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ABSTRACTIn this study, we investigate novel fractional tuberculosis model with Caputo fractional derivative. The computational solution of the fractional tuberculosis disease is obtained with the help of the generalized Euler's method (GEM). This article considers two treatment strategies: protective treatment for latent populations and main treatment for infected ones. The compartmental structure of the six-dimensional model includes the susceptible, latent, infected, recovered, and treatment classes. To examine the nature of differential equations of fractional order that arise in biological illness, the findings produced utilizing the method under consideration are more accurate and straightforward. Additionally, the stability of the equilibrium point is also investigated. The fractional model has been graphically simulated using MATLAB22.

Substantial advancements have been made in applying fractional calculus to understanding the epidemiology of viral diseases. However, it remains troubling that over 2,000,000 children, particularly those under the age of 5 and elderly individuals over 65, succumb to pneumonia annually in developing nations. This paper uses a deterministic SVEIR (susceptible, vaccinated, exposed, infected, and recovered) model to investigate pneumonia disease dynamics from a mathematical perspective. The governing model has been generalized from Caputo fractional derivatives, and the generalized Euler’s method has been used to calculate the approximate solution of the governing model. The dynamical systems theory examines the model’s stability analysis, basic reproduction number, and equilibrium points. The linearization method for spatial equilibrium and the Lyapunov functional method demonstrate that the model is locally asymptotic stable for disease-free equilibrium. Graphical results are showcased through MATLAB21 to illustrate the resolution of the problem. The research findings suggest that the disease will eventually disappear from the population if vaccination coverage rises over the necessary vaccination threshold. According to sensitivity analysis, the most sensitive factors are the transmission rate and the pace at which exposed individuals become contagious. According to the study, we must strengthen treatment effectiveness to prevent disease spreading.

In this paper, we delve into the realm of mathematical modeling as a powerful theoretical tool to understand essential aspects of medical-biological phenomena. This study focuses on developing a mathematical model incorporating the incomplete I-function (IIF) and estimating glucose supply in the human bloodstream. The results of our investigations are far-reaching, revealing many exciting scenarios across the various parameters under investigation. These results are not only practical but can also play an essential role in the contexts of medical and biological fields.

Abstract This study focuses on improving the accuracy of assessing liver damage and early detection for improved treatment strategies. In this study, we examine the human liver using a modified Atangana-Baleanu fractional derivative based on the mathematical model to understand and predict the behavior of the human liver. The iteration method and fixed-point theory are used to investigate the presence of a unique solution in the new model. Furthermore, the homotopy analysis transform method, whose convergence is also examined, implements the mathematical model. Finally, numerical testing is performed to demonstrate the findings better. According to real clinical data comparison, the new fractional model outperforms the classical integer-order model with coherent temporal derivatives.

Sediment deposition is a natural process that occurs in all reservoirs, resulting in significant storage loss, which has an adverse effect on the economic development of the local area. It is necessary to take appropriate action to control the sedimentation and prevent loss of the storage capacity of the reservoir. In the present study, runoff and sediment data collected at the Konijerla hydrometric station of Wyra reservoir for the period of 1991 to 2019 are used. Data from 2011 to 2016 is used to calibrate and the data from 2017 to 2019 is used to validate the SWAT model. The Wyra watershed consists of 26 sub-basins and 47 HRUs (Hydrological Response Units). Out of these sub-basins, one of the sub-basins is contributing 18.8% of sedimentation. It was also observed that two other sub-basins, though less in area, generate high sediments. Seasonal sediment analysis showed that sedimentation increased by 12% in the month of August for wet years. Overall sedimentation increased in wet years by 10.60% and in dry years, it decreased by 18.78%. The SWAT model was satisfactory in the calibration and validation periods for various parameters used. Hence, this model can be used for sedimentation study, as well as a planning tool in the reservoir capacity management.

