Intensified degradation of tartrazine dye present in effluent using ultrasound combined with ultraviolet irradiation and oxidants.

Effluent containing tartrazine can affect the environment and human health significantly prompting the current study into degradation using a sonochemical reactor operated individually and combined with advanced oxidation processes. The optimum conditions for ultrasound treatment were established as dye concentration of 10 ppm, pH of 3, temperature as 35 °C, and power as 90 W. The combination approach of H2O2/UV, H2O2/US, and H2O2/UV/US resulted in higher degradation of 25.44%, 57.4%, and 74.36% respectively. Use of ZnO/UV/US approach increased the degradation significantly to 85.31% whereas maximum degradation as 93.11% was obtained for the US/UV/Fenton combination. COD reduction was found maximum as 83.78% for the US/UV/Fenton combination. The kinetic analysis showed that tartrazine dye degradation follows pseudo first-order kinetics for all the studied processes. Combination of Fenton with UV and US was elucidated as the best approach for degradation of tartrazine.

The Sociodemographic Characteristics of Indian Nursing Students and Their Intentions to Migrate Overseas for Work.

India being the second largest nurse exporter to the Organisation for Economic Cooperation and Development (OECD) countries, currently faces a shortage of 2.4 million nurses. The problem of nurse shortage has been aggravated by the COVID pandemic. The young age at which the Indian nurses migrate, suggests that the decision to work overseas is made probably at the time of pursuing the studies or probably one pursues nursing because it opens the opportunity for working overseas. The objective of this study was to assess the intensions of nursing students to pursue overseas career on completion of their studies. The study used a cross-sectional survey design to collect data from 1408 nursing students from across four states of India namely, Karnataka, Kerala, Maharashtra and Rajasthan using a google survey form. The major finding of the study was that 54% of the respondents intended to migrate overseas. Better career advancement opportunities, better working conditions, higher pay, better lifestyle, were the reasons cited by those who had an intension to migrate. Establishing norms for nurse-patient ratios, and scope of work along with pay scales for nurses with various qualifications and experience could be the most strategic moves that the policy makers can consider to control brain drain in nursing and control nurse migration.

68 Ga-PSMA-11 PET/CT and 64 CuCl 2 PET/CT Help in Identifying Rare Metastatic Site of Penile Shaft in a Patient of Carcinoma Prostate.

ABSTRACT: A 71-year-old man, presenting with complaints of burning sensation and pain during urination, finally diagnosed with prostate carcinoma. Ultrasonography of the abdomen and pelvis revealed prostatomegaly. Serum PSA level was elevated, and TRUS-guided biopsy demonstrated acinar adenocarcinoma (Gleason score: 5 + 4 = 9). 68 Ga-PSMA-11 PET/CT for initial staging showed PSMA-avid enlarged prostate, pelvic lymphadenopathy, and focal PSMA uptake in the left side of the shaft of the penis. The patient also underwent a 64 CuCl 2 PET/CT, which demonstrated similar findings of enlarged prostate and adenopathy with focally increased tracer uptake in the shaft of the penis coinciding with the lesion observed on 68 Ga-PSMA-11 PET/CT, thereby detecting a rare metastatic site from carcinoma prostate.

Engineered vitamin E-tethered non-immunogenic facial lipopeptide for developing improved siRNA based combination therapy against metastatic breast cancer.

RNA interference based therapeutic gene silencing is an emerging platform for managing highly metastatic breast cancer. Cytosolic delivery of functional siRNA remains the key obstacle for efficient RNAi therapy. To overcome the challenges of siRNA delivery, we have engineered a vitamin E-tethered, short, optimum protease stabilized facial lipopeptide based non-immunogenic, biocompatible siRNA transporter to facilitate the clinical translation in future. Our designed lipopeptide has an Arginine-Sarcosine-Arginine segment for providing optimum protease-stability, minimizing adjacent arginine-arginine repulsion and reducing intermolecular aggregation and α-tocopherol as the lipidic moiety for facilitating cellular permeabilization. Interestingly, our designed non-immunogenic siRNA transporter has exhibited significantly better long term transfection efficiency than HiPerFect and can transfect hard to transfect primary cell line, HUVEC. Our engineered siRNA therapeutics demonstrated high efficacy in managing metastasis against triple negative breast cancer by disrupting the crosstalk of endothelial cells and MDA-MB-231 and reduced stemness and metastatic markers, as evidenced by downregulating critical oncogenic pathways. Our study aimed at silencing Notch1 signalling to achieve "multi-targeted" therapy with a single putative molecular medicine. We have further developed mechanistically rational combination therapy combining Notch1 silencing with a repurposed drug m-TOR inhibitor, metformin, which demonstrated synergistic interaction and enhanced antitumor efficacy against cancer metastasis.

