Influence of oxyhydrogen gas retrofit into two-stroke engine on emissions and exhaust gas temperature variations.

The generation of power and fuel sustainability that contributes to a cleaner output of exhaust gases is one of the most important objectives the world seeks. In this paper, oxyhydrogen gas is used to retrofit into a two-stroke engine. The water was electrolysed and generated a mixture of oxygen (O2) and hydrogen (H2) or known as oxyhydrogen (HHO) gas via an electrolytic dry cell generator. The HHO was retrofitted experimentally to investigate the engine emissions and exhaust gas temperature from a 1.5 kW gasoline engine. The engine was tested with different power ratings (84-720 W) to investigate the performance and emissions of the engine using gasoline followed by the addition of HHO. The emissions of CO and NOx were measured with different amounts of HHO added. The exhaust temperature was calculated as one of the variables to be considered in relation to pollution. The air-fuel ratios are varied from 12 to 20% in the experiment. The most appropriate air-fuel ratio needed to start the generator with the most environmentally friendly gas emission was analysed. The results showed that the addition of HHO to the engine is successful in reducing fuel consumption up to 8.9%. A higher percentage of HHO added also has improved the emissions and reduced exhaust gas temperature. In this study, the highest quantity of HHO added at 0.15% of the volume fraction reduced CO gas emission by up to 9.41%, NOx gas up to 4.31%, and exhaust gas temperature by up to 2.02%. Generally, adding oxyhydrogen gas has significantly reduced the emissions, and exhaust temperature and provided an eco-friendly environment.

Nationwide prevalence of Rickettsia felis infections in patients with febrile illness in Bangladesh.

From July 2015 to December 2016, the presence of rickettsial pathogens was investigated for 414 patients with unknown fever in eight places in all the divisions of Bangladesh. Rickettsia felis was identified in blood samples from all the regions (overall detection rate, 19.6%), suggesting nationwide prevalence of R. felis infections.

Determination of ammonium and organic bound nitrogen by inductively coupled plasma emission spectroscopy.

The continuous flow sample introduction technique with a hydride generator system in conjunction with an inductively coupled plasma emission spectrometer (ICP-AES-HG), is used in this study for quantitative determination of ammonium and organic bound nitrogen in aqueous and solid samples. Ammonia vapor released from ammonium salt after treatment with concentrated NaOH is transferred by argon to plasma for detection at 174.273 nm using axial argon plasma mode. The calibration curves were linear within a range of 25-1000 mg L(-1)N as ammonium molybdate with correlation coefficients of better than 0.99 and limits of detection of about 10-25mg L(-1)N. The percent recovery of N (25-500 mg L(-1)N) in soft (distilled) water and high salt content (1.7 mol L(-1) NaCl) matrices was found to be in the range of about 97-102% with %RSD in the range of 4.6-0.62. The sensitivity, limit of detection, and blank contribution from the atmospheric nitrogen, were tremendously improved in this method compared with the available ICP-AES spray chamber counterpart. Furthermore, the ICP-AES-HG method gave results for real samples (soil, fertilizer, waste water) containing about 50-1800 mg L(-1)N in good agreement with those obtained by the standard Kjeldahl method. No statistical differences at the 95% confidence level on applying the t-test were observed between the values obtained by the two methods. Thus, the ICP-AES-HG method is reliable and faster than the conventional tedious Kjeldahl method, superior to the ICP-AES spray chamber method, and almost free from matrix interference which is usually a critical factor in atomic emission spectroscopic techniques.

Concomitant diseases in a cohort of patients with idiopathic myositis during long-term follow-up.