The present article introduces and studies the Fredholm-type integral equation with an incomplete I-function (IIF) and an incomplete $ \bar {I} $ -function (I $ \bar {I} $ F) in its kernel. First, using fractional calculus and the Mellin transform principle, we solve an integral problem involving IIF. The idea of the Mellin transform and fractional calculus is then used to analyse an integral equation using the incomplete $ \bar {I} $ -function. This is followed by the discovery and investigation of several important exceptional cases. This article's general discoveries may yield new integral equations and solutions. The desired outcomes seem to be very helpful in resolving many real-world problems whose solutions represent different physical phenomena. And also, findings help solve introdifferential, fractional differential, and extended integral equation problems.

Calcium is an essential element in our body and plays a vital role in moderating calcium signalling. Calcium is also called the second messenger. Calcium signalling depends on cytosolic calcium concentration. In this study, we focus on cellular calcium fluctuations with different buffers, including calcium-binding buffers, using the Hilfer fractional advection-diffusion equation for cellular calcium. Limits and start conditions are also set. By combining with intracellular free calcium ions, buffers reduce the cytosolic calcium concentration. The buffer depletes cellular calcium and protects against toxicity. Association, dissociation, diffusion, and buffer concentration are modelled. The solution of the Hilfer fractional calcium model is achieved through utilizing the integral transform technique. To investigate the influence of the buffer on the calcium concentration distribution, simulations are done in MATLAB 21. The results show that the modified calcium model is a function of time, position, and the Hilfer fractional derivative. Thus the modified Hilfer calcium model provides a richer physical explanation than the classical calcium model.

The study discussed in this article is driven by the realization that many physical processes may be understood by using applications of fractional operators and special functions. In this study, we present and examine a fractional integral operator with an I-function in its kernel. This operator is used to solve several fractional differential equations (FDEs). FDE has a set of particular cases whose solutions represent different physical phenomena. Many mathematical physics, biology, engineering, and chemistry problems are identified and solved using FDE. Specifically, a few exciting relations involving the new fractional operator with incomplete I-function (IIF) in its kernel and classical Riemann Liouville fractional integral and derivative operators, the Hilfer fractional derivative operator, and the generalized composite fractional derivate (GCFD) operator are established. The discovery and investigation of several important exceptional cases follow this.

In order to understand and manage infectious illnesses, mathematical models are extremely important. They support decision making by researchers and public health workers in predicting the spread of diseases, evaluate the results of interventions, and gathering data. This study considers a fractionalized hepatitis B virus (HBV) infection model with cell cure. The Atangana Baleanu fractional model was initially established for the epidemic issue. This paper analyses the fractional form that makes up the HBV infection model utilizing the numerical methodology, homotopy analysis transform method (HATM). The suggested technique is created with the use of the homotopy analysis method (HAM), the homotopy polynomial, and the Laplace transformation. Additionally, the existence and uniqueness of the solution are considered, and stability analysis is given by the fixed-point theory (FPT) of the HBV model. Through MATLAB21, the obtained solutions are graphically simulated. The graphical solutions demonstrated that the peak of viral propagation is reduced when a fractional-order derivative is included to the model, and cell damage is minimized by starting treatment early on; however, the disease takes longer to be completely eradicated. The outcomes will be beneficial in the medical field. The fractional model lets us draw significant information essential for predicting disease outcomes and planning appropriate clinical management for patients.

Ethiopia is one of the countries highly affected by the COVID-19 pandemic in Africa. A new study has looked at the transmission dynamics of the outbreak in Ethiopia based on the age categories of the infected individuals. Infected individuals are divided into three age categories (less than 14 years (I $ _{1} $ ), 15–54 years (I $ _{2} $ ), and above 54 years I $ _{3} $ ). Chebyshev polynomial of the fourth kind is used to convert a fractional system into an algebraic system of equations, which is then solved using iterative methods. The fundamental reproduction number $ (\mathcal R _{0}) $ is calculated using the next-generation matrix technique, and the disease-free and endemic equilibrium points, as well as their stability, are carefully studied. We calculated the parameters and starting conditions provided for our model using data from the Ethiopian Public Health Institute (EPHI) and the Ethiopian Ministry of Health from 29 February 2021, to 7 June 2021.

