Low-cost Mn- and Li-rich layered oxides suffer from rapid voltage decay, which can be improved by increasing the nickel content to derive high nickel Li-rich layered oxides (HNLO) but is normally accompanied by reduced capacity and inferior cycling stability. Herein, Na or K ions are successfully doped into the lattice of high nickel Li-rich Li1.2-xMxNi0.32Mn0.48O2 (M = Na, K) layered oxides via a facile expanded graphite template-sacrificed approach. Both Na- and K-doped samples exhibit excellent rate capability and cycling stability compared with the un-doped one. The Na-doped sample shows a capacity retention of 93% after 200 cycles at 1C, which is quite outstanding for HNLO. The greatly improved electrochemical performances are attributed to the increased effective Li content in the lattice via Li antievaporation-loss engineering, the expanded Li slab, the pillaring effect, the increased C2/m component, and the improved electronic conductivity. Different performances by the introduction of sodium and potassium ions may be ascribed to their different ionic radii, which give rise to their different doping behaviors and threshold doping amounts. This work provides a new idea of enhancing electrochemical performance of HNLO by doping proper alien elements to increase the lattice lithium content effectively.Graphitic carbon nitride (g-C3N4) is known to photogenerate hydrogen peroxide in the presence of hole quenchers in aqueous environments. Here, the g-C3N4 photocatalyst is embedded into a host polymer of intrinsic microporosity (PIM-1) to provide recoverable heterogenized photocatalysts without loss of activity. Different types of g-C3N4 (including Pt@g-C3N4, Pd@g-C3N4, and Au@g-C3N4) and different quenchers are investigated. Exploratory experiments yield data that suggest binding of the quencher either (i) directly by adsorption onto the g-C3N4 (as shown for α-glucose) or (ii) indirectly by absorption into the microporous polymer host environment (as shown for Triton X-100) enhances the overall photochemical H2O2 production process. The amphiphilic molecule Triton X-100 is shown to interact only weakly with g-C3N4 but strongly with PIM-1, resulting in accumulation and enhanced H2O2 production due to the microporous polymer host.IGSF1 deficiency is a rare X-linked condition characterized by central hypothyroidism (CeH) and a wide variety of other clinical features with variable prevalence, including a delayed pubertal testosterone rise and growth spurt in contrast to normal or accelerated testicular growth, and adult macroorchidism with relatively low serum testosterone concentrations. Other features include increased waist circumference, attention deficit, prolactin deficiency and transient partial growth hormone (GH) deficiency in childhood in contrast to an increased GH secretion in adulthood. Patients with this disorder are not detected if neonatal screening programs are based on thyroid-stimulating hormone (TSH) concentrations. A 13.2-year-old male patient was referred to the pediatric endocrinology clinic for evaluation of short stature. He was born large for gestational age into a nonconsanguineous family. During work-up for short stature, deficiencies of TSH, prolactin and GH were detected, leading to treatment with levothyroxine and GH. At 16.9 years, GH treatment was stopped and during transition to adult care, his IGF-I level was above the normal range. This prompted an analysis of IGSF1, in which a novel hemizygous variant causing a stop codon at c.3559C>T (p.Q1187*) was found, confirming the diagnosis of the IGSF1 deficiency syndrome. In this report, we describe his clinical and hormonal characteristics at presentation and during long-term follow-up.Hypoglycemia presents with a spectrum of neurological manifestations ranging from lightheadedness to confusion and coma. We report here the case of a 61-year-old woman with right hemiparesis presenting within the window period for stroke thrombolysis. MRI brain showed diffusion restriction in posterior limb of left internal capsule and splenium. Patient had documented hypoglycemia of 38 mg/dL. Patient’s hemiparesis resolved after glucose correction, and radiological findings completely resolved after 10 days. We present this case to highlight the rare radiological finding of simultaneous internal capsule and splenium involvement in hypoglycemic hemiparesis and the importance to rule out stroke mimics to avoid unwanted thrombolysis.Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, idiosyncratic reaction to a drug which presents after a prolonged latency period. Although it most commonly occurs with aromatic anticonvulsants, antibiotics are also occasionally implicated. A 50-year-old male was admitted for left pyopneumothorax. He was started on intravenous piperacillin-tazobactam (Pip/Taz) and clindamycin. After 10 days of treatment, he developed high grade fever with maculopapular rashes with areas of scaling. He had elevated WBC counts with eosinophils of 21% and raised serum transaminases. After excluding other possible etiologies for febrile illness, a possibility of DRESS was considered. Naranjo scale, used for causality assessment, yielded a total score of 6, pointing toward probable adverse drug reaction. Also, the patient had 6 out of the 7 inclusion criteria for DRESS as per European Registry of Severe Cutaneous Adverse Reaction (RegiScar) scoring. Pip/Taz was found to be causative drug and was discontinued. He was conservatively managed with antipyretics and topical steroids. Fever subsided the day after stopping Pip/Taz and his rashes resolved gradually. In conclusion the possibility of antibiotics-induced DRESS should be considered and high index of vigilance is advised.

