Demographic Characteristics, Clinical Profile, Outcome and Risk Factors of Covid-19 among Health Care Workers in a COVID Dedicated Hospital.

The extremely contagious global outbreak of the novel Coronavirus disease 2019 (Covid-19) caused by Severe acute respiratory syndrome coronavirus-2(SARS- CoV-2) is causing concern worldwide since its emergence. Healthcare workers (HCWs) are more susceptible for acquiring Covid-19 due to direct or indirect exposure to Covid-19 patients. Therefore, it is important to investigate demographic, clinical characteristics and outcome of affected persons and possible source of infection with exposure details. This study aimed at determining the demographic and clinical profile, outcome and possible risk factors for infection among the HCWs at Kurmitola General Hospital (KGH), Bangladesh. This retrospective observational study was done among the SARS-CoV-2 positive HCWs of Kurmitola General Hospital (KGH) from April 2020 to January 2021. Out of total 1323 HCWs, 180(13.9%) cases were detected Covid-19 positive. Among the infected HCWs, 76(42.2%) were male and 104(57.8%) were female. The mean age was 32.8±6.95 years. Eighty nine (89) were nurses (49.4%) and 67 were physicians (37.2%). Among them, 23(13.0%) had no definite symptoms. Mild symptoms had in 137(76.11%) and 40(22.22%) had moderate symptoms. Most common symptoms were fever 112(62.0%), weakness 108(60.0%), cough 102(57.0%) and myalgia 54(30.0%). Pre-existing comorbidities had 43(24.0%). Bronchial asthma 27(15.0%), HTN 24(13.0%) and DM 21(12.0%) were the most prevalent comorbidities. All completely were recovered ultimately. Fatigue 52(28.89%), shortness of breath 15(8.3%), cough 13(7.2%) were the most common long-term complications. Among them, 53(29.0%) pointed toward lack of maintaining a hygienicatmosphere, as their possible cause of being infected, whereas 37(21.0%) could not identify the cause. Maximum HCWs, 170 cases (94.44%) used PPE during their duty. Adequate training get 26(14.44%) on PPE use and Infection prevention and control (IPC). This study concludes almost 1.4 in 10 HCWs at KGH were infected with SARS-CoV-2 while working in hospital during the Covid-19 pandemic. Affected HCWs have relatively female predominance with younger age, milder symptoms, and less underlying diseases in this study. Fatigue and shortness of breath are most common long-term complications, which hampers their working ability. Most of them did not get any training on PPE use and IPC.

Clinical Profile and Lab Findings of Dengue Fever in Children Admitted in a Tertiary Care Hospital.

Dengue is an arboviral infection dengue virus (DENV 1-4) transmitted by Aedes mosquito. It shows a wide range of clinical presentation from asymptomatic cases to undifferentiated fever, dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS) or non-severe and severe dengue. Most cases of dengue are self-limiting; however, severe dengue has high mortality if not diagnosed and managed early during the disease. Dengue virus (DENV) infection is a serious global public health challenge resulting approximately 200 million cases of morbidity and 50,000 cases of mortality annually. Management is based on clinical and lab parameters with certain lab tests aiding in the early forecast of severe dengue. While serological tests (detection of nonstructural protein 1 [NS1] antigen, immunoglobulin IgM and IgG antibodies aid in diagnosis of dengue, simple, cost-effective, easy tests such as hematocrit and platelet counts have great utility in resource-poor healthcare systems for predicting onset of severe dengue. To determine the clinical profile and lab findings of different varieties of Dengue fever in children admitted in a tertiary care hospital. This retrospective observational study was designed to collect data from the medical records of children of both sexes, aged up to 12 years old. The study was conducted from April 2019 to September 2019 in pediatrics department of BSMMU, Dhaka. A total of 50 children who were admitted with the complaints of fever and were found positive for either NS1 antigen or dengue IgM or IgG antibodies were included in the study. Patients with chronic diseases or any concurrent infections were excluded. Samples were collected from hospital record and kept in a separate management system only for dengue patients. The demographics, clinical and laboratory findings were recorded via structured data collection sheet. Among 50 cases, 22 were dengue fever, 17 were dengue hemorrhagic fever and 11 were dengue shock syndrome. The mean age of study participant was 6.95. Out of 50 patients, Male 62.0% were predominant over the female 38.0% and majority 74.0% came from urban area. Fever (95.5%) was mostly the presenting feature in dengue fever. Bleeding (29.4%) and tourniquet test positive (47.0%) were most in DHF. Hypotension (90.0%), tachycardia (90.9%), edema (18.2%), shock (90.9%) and hepatomegaly (72.7%) were mostly present in DSS. Neutropenia (72.7%) was significant in DSS. Platelet count (32,588.24±22,335.67) was significantly low in DHF. Albumin count (27.82±5.25) and TCO2 (18.27±1.8) were significantly low in DSS. Statistical analysis was done by Kuskalwallis test for categorical data analysis and one way ANOVA test for comparison of continuous data. P value <0.05 is considered as significant. This time it was seen that bleeding, tourniquet test positivity with low platelet count is seen in DHF. But DSS was marked by hepatomegaly and hypoalbuminaemia.