Introduction: Second generation Supraglottic Airway Devices (SADs) contain a gastric drain tube which separates the respiratory and the alimentary tract. This provides a better oropharyngeal seal and reduces the risk of pulmonary aspiration of refluxed gastric contents compared to the first generation SADs. Aim: To compare Ambu® AuraGain™ (AAU) laryngeal mask airway with LMA® ProSeal™ (PLMA) in terms of Oropharyngeal Leak Pressure (OLP) in laparoscopic surgeries. Materials and Methods: This randomised clinical study was conducted from December 2017-September 2019, at Shri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad, India in 80 patients, aged 18-65 years, of American Society of Anaesthesiologists (ASA) physical status I and II undergoing laparoscopic surgeries. Patients were randomly assigned to one of the two groups: group PLMA and group AAU. After induction of anaesthesia, SADs were inserted by an experienced anaesthesiologist. OLP, pharyngeal mucosal pressure, peak airway pressure and secondary outcome parameters (the number of attempts, time required, ease, and haemodynamic response associated with insertion of LMA) were recorded at set time points. Data was analysed using Statistical Packages for Social Sciences (SPSS) version 22. Results: All patients in both the groups were comparable in terms of demographic data and baseline vital parameters. The Oropharyngeal Leak Pressure of group AAU was comparable to group PLMA at all measured time-points. The two groups were comparable in terms of pharyngeal mucosal pressure immediately after insertion of LMA, but group AAU had lesser pharyngeal mucosal pressure compared to group PLMA immediately after pneumoperitoneum, at 30 and 60 minutes. Mean peak airway pressures were lower in group AAU than group PLMA immediately after insertion of LMA (15.53±1.50 versus 17.06±2.56 cmH2O, p=0.004) and immediately after creation of pneumoperitoneum (23.03±2.96 versus 26.58±10.12 cmH2O, p=0.04). Both the groups were comparable in terms of number of attempts, time taken, haemodynamic response associated with LMA insertion and with passage of gastric tube except that PLMA was easier to insert in the first attempt compared to AAU (26/40 versus 13/40, Grade 1 ease of insertion). Conclusion: Ambu® AuraGain™ could be a useful alternative to LMA® ProSeal™ in patients undergoing laparoscopic surgeries.

Abstract Background COVID-19 has caused a global pandemic of unprecedented proportions. Elective cardiac surgery has been universally postponed with only urgent and emergency cardiac operations being performed. The National Health Service in the United Kingdom introduced national measures to conserve intensive care beds and significantly limit elective activity shortly after lockdown. Case presentation We report two cases of early post-operative mortality secondary to COVID-19 infection immediately prior to the implementation of these widespread measures. Conclusion The role of cardiac surgery in the presence of COVID-19 is still very unpredictable and further studies on both short term and long term outcomes are warranted.

During the times of the ongoing COVID pandemic, aerosol-generating procedures such as bronchoscopy have the potential of transmission of severe acute respiratory syndrome coronavirus 2 to the healthcare workers. The decision to perform bronchoscopy during the COVID pandemic should be taken judiciously. Over the years, the indications for bronchoscopy in the clinical practice have expanded. Experts at the Indian Association for Bronchology perceived the need to develop a concise statement that would assist a bronchoscopist in performing bronchoscopy during the COVID pandemic safely. The current Indian Association for Bronchology Consensus Statement provides specific guidelines including triaging, indications, bronchoscopy area, use of personal protective equipment, patient preparation, sedation and anesthesia, patient monitoring, bronchoscopy technique, sample collection and handling, bronchoscope disinfection, and environmental disinfection concerning the coronavirus disease-2019 situation. The suggestions provided herewith should be adopted in addition to the national bronchoscopy guidelines that were published recently. This statement summarizes the essential aspects to be considered for the performance of bronchoscopy in COVID pandemic, to ensure safety for both for patients and healthcare personnel.

