Blood Stains Research Articles

Biochemical characterization of immobilized recombinant subtilisin and synthesis and functional characterization of recombinant subtilisin capped silver and zinc oxide nanoparticles

This pioneering research explores the transformative potential of recombinant subtilisin, emphasizing its strategic immobilization and nanoparticle synthesis to elevate both stability and therapeutic efficacy. Achieving an impressive 95.25 % immobilization yield with 3 % alginate composed of sodium along with 0.2 M CaCl2 indicates heightened pH levels and thermal resistance, with optimal action around pH 10 as well as 80 °C temperature. Notably, the Ca-alginate-immobilized subtilisin exhibits exceptional storage longevity and recyclability, affirming its practical viability. Comprehensive analyses of the recombinant subtilisin under diverse conditions underscore its adaptability, reflected in kinetic enhancements with increased Vmax (10.7 ± 15 × 103 U/mg) and decreased Km (0.19 ± 0.3 mM) values post-immobilization using N-Suc-F-A-A-F-pNA. UV–visible spectroscopy confirms the successful capping of nanoparticles made of Ag and ZnO by recombinant subtilisin, imparting profound antibacterial efficacy against diverse organisms and compelling antioxidant properties. Cytotoxicity was detected against the MCF-7 breast cancer line of cells, exhibiting IC50 concentrations at 8.87 as well as 14.52 µg/mL of AgNP as well as ZnONP, correspondingly, indicating promising anticancer potential. Rigorous characterization, including FTIR, SEM-EDS, TGA and AFM robustly validate the properties of the capped nanoparticles. Beyond therapeutic implications, the investigation explores industrial applications, revealing the versatility of recombinant subtilisin in dehairing, blood clot dissolution, biosurfactant activity, and blood stain removal. In summary, this research unfolds the exceptional promise of recombinant subtilisin and its nanoparticles, presenting compelling opportunities for diverse therapeutic applications in medicine. These findings contribute substantively to biotechnology and healthcare and stimulate avenues for further innovation and exploration.

Exploration of a novel protease from Phytolacca dodecandra (Endod) berries for potential application in detergent formulation

AbstractConventional detergent formulations contain either petroleum‐derived or synthetic chemicals. Hence, the replacement of these chemicals with natural products such as enzymes is considered a green technology. Among these enzymes, protease is renowned in detergent formulations. Therefore, the objective of this study was to explore and characterize a new protease from Phytolacca dodecandra, because the plant is traditionally known for detergency purposes. Enzyme extraction was performed with Glycine/NaOH buffer, pH = 10.0. Gelatin hydrolysis and agar well diffusion tests were implemented as qualitative assays, whereas the enzyme assay technique was applied for the quantitative investigation of the new protease from plant extracts. The crude enzyme was partially characterized concerning temperature and pH tolerance, washing performance, detergent compatibility, and stability. The finding of this study revealed that Phytolacca dodecandra contains protease and is characterized by 1418.84 U/mL of enzyme activity, where 1 unit (U) of enzyme activity refers to the amount of enzyme required to liberate 1 μg of tyrosine/mL/min under the defined assay conditions. The enzyme showed maximum activity at pH 10.5 and 45°C. The enzyme was stable and maintained 99.52% activity at 40°C and 91.73% at pH 10.0 after 2 h pre‐incubation. The enzyme showed excellent wash performance and could potentially remove blood stains completely within 3 min. After 2 h of pre‐incubation the enzyme maintained 69.06% and 54.88% of its activity in the presence of Azzy and Sunlight, respectively. The enzyme maintained 71.99% of its residual activity after 60 days of storage. If further studies are conducted, all these properties of the newly investigated protease can make the enzyme applicable in detergent formulations.

Malaria Slide Bank to Strengthen and Improve the Quality of Malaria Diagnosis: A National Slide Repository in India.

