Individualized Homeopathic and Organopathic Supportive Management of Sickle Cell Disorder: A Case Series of Six Patients from a Particularly Vulnerable Tribal Group in India.

BACKGROUND: Sickle cell disorder (SCD) is a hereditary blood disease characterized by an abnormality in the oxygen-carrying protein hemoglobin present in red blood cells. Genetic abnormality causes these cells to become sickle-shaped, with shorter lifespan. Vaso-occlusive crisis is a major symptom of SCD: it is a sudden and severe episode of pain, and occurs when sickle-shaped cells block blood flow. This blockage can lead to tissue damage, inflammation and pain. OBJECTIVES: This case series aims to observe the clinical outcomes from prescribing individualized homeopathic medicines along with organopathic supportive medicine in the management of SCD through the analysis of case studies of six patients from a particularly vulnerable tribal group (PVTG) in India that manifests genetic predisposition for the disease. METHOD: The patients were administered individualized homeopathic and organopathic supportive medicines, after a comprehensive door-to-door survey and subsequent screening, conducted between October 2020 and May 2023 in the Dindori and Mandla districts of the central Indian state, Madhya Pradesh. Clinical symptoms, laboratory parameters including hemoglobin, along with scores from a visual analogue scale (VAS) for pain and from the World Health Organization Quality of Life (WHOQoL) Questionnaire, were determined. RESULTS: Individualized homeopathic and organopathic supportive management led to improvements in clinical symptoms for all six patients. Laboratory test results showed a statistically significant increase in hemoglobin level associated with treatment. The VAS for pain indicated decreased pain frequency and severity. WHOQoL scores also improved, indicating enhanced well-being for each patient. No adverse effects were reported during treatment. CONCLUSION: This study suggests that individualized homeopathic medicine and organopathic supportive management have a beneficial role in managing SCD and may be valuable in the context of PVTGs in India. To establish a more comprehensive understanding of its efficacy, further studies should involve larger cohorts to allow for a thorough evaluation, including comparative analyses with standard therapies.

Beam energy metrics for the acceptance and quality assurance of Halcyon linear accelerator.

PURPOSE: Establish and compare two metrics for monitoring beam energy changes in the Halcyon platform and evaluate the accuracy of these metrics across multiple Halcyon linacs. METHOD: The first energy metric is derived from the diagonal normalized flatness (FDN ), which is defined as the ratio of the average measurements at a fixed off-axis equal distance along the open profiles in two diagonals to the measurement at the central axis with an ionization chamber array (ICA). The second energy metric comes from the area ratio (AR) of the quad wedge (QW) profiles measured with the QW on the top of the ICA. Beam energy is changed by adjusting the magnetron current in a non-clinical Halcyon. With D10cm measured in water at each beam energy, the relationships between FDN or AR energy metrics to D10cm in water is established with linear regression across six energy settings. The coefficients from these regressions allow D10cm (FDN ) calculation from FDN using open profiles and D10cm (QW) calculation from AR using QW profiles. RESULTS: Five Halcyon linacs from five institutions were used to evaluate the accuracy of the D10cm (FDN ) and the D10cm (QW) energy metrics by comparing to the D10cm values computed from the treatment planning system (TPS) and D10cm measured in water. For the five linacs, the D10cm (FDN ) reported by the ICA based on FDN from open profiles agreed with that calculated by TPS within -0.29 ± 0.23% and 0.61% maximum discrepancy; the D10cm (QW) reported by the QW profiles agreed with that calculated by TPS within -0.82 ± 1.27% and -2.43% maximum discrepancy. CONCLUSION: The FDN -based energy metric D10cm (FDN ) can be used for acceptance testing of beam energy, and also for the verification of energy in periodic quality assurance (QA) processes.

Mental health and well-being impacts of COVID-19 on rural paramedics, police, community nurses and child protection workers.