Background: Masticatory forces generate various degrees of stress and strain in the periodontium of teeth which determine the clinical functions and load-bearing capacity of the teeth. There are few in vitro studies that have analyzed stress generated due to combined forces acting on the teeth. Thus, the objective of the present study was to do a comparative analysis of the influence of various stresses on the periodontal ligament and alveolar bone of maxillary central incisor with normal bone height and reduced bone height under simulated standard masticatory using finite element stress analysis. Methodology: A 3D model of the tooth was obtained with the help of ANSYS software. These models were subjected to various oblique forces, i.e., 100N and 235.9N, applied at 45° angle on the lingual surface of the maxillary central incisor and stress values were recorded in three dimensions. The results from FE analysis were analyzed using 3D Von Mises Criteria. Results: It was observed that in healthy periodontium; it was observed that among the periodontal structure studied, the maximum stress levels were exerted on root followed by cortical bone, cancellous bone, and PDL, irrespective of the force, as compared to the diseased periodontium, in which the bone height was reduced, the maximum stresses were on root followed by cortical bone, PDL, and cancellous bone. Conclusion: The main factor governing the success of any periodontal procedure depends on the height of the remaining bone and the amount of force exerted on to the tooth and the stress generated within the tooth. The finite element method could be of substantial importance in this respect as it can assess the stresses of various occlusal forces on the periodontal ligament, root, cortical bone, and cancellous bone of teeth in a periodontally healthy and diseased state.

Introduction: Periodontitis is inflammation of periodontium. Periodontal disease is associated with various risk factors among which female hormonal alterations such as menopause have been found to be connected with periodontal breakdown and osteoporosis in women. The aim of this study was to determine the periodontal status in pre- and postmenopausal females. Materials and Methods: In this study, 60 female patients were analyzed aged between 40 and 60 years. Group 1 (test) comprised 30 premenopausal women with/without chronic periodontitis and Group II (control) comprised 30 postmenopausal women with/without chronic periodontitis. After recording clinical parameters, the scores were provided using Orthopantomograph for each patient. Paired t-test was applied for intragroup comparison and independent sample t-test was applied for intergroup comparison. The value of P < 0.05 was considered statistically significant. Results: The mean plaque index, gingival index, calculus index, pocket probing depth, and clinical attachment loss scores in the premenopausal group were less as compared to postmenopausal group. Both the groups showed statistically significant differences with T=15.28 and P = 0.01. Conclusion: Postmenopausal women are more susceptible to periodontitis. Hence, precaution and initial management of oral diseases should be the utmost priority in women's health. The effect of sex hormones can be reduced with regular dental examination, maintaining good oral hygiene, and hormonal replacement therapies.

Background: Vitiligo is a depigmenting disorder which can be psychologically devastating. Childhood-onset vitiligo has different epidemiological and clinical characteristics as compared to adults. Aims and Objectives: The aim was to study the clinico-epidemiological and hematologic investigation profiles of childhood vitiligo. Materials and Methods: First 200 pediatric patients younger than 18 years, with vitiligo who attended the dermatology outpatient department of a tertiary center in Northeast India, between September 2015 and August 2017 were included in the study. A detailed history and examination along with autoimmune diseases and laboratory parameters were recorded. Results: Among the 200 patients, 62% were girls. The mean age was 10.3 ± 4.9 years. The mean age at onset was 9.1 ± 4.9 years (ranging 2 months–17 years), with duration of disease varying from 1 month to 8 years with mean duration of 1.39 ± 1.63 years. Most common pattern of vitiligo was vulgaris (39.5%) followed by focal (25%), segmental (15.5%) genital (10%), acral and lateral lip (8%), and acrofacial (4%). Family history of vitiligo was seen in 12% of patients. In 96% patients, only

Charcot-Marie-Tooth disease (CMT), also known as hereditary motor sensory neuropathy, is a heterogeneous group of disorders best known for causing inherited forms of peripheral neuropathy. The X-linked form, CMTX1, is caused by mutations in the gap junction protein beta 1 (GJB1) gene, expressed both by peripheral Schwann cells and central oligodendrocytes. Central manifestations are known but are rare, and there are few case reports of leukoencephalopathy with transient or persistent neurological deficits in patients with this CMT subtype. Here, we report the case of a man with multiple male and female family members affected by neuropathy who carries a pathologic mutation in GJB1. He has experienced three transient episodes with variable neurological deficits over the course of 7 years with corresponding changes on magnetic resonance imaging (MRI). This case illustrates CMT1X as a rare cause of transient neurological deficit and demonstrates the evolution of associated reversible abnormalities on MRI over time. To the best of our knowledge, this report provides the longest period of serial imaging in a single patient with this condition in the English language literature.