Malaria elimination is one of the top health care priorities in India, necessitating accessible and accurate diagnosis for effective treatment. A malaria slide bank in India is a collection of quality-controlled malaria-positive and -negative slides and is considered a vital asset for quality diagnosis. The collection of blood samples, preparation of blood smears, staining, quality control, molecular characterizations, and slide validation were carried out according to standard operating procedures in accordance with the WHO reference laboratory. The true count and parasite density per microliter were computed in accordance with WHO guidelines. Over 27 months, 48 batches (8,196 slides) were prepared. Overall, the majority of slide batches were Plasmodium vivax (45.9%; 22/48), followed by Plasmodium falciparum (25%; 12/48), malaria-negative infections (25%; 12/48), and mixed infections (4.1%; 2/48). All 48 batches passed internal validation by WHO-certified level-1 microscopists. For a batch, the true count was the median of the validators' counts (range, 111-280,795 parasites/µL). Except for mixed infections, the PCR results agreed with the verified microscopy results. Malaria slide bank slides would be a valuable tool for quality control, assurance, and microscopist training.

Three-dimensional internal flow evolution of an evaporating droplet and its role in particle deposition pattern

The internal flow within an evaporating sessile droplet is one of the driving mechanisms that lead to various particle deposition patterns seen in applications such as inkjet printing, surface patterning, and blood stain analysis. Despite decades of research, the causal link between droplet internal flow and particle deposition patterns has not been fully established. In this study, we employ a three-dimensional (3D) imaging technique based on digital inline holography to quantitatively assess the evolution of internal flow fields and particle migration in three distinct types of wetting droplets, namely water droplets, sucrose aqueous solution droplets, and sodium dodecylsulfate aqueous solution droplets, throughout their entire evaporation process. Our imaging reveals the three-stage evolution of the 3D internal flow regimes driven by changes in the relative importance of capillary flow, Marangoni flow, and droplet boundary movement during evaporation. Moreover, the migration of individual particles from their initial locations to deposition can be divided into five categories, with some particles depositing at the contact line and others inside the droplet. In particular, we observe the changing migration directions of particles due to competing Marangoni and capillary flows. We further develop an analytical model that predicts the droplet internal flow, deposition patterns, and determines the deposition mechanisms depending on their initial locations and evolving internal flow. The model, validated using different types of droplets from our experiment and the literature, can be further expanded to other Newtonian and non-Newtonian droplets, potentially serving as a real-time assessment tool for particle deposition in various applications.

Uniportal Dual Mode Dry-Saline Endoscopy for Lumbar Disc Herniation

Objective: Posterior dry medium endoscopic lumbar discectomy techniques have been successfully used to treat lumbar disc prolapse. A drawback of these techniques is repeated blood staining of the scope tip while working close to the surgical target. To address this drawback, we modified the design of the previous Arthrospine system and made it compatible for use in air and saline medium to treat lumbar, cervical, and thoracic disc prolapse. Herein, we describe the operative technique and results of lumbar discectomy in a dual (air/saline) medium using this system.Methods: Eighty patients underwent endoscopic discectomy using the Arthrospine Duo system for lumbar disc prolapse. The procedure was conducted through a muscle dilatation approach using 5-mm and 10-mm dilators. The Arthrospine Duo tube was passed over a 10-mm dilator, the working insert was adjusted over the tube in a press-fit manner, and endoscopic discectomy was performed using a 30° arthroscope and conventional microdiscectomy instruments in an air or saline medium.Results: As per the modified MacNab criteria, 80% (n=64) of patients had excellent, 12.5% (n=10) good, 6.25% (n=5) fair, and 1.25 patients (n=1) had poor results. The leg pain visual analogue scale improved from 7.87±0.68 to 1.3±0.67 at 2 years of follow-up. As complications, dural tears and transient paraesthesia occurred in 4 patients (5%) each, nerve root injury in 1 patient (1.25%), and superficial wound infection in 5 patients (6.25%).Conclusion: The uniportal Arthrospine Duo system can be used in air/saline medium and is an excellent minimally invasive option for lumbar discectomy.

