A novel circular approach to analyze the challenges associated with micro-nano plastics and their sustainable remediation techniques.

The mismanagement of consumer-discarded plastic waste (CDPW) has raised global environmental concerns about climate change. The COVID-19 outbreak has generated ∼1.6 million tons of plastic waste per day in the form of personal protective equipment (masks, gloves, face shields, and sanitizer bottles). These plastic wastes are either combustible or openly dumped in aquatic and terrestrial environments. Open dumping upsurges emerging contaminants like micro-nano plastics (MNPs) that directly enter the ecosystem and cause severe impacts on flora and fauna. Therefore, it has become an utmost priority to determine sustainable technologies that can degrade or treat MNPs from the environment. The present review assesses the sources and impacts of MNPs, various challenges, and issues associated with their remediation techniques. Accordingly, a novel sustainable circular model is recommended to increase the degradation efficiency of MNPs using biochemical and biological methods. It is also concluded that the proposed model does not only overcome environmental issues but also provides a sustainable secondary resource to meet the sustainable development goals (SDGs).

Sustainable approach for valorization of solid wastes as a secondary resource through urban mining.

The incessant population has increased the production and consumption of plastics, paper, metals, and organic materials, which are discarded as solid waste after their end of life. The accumulation of these wastes has created growing concerns all over the world. However, conventional methods of solid waste management i.e., direct combustion and landfilling have caused several negative impacts on the environment (releasing toxic chemicals and greenhouse gases, huge land use) besides affecting human health. Therefore, it is requisite to determine sustainable alternative technologies that not only help in mitigating environmental issues but also increase the economic value of the discarded solid wastes. This process is known as urban mining where waste is converted into secondary resources and thereby conserves the natural primary resources. Thus, this review highlights the technological advancements in the valorization process of discarded wastes and their sustainable utilization. We also discussed several limitations of the existing urban mining processes and further the feasibility of valorization techniques was critically analyzed from a techno-economical perspective. This paper recommends a novel sustainable model based on the circular economy concept, where waste is urban mined and recovered as a secondary resource to support the united nations sustainable development goals (SDGs). The implementation of this model will ultimately help the developing countries to achieve the target of SDGs 11, 12, and 14.

Study of Clinical, Hematological and Molecular Characteristics of Patients of Thalassemia and Hemoglobinopathies in Tertiary Care Hospital.

To study clinical, hematological and molecular characteristics of patients of thalassemia and hemoglobinopathies and to correlate the molecular characteristics with clinical and hematological presentations. Material: This observational cross sectional study included 100 patients of age >12 years of all genders with chronic haemolytic anemia and history of multiple blood transfusion. Blood and radiological investigations were done. Clinical, hematological and molecular characteristics were studied. Observation and Clinical: Pallor was present in all cases and icterus in 32% cases. Total 48% of the patients had hepatomegaly and 98% had splenomegaly. Among genotypes, 15% cases had α-thalassemia, 62% had ß thalassemia + 뫧 thalassemia, 7% had HbS hemoglobinopathy, and 16% had HbE hemoglobinopathy. Hematological: Hemoglobin showed significant association with molecular genotypes of thalassemia with lowest being present in ß-thalassemia + 뫧 thalassemia and HbE.MCV showed significant association with molecular genotypes, with HbE having the lowest MCV of 65.5 fl. LDH levels showed a significant association with molecular genotype with highest being in HbS hemoglobinopathy. Molecular Characteristics: Common mutations in compound α-thalassemia were 3.7, 4.2 and 20.5 deletion. As for ß-thalassemia and 뫧 thalassemia, 47 cases had heterozygous type and 15 cases had homozygous types. In ß-thalassemia, the homozygous type showed IVS1- 5(G→C),CD 41/42(→CTT) and IVSII-654(G→T) while heterozygous type showed CD16(→G), CD 41/42(→CTT), IVS1-5(G→C), and IVSII-654(G→T) . In 뫧 thalassemia, the heterozygous type showed 뫧 inversion mutation.In HbS hemoglobinopathy, heterozygous type showed Codon 6(A→T) and compound heterozygous type showed IVS1- 5(G→C) and Codon 6(A→T). In HbE hemoglobinopathy,the homozygous type showed CD26(G→A) and compound heterozygous type showed IVS1-5(G→C) and IVSII 654(G→T). Conclusion: The common thalassemia genotypes observed in our study were α-thalassemia (15%), ß thalassemia + 뫧 thalassemia, (62%) HbS hemoglobinopathy (7%), and HbE hemoglobinopathy (16%). The patients presented with pallor, icterus, hepatomegaly, and splenomegaly which were comparable among all molecular genotypes of thalassemia and hemoglobinopathies. α-thalassemia had compound α-thalassemia with common mutations being 3.7, 4.2 and 20.5 deletion. As for ß-thalassemia and 뫧 thalassemia, 47 cases had heterozygous type and 15 cases had homozygous types. In 뫧 thalassemia, the heterozygous type showed 뫧 inversion mutation in 5 cases. MCH, Retic count, ferritin stores, and peripheral blood smear were similar in all molecular genotypes. Hemoglobin, MCV and LDH showed a significant association with molecular genotypes. Microcytic hypochromic anaemia was commonest among all.The findings of the present study show that the genotypes of thalassemia are characterized by diversity as well as significant genetic heterogeneities.

