphocyte transformation in normal subjects were significantly (P < 0.05) higher than those with tuberculosis. The ratio of tuberculin-specific CD4 to CD8 cells in short-term cultures were significantly (P less than 0.05) higher in the vaccinees. In group (A), 70 % had positive ratios as against 20 %and 0 %in groups (B) and (C), respectively. Secretion of IL-2 by the cells was significantly (P < 0.05) high in the vaccinated. None of the unvaccinated children had positive levels of IL-2. The vaccinees also had highly significant (P < 0.01) levels of IFN-)in the supernatants of cell-cultures, following tuberculin stimulation. In majority of the BCG vaccinated children, the stimulation of specific TH1 cells seem to be considerably high, in short-term in vitro cultures. While these responses were not so marked in the unvaccinated, they were almost totally absent in the patients.