Case Report: Milliary TB in Adolescence Diagnosed in Tapin, South Kalimantan, A Call for TB Awereness

This case report presents the clinical scenario of a 15-year-old adolescent admitted to the emergency room with complaints of shortness of breath and a persistent productive cough for the past 3 weeks, despite over-the-counter medication. The cough did not improve with over-the-counter medication. He also sometimes noticed blood stains in his phlegm. During the physical examination, a BCG scar was found on the right upper arm. The results showed that positive HIV status and the absence of BCG scars were significantly associated with miliary TB and extrapulmonary TB. However, in this case, both factors were not detected. The treatment regimen for miliary TB requires therapy for a minimum of 12 months, but teenagers experience difficulties in undergoing therapy due to the consumption of illegal drugs every day for a long period of time. Apart from that, social isolation and disrupted daily activities are also challenges for teenagers. The death rate from miliary TB in children reaches 15-20%, highlighting the importance of awareness of this disease. Therefore, handling and treating TB in adolescents requires special attention and further efforts to reduce the risk of treatment failure. Awareness of TB, especially in adolescents with chronic respiratory symptoms, must be increased to overcome this challenge in the future.

Drying Stages of Blood Drops

Blood is one of the most important & most frequently encountered evidence in criminal investigation. It can be found in almost every type of criminal activity involving physical violence like murders, robberies, rape cases, etc. Blood stain may found on location such as seen of occurrence, the culprit, the victim, the weapon, of offence, the vehicle and the route taken by the culprit. The position, size & shape of the stain often help in reconstruction of crime seen. The stain may be in the form of splashes, smears, & pools. The colour of the bloodstains varies accordingly to their age, the amount of blood present, and the nature of the material. As bloodstain increases in age, they progress through series of colour changes from red to reddish brown to green & eventually to dark brown to black. When blood is exposed to an external environment the drying process on various surfaces is initiate. Size, volume, nature of target surface, & influence of external environment such as temperature humidity, air flow affects the drying time of bloodstain. The drying of bloodstain is initially around the edges or periphery and proceeds inward to the central portion of the stain as the drying process continues. Drying time and skeletonization are both important alteration of blood. Presence of significant dried & clotted blood on surface at a scene indicates a significant time lapse between blood shade & the observation of the blood.

From Farm to Fork: Transforming Egg Quality and Boosting Export Potential using Artificial Intelligence on Poultry Farming

Nothing can spoil fresh eggs that were laid by chickens, like dirty vent feathers, blood strains and minor cracks. Eggs play an important role in the context of human health due to its cheap cost and accessibility across the globe. But egg damage paves the way for a significant size of a shortage of nutritions, and creates demand which leads to an increase in price. The brand name of the company that supplies the eggs loses its reputation when damaged eggs reach the market along with good eggs and this can also lead to business loss. India is considered to be one of the worst farm poultry industries across the world, because of poor maintenance of farm, lack of cleanliness and non-compliance to the safety standards. Just because of this, the Indian market loses its power of negotiation on price and loses the opportunity to export the eggs to foreign countries even though India's egg production is close to the egg production margin of other countries. Not only from the perspective of commerce but also from the view of health this can lead to adverse consequences when the unclean eggs are consumed by the public or people who have less immunity. Every year a significant number of people are suffering from diseases when the eggs, which are poorly handled in the process of quality control, are consumed. This could also lead to a fixation of mindset to the consumer that these are usual eggs in india. The consequence of this mindset could result in more severe effects in consumerism over the period of time. This might also prevent people from purchasing the eggs for consumption. The major reason for this is unhygienic rearing practice and improper quality control measures. These are open invitations for egg contamination although India is the third largest country in the world in the production of eggs. There are more than forty seven million egg producers who do not meet safety standards, most of the produce are rejected for export due to chemicals used during the rearing process. Consumption of these eggs had led to a serious issue in india. A sizable number of people are resistant to antibiotics just because of the consumption of eggs that were produced using chemicals and eggs in which chemicals were intact on the shell of that egg. An article that was published by a renowned newspaper states that consumption of such contaminated eggs, which had heavy metal, has led to poisoning in children, paving the way for mental development problems, sometimes mental retardation. This study has attempted to reduce the severe consequences which are a result of consuming eggs with dirt or damaged eggs. A huge effort has been made to ensure that this scenario changes over the period of time, by incorporating AI in the field of Poultry industry in order to enhance the quality of egg production. The study we conducted clearly shows that most of the poor rearing practice happens due to human error. This can be changed by replacing the human efforts by machine, we could replace the entire quality control process especially removing the spoiled eggs from the the batch that is to be sent to the market. The model that we tried to build has given marvelous results in separating the spoiled from the good eggs. The algorithm will not only identify the spoiled eggs but also stores the final output in the database where the Organisations can access it at any point of time. The AI Object detection model will detect the cracked eggs, the eggs with dirt, the eggs with blood stain and many more. In nutshell our object detection model will detect all abnormal eggs which will help us prevent the abnormal eggs from reaching the consumer.

