Role of Single Port Rigid Thoracoscopy in Undiagnosed Pleural Effusion.

BACKGROUND: In recent years, medical thoracoscopy has been well established to play an important role in undiagnosed pleural effusion; however, this procedure is underutilized due to limited availability of the instruments it requires. This study analysed the outcome of single port rigid thoracoscopy in patients with undiagnosed pleural effusions. METHODS: This study retrospectively analysed the outcomes of all patients with undiagnosed pleural effusion presenting to our centre between 2016 to 2020 who underwent single port rigid medical thoracoscopy as a diagnostic procedure. RESULTS: In total, 92 patients underwent single port rigid medical thoracoscopy. The most common presenting symptom was shortness of breath. A majority of the patients had lymphocytic exudative pleural effusion. The average biopsy sample size was 18 mm, and no major complication was reported in any of the patients. CONCLUSION: Single port rigid thoracoscopy is a safe and well-tolerated procedure that yields a biopsy of a larger size with high diagnostic yield. Moreover, the low cost of the instruments required by this procedure makes it particularly suited for use in developing countries.

π-Stacking among the Anthracenyl Groups of a Copper Complex Resulted in Doubling of Unit Cell Volume To Provide New Polymorphs.

Two polymorphs of the 9-N-(3-imidazolylpropylamino)methylanthracene (Hanthraimmida) containing hydrated copper(II)-2,6-pyridinedicarboxylate complex are reported. The two polymorphs have either lamellar or Herringbone arrangements of π-stacks among the anthracenyl groups of organocation. The difference between the two polymorphs originated from having face-to-face stacking arrangements between the two anthracenyl groups of the symmetry independent cations within the unit cell in one of the polymorphs. The π-stacked anthracenyl groups in consecutive layers of the polymorphs are oriented in one direction in the polymorph designated as P1, whereas the polymorph designated as P2 has such orientations in opposite directions. The unit cell volume of the polymorph P2 (Z = 4) has approximately twice the volume of the polymorph P1 (Z = 2); it happend due to coalescence of two unit cells of P1 in the ab-crystallographic plane. A mixed methanol/water solvate of the copper complex is also reported. It has a channel-like arrangement of the cations; has the anions and the solvents within the cation embraced channel-like enclosures. This complex is unstable, once taken out from the methanol solvent, it transforms in real time to P2 by replacements of the methanol molecules by water molecules.

Suprascapular Nerve Block (SSNB) improves the outcome in exercise based management of Primary Adhesive Capsulitis (PAC): A prospective randomized comparative study.

Background and Aims: Increased pain and associated stiffness hinders the advantages of exercise and process of recovery in primary adhesive capsulitis. We hypothesized that suprascapular nerve block may positively affect the outcome due to its role in pain relief of acute or chronic shoulder pain. We compared the effect of suprascapular nerve block and exercise with only exercise on the recovery of primary adhesive capsulitis. Material and Methods: A total of 96 patients of both sexes presenting with primary adhesive capsulitis were divided by computer randomization in two equal groups (n = 48). Group A received exercise only and Group B received suprascapular nerve block followed by exercise. Oral paracetamol was given for analgesia as desired. Patients were followed up at 4, 8, 16, and 24 weeks. Pain was assessed by visual analog scale; functional outcome by Shoulder Pain and Disability Index and range of movement by goniometer. Results: The pain scores and Shoulder Pain and Disability Index scores were significantly lower at all observation points of 4, 8,16, and 24 weeks in Group B than Group A (P < 0.05). The range of movement in all the ranges of forward flexion, extension, internal and external rotation, and abduction at all observation points was significantly higher in Group-B (P < 0.05) compared to Group A. The consumption of analgesics was significantly more in Group A than Group B at 4 and 8 weeks (P = 0.020 and P = 0.044) but comparable at 12 and 24 weeks (P = 0.145 and P = 0.237 respectively). Conclusion: Combining SSNB with exercise is more effective in treatment of primary adhesive capsulitis than exercise alone and reduces the use of analgesics. SSNB it is effective and safe to use in primary adhesive capsulitis.

