Stroke in a Patient With Pulmonary Siderosis: An Unusual Association.

Occupational lung diseases are a major hazard, which can lead to severe complications and a worsening quality of life. Out of these diseases, pulmonary siderosis was considered an innocuous disease. We detail the case of a 42-year-old man who had a history of chronic exposure to ferrous fumes due to his occupation. He presented with breathlessness and symptoms of a stroke. CT imaging studies showed an ischemic infarct in the brain and changes suggestive of interstitial lung disease in the chest, which was eventually diagnosed as pulmonary siderosis. In spite of having no comorbidities and significant past history, the patient developed a debilitating condition most likely as a consequence of the underlying lung pathology. We want to highlight the importance of early detection and proper management of interstitial lung diseases.

A Rare Case of Hereditary Hemochromatosis Presenting As Hyperbilirubinemia.

Hemochromatosis is a condition marked by excessive iron accumulation, causing dysfunction in various organs. A 50-year-old woman, previously in good health, reported abdominal pain and yellowing of the skin and eyes for one month. Upon examination, she exhibited widespread jaundice, leg swelling, and abdominal distention. Her total bilirubin level was 24.52 mg/dL at admission, indicating hyperbilirubinemia. Imaging studies, including USG and CT scans, revealed mild to moderate ascites and altered liver texture. Elevated serum ferritin (1443 ng/mL) and transferrin saturation (84%) suggested iron overload. A liver biopsy confirmed the presence of iron deposits in hepatocytes, leading to a diagnosis of hemochromatosis. Genetic testing was negative for the C282Y and H63D mutations, resulting in a diagnosis of non-homeostatic iron regulator (non-HFE) related hereditary hemochromatosis. The patient began weekly phlebotomy and was monitored regularly, with a liver transplant being considered as a potential treatment.

A Case of Pyrexia of Unknown Origin Diagnosed as Hemophagocytic Lymphohistiocytosis.

Hemophagocytic lymphohistiocytosis (HLH) is a rare disease that is even rarer in the adult population. It requires a high degree of suspicion from the treating physician, and if diagnosed early, patients might have a survival benefit from this highly fatal condition. HLH is a disorder of immune regulation where the hyperactivity of cytokines attacks different cells, which leads to multiple organ dysfunctions. Varying presentations and similarities with other diseases make diagnosis difficult. Familial HLH is commonly seen in the pediatric population, while acquired or secondary HLH is seen in adults. Secondary HLH is commonly triggered by neoplasms, infections, rheumatological diseases, and other autoimmune diseases. Here is a case of HLH that presented as chronic undiagnosed fever. In this case report, we have discussed in detail this disease, its presentation, investigations, treatment, and other important information that will help practicing doctors better diagnose and treat HLH patients.

Photocatalytic performance and interaction mechanism of reverse micelle synthesized Cu-TiO2 nanomaterials towards levofloxacin under visible LED light.

The degradation performance of Cu-TiO2 nanomaterials towards levofloxacin (LFX) antibiotic was investigated under an environmentally benign visible LED light source. Cu-TiO2 nanomaterials were prepared using the reverse micelle sol-gel method with different copper content ranging from 0.25 to 1.0 wt% concerning titania. Characterization of Cu-TiO2 samples was performed by XRD, TEM, UV-Vis, BET, ICP-MS, FTIR and XPS techniques. 0.5 wt% Cu-TiO2 showed crystallite size below 6 nm, surface area (69.85 m2/g) and significant visible light absorption capacity. Both Cu1+ and Cu2+ are formed in lower Cu-doped TiO2 samples, whereas only Cu2+ is present in higher Cu-doped TiO2 samples as evident in XPS analysis. 0.5 wt% Cu-TiO2 has shown the optimum photocatalytic degradation of 75.5% under 6 h. of a visible light source. FTIR analysis of LFX adsorbed Cu-TiO2 materials indicated the pollutant-catalyst interaction, where the declining trend was observed in photocatalytic degradation efficiency for higher Cu-doped TiO2 samples due to copper-LFX complex formation. Copper-LFX complexes are formed due to the presence of Cu2+ in higher Cu-doped TiO2 nanomaterials, which might have hindered the photocatalytic activity under visible light. Effects of initial pollutant concentration, catalyst loading and visible light intensity on the degradation of LFX are studied. Photocatalytic degradation pathways of LFX using best performing Cu-TiO2 material were also proposed based on the LC-MS analysis.

Raman and Mossbauer spectroscopy and X-ray diffractometry studies on quenched copper-ferri-aluminates.

Four spinel ferrite compositions of the CuAl(x)Fe(2-x)O4, x = 0.0, 0.2, 0.4, 0.6, system prepared by usual double-sintering ceramic route and quenched (rapid thermal cooling) from final sintering temperature (1373 K) to liquid nitrogen temperature (80 K) were investigated by employing X-ray powder diffractometry, (57)Fe Mossbauer spectroscopy, and micro-Raman spectroscopy at 300 K. The Raman spectra collected in the wavenumber range of 100-1000 cm(-1) were analyzed in a systematic manner and showed five predicted modes for the spinel structure and splitting of A1g Raman mode into two/three energy values, attributed to peaks belonging to each ion (Cu(2+), Fe(3+), and Al(3+)) in the tetrahedral positions. The suppression of lower-frequency peaks was explained on the basis of weakening in magnetic coupling and reduction in ferrimagnetic behavior as well as increase in stress induced by square bond formation on Al(3+) substitution. The enhancement in intensity, random variation of line width, and blue shift for highest frequency peak corresponding to A1g mode were observed. The ferric ion (Fe(3+)) concentration for different compositions determined from Raman spectral analysis agrees well with that deduced by means of X-ray diffraction line-intensity calculations and Mossbauer spectral analysis. An attempt was made to determine elastic and thermodynamic properties from Raman spectral analysis and elastic constants from cation distribution.

Cardiac disease in pregnancy--maternal and perinatal outcome.

To assess the maternal and perinatal outcome in pregnant women with cardiac disease, a prospective study was carried out among 51 pregnant women with cardiac disease between January 2006 and August 2008 at a tertiary care centre at BJ Medical College, Ahmedabad, Gujarat. Rheumatic cardiac disease (68.62%) with mitral valve involvement (88.57%) was the commonest cardiac disease. In congenital cardiac disease (21.57%) group septal defect was found as the predominant form. Cardiac surgeries were performed in 11 women before pregnancy out of which 7 had balloon valvotomies, 3 had valve replacements and one had corrective tetrology of Fallot surgery. Two valvotomies were safely done during pregnancy. Out of 51 total patients, two women had opted for termination and two were lost to follow-up. Cardiac complications developed in 17.02% of the women, most common being congestive cardiac failure. It was found more in New York Heart Association grades III and IV (p = 0.00001). A total of 68.08% women delivered vaginally and 31.91% delivered by caesarean section. Complication rate was high (33.33%) in caesarean section group (p = 0.05). Maternal and perinatal outcome was good in general with no maternal death and three perinatal deaths. There were more preterm babies (27.7%; p = 0.03) and babies with intra-uterine growth restriction (48.9%; p = 0.65). None of the newborns of the women who had received anticoagulants had any congenital malformation. Rheumatic heart disease still constitutes the major type of heart disease in our country. Maternal and perinatal morbidity increases with increase in New York Heart Association grade. Surgically treated women tolerate pregnancy well. Vaginal delivery is safer and caesarean section should be reserved only for obstetric indications. Maternal and perinatal outcome can be improved by team approach at tertiary care centre.