Synthesis characterization and application of butyl acrylate mediated eco-friendly silver nanoparticles using ultrasonic radiation.

In the present investigation, with an effort to provide appropriate material for future applications, we have touched on two viable advancement targets: the production of silver nanoparticles (Ag-NPs) employing an ultrasonic approach and the use of Ag-NPs in environmental remediation. A green economical method was involved to prepare Ag-NPs using butyl acrylate as a stabilizer. The following techniques were used for analysing Ag-NPs: energy dispersive X-ray spectroscopy (EDX), transmission electron microscopy (TEM), field emission scanning electron microscopy (FESEM), powder X-ray diffraction (XRD), and Fourier transformed infrared (FT-IR) spectroscopy. X-ray diffraction (XRD) analysis for the lattice characteristics showed that Ag-NPs have a face-centered structure with an average crystallite size of 9.51-11.83 nm. FE-SEM and TEM analysis were used for morphological investigations, and revealed that Ag-NPs had a spherical shape with an average particle size of 16.27 nm. The EDX profile displayed a strong signal at ∼3.0 keV, which indicated that the samples comprised silver. UV-Visible spectrophotometer with the absorption maximum occurring between 401 and 411 nm further confirmed the formation of Ag-NPs. The dye degradation effect of synthesized Ag-NPs on methylene blue and Rhodamine B was analyzed to assess their ability for environmental remediation, and results showed that around 100% of the dye degradation effect. This study has provided a most plausible mechanism for the dye degradation.

Sensitization Lectures for Reducing Weight Bias in Undergraduate Medical Students.

INTRODUCTION: Discrimination exists in one form or another in every society, usually against those who are weaker, in fewer numbers, or different from the rest. Most physicians are empathetic towards their patients but can either not keep an eye on their subordinates or lack the power to act against such employees. Persons experiencing discrimination in healthcare centers may try to avoid or postpone future visits, resulting in delayed diagnosis and treatment of ailments. Obesity bias present in society has crept into healthcare centers and intimidates persons with obesity who are seeking medical aid. Implicit and explicit obesity bias has been recorded in healthcare students. METHODS: Data from 102 undergraduate medical students (23 female) who completed this study was analyzed. Implicit bias (tested online using the Implicit Association Test) and explicit bias (measured using four types of tool kits) were measured before and after conducting an obesity sensitization program (OSP) comprising four lectures on the causes and consequences of obesity and obesity discrimination and its consequences. RESULTS: The change in implicit bias was not significant. However, a significant reduction was noted in the four different types of tools for explicit bias after conducting the OSP. CONCLUSION: OSP helped medical students identify obesity bias and reduce explicit bias. Sensitization lectures conducted in medical colleges and schools can help reduce such discrimination in healthcare centers.

Reactive Hypoglycemia in Patients Prior to Cataract Surgery: A Case Series.

Cataract surgery is one of the most frequently performed surgical procedures and is often performed under topical anesthesia in conscious patients. Sweating, palpitations, and anxiety may be seen in patients about to undergo surgery. However, these are typical adrenergic symptoms of hypoglycemia and should be further investigated if occurring before surgery. Here, we report five cases of postprandial or reactive hypoglycemia observed in hospital settings just before conducting cataract surgeries in non-diabetic 52-78-year-old patients from 2019 to 2023.

Increased expression of serum IL-18 and IL-18R in newly diagnosed type 2 diabetes mellitus.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disorder in which genetic, sedentary lifestyle, obesity, and environmental factors come together to produce insulin resistance in target tissues, leading to hyperglycemia. Evidence reveals that inflammation may play an essential role in the pathogenesis of T2DM. Interleukin-18 (IL-18), a proinflammatory cytokine, plays a crucial role in the acute and chronic inflammatory process. The association of IL-18 levels with IL-18R expression in T2DM has not been investigated so far. The aim of this study was to compare the peripheral changes in serum IL-18 levels and its receptor (IL18R) expression in newly diagnosed T2DM and healthy controls. METHODS: A total of 35 newly diagnosed type 2 diabetic cases and 35 non-diabetic controls were enrolled after obtaining informed consent. Venous whole blood was taken under aseptic conditions. Biochemical parameters were estimated in an auto-analyzer. Serum IL-18 levels were calculated using ELISA, whereas IL-18R expression was determined via RT-PCR. GAPDH was used as an internal control. RESULTS: When compared to non-diabetic controls, the serum IL-18 levels were significantly higher in T2DM patients (P=0.010) along with a significant upregulation of IL18R (P=0.0018). Serum IL-18 levels in T2DM and non-diabetic controls were 669.5 (445) and 498.3 (404.9) pg/mL respectively, and IL-18R showed a fold change of 10.33. CONCLUSIONS: Both serum IL-18 and its receptor IL-18R is significantly higher in newly diagnosed T2DM patients.