Objective. Neonatal sepsis is associated with abnormal neurodevelopmental outcomes but not with poor growth at 9 to 15 months of corrected age in LBW infants. Design, Setting, and Participants. This is a prospective cohort study involving 128 eligible preterm low-birth-weight (LBW) infants admitted during the period of 2013-2014 to the Durgabai Deshmukh Hospital and Research Center. All patients were followed up in the outpatient Department of Pediatrics. They were divided into the sepsis and nonsepsis group. Results. A total of 94 infants were evaluated (40 in sepsis and 54 in nonsepsis group). At the age of 9–15 months, low-birth-weight infants with neonatal sepsis had an increased risk of neurodevelopmental disorders (67.5 versus 20.3%; RR: 3.31 (1.87–5.85)). There is no statistically significant difference in the growth outcomes. Conclusion. Neonatal infections are associated with the abnormal neurodevelopmental outcomes in LBW infants but there was no significant difference at growth outcome at 9 to 15 months of corrected age between both groups.

An analytical model is presented for light scattering associated with heat transport near a cell membrane that divides a complex system into two topologically distinct half-spaces. Our analysis is motivated by experiments on vibrational photothermal microscopy which have not only demonstrated remarkably high contrast and resolution, but also are capable of providing label-free local information of heat transport in complex morphologies. In the first Born approximation, the derived Greens function leads to the reconstruction of a full 3D image with photothermal contrast obtained using both amplitude and phase detection of periodic excitations. We show that important fundamental parameters including the Kapitza length and Kapitza resistance can be derived from experiments. Our goal is to spur additional experimental studies with high-frequency modulation and heterodyne detection in order to make contact with recent theoretical molecular dynamics calculations of thermal transport properties in membrane systems.

Background and Aims : Utility of gabapentin for pre-operative anxiolysis as compared to commonly administered alprazolam is not evident. The aim of the present study was to compare the effects of pre-operative oral gabapentin 600 mg, alprazolam 0.5 mg or a placebo on pre-operative anxiety along with post-operative pain and morphine consumption. Methods: Seventy five patients scheduled for abdominal hysterectomy under general anaesthesia were included. Groups gabapentin, alprazolam and placebo, received oral gabapentin 600 mg, alprazolam 0.5 mg and one capsule of oral B-complex forte with Vitamin C respectively, on the night prior to surgery and 2 h prior to surgery. Visual analogue scale (VAS) was used to measure the anxiety and post-operative pain. All patients received patient-controlled analgesia. Statistical tests used were Kruskal-Wallis test, Wilcoxon signed rank test and one-way ANOVA. Results: Alprazolam provided significant anxiolysis (median [interquartile range] baseline VAS score 35 [15.5, 52] to 20 [6.5, 34.5] after drug administration; P = 0.007). Gabapentin did not provide significant decrease in anxiety (median [interquartile range] VAS score 21 [7.5, 41] to 20 [6.5, 34.5]; P = 0.782). First analgesic request time (median [interquartile range in minutes]) was longer in group gabapentin (17.5 [10, 41.25]) compared to group placebo (10 [5, 15]) (P = 0.019) but comparable to that in group alprazolam (15 [10, 30]). Cumulative morphine consumption at different time periods and total morphine consumption (mean [standard deviation]) at the end of study period (38.65 [18.04], 39.91 [15.73], 44.29 [16.02] mg in group gabapentin, alprazolam and placebo respectively) were comparable. Conclusion: Gabapentin 600 mg does not have significant anxiolytic effect compared to alprazolam 0.5 mg. Alprazolam 0.5 mg was found to be an effective anxiolytic in the pre-operative period. Neither alprazolam nor gabapentin, when compared to placebo showed any opioid sparing effects post-operatively.