This study aims to report the concomitant diseases observed and damage outcome in a cohort of patients with adult idiopathic inflammatory myositis (IIM) during long-term follow-up. All patients with IIM were identified from a single centre (follow-up between 1979 and 2006) and fulfilled at least three of the four Bohan and Peter criteria. Patients with inclusion body myositis, juvenile-onset myositis and overt overlap syndromes were excluded. Medical notes were retrospectively reviewed. Concomitant diseases identified were divided into 12 different organ systems (bone, cardiac, respiratory, gastrointestinal, renal, central nervous, malignancy, infection, endocrine, eyes, dermatological and haematological). Patient damage index was calculated using the Myositis Damage Index tool. Fifty-five patients (31 polymyositis, 24 dermatomyositis) were identified. The most prevalent organ system involved was lung with 40 events per 1,000 patient years follow-up. There was significant steroid-related complications with 17/18 patients with bone involvement having osteopenia/osteoporosis. Sjogren's syndrome (n = 3) was the most frequent concomitant auto-immune disease observed. Patients with a higher number of organ systems involved had a significantly higher damage index (r = 0.48, p = 0.001). White patients showed a significant trend to develop more than three other organ system involvement (p < 0.0001) and myositis-related lung disease (p < 0.0001) compared to other races. There is significant steroid-related morbidity in adult IIM patients under long-term follow-up. The prevalence of another concomitant auto-immune disease unlike patients with lupus or Sjogren's syndrome is low.

Clinical outcome following B cell depletion therapy in eight patients with refractory idiopathic inflammatory myopathy.

OBJECTIVE: To assess the efficacy of B lymphocyte depletion therapy (BCDT) in patients with refractive idiopathic inflammatory myopathy (IIM). METHODS: Eight patients thought to have IIM were treated with BCDT utilising rituximab. Five were treated as part of an open label trial and three on the basis of perceived clinical need. Rituximab (1 gram) and methylprednisolone (100 mg) were given as intravenous infusions on days 0 and 14. The primary efficacy outcome at 6 months was 15% improvement in muscle strength and 30% reduction in CPK. RESULTS: Two patients with Jo-1 antibody positive dermatomyositis (DM) demonstrated a clinical response. Both achieved >30% improvement in CPK. In one, the CPK remained within the normal range for 10 months, the other had a normalised CPK and stabilisation of lung function tests for 36 months. Muscle strength by myometry, however, did not achieve the primary outcome, although, patient 1, demonstrated an improvement of 20% at 8 months (the patient had elective surgery of the hand during the study period). Jo-1 antibody levels fell modestly in both patients but remained detectable. Re-evaluation of three patients revealed that one had inclusion body myositis, one had sporadic muscular dystrophy and one subsequently developed nodular sclerosing lymphoma. All except one patient showed adequate B cell depletion with re-population occurring 3- >42 months after BCDT. One patient did not deplete and died of an unrelated cause. CONCLUSIONS: This study emphasizes the importance of identifying and selecting the appropriate sub-group of patients with IIM most likely to respond to BCDT.

Clinical assessment in adult onset idiopathic inflammatory myopathy.

PURPOSE OF REVIEW: Outcome measures have been developed and validated for many rheumatic diseases and used in clinical trials. The clinical assessment and measures of improvement in clinical trials of patients with idiopathic inflammatory myopathy (IIM) has varied to date and over the past few years an attempt has been made to reach a consensus in defining this improvement. RECENT FINDINGS: The IMACS group (International Myositis Outcome Assessment Collaborative Study) has proposed core set measures for disease activity and damage assessment in adults. Distinguishing between activity and damage can be difficult and measures to ascertain this are discussed. SUMMARY: Significant progress has been made in developing international consensus in the assessment of IIM. Further developments are underway to assess the reliability and validity of measures that should capture the multisystem nature of this disease.

Pregnancy outcome in adult-onset idiopathic inflammatory myopathy.

OBJECTIVES: To assess the prevalence of pregnancy in 28 females with dermatomyositis (DM) and polymyositis (PM), assess the outcome in those who became pregnant after the onset of the disease and review the literature of all published cases. METHOD: Fifty-four patients with myositis have been under long-term follow-up from 1976-2001 (28 female, nine male). RESULTS: Twenty-eight female patients were divided into 15 with pure DM/PM (seven PM, eight DM) and 13 with an overlap syndrome. The majority of patients had the onset of the disease after childbearing years (mean age of 32 yr for the overlap group and 41 for the DM/PM group). Only four of our patients (14.3%) have been pregnant after the onset of the disease. One patient had a spontaneous abortion, but was on methotrexate and had active disease; one had a late pregnancy loss, but had active disease; and the other two had uneventful pregnancies during a time when the disease was in remission. CONCLUSION: Fetal prognosis in the main reflects the level of maternal disease. The more active the myositis during the pregnancy, the greater the chance of fetal loss.

