A case of bilateral sclerouveitis with secondary glaucoma right eye.

Infectious scleritis is rare and most commonly herpetic in origin. We report an unusual bilateral subacute presentation of scleritis with uveitis and glaucoma which responded to treatment with acyclovir. A 47-year-old male coast guard personnel presented with 2 months history of bilateral red eye. He was initially managed elsewhere as conjunctivitis, and on examination had bilateral diffuse redness of the eyes persisting with phenylephrine, with scleral edema and mild globe tenderness. Investigations for underlying autoimmune systemic illness were normal. He showed inadequate response to topical steroids and cycloplegics and developed uveitis and glaucoma while on steroids. He was then given tablet acyclovir with antiglaucoma topical medications with which he showed rapid response and complete resolution. The case is being reported for highlighting this unusual bilateral presentation of scleritis with uveitis and glaucoma with possible viral etiology.

Designing a bed-side system for predicting length of stay in a neonatal intensive care unit.

Increased length of stay (LOS) in intensive care units is directly associated with the financial burden, anxiety, and increased mortality risks. In the current study, we have incorporated the association of day-to-day nutrition and medication data of the patient during its stay in hospital with its predicted LOS. To demonstrate the same, we developed a model to predict the LOS using risk factors (a) perinatal and antenatal details, (b) deviation of nutrition and medication dosage from guidelines, and (c) clinical diagnoses encountered during NICU stay. Data of 836 patient records (12 months) from two NICU sites were used and validated on 211 patient records (4 months). A bedside user interface integrated with EMR has been designed to display the model performance results on the validation dataset. The study shows that each gestation age group of patients has unique and independent risk factors associated with the LOS. The gestation is a significant risk factor for neonates < 34 weeks, nutrition deviation for < 32 weeks, and clinical diagnosis (sepsis) for ≥ 32 weeks. Patients on medications had considerable extra LOS for ≥ 32 weeks' gestation. The presented LOS model is tailored for each patient, and deviations from the recommended nutrition and medication guidelines were significantly associated with the predicted LOS.

Development of data dictionary for neonatal intensive care unit: advancement towards a better critical care unit.

BACKGROUND: Critical care units (CCUs) with extensive use of various monitoring devices generate massive data. To utilize the valuable information of these devices; data are collected and stored using systems like clinical information system and laboratory information management system. These systems are proprietary, allow limited access to their database and, have the vendor-specific clinical implementation. In this study, we focus on developing an open-source web-based meta-data repository for CCU representing stay of the patient with relevant details. METHODS: After developing the web-based open-source repository named data dictionary (DD), we analyzed prospective data from 2 sites for 4 months for data quality dimensions (completeness, timeliness, validity, accuracy, and consistency), morbidity, and clinical outcomes. We used a regression model to highlight the significance of practice variations linked with various quality indicators. RESULTS: DD with 1555 fields (89.6% categorical and 11.4% text fields) is presented to cover the clinical workflow of a CCU. The overall quality of 1795 patient days data with respect to standard quality dimensions is 87%. The data exhibit 88% completeness, 97% accuracy, 91% timeliness, and 94% validity in terms of representing CCU processes. The data scores only 67% in terms of consistency. Furthermore, quality indicators and practice variations are strongly correlated (P < 0.05). CONCLUSION: This study documents DD for standardized data collection in CCU. DD provides robust data and insights for audit purposes and pathways for CCU to target practice improvements leading to specific quality improvements.

Opening gambit: Strategic options to initiate the tobacco endgame.

Endgame strategies to rapidly hasten the decline of tobacco are already well within reach; a few plausible policy options are outlined herein for policy practitioners, tobacco control advocates, and public health specialists. The implementation of these measures which already exist within the gamut of existing legislation requires the galvanization of political will. The options we essay include liquidating existing public investments in tobacco, holding tobacco companies accountable within the jurisdictions of their operations, fixing liability for injury and the imposition of realistic costs on insurance providers.

Modulational instability in the full-dispersion Camassa-Holm equation.

We determine the stability and instability of a sufficiently small and periodic travelling wave to long-wavelength perturbations, for a nonlinear dispersive equation which extends a Camassa-Holm equation to include all the dispersion of water waves and the Whitham equation to include nonlinearities of medium-amplitude waves. In the absence of the effects of surface tension, the result qualitatively agrees with the Benjamin-Feir instability of a Stokes wave. In the presence of the effects of surface tension, it qualitatively agrees with those from formal asymptotic expansions of the physical problem and improves upon that for the Whitham equation, predicting the critical wave number at the strong surface tension limit. We discuss the modulational stability and instability in the Camassa-Holm equation and other related models.

Cyclohexanone and 3-aminopropyltrimethoxysilane mediated controlled synthesis of mixed nickel-iron hexacyanoferrate nanosol for selective sensing of glutathione and hydrogen peroxide.

We report the cyclohexanone and 3-aminopropyltrimethoxysilane (3-APTMS) mediated controlled synthesis of mixed nickel-iron hexacyanoferrate (Ni-Fehcf) nanosol of 34 nm average size. The new method allows the synthesis of a variety of mixed metal hexacyanoferrate (Mhcf) nanodispersion along with option for controlling the inversion of electrochemichemical behavior of Prussian blue(PB) into desired Mhcf. The typical process involves the mixing of 3-APTMS treated potassium ferricyanide with desired concentrations of nickel sulfate containing fixed amount of cyclohexanone resulting in a uniform spherical nanodispersion of mixed Ni-Fehcf. The different molar ratio of Ni : Fe (i.e. 1 : 1; 1 : 5 and 1 : 10) yielded a mixed Ni-Fehcf showing three different electrochemical properties ascribed to nickel hexacyanoferrate (Nihcf); both Nihcf and PB, and PB respectively. The mixed Ni-Fehcf resulting from a 1 : 5 Ni : Fe molar ratio has been found to be an excellent material for selective electroanalytic applications attributed to hydrogen peroxide and glutathione sensing due to the presence of PB and Nihcf behaviors respectively. The electrocatalytic property of Nihcf in mixed Ni-Fehcf is significantly better than that of conventional Nihcf for glutathione analysis and further increases on the incorporation of AuNPs.