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Background: Severe dengue causes more than 22,000 deaths annually worldwide. Complicated dengue has high mortality of 44-72%. Disordered immune system with capillary leak and thrombocytopenia are hallmark of complicated dengue. Intravenous immunoglobulin (IV Ig) therapy has shown to be effective in complicated dengue in pediatric age group with refractory shock, but studies in adults are lacking. Its immunoresuscitative role is not yet fully explored in critically ill patients with severe dengue. Methods: This is retrospective observational study of patients with complicated dengue fever who were administered IV Ig therapy in a tertiary care hospital of southern India from 01 Jan 2018 to 31 Dec 2019. Results: A total of 999 patients with dengue were admitted; 754 (75.47%) were males, and 245 (24.53%) were females. A total of 402 (40.24%) patients presented with warning signs. Bleeding was seen in 121 patients (12.11%); 102 (10.21%) had shock; 29 (2.90%) had acute kidney injury and 24 (2.40%) had adult respiratory distress syndrome. Overall, four people died (mortality rate: 0.40%). IV Ig in the dose of 0.4 g/kg for 5 days was used in 13 critically ill patients where standard therapy failed, 9 patients with refractory shock (which included three with myocarditis with refractory shock), 2 with encephalitis, 2 in hemophagocytic lymphohistiocytosis. Two patients died, one with myocarditis with refractory shock and another with refractory shock. Conclusion: IV Ig therapy in critically ill patients with complicated dengue can be used as a rescue therapy.

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Pleuropulmonary mucormycosis is relatively rare disease and that too localised disease is very rare but has got better prognosis. Maintaining a high level of suspicion is important in right clinical setting with pleuropulmonary involvement that fails to antibacterial agent either clinically or radiologically.

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We have carried out an extensive investigation into the effect of doping on both the A- and B-sites for the multiferroic La(0.5)Bi(0.5)Mn(0.5)Fe(0.5)O(3) in relation to its physical properties. The temperature dependent magnetization and dielectric response are determined for different percentages of Bi- and Fe-substitutions. For La(0.5)Bi(0.5)Mn(0.7)Fe(0.3)O(3), there is a prominent ferromagnetic transition T(C) around 110 K, whereas the other La(0.5)Bi(0.5)Mn(0.3)Fe(0.7)O(3) and La(0.3)Bi(0.7)Mn(0.3)Fe(0.7)O(3) phases fail to exhibit any clear transition. On the other hand, for the Fe-rich phases, the coercive field increases to 2450 Oe compared to 1720 Oe (for the Mn-rich phase). All the compositions exhibit coexistence of ferromagnetic and antiferromagnetic phases at low temperatures. The temperature dependent dielectric constant of the investigated samples varies from 32,000 to 500 at room temperature and the data has been analyzed using the universal dielectric response model.

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This study concerns the utilization of waste steel-making slag, a by-product that contains mainly CaO, Fe(2)O(3) and SiO(2). The as-received slag was ground and thermally activated by temperature treatment from 110 to 1000 degrees C for 24 h. Although the as-received slag was amorphous, it became partially crystallized during grinding. These crystalline phases were larnite and iron oxide but other crystalline phases also appeared in addition to larnite after calcination. The uptake of Ni(2+), PO(4)(3-) and NH(4)(+) by the samples was investigated from solutions with initial concentrations of 10 mmol/l. The sample calcined at 800 degrees C showed the highest Ni(2+) uptake (4.85 mmol/g) whereas the highest simultaneous uptake of PO(4)(3-) (2.75 mmol/g) and NH(4)(+) (0.25 mmol/g) was achieved by calcining the material at 700 degrees C. The principal mechanism of Ni(2+) uptake is thought to involve replacement of Ca(2+) by Ni(2+). The mechanism of PO(4)(3-) uptake is mainly by formation of calcium phosphate while that of NH(4)(+) involves sorption by the porous silica surface of the samples.