COVID-19 with and without anosmia or dysgeusia: A case-control study.

Various new clinical signs and symptoms, such as dysfunction of smell (anosmia) and taste (dysgeusia) have emerged ever since the coronavirus disease 2019 (COVID-19) pandemic begun. The objective of this study was to identify the clinical presentation and factors associated with 'new loss/change of smell (anosmia) or taste (dysgeusia)' at admission in patients positive by real time polymerase chain reaction for SARS-CoV-2 infection. All adult COVID-19 patients with new onset anosmia or dysgeusia at admission were included in study group. Equal number of age and gender matched COVID-19 patients without anosmia or dysgeusia at admission were included in the control group. A total of 261 COVID-19 patients were admitted during the study period of which 55 (21%) had anosmia and or dysgeusia. The mean (SD) age was 36 (13) years and majority were males (58%, n = 32). Comorbidity was present in 38% of cases (n = 21). Anosmia and dysgeusia were noted in more than 1/5th of the cases. Anosmia (96%, n = 53) was more common than dysgeusia (75%, n = 41). Presence of both ansomia and dysgeusia was noted in 71% of patients (n = 39). On comparing the cases with the controls, on univariate analysis, fever (higher in cases), rhinitis (lower in cases), thrombocytopenia, elevated creatinine and bilirubin (all higher in cases) were significantly associated with anosmia or dysgeusia. On multivariate analysis, only rhinitis (odds ratio [OR]: 0.28; 95% confidence interval [CI]: 0.09-0.83; p = .02) thrombocytopenia (OR: 0.99; 95% CI: 0.99-0.99; p = .01) and elevated creatinine (OR: 7.6; 95% CI: 1.5-37.6; p = .01) remained significant. In this retrospective study of COVID-19 patients, we found anosmia and dysgeusia in more than 1/5th of the cases. Absence of rhinitis, low platelet counts and elevated creatinine were associated with anosmia or dysgeusia in these patients.

Microbial community in human gut: a therapeutic prospect and implication in health and diseases.

