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OBJECTIVE: This study assessed the delivery of tiotropium via Respimat® in addition to standard care of treatment among chronic obstructive pulmonary disease (COPD) patients. We study the efficacy, clinical outcome of handling inhaler device, rate of exacerbation and frequency of hospital admission of tiotropium via Respimat® with and without the use of a spacer (AeroChamber®). METHODS: Randomised, open-label study of COPD patients which was randomised into two groups: spacer or nonspacer groups using tiotropium via Respimat®. Treatment with their pre-existing inhalers continued. Subjects were assessed at weeks 0, and 8 for forced expiratory volume in 1 second (FEV1), COPD assessment tool (CAT), St. George's Respiratory Questionnaire (SGRQ), and satisfaction questionnaire. RESULTS: We enrolled 96 subjects: 49 in the spacer group and 47 in the non-spacer group. The mean predicted FEV1 in spacer group was 54.48% at baseline and 57.5l% at week 8: p=0.011. In the non-spacer groups, FEV1 was 54.48% at baseline and 59.20% with a mean increment of 4.72 in both groups: p=0.002. There were no difference of exacerbation rates and hospital admission between both groups. At baseline, mean CAT score in the spacer group was 14.01 which improved to 9.80 (p<0.001) and 14.01 to 8.80 (p<0.001) in the non-spacer group. SGRQ total score reduced in both groups with mean difference of 3.1 (p<0.001) and 3.7: (p<0.001) at weeks 0 to 8. CONCLUSION: There was no difference between exacerbation and hospital admissions between both groups. There was no difference in FEV1, CAT and SQRQ score using Tiotropium via Respimat® with or without a spacer.
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Enfermedad Pulmonar Obstructiva Crónica , Derivados de Escopolamina , Broncodilatadores/uso terapéutico , Humanos , Satisfacción del Paciente , Satisfacción Personal , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Derivados de Escopolamina/efectos adversos , Bromuro de Tiotropio/efectos adversos , Resultado del TratamientoRESUMEN
Background & objectives: Infection fatality ratio (IFR) is considered a more robust and reliable indicator than case fatality ratio for severity of SARS-CoV-2 infection. Age- and sex-stratified IFRs are crucial to guide public health response. Infections estimated through representative community-based serosurveys would gauge more accurate IFRs than through modelling studies. We describe age- and sex-stratified IFR for COVID-19 estimated through serosurveys conducted in Chennai, India. Methods: Two community-based serosurveys were conducted among individuals aged ≥10 yr during July and October 2020 in 51 of the 200 wards spread across 15 zones of Chennai. Total number of SARS-CoV-2 infections were estimated by multiplying the total population of the city aged ≥10 yr with the weighted seroprevalence and IFR was calculated by dividing the number of deaths with the estimated number of infections. Results: IFR was 17.3 [95% confidence interval (CI): 14.1-21.6] and 16.6 (95% CI: 13.8-20.2) deaths/10,000 infections during July and October 2020, respectively. Individuals aged 10-19 years had the lowest IFR [first serosurvey (R1): 0.2/10,000, 95% CI: 0.2-0.3 and second serosurvey (R2): 0.2/10,000, 95% CI: 0.1-0.2], and it increased with age and was highest among individuals aged above 60 yr (R1: 140.0/10,000, 95% CI: 107.0-183.8 and R2: 111.2/10,000, 95% CI: 89.2-142.0). Interpretation & conclusions: Our findings suggested that the IFR increased with age and was high among the elderly. Therefore, elderly population need to be prioritized for public health interventions including vaccination, frequent testing in long-term care facilities and old age homes, close clinical monitoring of the infected and promoting strict adherence to non-pharmaceutical interventions.