OBJECTIVE: To investigate the impact of COVID-19 on the mental health and well-being of rural paramedics, police, community nursing and child protection staff. METHOD: An online survey was distributed to investigate the sources of stress and support across individual, task and organisational domains. SETTING AND PARTICIPANTS: The survey was completed by 1542 paramedics, police, community nurses and child protection workers from all states and territories of Australia. This study describes the data for the 632 rural participants. MAIN OUTCOME MEASURES: The main measures of well-being were the Public Health Questionnaire (PHQ9), the Generalised Anxiety Disorder (GAD7), the Maslach Burnout Inventory (MBI), workplace engagement, intention to quit and COVID-19-related stress. RESULTS: The mean depression and anxiety scores were 8.2 (PHQ9) and 6.8 (GAD7). This is 2-3 times that found in the general community. Over half (56.1%) of respondents showed high emotional exhaustion (burnout). The emotional exhaustion, depersonalisation and personal accomplishment mean scores were 28.5, 9.3 and 34.2, respectively. The strongest associations with burnout and psychological distress were workload, provision of practical support, training and organisational communication. A significant proportion of respondents were seriously considering quitting (27.4%) or looking for a new job with a different employer (28.5%) in the next 12 months. CONCLUSIONS: COVID-19 has increased the workload and stress on rural front-line community staff. The major sources of stress were related to organisations' responses to COVID-19 and not COVID-19 per se. The data suggest the most effective mental health interventions are practical and preventive, such as firstly ensuring fair and reasonable workloads.

Monochromatic NIR UC emission in Tm3+/Yb3+co-doped GdVO4 phosphor: the effect of the Bi3+ ion concentration and pump power of a diode laser.

A Tm3+/Yb3+/Bi3+ co-doped GdVO4 phosphor sample has been synthesized using a high-temperature solid-state reaction technique. The X-ray diffraction patterns reveal pure phase formation and crystalline behavior of the synthesized samples. Intense blue and NIR upconversion emissions have been observed upon excitation with a 980 nm diode laser. It is found that the addition of the Bi3+ ion to the phosphor reduces the intensity of blue emission and enhances the NIR emission intensity to the extent that NIR emission is nearly monochromatic [(INIR/IBlue) ∼ 14]. This ratio is further improved up to 70 times (almost monochromatic) by varying the pump power of the diode laser. Thus, this material can be used as a cheap source of monochromatic NIR emission at 800 nm for bioimaging.

Evaluation of Shoulder Injuries: A Comparative Study of Imaging by Magnetic Resonance Imaging (MRI) and Magnetic Resonance Arthrography (MRA).

Background: In contrast to the standard shoulder arthroscopy, current radio-diagnostic techniques like magnetic resonance arthrography (MRA), and magnetic resonance imaging (MRI) provide less invasive intricate structural detail of shoulder anatomy. Objectives: Comparison of efficacy of MRA and MRI for diagnosing suspected rotator cuff injury. Materials and Methods: Over the course of 4 years (from June 2017 to June 2021), a comparative study, including 100 individuals with suspected rotator cuff pathology, was conducted. For the evaluation of shoulder injuries, the assessment and comparison of MRA and MRI were done in terms of sensitivity (Sn), positive predictive value (PPV), and diagnostic accuracy (DA). Results: MRI and MRA were positive in 76 (76%) and 98 (98%) patients, respectively. The Sn and PPV of MRI for diagnosing the shoulder injury were 76% and 100%, respectively, whereas the Sn and PPV of MRA were 98% and 100%, respectively. MRA was better than MRI in terms of diagnostic accuracy (98% vs. 76%, P = 0.03). Conclusion: MRA is a nonsurgical effective method in evaluating and diagnosing rotator cuff injuries in comparison to MRI.

The association of continuous glucose monitoring with glycemic parameters in patients with uncontrolled type 2 diabetes: A prospective observational study.

