Risk Factors and Clinical Outcomes of Asymptomatic Bacteriuria in Pregnant Women: A Comprehensive Analysis.

Background Asymptomatic bacteriuria (ASB) in pregnant women poses risks to maternal and neonatal health. Understanding its prevalence and associated risk factors is crucial for effective management. This study aimed to determine the prevalence of ASB among pregnant women and identify associated risk factors. Methodology A cross-sectional study involving 294 pregnant women was conducted. ASB prevalence was determined, and bivariate analysis was performed to identify associated risk factors. Logistic regression analysis was employed to assess the significance of identified risk factors. Results The overall prevalence of ASB was 17.34%. Bivariate analysis revealed associations between ASB and maternal age (p > 0.05), socioeconomic status (p < 0.001), previous urinary tract infection (UTI) history (p < 0.001), diabetes mellitus (p = 0.00204), and anemia (p = 0.522). Multivariate logistic regression confirmed significant associations of ASB with maternal age (p = 0.008), parity (p = 0.001), previous UTI (p < 0.001), and diabetes mellitus (p < 0.001). Conclusion This study underscores the importance of screening for ASB during prenatal care, particularly among pregnant women with advanced maternal age, higher parity, previous urinary tract infection (UTI) history, and diabetes mellitus. Tailored screening strategies and prompt treatment can mitigate the risks associated with untreated ASB, improving maternal and neonatal outcomes. Healthcare providers should integrate these findings into routine antenatal care protocols to optimize maternal and fetal health.

Pathways in permanganate oxidation of mandelic acid: reactivity and selectivity of intermediate manganese species.

We report a comprehensive kinetic and product study of the oxidation of mandelic acid (MA) by permanganate in the pH range of 1-13, including a full account of total oxidizing equivalents (five and three-electron change in acidic and basic media, respectively). In the entire pH range, the reaction shows a primary kinetic deuterium isotope effect (kH/kD ≥8-9), indicating rate-limiting hydride transfer. The deuterium label in α-deutero-mandelic acid is retained in benzaldehyde. Benzaldehyde (BZ) is formed in post-rate limiting steps due to reactions involving manganese intermediates. In alkaline pH (≥13), in the presence of barium acetate, Mn(VI) is removed as insoluble blue barium manganate; the stoichiometry of the first step of reduction was found to be: MA + 2Mn(VII) → PGA + 2Mn(VI). Manganate, MnO42-, is directly reduced to MnO2 giving an additional mole of phenylglyoxylic acid (PGA). The experimentally observed ratio of benzaldehyde to phenylglyoxylic (BZ/PGA) provides a basis for discrimination between mechanistic choices that include direct reduction of Mn(V) to Mn(III) (in an acidic medium), disproportionation to Mn(IV) and Mn(VI) or oxidation to Mn(VI) by a second mole of permanganate. Interestingly, at pH 4, a stoichiometric, soluble Mn(IV) is observed for the first time for hydroxy-acid oxidation, reminiscent of the Guyard reaction. Because of the widespread use of permanganate as an environmentally green oxidant, results from mandelic acid oxidation have implications for the remediation of dissolved organic matter (DOM) including hydrocarbons and nitroaromatics in waste and groundwater.

[Recreative drug use and cardiovascular disease]. / Consommation de drogues récréatives et pathologies cardiovasculaires.

Widely spread, and continuously increasing, recreational drug use in general population has been associated with cardiovascular events, as illustrated by clinical studies and supported by a pathophysiological rationale. Understanding the cardiovascular effects of drugs, screening, and secondary prevention are crucial components in the management of those patients in cardiology.

A review of potential mechanisms and uses of SGLT2 inhibitors in ischemia-reperfusion phenomena.

Recently added to the therapeutic arsenal against chronic heart failure as a first intention drug, the antidiabetic drug-class sodium-glucose cotransporter-2 inhibitors (SGLT2i) showed efficacy in decreasing overall mortality, hospitalization, and sudden death in patients of this very population, in whom chronic or acute ischemia count among the first cause. Remarkably, this benefit was observed independently from diabetic status, and benefited both preserved and altered ventricular ejection fraction. This feature, observed in several large randomized controlled trials, suggests additional effects from SGLT2i beyond isolated glycemia control. Indeed, both in-vitro and animal models suggest that inhibiting the Na+/H+ exchanger (NHE) may be key to preventing ischemia/ reperfusion injuries, and by extension may hold a similar role in ischemic damage control and ischemic preconditioning. Yet, several other mechanisms may be explored which may help better target those who may benefit most from SGLT2i molecules. Because of a large therapeutic margin with few adverse events, ease of prescription and potential pharmacological efficacity, SGLT2i could be candidate for wider indications. In this review, we aim to summarize all evidence which link SGLT2i and ischemia/reperfusion injuries modulation, by first listing known mechanisms, including metabolic switch, prevention of lethal arrythmias and others, which portend the latter, and second, hypothesize how the former may interact with these mechanisms.

