Spontaneous retroperitoneal haemorrhage post-coronary angioplasty: a case report.

BACKGROUND: Spontaneous retroperitoneal haemorrhage (SRH) is a rare cause of retroperitoneal haemorrhage in patients who are on anticoagulants or antiplatelet agents or both. CASE SUMMARY: We report here a rare and catastrophic complication of use of anticoagulants and antiplatelet drugs in a case undergoing coronary angioplasty. The patient had multiple coronary risk factors and developed acute myocardial infarction with pulmonary oedema and hypotension during hospitalization for treatment of lower respiratory tract infection and diabetic ketoacidosis. He underwent successful angioplasty of the culprit vessel but later developed hypotension attributable to retroperitoneal haemorrhage. No bleeding site was identified despite extensive evaluation of the aorta and iliac vessels. DISCUSSION: A diagnosis of SRH is considered when a patient on anticoagulants or antiplatelet drugs develops retroperitoneal haemorrhage without any specific identifiable site of bleeding in the retroperitoneum. Diffuse vasculopathy and atherosclerosis or vasculitis of the small vessels in the retroperitoneum may result in rupture of the most friable vessels and result in bleeding. Intense cough, forceful vomiting or sneezing may also be responsible for traumatizing the vessels and resulting in bleeding. Most cases recover with conservative management but some may benefit from interventional occlusion of the leak or surgical decompression in cases of abdominal compartment syndrome.

Development of superhydrophillic tannic acid-crosslinked graphene oxide membranes for efficient treatment of oil contaminated water with enhanced stability.

In the present age of industrialization, oil contamination in the waste water has become a huge global concern due to its several negative impacts on human health and aquatic ecosystem. In order to address this problem, a novel oleophobic and super-hydrophilic graphene-based membrane has been developed using simple and cost-effective vacuum filtration methodology. Prior developing the membranes, the graphene oxide (GO) sheets were crosslinked with tannic acid (TA) molecules in order to improve their mechanical and surface properties. To obtain the structural and morphological information of the membranes and their constituents, Field Emission Scanning Electron (FE-SEM) microscopy, X-Ray Diffraction (XRD), FTIR spectroscopy and Raman spectroscopy was used. When tested with simulated oilfield effluent samples, these membranes exhibited significant reduction in the values of chemical oxygen demand (COD), total dissolved solids (TDS), total suspended solids (TSS) and turbidity demonstrating low-oil adhesion and preferable oil rejection rates. Moreover, such crosslinked membranes are highly stable which can withstand the pressure of water filtration. In such a way, TA crosslinked GO membranes present a robust and efficient way to treat oil contaminated water released from various industries which can be reused for numerous further applications.

High throughput detection and genetic epidemiology of SARS-CoV-2 using COVIDSeq next generation sequencing

The rapid emergence of coronavirus disease 2019 (COVID-19) as a global pandemic affecting millions of individuals globally has necessitated sensitive and high-throughput approaches for the diagnosis, surveillance and for determining the genetic epidemiology of SARS-CoV-2. In the present study, we used the COVIDSeq protocol, which involves multiplex-PCR, barcoding and sequencing of samples for high-throughput detection and deciphering the genetic epidemiology of SARS-CoV-2. We used the approach on 752 clinical samples in duplicates, amounting to a total of 1536 samples which could be sequenced on a single S4 sequencing flow cell on NovaSeq 6000. Our analysis suggests a high concordance between technical duplicates and a high concordance of detection of SARS-CoV-2 between the COVIDSeq as well as RT-PCR approaches. An in-depth analysis revealed a total of six samples in which COVIDSeq detected SARS-CoV-2 in high confidence which were negative in RT-PCR. Additionally, the assay could detect SARS-CoV-2 in 21 samples and 16 samples which were classified inconclusive and pan-sarbeco positive respectively suggesting that COVIDSeq could be used as a confirmatory test. The sequencing approach also enabled insights into the evolution and genetic epidemiology of the SARS-CoV-2 samples. The samples were classified into a total of 3 clades. This study reports two lineages B.1.112 and B.1.99 for the first time in India. This study also revealed 1,143 unique single nucleotide variants and added a total of 73 novel variants identified for the first time. To the best of our knowledge, this is the first report of the COVIDSeq approach for detection and genetic epidemiology of SARS-CoV-2. Our analysis suggests that COVIDSeq could be a potential high sensitivity assay for detection of SARS-CoV-2, with an additional advantage of enabling genetic epidemiology of SARS-CoV-2.

Financial Advice for Difficult Times: 2 Sides of a Coin.

