Modelling the Impact of Multiple Pro-inflammatory Cytokines Using Molecular Communication

Motivated by various health care applications and many other novel fields of Molecular Communication (MC), it has become an important field of research since the last decade. This paper proposes a molecular communication-based model for the spread of the SARS-CoV2 virus in the human body. The virus uses the ACE2 receptor as a gateway to enter the blood vessels, organs and then replicate itself. In response to the infection, the immune system synthesizes pro-inflammatory cytokines such as IL6, IL2, and TNFa. This active bodily response may be further compromised by the generation of anti-inflammatory cytokines such as IL4 and IL10. We also propose a mathematical model using a Markov state transition for a flow-based molecular communication system which contributes to the detection of these pro-inflammatory cytokines level and gives a further inference about the infection in the body by taking multiple cytokines into account. © 2022 IEEE.

Massive Haemoperitoneum Postovulation: A Rare Complication of Unmonitored Anticoagulant Therapy

Derangements in coagulation profile due to on-going anticoagulant medication can complicate the most primitive physiology in a woman, ovulation. Unmonitored anticoagulant therapy can lead to an array of complications, one of which is intraperitoneal haemorrhage secondary to numerous medical and surgical conditions. The resultant haemoperitoneum can cause sudden hypovolemic shock, especially in a patient with compromised cardiovascular status. This report narrates the case of a 30 years old nulliparous female patient on anticoagulant therapy, operated for multiple cardiac defects and developed massive haemoperitoneum as a consequence of ovulation. The patient presented in shock to the Emergency Department with unstable haemodynamic status. A multi-disciplinary approach to the case converged on ruptured functional ovarian cyst as a working diagnosis. Conservative management of haemoperitoneum was decided upon, whereby correcting shock and providing pro-coagulant therapy along with blood products was the main line of management. All efforts failed soon after when the cyst wall ruptured catastrophically, leading to collapse of the general condition of the patient. Surgical approach was undertaken and a ruptured ovarian cyst wall was identified to be the cause. The cyst wall was subsequently repaired electrosurgically and the patient recovered well with an uneventful postoperative period. However, the characteristic feature of this case is the lack of follow-up due to lockdown restrictions of this continuum, the Coronavirus Disease-2019 (COVID-19) pandemic. The management of such cases must be carefully titrated, keeping in mind the risks and benefits of both pro-coagulant and anti-coagulant therapy wherein one can jeopardise the effects of the other.