Juvenile lupus, cytomegalovirus infection and cardiac tamponade: case report

ABSTRACT Objective: To describe a rare case of cardiac tamponade in a pediatric patient with systemic lupus erythematosus (SLE) and cytomegalovirus (CMV) infection, and to discuss the relationship between these morbidities, the diagnostic approach, and the possible treatments. Case description: A 9-year-old girl presented to the emergency department with severe dyspnea, muffled heart sounds, jugular vein distention, hemodynamic instability, and intense pallor. She had previously been followed up at the outpatient clinic for a six-month history of mild respiratory distress, polyarthritis, fever, and various cutaneous manifestations. Doppler echocardiogram revealed pericardial effusion. The patient was submitted to pericardiocentesis followed by water seal pleuropericardial drainage, with no complications. The investigation continued, with fulfillment of clinical and laboratory SLE criteria plus CMV antigenemia of 15/200,000 cells. Medications to control CMV infection and SLE were then initiated, with good clinical and laboratory response. Comments: Pediatric SLE commonly manifests in a more severe form, accounting for high morbimortality. Cardiac tamponade could be one of the first manifestations of SLE, which can also be precipitated by infectious agents, such as CMV, leading to diagnostic confusion and misleading the treatment. Changes in therapeutics must also be considered in the presence of both conditions. This study presents a juvenile SLE case aggravated by a CMV infection with the unusual manifestation of cardiac tamponade.%

Suction Versus Nonsuction Drainage After Uniportal Video-Assisted Thoracoscopic Surgery: A Propensity Score-Matched Study

BackgroundUniportal video-assisted thoracoscopic surgery (UniVATS) was utilized with a rapid growth. The evidence is sparse, however, on whether to add external suction to water-seal drainage for chest drainage after UniVATS. This retrospective propensity score-matched study aimed to identify the necessity of adding external suction to chest drainage after UniVATS.MethodsPatients with lung cancer who underwent UniVATS were included from our prospectively maintained database. Patients were divided into two cohorts based on the addition of external suction to postoperative water-seal drainage or not. Propensity score-matched analysis was performed to identify the impact of suction on chest tube duration, incidence of persistent air leak, hospital stay, and hospitalization cost. Multivariable model with interaction terms was constructed to identify impact of covariables on effect of suction.ResultsThe two cohorts matched well on baseline characteristics (nonsuction: 173; suction: 96). Compared with nonsuction group, suction group showed longer median chest tube duration (3 vs. 2 days, p = 0.003), higher incidences of persistent air leak (9.4% vs. 1.2%, p = 0.003), persistent drainage (16.8% vs. 5.8%, p = 0.007), and reduced drainage volume within first 3 postoperative days (386.90 vs. 504.78 ml, p = 0.011). Resection extent was identified to mediate the relationship between suction and chest tube drainage.ConclusionsThese findings discouraged adding external suction to water-seal drainage after UniVATS regarding longer chest tube duration and more persistent air leak. Patients undergoing lobectomy would benefit more from water-seal drainage without external suction compared with those doing sublobectomy.

Research on frog-inspired swimming robot driven by pneumatic muscles

This article designs a frog-inspired swimming robot based on pneumatic muscles. The musculoskeletal characteristics of the frog are refined and used as the basis for the design of the robot joint structure and movement mode. The posture adjustment module, joint water seal, and power system are designed to meet the robot’s motion requirements, and the structure optimization design of the robot is completed by combining simulation analysis. The body length of the robot is about 710 mm, and the overall mass is 10 kg. Combining the structural characteristics of the robot, the control system is built to realize the frog-like motion. The robot’s propulsion speed is about 0.6 m/s, the propulsion distance reaches 2.4 m, the turning angle is 30°, and the turning radius is 0.6 m. The prototype experiment verifies the rationality of the frog-inspired swimming robot structure design and the reliability of the control system and water seal.

Cholera outbreak in Forcibly Displaced Myanmar National (FDMN) from a small population segment in Cox’s Bazar, Bangladesh, 2019

Background Bangladesh experienced a sudden, large influx of forcibly displaced persons from Myanmar in August 2017. A cholera outbreak occurred in the displaced population during September-December 2019. This study aims to describe the epidemiologic characteristics of cholera patients who were hospitalized in diarrhea treatment centers (DTCs) and sought care from settlements of Forcibly Displaced Myanmar Nationals (FDMN) as well as host country nationals during the cholera outbreak. Methods Diarrhea Treatment Center (DTC) based surveillance was carried out among the FDMN and host population in Teknaf and Leda DTCs hospitalized for cholera during September-December 2019. Results During the study period, 147 individuals with cholera were hospitalized. The majority, 72% of patients reported to Leda DTC. Nearly 65% sought care from FDMN settlements. About 47% of the cholera individuals were children less than 5 years old and 42% were aged 15 years and more. Half of the cholera patients were females. FDMN often reported from Camp # 26 (45%), followed by Camp # 24 (36%), and Camp # 27 (12%). Eighty-two percent of the cholera patients reported watery diarrhea. Some or severe dehydration was observed in 65% of cholera individuals. Eighty-one percent of people with cholera received pre-packaged ORS at home. About 88% of FDMN cholera patients reported consumption of public tap water. Pit latrine without water seal was often used by FDMN cholera individuals (78%). Conclusion Vigilance for cholera patients by routine surveillance, preparedness, and response readiness for surges and oral cholera vaccination campaigns can alleviate the threats of cholera.