Altered expression of specific antioxidant (SOD1 and SOD2) and DNA repair (XRCC1 and OGG1) genes in patients with newly diagnosed type-2 diabetes mellitus.

BACKGROUND: Uncontrolled increase in Reactive Oxygen Species (ROS) leads to the release of free radicals. Additionally, when antioxidants go below a certain level, major molecules of our system such as DNA, proteins, and many other macromolecules get damaged, leading to cancer, heart diseases, and metabolic syndromes like diabetes. Therefore, we in our study focused on newly diagnosed Type 2 Diabetes Mellitus (T2DM) patients and tried to evaluate the expression of antioxidant enzyme encoding genes; Superoxide Dismutase 1(SOD1) and Superoxide Dismutase 2 (SOD2) and DNA repair genes; X-ray repair cross-complementing 1(XRCC1) and 8-oxoguanine DNA glycosylase 1 (OGG1) in them. METHODS: Expression analysis was performed by RT-PCR on 60 subjects (30 T2DM cases and 30 non-diabetic controls). The level of the SOD enzyme was also estimated in a serum sample by the colorimetric method. Biochemical parameters such as fasting plasma glucose (FBG), glycated haemoglobin (HbA1c), high sensitivity C-reactive protein (hsCRP), and lipid profile were estimated in an auto analyzer. Receiver operating characteristic (ROC) curve analysis was done, the area under the curve for mRNA expression and enzyme level was calculated to determine their potential as markers in newly diagnosed T2DM. RESULTS: Down-regulation of both SOD1 (0.43 fold, p=0.02) and SOD2(0.41 fold, p=0.13) and up-regulation of both XRCC1(1.15 fold, p>0.05) and OGG1(1.49 fold, p>0.05) was observed in patients with T2DM. We also observed a significant decrease (p=0.02) in SOD enzyme levels in diabetic cases than in controls (599.8 ± 178.9 and 691.3 ±127.3). CONCLUSIONS: We report that antioxidant repair genes are downregulated and DNA repair genes are upregulated in newly diagnosed T2DM patients. SOD levels and SOD1 gene expression can serve as informative biomarkers for identifying T2DM patients.

Role of interleukin-2 and interleukin-18 in newly diagnosed type 2 diabetes mellitus.

OBJECTIVES: The study aimed to compare the levels of anti-inflammatory interleukin-2 (IL-2) and proinflammatory interleukin-18 (IL-18) among newly diagnosed type 2 diabetes mellitus (T2DM) and nondiabetic volunteers, to predict their roles as markers in the diagnosis of newly diagnosed T2DM. METHODS: In the study, 60 subjects were enrolled (30 T2DM cases and 30 non-diabetic controls). Biochemical parameters such as fasting plasma glucose (FBS), glycated haemoglobin (HbA1c), high sensitivity C-reactive protein (hs-CRP) and lipid profile were estimated in auto-analyser. Serum IL-2 and IL-18 levels were assessed by enzyme-linked immune sorbent assay (ELISA). RESULTS: Significant differences were observed in the levels of interleukins among study groups. The median (95% confidence interval) of IL-2 in cases and controls were 8.55 (6.07-47.23) and 45.87 (12.81-145.4) (p=0.02). The median (95% CI) of IL-18 on the other hand in cases and controls were 691.6 (580.3-872.6) and 511.1 (452.6-557.5) (p=0.0014). CONCLUSIONS: Our study is the first to correlate IL-2 and IL-18 in newly diagnosed T2DM patients. Findings from this study highlight the anti-inflammatory role of IL-2 and proinflammatory role of IL-18 in T2DM. ROC analysis helped predict their role as markers in T2DM diagnosis.

Urinary Protein Creatinine Ratio in Normal Zero to Three-Day-Old Indian Neonates.