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A pharmacokinetic study of demeclocycline was carried out following intravenous administration at 5 mg/kg body weight in lactating goats. Demeclocycline appeared within 5 min in plasma, interstitial fluid (isf) and urine, while it appeared at 1 h in milk. Peak concentrations of 21.70 +/- 4.06, 2.67 +/- 0.23, 5.65 +/- 0.45 and 82.23 +/- 10.06 micrograms/ml were attained at 5 min and at 6, 8 and 8 h in plasma, isf, milk and urine respectively. A potentially therapeutic concentration of greater than or equal to 0.5 micrograms/ml was maintained from 5 min-36 h, 30 min-30 h, 1-36 h and 5 min-48 h in plasma, isf, milk and urine respectively. The drug was detectable in all the above biological fluids for at least 48 h. A low distribution half life (t1/2 alpha) of 0.44 +/- 0.04 h and a high elimination half life (t1/2 beta) of 19.24 +/- 1.22 h denote rapid distribution but very slow elimination of the drug in goats. A high tissue plasma concentration ratio [K12:(K21-beta)] of 5.12 +/- 0.97 during the elimination phase and a Vdarea of 1.59 +/- 0.18 L/kg indicate uniform distribution of demeclocycline in the tissues and body fluids of goats. The dosage regimen for maintaining minimum plasma concentration (Cp infinity min = MIC) of 0.5, 1.0 and 1.5 micrograms/ml at selected dosage intervals of 12 and 24 h was also calculated.

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A pharmacokinetic study of doxycycline after intravenous administration at 5 mg/kg body weight in goats revealed that a concentration of greater than or equal to 0.5 microgram/ml was maintained for 5 min-2 h, 4-12 h, 2-12 h and 5 min-greater than 48 h in plasma, interstitial fluid, milk and urine respectively. The low t1/2 alpha of 0.73 +/- 0.11 h and high t1/2 beta of 16.63 +/- 1.58 h show that the drug is rapidly distributed but slowly eliminated from the body. The tissue:plasma concentration of 4.86 +/- 1.06 during the elimination phase [K12/(K21-beta)] indicates a high expected tissue concentration, which is supported by similarly increased drug concentration in interstitial fluid and milk. The high Vdarea of 9.78 +/- 0.86 L/kg observed denotes that, apart from its wide distribution, the drug may be stored in fat depots as it is known to be highly lipophilic. As the drug maintained a therapeutic concentration for a shorter time in plasma, and the calculated dose rate for maintaining a minimal plasma concentration of 0.5-1.5 micrograms/ml is relatively high, it may not be of much use in treating septicaemia in this species. Since the observed tissue:plasma concentration was higher and a therapeutic concentration was maintained in interstitial fluid and milk for longer, the drug can be used for other systemic infections at a lower dose rate than that required for treating septicaemia. As the drug maintained a very high concentration in urine, it may be of particular value in treating urinary tract infections caused by sensitive micro-organisms.

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A single dose kinetics of isoniazid and rifampicin alone, and combination was studied in well-nourished and malnourished patients of tuberculosis. The elimination half-life of isoniazid was significantly increased when administered in combination with rifampicin in well-nourished and malnourished patients, while no significant difference was observed in any of the pharmacokinetic parameters of rifampicin in combination with isoniazid or alone in both groups of patients. Results are discussed on the basis of pharmacokinetic drug interaction.

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Magnesium is a most important cation in the body mostly distributed in the skeleton, muscles and liver. The most important causes of magnesium deficiency in the body include wide range of gastrointestinal disorders, diuretic therapy, endocrine disorders, renal diseases, alcoholism, etc. The demonstration of hypomagnesemia in patients of digitalis toxicity is of great clinical significance since magnesium can be replaced among these patients and toxicity and mortality due to this drug can be minimised. In patients with low serum magnesium, the cellular content of this ion may be normal. Therefore, it is of great interest to study the myocardial level of this ion in cardiovascular diseases. The clinical features of magnesium deficit are related to neuromuscular disorders. However, ST and T waves changes are quite commonly seen in the electrocardiogram and cardiac arrhythmias rarely have also been described. Magnesium administration on the other hand causes hypotention, bradycardia, and conduction defects. Magnesium depresses central nervous system, neuromuscular transmission and conductivity of the heart. Magnesium therapy is indicated when clinical features of magnesium deficiency are present in association with low serum or tissue levels.

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