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Gastrointestinal mucormycosis, a rare fatal fungal infection in an immunocompromised host, affects mainly the stomach. Colonic mucormycosis is infrequent and is associated with high mortality. Perianal involvement is seen in almost one-third of patients with Crohn's disease. Perianal Crohn's disease is a particularly debilitating form of the disease, which requires multidisciplinary care. It may also require profound immunosuppression with biological agents to control disease activity. Opportunistic infections can complicate the disease course in these patients. We present a case of a middle-aged female with perianal Crohn's disease on adalimumab who developed colonic mucormycosis causing a flare in her disease activity. This patient highlights the need to increase awareness about fungal infections as a cause of disease flare in inflammatory bowel disease.
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Due to their easy integration for self-powered operation, integrated energy harvesting and storage could be the game changer in smart, flexible, and portable electronic devices. Three-electrode integration is the most promising approach among all possible configurations because it is less complex and compatible with most techniques. Although the photoconversion efficiency has increased above 20% due to the integration of high-performance perovskite solar cells, the electrochemical storage efficiency (efficacy of the integration) is much below 80% due to a significant potential drop and impedance mismatch. In this context, we introduced perovskite-based solid-state thin film supercapacitors integrated with stable, air-processed perovskite solar cells for an uninterrupted power supply. Our measurement shows that the best performance can be achieved by optimizing several parameters, including series-connected solar cells, light intensity, and photovoltaic active area. The critical challenge with these integrated systems is to maintain a uniform charging current of the supercapacitors throughout the charging cycle while minimizing self-discharging. We achieved an electrochemical storage efficiency of â¼87% at an overpotential of 0.8 V. The overpotential can be as low as 2 mV. We fabricated fully solution-processed series-connected solar cells to integrate with stacked supercapacitors to improve the operating voltage beyond 2.1 V. The photocharging and dark discharging of these integrated devices have been tested over 200 cycles, and a negligible drop in efficiency has been observed. Our detailed energy conversion and storage analysis in these systems unveils the mechanism and losses due to three-terminal integration.
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Infertility is encountered as a stressful condition by couples worldwide, impacting not just their physical and mental well-being but also placing financial strain on them. Ayurvedic management provides a promising, cost-effective avenue for addressing infertility disorders and enhances the success rates of in vitro fertilization (IVF), especially after previous unsuccessful attempts. This study aims to enhance clinical evidence and expand the scope of Ayurvedic approaches for managing infertility. A systematic literature search was conducted in PubMed and Scopus search engines for studies evaluating Ayurveda treatment modalities in infertility. Articles were searched using a combination of Medical Subject Heading (MeSH) terms, and the risk of bias was assessed using Robvis and the Joanna Briggs Institute (JBI) Critical Appraisal Tool. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 14 studies were considered in this systematic review, involving 248 patients. Among them, 84 were males and 164 were females. Of the 14 included studies, six were original studies, whereas eight were case reports. Our research contributes to addressing a notable research gap by conducting a comprehensive analysis of Ayurvedic treatments for infertility or medical conditions that lead to infertility. However, the limited sample size and lack of standardized protocols highlight the need for rigorous experimental research to establish the efficacy and safety of Ayurvedic treatments for infertility.
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Background: Diagnostic and therapeutic algorithms given by various societies for hepatitis B are fragmented and complex. The clinico-epidemiologic spectrum of hepatitis B is not studied with large-scale data from our region. We aimed to develop a comprehensive algorithm for the treatment of hepatitis B and study its clinico-epidemiological spectrum. Methods: From 2014-2019, the clinico-laboratory data of hepatitis B surface antigen (HbsAg)-positive patients were prospectively recorded. King George's Medical University hepatitis B therapeutic algorithm (KGHeBTA) was developed on the basis of the standard existing guidelines. The prevalence of different clinical stages of HBsAg-positive patients was calculated and their treatment records reviewed. Testing circumstances and risk factors were noted. Results: Among 1,508 data record sheets, 421 were complete. According to the KGHeBTA algorithm, 221 had detectable hepatitis B virus DNA. 21% were cirrhotic and 79% non-cirrhotic. 72% were incidentally detected asymptomatic hepatitis B, 7% were hepatitis B with acute symptoms, 0.7% were acute hepatitis B, and 22% were chronic hepatitis B. 20% patients were eligible for antivirals and 80% patients were not eligible. 32% patients were actually treated with antivirals due to the inclusion of some special indications as pregnancy and family history. Screening during various medical illnesses (40%) was the most common and during health camps (0.2%), the least common testing approach. Road-side shaving (52%) was the most common and intravenous drug abuse (0.2%) and the least common risk factor for the detection of hepatitis B in our data pool. Conclusions: HBsAg-positive patients can be easily worked up and treated based on the proposed algorithm (KGHeBTA). About one fourth to one fifth of all HBsAg-positive patients were eligible and treated with oral antivirals. Most of the patients were incidentally detected asymptomatic hepatitis B screened during medical illnesses. Roadside shaving and intravenous drug abuse were the most and the least common risk factors.
