Venoarterial Extracorporeal Membrane Oxygenation is Effective in Severe Aluminum Phosphide Overdose Despite Delayed Presentation.

Aluminum phosphide (ALP) is a potentially lethal poison. The mortality rate in ALP overdose is close to 100%. ALP has no specific antidote, and only supportive therapy is possible, with timely extracorporeal support mentioned as a modality. We present a case of severe ALP overdose in a young female with delayed presentation (>24 hours) and multiorgan failure (MOF)/shock successfully managed with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Unique features of this case include consumption of lethal quantity of ALP (5 g), severe toxicity with MOF, and shock secondary to a delayed presentation, all of which incrementally added to a high mortality. This was managed with the help of VA-ECMO as a last option with a successful outcome. This highlights the fact that late ECMO deployment, despite absorption of a large quantity and MOF/shock/acidosis, can still be salvageable with appropriate management. HOW TO CITE THIS ARTICLE: Kumar PHG, Kalluraya MA, Jithendra C, Kumar A, Kanavehalli SP, Furtado AD, et al. Venoarterial Extracorporeal Membrane Oxygenation is Effective in Severe Aluminum Phosphide Overdose Despite Delayed Presentation. Indian J Crit Care Med 2021;25(12):1459-1461.

Preclinical PERCIST and 25% of SUVmax Threshold: Precision Imaging of Response to Therapy in Co-clinical 18F-FDG PET Imaging of Triple-Negative Breast Cancer Patient-Derived Tumor Xenografts.

Numerous recent works highlight the limited utility of established tumor cell lines in recapitulating the heterogeneity of tumors in patients. More realistic preclinical cancer models are thought to be provided by transplantable, patient-derived xenografts (PDXs). The inter- and intratumor heterogeneity of PDXs, however, presents several challenges in developing optimal quantitative pipelines to assess response to therapy. The objective of this work was to develop and optimize image metrics for 18F-FDG PET to assess response to combination docetaxel and carboplatin therapy in a co-clinical trial involving triple-negative breast cancer PDXs. We characterized the reproducibility of standardized uptake value (SUV) metrics to assess response to therapy, and we optimized a preclinical PERCIST paradigm to complement clinical standards. Considerations in this effort included variability in tumor growth rate and tumor size, solid tumors versus tumor heterogeneity and a necrotic phenotype, and optimal selection of tumor slices versus whole tumor. Methods: A test-retest protocol was implemented to optimize the reproducibility of 18F-FDG PET SUV thresholds, SUVpeak metrics, and preclinical PERCIST parameters. In assessing response to therapy, 18F-FDG PET imaging was performed at baseline and 4 d after therapy. The reproducibility, accuracy, variability, and performance of imaging metrics to assess response to therapy were determined. We defined an index called the Quantitative Response Assessment Score to integrate parameters of prediction and precision and thus aid in selecting the optimal image metric to assess response to therapy. Results: Our data suggest that a threshold of 25% of SUVmax (SUV25) was highly reproducible (<9% variability). The concordance and reproducibility of preclinical PERCIST were maximized at α = 0.7 and ß = 2.8 and exhibited a high correlation with SUV25 measures of tumor uptake, which in turn correlated with the SUV of metabolic tumor. Conclusion: The Quantitative Response Assessment Score favors SUV25 followed by SUVpeak for a sphere with a volume of 14 mm3 (SUVP14) as optimal metrics of response to therapy. Additional studies are warranted to fully characterize the utility of SUV25 and preclinical PERCIST SUVP14 as image metrics for response to therapy across a wide range of therapeutic regimens and PDX models.

New Flexible Channels for Room Temperature Tunneling Field Effect Transistors.

Tunneling field effect transistors (TFETs) have been proposed to overcome the fundamental issues of Si based transistors, such as short channel effect, finite leakage current, and high contact resistance. Unfortunately, most if not all TFETs are operational only at cryogenic temperatures. Here we report that iron (Fe) quantum dots functionalized boron nitride nanotubes (QDs-BNNTs) can be used as the flexible tunneling channels of TFETs at room temperatures. The electrical insulating BNNTs are used as the one-dimensional (1D) substrates to confine the uniform formation of Fe QDs on their surface as the flexible tunneling channel. Consistent semiconductor-like transport behaviors under various bending conditions are detected by scanning tunneling spectroscopy in a transmission electron microscopy system (in-situ STM-TEM). As suggested by computer simulation, the uniform distribution of Fe QDs enable an averaging effect on the possible electron tunneling pathways, which is responsible for the consistent transport properties that are not sensitive to bending.

Working Length Determination of Root Canal of Young Permanent Tooth: An In vitro Study.

BACKGROUND: Determination of correct working length is one of the keys to success in endodontic therapy. AIM: The aim of this study was to evaluate the diagnostic efficacy of various methods to determine working length of root canal. MATERIALS AND METHODS: Tactile method was assessed using digital radiography and compared with electronic method using apex locator. A total sample of 30 single rooted young permanent teeth the (mandibular first premolars) with matured apices were selected for the study. Access cavity preparation was carried out. Working length was measured by tactile method using digital radiography and electronic method using apex locator with no 15 K file. Actual working length was established by grinding of cementum and dentine from the root apex and was observed under stereomicroscope. Data was collected and statistical analysis was carried out with the help of SPSS-15. RESULTS: The results of this study showed that there was a significant difference between tactile method assessed by digital radiography and electronic method using apex locator. CONCLUSION: Apex locator was found to be more reliable and accurate when compared with the actual length.