Ganglioneuroma Mimicking Nephroblastoma: A Case Report.

Ganglioneuroma is an uncommon benign, slow-growing tumor arising from the neural crest. It rarely turns malignant even after decades of benign existence. Imaging modalities give a definite clue to the existence of a neurogenic mass but it is finally diagnosed on histopathology examination. Here, a 3-year-old girl presented with ganglioneuroma that mimicked renal mass on imaging in a tertiary care hospital, Dhaka, Bangladesh on January, 2016. Later on, it was confirmed as neuroganglioma by histopathological examination. As treatment differs widely between ganglioneuroma and nephroblastoma, a minor mistake in the accurate diagnosis may endanger the life of a patient through potential adverse effects of therapy. So, we should keep in mind about ganglioneuroma regarding evaluation of any kidney or abdominal masses.

Serum Na+ Level in Children Suffering from Acute Bronchiolitis: A Review.

Bronchiolitis is the leading cause of lower respiratory tract infection (LRTI) in infants. Respiratory syncitial virus (RSV) is the most common cause of bronchiolitis in infants and young children. Hyponatremia is a commonly overlooked important extrapulmonary manifestation of bronchiolitis. It is now known that the syndrome of inappropriate anti diuretic hormone secretion (SIADH) occurs frequently in several pulmonary conditions including bronchiolitis which may lead to hyponatremia. In many studies,a good number of patients admitted with bronchiolitis were found to have hyponatremia e.g. Wilson et al. A high index of suspicion with prompt diagnosis and treatment can save life and prevent handicaps. Serum electrolyte level should be measured in all children hospitalized for bronchiolitis. Neurological complications may occur in hyponatremia and fluid therapy in vulnerable infants should be appropriately planned to reduce this risk.

High relaxation barrier in neodymium furoate-based field-induced SMMs.

Two new neodymium molecular magnets of formula {[Nd(α-fur)3(H2O)2]·DMF}n (1) and {[Nd0.065La0.935(α-fur)3(H2O)2]}n (2), α-fur = C4H3OCOO, have been synthesized. In (1) the furoate ligands, in bidentate bridging mode, consolidate zig-zag chains running along the a-direction. Compound (2) is a magnetically diluted complex of a polymeric chain along the b-axis. Heat capacity, dc magnetization and ac susceptibility measurements have been performed from 1.8 K up to room temperature. Ab initio calculations yielded the gyromagnetic factors gx* = 0.52, gy* = 1.03, gz* = 4.41 for (1) and gx* = 1.35, gy* = 1.98, gz* = 3.88 for (2), and predicted energy gaps of Δ/kB = 125.5 K (1) and Δ/kB = 58.8 K (2). Heat capacity and magnetometry measurements agree with these predictions, and confirm the non-negligible transversal anisotropy of the Kramers doublet ground state. A weak intrachain antiferromagnetic interaction J'/kB = -3.15 × 10-3 K was found for (1). No slow relaxation is observed at H = 0, attributed to the sizable transverse anisotropy component, and/or dipolar or exchange interactions enhancing the quantum tunnelling probability. Under an external applied field as small as 80 Oe, two slow relaxation processes appear: above 3 K the first relaxation mechanism is associated to a combination of Orbach process, with a sizeable activation energy U/kB = 121 K at 1.2 kOe for (1), Raman and direct processes; the second, slowest relaxation mechanism is associated to a direct process, affected by phonon-bottleneck effect. For complex (2) a smaller U/kB = 61 K at 1.2 kOe is found, together with larger g*-transversal terms, and the low-frequency process is quenched. The reported complexes represent rare polymeric Nd single-ion magnets exhibiting high activation energies among the scarce Nd(iii) family.

