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A high-fidelity synthetic diagnostic has been developed for the ITER core x-ray crystal spectrometer diagnostic based on x-ray ray tracing. This synthetic diagnostic has been used to model expected performance of the diagnostic, to aid in diagnostic design, and to develop engineering tolerances. The synthetic model is based on x-ray ray tracing using the recently developed xicsrt ray tracing code and includes a fully three-dimensional representation of the diagnostic based on the computer aided design. The modeled components are: plasma geometry and emission profiles, highly oriented pyrolytic graphite pre-reflectors, spherically bent crystals, and pixelated x-ray detectors. Plasma emission profiles have been calculated for Xe44+, Xe47+, and Xe51+, based on an ITER operational scenario available through the Integrated Modelling & Analysis Suite database, and modeled within the ray tracing code as a volumetric x-ray source; the shape of the plasma source is determined by equilibrium geometry and an appropriate wavelength distribution to match the expected ion temperature profile. All individual components of the x-ray optical system have been modeled with high-fidelity producing a synthetic detector image that is expected to closely match what will be seen in the final as-built system. Particular care is taken to maintain preservation of photon statistics throughout the ray tracing allowing for quantitative estimates of diagnostic performance.
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Monitoring mosquito host choice to identify high-risk groups for different vector-borne diseases is important to devise vector control strategies and disease management. The present study was conducted to develop and validate a PCR-based method to identify human sex in blood-fed Aedes aegypti mosquitoes. Several human genes present in both the X and Y chromosomes were screened and diagnostic PCR primers were successfully designed and amplified for the human STS gene. The limit of detection of this PCR assay was carried out on Ae. aegypti fed with human blood up to 5 days (120 hours) post blood-meal under laboratory condition. The efficiency of this PCR assay was evaluated in field-collected Ae. aegypti mosquitoes and compared with other existing methods. The developed PCR primers can successfully amplify and distinguish human sex in mosquitoes up to 72 hours after a blood meal, with an amplified product of 627bp and 298bp for male (XY) and 627bp for female (XX) blood-fed mosquitoes. Further, validation of this assay in field-collected Ae. aegypti mosquitoes revealed that this assay could detect human sex in mosquito blood meal substantially more efficiently (c2 = 4.5, p = 0.034) than other PCR based assay. The newly developed PCR assay highly specific to human DNA and can distinguish male and female DNA for up to 72 hours. This assay can be is used for identifying highrisk groups and extended to other medically important hematophagous insects to assess their role in disease transmission and epidemic preparedness.
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Aedes , Reacción en Cadena de la Polimerasa , Animales , Aedes/genética , Femenino , Masculino , Humanos , Reacción en Cadena de la Polimerasa/métodos , Conducta Alimentaria , Mosquitos Vectores/genética , SangreRESUMEN
Purpose: Errors in the identification of true patients in a health-care facility may result in the wrong dose or dosage being given to the wrong patient at the wrong site during radiotherapy sessions, radiopharmaceutical administration, radiological scans, etc. The aim of this article is to reduce the error in the identification of correct patients by implementation of the Python deep learning-based real-time patient identification program. Materials and Methods: The authors utilized and installed Anaconda Prompt (miniconda 3), Python (version 3.9.12), and Visual Studio Code (version 1.71.0) for the design of the patient identification program. In the field of view, the area of interest is merely face detection. The overall performance of the developed program is accomplished over three steps, namely image data collection, data transfer, and data analysis, respectively. The patient identification tool was developed using the OpenCV library for face recognition. Results: This program provides real-time patient identification information, together with the other preset parameters such as disease site, with a precision of 0.92%, recall rate of 0.80%, and specificity of 0.90%. Furthermore, the accuracy of the program was found to be 0.84%. The output of the in-house developed program as "Unknown" is provided if a patient's relative or an unknown person is found in restricted region. Interpretation and Conclusions: This Python-based program is beneficial for confirming the patient's identity, without manual interventions, just before therapy, administering medications, and starting other medical procedures, among other things, to prevent unintended medical and health-related complications that may arise as a result of misidentification.