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COVID-19 , Anciano , COVID-19/mortalidad , Femenino , Humanos , India/epidemiología , Masculino , SARS-CoV-2 , Estudios SeroepidemiológicosRESUMEN
The present study investigated the effect of arachidonic acid (AA) and selected prostaglandins on the regulation of vitellogenesis, ecdysteroidogenesis and methyl farnesoate (MF) synthesis in the freshwater crab Oziotelphusa senex senex and the giant mud crab, Scylla serrata Administration of AA and prostaglandin F2α (PGF2α) and prostaglandin E2 (PGE2) significantly increased ovarian index, oocyte diameter and ovarian vitellogenin levels and ecdysteroid and MF levels in the hemolymph of crabs. Secretions of MF and ecdysteroids from in vitro cultured mandibular organs (MO) and Y-organs (YO) isolated from intermolt crabs injected with AA, PGF2α and PGE2 were greater when compared with controls. In contrast, injection of prostaglandin D2 (PGD2) had no effect on vitellogenesis, ecdysteroid and MF levels in circulation. In vitro secretion of MF from MO explants isolated from avitellogenic crabs incubated with AA, PGF2α and PGE2 increased in a time-dependent manner. Conversely, incubation of YOs isolated from avitellogenic crabs with AA, PGF2α and PGE2 had no effect on secretion of ecdsyteroids. These results implicate prostaglandins in the regulation of reproduction by inducing the synthesis of MF and consequent ecdysteroid synthesis in brachyuran crabs, and provide an alternative molecular intervention mechanism to the traditional eyestalk ablation methodology to induce vitellogenesis and ovarian maturation in crustaceans.
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Ácido Araquidónico/administración & dosificación , Braquiuros/fisiología , Ecdisteroides/metabolismo , Ácidos Grasos Insaturados/metabolismo , Prostaglandinas/administración & dosificación , Vitelogénesis/fisiología , Animales , Braquiuros/efectos de los fármacos , Femenino , Especificidad de la Especie , Vitelogénesis/efectos de los fármacosRESUMEN
BACKGROUND AND OBJECTIVE: Coronavirus Disease 2019 (COVID- 19) was first reported in Malaysia in March 2020. We describe here the clinical characteristics and computed tomography (CT) patterns in asymptomatic young patients who had laboratory-confirmed COVID-19. METHODS: This is a retrospective observational study where 25 male in-patients with laboratory-confirmed COVID-19 in Hospital Canselor Tuanku Muhriz. Demographics, clinical data and CT images of these patients were reviewed by 2 senior radiologists. RESULTS: In total there were 25 patients (all males; mean age [±SD], 21.64±2.40 years; range, 18-27 years). Patients with abnormal chest CT showed a relatively low normal absolute lymphocytes count (median: 2.2 x 109/L) and absolute monocyte count (median: 0.5 x 109/L). Lactate dehydrogenase was elevated in 5 (20%) of the patients. The procalcitonin level was normal while elevated levels of alanine aminotransferase, total bilirubin, platelet and C-reactive protein were common. Baseline chest CT showed abnormalities in 6 patients. The distribution of the lesions were; upper lobe 3 (12%) lower lobe 3 (12%) with peripheral distribution 4 (16%). Of the 25 patients included, 4 (16%) had ground glass opacification (GGO), 1 (4%) had a small peripheral subpleural nodule, and 1 (4%) had a dense solitary granuloma. Four patients had typical CT features of COVID-19. CONCLUSION: We found that the CT imaging showed peripheral GGO in our patients. They remained clinically stable with no deterioration of their respiratory symptoms suggesting stability in lung involvement. We postulate that rapid changes in CT imaging may not be present in young, asymptomatic, non-smoking COVID-19 patients. Thus the use of CT thoraxfor early diagnosis may be reserved for patients in the older agegroups, and not in younger patients.
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Enfermedades Asintomáticas , Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , COVID-19 , Hospitales de Enseñanza , Humanos , Masculino , Pandemias , Estudios Retrospectivos , SARS-CoV-2 , Adulto JovenRESUMEN
The possible involvement of 13-cis retinoic acid (CRA) in the regulation of ovarian development in Oziotelphusa senex senex was investigated. Injection of CRA, into avitellogenic crabs significantly increased ovarian index, oocyte diameter and ovarian vitellogenin levels. Injection of CRA also resulted in a significant increase in the secretory rates of mandibular organs and Y-organs and circulatory levels of the methyl farnesoate and ecdysteroids. Further, administration of CRA into avitellogenic crabs produced higher amounts of Retinoid X Receptor, Ecdysteroid Receptor, E75 and vitellogenin mRNAs in the hepatopancreas. Mandibular organ and Y-organ explants isolated from avitellogenic crabs secreted more of methyl farnesoate and ecdysteroids respectively when incubated with CRA. Taken together, these observations led us to hypothesize that CRA stimulates ecdysteroidogenesis and methyl farnesoate synthesis, up-regulates EcR, RXR and E75 expression in hepatopancreas, which then induces vitellogenin gene expression. Vitellogenin is subsequently taken up from hemolymph by ovaries ensuing in ovarian maturation.
