Hemophagocytic lymphohistiocytosis: An unusual presentation of tuberculosis in hemodialysis patients

We report a series of three patients with end‐stage renal disease on maintenance hemodialysis presenting with hemophagocytic lymphohistiocytosis (HLH) as an unusual manifestation of extrapulmonary tuberculosis. All three patients were middle‐aged men. They presented with fever, pancytopenia, varying degrees of hepatosplenomegaly, abnormal liver function tests, coagulopathy, increased serum ferritin, and triglycerides. Tests for fever work‐up were negative. Bone marrow examination revealed hemophagocytosis and caseating granuloma. Acid fast bacilli were demonstrated in two patients. The HLH‐2004 diagnostic criteria suggested by the histiocytic society were followed to arrive at the diagnosis. All of them succumbed to death even before the definitive diagnosis could be made. We suggest that aggressive diagnostic work‐up must be done when hemodialysis patients present with fever and pancytopenia. Priority should be toward early diagnosis and appropriate treatment to improve the prognosis.     

Effect of La2O3 addition and sintering mode on the mechanical properties and microstructural evolution on an 8YSZ ceramic alloy

In this research, the influence of La₂O₃ addition on the microstructure, phase stability and mechanical properties of 8?mol% yttria stabilized zirconia (8YSZ) was studied. 8YSZ with La₂O₃ (9, 12 and 15?wt%) ceramics were fabricated by microwave and conventional sintering at 1400?°C/ 20?min and 1400?°C/ 5?h, respectively. Irrespective of the sintering technique, the relative sintered density was found to decrease with increasing amount of La₂O₃. The grain growth of 8YSZ was enhanced significantly by the addition of La₂O₃. The XRD results demonstrated that addition of La₂O₃ up to 15?wt% did not disrupt the cubic 8YSZ phase regardless of sintering technique; additionally evolution of pyrochlore phase, La₂Zr₂O₇ was observed in all sintered specimens. Vickers hardness of 8YSZ ceramic compacts were also found to decrease with increasing amount of La₂O₃.     

The effects of thermal radiation on unsteady MHD free convective flow through the porous medium between two vertical plates with Hall effects

The effects of thermal radiation and Hall current on magnetohydrodynamic free convection three-dimensional flow in a vertical channel filled with a porous medium have been studied. We consider an incompressible viscous and electrically conducting incompressible viscous fluid in a parallel plate channel bounded by a loosely packed porous medium. The fluid is driven by a uniform pressure gradient parallel to the channel plates, and the entire flow field is subjected to a uniform inclined magnetic field of strength inclined at an angle of inclination $\alpha$ with the normal to the boundaries in the transverse xy-plane. The temperature of one of the plates varies periodically, and the temperature difference between the plates is high enough to induce radiative heat transfer. The effects of various parameters on the velocity profiles, the skin friction, the temperature field, and the rate of heat transfer in terms of their amplitude and phase angles are shown graphically.