Ultrasonographic Evaluation of Osteoarthritis-affected Knee Joints: Comparison with Kellgren-Lawrence Grading and Pain Scores.

BACKGROUND: The objective was to compare ultrasonographic findings with clinical and radiographic findings in osteoarthritis (OA)-affected knee joints. METHODS: This prospective study was conducted in Subharti Medical College, Meerut, after getting clearance from the ethical committee. Eighty-five symptomatic knees fulfilling American College of Rheumatology criteria for OA were included in the study. Patients with trauma, inflammatory, and infective conditions of the knee and with a history of intra-articular interventions and surgery were excluded. Demographic data, body mass index (BMI), visual analog scale (VAS), and Western Ontario and McMaster Universities Arthritis (WOMAC) questionnaire score were obtained. Kellgren-Lawrence (K-L) score was obtained on radiography. Ultrasonographic findings which were recorded include effusion, meniscal extrusion, femorotrochlear cartilage grading, maximum length of osteophytes at medial and lateral compartments, and presence or absence of Baker cyst. RESULTS: A total of 85 consecutive symptomatic knees were examined. The male: female ratio was 22:63, with a mean age of 54.52 ± 9.44 years, mean duration of disease of 24.24 ± 19.14 months, mean BMI of 28.91 ± 3.69 kg/m2, and mean score of VAS and WOMAC pain scale of 6.27 ± 1.45 and 62.45 ± 10.96, respectively. K-L grading of 1, 2, 3, and 4 was reported in 12.9%, 21.2%, 25.9%, and 40% of the knees, respectively. The mean VAS score and WOMAC score showed statistically significant correlation with KL grading (P < 0.05). Knees with the presence of osteophytes, medial meniscal extrusion, effusion, and medial femoral trochlear cartilage grading showed statistically significant correlation with VAS and WOMAC scores (P < 0.05). However, the correlation was not significant for lateral meniscus extrusion and lateral femoral trochlear cartilage grading. CONCLUSION: Our study found that K-L grading and few ultrasonographic criteria showed a significant positive correlation with pain scores, while few other ultrasonographic criteria did not. Both imaging modalities are complementary to each other, rather than one being superior to the other.

Changes in the proportions of an active pharmaceutical through cocrystals.

In this study, the modulation of amounts sulfathiazolium cations in different 2,6-pyridinedicarboxylates is demonstrated. An uncommon monoionic sulfathiazolium zinc 2,6-pyridinedicarboxylate (1:1 electrolyte) complex was characterized. Conventional sulfathiazolium zinc-bis-2,6-pyridinedicarboxylate dianionic complexes (2:1 electrolyte) were formed when hydroxyaromatic compounds such as 1,3-dihydroxybenzene or 3-nitrophenol were used as guest components. Thus, with the aid of the hydroxyaromatic molecules the zinc-bis-2,6-pyridinedicarboxylate complexes were stabilized with the relatively large sized sulfathiazolium cations. It was a consequence of domain expansion by the phenolic compounds. Sandwiched aromatic guests between the 2,6-pyridinedicarboxylates provided appropriate packing to accommodate the two large cations in the self-assemblies, which helped to modulate the amounts of sulfathiazole in different formulations. Antibacterial activities with E. coli DH5α have shown that the salt and the complexes have lower g/ml antibacterial activity than the parent drug.

Structure and Electronic Properties of InSb Nanowires Grown in Flexible Polycarbonate Membranes.