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Braquiuros/fisiología , Isotretinoína/metabolismo , Vitelogénesis/fisiología , Animales , Braquiuros/crecimiento & desarrollo , Ecdisteroides/metabolismo , Proteínas del Huevo/genética , Ensayo de Inmunoadsorción Enzimática , Femenino , Agua Dulce , Hemolinfa/metabolismo , Hepatopáncreas/metabolismo , Ovario/crecimiento & desarrollo , ARN Mensajero/metabolismo , Receptores de Superficie Celular/genética , Receptores de Esteroides/genética , Receptores X Retinoide/genética , Receptores X Retinoide/metabolismoRESUMEN
Storage pests, particularly bruchids, are major biotic constraints causing significant storage losses in pulses. Conventional control methods relying on insecticides and fumigants often lead to food contamination due to toxic pesticide residues and a rapid decline in seed germination. In this investigation, through green nano-technological application, a promising and sustainable alternative for pest management is developed. Silver and copper nanoparticles were synthesized through ocimum leaf extract. The characterization of silver and copper nanoparticles was carried out by UV-spectroscopy, particle size analyzer, scanning electron microscopy, X-ray diffraction, and Fourier-transform infrared. Both the nanoparticles were spherical and crystalline in nature. Greengram seeds were primed with standardized silver and copper nanoparticles at different concentrations (1000, 1500, and 2000 ppm) and compared with castor-treated, deltamethrin-treated, and untreated control seeds for seed quality, growth, and yield. After one month of storage, all the pulse beetles released in different treatments exhibited 100 % mortality, whereas in control, the insects multiplied. At the end of nine months, the control seeds had shown 72 % damage and 39.67 % germination. In contrast, silver nanoparticles at 1000 ppm showed no seed damage and achieved 81.67 % germination, which was on par with copper nanoparticles at 1000 ppm with 79.33 % germination. Seed priming of silver and copper nanoparticles at 1000 ppm also demonstrated superior performance in all the seed quality and biochemical parameters (alpha amylase and catalase) throughout the storage period. Whereas, in the greenhouse experiment, enhanced growth (35.96 cm, 46.48 cm, and 53.00 cm at 30, 60 DAS, and at harvest, respectively) and yield per plant (3.75 g) were significantly higher in plants that were given foliar application with silver nanoparticles at 1000 ppm. Furthermore, foliar application of these nanoparticles at all concentrations (1000, 1500, and 2000 ppm) did not exhibit any adverse effects on soil microbial organisms, as assessed by dehydrogenase enzyme activity. Hence, this research highlights the potential use of silver and copper nanoparticles at 1000 ppm as effective tools for storage pest management and contributing to improved agricultural productivity and sustainability.
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In the present study, Lactobacillus plantarum-HDS27 strain isolated from bovine milk was used for the enhanced production of riboflavin. Production medium was optimized by one factor at a time with different parameters. Statistical optimization by Response surface methodology (RSM), central composite design was used to optimize variables such as pH, temperature, glucose, and yeast extract. The present study reveals the maximum riboflavin production by one factor at a time was obtained under the culture conditions; glucose, yeast extract, pH 6, the temperature at 40°C, and 3% of inoculum size. In RSM, analysis of variance for the responses was calculated. Among the tested variables, pH, yeast extract, and temperature showed significant impact on riboflavin production. Maximum amount of yeast extract in production medium resulted in increased riboflavin production. The riboflavin production after 24 h with the optimal condition was found to be 12.33 mg/L. It was found proximate to the expected value (12.29 mg/L) achieved by the RSM model. The yield of riboflavin was increased to 3.66-fold after 24 h with the optimized parameters. The current research, emphasizes that the Lactobacillus plantarum-HDS27 could be an excellent strain for the large-scale industrial production of riboflavin.