Safety and clinical outcomes of remdesivir in hospitalised COVID-19 patients: a retrospective analysis of active surveillance database.

BACKGROUND: Real-world data on safety and clinical outcomes of remdesivir in COVID-19 management is scant. We present findings of data analysis conducted for assessing the safety and clinical outcomes of remdesivir treatment for COVID-19 in India. METHODS: This retrospective analysis used data from an active surveillance programme database of hospitalised patients with COVID-19 who were receiving remdesivir. RESULTS: Of the 2329 patients included, 67.40% were men. Diabetes (29.69%) and hypertension (20.33%) were the most common comorbidities. At remdesivir initiation, 2272 (97.55%) patients were receiving oxygen therapy. Remdesivir was administered for 5 days in 65.38% of patients. Antibiotics (64.90%) and steroids (47.90%) were the most common concomitant medications. Remdesivir was overall well tolerated, and total 119 adverse events were reported; most common were nausea and vomiting in 45.40% and increased liver enzymes in 14.28% patients. 84% of patients were cured/improved, 6.77% died and 9.16% showed no improvement in their clinical status at data collection. Subgroup analyses showed that the mortality rate was significantly lower in patients < 60 years old than in those > 60 years old. Amongst patients on oxygen therapy, the cure/improvement rate was significantly higher in those receiving standard low-flow oxygen than in those receiving mechanical ventilation, non-invasive ventilation, or high-flow oxygen. Factors that were associated with higher mortality were age > 60 years, cardiac disease, diabetes high flow oxygen, non-invasive ventilation and mechanical ventilation. CONCLUSION: Our analysis showed that remdesivir is well tolerated and has an acceptable safety profile. The clinical outcome of cure/improvement was 84%, with a higher improvement in patients < 60 years old and on standard low-flow oxygen.

Linking nursing education to practice in India.

Governed by central and state nursing Acts that are dated and disconnected, and numbers below global norms, nursing education and practice function within caste- and gender-based prejudices in India. Nursing education is fragmented and siloed, and nursing practice is delinked from education. The study strategically relooks at the Acts and highlights pathways that can strengthen, sustain, or weaken nursing education and practice, and suggests how nursing education can be linked to practice.

Frequency of Corneal Astigmatism in Patients Presenting for Senile Cataract Surgery at a Teaching Hospital in Indian Rural Population.

PURPOSE: The aim of this study was to assess prevalence of corneal astigmatism before cataract surgery in old age in Indian rural population. DESIGN: Prospective, cross-sectional, and observational study. METHODS: Keratometric values were measured with an auto refractokeratometer in patients presenting for cataract surgery between January 2017 and May 2018. The demographic profiles of patients were recorded. Axial length and intraocular lens power were measured. Data were analyzed in SPSS software. RESULTS: This study included 1000 eyes of 880 patients with a mean age of 65.1 ±â€Š10.12 years. The mean astigmatism was 0.89 ±â€Š0.63 D. A total of 179 eyes (17.9%) had astigmatism between 1.00 and 1.49 D; 34 eyes (3.4%) had astigmatism between 2.00 and 2.5 D; and 20 eyes (2%) had astigmatism >3 D. Overall, 325 eyes (32.5%) had astigmatism >1.00 D. Against the rule astigmatism was seen in 44.6% cases, oblique astigmatism was seen in 32% cases, and with the rule astigmatism was seen in 20.7% cases. Against the rule astigmatism increased with age and reached a maximum between 60 and 69 years. Male eyes had flatter corneal curvature than female eyes. The mean axial length was 25.59 mm, and the mean intraocular lens power was 21.05 ±â€Š1.0D. CONCLUSIONS: We found that 32.5% patients had corneal astigmatism >1 D and may benefit from toric intraocular lenses implantation. The results of this analysis provide normative data for the hospital to plan for correction of corneal astigmatism in patients undergoing cataract surgery.