Slow relaxation in a {Tb2Ba(α-fur)8}n polymer with Ln = Tb(iii) non-Kramers ions.

We report the synthesis, crystal structure and magnetic properties of a new heteronuclear polymeric complex based on non-Kramers Tb ions and carboxylic α-fur = C4H3OCOO ligands: {[Tb2Ba(α-fur)8(H2O)4]·2H2O}n. The α-furoate ligands consolidate 1D zig-zag chains running along the c-axis, formed by Tb2 dimers separated by Ba ions. Ab initio calculations, in combination with the fit of experimental data, predict that the single-ion magnetic ground state is highly anisotropic () and consists of a quasi-doublet with a ΔTb/kB = 3.22 K gap, well separated from the next excited state, while the gap for the Tb2 dimer is Δ2Tb/kB = 2.58 K. Static magnetization and heat capacity measurements show that, magnetically, the system can be modeled as dimers of non-Kramers Tb ions, coupled by an antiferromagnetic intradimer interaction J'*/kB = -1.6 K. Dipolar interactions couple the Tb ions in the dimer with their first neighbour ions along the chain, with J''*/kB = -0.15 K, and with the surrounding ions out of the chain, with maximum J'''*/kB = -0.03 K. Ac susceptibility measurements in H = 0 performed down to 50 mK temperatures have enabled us to observe slow relaxation of magnetization, with an Orbach-like activation energy of U/kB = 1.1 K. It is assigned to the sluggish response of the 3D spin system due to a short-range ordering, possibly enhanced by the presence of disorder caused by defects in the polymeric chains. Under the application of a magnetic field, the system slowly relaxes by two distinct direct processes, strongly affected by a phonon bottleneck effect. We discuss the different relaxational phenomenology of the new complex in comparison with that of the isostructural {[Dy2Ba(α-fur)8(H2O)4]·2H2O}n, differing only in the Kramers nature of the ions, and the mononuclear {Ln(α-fur)3(H2O)3}n (Ln = Tb, Dy) complexes, previously reported.

Investigations on the photochromic properties of 2,6-bis(5-bromo-2-hydroxybenzylidene)cyclohexanone.

The network of chemical reactions of 2,6-bis(5-bromo-2-hydroxybenzylidene)cyclohexanone (BHBC) when subjected to light and different pH values has been investigated. The pH dependent species involved in the chemical network have been identified and characterized by NMR and UV-VIS spectroscopy. Direct pH jumps were carried out by adding a strong acid to equilibrated solutions of trans-chalcone (Ct) forming the flavylium cation which was stable only under extremely acidic conditions (pH < 0.5). The single crystal X-ray study and NMR analysis has confirmed the structure of the new flavylium cation. In the case of a reverse pH jump, the Ct species interconverted instantaneously into deprotonated trans-chalcone (Ct2-) around pH 12. A new colorless compound 3,11-dibromo-7,8-dihydro-6H-chromeno[3,2-d]xanthene (B-B) isolated from the equilibrated solution of trans-chalcone species in methanol after long periods of time (100 h) under dark conditions has been isolated and fully characterized by NMR and X-ray diffraction. The rate of the reaction increased when the solution of trans-chalcone was exposed to light and the total conversion of Ct into the spiropyran-like compound (B-B) was achieved in about 30 minutes. The B-B form was stable under neutral and basic conditions, while at low pH values it converts into a cationic AH+ form.

Correction: magnetic relaxation versus 3D long-range ordering in {Dy2Ba(α-fur)8}n furoate polymers.

Correction for 'Magnetic relaxation versus 3D long-range ordering in {Dy2Ba(α-fur)8}n furoate polymers' by E. Bartolomé et al., Dalton Trans., 2014, 43, 10999-11013.

Structural and magnetic properties of some lanthanide (Ln = Eu(iii), Gd(iii) and Nd(iii)) cyanoacetate polymers: field-induced slow magnetic relaxation in the Gd and Nd substitutions.