Fluoride Geochemistry and Exposure Risk Through Groundwater Sources in Northeastern Parts of Rajasthan, India.

Exposure to fluoride concentrations above a threshold of 1.5 mg/L can cause joint pains, restricted mobility, skeletal and dental fluorosis. This study aims to determine the hydrochemical evolution of the fluoride-rich groundwater and estimate the risk of fluoride exposure to the residents of semi-arid northeastern part of Rajasthan, India. The methodology involves measurement of fluoride and other ionic concentrations in groundwater using ion chromatography, followed by an estimation of the cumulative density function and fluorosis risk. The fluoride concentration in water samples varied from 0.04 to 8.2 mg/L with 85% samples falling above the permissible limit. The empirical cumulative density function was used to estimate the percentage and degree of health risks associated with the consumption of F- contaminated water. It is found that 55% of the samples indicate risk of dental fluorosis, 42% indicate risk of deformities to knee and hip bones, and 18% indicate risk of crippling fluorosis. In addition, instances of high nitrate concentrations above the permissible limit of 45 mg/L are also found in 13% of samples. The fluoride rich groundwater is mainly associated with the Na-HCO3-Cl type water facies while low fluoride groundwater shows varied chemical facies. The saturation index values indicate a high probability of a further increase in F- concentration in groundwater of this region. The calculated fluoride exposure risk for the general public in the study area is 3-6 times higher than the allowed limit of 0.05 mg/kg/day. Based on the results of this study, a fluorosis index map was prepared for the study area. The northern and northeastern parts are less prone to fluorosis, whereas the south-central and southwestern parts are highly vulnerable to fluorosis. The inferences from this study help to prioritize the regions that need immediate attention for remediation.

Pressure Pain Threshold in Patients With Chronic Pain: A Systematic Review and Meta-Analysis.

INTRODUCTION: In chronic pain conditions, the pressure pain threshold has been used to investigate the presence of central sensitization. METHODS: A systematic review and meta-analysis were conducted to compare the threshold in chronic pain patients and healthy individuals. Ovid MEDLINE and Embase up to July 2019 were used to conduct the search. Search strategy included terms and sets of terms that describe the concepts "sensory testing" and "pain measurement." RESULTS: The included studies consisted of 24 were case-control studies and 12 cross-sectional studies. The pooled total sample size was 1280 cases of patients with different diagnoses of chronic pain and 1463 healthy controls. Among the included studies, 32 reported a significant decrease of the pressure pain threshold among patients compared with the controls and four reported no statistically significant difference. The pooled pressure pain threshold mean difference was -1.17 (95% confidence interval = -1.45 to -0.90). There was, however, evidence of significant heterogeneity across the studies (I2 = 87.42%, P < 0.001). CONCLUSIONS: Patients who experience chronic pain have a significantly lower pressure pain threshold compared with healthy controls. Future research is needed to elucidate factors attributed to the change in pressure pain threshold among patients with chronic pain, as well as the time that the central sensitization occurs.

An insight into the awareness and utilization of "dental evidence" among the police force in Punjab.

INTRODUCTION: The prime objective of the subsequent investigation is to ascertain the identity of an individual by the evaluation of evidence and facts relevant to crime or disaster. The whole process revolves around the correct interpretation of the facts, reconstruction, and comprehension of the sequence of events and thus single evidence forms a very important piece of information. In most of the countries including India, forensic medical, and dental evaluation at the crime scene are performed by police officials as medical and dental experts are rarely involved as first responders. AIMS AND OBJECTIVES: This questionnaire-based study is aimed to emphasize the importance of dental evidence in human identification, age and gender determination, and expanding the role of dentistry in criminal investigations. MATERIAL AND METHODS: A questionnaire-based study was conducted among the 350 gazetted and nongazetted police officers posted in Ludhiana (Punjab) commissionerate. It was exploratory in nature. RESULTS: We found that the gazetted officers, postgraduates, and personnel with <20 years of experience revealed that commendable knowledge, positive attitude, and approach for the practical applications of forensic odontology (FO) in routine investigations. CONCLUSION: Dental professionals and law enforcement agencies must go hand in hand so that FO can be utilized to its maximum potential.

