In this study the records of 45 patients with sickle cell disease involved in 63 presentations of acute chest syndrome at the Princess Margaret Hospital in Nassau, the Bahamas, between 1997 and 2001 were examined. Patients were divided into three groups on the basis of age (<13 years, 13–18 years, ⩾19 years) with a view to assessing clinical presentation. The incidence of symptoms, physical signs, and laboratory findings were enumerated and significant differences between age groups determined. The data were analysed using analysis of variance, t test, and χ2 test and compared with existing knowledge on the subject. This study proposed to evaluate the clinical presentation of acute chest syndrome with emphasis on historical and physical findings, and to encourage the physician to maintain a high index of suspicion for the condition in susceptible patients. It was found that presentation varied significantly with age groups, children presenting most classically with fever and cough and adults, with chest pain. The 13–18 age group emerged as the group which presented most frequently with the typical symptoms of chest infection, thus potentially making diagnosis easier. Of note, the most frequent finding was a normal examination, while the second commonest physical finding was crepitations on auscultation of the chest.

This work reports density functional theory and time-dependent density functional theory calculations of the optimized geometries, electronic structures and optical properties of molecular dyes D1, D2, D3, D4, D5, and D6 formulated through substitution of 2-hexylthiophene to alizarin using the hybrid functional B3LYP and 6-31G (d,p) basis sets. The dyes are considered as potential pigments for dye-sensitized solar cells. For all dyes, HOMO/LUMO (Highest Occupied Molecular Orbital/Lowest Unoccupied Molecular Orbital) analysis results in positive outcomes upon electron injection to semiconductors and subsequent dye regeneration by the electrolyte. It is found that charge transfer is from the thiophene and unsubstituted ring of alizarin to the substituted ring of alizarin containing C=O and OH groups. The C=O groups are observed to be very important in strengthening the dyes as they are revealed to be the anchoring group bonding to the TiO2 semiconductor. Comparatively, dye D6 is observed to possess high absorption ability and electron injection power through a study of the light-harvesting efficiency and injection driving force (Δ Ginject). The estimated values of open-circuit voltage ( Voc) for the computed dyes are also presented. Decisively, all the considered dyes prove to be useful as potential photosensitizers in solar cells using a TiO2 semiconductor and [Formula: see text] coupling electrolyte.

Background India implements universal drug susceptibility testing (UDST) using rapid genotypic tests (cartridge-based nucleic acid amplification test CBNAAT - and line probe assay - LPA). to bridge the gap of diagnosis of multidrug/rifampicin-resistant TB. There is limited evidence assessing the implementation of UDST in India. We assessed the implementation among people with pulmonary TB notified from public facilities in October 2019 from Raichur (Karnataka), India. Methods A cohort study involving secondary data in routine programme settings was conducted. All people with TB underwent a rapid genotypic DST for rifampicin resistance followed by first line-LPA (FL-LPA) if sensitive and second line-LPA (SL-LPA) if resistant. Results Of 217 people, 15.7% (n=34) did not undergo rapid genotypic DST. Of 135 who were rifampicin-sensitive detected on CBNAAT, 68.1% (n=92) underwent FL-LPA, and out of the six rifampicin-resistant cases, 66.7% (n=4) underwent SL-LPA. Overall, 65.4% (142/217) completed the UDST algorithm. Children (aged <15 y) and people with bacteriological non-confirmation on microscopy were less likely to undergo rapid genotypic DST. Of 183 patients who underwent both rapid genotypic DST and sputum smear microscopy, 150 were bacteriologically confirmed and, of them, 9 (6%) were ‘rapid DST-negative’. Conclusion We found gaps at various steps. There were a significant number of ‘rapid DST-negative, smear-positive’ patients.

Chronic kidney disease (CKD) is a worldwide public health problem and is associated with high morbidity and mortality. The majority of patients with CKD stage 5 (CKD-5), who cannot undergo renal transplant, depend on maintenance hemodialysis by surgically created access sites. Native fistulae are preferred over grafts due to their longevity. More than half of these vital portals for dialysis access will fail over time. Screening procedures to select high-risk patients before thrombosis or stenosis appears have resulted in aggressive management. These patients are referred for angiographic evaluation and/or therapy. We present the patterns of dialysis-related interventions done in our institution.

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