The lanthanide(iii) cyanoacetate complexes of the formula {[Ln2(CNCH2COO)6(H2O)4]·2H2O}n, where Ln = Eu (), Gd (), Nd (), have been prepared and characterized by X-ray diffraction analysis. Complexes and are isostructural and differ from the binding scheme of the neodymium compound , structurally described earlier. In all cases, the cyano group of the cyanoacetate ligand is not coordinated to the lanthanide cation. The carboxylic groups exhibit different binding modes: 2-bidentate-chelating, 2-bidentate and 2-tridentate-chelating bridging for and , and 4-bidentate and 2-tridentate-chelating bridging for the complex . The Eu compound shows field induced paramagnetism, as expected for a non-magnetic ground state with mixing from higher states. Combining the dc magnetization and luminescence measurements the spin-orbit coupling constant λ = 343 ± 4 cm(-1) was found, averaged over the two different sites for Eu in the lattice. In the Gd complex , a crystal field splitting of D/kB = -0.11 ± 0.01 K has been found for the S = 7/2 multiplet of the Gd(iii) ion. No slow relaxation at H = 0 is observed because the low anisotropy barrier allows fast spin reversal through classical processes. The application of an external magnetic field induces two slow relaxation processes. It is argued that the first relaxation rate is caused by the resonant phonon trapping (RPT) mechanism, while the second, slower relaxation rate is due to the lifting of the Kramers degeneracy on the ground state. For compound heat capacity and dc susceptibility measurements indicate that at very low temperatures the ground state Kramers doublet has strong single ion anisotropy. The energy to the next excited doublet ΔZFS/kB = 104 K has been calculated by ab initio calculation methods. The g* tensor has also been calculated, showing that it has predominant anisotropy along the z-axis, and there is an important transversal component. At H = 0 quantum tunnelling is an effective mechanism in producing a fast relaxation to equilibrium at temperatures above 1.8 K. The dipolar or exchange interactions and a sizable transverse anisotropy component in the ground state enhance the quantum tunneling probability. Under an external applied field, two slow relaxation processes appear: above 3 K the first relaxation mechanism is of the Orbach type, with an activation energy U/kB = 27 K; the slower relaxation is caused by the direct relaxation process from the ground state to the Kramers split levels by the applied field.

Magnetic relaxation versus 3D long-range ordering in {Dy2Ba(α-fur)8}n furoate polymers.

A novel Dy-complex formulated as {[Dy2Ba(α-C4H3OCOO)8·(H2O)4]·2H2O}n, {Dy2Ba(α-fur)8}n, has been synthesized, structurally characterized, and magnetically and thermally investigated as a function of field and temperature, down to 85 mK. The α-furoate ligands consolidate 1D zig-zag chains formed by Dy2 dimers separated by Ba ions. Ab initio calculations were used to determine the easy anisotropy axis direction, the gyromagnetic tensor components and the energy levels of each Dy. The heat capacity and susceptibility measurements allowed us to conclude that intradimer and interdimer interactions are ferromagnetic and of the same order, J'/k(B) ≈ J''/k(B) = +0.55 K. In the absence of an applied magnetic field, the dynamic relaxation of the magnetization occurs through the fast (τ(T) ~ 10(-5) s) spin-reversal of each of the individual Dys through a quantum tunneling (QT) process. A long-range 3D ordered state is achieved at T(N) = 0.25 K, in which the ferromagnetically coupled zig-zag chains (J'/k(B) ≈ J''/k(B) = +0.528(1) K) running along the c-axis are antiferromagnetically coupled to the adjacent chains (J'''/k(B) = -0.021(1) K). Critical slowing down of the QT time constant is observed when the temperature approaches T(N). Under the application of a magnetic field, the QT relaxation is replaced by an Orbach process (with energy barrier U/k(B) = 68 K and τ0 ~ 10(-9) s at H = 2 kOe) and a very slow (τ(s) ∼ 0.2 s) relaxation process. We propose and demonstrate the proof of concept of a spintronic device, in which two different relaxation rates can be selected, and on/off switched by magnetic field biasing. The dynamical behavior of this compound is compared with another furoate to discuss the effect of competitive interactions.

[Medical care of adolescents]. / Meditsinskoe obespechenie podrostkov.

The authors discuss staged transfer of adolescents aged 15-17 years to pediatric outpatient institutions by discontinuing their transfer to general therapeutic and prophylactic institutions and thus initiate continuous medical services for children till the age of 18 years within the framework of pediatric service. Experience gained in the Ryazan region is presented and the basic features in organization of public health organs and institutions of the territory in this direction are described; the role of complex prophylactic measures and inter-departmental approach to solution of this problem are discussed.