Background: Uncontrolled glycemic parameters in type 2 diabetes mellitus (T2DM) are a major concern. The present study aimed to evaluate the effectiveness of continuous glucose monitoring (CGM) on glycemic control in type 2 diabetics on insulin therapy. Materials and Methods: This prospective observational study was done in the Outpatient Department of General Medicine from January 1, 2021 till December 31, 2021 on patients with confirmed T2DM and on insulin therapy. Patients underwent detailed history and physical examination. The CGM device was inserted to record blood glucose levels throughout the day and night for monitoring. Parameters like glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), post-paradial blood sugar (PPBS), and lipid profile parameters [cholesterol, triglyceride (TG), and low-density lipoprotein (LDL)] were compared at baseline and after a follow-up of 3 months. P-value < 0.05 was used to indicate significant difference. Results: Of 107 patients screened, 100 were included in the study and seven were excluded. The mean age of the patients was 60.6 ± 11.1 years. Fifty-six (56%) of the patients were males, and 44 (44%) were females. The mean body mass index (BMI) was 22.9 ± 2.4 kg/m2. Compared to baseline values, after 3 months of CGM, there was significantly decreased HbA1c (9.41 ± 0.83 vs 9.87 ± 1.16 g%, P < 0.001), FBS (194.640 ± 22.4587 vs 205.10 ± 35.7758 mg/dl, P = 0.002), PPBS (271.160 ± 29.1235 vs 299.180 ± 42.3798, P < 0.001), cholesterol (184.470 ± 28.5192 vs 198.430 ± 38.8367 mg/dl, P < 0.001), LDL (102.410 ± 22.8973 vs 112.040 ± 30.8859, P < 0.001), and TG (140.890 ± 18.0979 vs 146.730 ± 20.8665 mg/dl, P < 0.001). Conclusion: There was a significant improvement in the glycemic parameters and lipid profile parameters with the adoption of CGM. Overall, CGM is a novel method for practical use for management of patients with T2DM.

A Systematic Review of Radiological Diagnosis and Management of May-Thurner Syndrome.

May-Thurner syndrome (MTS) is an anatomical condition of external luminal compression of common iliac vein due to a partial obstruction of the common iliac vein between common iliac artery and lumbar vertebra causes deep-vein thrombosis, venous hypertension, and chronic venous insufficiencies. In this article, we review present evidence of the clinical diagnosis and management of MTS. Here, we conducted a literature review of studies on MTS. We also reviewed different clinical features, presentation, diagnostic methods, and therapeutic procedure for this condition. Most studies mentioned the diagnosis of this condition is performed by color Doppler, computed tomographic angiography, venography, and problem-solving cases by intravascular ultrasound technique. Nonsurgical methods of management are first line, and vascular surgery is reserved for refractory cases. Multiple modalities are required to reach the diagnosis of MTS, and noninvasive intervention radiology methods are the first line of management. This review highlights the presentations of MTS and outlines diagnostic procedure and management.

Utility of Pulmonary Angiography by 128-Slice Computed Tomographic Scanner in Diagnosis of Tetralogy of Fallot Cases.

Tetralogy of Fallot (TOF) is a significant cause of cyanotic congenital heart disease (CHD) encountered in childhood with few cases manifesting in adulthood. It has four classical features (ventricular septal defect, overriding of aorta, hypertrophy of right ventricular hypertrophy, and right ventricular outflow tract obstruction), but the clinical presentation and course can be variable. Due to various anatomical variations and complex anatomy, presurgical planning and postoperative follow-up by pulmonary computed tomographic angiography (CTA) have a very important role. With continued technological advances and the availability of 128-slice computed tomographic (CT) scans, they now play an important role in TOF preoperative evaluation and workup, assisting by minimizing routine invasive digital subtraction catheter angiography. The fast scan of a 128-slice CTA with very sensitive detectors is a very useful modality for studying the complex anatomy and variations as well as its utilization for postoperative management. In this article, we report four cases of TOF where we used a 128-slice scan for performing pulmonary angiography (Optima 660, GE 128, 2180 Premier Row, Orlando, FL 32809, U.S.A.) for preoperative diagnosis and management of three cases and work up for revision surgery for an already operated case with a nonfunctional modified Blalock-Taussig shunt with additional lung parenchymal findings simultaneously. This study will explain the advantageous role of the 128-slice CT scanner over the lesser-slice CT scanners with the ability of pulmonary CTA to facilitate accurate diagnosis and postoperative management.

Transformer-based decoder of melanoma classification using hand-crafted texture feature fusion and Gray Wolf Optimization algorithm.