The interest in the working and functionality of the human gut microbiome has increased drastically over the years. Though the existence of gut microbes has long been speculated for long over the last few decades, a lot of research has sprung up in studying and understanding the role of gut microbes in the human digestive tract. The microbes present in the gut are highly instrumental in maintaining the metabolism in the body. Further research is going on in this field to understand how gut microbes can be employed as potential sources of novel therapeutics; moreover, probiotics have also elucidated their significant place in this direction. As regards the clinical perspective, microbes can be engineered to afford defence mechanisms while interacting with foreign pathogenic bodies. More investigations in this field may assist us to evaluate and understand how these cells communicate with human cells and promote immune interactions. Here we elaborate on the possible implication of human gut microbiota into the immune system as well as explore the probiotics in the various human ailments. Comprehensive information on the human gut microbiome at the same platform may contribute effectively to our understanding of the human microbiome and possible mechanisms of associated human diseases.

Bacterial isolation of milk samples submitted from clinical mastitis buffaloes during 2007 to 2016.

The present study determined trends in the isolation of bacterial pathogens in milk samples submitted from clinical mastitis buffaloes at the University mastitis laboratory during 2007 to 2016. Culture results (n = 3945) were classified into six categories (Staphylococcus spp., 28.7%; Streptococcus spp., 1%; Corynebacterium spp., 1.1%; gram-negative organisms, 3.2%; others including mixed growths, 3.3%; and no growth, 62.7%). Overall, culture results were significantly associated with year (χ2 = 112.28; df = 10; P < 0.001) and season (χ2 = 136.03; df = 20; P < 0.001). From 2007-2009 to 2013-2016, the isolation of Staphylococcus spp. increased from 28.2 to 48.4%, while isolation of Streptococcus spp. (50 to 20%) and Corynebacterium spp. (65.1 to 16.3%) decreased. The proportion of samples characterized as no growth increased from 26.4% (2007-2009) to 46.3% (2013-2016). Further, the proportion of clinical mastitis cases increased over the study years (goodness-of-fit χ2 = 59; df = 2; P < 0.001). With respect to season, the proportion of Staphylococcus spp. (30.6%; 346/1132), Corynebacterium spp. (48.8%; 21/43), and gram-negative bacteria (55.9%; 71/127) were more associated with the monsoon, and that of Streptococcus spp. (47.5%; 19/40) with the winter. Seasonal effects were also observed on the occurrence of clinical mastitis cases; comparatively, more clinical mastitis cases (35.6%; 523/1473) were observed during the monsoon season (goodness-of-fit χ2 = 276.7; df = 4; P < 0.001) as compared with other seasons. The present study concludes that Staphylococcus spp. are the major cause of intramammary infections in buffaloes with clinical mastitis, demanding more studies regarding its epidemiology and pathogenicity. Also, more efforts are needed in the prevention and control of clinical mastitis in buffaloes, especially, during the monsoon season.

Hydrometrocolpos etiology and management: past beckons the present.

Hydrometrocolpos is a rare condition in which the uterus and the vagina are grossly distended with a retained fluid other than pus or blood. It may present during the neonatal period or later at puberty. Most cases reported earlier were stillbirths and were diagnosed only on autopsy. Antenatal diagnosis is now possible with the advent of ultrasound. An early diagnosis and speedy management is the key to survival. Many previous case reports have focused on the varied clinical presentations, multiple causes, associated syndromes and/or the radiological diagnosis of this condition. However, management options for different types of hydrometrocolpos have not yet been concisely discussed. We have reviewed the literature and tried to summarize the management options applicable to most case scenarios of hydrometrocolpos.

A review of genetic factors contributing to the etiopathogenesis of anorectal malformations.