This article invites 2 experts having knowledge of financial management: one from within the dental fraternity and one from outside to assist the orthodontists (academic and practitioners alike) to help provide some guidance to sail through these turbulent times. With the COVID-19 pandemic, we are witnessing an unprecedented moment in history that has impacted the entire globe at a never before seen scale. This coronavirus has resulted in a double black swan event where there is a health and financial pandemic at the same time. As orthodontists, you are also corona warriors and part of the first line of defense! But even you would be facing a decrease in patients and earnings, maybe even an increase in your expenses as you are battling through this pandemic. These turbulent times have greatly affected businesses and livelihoods, and everyone wants to know the best thing that they can do to manage and optimize their personal finances.

Three-Year Outcomes of Biodegradable Polymer-Coated Ultra-Thin (60 µm) Sirolimus-Eluting Stents in Real-World Clinical Practice.

INTRODUCTION: Although drug-eluting stents (DES) have outclassed the use of bare metal stents, the safety and efficacy of DES at long-term follow-up has still been conflicting because of increased occurrence of late or very late restenosis and stent thrombosis after DES implantation. Hence, the present study was aimed to evaluate the 3-year safety and clinical performance of biodegradable polymer-coated ultra-thin (60 µm) sirolimus-eluting stent (SES) in real-world patients with coronary artery disease (CAD). MATERIALS AND METHODS: This was a physician-initiated, retrospective, single-centre, observational study that included 237 consecutive patients who had previously undergone implantation of only Supraflex SES (Sahajanand Medical Technologies Pvt Ltd, Surat, India) for the treatment of CAD. Follow-up was received after 1 year and 3 years of stent implantation. The primary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI) and target lesion revascularisation (TLR). Stent thrombosis was considered as a safety endpoint. RESULTS: The mean age of patients was 64.1 ± 10.2 years, and 192 (81.0%) patients were male. The average stent length and diameter were 24.4 ± 9.0 mm and 3.1 ± 0.4 mm, respectively. The cumulative MACE rate at 3 years follow-up was 6.5% which included 4 (1.8%) cardiac deaths, 6 (2.8%) MI, and 4 (1.8%) TLR. There were 2 (0.9%) cases of stent thrombosis. CONCLUSION: Treatment of patients with CAD in real-world clinical practice was associated with sustained clinical safety and low rates of restenosis, stent thrombosis and MACE up to 3 years after Supraflex SES implantation.

Three-Year Outcomes of Biodegradable Polymer-Coated Ultra-Thin (60 µm) Sirolimus-Eluting Stents in Real-World Clinical Practice

INTRODUCTION@#Although drug-eluting stents (DES) have outclassed the use of bare metal stents, the safety and efficacy of DES at long-term follow-up has still been conflicting because of increased occurrence of late or very late restenosis and stent thrombosis after DES implantation. Hence, the present study was aimed to evaluate the 3-year safety and clinical performance of biodegradable polymer-coated ultra-thin (60 µm) sirolimus-eluting stent (SES) in real-world patients with coronary artery disease (CAD).@*MATERIALS AND METHODS@#This was a physician-initiated, retrospective, single-centre, observational study that included 237 consecutive patients who had previously undergone implantation of only Supraflex SES (Sahajanand Medical Technologies Pvt Ltd, Surat, India) for the treatment of CAD. Follow-up was received after 1 year and 3 years of stent implantation. The primary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI) and target lesion revascularisation (TLR). Stent thrombosis was considered as a safety endpoint.@*RESULTS@#The mean age of patients was 64.1 ± 10.2 years, and 192 (81.0%) patients were male. The average stent length and diameter were 24.4 ± 9.0 mm and 3.1 ± 0.4 mm, respectively. The cumulative MACE rate at 3 years follow-up was 6.5% which included 4 (1.8%) cardiac deaths, 6 (2.8%) MI, and 4 (1.8%) TLR. There were 2 (0.9%) cases of stent thrombosis.@*CONCLUSION@#Treatment of patients with CAD in real-world clinical practice was associated with sustained clinical safety and low rates of restenosis, stent thrombosis and MACE up to 3 years after Supraflex SES implantation.

Tailoring of the chlorine sensing properties of substituted metal phthalocyanines non-covalently anchored on single-walled carbon nanotubes.

To investigate how central metal tunes the synergetic interactions between substituted metallo-phthalocyanine and single-walled carbon nanotubes in enhancing the gas sensing properties, a comparative study has been performed by varying the central metal ion in fluorinated metal phthalocyanines and single-walled carbon nanotube hybrid. Hybrids of metal(ii)-1,2,3,4,8,9,10,11,15,16,17,18-24,25-hexa-decafluoro-29H,31H-phthalocyanine/single-walled carbon nanotube (F16MPc/SWCNTs-COOH, where M = Co, Zn) have been synthesized through π-π stacking interactions using the solution route. Spectroscopic (FT-IR, UV-vis, XPS and Raman), electron microscopic (TEM and FE-SEM) and TGA investigations have confirmed the successful functionalization and interaction of SWCNTs-COOH with F16MPc. Parts per billion (ppb) level Cl2-selective chemiresistive gas sensors have been fabricated on glass substrates with precoated gold electrodes by using these hybrids. The responses of various F16MPc/SWCNTs-COOH sensors have demonstrated the central metal ion-dependence in the sensitivity of Cl2.