Metastatic large cell neuroendocrine carcinoma of larynx: Individualizing tumor biology by dual tracer positron emission tomography/computed tomography (68Ga-DOTATATE and 18F-fluorodeoxyglucose) molecular imaging and disease stabilization following 177Lu-DOTATATE peptide receptor radionuclide therapy after initial progression on chemoradiotherapy.

Debate exists on the disease biology and course of primary large cell neuroendocrine carcinoma (LCNEC) of larynx, being classified as a variant of atypical carcinoid by the World Health Organisation-2005 classification, while literature of its aggressive behavior indicating poorly differentiated neuroendocrine carcinoma (akin to pulmonary LCNEC) exists. The utility of dual tracer positron emission tomography/computed tomography (68Ga-DOTATATE and 18F-fluorodeoxyglucose) in deciphering the dynamic tumor biology and feasibility of peptide receptor radionuclide therapy (PRRT) is illustrated in metastatic LCNEC of epiglottis after disease progression following conventional chemoradiotherapy. Relatively, atypical sites of soft-tissue metastases (subcutaneous tissue of arm, scrotal sac, peritoneum, and lamina of thyroid cartilage) and xiphisternum and disease stabilization following 177Lu-DOTATATE PRRT were other noteworthy unique aspects of this report.

Effectiveness of prehemodialysis preparatory program on improving coping among chronic kidney disease patients.

Diagnosis of chronic kidney disease (CKD) and initiation of dialysis treatment is reported to be stressful for patients. It is essential that patients use effective coping strategies to deal with these stressors, since ineffective coping could have several adverse effects on various treatment-related as well as personal aspects of life, thereby lowering the quality of life in these patients. The study used a quasi-experimental design. The study population comprised 100 adult patients with Stage 3 and Stage 4 CKD whose glomerular filtration rate was deteriorating and required to undergo hemodialysis (HD) treatment. Carver's Brief Cope Scale was used to assess coping strategies used. The study was carried out in a tertiary care hospital in Bengaluru, India. Patients in the intervention group received pre-HD preparatory program and those in the control group received standard care. Postassessment for coping strategies used was carried out two weeks after the delivery of intervention. Highly significant statistical differences were observed in the use of certain adaptive coping strategies among the experimental group as compared to the control group after implementation of pre-HD preparatory program. These adaptive coping strategies included self-distraction (P = 0.011), active coping (P = 0.000), planning (P = 0.026), acceptance (P = 0.001), and religion (P = 0.005). The intervention was not found to be significant in reducing use of maladaptive coping strategies (P = 0.095). In India, 61%-66% of patients who present to nephrologists are already in end-stage renal disease. These patients hardly receive any organized education that would prepare them to understand their disease and enable them to manage it to the best of their abilities. An ongoing patient education and counseling program led by trained nurse educator will help patients cope effectively with the diagnosis of CKD and its treatment.

Comparative evaluation of the amount of the residual monomer in conventional and deep-frozen heat cure polymethylmethacrylate acrylic resin: An in vitro study.

