Antiarthritic potential of ethanolic extract of Ixora coccinea leaves on complete Freund's adjuvant-induced arthritis in animal model.

CONTEXT: Ixora coccinea leaves possess antioxidant, anti-inflammatory, antinociceptive, antimutagenic, and gastroprotective properties. On this background, its antiarthritic potential was evaluated. AIMS: The objective is to evaluate the effect of Ethanolic extract of Ixora coccinea leaves (EEICL) on complete Freund's adjuvant-induced arthritis in rats. SETTINGS AND STUDY DESIGN: PG research laboratory, Pharmacology Department, MKCG Medical College, Berhampur, Odisha. SUBJECTS AND METHODS: Thirty-six Wistar albino rats were randomly distributed into sixgroups (n = 6) as follows: Gr 1 (normal control)-DW p.o, Gr-2 (disease control [DC] - Tween 80 p.o), Gr-3 (piroxicam 0.9 mg/kg p.o), Gr-4 (EEICL-1 g/kg, p.o, Gr 4-EEICL-1.5 g/kg p.o, Gr 5-ED50 (0.82 g/kg) + piroxicam (0.45 mg/kg) p.o. After induction of arthritis, drugs, and vehicles were administered daily from 5th to 25th day. On 0, 5th, 10th, 15th, and 25th day, parameters like body weight, rotarod fall time, paw volume displacement, and arthritis index were measured. On the last day, Erythrocyte sedimentation rate (ESR), tissue malondialdehyde (MDA), and histopathological analysis were done. STATISTICAL ANALYSIS USED: Analysis of parametric data was done by one-way ANOVA and nonparametric data by Kruskal-Wallis test using graph pad prism 7.0. P < 0.05 was considered statistically significant. RESULTS: EEICL (1.5 mg/kg) showed anti-arthritic effect compared with DC. Rotarod fall-off time 137.5 ± 2.5 sec and body weight (139 ± 12.74 g) were increased significantly. The percentage inhibition of paw volume was increased(52%) whereas arthritic score(0.33), ESR(3.51mm/hr), synovial tissue MDA level (0.62±0.13µmol/gm) and Mankin score(2) were reduced significantly as compared to disease control. CONCLUSIONS: EEICL has anti-arthritic potential in rat model.

Ultra-large near-infrared omnidirectional photonic bandgaps in cascaded one-dimensional photonic crystals containing all-dielectric metamaterials.

In conventional one-dimensional (1-D) photonic crystals (PCs) consisting of isotropic dielectrics, photonic bandgaps (PBGs) substantially shift toward shorter wavelengths as incident angle increases. This strong blueshift characteristic of PBGs significantly reduces the widths of near-infrared omnidirectional photonic bandgaps (OPBGs). Recently, researchers achieved a kind of special PBG called angle-insensitive PBGs in 1-D PCs containing all-dielectric elliptical metamaterials (EMMs). The emergence of angle-insensitive PBGs provides us a possibility to achieve ultra-large near-infrared OPBGs. Herein, we design two 1-D PCs containing all-dielectric EMMs with near-infrared angle-insensitive PBGs in different wavelength ranges. By cascading two 1-D PCs containing all-dielectric EMMs together, we achieve an ultra-large near-infrared OPBG with a width up to 1.004 µm (relative bandwidth of 63.9%). In addition, the width of the near-infrared OPBG demonstrates robustness against the layer thickness. Our work not only provides a feasible route to achieving ultra-large near-infrared OPBGs, but also facilitates the design of broadband omnidirectional mirrors.

Terahertz angle-independent photonic bandgap in a one-dimensional photonic crystal containing InSb-based hyperbolic metamaterials: erratum.

This erratum corrects the typing errors in Eq. (6) and the caption of Fig. 4 of the original paper, Appl. Opt.61, 7677 (2022).APOPAI0003-693510.1364/AO.470923 The correction does not affect the results of the original paper.

Aortic valve surgery in the pediatric population: pathophysiology, clinical features and management.

