Electrochemical Properties of Tin Sulfide Nano-Sheets as Cathode Material for Lithium-Sulfur Batteries.

Unprecedented self-assembled hierarchical nano-sheets of SnS were synthesized by the hydrothermal method. In a typical reaction, SnCl2.2H2O and Na2S.9H2O were used as reactants. Structural and morphological properties were studied by X-ray diffraction (XRD), and scanning electron microscopy (SEM) while the electrochemical properties were measured by cyclic voltammetry, charge-discharge cycles, and electrochemical impedance spectroscopy (EIS). SEM results showed the 1-D SnS nano-sheets with an average thickness of around 20 nm. Cyclic voltammogram and charge-discharge spectra showed good cycling stability. All these results showed that SnS nano-sheets are promising candidate material to be used as electrode for Li-S batteries.

Burden, predictors and temporal relationships of comorbidities in patients with hidradenitis suppurativa: a hospital-based cohort study.

AIM: To examine the burden, predictors and temporal relationships of comorbidities in patients with hidradenitis suppurativa (HS). METHODS: Information on HS and ten systemic comorbidities was obtained by interview and clinical examination, including blood pressure, body mass index (BMI) and blood samples, in a cohort of consecutive HS outpatients. RESULTS: A total of 302 patients were included. About 86.6% had at least one comorbidity. The mean number of comorbidities per patient was 2.1. One or more cardiovascular comorbidities were observed in 76.5% with evidence of substantial unawareness and undertreatment; 48.4% had hypertension, 9.3% had diabetes, 57.7% had dyslipidaemia and 36.7% were obese. About 6.6% had inflammatory bowel disease, 6.3% had arthritis, 29.5% had a psychiatric diagnosis, 5.6% had psoriasis, 7.9% had obstructive lung disease, and 6.6% had polycystic ovary syndrome. These comorbidities occurred at different time points in relation to the onset of HS with evidence of shared as well as differential risk factors. Age (per year), HR = 0.87 (0.79-0.96), P < 0.006, age of onset of HS (per year), HR = 1.26 (1.14-1.40), P < 0.001, male sex, HR = 2.51 (0.88-7.16), P = 0.086, Hurley stage III (vs. Hurley I + II), HR = 3.46 (1.25-9.58), P = 0.017, BMI (per unit), HR = 1.12 (1.04-1.20), P = 0.002, and blood glucose (per unit), HR = 1.27 (1.16-1.39), P < 0.001 were significant predictors for onset of diabetes. CONCLUSION: There is a substantial burden, unawareness and undertreatment of several systemic comorbidities in patients with HS. Comorbidities occur at different time points in relation to the onset of HS. This should lead to higher awareness among treating specialists.

Meta-analysis of laparoscopic transcystic versus transcholedochal common bile duct exploration for choledocholithiasis.

Background: It is not clear whether laparoscopic transcystic exploration (LTCE) laparoscopic choledochotomy (LCD) is superior in the management of choledocholithiasis. In this meta-analysis, the success of LTCE versus LCD was evaluated. Methods: Cochrane Central Register of Controlled Trials, Web of Science, Trip, PubMed, Ovid and Embase databases were searched systematically for relevant literature up to May 2017. Studies that compared the success rate of LTCE and LCD in patients with choledocholithiasis were included. PRISMA guidelines were followed. Multiple independent reviewers contributed on a cloud-based platform. Random-effects model was used to calculate odds ratios (ORs) or standardized mean differences (MDs) with 95 per cent confidence intervals. An a priori hypothesis was generated based on clinical experience that LTCE is as successful as LCD. Results: Of 3533 screened articles, 25 studies comprising 4224 patients were included. LTCE achieved a lower duct clearance rate than LCD (OR 0.38, 95 per cent c.i. 0·24 to 0·59). It was associated with a shorter duration of surgery (MD -0·86, 95 per cent c.i. -0·97 to -0·77), lower bile leak (OR 0·46, 0·23 to 0·93) and shorter hospital stay (MD -0·78, -1·14 to -0·42) than LCD. There was no statistically significant difference in conversion, stricture formation or reintervention rate. Conclusion: LCD has a higher rate of successful duct clearance, but is associated with a longer duration of surgery and hospital stay, and a higher bile leak rate.

Effectiveness of omalizumab in chronic spontaneous urticaria assessed with patient-reported outcomes: a prospective study.

AIM: To examine the effectiveness of omalizumab (anti-IgE) on symptoms and disease-related quality of life in chronic spontaneous urticaria (CSU) and to identify possible patient-specific factors associated with response to omalizumab in patients with antihistamine refractory CSU. METHODS: Six months prospective trial of omalizumab 300 mg every 4 weeks among patients with CSU from a dermatological university department. The primary outcome was the urticaria activity score in the past week (UAS7) at 3 months. RESULTS: A total of 117 patients (39 men and 78 women) with a mean age of 42 years were included. The mean baseline UAS7 score was 29.3 points (SD = 10.8), which improved to 11.9 points (SD = 12.9) at 3 months follow-up, difference = 17.4 points (95% CI: 14.8-19.9), P < 0.0001. Other patient-reported outcomes (PROs) also improved significantly during 3 months of treatment. No significant further improvement was seen between three and 6 months follow-up. None of the following patient-specific factors: sex, age, age of onset of CSU, symptom duration, presence of chronic inducible urticaria (CINDU), comorbidities, positive urticaria HR test, smoking, ethnicity, angio-oedema, serum total IgE level, CRP, leucocytes, absolute neutrophil count or previous treatment with prednisolone or montelukast were significantly associated with response to omalizumab at 3 months, P > 0.05 for all comparisons. Previous treatment with traditional immunosuppressant drugs (azathioprine, cyclosporine or methotrexate) was associated with poorer treatment response to omalizumab at 3 months, P < 0.001. A strong correlation was seen between different patient-reported outcomes (PROs) at baseline and 3 months follow-up. Fifteen patients (12.8%) reported side-effects of the treatment. CONCLUSION: Omalizumab is a highly effective therapy for antihistamine refractory CSU with treatment effects similar to those observed in randomized controlled trials. Validated PROs to assess disease activity, disease control and impairment of quality of life are valuable tools in the clinical management of CSU. Identification of patient-specific predictors of effect and safety of omalizumab in CSU is still warranted.