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Chapati is an unleavened flat baked product and it is prepared using whole wheat flour. One of the problems with chapatis is that they stale rapidly during storage and therefore, they have to be consumed immediately after their preparation. With changing socio-economic conditions and lifestyles, there is an increasing demand for ready to eat chapatis. In the present study, to control staling, chapatis were prepared using whole wheat flours of four different varieties by incorporating additives such as surfactant and fat. The chapatis stored at room temperature for 24 h, 48 h, 72 h and 96 h were evaluated for their quality parameters such as moisture content, chemical properties, sensory attributes, microstructure and amylograph characteristics. The moisture, soluble starch and soluble amylose contents in control chapatis decreased steadily with storage time and at the end of 96 h, the decrease in moisture, soluble starch and soluble amylose contents in chapatis prepared from different varieties were 3-8%, 80-82% and 78-85%, respectively. However, these changes were found to be at a very lesser rate in chapatis prepared from doughs treated with glycerol monostearate (GMS) and fat compared to that of control. Decrease in amylograph paste viscosity was more in control chapatis during storage compared to that of treated chapatis. Scanning electron microscopic studies of chapatis stored up to 96 h revealed that starch granules were uniform in both GMS and fat treated chapatis, when compared to control chapatis. Sensory studies showed that overall quality scores for chapatis prepared from GMS and fat treated doughs did not show any significant differences on storage. Thus, the results suggested that incorporation of surfactant and fat in dough not only improved the overall quality attributes of chapatis but also controlled their staling, during their storage.
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The excitation functions for 64,66,67,68,70Zn(p,n)64,66,67,68,70Ga and 64,66,67,68,70Zn(p,2n)63,65,66,67,69Ga have been calculated for incident proton energies from threshold values to 30â¯MeV using the statistical model code TALYS-1.6. The (p,n) and (p,2n) cross sections have been calculated using both phenomenological Koning and Delaroche (KD) and semimicroscopic Jeukenne-Lejeune-Mahaux-Bruyeres (JLMB) optical model potentials. The phenomenological back-shifted Fermi gas model (BFM) and microscopic Hartree-Fock (HF) approaches for calculation of level densities have been compared in the present work. The pre-equilibrium process has been treated using exciton model. The sensitivity of cross section data to different models of optical model potential and level density have been investigated. It is found that the (p,n) and (p,2n) cross section calculations with semimicroscopic JLMB optical model potential and microscopic HF level density show agreement with the data. The (p,n) and (p,2n) cross section calculations have been compared with corresponding cross sections from nuclear data library, TENDL-2019. The (p,xn) cross sections obtained will be useful in several applications, particularly, for optimization of production routes for Ga isotopes.
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In general, in peritoneal dialysis (PD) practice in hospitals, Twardowski and Prowant's exit-site classification system is used, while the International Society for Peritoneal Dialysis (ISPD) exit-site scoring system is practical to use in community visits with less experienced healthcare personnel. Nevertheless, when exit-site scoring is 3 points under the ISPD exit-site score system and it falls in the category of equivocal under the Twardowski and Prowant's exit-site classification, the physician should be vigilant about the possibility of developing peritonitis, and hence, patients need to be kept under periodic monitoring.
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Infecciones Relacionadas con Catéteres/clasificación , Infecciones Relacionadas con Catéteres/tratamiento farmacológico , Fallo Renal Crónico/terapia , Diálisis Peritoneal/efectos adversos , Peritonitis/clasificación , Peritonitis/etiología , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Infecciones Relacionadas con Catéteres/epidemiología , Catéteres de Permanencia/efectos adversos , Estudios de Cohortes , Femenino , Humanos , Fallo Renal Crónico/diagnóstico , Masculino , Persona de Mediana Edad , Diálisis Peritoneal/métodos , Peritonitis/tratamiento farmacológico , Pronóstico , Medición de Riesgo , Sociedades Médicas , Resultado del Tratamiento , Adulto JovenRESUMEN
In the title mol-ecule, C(10)H(14)N(2)S, the n-butyl chain assumes a trans zigzag conformation. The dihedral angle between the pyridine ring and the thio-amide plane is 23.38â (8)°. The mol-ecules in the crystal structure are linked by an inter-molecular N-Hâ¯N hydrogen bond.