There are several conditions where the function of the aortic valve can be compromised in the pediatric population. The aortic valve is composed of three leaflets which are thin and mobile and are attached to the aortic sinuses. Each leaflet is made up of connective tissue, forming a highly ordered network of extracellular matrix components. Together, this enables the aortic valve to open and close more than 100,000 times throughout the day. However, there are conditions where the structure of the aortic valve can be compromised resulting in its function being affected. Conditions such as congenital valvular aortic stenosis and abnormal valve morphology including bicuspid valves often necessitate intervention to improve symptoms and quality of life in children. Other conditions which result in requiring surgical intervention include infective endocarditis and trauma. In this article, we present the common forms of aortic valve disease in the pediatric population and the clinical presentation and pathophysiology of these. We also discuss the range of management options including medical management and percutaneous intervention. Surgical interventions such as Aortic annular enlargement techniques, the Ross procedure and the Ozaki procedure will also be discussed. The effectiveness, complications and long-term outcomes associated with these methods will be explored.

Terahertz angle-independent photonic bandgap in a one-dimensional photonic crystal containing InSb-based hyperbolic metamaterials.

According to the Bragg scattering theory, terahertz (THz) photonic bandgaps (PBGs) in all-dielectric one-dimensional (1-D) photonic crystals (PhCs) are strongly dependent on the incident angle. Such a strongly angle-dependent property of the PBGs not only limits the widths of omnidirectional PBGs, but also causes the strongly angle-dependent property of defect modes and optical Tamm states in multilayer structures containing all-dielectric 1-D PhCs. Until now, ways to achieve a THz angle-independent PBG have been an open problem. Herein, according to the existing phase-variation compensation theory, we achieve a THz angle-independent PBG in a 1-D PhC containing indium antimonide (InSb)-based hyperbolic metamaterials for transverse magnetic polarization. Different from conventional strongly angle-dependent PBGs, the angle-independent PBG remains almost unshifted as the incident angle changes. The relative frequency shifts of the upper and the bottom edges of the angle-independent PBG are only 1.4% and 0.4%, respectively. Besides, the angle-independent property of the PBG is robust against the disturbance of the layer thickness. The proposed 1-D PhC composes only two frequently used materials: silicon (Si) and InSb. Such a Si/InSb multilayer can be fabricated by the current ion-assisted electron beam coating or spin coating techniques. This THz angle-independent PBG would be utilized to design THz omnidirectional filters or absorbers.

Clinical Epidemiology and Predictors of Outcome in Chlorpyrifos Poisoning in Farming and Allied Agricultural Workers in East Godavari, Andhra Pradesh.

Background: Chlorpyrifos is the ninth most consumed pesticide for agricultural purposes in India. It is a chlorinated organophosphate that also causes poisoning in non-target species such as humans. There is a scarcity of published literature on chlorpyrifos intoxication in the Indian scenario. Objective: The objective of the study was to find out the clinical epidemiology and factors influencing the outcome of chlorpyrifos poisoning in the farming and allied agricultural workers. Methodology: The patient record-based cross-sectional study was carried out on 40 confirmed cases of chlorpyrifos poisoning in a tertiary care teaching hospital in East Godavari district, a predominantly agrarian region in the state of Andhra Pradesh. Clinic-demographic profile, aspects of poisoning, outcome in terms of recovery, death, ventilator support were obtained. Mortality or requirement of ventilator support was classified as a bad outcome. Carlsons' Co-morbidity Index, Poison Severity Score, and Glasgow Coma Scale score at the time of admission were assessed objectively. The strength of association between the predictor variables and the outcome was represented using the odds ratio. Statistical analysis was performed using Graph Pad Prism 8.0 trial version. Results: Chlorpyrifos poisoning constituted about 10% of pesticide poisoning and 25% of such cases had a poor outcome. The mean age was 44.73 ± 10.76 years, the majority being farmers. Younger age (<40 years), early reporting to hospital, Carlsons' Co-morbidity Index of less than 8, Glasgow Coma Scale score of more than 12, and Poison severity score of less than 2 were significantly associated with favorable outcome (P < 0.005). During admission, 60% of cases had a plasma pseudocholinesterase level of less than 1000 U/L. Lower plasma pseudocholinesterase was associated with a poor outcome (OR 9.62 CI 4.05-22.84). Conclusions: Farmers and allied agricultural workers are susceptible to chlorpyrifos intoxication. Along with clinical and laboratory parameters, Carlsons' Co-morbidity Index, Glasgow Coma Scale score, and Poison severity score at the time of admission are seen as reliable predictors of outcome.