Melanoma is a type of skin cancer that poses significant health risks and requires early detection for effective treatment. This study proposing a novel approach that integrates a transformer-based model with hand-crafted texture features and Gray Wolf Optimization, aiming to enhance efficiency of melanoma classification. Preprocessing involves standardizing image dimensions and enhancing image quality through median filtering techniques. Texture features, including GLCM and LBP, are extracted to capture spatial patterns indicative of melanoma. The GWO algorithm is applied to select the most discriminative features. A transformer-based decoder is then employed for classification, leveraging attention mechanisms to capture contextual dependencies. The experimental validation on the HAM10000 dataset and ISIC2019 dataset showcases the effectiveness of the proposed methodology. The transformer-based model, integrated with hand-crafted texture features and guided by Gray Wolf Optimization, achieves outstanding results. The results showed that the proposed method performed well in melanoma detection tasks, achieving an accuracy and F1-score of 99.54% and 99.11% on the HAM10000 dataset, and an accuracy of 99.47%, and F1-score of 99.25% on the ISIC2019 dataset. • We use the concepts of LBP and GLCM to extract features from the skin lesion images. • The Gray Wolf Optimization (GWO) algorithm is employed for feature selection. • A decoder based on Transformers is utilized for melanoma classification.

Peroneal Artery Pseudoaneurysm after Surgery for Non-union of Tibia: A Case Report with Review of Literature.

Introduction: Arterial pseudoaneurysm is a hematoma that is formed after damage to the arterial wall. We report a rare case of peroneal artery pseudoaneurysm after open reduction and internal fixation with interlocking nailing and partial fibulectomy for non-union for the right tibia in a 31-year-old male. The patient presented with a bleeding sinus over the leg swelling, and it was managed with an exploration of the pseudoaneurysm and ligation of the peroneal artery. Case Report: A 30-year-old male patient presented with a non-union tibia on the right side and had undergone plating of the tibia at another institute for a fracture of both bone legs approximately 18 months ago. The revision surgery was performed in which a previously inserted implant was removed and an interlocking nail was inserted, along with a partial fibulectomy. The post-operative period was uneventful. At 8 weeks after the second surgery, the patient came with a complaint of swelling at the outer aspect of the right leg. Computed tomography and angiography confirmed a peroneal artery pseudoaneurysm of 3.2 × 2.8 × 3.8 cm. Pseudoaneurysm was explored, and the artery was overrun with a Figure-8 stitches using a monofilamentous, and non-absorbable suture. Conclusion: This case report highlights the occurrence of pseudoaneurysm after an orthoapedic procedure such as a partial fibulectomy. A high level of clinical suspicion, proper imaging, and early endovascular or surgical intervention is recommended to prevent complications.

Analysis of constituents present in smokeless tobacco (Nicotiana tabacum)using spectroscopic techniques.

Laser-Induced Breakdown Spectroscopy (LIBS) is an analytical technique used to identify and quantify the elements present in any type of material present in any phase (solid, liquid, gas, and aerosol). In the present work, our objective is to find the presence of toxic and other elements in chewing tobacco (Nicotiana tabacum) using LIBS. Spectral signatures of elements like C, Fe, Si, Mg, Mn, Ca, Ti, Na, H, N, K, O, along with some toxic elements Al, Sr, Li, Cu, Sb, and Cr are observed in the LIBS spectra of these tobacco samples. The spectral intensity ratio is measured for quantitative analysis of elements present in the samples. Further, Atomic Absorption Spectroscopy is used for determining absolute concentration in these samples. A relation between the AAS result and the relative intensity of spectral lines measured in the LIBS is obtained using regression analysis. The multivariate technique, Principal Component Analysis (PCA), discriminates all the samples based on their toxicity and other constituents. Molecular study (Photoacoustic spectroscopy (PAS), UV-Visible (UV-vis), and FT-IR) of tobacco samples were performed to analyze the molecules present in the tobacco samples.

Volumetric Arc Therapy Treatment Plan Dosimetry Correction Method to Account Patient Weight Loss during a Course of Radiation Therapy.