Background: Novel cardioprotective strategies are required to improve clinical outcomes in higher-risk patients undergoing coronary artery bypass graft (CABG) with or without valve surgery. Remote ischaemic preconditioning (RIPC) in which brief episodes of non-lethal ischaemia and reperfusion are applied to the arm or leg has been demonstrated to reduce perioperative myocardial injury (PMI) following CABG with or without valve surgery. Objective: To investigate whether or not RIPC can improve clinical outcomes in this setting in the Effect of Remote Ischaemic preconditioning on Clinical outcomes in patients undergoing Coronary Artery bypass graft surgery (ERICCA) study in patients undergoing CABG surgery. Design: Multicentre, double-blind, randomised sham controlled trial. Setting: The study was conducted across 30 cardiothoracic centres in the UK between March 2010 and March 2015. Participants: Eligible patients were higher-risk adult patients (aged > 18 years of age; additive European System for Cardiac Operative Risk of ≥ 5) undergoing on-pump CABG with or without valve surgery with blood cardioplegia. Interventions: Patients were randomised to receive either RIPC (four 5-minute inflations/deflations of a standard blood pressure cuff placed on the upper arm) or the sham control procedure (simulated RIPC protocol) following anaesthetic induction and prior to surgical incision. Anaesthetic management and perioperative care were not standardised. Main outcome measures: The combined primary end point was the rate of major adverse cardiac and cerebral events comprising cardiovascular death, myocardial infarction, coronary revascularisation and stroke within 12 months of randomisation. Secondary end points included perioperative myocardial and acute kidney injury (AKI), intensive care unit and hospital stay, inotrope score, left ventricular ejection fraction, changes in quality of life and exercise tolerance. Results: In total, 1612 patients (sham control group, n = 811; RIPC group, n = 801) were randomised in 30 cardiac surgery centres in the UK. There was no difference in the primary end point at 12 months between the RIPC group and the sham control group (26.5% vs. 27.7%; hazard ratio 0.95, 95% confidence interval 0.79 to 1.15; p = 0.58). Furthermore, there was no evidence for any differences in either adverse events or the secondary end points of PMI (72-hour area under the curve for serum high-sensitivity troponin T), inotrope score, AKI, intensive therapy unit and hospital stay, 6-minute walk test and quality of life. Conclusions: In patients undergoing elective on-pump CABG with or without valve surgery, without standardisation of the anaesthetic regimen, RIPC using transient arm ischaemia–reperfusion did not improve clinical outcomes. It is important that studies continue to investigate the potential mechanisms underlying RIPC, as this may facilitate the translation of this simple, non-invasive, low-cost intervention into patient benefit. The limitations of the study include the lack of standardised pre-/perioperative anaesthesia and medication, the level of missing and incomplete data for some of the secondary end points and the incompleteness of the data for the echocardiography substudy. Trial registration: ClinicalTrials.gov NCT01247545. Funding: This project was funded by the Efficacy and Mechanism Evaluation programme, a MRC and NIHR partnership, and the British Heart Foundation.

Background: The standard recommended insertion technique for LMA Classic™ requires the insertion of index finger into the oral cavity. Several anesthesiologists are reluctant to do this. We conducted this study to evaluate the modified technique of insertion of LMA Classic™ (not requiring insertion of fingers into the patient′s mouth) against the standard index finger insertion technique. Materials and Methods: This prospective, randomized, comparative study was conducted on 200 consenting patients. Patients suitable for anesthetic with LMA Classic™ were randomized to standard technique group (standard insertion technique) and modified technique group (technique not requiring digital intraoral manipulation). Laryngeal mask airway (LMA) was inserted by five designated anesthesiologists. Anesthetic protocol was standardized. Time taken to achieve an effective airway, ease of insertion, glottic view obtained through LMA, and incidence of sore throat were assessed. Results: Patient characteristics and duration of surgery were comparable between the groups. Time to achieve an effective airway was comparable [18.5 (8) s with standard technique and 19.7 (10) s with modified technique; data are mean (standard deviation)]. Ease of insertion (92 easy with standard technique and 91 easy with modified technique), success rate (99% in both the groups), glottic view with fiberoptic bronchoscope, and sore throat incidence (six patients with standard technique and eight patients with modified technique) were comparable. The first attempt success rate was significantly higher with the standard technique (98 patients in the standard technique group and 91 patients in the modified technique group). Conclusions: LMA Classic™ can be inserted successfully without the need to insert index finger into patient′s mouth, though the first attempt success rate is higher with the standard technique.