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Riboflavin is an essential, water-soluble vitamin (B2) and a component of basic cellular metabolism. The aim of the present study is to isolate and characterize riboflavin producing bacteria from different food sources. Ten different riboflavin enriched food sources were collected from Vellore district. Totally 72 bacterial strains were isolated and cultured on nutrient agar plates. Out of these, 43 strains were identified as riboflavin producers. Isolated bacterial strains HDS27, HDS07, HDS14, HDS18, HDS38 and HDS54 isolated from milk, mushroom, spinach, lamb kidney, beef liver and mackerel fish were found to be potent riboflavin producers. Based on morphological, biochemical and molecular characterization, the potent strains were identified as Lactobacillus plantarum (HDS27), Bacillus cereus (HDS07), Delftia tsuruhatensis (HDS14), Citrobacter freundii (HDS18), Enterobacter cloacae (HDS38) and Bacillus cereus (HDS54). The selected potent isolates HDS27 from milk and HDS07 from mushroom showed a maximum riboflavin production of 3.69 mg/L and 2.9mg/L respectively. The present study explores the riboflavin producing novel bacteria from different food sources. This is the first report that the Enterobacter cloacae isolated from beef liver, Delftia tsuruhatensis from spinach and Citrobacter freundii from lamb kidney has the ability to produce riboflavin. These potent strains could be a better starter for substituting the conventional bacteria for large scale production of riboflavin in industry.
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Riboflavina , Bacillus cereus , Citrobacter freundii , Lactobacillus plantarumRESUMEN
INTRODUCTION: Anaemia is associated with increased post-operative morbidity and mortality. We retrospectively assess the relationship between preoperative anaemia and in-hospital mortality in valvular cardiac surgical population. MATERIALS AND METHODS: Data from consecutive adult patients who underwent valvular repair/ replacement at our institute from January 2010 to April 2014 were collected from hospital records. Anaemia was defined according to WHO criteria (hemoglobin <13g/dl for males and <12g/dl for females). 1:1 matching was done for anemic and non-anemic patients based on propensity for potentially confounding variables. Logistic regression was used to evaluate the relationship between anaemia and in-hospital mortality. MatchIt package for R software was used for propensity matching and SPSS 16.0.0 was used for statistical analysis. RESULTS: 2449 patients undergoing valvular surgery with or without coronary artery grafting were included. Anaemia was present in 37.1% (33.91% among males & 40.88% among females). Unadjusted OR for mortality was 1.6 in anemic group (95% Confidence Interval [95% CI] - 1.041-2.570; p=0.033). 1:1 matching was done on the basis of propensity score for anaemia (866 pairs). Balancing was confirmed using standardized differences. Anaemia had an OR of 1.8 for mortality (95% CI- 1.042 to 3.094, P=0.035). Hematocrit of < 20 on bypass was associated with higher mortality. CONCLUSION: Preoperative anaemia is an independent risk factor associated with in-hospital mortality in patients undergoing valvular heart surgery.
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Anemia/complicaciones , Anemia/mortalidad , Válvulas Cardíacas/cirugía , Mortalidad Hospitalaria , Periodo Preoperatorio , Adulto , Femenino , Humanos , Masculino , Estudios Retrospectivos , Riesgo , Factores de RiesgoRESUMEN
A simple technique employed for the restoration of the obliterated painted registration number on a motor vehicle involved in a case of murder is described.
