Multiple white matter infarctions, arranged parallel to the lateral ventricle, are associated with severe hemodynamic impairment. This pattern of infarction is likely due to a hemodynamic mechanism.

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The haematological profile in 20 culture proven patients with typhoid fever of varying age and of both sexes was studied. Significant changes observed were anaemia, leucopenia, eosinopenia, thrombocytopenia and sub-clinical disseminated intravascular coagulation. The bone marrow of typhoid patients showed myeloid maturation arrest, decrease in the number of erythroblasts and megakaryocytes with increased phagocytic activity of histiocytes.

BackgroundPatients with chronic obstructive pulmonary disease (COPD) have increased cardiovascular risk. Natriuretic peptides (NP) in other populations are useful in identifying cardiovascular disease, stratifying risk, and guiding therapy.MethodsWe performed a systematic literature review to examine NP in COPD, utilising Medline, EMBASE, and the Cochrane Library.ResultsFifty one studies were identified. NP levels were lower in stable compared to exacerbation of COPD, and significantly increased with concomitant left ventricular systolic dysfunction or cor pulmonale. Elevation occurred in 16 to 60% of exacerbations and persisted in approximately one half of patients at discharge. Cardiovascular comorbidities were associated with increased levels. Levels consistently correlated with pulmonary artery pressure and left ventricular ejection fraction, but not pulmonary function or oxygen saturation. NP demonstrated high negative predictive values (0.80 to 0.98) to exclude left ventricular dysfunction in both stable and exacerbation of COPD, but relatively low positive predictive values. NP elevation predicted early adverse outcomes, but the association with long term mortality was inconsistent.ConclusionNP reflect diverse aspects of the cardiopulmonary continuum which limits utility when applied in isolation. Strategies integrating NP with additional variables, biomarkers and imaging require further investigation.

Atomic force microscopy analysis of polyhydroxyalkanoate (PHA) inclusions isolated from sonicated Ralstonia eutropha cells revealed that they exhibit two types of surface structure and shape; rough and ovoid, or smooth and spherical. Smooth inclusions possessed linear surface structures that were in parallel arrays with 7-nm spacing. Occasionally, cracks or fissures could be seen on the surface of the rough inclusions, which allowed a measurement of approximately 4 nm for the thickness of the boundary layer. When the rough inclusions were imaged at higher resolution, globular structures, 35 nm in diameter, having a central pore could be seen. These globular structures were connected by a network of 4-nm-wide linear structures. When the inclusions were treated with sodium lauryl sulfate, the boundary layer of the inclusion deteriorated in a manner that would be consistent with a lipid envelope. When the boundary layer was largely gone, 35-nm globular disks could be imaged laying on the surface of the filter beside the inclusions. These data have facilitated the development of a preliminary model for PHA inclusion structure that is more advanced than previous models.

Osteochondromas represent a hyperplastic-dysplastic disturbance of bone from progressive endochondral ossification. The tumors slowly enlarge, creating insidious but progressive symptoms. Magnetic resonance imaging, computed tomography, and postmyelogram computed tomography are useful in evaluating the size and extent of spinal osteochondromas as a cause of spinal cord compression.

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Introduction and Objective: The rising burden of type 2 diabetes mellitus (T2DM) globally has led to huge morbidity and socioeconomic impact in developing countries. In India, too, it has become a silent epidemic and it is estimated that there are over 60 million diabetics. Although in recent years, a lot of research papers have come up on the management of diabetes, latest treatment modalities may not be affordable to all. So, it becomes imperative to prioritize research on prevention and primary care. Magnesium is an intracellular cation and coenzyme for various reactions of the glycolytic pathway. Hypomagnesemia has been shown to precipitate hyperglycemia and has, therefore, been implicated in insulin resistance and its microvascular complications. Poor glycemic control has been associated with retinopathy. Hence, we evaluated association of serum magnesium with T2DM and diabetic retinopathy. Materials and Methods: In a cross-sectional study in North India, 250 consenting adult patients from outpatient department of family medicine of our hospital were recruited. Critically ill patients and those on magnesium supplements were excluded. Clinicolaboratory profile was evaluated. Patients were divided based on serum magnesium level ≤ 1.7 mg/dL (group 1) and > 1.7 mg/dL (group 2). Glycemic control and proportion of diabetic retinopathy were compared between these two groups by using univariate regression analysis. Results: Out of 250 patients, 110 patients (44%) were found to have hypomagnesemia. Glycemia by fasting blood sugar ( P = 0.02), post-Prandial blood sugar ( P = 0.04), and HbA 1C ( P = 0.01) was poorly controlled in hypomagnesemia group. In group 1, 62.7% had non proliferative diabetic retinopathy and 21.8% had proliferative diabetic retinopathy, whereas in group 2, 14.3% had nonproliferative diabetic retinopathy and 8.6% had proliferative diabetic retinopathy ( P < 0.001). Conclusions: Magnesium deficiency is associated with increased risk of diabetic retinopathy and poor glycemic control. Dietary supplementation may be advised to prevent such complications and improve glycemic control.