Evaluation of Forensic Luminol in Detection of Blood Stains in Instruments Following Dental Treatment.

Background Saliva and blood, being biological materials with a high potential for infectious transmission in dental environments, pose significant risks to dental professionals, assistants, and patients alike. Therefore, practitioners must adopt stringent security measures to ensure patient care, considering all parties as potential carriers of microorganisms capable of causing infectious diseases. Currently, various methods of disinfection and sterilization are employed to maintain the aseptic chain effectively. Having reliable methods for detecting substances in liquids, particularly body fluids, is crucial and highly convenient. Luminol, a chemiluminescent agent widely used in forensic science for detecting minute traces of blood that are invisible to the naked eye, presents itself as a valuable tool. Blood, a major bodily fluid often present in instruments following dental procedures, underscores the importance of its detection. Hence, in this study, luminol was utilized to detect blood traces in dental instruments following dental treatment, both before and after sterilization or disinfection. Objective Blood and saliva splashes, together with highly contagious aerosols, are always a part of dental procedures. The objective of the current study is to detect traces of blood stains on face shields, surgical instruments, and endodontic files using luminol before and after sterilization. Materials and methods Sample size calculation was done with G*Power software (Version 3.1.9.4, Düsseldorf, Germany), and a total of 30 instruments were selected for the study. In the present study, a total of 30 items were collected and utilized, including 14 instruments used after implant placement, 12 endodontic files employed after root canal treatment, and four face shields utilized during these procedures. Meanwhile, a freshly prepared luminol solution was applied to these instruments, and they were viewed in a dark environment both before and after sterilization procedures. Luminescence generated by luminol was observed in the instruments, indicative of the presence of blood not visible to the naked eye. Statistical analysis for both groups was done with IBM SPSS Statistics for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago, IL, USA). Intragroup comparison was done using the Friedman test, and intergroup comparison was done using the Wilcoxon signed-rank test. Results Blood stains and chemiluminescence were visualized in two out of 10 endodontic files (one #15 K-file and #20 K-files) and two out of four face shields. The intragroup comparison was done using the Friedman test, and it was found to be statistically significant (p < 0.05). Intergroup comparison was done using the Wilcoxon signed-rank test and was found to be statistically insignificant (p > 0.05). Conclusion Following sterilization and disinfection, there were no visual blood stains or chemiluminescence. Therefore, luminol was found to be effective in detecting blood stains in endodontic files, surgical instruments, and face shields, as well as in validating the sterilization and disinfection processes. Hence, sterilization in dentistry stands as a critical measure to guarantee patient safety, halt the dissemination of infections, and uphold exemplary clinical care standards.

Abnormal biochemical indicators of neonatal inherited metabolic disease in carriers