AIM: This study aims to validate volumetric arc therapy (VMAT) plan correction method for a patient's lost weight during the course of radiotherapy. MATERIALS AND METHODS: VMAT plans of prostate and head and neck cancers were considered to evaluate dosimetric effects due to external surface changes caused by patient's weight loss during treatment. Accepted VMAT treatment plan was recalculated on the planning computed tomography (CT) with a newly created external contour from cone-beam CT and was compared with the original plan. Monitor unit (MU) correction was applied based on a simple formalism, and doses were recalculated. Dose statistics were compared with the original plan. Ten patients with significant weight loss were considered to validate proposed MU correction method by comparing the dose statistics before and after MU corrections. RESULTS: We observed 3.7%-5.2% change in the plan maximum dose for one cm change in path length to isocenter with increased planning target volume dose, D95 by 4%. The organs at risk (OAR) doses increased as high as 6.8%. Using MU correction method, target volume and OARs dose changes were reduced to <1% when compared with the original plan. The correction method brought down the maximum plan dose and volume of 95% isodose (V95) cloud below an acceptable range of 1%-2% in 10 patients treatment plans. CONCLUSION: Image-guided radiation therapy process detects the weight loss, which affects the treatment plan's dose distribution and should be corrected. Applying the correction method described here keeps the patient dosimetry within 1% of the original plan, which is clinically acceptable. The process of plan dosimetry correction to address weight loss can be completed within 30 min without repeating imaging and planning process.

Variation of V105% between pre- and postmerged subfields in field-in-field hypofractionated breast radiotherapy plans.

Hypofractionated whole-breast irradiation has emerged as a viable alternative to conventional fractionation. In the field-in-field forward planning technique, a merged plan with 2 to 4 segmental fields is the final plan delivered to the machine. As per the ASTRO guidelines for the hypofractionation regimen, the volume of breast tissue receiving V105% of the prescription dose should be less than 200 cc. However, we have noticed substantial changes to this volume (change in V105% between -55 cc and + 47.1 cc) after merging the subfields. This study compares the V105% of 29 breast plans before and after merging the subfields.

Effect of Synthesis Techniques on the Optical Properties of Ho3+/Yb3+ Co-doped YVO4 Phosphor: A Comparative Study.

The Ho3+/Yb3+-codoped YVO4 phosphors have been synthesized by three different techniques (viz., solution combustion, sol-gel, and solid-state reaction techniques). X-ray diffraction patterns confirm the formation of a pure phase in the samples synthesized by all of the three methods; however, the average crystallite sizes in the three cases are different. The crystallite size increases if they are heated to higher temperature. The particle sizes are measured by scanning electron microscopy, which shows an increase in particle size with increasing the calcination temperature. The vibrational behavior of all of the three synthesized phosphor samples is studied by the Fourier transform infrared (FTIR) technique. The UV-vis absorption measurements give a large number of bands in all of the three samples prepared by three different methods. The upconversion (UC) emissions in all three samples have been monitored using a 980 nm diode laser. It gives an intense red emission in all of the three samples. Upconversion emission intensity is more prominent in the phosphor sample synthesized by the sol-gel technique and heated at 1473 K. The enhancement in UC emission intensity is well understood by the shape and size of the particles and also confirmed by the FTIR and UV-vis measurements. It is interesting to note that whereas UC measurements give red and weak green emissions, downshifting (DS) measurements show intense green, weak red, and broad blue emissions on UV excitation (323 nm). The DS behavior shows the same characteristics of the enhancement in overall emission. Overall, the phosphor sample synthesized by the sol-gel method gives better results in upconversion and downshifting behaviors when heated at 1473 K.

Pre-treatment neutrophil-lymphocyte ratio is associated with overall mortality in localized non-small cell lung cancer treated with stereotactic body radiotherapy.