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Conducción de Automóvil/legislación & jurisprudencia , Medicina Legal/métodos , Concesión de Licencias , Vehículos a Motor , Pintura , Diseño de Equipo , Homicidio/legislación & jurisprudenciaRESUMEN
BACKGROUND: The role of chemotherapeutic agents in periodontal therapy as adjuncts to mechanical debridement maybe justified by the inherent limitations of mechanical therapy. The aim of this study was to evaluate the long term efficacy of a locally delivered 2% minocycline gel as an adjunct to scaling and root planing in managing chronic periodontitis. MATERIALS AND METHODS: This was a randomized controlled trial using a split-mouth study design. Twenty two pairs of sites with similar probing depths were randomly allocated to test and control groups. All sites received thorough scaling and root planing followed by minocycline gel application in the test sites. Probing depths, relative attachment levels, plaque index, and microbiological parameters were evaluated for both the groups over a 9-month period. RESULTS: Overall parameters improved from baseline in both the test and control groups. For most parameters, the differences between test and control groups were not significant at different time intervals. The probing depth values in the test group at six (3.64±0.83 mm) and nine months (3.81±0.79 mm) were significantly less than control group(4.24±0.95 mm at six and 4.63±0.94 mm at nine months), these differences being significant at P<0.05 and <0.01, respectively. At the end of nine months, the number of non-motile bacilli in test group (21.65±3.74) were significantly less than control group (25.5±3.01), the difference being significant at P<0.02. CONCLUSION: The overall view of results in our investigation did not show any significant advantage of using 2% minocycline gel over scaling and root planning as an effective local drug delivery system and calls for further clinical trials to objectively evaluate its adjunctive in treatment of periodontitis.
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BACKGROUND AND OBJECTIVES: Traditional methods of periodontal therapy produce results in healing of tissues by repair; however, what we require is regeneration of the lost tissues. The periodontal ligament (PDL) cells appear to be important in periodontal wound healing. Platelet derived growth factor (PDGF), a potent mitogen and useful mediator for wound healing, has been extensively studied in periodontal regeneration. This in vitro study was designed to evaluate the effect of PDGF-AB on human PDL fibroblasts (hPDLF) at 50, 100 and 150 ng/ml dosages at 24, 48 and 72 hours time duration. MATERIALS AND METHODS: Tissue explants from three different patients were harvested from the roots of freshly extracted, uninfected and impacted third molars. The cells cultured from all samples were divided into 4 groups: Group-1 was the control group, and the experimental groups were designated as Group-2, Group-3 and Group-4, to test the effect of PDGF-AB at 50, 100 and 150 ng/ml by proliferation assay carried out at 24, 48 and 72 hours. RESULTS: The results revealed maximum mitogenic response of PDL cells at 100 ng/ml and at 48 hours, suggesting that the mitogenic response of PDGF-AB is both, time and dose dependent. CONCLUSIONS: The results of this in vitro study suggest that PDGF has maximum mitogenic response on hPDLF at 48 hours and for 100 ng dose. However for clinical application, randomized controlled clinical trials are required to substantiate the results of this in vitro study.
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Keratocystic odontogenic tumor (KCOT), also known as odontogenic keratocysts, as defined by World Health Organization (WHO), are known for their peculiar behavior, varied origin, debated development, unique tendency to recur, and disputed treatment modalities. We present a case of KCOT involving symphysis menti, right and left halves of the body of mandible in an 11-year-old girl treated with enucleation and open dressing (bismuth, iodoform, paraffin paste) with long-term follow-up.
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Neoplasias Mandibulares/patología , Quistes Odontogénicos/patología , Tumores Odontogénicos/patología , Niño , Femenino , Lateralidad Funcional , Humanos , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/cirugía , Quistes Odontogénicos/diagnóstico por imagen , Quistes Odontogénicos/cirugía , Tumores Odontogénicos/diagnóstico por imagen , Tumores Odontogénicos/cirugía , Radiografía , Resultado del TratamientoRESUMEN
Osteomyelitis of the maxillofacial skeleton is a rare condition in recent times. The combination of antibiotic therapy and surgical debridement is effective in the treatment of chronic suppurative osteomyelitis (CSO). This case report describes the successful surgical treatment of CSO of the mandible in an 18-year-old adult. Treatment included a pre-surgical course of antibiotics followed by sequestrectomy, resection of the coronoid process and removal of the pathologically fractured condylar process of the left side of the mandible. On post-operative clinical review at 1 week, the extra oral draining sinus healed with improved mouth opening.