BackgroundTraditional biochemical screening for neonatal inherited metabolic diseases has high false-positive rates and low positive predictive values, which are not conducive to early diagnosis and increase parents’ anxiety. This study analysed the relationship between gene variant carriers and their biochemical indicators in traditional biochemical screening, aiming to find explanations for false positives in newborns.ResultsThis retrospective study included 962 newborns. Newborns underwent traditional biochemical screening at birth using blood staining and genomic sequencing of their stored blood staining using the NeoSeq Pro panel, which was able to detect 154 pathogenic genes and 86 diseases. A total of 632 newborns were carriers of gene variants. 56% of congenital hypothyroidism carriers had higher thyroid-stimulating hormone levels than normal newborns. Abnormal biochemical indices were detected in 71% of carriers of organic acid metabolic diseases, 69% of carriers of amino acid metabolic diseases, and 85% of carriers of fatty acid β oxidation disorders. In carriers associated with organic acid metabolic diseases, the propionylcarnitine (C3), C3/acetylcarnitine (C2), and methylmalonylcarnitine (C4DC) + 3-hydroxyisovalerylcarnitine (C5OH) levels were higher than those in non-carriers (C3: 4.12 vs. 1.66 µmol/L; C3/C2: 0.15 vs. 0.09; C4DC + C5OH: 0.22 vs. 0.19 µmol/L). In carriers associated with amino acid metabolic diseases, phenylalanine levels were higher than those in non-carriers (68.00 vs. 52.05 µmol/L). For carriers of fatty acid β oxidation disorders, butyrylcarnitine levels were higher than those in non-carriers (0.31 vs. 0.21 µmol/L), while the free carnitine levels were lower than those in non-carriers (14.65 vs. 21.87 µmol/L). There was a higher occurrence of carriers among newborns who received false-positive results for amino acid metabolic diseases compared to those who received negative results (15.52% vs. 6.71%). Similarly, there was a higher occurrence of carriers among newborns who received false-positive results for fatty acid β oxidation disorders compared to those who received negative results (28.30% vs. 7.29%).ConclusionsThis study showed that the carriers comprised a large number of newborns. Carriers had abnormal biochemical indicators compared with non-carriers, which could explain the false-positive rate for newborns using traditional newborn biochemical screening, especially in amino acid metabolic and fatty acid β oxidation disorders.

The Evaluation of Artificial Intelligence Technology for the Differentiation of Fresh Human Blood Cells From Other Species' Blood in the Investigation of Crime Scenes.

The current study used the deep machine learning approach to differentiate human blood specimens from cow, goat, and chicken blood stains based on cellmorphology. A total of 1,955 known Giemsa-stained digitized images were acquired from the blood of humans, cows, goats, and chickens. To train the deep learning models, the well-known VGG16, Resnet18, and Resnet34 algorithms were used. Based on the image analysis, confusion matrices were generated. Findings showed that the F1 score for the chicken, cow, goat, and human classes were all equal to 1.0 for each of the three algorithms. The Matthews correlation coefficient (MCC) was 1 for chickens, cows, and humans in all three algorithms, while the MCC score was 0.989 for goats by ResNet18, and it was 0.994 for both ResNet34 and VGG16 algorithms. The three algorithms showed 100% sensitivity, specificity, and positive and negative predictive values for the human, cow, and chicken cells. For the goatcells, the data showed 100% sensitivity and negative predictive values with specificity and positive predictive values ranging from 98.5% to 99.6%. These data showed the importance of deep learning as a potential tool for the differentiation of the species of origin of fresh crime scene blood stains.

Gender Identification by Fingerprint Pattern and Salivary Blood Group Antigen Expression: A Forensic Approach.

Introduction Fingerprints found at the crime scene are important and valuable evidence, as they are unique to every individual. Determining the blood group from the blood samples obtained at the site of the crime helps in identifying a person. However, where blood stains are not available, saliva obtained at the crime site can be used to identify the victim. Since fingerprint patterns and blood groups are unique to every individual and remain unchanged throughout life, the correlation between dermatoglyphics and blood groups can be of use in victim identification. Objectives The present study is conducted with the objective of finding out if there is any association between the distribution of fingerprint patterns and blood groups and if this association is of use in gender identification. Materials and method Fingerprint patterns were determined in 200 (females: n = 152, males: n = 48) dental undergraduate students in the age range of 18 to 24 years. ABO blood grouping was done on saliva by using the absorption-elution method. To determine the accuracy of ABO blood group determination using saliva, it was correlated with the ABO blood grouping in blood. Observations and result The most common fingerprint pattern was found to be loops (87, 43.50%), followed by whorls (81, 40.50%) and arches (32, 16.00%). The most common blood group was B (68, 34%), followed by O (46, 23%) and A (42, 21%), and the least common was AB (12, 6%). A higher percentage of secretors in saliva was observed in females (130, 86%) than males (38, 79%). The correlation of gender with blood group and fingerprint pattern showed that in males, the most common blood group was B (20, 42%), and the most common fingerprint pattern was whorls (21, 44%). In females, the most common blood group was B (48, 32%), while the most common fingerprint pattern was loop (68, 45%). Conclusion Present study reports an association between blood group and dermatoglyphics, which may help in gender identification. Saliva can be used as a helpful tool in victim identification in cases where blood stains are not available.