Comparative evaluation of microleakage of three restorative glass ionomer cements: An in vitro study.

PURPOSE: The aim of this study was to compare the microleakage of glass ionomers (conventional and resin modified) with that of recently introduced nanoionomers. MATERIALS AND METHODS: Standardized class I and class V cavities were prepared on 120 young permanent teeth. Samples were equally divided into group I (class I restorations) and group II (class V restorations), and further divided into subgroups. The subgroups were restored with Fuji IX, Fuji II LC, and newly introduced Ketac(™) N 100 (KN 100). Samples were thermocycled and submerged in Acridine dye for 24 h. Samples were sectioned to view under fluorescent microscope and marginal leakage was evaluated by Chi-square and Kruskal - Wallis test. RESULTS: Fuji IX showed the maximum leakage, followed by LC II and the least was observed in KN 100. In class I restorations, there was significant difference while comparing Fuji IX with Fuji LC II and KN 100 and nonsignificant difference between LC II and KN100. In class V restorations, Fuji IX and KN100, KN 100 and LC II showed significant difference. Fuji IX and LC II showed nonsignificant difference. CONCLUSION: Within the limitations of this study, Fuji IX showed the maximum microleakage. KN 100 showed minimum leakage, better sealing ability, and was more consistent.

A comparative study of glutamate oxaloacetate transaminase (GOT) and glutamate pyruvate transaminase (GPT) levels in the saliva of diabetic and normal patients.

Diabetes has been reported to affect salivary glands adversely in humans and experimental models. Glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT) and lactate dehydrogenase (LDH) are salivary enzymes that also are widely distributed in animal tissues. We determined GOT and GPT levels in saliva samples of 100 type 1 and 30 type 2 diabetic patients using reflectance spectrophotometry and compared them to 30 age and sex matched healthy controls. Statistically significant differences were observed in the mean values of GOT and GPT in type 1 diabetics compared to type 2 and control groups. Significantly higher GOT levels were found in the 1-20 year age group of type 1 diabetics. Our findings suggest that salivary gland damage is due to the same immunological attack that affects pancreatic ß cells and results in type 1 diabetes.

Comparative evaluation of ELISA and dot-blot for the diagnosis of tuberculous meningitis.

Tuberculous meningitis is a central nervous system tuberculosis caused by M. tuberculosis. It causes high mortality if delayed in diagnosis and treatment. In this comparative study, Cerebrospinal fluid from TBM and non TBM patients were analyzed by ELISA and Dot-blot for anti-tuberculous antibodies. About 70% of the TBM samples showed positivity by Dot-blot and 72.5% by ELISA. Among the non TBM controls, 2.9% showed positivity by Dot-blot and 4.4% by ELISA. Both methods did not differ significantly as seen by Fisher's exact test (p = 0.50). Thus, Dot-blot could be an easy alternative to ELISA for quick diagnosis of TBM.

Room-temperature tunneling behavior of boron nitride nanotubes functionalized with gold quantum dots.

One-dimensional arrays of gold quantum dots (QDs) on insulating boron nitride nanotubes (BNNTs) can form conduction channels of tunneling field-effect transistors. We demonstrate that tunneling currents can be modulated at room temperature by tuning the lengths of QD-BNNTs and the gate potentials. Our discovery will inspire the creative use of nanostructured metals and insulators for future electronic devices.

Double-chambered right ventricle with pulmonary valve endocarditis.

We describe a rare case of pulmonary valve endocarditis associated with a double-chambered right ventricle in an adolescent male highlighting the two-dimensional and three-dimensional transthoracic echocardiographic findings. He was managed with aggressive antibiotic therapy followed by surgery. The echocardiographic findings were confirmed during surgery.

Estimation of salivary and tongue coating pH on chewing household herbal leaves: A randomized controlled trial.

OBJECTIVES: The purpose of the study was to evaluate saliva and tongue coating pH and also to assess the degree of tongue coating in healthy subjects before and after chewing herbal leaves (tulsi, mint, and curry leaf). MATERIALS AND METHODS: A double-blind, randomized, concurrent, parallel-group study was conducted among 60 volunteer subjects, who were randomly assigned into three groups of 20 each (tulsi, mint, and curry leaf) and were asked to chew five to six fresh leaves of the respective plants twice daily for 7 days. Salivary and tongue coating pH were measured by a digital pH meter and color pH indicators. Data were analyzed statistically using repeated measure analysis of variance and Student's t-test. RESULTS: Mean salivary pH values showed an increase immediately and 30 min after chewing the herbal leaves. A significant difference (P < 0.01) was observed between mint and curry leaf groups immediately after chewing and between tulsi and curry leaf groups (P < 0.05) 30 min after chewing the leaves. Tongue coating pH showed an increase toward alkalinity in all the groups. The assessment of tongue coating showed an increase in scores among tulsi and curry leaf groups, but this difference was not statistically significant. CONCLUSION: Chewing traditional medicinal plant leaves can be considered as safe, effective, and economical alternate options for maintaining good oral health.