BACKGROUND: Neutrophil-lymphocyte ratio (NLR) has been associated with mortality in several disease sites. We hypothesized that NLR is associated with inferior outcomes in localized non-small cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT). METHODS: We evaluated the association of pre-treatment NLR, obtained within 6 months of starting SBRT, with overall survival, as well as primary tumor, regional, and distant recurrence. Multivariate Cox regression was then used to assess pre-treatment NLR as a predictor of mortality. We validated our findings in an independent cohort of patients treated at two other institutions. In a secondary analysis, we also evaluated the association of post-treatment NLR with mortality in the training cohort. RESULTS: A total of 156 patients and 166 tumors were included in the training cohort with a median follow-up of 13.4 months. After dichotomization by median, NLR > 3.6 was associated with mortality on univariate (p = 0.010) and multivariate analysis (p = 0.023). In the validation cohort, NLR > 3.6 was similarly associated with mortality on univariate (p = 0.031) and multivariate (p = 0.007) analysis. In a secondary analysis in the training cohort, we found post-treatment NLR was significantly increased compared to pre-treatment NLR (p < 0.001) and associated with mortality on univariate analysis (p = 0.005) and multivariate analysis (p = 0.010). CONCLUSIONS: Pre-treatment NLR > 3.6 is associated with mortality in patients treated with SBRT. This finding was validated in an independent cohort of patients treated at two other institutions. Additionally, post-treatment NLR was significantly increased from pre-treatment and associated with overall survival.

Daily Image Guidance With Cone Beam Computed Tomography May Reduce Radiation Pneumonitis in Unresectable Non-Small Cell Lung Cancer.

PURPOSE: To investigate the impact of daily image-guided radiation therapy technique on clinical outcomes in patients with inoperable non-small cell lung cancer treated with definitive chemoradiation therapy. METHODS AND MATERIALS: We compared patients with inoperable non-small cell lung cancer receiving daily cone beam computed tomography (CBCT) after an initial 4-dimensional computed tomography (4DCT) simulation (n = 76) with those receiving daily 2-dimensional orthogonal kilovoltage (kV) imaging (n = 48). The primary endpoint was time to grade ≥2 radiation pneumonitis (RP2), estimated with the cumulative incidence method, compared with Gray's test, and modeled with the Fine-Gray method. RESULTS: Median follow-up was 40.6 months (range, 5.9-58.1 months) for the CBCT group and 75.8 months (range, 9.9-107.8 months) for the orthogonal kV group. Four-dimensional computed tomography simulation was used in 100% (n = 76) of the CBCT group and 56% (n = 27) of the orthogonal kV group (P < .0001). The 1-year cumulative incidence of RP2 was lower in the CBCT group than in the orthogonal kV group (24% vs 44%, P = .020). On multivariate analysis, daily imaging with CBCT after an initial 4DCT simulation was associated with a decreased risk of RP2 (adjusted hazard ratio 0.43, 95% confidence interval 0.22-0.82, P = .011), a finding that persisted among only patients who received 4DCT simulation (adjusted hazard ratio 0.48, 95% confidence interval 0.23-0.98, P = .045). There was no difference in locoregional progression, distant metastasis, any progression, or overall survival between groups. CONCLUSIONS: Daily image guided radiation therapy with CBCT compared with 2-dimensional orthogonal kV imaging was associated with a decreased risk of RP2. Clinicians could consider the implications of localization methods during curative intent radiation therapy.

Role of MRI in a Series of Cases with Biceps Injuries of the Shoulder.

Dislocation and injury of the biceps is associated with acute and chronic trauma, degenerative changes, repetitive microtrauma, or injuries associated with recurrent and neglected cases of shoulder dislocation. The cases of displaced biceps injuries are relatively rare (only 1/6th of all rotator cuff injuries). The dislocation of biceps is manifested with pain and restriction of movements. The X-ray shoulder is not of much help in this condition barring for ruling out the fractures of humerus and scapula. Ultrasound is an important tool in the dislocation and shows empty bicipital groove which raises the suspicion of the soft tissue injures. Ultrasound is a problem solving tool when the equivocal findings in MRI (Magnetic Resonance Imaging) in other muscular injuries also. MRI is the modality of choice in these conditions. The bone and anatomy is better visualised on the T1WI images and the pathology is better visualised on the PDFS (Proton Density Fat Saturation) and the STIR (Short Tau Inversion Recovery) images. The role of Non Contrast Computed Tomography (NCCT) is important in associated suspicious bony abnormalities as highlighted in the article. The biceps region is a hidden area and challenging on arthroscopy due to poor visualisation of the extra-articular tendon part. MRI study helps the orthopaedicians for better management of the hidden areas. This series highlights the role of each modality in the diagnosis and management of the biceps lesions.