A developmental validation of the Quick TargSeq 1.0 integrated system for automated DNA genotyping in forensic science for reference samples.

Analysis of short tandem repeats (STRs) is a global standard method for human identification. Insertion/Deletion polymorphisms (DIPs) can be used for biogeographical ancestry inference. Current DNA typing involves a trained forensic worker operating several specialized instruments in a controlled laboratory environment, which takes 6-8h. We developed the Quick TargSeq 1.0 integrated system (hereinafter abbreviated to Quick TargSeq) for automated generation of STR and DIP profiles from buccal swab samples and blood stains. The system fully integrates the processes of DNA extraction, polymerase chain reaction (PCR) amplification, and electrophoresis separation using microfluidic biochip technology. Internal validation studies were performed using RTyper 21 or DIP 38 chip cartridges with single-source reference samples according to the Scientific Working Group for DNA Analysis Methods guidelines. These results indicated that the Quick TargSeq system can process reference samples and generate STR or DIP profiles in approximately 2h, and the profiles were concordant with those determined using traditional STR or DIP analysis methods. Thus, reproducible and concordant DNA profiles were obtained from reference samples. Throughout the study, no lane-to-lane or run-to-run contamination was observed. The Quick TargSeq system produced full profiles from buccal swabs with at least eight swipes, dried blood spot cards with two 2-mm disks, or 10ng of purified DNA. Potential PCR inhibitors (i.e., coffee, smoking tobacco, and chewing tobacco) did not appear to affect the amplification reactions of the instrument. The overall success rate and concordance rate of 153 samples were 94.12% and 93.44%, respectively, which is comparable to other commercially available rapid DNA instruments. A blind test initiated by a DNA expert group showed that the system can correctly produce DNA profiles with 97.29% genotype concordance with standard bench-processing methods, and the profiles can be uploaded into the national DNA database. These results demonstrated that the Quick TargSeq system can rapidly generate reliable DNA profiles in an automated manner and has the potential for use in the field and forensic laboratories.

A case report of Ayurvedic management on Dantavidradhi w.s.r. to periodontal Abscess

Background: Aacharya Vagbhatta has described seventy five Mukhroga; among them Dantamooolgat Roga are thirteen. Dantavridradhi (Periodontal Abscess) is one of the Dantamulagata Roga can be correlated with periodontal Abscess. Dantavridhi (Periodontal Abscess) is Tridoshaja, Sadhya Vyadhi as swelling develops on gums and accomplished with pain, burning sensation, pus discharge and sometimes with blood stains. Materials and Methods: A 47 year old normal and oriented female patient attended Shalakya Tantra OPD at ITRA Hospital with complains of swelling on upper jaw gums (gingiva) as chief complain associated with pain during chewing, mild pus discharge since 12 days. She was diagnosed with Dantavridradhi (Periodontal Abscess) and treated by Ayurvedic management as orally Triphala Guggulu, Gandusha and Kavala with Panchtiktak Kwatha, Pratisarana/Lepa of Katuki Churna mixed with Gomutra locally and adviced to maintain oral hygiene properly. Observation and Result: Considerable reduction of swelling is observed on the upper jaw gums (gingiva) within 8 days. Pain and pus discharge were relieved after 5 days. Complete relief in symptoms were noticed after 10 days. Conclusion: Ayurveda line of treatment approach is helpful in the management of Dantavridradhi (Periodontal Abscess).

Research Progress on Biological Evidence Identification in Fire Scenes.

Biological evidence is relatively common evidence in criminal cases, and it has strong probative power because it carries DNA information for individual identification. At the scene of fire-related cases, the complex thermal environment, the escape of trapped people, the firefighting and rescue operations, and the deliberate destruction of criminal suspects will all affect the biological evidence in the fire scene. Scholars at home and abroad have explored and studied the effectiveness of biological evidence identification in fire scenes, and found that the blood stains, semen stains, bones, etc. are the main biological evidence which can be easily recovered with DNA in fire scenes. In order to analyze the research status and development trend of biological evidence in fire scenes, this paper systematically sorts out the relevant research, mainly including the soot removal technology, appearance method of typical biological evidence, and possibility of identifying other biological evidence. This paper also prospects the next step of research direction, in order to provide reference for the identification of biological evidence and improve the value of biological evidence in fire scenes.