KNOWLEDGE OF STAFF NURSES REGARDING CARE OF PATIENT WITH CHEST TUBE DRAINAGE IN SELECTED HOSPITALS, KAMRUP (M), ASSAM.

Background of the study: Chest tube drainage which is also known as Under water seal drainage (UWSD), tube thoracotomy, or intercostal drainage, has a paramount importance in some emergencies or critical care situation. Inefcient nursing care or malfunction in chest tube drainage may associated with life threatening complications, or can be deadly for a patient in a matter of second. The aim of the study was to assess knowledge of staff Aim: nurses regarding care of patient with chest tube drainage. Method: Descriptive research design was adopted and 178 staff nurses working in ICU were selected by using non probability convenience sampling technique in selected hospitals, Kamrup (M), Assam and who fullls the inclusion criteria. It was found that majority 97(55%) of the Results: respondents had moderately adequate knowledge, 68(38%) respondents had inadequate knowledge, and 13(7%) had adequate knowledge. The mean and standard deviation of knowledge level is 15 and 4 respectively. The association was statistically tested by using Chi square at p≤0.001 level of signicance. The study shows that, out of 178 respondents, 68 (38%) had inadequate Conclusion: knowledge, 97 (55%) had moderately adequate knowledge and 13 (7%) had adequate knowledge regarding care of patient with chest tube drainage. So the investigator concluded that the in-service education in regular basis is very important for continuous learning.

"PALLADIUM ON COAL" CATALYST OBTAINED BY PYROLYSIS OF POWDER CELLULOSE GRANULES IM-PREGNATED WITH PALLADIUM NITRATE

By pyrolysis of powdered cellulose granules impregnated with palladium nitrate, catalysts of 1–8% Pd / C were obtained. Pyrolysis was carried out in a reactor with a water seal at 600 ° C. Metal reduction was carried out with pyrolysis gases and matrix carbon. It was found that the ash content of powdered cellulose granules is ~ 40 times less than the ash content of sulfate cellulose, from which they were made. It was shown by X-ray phase analysis and electron microscopy that palladium in the catalysts is present in the form of Pd (0) nanoparticles uniformly covering carbon fibers and shapeless massive metal precipitates up to 20 μm in diameter. In catalysts 1–3% Pd / С, nanoparticles 10–40 nm dominate (> 95%), in 8% Pd / С, 20–70 nm. The share of massive metal formations in Pd (1%) / C, Pd (3%) / C and Pd (8%) / C is: ~ 2%, ~ 5% and ~ 60%, respectively. They consist of aggregated spherical particles 0.05–0.15 µm in diameter. XRD palladium oxide was not detected in the catalysts. The presence of palladium nitrate in powdered cellulose during its carbonization has a significant effect on the formation of the carbon matrix. With an increase in the content of palladium nitrate in powdered cellulose, the yield of carbon material decreases and its total porosity increases. Infrared spectroscopy revealed the presence of oxygen-containing ether groups in the carbon matrix of palladium catalysts. The activity of catalysts in the model process of decomposition of hydrogen peroxide increases with increasing dispersion of palladium nanoparticles.

Heimlich Valve as an Ambulation Management of Persistent Pneumothorax or Fluidopneumothorax

Pneumothorax or fluidopneumothorax is a critical condition when there is some air or/and fluid in the plural cavity. The symptoms may include shortness of breath, chest pain, blue discoloration of the skin or lips, increased heart rate, and loss of consciousness. Pleural cavity drainage is management therapy with the concept of Water Seal Drainage (WSD), which requires a long hospital stay. Heimlich valve is a non-return valve that allows fluid and air to exit the thoracic cavity (on inspiration) and prevents fluid and air from re-entering (during expiration). Heimlich valve is a viable, inexpensive, convenient, safe, effective, and efficient alternative in the management of ambulation of patients requiring prolonged pleural cavity drainage. The use of Heimlich valve is an alternative option for patients with persistent pneumothorax or fluidopneumothorax. It can shorten the time of treatment in the hospital, lowering treatment costs, and minimize the presence of nosocomial infections. Relative contraindications include fluidopneumothorax with massive pleural effusion or empyema. The risks and complications are dislodgement or improper reattachment, leaking valve, adhesion, and blockage, thus becoming tension pneumothorax or pleural cavity infection. Currently the latest innovation also improves the patient’s convenience, like Thoracic Vent, Pneumostat, or Mini Mobile Dry Seal Drain.