AI-enabled epidermal electronic system to automatically monitor a prognostic parameter for hypertension with a smartphone.

We present a wearable, flexible, wireless and smartphone-enabled epidermal electronic system (EES) for the continuous monitoring of a prognostic parameter for hypertension. The thin and lightweight EES can be tightly attached to the chest of a patient and synchronously monitor first lead electrocardiograms (ECG) and seismocardiograms (SCG). To demonstrate the concept, we developed the EES using state-of-the-art cleanroom technologies. Two types of sensors were integrated: A pair of metal electrodes to contact the skin and to record ECG and a vibration sensor based on a thin piezoelectric polymer to record SCG from the same location of the chest, simultaneously. The complete EES was powered by the near field communication functionality of the smartphone. We developed a machine-learning algorithm and trained it on public ECG data and recorded SCG signals to extract characteristic features of the recordings. Binary classifiers were used to automatically annotate peaks. After training, the algorithm was transferred to the smartphone to continuously analyze the timing between particular ECG and SCG peaks and to extract the Weissler's index as a prognostic parameter for hypertension. Tests with data of healthy control persons and clinical experiments with patients diagnosed with cardio-pulmonary hypertension showed a promising prognostic performance. The presented EES technology could be utilized for pre-screening of cardio-pulmonary hypertension, which is a strong burden in our today's healthcare system.

Genomic, morphological, and biochemical analyses of a multi-metal resistant but multi-drug susceptible strain of Bordetella petrii from hospital soil.

Contamination of soil by antibiotics and heavy metals originating from hospital facilities has emerged as a major cause for the development of resistant microbes. We collected soil samples surrounding a hospital effluent and measured the resistance of bacterial isolates against multiple antibiotics and heavy metals. One strain BMCSI 3 was found to be sensitive to all tested antibiotics. However, it was resistant to many heavy metals and metalloids like cadmium, chromium, copper, mercury, arsenic, and others. This strain was motile and potentially spore-forming. Whole-genome shotgun assembly of BMCSI 3 produced 4.95 Mb genome with 4,638 protein-coding genes. The taxonomic and phylogenetic analysis revealed it, to be a Bordetella petrii strain. Multiple genomic islands carrying mobile genetic elements; coding for heavy metal resistant genes, response regulators or transcription factors, transporters, and multi-drug efflux pumps were identified from the genome. A comparative genomic analysis of BMCSI 3 with annotated genomes of other free-living B. petrii revealed the presence of multiple transposable elements and several genes involved in stress response and metabolism. This study provides insights into how genomic reorganization and plasticity results in evolution of heavy metals resistance by acquiring genes from its natural environment.

Rare case of tracheal bronchus in a patient posted for minimal invasive cardiac surgery.

The tracheal bronchus is a rare congenital anomaly which occurs as a result of an additional tracheal outgrowth early in the embryonic life. It originates more commonly from the right wall of the trachea, above the carina. It is usually asymptomatic but may cause recurrent pneumonia, chronic bronchitis, or bronchiectasis. Here, we present the case of a 57-year-old lady posted for minimally invasive coronary surgery who was incidentally found to have an accessory bronchus during establishing one lung ventilation. The clinical implications of such a scenario is highlighted.

Cardiac surgery in octogenarians.

The incidence of cardiac surgery in elderly patients has been increasing. Recent studies have shown that cardiac surgical procedures performed in octogenarians, in otherwise good physical and mental health, can improve mortality, morbidity, and quality of life. This study aimed to describe the preoperative clinical and demographic characteristics associated with immediate postoperative outcomes and determine whether intra-operative factors related to surgical and cardiopulmonary by-pass techniques impacted upon these. The results of cardiac surgeries performed at BM Birla Heart Research Centre, Kolkata for patients older than 80 years were retrospectively analysed between January 2009 and September 2011. Out of 61 cases, rate of hospital death, prolonged stay (length of stay > 14 days), return to intensive care unit were as follows: 2 (3.2%), 30 (49.1%), 3 (4.9%). Eight patients (13.1%) developed pulmonary, 5 (8.1%) renal and 1 (1.6%) gastro-intestinal complications. Two patients (3.2%) developed neurological defecit. Thus, newer techniques in cardiac surgical procedures are successful in most octogenarians with increased hospital morbidity, and longer hospital stay.