Penetrating Fishhook Ocular Injury: Challenging management in low- resource country

Introduction : Fishing is a common income source in rural areas, but fishhook eye injuries are rare. This report describes a case of a rare penetrating fishhook ocular injury, which resulted in endophthalmitis and eye evisceration, and highlights the challenges caused by delayed referral and limited options for intravitreal antibiotics due to inadequate consumable availability.&#x0D; Case Illustration : A 13-year-old boy from Vanuatu had a fishhook in his right eye and was referred to an Ophthalmologist one day later due to unavailability of flights. Upon arrival, endophthalmitis signs were noted, with the left eye having a visual acuity of 6/7.5 and the right eye showing only hand movement. The right eye showed corneal edema and a blood stain around the fishhook, fresh keratic precipitates, discharge and conjunctival edema. The fishhook was removed, and the cornea repaired under local anesthesia. On Day 1 post-operation, Intravitreal vancomycin and moxifloxacin were administered after procuring privately from pharmacies outside the hospital. However, the patient's condition worsened, requiring evisceration of the right eye.&#x0D; Discussion : Prompt management of penetrating eye injuries is crucial, with patients requiring broad spectrum antibiotics, tetanus shots, and an eye shield during referral. However, challenges such as lack of an eye shield and transportation delays worsened the patient's condition before arrival. This case also highlights the challenges faced in treating the patient effectively by the ophthalmologist due to limited options intravitreal antibiotics.&#x0D; Conclusion Timely management and urgent referral are crucial in low-resource areas to prevent complications. Essential consumables are necessary for effective treatment by an ophthalmologist.

Further experiments and remarks regarding the possible formation of blood stains on the Turin Shroud: stains attributed to the nailing of the hands

The formation of red discolorations (‘blood stains’) on the Turin Shroud (TS), a Christian relic believed to be the burial cloth of Jesus of Nazareth, is controversially discussed. We performed experiments to identify possible explanations for the formation of the stains on the hands and forearms of the Turin Shroud Man (TSM). In preliminary non-standardised experiments, after applying blood to the dorsal and palmar side of the probands’ wrists, they moved their arms around at their own discretion to provoke blood flows as similar as possible to those on the TS. A blood stain pattern similar to that on the left wrist could be provoked by slowly turning the wrist to the ulnar side. In contrast, a branched pattern of multiple streaks, as depicted on the forearms, was difficult to reproduce. In a standardised test setup, the probands moved their dry, dirtied, or oiled arms jerkily in a predetermined sequence of movements. More body hair only slightly facilitated the formation of a branched pattern. On oiled skin, however, the formation of branches was significantly facilitated. This may support the hypothesis that the blood stains on the forearms were formed by moving the body between the unnailing and the burial. The formation of a branched pattern seems feasible if the arms were moved jerkily and were possibly exposed to water and oils postmortem (e.g. transporting the washed and oiled body). Nevertheless, the well-defined blood stains with multiple branchings are difficult to explain. Additionally, the blood stains on the forearms may have originated from deep scourging wounds, where dried blood was again mobilised by water (and oil). We are aware that no reliable conclusions about the formation of the ‘blood stains’ on the TS can be drawn from our findings. However, they may contribute to the discussion on this topic.

Metabolite Biomarkers for Early Ischemic-Hypoxic Encephalopathy: An Experimental Study Using the NeoBase 2 MSMS Kit in a Rat Model.