Transient hair loss in patients with chronic spontaneous urticaria treated with omalizumab.

SUMMARY: Omalizumab (anti-IgE) is used as add-on therapy for antihistamine refractory chronic urticaria patients. The most commonly reported adverse effects were headache, arthralgia, upper respiratory infections, fatigue, nausea and injection-site reactions. However, lately a few cases of hair loss have been reported. We describe a case of transient hair loss in a young female patient after initiating treatment with omalizumab. Despite this side effect, the patient continued with omalizumab treatment for 10 months with good effect.

Trichothecium roseum Causes Fruit Rot of Tomato, Orange, and Apple in Pakistan.

During a field survey of greenhouses and fresh markets in 2013, fruits of tomato, oranges, and apples exhibited rot symptoms with white mycelial growth and salmon-color sporulation in the vicinity of Sargodha city (32°5'1″ N, 72°40'16″ E), Pakistan. Diseased fruit samples were collected in plastic bags and taken to laboratory on ice for further diagnosis. Diseased fruits were observed under a stereo microscope and single spores were removed using an inoculating needle. Isolation from single spores showed pink to white colonies on potato dextrose agar (PDA) containing hyaline, 2-celled, ellipsoid to pyriform conidia (17 to 24 × 7 to 11 µm) with slanting and truncate basal mark and produced in clusters. Conidiophores were branched (105 to 254 × 2 to 4 µm) and hyphae were hyaline (3 to 5 µm in diameter). These characteristics of the fungus were similar to Trichothecium roseum (Pers.) as reported by Inácio et al. (1). Genomic DNA was extracted by using CTAB buffer from a single pure colony of one isolate of the fungus and PCR analysis was performed for ITS region and part of the 5' end of the beta tubulin (TUB) gene (2,3). Single fragments of 550 bp and 1.5 kb length from ITS and TUB gene were amplified and sequenced (GenBank Accession Nos. KF975702 and KJ607590, respectively). Sequence analysis showed 99% similarity with T. roseum isolates from different regions of the world. Phylogenetic analysis (MEGA version 5.2 with WAG model) showed the close relatedness to the isolates of T. roseum from Pakistan and isolates from other parts of the world that revealed the low genetic variability of ITS region. TUB gene sequence analysis indicated 100% homology with isolates of T. roseum and to the other species in Hypocreales. Pathogenicity tests were performed on tomato cvs. Nova Mech and Rio Grande, orange cv. Kinnow, and on apple cv. Golden Delicious by inoculating five fruits from each cultivar. Spore suspensions (105 conidia/ml of sterilized distilled water) were inoculated into all wounded fruits (9 wounds/fruit) of each cultivar and incubated at 25°C for the development of symptoms. Five wounded fruits of each cultivar were inoculated with sterilized distilled water as a control treatment. The fruits were kept in plastic boxes and incubated in humid chambers for 5 days. The symptoms on apples were observed as brown rot with pinkish spores on rotted tissue. The cross section of apple fruits also showed the brown rotted tissues internally. The fungus developed mycelium and spores on the surface and caused severe rotting inside the tomato and citrus fruits. T. roseum was re-isolated by picking a single spore from rotted tissues of fruits under a stereo microscope, and culturing on PDA. The re-isolated fungus was confirmed morphologically and by molecular techniques. Tomato and apple has been reported as a host for T. roseum (1,4,5) but oranges have not. To our knowledge, this is the first record of T. roseum infecting tomato, oranges, and apples in Pakistan. References: (1) C. A. Inácio et al. Plant Dis. 95:1318. 2011. (2) K. O'Donnell, and E. Cigelnik. Mol. Phylogenet. Evol. 7:103, 1997. (3) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990. (4) Y. H. Yun et al. Afr. J. Microbiol. Res. 7:1128, 2013. (5) M. Zabka et al. Mycopathologia. 162:65, 2006.

Microbiology of wound infections among hospitalised patients following the 2005 Pakistan earthquake.

After a devastating earthquake hit Northern Pakistan in October 2005, we retrospectively analysed the microbiology records of patients admitted with trauma wounds to Shifa International Hospital, Pakistan. For comparison, we included the records of hospitalised patients with wound infections before, and after, the earthquake. Age and hospital stay were entered as continuous variables and mean +/- SD was reported. Gender, type of injuries, micro-organisms isolated, susceptibilities and type of growth (single/polymicrobial) were entered as categorical variables and frequency reported. Relative risk with 95% confidence interval was shown for the two groups. Mean +/- SD age of patients was 35.15+/-11.11 years with female preponderance (58.4%). Fractures were the commonest injuries (55.9%). Gram-negative bacteria were the commonest organisms found (89%), with a predominance of polymicrobial infections (59.6%) and multidrug-resistant organisms (61.5%). Pseudomonas aeruginosa, Enterobacter spp. and Acinetobacter spp. were the commonest isolates, and most of these were multidrug resistant.