STATEMENT OF PROBLEM: Heat cure acrylic resin material with reduced monomer content is generally recommended for clinical usage as it leads to improved mechanical, physical, and biocompatibility properties. AIMS AND OBJECTIVE: The purpose of the present study was to evaluate and compare the amount of the residual monomer in the conventional and three different groups of deep-frozen heat cure polymethylmethacrylate (PMMA) acrylic resin. MATERIALS AND METHODS: Totally 40 Specimens of heat cure PMMA acrylic resin (DPI India) (10 conventional heat cure and 30 deep frozen) were made using two disc-shaped stainless steel molds and invested into type II dental stone using compression molding technique. Each group contained 10 specimens (n = 10). Group 1: Control group of conventional polished PMMA specimen stored in water for 24 h at +37°C (10 specimens), Group 2: Deep frozen unpolished PMMA (10 specimens), Group 3: Deep frozen polished PMMA (10 specimens), and Group 4: Deep frozen polished PMMA specimen stored in water for 24 h at +37°C (10 specimens). Amount of the residual monomer content in all the specimens was measured using high-performance liquid chromatography. Data were analyzed using One-Way Analysis of Variance and multiple comparison Tukey's post hoc test (α = 0.05). RESULTS: Least residual monomer content was found in Group 4 (0.12 wt%) followed by Group 3 (0.19 wt%), Group 2 (0.23 wt%), and Group 1 (0.26 wt%). Statistically significant difference (P < 0.05) was found in residual monomer content for all the four groups tested. Post hoc test for intergroup comparison also showed a significant difference between groups. CONCLUSION: The amount of the residual monomer was found to be least in deep-frozen polished PMMA specimen stored in water for 24 h at +37°C (Group 4). Thus, it can be concluded that deep freezing, polishing, and storing in water can reduce the residual monomer content.

Design and Synthesis of Pyrazole-3-one Derivatives as Hypoglycaemic Agents.

Pyrazole-3-one compounds were designed on the basis of docking studies of previously reported antidiabetic pyrazole compounds. The amino acid residues found during docking studies were used as guidelines for the modification of aromatic substitutions on pyrazole-3-one structure. Depending on the docking score, the designed compounds were selectively prioritized for synthesis. The synthesized compounds were subjected to in vivo hypoglycemic activity using alloxan induced diabetic rats and metformin as a standard. Compound 4 having sulphonamide derivative was found to be the most potent compound among the series.

Pharmacokinetics of colistin in critically ill patients with multidrug-resistant Gram-negative bacilli infection.

PURPOSE: Colistin, which had not been used widely because of nephrotoxicity and neurotoxicity, has gained clinical importance in recent times due to the resurgence of multidrug-resistant Gram-negative bacilli. Very few studies, especially pharmacokinetic studies, have been performed with intravenous colistimethate sodium, and none in India. The aim of our study was to study the single-dose and steady-state pharmacokinetics of colistin in patients with multidrug-resistant Gram-negative bacilli infections. METHOD: This was a prospective open-label pharmacokinetic study done in an intensive care unit in a tertiary care hospital on 15 critically ill patients with proven multidrug-resistant Gram-negative bacilli infection. Colistimethate sodium was injected as intermittent intravenous infusions in accordance with the recommendations on the package insert. For patients weighing ≥ 60 kg with a normal renal function or with a creatinine clearance (CL(CR)) of between 20 and 50 ml/min, the drug was administered at 2 million international units (MIU) every 8 h; for those with a CL(CR) of 10-20 ml/min, the dose was 2 MIU every 12 h. Those patients who weighed <60 kg were administered 50,000 IU/kg/day in three divided doses at 8-h intervals. Both single-dose and steady-state pharmacokinetics of colistin were determined and correlated with clinical outcomes. RESULTS: A wide inter-individual variation was observed in pharmacokinetic parameters. The median (range) of the maximum plasma drug concentration/minimum inhibitory concentration (C(max)/MIC) ratio for Acinetobacter spp. was 13.4 (1.3-40.3) following the administration of a single dose of colistimethate sodium and 26.3 (0.9-64.9) at steady-state. For Pseudomonas spp., these values were 3.18 (1.6-23.1) following the single dose and 3.82 (2.3-10.9) at steady-state. For those patients whose cultures grew Acinetobacter spp., an optimum value of the C(max)/MIC ratio of >8 was achieved in seven of nine patients after the single dose and in seven of eight patients at steady-state. For those patients whose cultures grew Pseudomonas spp, only one patient after the single dose and one patient at steady-state achieved a C(max)/MIC ratio of >8. A significant association was noted between dose and survival, and a trend was observed with patients weighing ≤ 60 kg (who received 50,000 IU/kg/day instead of 6 MIU/day for those >60 kg) having an increased mortality. CONCLUSION: The pharmacokinetic parameters of colistin were comparable to those reported in previous studies in critically ill patients. However, the recommended dose may be inadequate to maintain the C(max)/MIC ratio to an optimal level-at least in patients infected with Pseudomonas spp. The dose recommendation should be based only on creatinine clearance and not body weight.