Hypoxic-ischemic encephalopathy (HIE) is one of the most common causes of childhood disability. Hypothermic therapy is currently the only approved neuroprotective approach. However, early diagnosis of HIE can be challenging, especially in the first hours after birth when the decision to use hypothermic therapy is critical. Distinguishing HIE from other neonatal conditions, such as sepsis, becomes a significant problem in diagnosis. This study explored the utility of a metabolomic-based approach employing the NeoBase 2 MSMS kit to diagnose HIE using dry blood stains in a Rice-Vannucci model of HIE in rats. We evaluated the diagnostic fidelity of this approach in a range between 3 and 6 h after the onset of HIE, including in the context of systemic inflammation and concomitant hypothermic therapy. Discriminant analysis revealed several metabolite patterns associated with HIE. A logistic regression model using glycine levels achieved high diagnostic fidelity with areas under the receiver operating characteristic curve of 0.94 at 3 h and 0.96 at 6 h after the onset of HIE. In addition, orthogonal partial least squares discriminant analysis, which included five metabolites, achieved 100% sensitivity and 80% specificity within 3 h of HIE. These results highlight the significant potential of the NeoBase 2 MSMS kit for the early diagnosis of HIE and could improve patient management and outcomes in this serious illness.

Comparison of Baska mask and I-gel with endotracheal tube in laparoscopic cholecystectomy: A randomized controlled study

Background: Supraglottic airway devices are frequently used instead of endotracheal intubation in laparoscopic surgeries. Two such devices, I-gel (IG) and Baska mask (BM), have been compared with respect to their sealing properties and leak fraction (LF) in comparison to the endotracheal tube. Aims and Objectives: The aim of the present study is to compare the performance of IG and BM with endotracheal tube in patients undergoing laparoscopic cholecystectomy under general anesthesia. Materials and Methods: In this randomized trial, 84 patients scheduled for laparoscopic cholecystectomy under general anesthesia were randomized to group (endotracheal tube [ETT], n=28), group BM (BM, n=28), or group IG (IG, n=28). All the patients received standard general anesthesia and the airway was maintained with either of three devices. The primary outcomes were the difference in the LF and airway sealing pressure (ASP) at different time points before and after pneumoperitoneum. Secondary outcomes were insertion-time, number of insertion attempts, and gastric insufflations. Heart rate and blood pressure were recorded. Complications such as sore throat, coughing, laryngospasm, blood staining of the device, and aspiration were noted. Results: P-values of LF of the three groups at time points T- after insertion (Ti), T-after pneumoperitoneum (Tp), and T- after peritoneal deflation (Tr) were 0.000 each and P-values of ASP at those time points were 0.000 each, respectively. Insertion time was significantly less for IG than ET (P&lt;0.001). Heart rate and blood pressure showed P-values at Ti and Tp (P=0.004 and 0.000). Conclusion: It was concluded that IG or BM can maintain an airway with adequate seal and were not associated with any incidence of aspiration or laryngospasm. IG placement was found to be easier whereas the ease of ventilation was noted with BM.

Effect of the new video laryngeal mask airway SaCoVLM on airway management in lateral laparoscopic urological surgery: A single center randomized controlled trial

There are few pertinent studies about the application of laryngeal mask airways (LMAs) in lateral decubitus surgery. Therefore, the aim of our study was to evaluate the effects of lateral position and pneumoperitoneum on oropharyngeal leak pressure (OLP) and ventilation efficiency for the LMA SaCoVLM. Patients undergoing elective retroperitoneal laparoscopic urological surgery were randomized 1:1 to the Supreme group or SaCoVLM group. The primary outcome was the OLP with LMA insertion. The secondary outcomes were the first-attempt success rate, insertion time, adjustment times, gastric tube success rate, LMA alignment accuracy, LMA removal time, regurgitation or aspiration, LMA blood staining, and incidence of adverse events 24 h after surgery. We recruited 70 patients to complete the study. Regardless of lateral position and pneumoperitoneum, the OLP was greater in the SaCoVLM group (n = 35) than in the Supreme group (n = 35), with a median difference of 4–7 cmH2O. The first-attempt success rate of the SaCoVLM group was higher than that of the Supreme group (91.4% vs. 77.1%, risk ratio (RR): 1.19; 95% CI 0.96 to 1.46, P = 0.188). Thus, in the lateral position with pneumoperitoneum, although the new video LMA SaCoVLM has a higher OLP than the LMA Supreme, both devices provide sufficient ventilation efficiency.