Study on the Role of Gastrointestinal Parasite in Irritable Bowel Syndrome Patients in a Tribal Region of India.

Background Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder in which abdominal pain is associated with a change in bowel habits. Gut inflammation might be one of the mechanisms of pathogenesis. However, the cause of IBS is not clearly understood. Post-infectious IBS (PI-IBS) is the onset of IBS after an episode of infectious gastroenteritis. While the exact pathophysiology of PI-IBS is not established, the mechanism might be an altered serotonin signaling activity, inflammation, malabsorption, and small intestinal bacterial overgrowth. Various parasites such as Blastocystis hominis and Dientamoeba fragilis have a possible role in the etiology of IBS. E ntamoeba histolytica is one of the predominant GI parasites in developing regions of the world, and the symptoms of non-dysenteric amebic colitis may mimic those of IBS, which makes them difficult to distinguish from each other. Our study will address the relationship between the different gastrointestinal protozoan parasites in IBS and the role of antiparasitic therapy in PI-IBS. This study also aimed to determine the prevalence of GI protozoan parasites in patients with IBS in a tribal region of India. Methods We conducted a descriptive facility-based cross-sectional study of patients presenting with IBS to Saheed Laxman Nayak Medical College and Hospital, Koraput, Odisha, from 2017 to 2021. We collected stool samples for histopathological analysis using direct wet mount and formal-ether concentration microscopy techniques if diarrhea persisted beyond the antidiarrheal therapy. The samples from IBS patients were compared against 80 healthy control patient stool samples. We used IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY,) to analyze the data. Results Our study included 120 patients with IBS, of whom 67 (56%) were infected with GI parasites. In the control group, 16 (20%) were infected with GI parasites, which was significantly fewer than the test group (p<0.001). Conclusion We found a widespread infestation with GI parasites in patients with diarrhea-predominate IBS. A parasitological stool test should be included in the diagnostic approach to IBS. Initiating early diagnosis and treatment can reduce the chance of post-infectious IBS.

The impact of magnetized cold plasma and its various properties in sensing applications.

These analyses present a novel magnetized cold plasma-based 1D photonic crystal structure for detecting the refractive index of various bio-analytes. The proposed structure is designed with two photonic crystals composed of an alternating layer of right-hand polarization and left-hand polarization of the magnetized cold plasma material with a central defect layer. Transmittance characteristics of the structure are studied by employing the well-known transfer matrix method. Various geometrical parameters such as electron density, external magnetic field, thickness of odd and even layers of the multilayers, thickness of the sample layer, and incident angle are judiciously optimized to attain the best sensitivity, figure of merit, quality factor, signal-to-noise ratio, detection range and limit of detection. Finally, a maximum sensitivity of 25 GHz/RIU is accomplished with the optimized value of structure parameters, which can be considered as a noteworthy sensing performance.

Design and Performance Analysis of Reconfigurable 1D Photonic Crystal Biosensor Employing Ge2Sb2Te5 (GST) for Detection of Women Reproductive Hormones.

