Osteomyelitis Masquerading as Cellulitis: A Case Report.

Osteomyelitis, a significant global healthcare issue, often results from infections related to open fractures, surgery, or conditions like diabetic foot ulcers. This report describes a case of osteomyelitis in a 62-year-old female with various pre-existing health conditions. The patient initially presented with swelling, pain, and difficulty walking in the right lower extremity, accompanied by systemic symptoms. Despite an initial diagnosis of cellulitis and treatment with ceftriaxone, a subsequent CT scan revealed a pretibial abscess and confirmed osteomyelitis caused by pan-sensitive Escherichia coli. Surgical debridement was performed, and the patient received six weeks of intravenous antibiotics. Hence, a heightened level of suspicion is essential to facilitate a timely diagnosis of osteomyelitis and enhance long-term prognosis. The case underscores the importance of a multidisciplinary approach, including meticulous surgical intervention and tailored antimicrobial therapy, in achieving positive outcomes for osteomyelitis patients.

D-Shaped Left Ventricle, Anatomic, and Physiologic Implications.

Right ventricular loading/pressure influences left ventricular function because the two ventricles pump in series and because they are anatomically arranged in parallel, sharing the common ventricular septum. Flattening of the interventricular septum detected during echocardiographic examination is called D-shaped left ventricle. We present a case of an elderly male of African descent, who presented with increased shortness of breath. Transthoracic echocardiogram showed flattening and left sided deviation of interventricular septum causing a decreased size in left ventricle, secondary to volume/pressure overload in the right ventricle. While patient received hemodialysis therapy and intravascular volume was removed, patient blood pressure was noted to increase, paradox. Repeated transthoracic echocardiogram demonstrated less left deviation of interventricular septum compared with previous echocardiogram. We consider that it is important for all physicians to be aware of the anatomic and physiologic implication of D-shaped left ventricle and how right ventricle pressure/volume overload affects its function and anatomy.

Complications associated with Plasmodium vivax malaria: a retrospective study from a tertiary care hospital based in Western Uttar Pradesh, India.

BACKGROUND: Plasmodium vivax (p. vivax) malaria was traditionally considered as benign tertian malaria, however, recent studies have pointed out that p. vivax have potential to cause all severe complications previously attributed to p. falciparum infection only. The aim of this report is to study the incidence of various clinical and biochemical complications associated with severe p. vivax malaria. METHODS: A retrospective analysis was performed on all patients with p. vivax malaria admitted to our center between January 2009 and December 2011. Severe malaria was defined as per World Health Organization (WHO) criteria. Clinical and laboratory parameters were recorded. Patients with evidence of p. falciparum, mixed malarial infection and chronic systemic diseases were excluded from the study. RESULTS: Sixty-two patients met the criteria for severe malaria during the study period. The complications observed were Hepatic dysfunction in 18 (29%), renal dysfunction in 13 (21%), cerebral malaria in 10 (16.1%), acute respiratory distress syndrome (ARDS) in 6 (9.7%), shock in 10 (16.1%), severe anemia in 16 (25.8%), thrombocytopenia in 35 (56.5%), and hypoglycemia in 3 (4.8%) patients. Three mortalities were observed. CONCLUSIONS: P. vivax has immense potential to cause life threatening complications and even death, more research is required to understand the exact pathogenesis of various complications encountered in vivax malaria.

Application of ozone based treatments of secondary effluents.

The present work was aimed at studying the efficiency of ozone in oxidation processes, coliform inactivation and Disinfection Byproducts (DBPs) formation, associated with the potential of ozone to increase the Biodegradable Dissolved Organic Carbon (BDOC) in secondary effluent with applied ozone doses of 5.0, 10.0 and 15.0 mg/L for contact times of 2, 5 and 10 min. The wastewater used in this work was collected from the Bhagwanpur Sewage Treatment Plant, Varanasi, India. Results of this experiment showed that 10 mg O(3)/L O(3) for 5 min exposure was found most suitable dose for highest degradation of COD, TOC, UV(254), color, turbidity and total nitrogen parameters. The inactivation range of microbial biomass range was found in between 95% and 98%. Experiment revealed the fact that aldehydes and carboxylic acid formation were significantly related with the ozone dose and exposure time and ozone might enhance the treatment efficiency of secondary effluent treatment.

Poly(acrylonitrile) grafted Ipomoea seed-gums: a renewable reservoir to industrial gums.

Plants of Ipomoea genus are widely distributed in India as wild vegetation and are reported source for the seed gums. Seed gums from Ipomoea dasysperma, Ipomoea hederacea, and Ipomoea palmata plants were grafted with polyacrylonitrile (PAN) using potassium persulfate/ascorbic acid redox initiator for modifying their properties for potential industrial applications. Under identical grafting conditions, the extent of the grafting was observed to be dependent on the galactose-to-mannose ratio and the degree of the branching in the galactomannans. Viscosity, gel formation, film formation, and the shelf life of the grafted gum solutions and water and saline retention capacity of the grafted seed gums were determined and compared with the parent gums. Water retention of the alkalie hydrolyzed grafted seed gums were also studied. Grafted gums were characterized using FTIR, NMR, and XRD analysis.