Prevalence, patterns of disease and outcome in patients with systemic lupus erythematosus who develop severe haematological problems.

OBJECTIVE: To evaluate the prevalence of major haemolytic disease-severe autoimmune haemolytic anaemia and severe thrombocytopenia-and to assess when these features develop. We also sought to analyse the clinical and serological outcomes of patients with haemolytic anaemia and thrombocytopenia with systemic lupus erythematosus (SLE) as compared with patients without these cytopenias. METHODS: We reviewed retrospectively all the available case notes from our lupus cohort of 305 patients followed up between 1978 and 2000 (mean follow-up 7 yr). We identified 30 patients with SLE (9.8%), of whom 20 (6.6%) had severe haemolytic anaemia and 10 (3.3%) had severe thrombocytopenia. Each patient was matched for age, sex and ethnicity with two control patients. RESULTS: We recorded a total of 42 episodes of severe haematological events: four patients had a second haemolytic episode and eight patients had a second thrombocytopenic episode. Five patients had both thrombocytopenia and haemolytic anaemia. One per cent of patients had severe haemolytic anaemia prior to the diagnosis of SLE and 2.5% of patients presented with these haematological disorders. Haemolytic anaemia and thrombocytopenia were associated with renal involvement (0.01>P>0.001) and anticardiolipin antibodies (ACL) (0.01>P>0.001), but not anti-dsDNA antibodies. Calculation of the BILAG index at the time of severe haematological crisis demonstrated that renal, central nervous system involvement and general symptoms are more frequently present. Forty-one per cent of patients were already on either prednisolone (<10 mg) or an immunosuppressive agent at the onset of the event. CONCLUSION: Our data demonstrate that both haemolytic anaemia and thrombocytopenia are associated with ACL but not anti-dsDNA antibodies. When faced with a patient with a severe haematological manifestation of lupus, active disease in other organs is likely to be present.

Outcome of a cohort of 300 patients with systemic lupus erythematosus attending a dedicated clinic for over two decades.

OBJECTIVE: To examine the mortality rate and causes of death in a cohort of 300 patients with systemic lupus erythematosus (SLE). METHODS: A retrospective analysis was performed on all patients attending the SLE clinic between 1978 and 2000. Information was obtained on those patients lost to follow up. Cause of death was analysed and categorised as early (<5 years after diagnosis of SLE) and late (>5 years after diagnosis of SLE). Standardised mortality rates were obtained. RESULTS: The patients were followed up for a median of 8.3 years. Seventy three (24%) patients were no longer followed up at the end of the study period, of whom 41 (14%) had died. Of the 32 patients lost to follow up, 14 were being actively followed up within the UK, 16 were followed up outside the UK, and two patients were untraceable. The most common cause of death was malignancy, which accounted for eight (20%) deaths, followed by infection and vascular disease, which accounted for seven (17%) deaths each. CONCLUSIONS: Malignancy was the most common cause of death. Cause of death varied depending on disease duration. Forty per cent of early deaths were due to SLE related renal disease, whereas 23% of late deaths were due to vascular causes. Death due to infection occurred throughout the follow up period. There was a fourfold increased risk of death in our cohort of patients with SLE compared with the general population.

Increase in bile flow and biliary excretion of glutathione-derived sulfhydryls in rats by drug-metabolizing enzyme inducers is mediated by multidrug resistance protein 2.

Glutathione (GSH) is an important cellular constituent for normal liver homeostasis. Certain drug-metabolizing enzyme inducers (i.e., phenobarbital [PB] and pregnenolone-16alpha-carbonitrile [PCN]) increase biliary excretion of GSH-derived sulfhydryls (SH) as well as bile flow, whereas other drug-metabolizing enzyme inducers (i.e., 3-methylcholanthrene [3MC] and benzo(a)pyrene [BaP]), do not. The purpose of the study was to determine whether rat multidrug resistance protein 2 (Mrp2) is the inducible transporter responsible for increasing biliary SH excretion and bile flow. Sprague-Dawley (SD) rats were injected ip daily for 4 days with PB, PCN, 3MC, BaP, or vehicle; Mrp2-null Eisai hyperbilirubinemic (EHBR) rats were injected ip daily for 4 days with PCN or vehicle. Although no drug-metabolizing enzyme inducer altered hepatic GSH in SD rats, PB and PCN significantly increased the rate of biliary SH excretion and bile flow. Neither 3MC nor BaP affected the biliary SH excretion rate or bile flow. In control EHBR rats, despite elevated hepatic GSH, the rate of biliary SH excretion was almost completely eliminated and bile flow was dramatically reduced compared with SD rats. Furthermore, PCN treatment did not affect bile flow or the biliary SH excretion rate in EHBR rats. PB and PCN also increased Mrp2 protein levels, but 3MC and BaP did not. None of the drug-metabolizing enzyme inducers tested significantly increased Mrp2 mRNA levels. PCN increased Mrp2 protein, but not Mrp2 mRNA, in a time-dependent manner. In conclusion, Mrp2 is the inducible efflux transporter responsible for increased biliary SH excretion and bile flow after administration of some drug-metabolizing enzyme inducers.