The present research demonstrates a novel 1D photonic crystal (PhC) based reconfigurable biosensor pertaining to label-free detection of different concentrations of progesterone and estradiol, which play a vital role in developing reproductive hormones in women. The proposed sensor is designed by an alternative arrangement of Na3 AlF6 and CeO2, with a central defect layer. A thin layer of novel phase change chalcogenide material (Ge2 Sb2 Te5) is deposited along the two sides of the defect layer to improve the sensing performance. Numerical simulation of transmission spectrum for TE mode is carried out by using the transfer matrix method (TMM). The mainstay of this research is centered on the assay of shift in the defect mode position and intensity with respect to different concentrations of analyte, by changing the phase of the GST material from amorphous to crystalline. Interestingly, we observed a high tunability in defect mode wavelength, when the phase is changed from amorphous to crystalline, which leads to accomplishment of a high sensitivity of 1.75 nm/nmol/L for progesterone and 20.5 nm/nmol/L for estradiol. Aside from sensitivity, other significant parameters like figure of merit and detection limit are computed, which give a deep insight into the sensing performance. These encouraging sensing performances pave the path for efficient detection of different concentrations of progesterone and estradiol to monitor various gynecological problems in women.

Modeling of High-Performance SPR Refractive Index Sensor Employing Novel 2D Materials for Detection of Malaria Pathogens.

The present work exhibits a novel design of surface plasmon resonance (SPR) biosensor, which comprises CaF2 prism, TiO2, metal (Ag/Au), PtSe2, 2D materials (graphene/transition metal dichalcogenides (MoS2/WS2)) and sensing medium, for point-of-care detection of various stages of malaria diseases. The transfer matrix method (TMM) is employed to examine the angular reflectivity of the proposed structure after judiciously optimizing the layer thicknesses and layer numbers. Phase interrogation technique is utilised to validate the position of occurrence of resonance angles. Additionally, the proposed SPR structure is designed using COMSOL Multiphysics, to assay the electric field intensity and electric field enhancement factor near the edge of 2D material-sensing layer interface. Simulation upshots revealed that the use of new class of 2D materials catapult the sensor performance to a new height compared to the traditional SPR configuration. A maximum sensitivity of 240.10°/RIU, quality factor of 78.46 RIU-1 and detection accuracy of 1.99 is attained for Ag-based SPR configuration with bilayer of WS2. Sensing parameters are compared with previously reported works to prove the superiority of the present research. Moreover, the real-time and label-free detection of malaria diseases makes the suggested sensor worth to fabricate as a SPR chip with the recent nanofabrication technologies.

Aortic root replacement to treat type A aortic dissection: A comparison of midterm outcomes between composite valve grafts and porcine aortic roots.

BACKGROUND: Porcine aortic roots (PAR) have been reported in the literature with acceptable short- and long-term outcomes for the treatment of aortic root aneurysms. However, their efficacy in type A aortic dissection (TAAD) is yet to be defined. METHODS: Using data from a locally collated aortic dissection registry, we compared the outcomes in patients undergoing aortic root replacement for TAAD using either of two surgical options: (a) PAR or (b) composite valve grafts (CVG). A retrospective analysis was conducted for all procedures in the period from 2005 to 2018. RESULTS: A total of 252 patients underwent procedures for TAAD in the time period. Sixty-five patients had aortic root replacements (PAR n = 30, CVG n = 35). Between-group comparisons identified a younger CVG group (50.5 vs 64.5, P < .05) although all other covariates were comparable. Operative parameters were comparable between the two groups. The use of PAR did not significantly impact operative mortality (odds ratio [OR], 0.93; 95% confidence interval [CI], 0.22-3.61; P = .992), stroke (OR, 2.91, 0.25-34.09, P = .395), reoperation (OR, 0.91; 95% CI, 0.22-3.62; P = .882) or length of stay (coeff 2.33, -8.23 to 12.90; P = .659) compared to CVG. Five-year survival was similar between both groups (PAR 59% vs CVG 69%; P = .153) and reoperation was negligible. Echocardiography revealed significantly lower aortic valve gradients in the PAR group (8.69 vs 15.45mm Hg; P < .0001), and smaller left ventricular dimensions both at 6-week and 1-year follow-up (P < .05). CONCLUSIONS: This study highlights the comparable short- and midterm outcomes of PAR in cases of TAAD, in comparison to established therapy.

Predictors of over-the-counter medication: A cross-sectional Indian study.