INTRODUCTION: Early neonates (1-7-day-old) may develop acute kidney injury or acute renal failure due to functional (pre-renal, may be caused by decreased renal perfusion), intrinsic (renal, may be caused by acute insult), or obstructive (due to anatomic urinary tract obstruction) causes. Urinary protein estimation is important for diagnosis, follow-up and prognosis of disease. The Protein Creatinine Ratio (PCR) has been successfully used to establish proteinuria in different types of patients. AIM: This study was undertaken to establish normal PCR range in neonates, to rule out abnormal protein excretion in sick neonates. MATERIALS AND METHODS: A total of 37 normal early neonates of age 0-3 days were enrolled for this study. Random spot urine samples were collected in paediatric urine bags for protein and creatinine estimation. RESULTS: The urinary PCR varied between 0.1-0.8. The range of PCR values obtained was greater in 0-1 day old infants, compared to infants older than one day. Changes in PCR values were due to variations in the creatinine excretion. CONCLUSION: Urinary PCR values ≤ 0.8 indicate normal protein excretion. However, reference intervals of PCR should be established for narrow age groups in case of early neonates, e.g. 0-6h, 6-12h, 12-24h, 24-72h old babies.

Effect of Age on Response to Experimental Pain in Normal Indian Males.

BACKGROUND AND OBJECTIVES: Response to experimental pain depends on the nature of the pain stimulus, as well as on gender, racial, cultural and socioeconomic factors. This study investigates the effect of age on pain sensitivity and cardiovascular reactivity produced by experimental pain. We have also compared the values of body mass index (BMI) and resting blood pressure of volunteers with the normal values. MATERIALS AND METHODS: The study was conducted on 83 Indian males of different age groups. The volunteers were divided into 4 groups: Children, Young Adults, Middle-Aged Adults and Old Adults; and their basal parameters (BMI, resting pulse and blood pressure) were recorded. Selected volunteers were subjected to cold pressor task (CPT). Pain sensitivity (PS) (pain threshold, tolerance and pain rating on a visual analog scale) and cardiovascular reactivity (CVR) (increase in pulse and blood pressure) were recorded. RESULTS: Many volunteers had abnormal values of BMI and resting blood pressure and had to be excluded from the study. PS and CVR between different groups were compared by one-way ANOVA. Significant differences in PS were observed, with highest pain sensitivity in Children and lowest in Old Adults. No significant differences were observed in the CVR. CONCLUSION: The high numbers of volunteers with abnormal basal parameters (BMI and resting blood pressure) show an urgent need to educate the general public about the dangers and risk factors of obesity and hypertension. Less exposure of children to painful encounters may be responsible for their high pain sensitivity while higher values of resting blood pressure and decreased sensitivity of the sensory systems with advancing age may be responsible for the hypoalgesia observed in old adults.

Assessment of lecture strategy with different teaching AIDS.

BACKGROUND AND OBJECTIVES: Medical/dental colleges in Northern India cater to students with diverse backgrounds, mother tongues, levels of comprehending English, and intelligence levels. This study was conducted to identify lecture strategy and teaching aid best suited for North Indian dental and medical students. It was conducted in two parts - 1. Survey of teachers' and students' opinion to obtain their preferences in teaching-learning practices followed in a conventional lecture, and 2. Comparison of students' performances after a single trial lecture with different groups of students, using different teaching aids (TAs). MATERIALS AND METHODS: Opinions of 33 faculty teaching first year dental/ medical students and 506 volunteer students (320 female) were compiled. Students were divided into four groups. A single trial lecture was held with each group (on the same topic, using identical lesson plan, by the same teacher) using a different teaching aid with each group. Lecture strategy was designed according to students' preferences (as obtained from opinion survey) regarding language of instruction and the number of mental breaks. TAs used with different groups were chalk and board (C&B), PowerPoint (PPT), overhead projector (OHP), and a combination of C&B and PPT. Pre- and post-tests using multiple choice questions were conducted with each group. RESULTS of post-test questionnaire and feedback from faculty attending the lecture were assessed for students' satisfaction and attentiveness in all four groups. RESULTS: Survey results indicated that although 97.6% students believed they had good/fair proficiency in English, 83.6% preferred being taught in a combination of English and Hindi; 44.3% students preferred C&B, 40.1% preferred PPT and 15.6% preferred the use of OHP as TA. After conducting a trial lecture with different TAs with each group, more than 90% students expressed satisfaction with the TA used for that group. Significantly better performance was observed in the post-lecture test when C&B was used. CONCLUSION: The needs of students in India are different from those of their Western counterparts, and should be considered during didactic lectures to improve the students' understanding. Post-test results were better when C&B was used, as more students were attentive and/or took notes.

