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Coronavirus 2 (SARS-CoV-2) has created worldwide healthcare problems and strained health resources. Reduced eosinophil levels are one of the unique discoveries that have been discovered in COVID 19 recently. The goal of this study is to establish the association between the mortality in COVID-19 with eosinopenia by retrospectively analysing data from fifty COVID-19 patients with varying illness severity, including moderate, severe, and critically ill. Fifty patients taken from Sree Balaji Medical College and Hospital, of which twenty five critically ill patients and twenty-five having moderate to severe COVID-19 infection at hospital admission were enrolled. After being admitted to the hospital, information on the patient's medical history, clinical symptoms, CT severity score, and outcomes were taken from their medical records. The study concluded that Compared to individuals with moderate and severe disorders, critical illness patients' eosinophil levels were much lower. Eosinophil levels gradually decreasing was found to be a separate factor which has been associated with mortality. Patients with COVID-19 who have eosinopenia have a considerably higher mortality rate. These values can be obtained by simple means such as obtaining peripheral blood, so this is an easy and an effective indicator in monitoring these patients.

To compare quantitative values of parameters of coagulation pathway like Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), International Normalized Ratio (INR) and D-Dimer (DD) on date of admission versus date of patient's mortality. A total of 50 patients who were tested positive for COVID-19 in our hospital between April 21, 2021 and May 30, 2021, were taken into this study. The changes in PT, APTT, INR and DD were compared at day of admission and day of patient's mortality. The study involved 50 patients (36 male and 14 female). D-dimer at the day of admission (mean 1540.79 ng/ml; IQR 231-8776) was found with an elevation of 250% at the day of mortality (mean 5379.04ng/ml; IQR 434-10000). PT at the day of admission (mean 13.602; IQR 11.6-14.8) was found elevated (Normal range-10.5-13.5sec) in 19/50 patients which increased to 43/50 patients at the day of mortality, an increase of 126%. According to the study done, the number of patients with increased levels of PT, APTT, INR and DD were substantially greater at the time of mortality compared to the same patients at their time of admission, suggesting a dynamic coagulation process in COVID-19 patients. This likely suggested that the patients were in progression from a hypercoagulating state that transforms into a fibrinolytic state as a result of the extensive use of coagulation factors.

Brunner glands are exocrine glands that secrete mucus to protect against acid secretion. Brunner gland hyperplasia is an expansion in size and shape of glands due to excess mucus secretion which occurs in cases where acid is secreted in excess notably duodenal ulcer or gastritis. Usually asymptomatic as Brunner gland hyperplasia appears as small nodular growth noticed during endoscopic examination. Some Brunner gland hyperplasia causes gastric outlet symptoms that are seen in our case study, as we present a rare and interesting case of Brunner gland hyperplasia causing blockage of the gastric outlet (rare symptom). Although endoscopic removal was done in suspicion of malignancy and turned out to be benign Brunner gland hyperplasia which we are discussing in our case as an elaborate discussion. The importance of considering Brunner gland hyperplasia as a differential diagnosis for gastric outlet blockage, as well as the use of endoscopic biopsy for ruling out cancer, are reviewed in depth. There have been many reports in the adult literature of Brunner's gland hyperplasia causing the bleeding, blockage, or forming intestinal or duodenal folds. Similar cases of Brunner gland hyperplasia impeding stomach outflow are highly uncommon and should be reported.In cases of gastric outlet blockage, Brunner gland hyperplasia should be considered as a distinguishing a particular disease or condition from others that present with similar clinical features, and endoscopic assessment with histopathological microscopy may be a valuable tool in preventing needless surgical intervention. This case report research adds to the necessity of endoscopic biopsy.