Testicular toxicity of di-(2-ethylhexyl)phthalate in young Sprague-Dawley rats.

Di-(2-ethylhexyl)phthalate (DEHP), used widely in the manufacture of plastics, is a well-known reproductive toxicant. It causes apoptosis and loss of spermatogenic cells, resulting in testicular atrophy. Reports are scarce in the literature on the progression of apoptosis following repeated doses of phthalates. DEHP's mechanism of inducing testicular atrophy has been associated with depletion of zinc in the testis. ZnT-1 is a zinc transporter that is highly expressed in the testis. Thus, DEHP might exert its toxic effects on the testis by altering the expression of ZnT-1. In this regard, 25-day old Sprague-Dawley rats were given vehicle (5 ml corn-oil/kg, po) for 2, 7 and 14 days, or DEHP (2 g/5 ml corn-oil/kg, po) daily, for 1, 2, 3, 5, 7, 10 and 14 days. Zinc content in testes was determined by atomic absorption spectrophotometry, and ZnT-1 mRNA was quantified by the branched DNA signal amplification method. Body weight gain and testicular weight (absolute and relative) were significantly lower in DEHP-treated rats. DEHP produced morphological changes in the testis, including apoptosis, necrosis, and loss of spermatogenic cells, which resulted in testicular atrophy. Apoptotic index (AI: the percentage of apoptotic cells in seminiferous tubules), determined using the TUNEL technique, was markedly increased after 1 day (AI: 2.9%, control AI: 0.1-0.3%) followed by a peak at 3 days (AI: 11.5%) and a gradual decrease till 10-14 days (AI: 7-9%). Zinc content in testis was not changed 1 day after DEHP administration, but decreased significantly at later time points. No difference was found in ZnT-1 mRNA expression between control and DEHP-treated animals until day 14. Our results suggest that apoptosis, along with necrosis, plays an important role in the mechanism of testicular atrophy by DEHP. In addition, ZnT-1 mRNA expression was not altered by DEHP and therefore, it appears that ZnT-1 cannot account for the decrease in testicular Zn content. Pathological lesions and apoptosis occurred prior to the loss of zinc in testis, suggesting that zinc depletion might be a secondary effect of DEHP-induced testicular toxicity, rather than the cause.

Outcome in patients with idiopathic inflammatory myositis: morbidity and mortality.

OBJECTIVE: To assess the long-term outcome of a cohort of 46 patients with idiopathic myositis by assessing both health status, as measured by the SF-36, and cumulative survival probability over a 20-yr follow-up period at a single rheumatology centre. Methods and results. Forty-six patients under long-term follow-up from 1978 to 1999 were identified from our database. All patients fulfilled three out of four of the Bohan and Peter criteria for myositis. We excluded those with malignancy-associated disease and those with inclusion body myositis. Twenty-three patients (50%) had adult-onset polymyositis, 14 (30.4%) had adult-onset dermatomyositis, one had childhood-onset dermatomyositis and eight (17.4%) had an overlap syndrome (associated with either systemic lupus erythematosus or rheumatoid arthritis). During the course of the disease, seven patients (15.2%) went into full remission, eight (17.4%) had monophasic illness, nine (19.6%) had a relapsing-remitting course, 16 (34.8%) had chronic progressive illness and six (13.04%) died. All patients had significantly lower SF-36 scores in all aspects of health compared with the general population (P< or =0.001). Patients with chronic progressive illness had significantly greater bodily pain (P< or =0.05, t-test) than those with a relapsing-remitting illness, but did not differ in other aspects of health. There was no significant difference in the scores in the different domains of the SF-36 between the patients with active disease and those with inactive disease (0.05

Is there an association of malignancy with systemic lupus erythematosus? An analysis of 276 patients under long-term review.