Cardiovascular reactivity to stressors in Indian young adults with normotensive parents.

BACKGROUNDS AND OBJECTIVES: Stress-induced increase in heart-rate and blood pressure is termed cardiovascular reactivity (CVR). Various studies are designed to monitor the CVR and use different types of experimental stressors. We have compared the CVR to three different stressors used in CVR based studies (cold pressor task, hand grip test, and video game) to identify the best suited stressor for any study design. MATERIAL AND METHODS: The study was conducted on 82 (38 female) young Indian adults with normal resting basal parameters and normotensive parents. Each volunteer was subjected to three stressors: cold pressor task (CPT), hand grip test (HGT), and video game (VG). The CVR to the three stressors was compared amongst female subjects and amongst male subjects by ANOVA, and between female and male subjects by unpaired Student's t-test. RESULTS: Maximum CVR was obtained to HGT, while maximum gender difference in CVR was obtained in case of CPT. Heart rate and blood pressure changes obtained on playing VG were not statistically significant. CONCLUSION: When the purpose of research is to generate maximum possible CVR, we suggest the use of HGT; while if the purpose of the research is to study gender related differences, the use of CPT would be more appropriate. Unlike young adults of Western countries, VG is not perceived as a challenging task or stressor by young Indian adults and produces little change in heart rate and blood pressure.

Detection of proteinuria in pregnancy: comparison of qualitative tests for proteins and dipsticks with urinary protein creatinine index.

BACKGROUND AND OBJECTIVES: Excretion of urinary protein increases to 300 mg/d (from up to 150 mg/d) in normal pregnancy. Values above this may be due to disorders that can endanger the patient or her pregnancy. Quantitative analysis of 24-hour urine is considered the gold standard for ascertaining daily protein excretion. Routine laboratory tests performed on spot urine samples indicate protein concentration in the particular sample, and can lead to diagnostic error if urine output is less or more than 1L/d. The Protein Creatinine Index (PCI) shows good correlation with 24-hour protein estimation. However, PCI varies with sex and race. We have correlated the results of qualitative estimation procedures and the dipstick values with protein creatinine index. MATERIAL AND METHODS: We measured protein and creatinine in spot urine samples obtained from 57 pregnant and 80 non-pregnant healthy women of 18-36 years, and calculated PCI. We also tested the samples qualitatively for proteins by routine tests and dipsticks. RESULTS: Normal range of PCI in non-pregnant women, determined by a non-parametric method was 30-150. PCI was increased significantly in pregnancy (maximum increase in the third trimester). Amongst the qualitative tests, heat coagulation test gave the lowest percentage of false positives and a slightly higher percentage of false negatives compared to Heller's nitric acid and sulphosalicylic acid tests, and dipsticks. INTERPRETATIONS AND CONCLUSIONS: We conclude that heat coagulation test be used for initial screening, with PCI being performed on all samples testing positive to rule out false positives.

The stress-induced cardiovascular reactivity in the fasting and fed States of healthy young Indian males.

BACKGROUND AND OBJECTIVES: Low blood glucose levels have been associated with a hostile behaviour. The individuals who show aggressiveness and hostility are more likely to develop hypertension and cardiac diseases. The future hypertension has been linked with a high cardiovascular reactivity to stress. We have investigated the association of the blood glucose levels with the Cardio Vascular Reactivity (CVR) to stress. METHODS: Fourty six volunteers were subjected to stress (which was induced by the cold pressor task) in the fasting state and again, half an hour after the ingestion of 75 grams of glucose. The CVR in both conditions was compared in terms of an increase in the heart rate and the blood pressure. RESULTS: The resting pulse was lower and the blood pressure was higher in the fasting condition, as compared to the values which were obtained in the ½ hour post-prandial condition. The CVR to stress was significantly higher in the fasting condition. INTERPRETATION AND CONCLUSION: The increased resting heart rate and the decreased resting blood pressure in the ½ hourPost-Prandial (PP) condition was due to the higher levels of histamine in the post-prandial state. Low blood glucose levels are associated with a higher CVR to stress. This suggests that the persons are prone to develop future hypertension, those with frank hypertension, and the chronic pain sufferers should avoid prolonged fasts, in order to lower their CVR to the stress stimuli which are encountered in the daily life.