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2D-perovskites are generally more stable than 3D perovskites while charge transport in 2D-perovskites becomes inefficient. On the other hand, the instability of 3D perovskite films under heat, light and environmental conditions makes them inapplicable for practical purposes. Therefore, quasi-2D perovskites could be the optimum solution for stable yet highly efficient devices. Using the post-fabrication treatment method, we have converted methylammonium lead tribromide (MAPbBr3) 3D perovskite films into a quasi 2D-perovskite interfacial layer. In situ photoluminescence measurement during spin coating indicates a rapid conversion of 3D-perovskite into 2D-perovskites. The kinetics of oxygen and moisture diffusion, ion diffusion and electronic charge transport can be estimated from the time dependent PL measurements in the 3D and 2D/3D perovskite samples. 2D terminated perovskite samples show enhanced photoluminescence and improved stability in moisture and UV-irradiation. We also propose that a relatively wide bandgap of 2D-perovskite can give rise to a graded energy landscape at the interface for favorable charge separation. Simulation results reveal that the power conversion efficiency can be improved from 2.83% to 4.02% due to an increase in open-circuit voltage and fill factor in 2D/3D based MAPbBr3 solar cells without using any electron transport layer.
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BACKGROUND: Though small intestinal bacterial overgrowth (SIBO) is known in inflammatory bowel disease (IBD), the data on it are scanty and have limitations. METHODS: Data on IBD patients undergoing glucose hydrogen breath test (GHBT) were retrospectively analyzed to evaluate the frequency and risk factors of SIBO in IBD compared to 66 healthy controls. RESULTS: Patients with IBD (n=86; 45 ulcerative colitis [UC] and 41 Crohn's disease [CD]) more often had SIBO on GHBT than the healthy subjects (16/86 [18.6%] vs. 1/66 [1.5%]; p=0.002). SIBO was commoner among patients with CD than UC (14/41 [34.1%] vs. 2/45 [4.4%]; p=0.001). The frequency of SIBO among UC patients was comparable to healthy subjects (2/45 [4.4%] vs. 1/66 [1.5%]; p=not significant [NS]). Patients with CD than those with UC had higher values of maximum breath hydrogen and a greater area under the curve for breath hydrogen. Other factors associated with SIBO included female gender (11/16 [68.8%] with vs. 21/70 [30%] without SIBO; p=0.003), and having undergone surgery (8/16 [50%] vs. 6/70 [8.6%]; p=0.0002). SIBO patients had lower levels of total serum protein and albumin than those without SIBO (6.2 ± 1.5 g/dL vs. 7.0 ± 0.9 g/dL, respectively; p=0.009 and 3.5 ± 0.9 g/dL vs. 4.0 ± 0.6 g/dL, respectively; p=0.02). CD, female gender, and surgery for IBD tended to be the independent factors associated with SIBO among IBD patients on multivariate analysis. CONCLUSIONS: Patients with IBD, particularly CD, female, and those having undergone surgery, have a higher risk of SIBO than the healthy controls.
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Colitis Ulcerosa , Enfermedad de Crohn , Enfermedades Inflamatorias del Intestino , Pruebas Respiratorias , Estudios de Casos y Controles , Colitis Ulcerosa/complicaciones , Enfermedad de Crohn/complicaciones , Femenino , Glucosa/metabolismo , Humanos , Hidrógeno , Enfermedades Inflamatorias del Intestino/complicaciones , Intestino Delgado/microbiología , Estudios RetrospectivosRESUMEN
High voltage electric burns can cause various ocular injuries and may manifest in the form of conjunctival hyperemia, corneal opacities, uveitis, miosis, spasm of accommodation, cataract, retinal edema, papilledema, choroidal rupture, chorio-retinal necrosis/atrophy, retinal detachment and optic atrophy. The involvement of crystalline lens exclusively with sparing of other ocular structures is rare. We report a case of 16 year old male with bilateral total cataract after electrical injury by over-head high tension electric transmission cable accidentally falling on patient's head 6 months back. B scan showed no abnormality in both the eyes. The intra ocular pressure in both the eyes was within normal limits. Patient underwent lens aspiration with posterior chamber intraocular lens (PCIOL) implantation in both the eyes, under peribulbar anaesthesia (with an interval of 1 week between both the operations). Intra-operative and post-operative period were uneventful. Post operative BCVA was 6/6 in both eyes and fundus examination was within normal limits. Outcomes after surgery are very good if not associated with other ocular lesion like optic atrophy, chorio-retinal lesion, uveitis etc. This observation should encourage the ophthalmologist to undertake surgery for electric cataract, where necessary.
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We report a case of a 42-year-old female patient who presented to the ophthalmology outpatient department with painful red eye for 1 month. Slit-lamp microscopy showed a live worm in the anterior chamber of left eye. The worm was surgically removed under topical anaesthesia. It was sent to the microbiology department for further identification and was found to be adult female Loaloa.
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Cámara Anterior/parasitología , Infecciones Parasitarias del Ojo/diagnóstico , Nematodos/aislamiento & purificación , Adulto , Animales , Cámara Anterior/cirugía , Infecciones Parasitarias del Ojo/cirugía , Femenino , Humanos , Microscopía con Lámpara de HendiduraRESUMEN
PURPOSE: This study aims to describe and compare modified hang-back recession with the conventional hang-back recession in large angle comitant exotropia (XT). METHODS: A prospective, interventional, double-blinded, randomized study on adult patients (>18 years) undergoing single eye recession-resection for large angle (>30 prism diopters) constant comitant XT was conducted between January 2011 and December 2015. Patients in Group A underwent modified hang-back lateral rectus recession with adjustable knot while in Group B underwent conventional hang-back recession with an adjustable knot. Outcome parameters studied were readjustment rate, change in deviation at 6 weeks, complications and need for resurgery at 6 months. RESULTS: The groups were comparable in terms of age and preoperative deviation. The patients with the modified hang back (Group A) fared significantly better (P < 0.05) than those with conventional hang back (Group B) in terms of lesser need for adjustment, greater correction in deviation at 6 weeks and lesser need for resurgery at 6 months. CONCLUSION: This modification offers several advantages, significantly reduces resurgery requirement and has no added complications.