Two major challenges hinder the advance of aqueous zinc metal batteries for sustainable stationary storage: (1) achieving predominant Zn-ion (de)intercalation at the oxide cathode by suppressing adventitious proton co-intercalation and dissolution, and (2) simultaneously overcoming Zn dendrite growth at the anode that triggers parasitic electrolyte reactions. Here, we reveal the competition between Zn2+ vs proton intercalation chemistry of a typical oxide cathode using ex-situ/operando techniques, and alleviate side reactions by developing a cost-effective and non-flammable hybrid eutectic electrolyte. A fully hydrated Zn2+ solvation structure facilitates fast charge transfer at the solid/electrolyte interface, enabling dendrite-free Zn plating/stripping with a remarkably high average coulombic efficiency of 99.8% at commercially relevant areal capacities of 4 mAh cm-2 and function up to 1600 h at 8 mAh cm-2. By concurrently stabilizing Zn redox at both electrodes, we achieve a new benchmark in Zn-ion battery performance of 4 mAh cm-2 anode-free cells that retain 85% capacity over 100 cycles at 25 °C. Using this eutectic-design electrolyte, Zn | |Iodine full cells are further realized with 86% capacity retention over 2500 cycles. The approach represents a new avenue for long-duration energy storage.

Background and Purpose. In pyogenic brain abscess, hemorrhage in the walls is considered exceptional. Recently, hemorrhagic changes in the walls of pyogenic abscess have been demonstrated on susceptibility weighted imaging with 3T MRI. Here, we report hemorrhagic changes in the walls of pyogenic brain abscess on susceptibility weighted imaging with 1.5T MRI. Method. MRI of brain was done using 1.5T MRI with diffusion weighted sequence, susceptibility weighted sequence, and other standard sequences in 3 consecutive cases of pyogenic brain abscess. Stereotactic biopsy and cultures were obtained in 2 cases. One case was treated empirically with antibiotics. Results. Susceptibility sequence demonstrated hemorrhage in the wall of brain abscess in all three cases. All three cases also demonstrated restricted diffusion on diffusion weighted imaging. Conclusion. Susceptibility weighted imaging can demonstrate hemorrhagic changes in the walls of pyogenic brain abscess on 1.5T MRI. Presence of hemorrhage in the walls of ring enhancing lesions should not automatically lead to a diagnosis of tumor.

Tuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. A 57 years old male presented with swelling over the left wrist since 3 years Three swellings over dorsal aspect of the left wrist Soft in consistency Non tender Non compressible Mobile at right angles to the plane of the wrist joint. ESR: 45 mm in 1 hr and rest blood investigations were normal. Ultrsonography showed giant cell tumor of Extensor Digitorum sheath. X-ray: soft tissue swelling and MRI was suggestive of extensor tendon sheath extraskeletal synovial Koch’s, or giant cell tumor of tendon sheath. Excision of swelling was planned and intraoperatively, rice bodies were seen inside it. Histopathological examination showed caseous necrosis with granuloma formation. Patient was put on DOT1 therapy. Tuberculous tenosynovitis was first described by Acrel in 1777. Rice bodies occurring in joints affected by tuberculosis were first described in 1895 by Reise. Rice bodies will be diagnosed on plain radiographs when mineralization occurs. More than 50% of cases recur within 1 year of treatment. The currently recommended 6-month course is often adequate with extensive curettage lavage and synovectomy should be performed. Surgery is essential, but the extent of surgical debridement is still debatable. The surgeon has to be aware of the significance of loose bodies when performing routine excision of innocuous looking wrist ganglia.