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Chronic kidney disease (CKD) is a major contributor to morbidity and mortality in India. CKD often coexists with heart failure (HF), diabetes, and hypertension. All these comorbidities are risk factors for renal impairment. HF and CKD are pathophysiologically intertwined, and the deterioration of one can worsen the prognosis of the other. There is a need for safe renal pharmacological therapies that target both CKD and HF and are also useful in hypertension and diabetes. Neurohormonal activation achieved through the activation of the sympathetic nervous system (SNS), the renin-angiotensin-aldosterone system (RAAS), and the natriuretic peptide system (NPS) is fundamental in the pathogenesis and progression of CKD and HF. Angiotensin receptor neprilysin inhibitor (ARNi), sodium-glucose cotransporter 2 inhibitors (SGLT-2i), and selective ß1-blocker (B1B) bisoprolol suppress this neurohormonal activation. They also have many other cardiorenal benefits across a wide range of CKD patients with or without concomitant HF, diabetes, or hypertension. This consensus statement from India explores the place of ARNi, SGLT-2i, and bisoprolol in the management of CKD patients with or without HF and other comorbidities.
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Antagonistas de Receptores de Angiotensina , Bisoprolol , Insuficiencia Renal Crónica , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Humanos , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/tratamiento farmacológico , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , India/epidemiología , Bisoprolol/uso terapéutico , Antagonistas de Receptores de Angiotensina/uso terapéutico , Consenso , Antagonistas de Receptores Adrenérgicos beta 1/uso terapéuticoRESUMEN
The rapidly increasing burden of hypertension is responsible for premature deaths from cardiovascular disease (CVD), renal disease, and stroke, with a tremendous public health and financial burden. Hypertension detection, treatment, and control vary worldwide; it is still low, particularly in low- and middle-income countries (LMICs). High blood pressure (BP) and CVD risk have a strong, linear, and independent association. They contribute to alarming numbers of all-cause and CVD deaths. A major culprit for increased hypertension is sympathetic activity, and further complications of hypertension are heart failure, ischemic heart disease (IHD), stroke, and renal failure. Now, antihypertensive interventions have emerged as a global public health priority to reduce BP-related morbidity and mortality. Calcium channel blockers (CCB) are highly effective vasodilators. and the most common drugs used for managing hypertension and CVD. Cilnidipine, with both L- and N-type calcium channel blocking activity, is a promising 4th generation CCB. It causes vasodilation via L-type calcium channel blockade and inhibits the sympathetic nervous system (SNS) via N-type calcium channel blockade. Cilnidipine, which acts as a dual L/N-type CCB, is linked to a reduced occurrence of pedal edema compared to amlodipine, which solely blocks L-type calcium channels. The antihypertensive properties of cilnidipine are very substantial, with low BP variability and long-acting properties. It is beneficial for hypertensive patients to deal with morning hypertension and for patients with abnormal nocturnal BP due to exaggerated sympathetic nerve activation. Besides its BP-lowering effect, it also exhibits organ protection via sympathetic nerve inhibition and renin-angiotensin-aldosterone system inhibition; it controls heart rate and proteinuria. Reno-protective, neuroprotective, and cardioprotective effects of cilnidipine have been well-documented and demonstrated.