Optically stimulated luminescence (OSL) response of Al2O3:C, BaFCl:Eu and K2Ca2(SO4)3:Eu phosphors.

This paper investigates the optically stimulated luminescence (OSL) response of BaFCl:Eu and K2Ca2(SO4)3:Eu phosphors for different doses and bleaching durations. The results have also been compared with the commercially available Landauer Al2O3:C (Luxel®) dosemeter. Nanocrystalline K2Ca2(SO4)3:Eu is known to be a sensitive thermoluminescent phosphor, but its OSL response is hardly reported. At first, pellets of nanocrystalline K2Ca2(SO4)3:Eu powder were prepared by adding Teflon as a binder. Their OSL signal was compared with that of the material in pure form, i.e. without adding the binder (in 100:1 ratio). It was observed that adding the binder does not appreciably affect the OSL intensity. On comparison with the commercially available Al2O3:C from Landauer, it was found that K2Ca2(SO4)3:Eu is around 15 times less sensitive than Al2O3:C. 'Homemade' BaFCl:Eu phosphor has also been studied. The intensity of BaFCl:Eu was ∼20 times more than the standard Al2O3:C dosemeter and ∼200 times more sensitive than K2Ca2(SO4)3:Eu in the dose range of 13-200 cGy. OSL dosemeters are believed to give luminescence signal even if they are read before, i.e. multiple reading may be possible under suitable conditions after single exposure. This was also checked for all the prepared dosemeters and it was found that Al2O3:C showed the least decrease of <2 %, followed by BaFCl:Eu of 15 % and K2Ca2(SO4)3:Eu with 20 %. Finally, Al2O3:C and BaFCl:Eu phosphors were also studied for their optical bleaching durations to which the respective signals get completely removed so that the phosphor can be re-used. It was observed that BaFCl:Eu is bleached faster and more easily than Al2O3:C.

Nontraditional cardiovascular biomarkers and estimation of cardiovascular risk in predialysis chronic kidney disease patients and their correlations with carotid intima media thickness.

BACKGROUND: Cardiovascular biomarkers such as N-terminal pro-B-type natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), hs-CRP (high sensitivity C-reactive protein), and albuminuria predict underlying heart disease in the general population as well as CKD patients. OBJECTIVES: We aimed to study the association of NT-proBNP, cTnT, hs-CRP, and spot urine albumin creatinine ratio with carotid intima media thickness (CIMT) for cardiovascular risk estimation in predialysis CKD (chronic kidney disease) patients. PATIENTS AND METHODS: This cross-sectional study included a total of 120 adult predialysis CKD patients. Forty patients were allocated in each predialysis CKD group of stages 3, 4, and 5. Serum cTnT and hs-CRP, plasma NT-proBNP, and single spot urine albumin creatinine ratio (ACR) were measured. Ultrasonographic examination of carotid artery was done with 7.5 MHz linear probe in B mode ultrasonography and carotid intima media thickness was measured. RESULTS: Mean values ± standard deviation of plasma NT-proBNP (pg/mL), serum hs-CRP (mg/L), spot urine ACR (mg/g of creatinine), and CIMT (mm) were 585.68 ± 514.84, 5.96 ± 2.52, 719.37 ± 411.36, and 0.78 ± 0.15, respectively in predialysis CKD patients (n = 120). Serum cTnT level was high in 40% of predialysis CKD patients. Among cardiovascular biomarkers, plasma NT-proBNP had maximum strength of correlation (Spearman Rho correlation coefficient; r = 0.575 and P < 0.0001) with the carotid intima media thickness followed by serum cTnT (Spearman Rho correlation coefficient; r = 0.419 and P < 0.0001), spot urine albumin creatinine ratio (Spearman Rho correlation coefficient; r = 0.322 and P < 0.0001), and serum hs-CRP (Spearman Rho correlation coefficient; r = 0.246 and P = 0.007). CONCLUSIONS: Nontraditional cardiovascular biomarkers such as plasma NT-proBNP, serum cTnT, serum hs-CRP, and spot urine ACR significantly correlate with CIMT. These biomarkers can estimate the cardiovascular risk in a predialysis CKD population with expected high cardiac morbidity and mortality.