Background Multisystem inflammatory syndrome in children (MIS-C) presents with inflammation and pathology of multiple organs in the pediatric population in the weeks following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods We characterized the SARS-CoV-2 antigen–specific cytokine and chemokine responses in children with MIS-C, coronavirus disease 2019 (COVID-19), and other infectious diseases. Results MIS-C is characterized by elevated levels of type 1 (interferon-γ, interleukin [IL] 2), type 2 (IL-4, IL-13), type 17 (IL-17), and other proinflammatory cytokines (IL-1α, IL-6, IL-12p70, IL-18, and granulocyte-macrophage colony-stimulating factor) in comparison to COVID-19 and other infectious diseases following stimulation with SARS-CoV-2–specific antigens. Similarly, upon SARS-CoV-2 antigen stimulation, CCL2, CCL3, and CXCL10 chemokines were significantly elevated in children with MIS-C in comparison to the other 2 groups. Principal component analysis based on these cytokines and chemokines could clearly distinguish MIS-C from both COVID-19 and other infections. In addition, these responses were significantly diminished and normalized 6–9 months after recovery. Conclusions Our data suggest that MIS-C is characterized by an enhanced production of cytokines and chemokines that may be associated with disease pathogenesis.

HfO2 and ZrO2 are two high-k materials that are important in the down-scaling of semiconductor devices. Atomic level control of material processing is required for fabrication of thin films of these materials at nanoscale device sizes. Thermal Atomic Layer Etch (ALE) of metal oxides, in which up to one monolayer of the material can be removed, can be achieved by sequential self-limiting fluorination and ligand-exchange reactions at elevated temperatures. However, to date a detailed atomistic understanding of the mechanism of thermal ALE of these technologically important oxides is lacking. In this paper, we investigate the hydrogen fluoride pulse in the first step in the thermal ALE process of HfO2 and ZrO2 using first principles simulations. We introduce Natarajan-Elliott analysis, a thermodynamic methodology, to compare reaction models representing the self-limiting (SL) and continuous spontaneous etch (SE) processes taking place during an ALE pulse. Applying this method to the first HF pulse on HfO2 and ZrO2 we found that thermodynamic barriers impeding continuous etch are present at ALE relevant temperatures. We performed explicit HF adsorption calculations on the oxide surfaces to understand the mechanistic details of the HF pulse. A HF molecule adsorbs dissociatively on both oxides by forming metal-F and O-H bonds. HF coverages ranging from 1.0 0.3 to 17.0 0.3 HF/nm2 are investigated and a mixture of molecularly and dissociatively adsorbed HF molecules is present at higher coverages. Theoretical etch rates of -0.61 0.02 Å /cycle for HfO2 and -0.57 0.02 Å /cycle ZrO2 were calculated using maximum coverages of 7.0 0.3 and 6.5 0.3 M-F bonds/nm2 respectively (M = Hf, Zr).

Mucopolysaccharidoses (MPS) are a group of storage disorders with an autosomal recessive inheritance. Sanfilippo disease is a type of MPS which occurs due to deficiency of lysosomal enzymes involved in the lysosomal degradation of heparan sulphate. They can be categorized into four different types based on the enzymes involved namely heparin N-sulfatase (type A), alpha-N-acetylglucosaminidase (type B), acetyl-CoA-glucosaminide acetyltransferase (type C) and N-acetylglucosamine-6-sulfatase (type D) respectively. In this case report we present a six years follow up of a child confirmed to have Sanfilippo type A disease, who developed chronic Idiopathic Thrombocytopenic Purpura (ITP).

Pattern Search technique can be used to find the solution for the optimization problem. In this paper, pattern search algorithm has been utilized to calculate the switching angles for the cascaded H-bridge inverter with the consideration of minimizing total harmonic distortion. Mathematical equations for the optimization problem were formulated by fourier analysis technique. Lower order harmonics such as third, fifth, seventh, ninth and eleventh order harmonics were taken into account to mitigate the total harmonic distortion of the inverter. Simulations have been carried out for thirteen level, fifteen level and seventeen level cascaded H-bridge inverter using matlab software. Total harmonic distortion of voltage and current for resistive load, resistive-inductive load and motor load were analyzed.

This paper compares the reduction of harmonics in various level cascaded H-bridge inverters. The switching angles for the cascaded H-bridge inverter were calculated by evolutionary optimization technique. Fourier analysis is used to determine the switching angles for the desired electrical parameters. Lower order harmonics such as third, fifth, seventh, ninth and eleventh order harmonics were taken into consideration to reduce the total harmonic distortion. Simulation was done for thirteen, fifteen and seventeen level cascaded H-bridge inverters using Matlab. Total harmonic distortion of voltage and current for R, RL and Motor load were analyzed. Full Text: PDF DOI: http://dx.doi.org/10.11591/ijpeds.v8.i1.pp10-19