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Bloqueadores de los Canales de Calcio , Dihidropiridinas , Hipertensión , Humanos , Hipertensión/tratamiento farmacológico , Bloqueadores de los Canales de Calcio/uso terapéutico , Dihidropiridinas/uso terapéutico , India/epidemiología , Antihipertensivos/uso terapéutico , Consenso , ComorbilidadRESUMEN
Heart failure (HF) is a global health concern that is prevalent in India as well. HF is reported at a younger age in Indian patients with comorbidity of type 2 diabetes (T2DM) in approximately 50% of patients. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), originally approved for T2DM, are new guideline-recommended and approved treatment strategies for HF. Extensive evidence highlights that SGLT2i exhibits profound cardiovascular (CV) benefits beyond glycemic control. SGLT2i, in conjunction with other guideline-directed medical therapies (GMDT), has additive effects in improving heart function and reducing adverse HF outcomes. The benefits of SGLT2i are across a spectrum of patients, with and without diabetes, suggesting their potential place in broader HF populations irrespective of ejection fraction (EF). This consensus builds on the updated evidence of the efficacy and safety of SGLT2i in HF and recommends its place in therapy with a focus on Indian patients with HF.
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Diabetes Mellitus Tipo 2 , Insuficiencia Cardíaca , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Humanos , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , Insuficiencia Cardíaca/tratamiento farmacológico , India , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/complicacionesRESUMEN
Bacteria commonly adhere to surfaces and produce polymeric material to encase the attached cells to form communities called biofilms. Within these biofilms, bacteria can appear to be many times more resistant to antibiotics or disinfectants. This systematic review explores the prevalence and microbial profile associated with biofilm production of bacteria isolated from endotracheal tubes and its associations with antimicrobial resistance. A comprehensive search was performed on databases PubMed, Embase, and Google Scholar for relevant articles published between 1st January 2000 and 31st December 2022. The relevant articles were exported to Mendeley Desktop 1.19.8 and screened by title and abstract, followed by full text screening based on the eligibility criteria of the study. Quality assessment of the studies was performed using the Newcastle-Ottawa Scale (NOS) customized for cross-sectional studies. Furthermore, the prevalence of antimicrobial resistance in biofilm-producers isolated from endotracheal tube specimens was investigated. Twenty studies encompassing 981 endotracheal tubes met the eligibility criteria. Pseudomonas spp. and Acinetobacter spp. were predominant isolates among the biofilm producers. These biofilms provided strong resistance against commonly used antibiotics. The highest resistance rate observed in Pseudomonas spp. was against fluoroquinolones whereas the least resistance was seen against piperacillin-tazobactam. A similar trend of susceptibility was observed in Acinetobacter spp. with a very high resistance rate against fluoroquinolones, third-generation cephalosporins and carbapenems. In conclusion, endotracheal tubes were associated with colonization by biofilm forming bacteria with varying levels of antimicrobial resistance. Biofilms may promote the occurrence of recalcitrant infections in endotracheal tubes which need to be managed with appropriate protocols and antimicrobial stewardship. Research focus should shift towards meticulous exploration of biofilm-associated infections to improve detection and management.
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Biopelículas , Farmacorresistencia Bacteriana , Intubación Intratraqueal , Biopelículas/efectos de los fármacos , Biopelículas/crecimiento & desarrollo , Humanos , Antibacterianos/farmacología , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Bacterias/clasificaciónRESUMEN
We describe an optical method to directly measure the position-dependent thermal diffusivity of reflective single crystal samples across a broad range of temperatures for condensed matter physics research. Two laser beams are used, one as a source to locally modulate the sample temperature, and the other as a probe of sample reflectivity, which is a function of the modulated temperature. Thermal diffusivity is obtained from the phase delay between source and probe signals. We combine this technique with a microscope setup in an optical cryostat, in which the sample is placed on a three-axis piezo-stage, allowing for spatially resolved measurements. Furthermore, we demonstrate experimentally and mathematically that isotropic in-plane diffusivity can be obtained when overlapping the two laser beams instead of separating them in the traditional way, which further enhances the spatial resolution to a micron scale, especially valuable when studying inhomogeneous or multidomain samples. We discuss in detail the experimental conditions under which this technique is valuable and demonstrate its performance on two stoichiometric bilayer ruthenates: Sr3Ru2O7 and Ca3Ru2O7. The spatial resolution allowed us to study the diffusivity in single domains of the latter, and we uncovered a temperature-dependent in-plane diffusivity anisotropy. Finally, we used the enhanced spatial resolution enabled by overlapping the two beams to measure the temperature-dependent diffusivity of Ti-doped Ca3Ru2O7, which exhibits a metal-insulator transition. We observed large variations of transition temperature over the same sample, originating from doping inhomogeneity and pointing to the power of spatially resolved techniques in accessing inherent properties.
