No abstract

Methylene blue is utilized as the main treatment of methemoglobinemia. Here we report two cases, in which patient suffered from aniline-induced methemoglobinemia with initial good response but later developed haemolytic anemia due to methylene blue therapy. He was treated with hydration, high flow oxygen and steroid therapy. Caution should be exercised while using methylene blue as antidote of acute methemoglobinemia as both methemoglobinemia and its antidote methylene blue can itself precipitate fatal haemolytic anemia.

There are only a few numbers of published reports available on oxidative stress parameters in hypothyroidism and many of which are in the field of human medicine. Studies on hypothyroidism in dogs lack an assessment of oxidative stress and some are vague and inconclusive. So, the current study was formulated primarily to address variations in chief antioxidant parameters in dogs with hypothyroidism, non-thyroid illness and euthyroidism. Secondly, magnitude of oxidative stress was measured in hypothyroid dogs prior to and during the course of levothyroxine therapy, which were compared statistically. Evaluation of thyroid profile (TT4, fT4 and cTSH) was carried out prior to the assessment of oxidative stress biomarkers such as, serum malondialdehyde (MDA), superoxide dismutase (SOD), reduced glutathione (GSH) and catalase. A total of 45 dogs were employed in the study, that includes 19 dogs with hypothyroidism, 11 dogs with non-thyroid illness and 15 dogs with euthyroidism. These dogs were brought either to the dermatological unit or the immunization unit. Dogs were divided into three groups: group 1 represented hypothyroidism (low fT4 or low TT4 and high cTSH); group 2 represented non-thyroid disease (low or normal TT4 and low cTSH i.e., inconclusive levels of thyroid hormones); and group 3 represented dogs with normal thyroid levels (euthyroid dogs). Descriptive statistics and normality plots were carried out using SPSS software version 21. Assuming that the variances were unequal, P values were calculated and compared by one-way ANOVA, post hoc multiple comparison analysis using the Games-Howell test. The mean thyroid hormone levels of hypothyroid dogs before (Day 0) and after (Day 60) treatment was significantly different (P<0.05). Hypothyroid dogs (group 1) displayed significantly lower mean fT4 levels (0.56±0.07) and higher mean cTSH levels (8.14±1.17) when compared to other groups. The mean values of serum biochemical parameters showed significant differences among groups (P<0.01). Various biomarkers showed a significant alteration viz., there was a significant reduction in catalase, SOD, GSH and increase in MDA in hypothyroid dogs when compared with euthyroid dogs. However, following therapy for 60 days, catalase, SOD and GSH levels elevated and MDA level reduced significantly and reached nearly to that of euthyroid dogs. Further, there was no significant difference between NTI and euthyroid dogs which demonstrated the antioxidant defence against oxidative stress in hypothyroid dogs. As an outcome, antioxidant measures and serum biochemical tests can be employed as a diagnostic tool to rule out oxidative stress in hypothyroid dogs.

Additive Manufacturing (AM) is one of the best techniques to fabricate customized medical models. This technique best suited for the medical industry. The surgical template design and dimensions vary from patient to patient, depending on the anatomy of the patient. AM provides flexibility to design a patient specific surgical template using the patient CT scan data. Medical processing software converts DICOM to 3D CAD data. This 3D CAD data is used to design the patient specific surgical template. This surgical template data is then converted into an STL file format to fabricate medical models using AM machines. The initial surgical template is fabricated using FDM machines, which are easily available and this template is used for pre surgical planning. After satisfactory results are obtained in the pre surgical planning, the same STL file is fabricated using a castable resin. The castable resin model is used for preparation of the mould for casting process. This mould is then used to produce the final surgical template with medical grade SS316. The cost of the final metal surgical template is reduced by 30 percent compared to production of same model fabricated using metal AM system. The major advantage of this process is that we obtain a patient specific template in traditional approved way, but at reduced cost.