Experimental fluid dynamics characterization of a novel micropump-mixer.

The application of lab-on-a-chip systems to biomedical engineering and medical biology is rapidly growing. Reciprocating micropumps show significant promise as automated bio-fluid handling systems and as active reagent-to-sample mixers. Here, we describe a thorough fluid dynamic analysis of an active micro-pump-mixer designed for applications of preclinical blood analysis and clinical diagnostics in hematology. Using high-speed flow visualization and micro-particle image velocimetry measurements, a parametric study is performed to investigate the fluid dynamics of six discrete modes of micropump operation. With this approach, we identify an actuation regime that results in optimal sample flow rates while concomitantly maximizing reagent-to-sample mixing.

Doxycycline Usage for Prevention of Leptospirosis among Farmers and Reasons for Failure to Use Chemoprophylaxis: A Descriptive Study from Southern Sri Lanka.

BACKGROUND: Leptospirosis causes substantial morbidity and mortality in Sri Lanka. Health authorities have implemented a chemoprophylaxis programme for prevention of disease for farmers who are at a high risk of leptospirosis. Only 39% of general population is aware of chemoprophylaxis. Awareness on chemoprophylaxis and its usage among the risk population and the reasons for non-usage was uncertain. Our aim was to assess the chemoprophylaxis usage for prevention of leptospirosis among farmers and reasons for failure to use such preventive strategy. METHODS: Cross-sectional descriptive study was conducted on farmers in community setting in Galle District. Multi-stage cluster sampling method was used. Out of the seventeen "Ministry of Health" (MOH) divisions within the Galle district, nine divisions were randomly selected and, subsequently, two subdivisions ("Public Health Midwife" divisions) were randomly selected from each MOH division. From each PHM division (total of 18), a cluster who does farming as the main source of income was selected. From these farmers, details on demographics, knowledge on leptospirosis and knowledge and practice on chemoprophylaxis usage were obtained through an interviewer administered open-ended questionnaire. From those who have not properly taken chemoprophylaxis, the reasons for non-usage were explored by semistructured interviews. RESULTS: We recruited 319 (77%-males) farmers to the study. Eighteen (5.6%) have already had leptospirosis. Majority (86.8%) of farmers were aware that doxycycline can be used to prevent the disease occurrence. Only 31% knew about correct recommendations of chemoprophylaxis usage adopted by the national guidelines. Only 28.5% (91) used doxycycline prophylaxis. Out of those, only 60 farmers (65.9%) continued the prophylaxis throughout the contact and followed national recommendations. Themes responsible for non-usage were elicited such as lack of awareness of chemoprophylaxis usage, false sense of security from the disease by perceived "immunity" due to prolong exposure or due to low prevalence of disease, lack of motivation, lack of availability of medication, and fear of side effects. CONCLUSIONS: Awareness of leptospirosis is better among farmers compared to the general population. Usage of chemoprophylaxis among farmers was highly inadequate. Individual and health system related hypotheses and myths exist for non-usage of chemoprophylaxis. Thus, an urgent concerted campaign aimed at increasing awareness within the target group through education and making medicines effectively distributed is essential for better prevention of the disease.

Corrigendum to "Metastatic Renal Cell Carcinoma Presenting as Prolonged Pyrexia and Stauffer's Syndrome: Can a Routine Ultrasound Scan Fail to Detect a Renal Cell Carcinoma?"

[This corrects the article DOI: 10.1155/2018/4215041.].

Metastatic Renal Cell Carcinoma Presenting as Prolonged Pyrexia and Stauffer's Syndrome: Can a Routine Ultrasound Scan Fail to Detect a Renal Cell Carcinoma?

Background: Prolonged pyrexia and weight loss are recognised paraneoplastic manifestations of renal cell carcinoma (RCC). Stauffer's syndrome is a rarely described paraneoplastic manifestation, which is described early in the course of RCC. We report a patient who presented with unresolving fever with multiple pulmonary opacities with biochemical evidence of hepatic choleastasis and was later diagnosed to have metastatic RCC with Stauffer's syndrome. Case Presentation: We report a 54-year-old female who was investigated for a poorly resolving fever and recent weight loss for two months. During her course of illness, she developed bilateral multiple opacifications in the chest radiograph with negative pyogenic, mycobacterial microbiological studies. Despite intravenous antibiotics, her fever continued. She was found to have elevated alkaline phosphatase and gamma-glutamyl transferase and she underwent imaging with ultrasound scan of abdomen twice, which did not reveal demonstrable abnormalities. Later, contrast CT of abdomen and chest was performed and detected a renal cell carcinoma of the right upper pole of the kidney with multiple lung metastases, which was concluded as a metastatic RCC with paraneoplastic Stauffer's syndrome. Conclusion: Prolonged pyrexia with loss of weight and Stauffer's syndrome could be features to suggest renal cell carcinoma in the absence of positive microbiological studies. Isoechoic RCC could be missed in routine ultrasonography. When a RCC is suspected in the setting of a pyrexia of unknown origin, ultrasound with doppler or a contrast CT should be requested to aid diagnosis.

Cerebral vasculitis and lateral rectus palsy - two rare central nervous system complications of dengue fever: two case reports and review of the literature.

BACKGROUND: Dengue fever is a common mosquito-borne viral illness with a clinical spectrum ranging from a simple febrile illness to potentially life-threatening complications such as dengue hemorrhagic fever and dengue shock syndrome. Dengue infection can affect many organs, including the central nervous system. The neurological manifestations reported in dengue infections are meningitis, encephalitis, stroke, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. CASE PRESENTATION: We report the cases of two interesting patients with confirmed dengue infection who presented with complications of possible central nervous system vasculitis and cranial nerve palsy. The first patient was a 53-year-old previously healthy Singhalese woman who developed acute-onset slurring of speech and ataxia with altered sensorium 1 day after recovery from a critical period of dengue hemorrhagic fever. Subsequent investigations revealed evidence of encephalopathy with brainstem ischemic infarctions. Her clinical picture was compatible with central nervous system vasculitis. She was treated successfully with intravenous steroids and had a full functional recovery. The second patient was a middle-aged Singhalese woman who had otherwise uncomplicated dengue infection. She developed binocular diplopia on day 4 of fever. An ocular examination revealed a convergent squint in the left eye with lateral rectus palsy but no other neurological manifestation. CONCLUSIONS: Central nervous system vasculitis due to dengue infection is a very rare phenomenon, and to the best of our knowledge, only one case of central nervous system vasculitis has been reported to date, in a patient of pediatric age. Cranial nerve palsy related to dengue infection is also rare, and only a few cases of isolated abducens nerve palsy have been reported to date. The two cases described in this report illustrate the rare but important central nervous system manifestations of dengue fever and support the fact that the central nervous system is one of the important systems that can be affected in patients with dengue infection.