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Parkinson's Disease in Mild Cognitive Impairment (PD-MCI) is a complex condition characterized by a variety of cognitive problems that coexist with the physical symptoms of Parkinson's disease (PD). This study aims to examine the different medical indicators and associated tendencies among different PD-MCI groups. We investigated 132 people who had been given PD-MCI diagnoses. Utilizing SPSS, statistical evaluations are carried out. In overall PD-MCI variants, this investigation found that visuospatial ability and attentional/executive performance are the most impaired cognitive areas. It was also noticed that distinct PD-MCI groups had variances in their neurological characteristics, in multi domain amnesia (Non-Memory) PD-MCI patients exhibiting especially severe issues with unstable posture and walking. The intricacy of PD- Mild Cognitive Impairment (MCI) is highlighted by those results, which also imply that the interplay between mental and physical signs may be controlled by a number of interrelated factors, such as particular cognitive areas, brain surfaces, and the general level of cognitive impairment.
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Disfunción Cognitiva , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/epidemiología , Enfermedad de Parkinson/diagnóstico , Pruebas Neuropsicológicas , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/diagnóstico , Atención , EncéfaloRESUMEN
Corneal diseases are a major cause of blindness in the world. Corneal transplantation has been a cornerstone in the management of several of these advanced pathologies. This article discusses the evolution of corneal transplantation over a century, its indications, complications and briefly the various surgical techniques. Such tremendous technical improvisations from total corneal transplantation to lamellar keratoplasties have generated significant interest in the ophthalmic world and garnered momentum to the fight against blindness. Armed Forces Medical Services are also in vogue more than ever in this forward surge.
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This prospective cross-sectional study evaluated the diagnostic and prognostic role of cerebrospinal fluid (CSF) tumor necrosis factor-alpha (TNF-α) in children with cerebral malaria (CM) and its role in the differentiation of CM from non-cerebral severe malaria. CSF TNF-α was measured using a human TNF-α enzyme-linked immunosorbent assay kit of 39 cases of CM and 19 cases of non-cerebral severe malaria. CSF TNF-α levels were significantly higher in CM (p < 0.001). Based on the receiver operating characteristics curve, a cutoff value of CSF TNF-α was 5.7 pg/ml for diagnosis of CM with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 87.2%, 94.7%, 97.1% and 78.3% respectively. The cutoff value of CSF TNF-α was 13.7 pg/ml for predicting adverse outcomes in CM with sensitivity, specificity, PPV and NPV of 100%, 96.8%, 88.9% and 100%, respectively. However, the cutoff value of CSF TNF-α was 4.96 pg/ml for predicting adverse outcomes in non-cerebral severe malaria with a sensitivity, specificity, PPV and NPV of 100%, 94.1%, 88.9% and 100% respectively. So, CSF TNF-α is an excellent biomarker and can be used as a diagnostic and prognostic tool. More studies are needed to establish CSF TNF-α as a predictor of neurological sequelae.