Role of HRCT Chest in Post Stem Cell Transplant Recipients Suspected of Pulmonary Complications.

INTRODUCTION: Stem cell transplantation is today's procedure of choice for management of various hematopoietic malignant and severe immunogenic disorders. High Resolution Computed Tomography (HRCT) is a common technique for the diagnosis of pulmonary complications in stem cell transplant recipients. There are a large number of complications which can complicate the post-transplant period. AIM: To study the role of HRCT chest in stem cell transplant patients developing pulmonary complications, detect any evidence of infection, detect clinical signs of lung infections, Graft versus Host Disease (GvHD) or other regimen related toxicities outlined earlier, detect any evidence of GvHD and correlate these clinical signs with radiological changes in the lungs. MATERIALS AND METHODS: The study was a prospective study of 52 participants with indication of stem cell transplantation. The study included recipients of HSCT transplant and the exclusion criteria was patients who failed for engraftment and having an associated history of pulmonary embolism. Patients were screened for pre-transplant chemotherapy, clinical examination, laboratory investigations including blood and biochemical examinations, imaging by ultrasound, chest radiography, baseline HRCT and a follow-up for post-transplant infections and complications with 16 slice Siemens CT scan. Statistical analysis was done using Pearson's chi-squared test. RESULTS: Four patients among the total 56 were excluded due to non-engraftment. The most common associated findings in decreasing order are (these patients died): consolidation, pancytopenia and gastrointestinal tract symptoms with VOD (Veno-Occlusive Disease). These findings were seen on HRCT as consolidation, cavities, ground glass opacities, fibrotic changes, bronchiectatic changes and tree in bud appearance. CONCLUSION: The study highlights the significant positive findings on the HRCT which were missed on routine chest radiograph and can be used for early diagnoses. Thus, HRCT helped in decreasing the mortality. The abnormal vitals and TLC counts showed a significant relation between the numbers of death in the study.

Hypophosphatemic osteomalacia in von Recklinghausen neurofibromatosis: Case report and literature review.

Osteomalacia in neurofibromatosis is a rare entity and distinct from more common dysplastic skeletal affections of this disease. As a rule, it is characterized by later onset in adulthood. There is renal phosphate loss with hypophosphatemia and multiple pseudofractures in the typical cases. The hypophosphatemic conditions that interfere in bone mineralization comprise many hereditary or acquired diseases, all of them sharing the same pathophysiological mechanism-reduction in phosphate reabsorption by the renal tubuli. This process leads to chronic hyperphosphaturia and hypophosphatemia, associated with inappropriately normal or low levels of calcitriol, causing rickets in children and osteomalacia in adults.

Hexavalent chromium reduction and plant growth promotion by Staphylococcusarlettae strain Cr11.

Cr(VI), a mutagenic and carcinogenic pollutant in industrial effluents, was effectively reduced by an indigenous tannery effluent isolate Staphylococcus arlettae strain Cr11 under aerobic conditions. The isolate could tolerate Cr(VI) up to 2000 and 5000 mg L(-1) in liquid and solid media respectively. S. arlettae Cr11 effectively reduced 98% of 100 mg L(-1) Cr(VI) in 24h. Reduction for initial Cr(VI) concentrations of 500 and 1000 mg L(-1) was 98% and 75%, respectively in 120 h. The isolate was also positive for siderophore, indole acetic acid, ammonia and catalase production, phosphate solubilization and biofilm formation in the presence and absence of Cr(VI). The isolate showed halotolerance (10% NaCl) and cross tolerance to other toxic heavy metals such as Hg(2+), Ni(2+), Cd(2+) and Pb(2+). Bacterial inoculation of Triticum aestivum in controlled petri dish and soil environment showed significant increase in percent germination, root and shoot length as well as dry and wet weight in Cr(VI) treated and untreated samples. This is the first report of simultaneous Cr(VI) reduction and plant growth promotion for a S. arlettae strain.