No Cochrane meta-analysis with grading of evidence is available on use of hydroxychloroquine (HCQ) in type-2 diabetes (T2DM). This meta-analysis evaluated the efficacy and safety of HCQ in T2DM.

Electronic databases were searched using a Boolean search strategy ((hydroxychloroquine) OR (chloroquine*)) AND ((diabetes) OR („diabetes mellitus”) OR (glycemia) OR (glucose) OR (insulin)) for studies evaluating hydroxychloroquine for glycemic control in T2DM. The primary outcome was a change in glycated haemoglobin (HbA1c). The secondary outcomes were changes in other glycemic/lipid parameters and adverse effects.

Data from 11 randomized controlled trials (RCTs) (3 having placebo as controls [passive controls] and 8 having anti-diabetes medications as controls [active controls]) involving 2,723 patients having a median follow-up of 24 weeks were analyzed. About 54.54% of the RCTs were of poor quality as evaluated by the Jadad scale. The performance bias and detection bias were at high risk in 63.64% of the RCTs. The HbA1c reduction with HCQ was marginally better compared to the active (mean differences [MD]-0.17% [95%, CI-0.30–0.04;P=0.009;I2=89%; very low certainty of evidence, VLCE]), and passive (MD-1.35% [95%CI-2.10–0.59;P=0.005;I2=74%]) controls. A reduction in fasting glucose (MD-16.63mg/dL[95%, CI -25.99 – -7.28mg/dL;P<0.001;I2=97%;VLCE]) and post-prandial glucose [MD -8.41mg/dL (95%CI -14.71 – -2.12mg/dL;P=0.009;I2=87%;VLCE]), appeared better with HCQ compared to active controls. The total adverse events (risk ratio [RR]0.93 [95% CI0.68-1.28]; P=0.65;I2=66%) were not different with HCQ compared to the controls.

The routine use of HCQ in T2DM cannot be recommended based on the current evidence.

The routine use of HCQ in T2DM cannot be recommended based on the current evidence.As global figures for dementia are set to rise significantly, there has been a shift towards using non-pharmacological interventions such as music therapy to enhance the quality of life for people with the condition. Research into music therapy interventions for this patient group in acute mental health inpatient settings, however, is limited. This article describes a service evaluation that explored whether group music therapy was effective for people with dementia in such settings. Open group music therapy sessions were hosted weekly in two acute wards and the researchers examined the social and behavioural outcomes of participants pre and post-intervention. The results indicated that music therapy significantly improved patient outcomes following participation. The outcome measure developed for this service evaluation was found to be a reliable tool for measuring the effectiveness of music therapy on patient outcomes.Pycnodysostosis is a rare disease with very few reported cased all over the world. It was first described in 1963 by Maroteaux and Lamy. It is also known as Toulouse-Lautrec syndrome, after a French artist, Henri de Toulouse Lautrec. The affected gene, CTSK, was first isolated in 1996. It is an autosomal recessive osteochondrodysplasia, characterized by disrupted function of osteoclasts. Incidence of this disease is 1.7 per 1 million births with a male to female ratio of 11 30% cases arise from consanguineous marriages.

The surgical method of removing the complete intact globe while leaving the extraocular muscles and orbital fat behind is called as enucleation. The intention behind this study is to share the experience of autogenous dermis fat graft as an orbital implant following enucleation and its cosmetic outcome. It was a prospective study conducted at the Orbit and Oculoplastic department of LRBT Tertiary Teaching Eye hospital from July 2018 to June 2019.

Eighty-five patients were recruited for this study belonging to either gender with ages ranging from 20 to 50 years. None of the recruited patients had undergone prior enucleation or evisceration. All the patients were informed and counseled about the surgical modus operandi and the expected outcomes and verbal consent was taken from each patient along with approval from the hospital’s ethical review committee before proceeding with the surgery. Every participant underwent primary enucleation followed by autogenous dermis fat graft orbital implant and followed up for duration of up to 3 months after the surgical procedure.

At ninety days after the procedure, 78.2% of patients had a very good cosmetic result.

The placement of autogenous dermis fat graft as an orbital implant following primary enucleation has a good accomplishment rate with excellent cosmetic outcome.

The placement of autogenous dermis fat graft as an orbital implant following primary enucleation has a good accomplishment rate with excellent cosmetic outcome.A 34 years old male, labourer by occupation was brought to our trauma centre in an inebriated state with a history of fall from a height of approximately 10 feet. He complained of pain in the right elbow. A complete examination of the affected upper limb revealed an ipsilateral anterior shoulder dislocation and a posterior elbow dislocation with no other concomitant injuries. Both the dislocations were reduced conservatively and the patient was successfully managed. The patient is absolutely fine now, 6 months post his dislocation and has resumed back to his work. This case has been presented to highlight the rare and unusual nature of the injury, since ipsilateral dislocation of shoulder and elbow occur infrequently.