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Malaria Cerebral , Factor de Necrosis Tumoral alfa , Humanos , Niño , Factor de Necrosis Tumoral alfa/líquido cefalorraquídeo , Malaria Cerebral/diagnóstico , Malaria Cerebral/líquido cefalorraquídeo , Estudios Prospectivos , Estudios Transversales , Curva ROCRESUMEN
The characterization of a rainfall simulator provides an excellent opportunity to study the potential of soil erosivity without waiting for natural rain. But, precise instrumentation is required to estimate the parameters, which is seldom available. To overcome this problem, the empirical and conceptual relationships obtained through physically-based modeling help to correlate the rain parameters contributing to soil erosion. The present laboratory study used five pressurized nozzles of different capacities and a Laser Precipitation Monitor (LPM) to generate different rain intensities (21.0-79.0 mm h-1) and to register drop size distribution, respectively. The sediment transportation induced by rain and runoff was measured with an erosion flume of 2.50 × 1.25 × 0.56 m with an adjustable longitudinal slope. The spatial uniformity, drop size distribution, drop velocity, and kinetic energy were used to evaluate the simulator's performance. The different rain erosivity parameters were correlated and tested statistically using linear and non-linear regression analysis. The rain simulation experiments of different intensities at different pressure ranges were performed on flat, 5, 10, and 15% slopes of the erosion flume to evaluate rain characteristics and record the surface runoff and sediment yield. The median drop sizes produced during the simulator ranged from 0.38 to 2.11 mm, coinciding with natural rain. The empirical relationships were developed to correlate surface discharge and sediment yield with rain intensity by optimizing the parameters for further study of experimental field plots of different slopes. The observed and estimated rain erosivity parameters showed a significant relationship (R2 = 0.75 to 0.93; P < 0.001) in multiple regression analysis, and the metrics used to test the developed regression equations showed lower MAE, MSE, and RMSE errors indicating the adequacy of the relationships. The results indicated that the simulator helps to understand the complex task of soil erosion with hydrologic and geomorphic processes in laboratory experimentation with sufficient accuracy in measuring sediment transport events.
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The present experiment was aimed at finding the optimal supplemental dose of nano-selenium in broiler chicken during the summer season for better performance in terms of growth, blood metabolites, immune response, antioxidant status, and selenium concentration in vital organs. Three-hundred-day-old Vencobb broiler chicks were randomly distributed into five dietary treatment groups with six replicates of 10 chicks each. The dietary treatments were as follows: T1 (control group), basal diet; T2, basal diet with 0.0375 ppm of nano-Se; T3, basal diet with 0.075 ppm of nano-Se; T4, basal diet with 0.15 ppm of nano-Se; T5, basal diet with 0.3 ppm of nano-Se. The experiment was carried out for 35 days. The average gain and feed conversion ratio were best observed in T4 and T5. The antibody titres were significantly higher (P < 0.05) in the treated birds. At the 5th week, erythrocytic glutathione peroxidase, catalase, and superoxide dismutase activities were significantly (P < 0.05) higher and lipid peroxidation values were significantly (P < 0.05) lower in all the nano-Se-treated groups. The Se levels in the liver, breast muscle, kidney, brain, and gizzard were significantly (P < 0.05) increased with increased dietary nano-Se. Histological studies of the liver and kidney in the highest nano-Se-treated groups (T4 and T5) did not show any abnormal changes. It is concluded that supplementation of nano-selenium at 0.15 ppm over and above the basal level improved the performance and protect the birds from summer stress without any adverse effect on the vital organs of chicken.
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Antioxidantes , Selenio , Animales , Antioxidantes/metabolismo , Selenio/metabolismo , Pollos , Suplementos Dietéticos , Estaciones del Año , Dieta/veterinaria , Alimentación Animal/análisisRESUMEN
;Heart failure (HF) is a huge global public health task due to morbidity, mortality, disturbed quality of life, and major economic burden. It is an area of active research and newer treatment strategies are evolving. Recently angiotensin receptor-neprilysin inhibitor (ARNI), a class of drugs (the first agent in this class, Sacubitril-Valsartan), reduces cardiovascular mortality and morbidity in chronic HF patients with reduced left ventricular ejection fraction (LVEF). Positive therapeutic effects have led to a decrease in cardiovascular mortality and HF hospitalizations (HFH), with a favorable safety profile, and have been documented in several clinical studies with an unquestionable survival benefit with ARNI, Sacubitril-Valsartan. This consensus statement of the Indian group of experts in cardiology, nephrology, and diabetes provides a comprehensive review of the power and promise of ARNI in HF management and an evidence-based appraisal of the use of ARNI as an essential treatment strategy for HF patients in clinical practice. Consensus in this review favors an early utility of Sacubitril-Valsartan in patients with HF with reduced EF (HFrEF), regardless of the previous therapy being given. A lower rate of hospitalizations for HF with Sacubitril-Valsartan in HF patients with preserved EF who are phenotypically heterogeneous suggests possible benefits of ARNI in patients having 40-50% of LVEF, frequent subtle systolic dysfunction, and higher hospitalization risk.