A dense array of vertically aligned indium antimonide (InSb) nanowires with high aspect ratio (diameter 150 nm, length 20 µ m) were grown in the pores of a track-etched polycarbonate membrane via a one-step electrochemical method. There are several reports on InSb nanowire growth in the pores of a mechanically rigid, nano-channel alumina template (NCA), where nanowire growth occurs in the pores of the NCA. This work on InSb nanowire growth in pores of track-etched polycarbonate (PC) membrane sheds light on the various factors that affect nucleation and nanowire growth. The average length and diameter of the as-grown nanowires was about 10 µ m and 150 nm, respectively. Two possible mechanisms accounting for two different morphologies of the as-grown nanowires are proposed. The polycrystallinity observed in some of the nanowires is explained using the 3D 'nucleation-coalescence' mechanism. On the other hand, single crystal nanowires with a high density of twin defects and stacking faults grow epitaxially by a two-dimensional (2D) nucleation/growth mechanism. To assess the electrical quality of the nanowires, two- and four-terminal devices were fabricated using a single InSb nanowire contacted by two Ni electrodes. It was found that, at low bias, the ohmic current is controlled by charge diffusion from the bulk contacts. On the other hand, at high bias, the effects of space charge limited current (SCLC) are evident in the current-voltage behavior, characteristic of transport through structures with reduced electrostatic screening. A cross-over from ohmic to SCLC occurs at about 0.14 V, yielding a free carrier concentration of the order of 10 14 cm - 3 .

Spin independent magnetoresistance effects in vertical graphene spin valves.

Vertical spin valve device configuration with multilayer graphene (MLG) as spacer has drawn significant attention in recent years because of its potential to produce large magnetoresistance (MR) effect due to perfect spin filtering. However, demonstration of this effect has remained elusive so far. Here we consider MLG vertical spin valve structures and show that they exhibit spin independent MR effects, which are orders of magnitude stronger than the spin dependent effects reported to date. These effects manifest within a moderate field range of 10 kG and depend on various factors such as hybridization near the top graphene surface, doping, defects and interlayer coupling. These effects highlight the rich spectrum of physical phenomena that manifest in such systems, which could be exploited in low to moderate magnetic field sensing applications.

Impact of Parthenium hysterophorus leaf extracts on the fecundity, fertility and behavioural response of Aedes aegypti L.

Different extracts of 1,000 ppm were prepared from the leaves of Parthenium hysterophorus using acetone, benzene, petroleum ether, diethyl ether and hexane as the solvents. The efficacy of each extract was assessed against dengue fever vector, Aedes aegypti by evaluating the variations in fecundity, fertility and behavioural response of the female adults. The leaf extracts could cause 70-100% repellency in the oviposition behaviour of the adults. The diethyl ether extract was found to be the most effective extract resulting in maximum effective repellency (99.7%) leading to the highest levels of reduced fecundity and 100% egg mortality followed by benzene extracts causing 93.8% reduced oviposition and 100% ovicidal effect. Hexane and acetone extracts with the least oviposition deterrence of 70-74% and negligible egg mortality (8-9%) proved to be the least effective extracts. The petroleum ether extract had a moderate impact resulting in 93.2% diminished fecundity and 41% ovicidal effect. The behavioural response of female adults of A. aegypti was evaluated by performing spatial repellency and contact irritancy assays. The most significant spatial repellency behaviour was elicited by acetone extracts leading to escape of 80% mosquitoes. Hexane and diethyl ether extracts could cause moderate response with 50-60% escape, while a slight and no reaction was observed on exposure to petroleum ether and benzene extracts, respectively. An interesting observation was the knocked-down activity caused by the hexane extracts with no recovery even after 24 h. A significant contact irritancy response was noticed in the mosquitoes on exposure to acetone leaf extracts resulting in first flight only after 4 s and a total of 12 flights during exposure. No irritancy behaviour was observed on exposure to diethyl ether and benzene leaf extracts. However, as against controls, a slight irritability response was noticed on exposure to hexane leaf extracts resulting in relative irritability of 1.2. Our results suggest the selective efficiency of Parthenium leaf extracts against A. aegypti, as the most effective oviposition deterrent and ovicidal agent was least effective as irritant extract and vice-versa. Further detailed research is needed to identify the active ingredient in the extracts and implement the effective mosquito management programme.