Right atrial spindle cell sarcoma as a rare cause of tricuspid stenosis.

Spindle cell sarcomas of the right atrium are extremely rare primary cardiac tumours with very few cases reported in the medical literature. The prognosis of this malignant neoplasm remains poor due to delay in diagnosis, early metastasis and few available therapeutic options. It responds poorly to chemotherapy and radiotherapy. Surgical excision is the mainstay of treatment. We report a 42-year-old man, who presented to emergency room with dyspnoea and fatigue (New York Heart Association classification II) since 1 month. Transthoracic echocardiogram showed massive pericardial effusion with tamponade. The patient underwent emergency pericardiocentesis; postpericardiocentesis echocardiogram showed large right atrial mass involving the right ventricle and the tricuspid valve causing tricuspid stenosis. Findings were confirmed by cardiac CT scan. Percutaneous transvenous biopsy was carried out which revealed spindle cell sarcoma.

In vivo delamination of coronary guidewire polytetrafluoroethylene layer - A dreaded complication.

Coronary guidewires are coated with polytetrafluoroethylene (PTFE) layer to decrease resistance and enhance trackability. Delamination and embolization of PTFE material can be detrimental during percutaneous coronary interventions. We report an occurrence of such delamination and discuss the implications and possible mechanism of this dreaded complication.

Percutaneous coronary intervention in a case of anomalous single coronary artery.

Anomalous origin of the right coronary artery is an uncommon entity with a reported incidence of 0.26%. The anomalous origin is usually from the left sinus of Valsalva. Anomalous origin of the right coronary artery (RCA) from the left anterior descending (LAD) artery is a rare occurrence. Symptomatic patients with associated significant coronary artery disease (CAD) may be treated with routine interventions such as percutaneous coronary intervention or coronary artery bypass surgery. We report a case of single coronary artery with severe proximal LAD stenosis. The RCA had its origin from the mid LAD. Coronary intervention was successfully carried out on the severe stenosis at the proximal LAD artery. These cases are rare. We discuss accurate diagnosis and appropriate management in such cases.

Utilization of carrageenan, citric acid and cinnamon oil as an edible coating of chicken fillets to prolong its shelf life under refrigeration conditions.

AIM: The present study was conducted to determine efficacy of edible coating of carrageenan and cinnamon oil to enhance the shelf life of chicken meat stored under refrigeration conditions. MATERIALS AND METHODS: Chicken breast was coated with carrageenan and cinnamon oil by three methods of application viz., spraying brushing and dipping. The coated meat was evaluated for drip loss, pH, thiobarbituric acid number (TBA), tyrosine value (TV), extract release volume (ERV), Warner-Bratzler shear force value (WBSFV), instrumental color, microbiological, and sensory qualities as per standard procedures. RESULTS: There was a significant difference observed for physicochemical parameters (pH, TBA, TV, ERV, drip loss and WBSFV) and microbiological analysis between storage periods in all the samples and between the control and treatments throughout the storage period but samples did not differed significantly for hunter color scores. However, there was no significant difference among three methods of application throughout the storage period though dipping had a lower rate of increase. A progressive decline in mean sensory scores was recorded along with the increase in storage time. CONCLUSION: The carrageenan and cinnamon edible coating was found to be a good alternative to enhance the shelf life of chicken meat under refrigeration conditions. It was also observed from study that dipping method of the application had comparatively higher shelf life than other methods of application.

Optimization of meat level and processing conditions for development of chicken meat noodles using response surface methodology.

Response surface methodology (RSM) is a mathematical and statistical technique for testing multiple process variables and their interactive, linear and quadratic effects, and useful in solving multivariable equations obtained from experiments simultaneously. In present study optimum meat level and processing conditions for development of shelf stable chicken meat noodles was determined using central composite design of response surface methodology (RSM). Effects of meat level (110-130 g); processing conditions such as steaming time (12-18 min) and drying time (7-9 h) on the water activity, yield, water absorption index, water solubility index, hardness, overall acceptability and total colour change of chicken noodles were investigated. The aim of present study was to optimize meat level and processing conditions for development of chicken noodles. The coefficients of determination, R(2) of all the response variables were higher than 0.8. Based on the response surface and superimposed plots, the optimum conditions such as 60 % meat level, 12 min steaming time and 9 h drying time for development of chicken noodles with desired sensory quality was obtained.