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Insuficiencia Cardíaca , Humanos , Insuficiencia Cardíaca/tratamiento farmacológico , Neprilisina/farmacología , Volumen Sistólico/fisiología , Tetrazoles/uso terapéutico , Tetrazoles/farmacología , Calidad de Vida , Función Ventricular Izquierda , Antagonistas de Receptores de Angiotensina/uso terapéutico , Antagonistas de Receptores de Angiotensina/farmacología , Resultado del Tratamiento , Antihipertensivos/uso terapéutico , Combinación de MedicamentosRESUMEN
Iron deficiency (ID) with or without anemia is frequently observed in patients with heart failure (HF). Uncorrected ID is associated with higher hospitalization and mortality in patients with acute HF (AHF) and chronic HF (CHF). Hence, in addition to chronic renal insufficiency, anemia, and diabetes, ID appears as a novel comorbidity and a treatment target of CHF. Intravenous (IV) ferric carboxymaltose (FCM) reduces the hospitalization risk due to HF worsening and improves functional capacity and quality of life (QOL) in HF patients. The current consensus document provides criteria, an expert opinion on the diagnosis of ID in HF, patient profiles for IV FCM, and correct administration and monitoring of such patients.
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Anemia Ferropénica , Insuficiencia Cardíaca , Deficiencias de Hierro , Humanos , Anemia Ferropénica/etiología , Anemia Ferropénica/complicaciones , Calidad de Vida , Hierro/uso terapéutico , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/tratamiento farmacológicoRESUMEN
Adverse cardiac remodeling refers to progressive structural and functional modifications in the heart because of increased wall stress in the myocardium, loss of viable myocardium, and neurohormonal stimulation. The guideline-directed medical therapy for Heart failure (HF) includes Angiotensin receptor-neprilysin inhibitor (ARNI) (sacubitril/valsartan), ß-blockers, sodium-glucose co-transporter 2 (SGLT2) inhibitors, and mineralocorticoid receptor antagonists (MRA). ARNI is under-prescribed in India despite its attractive safety and efficacy profile. Therefore, the consensus discusses objectives and topics related to ARNI in the management of cardiac remodeling, and experts shared their views on the early timely intervention of effective dosage of ARNI to improve the diagnosis and enhance mortality and morbidity benefits in cardiac reverse remodeling (CRR).
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Insuficiencia Cardíaca , Neprilisina , Humanos , Neprilisina/farmacología , Remodelación Ventricular , Tetrazoles/farmacología , Resultado del Tratamiento , Antagonistas de Receptores de Angiotensina/uso terapéutico , Volumen Sistólico , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/diagnóstico , AntihipertensivosRESUMEN
Meeting the requirement of high specific activity of radioisotopes and carrying out comprehensive research and development activities in the nuclear field, different nuclear facilities, including their waste disposal facilities, are going to be operational at Visakhapatnam, India. Due to environmental processes, the engineered disposal modules may lose their structural integrity and may release some radioactivity to the geo-environment. The subsequent migration of radionuclides reaching the geological environment will be governed by the distribution coefficient (Kd). Cs was chosen for the sorption study in two soil samples (soil-29 and 31) and to estimate the Kd in all the 40 soil samples through the laboratory batch method at the new campus of DAE, Visakhapatnam, India. Different soil chemical parameters like pH, organic matter, CaCO3, and cation exchange capacity were determined in 40 soil samples and their effect on Cs sorption was investigated. The effect of solution pH and initial concentration of Cs on sorption was also studied. The results show that the sorption of Cs increases with increasing pH. The Cs sorption was well explained by Freundlich and Dubinin-Radushkevich (D-R) isotherm models. Site-specific distribution coefficients (Kd) were also estimated and the values were found to vary from 75 ± 1 to 540 ± 12 L kg-1. The observed wide variation in Kd could be due to large variations in the physico-chemical properties of collected soil. The competitive ions effect study suggests that K+ has higher interference for Cs+ sorption as compared to Na+. The present study results will help assess the environmental impact due to Cs release in any unforeseen scenario and in planning effective remediation strategies.