The role of mental distraction on the pain response in healthy young Indian adults.

BACKGROUND AND OBJECTIVES: The pain sensitivity of a person depends on the type of pain, his/her genetics, racial and cultural factors. Its dependence on the gender is debatable. The significance of the psychological or the behavioural intervention in pain management is gaining importance, along with a reduction in the doses of the analgesics. We wished to investigate (a) whether Indian subjects showed a pain response which was similar to that which was reported for American subjects, (b) whether sex-related differences in the pain response were present in the Indian population, and (c) which method of mental distraction (from a choice of the presence of a male/female attendant, preferred music, and solving simple arithmetic problems) was best suited for the Indian subjects. METHODS: The cold pressor task was performed on a group of 80 subjects (38 females who were in the proliferative or the secretory phase of the menstrual cycle) under the conditions which have been mentioned above, as well as in the absence of mental distractants. RESULTS: The female subjects endured pain for a longer duration while they listened to the music of their choice; the male subjects endured pain longer while they were in conversation with the female attendants. INTERPRETATION AND CONCLUSIONS: A comparison with the reported data showed the Indian males to be more pain-sensitive than the American males. Sex related differences in the pain sensitivity were absent in the Northern Indian subjects. Preferred music was the most effective mental distractant for females, while a conversation with the female attendants was the most effective distractant for the male subjects.

Variation in response to experimental pain across the menstrual cycle in women compared with one month respose in men.

Gender differences in pain perception have been reported in literature. However, most such studies have ignored the role of female sex hormones in influencing pain response across menstrual cycle (MC). In this study, we have investigated the variation in pain response on different days of the menstrual cycle. Ninety subjects (60 females) were subjected to experimental pain of cold pressor task, on days 1, 7, 14, and 21 of the MC (females), and on four consecutive Mondays of a month (males). Male subjects showed no variation in pain response. Females reported higher pain sensitivity on days 7 and 14 of MC. We suggest that experimental pain studies involving female menstruating subjects should be carried out only during a particular phase of the cycle, and this phase should be reported in literature to increase the reproducibility of the experiment.

Polymer coated fiber Bragg grating thermometry for microwave hyperthermia.

PURPOSE: Measuring tissue temperature distribution during electromagnetically induced hyperthermia (HT) is challenging. High resistance thermistors with nonmetallic leads have been used successfully in commercial HT systems for about three decades. The single 1 mm thick temperature sensing element is mechanically moved to measure tissue temperature distributions. By employing a single thermometry probe containing a fixed linear sensor array temperature, distributions during therapy can be measured with greater ease. While the first attempts to use fiber Bragg grating (FBG) technology to obtain multiple temperature points along a single fiber have been reported, improvement in the detection system's stability were needed for clinical applications. The FBG temperature sensing system described here has a very high temporal stability detection system and an order of magnitude faster readout than commercial systems. It is shown to be suitable for multiple point fiber thermometry during microwave hyperthermia when compared to conventional mechanically scanning probe HT thermometry. METHODS: A polymer coated fiber Bragg grating (PFBG) technology is described that provides a number of FBG thermometry locations along the length of a single optical fiber. The PFBG probe developed is tested under simulated microwave hyperthermia treatment to a tissue equivalent phantom. Two temperature probes, the multiple PFBG sensor and the Bowman probe, placed symmetrically with respect to a microwave antenna in a tissue phantom are subjected to microwave hyperthermia. Measurements are made at start of HT and 85 min later, when a 6 degrees C increase in temperature is registered by both probes, as is typical in clinical HT therapy. The optical fiber multipoint thermometry probe performs highly stable, real-time thermometry updating each multipoint thermometry scan over a 5 cm length every 2 s. Bowman probe measurements are acquired simultaneously for comparison. In addition, the PFBG sensor's detection system drift over 10 h is measured separately to evaluate system stability for clinical applications. RESULTS: The temperature profiles measured by the two probes simultaneously under microwave HT are in good agreement showing mean differences of 0.25 degrees C. The stability of the detection system is better than 0.3 degrees C with response times of the PFBG sensor system of 2 s for each scan over ten points. CONCLUSIONS: The single fixed multipoint fiber thermometry capability compares favorably with the scanning Bowman probe data. This offers an enabling alternative to either scanning or bundled single point temperature probes for distributed thermometry in clinical applications.