OBJECTIVE: To estimate the risk of malignancy in a UK cohort of patients with systemic lupus erythematosus (SLE) under long-term review. METHOD: The University College London Lupus Clinic Database was used to identify a cohort of 276 patients followed up prospectively between 1978 and 1999. Standardized incidence ratios and 95% confidence intervals for all cancers were calculated using age and sex-specific cancer incidence rates for the southeast of England. RESULTS: In total, 16 malignancies were diagnosed in 15 patients. However, five malignancies were diagnosed before the diagnosis of SLE and were therefore excluded from the final statistical analysis. One case of basal cell carcinoma was also identified, but this was also excluded from the final analysis as no comparable figures were available for the general population. Death as a direct consequence of the malignancy occurred in six (2.3%) patients, accounting for 22.6% of the deaths in our cohort of SLE patients. Compared with the general population, the overall estimated risk for all cancers was not increased in the lupus cohort (standardized incidence rate 1.16 (95% confidence interval 0.55-2. 13). Hodgkin's lymphoma was the only individual cancer that was increased in our cohort of patients [standardized incidence rate 17. 82 (95% confidence interval 0.45-99.23)]. CONCLUSIONS: In our cohort of patients with SLE we did not show an overall increased risk of malignancy. However, SLE was associated with an increased risk of Hodgkin's lymphoma compared with the general population. From our cohort of 276 patients, none of those treated with cyclosporin (3%) developed malignancy, and out of 49 (18%) patients treated with cyclophosphamide only one patient developed malignancy. Out of the 10 patients in the final analysis who developed malignancy, six had treatment with prednisolone, four with azathioprine, five with hydroxychloroquine and only one with cyclophosphamide. No statistical difference in the above cytotoxic therapy was observed between those patients who developed malignancy and those who did not.

Electron spin resonance for quantitative assay of chlorpromazine in drug formulations by oxidation with cerium(IV) in sulfuric acid media.

For the first time electron spin resonance (ESR) spectroscopic technique has been used for a highly selective determination of chlorpromazine. The method is based on the oxidation reaction of chlorpromazine with cerium(IV) in sulfuric acid media. In this method 3.8x10(-3) mol dm(-3) cerium(IV) was used in 0.035 mol dm(-3) sulfuric acid with the ESR spectra recorded at room temperature. A calibration equation of the following form was obtained over the linear concentration range of 10-100 ppm with a correlation coefficient (r) of 0.999: A=1.355+0.0382C. The results obtained by the ESR method were found to be comparable with those obtained by the British Pharmacopoeia (BP) method. The method suffers no interferences excipients rendering the method suitable for determination of this drug in pharmaceutical preparations.

Differential electrolytic potentiometry, a detector in flow injection analysis for oxidation-reduction reactions.

For the first time, differential electropotentiometry (DEP) is coupled with the flow injection analysis (FIA) technique for detection of oxidation-reduction reactions, and is utilized for quantitative determination of vitamin C in pharmaceutical preparations using 1.0x10(-3)-M cerium(IV) in 0.50-M sulfuric acid as carrier. Two similar platinum electrodes were employed and polarized by a constant current. Optimization by the univariate method was carried out and the optimum conditions for current density, flow rate, sample size and concentration of sulfuric acid were 4 mA, 0.93 ml min(-1), 140 mul and 0.25 M, respectively. Vitamin C was determined in the concentration range 100-300 ppm with 0.9987 correlation coefficient and 1.9 standard deviation. The method was applied to the determination of vitamin C in pharmaceutical preparations and no excipient was found to pose any interference thus rendering the method suitable for determination of the drug in pharmaceutical preparations. The accuracy of the method was determined by comparison with the BP standard method.

A review of gastrointestinal manifestations of systemic lupus erythematosus.