CONTEXT: The determinants of over-the-counter (OTC) medication need to be understood to design adequate drug information policies. AIM: To determine the prevalence and predictors of OTC medication among the adult population of Berhampur town in Odisha, India. SETTINGS AND DESIGN: It was a prospective, cross-sectional, observational study carried out in the private retail pharmacy on a convenience sample of 880 adults over a period of 6 months at Berhampur, Odisha, India. MATERIALS AND METHODS: Medication use behavior was explored using a data collection form that had three parts. The first part captured data on the sociodemographic characteristics of drug consumers. The second and third part collected data on drug history and attitude toward the available health-care facility, respectively. STATISTICAL ANALYSIS: Descriptive statistics was used to represent the prevalence of OTC medication. Odds ratio and 95% confidence intervals (CIs) were used to determine the predictors of OTC medication. RESULTS: The overall prevalence of OTC medication use was 18.72% (95% CI: 15.34-47.16%). Younger age, male gender, lower income, and poor lifestyle were the predictors of OTC medication. Perception of poor accessibility to health care, the presence of chronic diseases and having a symptom count of more than two significantly increased the likelihood of OTC medication (P < 0.05). CONCLUSIONS: Sociodemographic profile, drug history, and attitude toward health-care availability in the locality can predict OTC medication behavior. Interventions aimed at changing the perceptions of the public regarding accessibility, affordability of the health care is likely to influence OTC medication behavior and make it safer.

Drug-related problems associated with self-medication and medication guided by prescription: A pharmacy-based survey.

OBJECTIVES: The objective of this study is to identify and compare the nature of the drug-related problems (DRPs) associated with self-medication and non-self-medication (drug use guided by a prescription). MATERIALS AND METHODS: The cross-sectional, observational study was conducted on 1100 adult participants at a convenience sample of six retail private pharmacy counters. The data collection form was based on the Pharmaceutical Care Network Europe version 6.2 classification for DRPs. Descriptive statistics was used to represent the prevalence of DRPs. Chi-square test was used to find out the association between the type of medication and DRPs. Odds ratio (OR) with confidence interval (CI) was computed to find the factors determining the occurrence of DRPs. P < 0.05 was considered to be statistically significant. Data were analyzed using SPSS version 16.0. RESULTS: The prevalence of self-medication was 18.72%. The prevalence of DRPs was 17.36%. In the self-medication group, the prevalence of DRPs was high (40.78%) as compared to the non-self-medication group (11.97%). DRP related to inappropriate drug dosing was observed in 44.83% and 40.45% subjects in self-medication and non-self-medication group, respectively (P < 0.001). The subjects in the self-medication group were about 5 times likely to have a DRP (OR: 5.06, CI: 3.59-7.14, P < 0.001). CONCLUSIONS: Self-medication is associated with a higher risk of various DRPs. Since retail pharmacy outlet is often the first point of contact between the patient and the health care system in a developing country, interventions like drug information activities at the retail pharmacy is likely to bring down the DRPs associated with self-medication.

Tubercular lesion of the foot presenting as epithelioma.

Tuberculosis continues to be the biggest public health problem worldwide. Tuberculosis verrucosa cutis (TVC) is a verrucose form of cutaneous tuberculosis that occurs in previously sensitised individuals due to exogenous reinfection with Mycobacterium tuberculosis or Mycobacterium bovis, and it reflects good cell-mediated immunity. An elderly man presented with multiple fungating growths, which were painless but associated with mild itching and serous discharge, on the right foot for 40 years. The lesions were free from deeper structures and no inguinal lymphadenopathy was observed. A provisional diagnosis of epithelioma was made based on the features described. However, incisional biopsy indicated that the lesions were tuberculous. As part of the anti-tubercular therapy, the lesions were excised and the wounds covered with split-thickness skin graft. The patient's recovery was uneventful, with no graft loss or infection reported. This case illustrates the importance of recognising cutaneous forms of tuberculosis, especially TVC, as an important differential diagnosis of epithelioma.