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Contaminantes Radiactivos del Suelo , Contaminantes del Suelo , Adsorción , Monitoreo del Ambiente , Contaminantes Radiactivos del Suelo/análisis , Contaminantes del Suelo/análisis , Suelo/química , IndiaRESUMEN
Diabetic foot ulcer (DFU) is globally a major health burden predisposing to limb amputation. Among the various treatment modalities, platelet-rich plasma (PRP) is emerging as a promising agent. It stimulates wound healing by providing a higher concentration of essential growth factors locally. Though the role of PRP in DFU healing is established, still the route of administration with maximal efficacy is yet to be defined. Our study aims to evaluate the efficacy of autologous PRP in the treatment of diabetic ulcers and compare the effect of topical and perilesional injections of PRP in DFU healing. We conducted a single-centre, prospective, interventional study on 60 patients with DFU, in 2 groups of 30 patients each. They were treated with freshly prepared autologous PRP injection perilesionally and topically respectively, once a week for 4 weeks. Ulcer size was assessed, using "imito-measure" software at presentation and 2, 4, 8, and 12 weeks post-therapy. Serum MMP-9 levels were assessed in both groups, pretreatment and post-treatment. For statistical analysis, SPSS software V-23 was used. On assessment, both groups had comparable baseline characteristics, Wagner's grading, and glycemic indices. The percentage reduction in the size of the wound at 2 weeks, 1 month, 2 months, and 3 months was greater in the perilesional group as compared to the topical PRP group.
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During the COVID-19 pandemic, elderly people have been more prone to depression, anxiety and stress. During these trying times, they require more attention and support for their mental health. This cross-sectional study was performed with the duration of 06 months from March 2021 to August 2021 in AIIMS, Bhopal in the state of Madhya Pradesh, in central India. And the participants recruited by systematic random sampling from a population aged more than 60 years, those who were able to read and write Hindi or English and having at least one family member; who reported to AIIMS, Bhopal during the second wave of COVID-19 in India. Those who were confirmed COVID-19 cases and undergoing treatment for the same, with diagnosed mental health disorders and who didn't give consent were excluded. A Google form based online semi-structured questionnaire along with DASS-21 scale was completed by participants. Elderly (>=60 years) will be selected. Of the 690 participants 7.25% reported mild to moderate depression, whereas 0.58 percent had severe or extremely severe depression. Mild to moderate anxiety were found in 9.56% of people, while 2.46% had severe or extremely severe anxiety. Mildly or moderately were stressed 4.78%, while 0.42% was severely or extremely anxious. Alcoholism and depression were found to have a statistically significant relationship (p=0.028). During the COVID-19 pandemic, elderly subjects who napped during the day were substantially less depressed (p=0.033). The older the respondents were, the more nervous they were during the pandemic (p=0.042). There is a link between alcohol consumption and stress (p=0.043) and it was seen that females were more stressed as compared to males (p=0.045). There was a strong correlation between participants' alcohol addiction and depressive symptoms. Psychological therapies for the elderly are thought to be necessary to enhance their psychological resilience and mental health. We need to tackle the stigma related to the COVID-19 and mental health issues.