Non-islet cell tumor-induced hypoglycemia (NICTH) secondary to phyllodes tumor is extremely rare but potentially life threatening if not treated promptly. We report a case of a 46-year-old Indian female without underlying diabetes mellitus who presented with a large breast tumor and recurrent severe symptomatic hypoglycemia. Investigations supported the diagnosis of NICTH. The hypoglycemia only resolved after corticosteroids and mastectomy. This case highlights the importance of considering NICTH in the evaluation of patients with voluminous tumor and hypoglycemia.
The objectives of this study are to compare the performance of newly developed baffled and conventional horizontal subsurface-flow (HSF) constructed wetlands in the removal of nitrogen at the hydraulic retention times (HRT) of 2, 3 and 5 days and to evaluate the potential of rice husk as wetland media for wastewater treatment. The results show that the planted baffled unit achieved 74%, 84% and 99% ammonia nitrogen (NH(4)(+)-N) removal versus 55%, 70% and 96% for the conventional unit at HRT of 2, 3 and 5 days, respectively. The better performance of the baffled unit was explained by the longer pathway due to the up-flow and down-flow conditions sequentially thus allowing more contact of the wastewater with the rhizomes and micro-aerobic zones. Near complete total oxidized nitrogen was observed due to the use of rice husk as wetland media which provided the COD as the electron donor in the denitrification process.
This study aims to compare the performance of planted and unplanted constructed wetlands with gravel- and raw rice husk-based media for phenol and nitrogen removal. Four laboratory-scale horizontal subsurface-flow constructed wetland units, two of which planted with cattail (Typha latifolia) were operated outdoors. The units were operated at a nominal hydraulic retention time of 7 days and fed with domestic wastewater spiked with phenol concentration at 300 mg/L for 74 days and then at 500 mg/L for 198 days. The results show that planted wetland units performed better than the unplanted ones in the removal and mineralization of phenol. This was explained by the creation of more micro-aerobic zones in the root zone of the wetland plants which allow a faster rate of phenol biodegradation, and the phenol uptake by plants. The better performance of the rice husk-based planted wetland compared to that of the gravel-based planted wetland in phenol removal could be explained by the observation that more rhizomes were established in the rice husk-based wetland unit thus creating more micro-aerobic zones for phenol degradation. The role of rice husk as an adsorbent in phenol removal was considered not of importance.
Thyrotoxicosis is a well-recognized cause of myopathy, but rarely presents as acute flaccid quadriparesis. We report a 25-year-old female with underlying uncontrolled Graves' disease who presented with thyroid storm and acute flaccid quadriparesis due to thyrotoxic myopathy. She showed marked clinical improvement with subsequent normalization of her thyroid parameters. Besides highlighting this rare association, this report underscores the importance of considering thyrotoxic myopathy in the evaluation of patients with acute flaccid quadriparesis.
Horizontal subsurface-flow (HSF) constructed wetland incorporating baffles was developed to facilitate upflow and downflow conditions so that the treatment of pollutants could be achieved under multiple aerobic, anoxic and anaerobic conditions sequentially in the same wetland bed. The performances of the baffled and conventional HSF constructed wetlands, planted and unplanted, in the removal of azo dye Acid Orange 7 (AO7) were compared at the hydraulic retention times (HRT) of 5, 3 and 2 days when treating domestic wastewater spiked with AO7 concentration of 300 mg/L. The planted baffled unit was found to achieve 100%, 83% and 69% AO7 removal against 73%, 46% and 30% for the conventional unit at HRT of 5, 3 and 2 days, respectively. Longer flow path provided by baffled wetland units allowed more contact of the wastewater with the rhizomes, microbes and micro-aerobic zones resulting in relatively higher oxidation reduction potential (ORP) and enhanced performance as kinetic studies revealed faster AO7 biodegradation rate under aerobic condition. In addition, complete mineralization of AO7 was achieved in planted baffled wetland unit due to the availability of a combination of aerobic, anoxic and anaerobic conditions.
Acceptability rates of human papillomavirus (HPV) vaccination by 362 Malaysian mothers were 65.7% and 55.8% for daughters and sons, respectively. Younger mothers, and those who knew someone with cancer, were more willing to vaccinate their daughters. If the vaccine was routine and cost free, acceptability rate was 97.8%.