In this review, we analyse critically the effects of systemic lupus erythematosus (SLE) on the gastrointestinal (GI) tract from mouth to anus, attempting to distinguish the features that are most likely to be due to therapy. GI manifestations of SLE include mouth ulcers, dysphagia, anorexia, nausea, vomiting, haemorrhage and abdominal pain. GI vasculitis is usually accompanied by evidence of active disease in other organs. Early recognition of the significance of these symptoms offers the best opportunity to improve the symptoms and to aid long-term survival.

Sequential injection technique for automated titration: spectrophotometric assay of vitamin C in pharmaceutical products using cerium(IV) in sulfuric acid.

For the first time sequential injection analysis (SIA) technique has been employed for titrimetry. A new SI titrimetric spectrophotometric method for the assay of vitamin C in drug formulations was explored. The method is based on the oxidation reaction of vitamin C with cerium(IV) in sulfuric acid media using a spectrophotometer as a detector with the wavelength monitored at 410 nm. A 2(3) factorial design chemometric approach was employed to study the interaction effect of the chemical and system variables, mainly cerium(IV), sulfuric acid concentrations and the flow rate. The results of the chemometric optimization revealed that the optimum operating conditions for the SI titrimetric analysis of vitamin C were 7.0 x 10(-3) M cerium(IV), 0.455 M sulfuric acid and 28.9 microL s-1 flow rate. A linear calibration plot for the determination of vitamin C was obtained in the concentration range between 30 to 200 ppm. The method was applied to the determination of vitamin C in pharmaceutical preparations and no excipient was found to pose any interference, thus rendering the method suitable for the determination of the drug in pharmaceutical preparations. The SIA method is found to be accurate when the results were statistically compared with the results obtained by the BP standard method. The SIA method is superior when compared to the conventional titration method, the BP standard method and previous methods with respect to precision and automation in solution handling.

Chemiluminescence method for the assay of perphenazine in drug formulation using permanganate in sulphuric acid with flow injection technique and a chemometrical optimization approach.

An accurate selective flow injection chemiluminescence (CL) method for the assay of perphenazine was explored. In the method 394 ppm permanganate solution was used as a chemiluminogenic reagent in 0.289 mol dm(-3) sulphuric acid media. A photomultiplier tube was used as a detector at a total flow rate of 4.94 ml/min. Perphenazine was determined by a linear calibration plot of the following equation in the range 50-350 ppm: mV=-4.488+0.1162C, with a correlation coefficient of 0.9989 for five measurements and a relative standard deviation less than 2.33. A sampling frequency not less than 110 samples h(-1) was established. Three factors namely, the flow rate, sulphuric acid and permanganate concentrations were found to have an influence on the amount of chemiluminescence intensity produced. Therefore, their interaction effects were thoroughly investigated by employing the 2(3) factorial design chemometrical approach and the results obtained revealed a higher interaction between sulphuric acid and permanganate and a less significant interaction for both reagents with the flow rate. The interaction of variables observed necessitated the conduct of the super modified simplex optimization procedure which has resulted in offering the proper optimum conditions as stated above and led to the quantitative assay of perphenazine. An interference study indicated that the method was suitable for application in pharmaceutical preparations.

Sequential injection spectrophotometric assay of bromazepam complexed with iron(II) in hydrochloric acid with chemometric optimization.

A sequential injection spectrophotometric method for the assay of bromazepam anxiolytic drug has been reported. The method is based on the complexation reaction of bromazepam with iron(II) in hydrochloric acid media and spectrophotometrically measuring the product at lambda(max)=585 nm. A comprehensive chemometrical optimization treatment was successfully utilized for determining the proper optimum operating conditions for both the system and the chemical variables. The experimental design approach was employed and a 2(k) factorial design was run for studying the interaction effects of four factors namely, hydrochloric acid concentration, iron(II) concentration, delay time and flow rate. The super modified simplex algorithm was utilized for optimizing the three highly interacting factors which were, hydrochloric acid, iron(II), and delay time. The conditions obtained were 150 microl 0.110 mol l(-3) hydrochloric acid, 75 microl 0.328 mol l(-3) iron(II), 1200 s delay time and 40 microl s(-1) flow rate. The method was found to be suitable for the determination of Bromazepam in pharmaceutical preparations and the results obtained for the assay of the compound in proprietary drugs indicate that the method suffers no interference from excipients.

Cesarean delivery of the second twin after vaginal delivery of the first twin.

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