BACKGROUND: Anorectal malformation (ARM) is a common congenital anomaly with a wide clinical spectrum. Recently, many genetic and molecular studies have been conducted worldwide highlighting the contribution of genetic factors in its etiology. We summarize the current literature on such genetic factors. MATERIALS AND METHODS: Literature search was done using different combinations of terms related to genetics in anorectal malformations. From 2012 to June 2017, articles published in the English literature and studies conducted on human population were included. OBSERVATIONS AND RESULTS: A paradigm shift was observed from the earlier studies concentrating on genetic aberrations in specific pathways to genome wide arrays exploring single nucleotide polymorphisms (SNPs) and copy number variations (CNVs) in ARM patients. Rare CNVs (including 79 genes) and SNPs have been found to genetically contribute to ARM. Out of disrupted 79 genes one such putative gene is DKK4. Down regulation of CDX-1 gene has also been implicated in isolated ARM patients. In syndromic ARM de novo microdeletion at 17q12 and a few others have been identified. CONCLUSION: Major genetic aberrations proposed in the pathogenesis of ARM affect members of the Wnt, Hox (homebox) genes, Sonic hedgehog (Shh) and Gli2, Bmp4, Fgf and CDX1 signalling pathways; probable targets of future molecular gene therapy.

NADPH oxidases differentially regulate ROS metabolism and nutrient uptake under cadmium toxicity.

The role of NADPH oxidases under cadmium (Cd) toxicity was studied using Arabidopsis thaliana mutants AtrbohC, AtrbohD and AtrbohF, which were grown under hydroponic conditions with 25 and 100 µM Cd for 1 and 5 days. Cadmium reduced the growth of leaves in WT, AtrbohC and D, but not in AtrbohF. A time-dependent increase in H2 O2 and lipid peroxidation was observed in all genotypes, with AtrbohC showing the smallest increase. An opposite behaviour was observed with NO accumulation. Cadmium increased catalase activity in WT plants and decreased it in Atrboh mutants, while glutathione reductase and glycolate oxidase activities increased in Atrboh mutants, and superoxide dismutases were down-regulated in AtrbohC. The GSH/GSSG and ASA/DHA couples were also affected by the treatment, principally in AtrbohC and AtrbohF, respectively. Cadmium translocation to the leaves was severely reduced in Atrboh mutants after 1 day of treatment and even after 5 days in AtrbohF. Similar results were observed for S, P, Ca, Zn and Fe accumulation, while an opposite trend was observed for K accumulation, except in AtrbohF. Thus, under Cd stress, RBOHs differentially regulate ROS metabolism, redox homeostasis and nutrient balance and could be of potential interest in biotechnology for the phytoremediation of polluted soils.

Radionuclides: Accumulation and Transport in Plants.

Application of radioactive elements or radionuclides for anthropogenic use is a widespread phenomenon nowadays. Radionuclides undergo radioactive decays releasing ionizing radiation like gamma ray(s) and/or alpha or beta particles that can displace electrons in the living matter (like in DNA) and disturb its function. Radionuclides are highly hazardous pollutants of considerable impact on the environment, food chain and human health. Cleaning up of the contaminated environment through plants is a promising technology where the rhizosphere may play an important role. Plants belonging to the families of Brassicaceae, Papilionaceae, Caryophyllaceae, Poaceae, and Asteraceae are most important in this respect and offer the largest potential for heavy metal phytoremediation. Plants like Lactuca sativa L., Silybum marianum Gaertn., Centaurea cyanus L., Carthamus tinctorius L., Helianthus annuus and H. tuberosus are also important plants for heavy metal phytoremediation. However, transfer factors (TF) of radionuclide from soil/water to plant ([Radionuclide]plant/[Radionuclide]soil) vary widely in different plants. Rhizosphere, rhizobacteria and varied metal transporters like NRAMP, ZIP families CDF, ATPases (HMAs) family like P1B-ATPases, are involved in the radio-phytoremediation processes. This review will discuss recent advancements and potential application of plants for radionuclide removal from the environment.

Relationship between teat morphological traits and subclinical mastitis in Frieswal dairy cows.

The present study was aimed to investigate the relationship between selected morphological traits of teat and subclinical mastitis (SCM) in Frieswal crossbred dairy cows. A total of 1040 quarters from 261 lactating cows were evaluated for teat shape (bottle/fleshy/collapsed/conical/normal/pencil and short), teat-end shape (dished/flat/funnel/pocketed/pointed and rounded), teat orientation (aligned/misaligned) and teat position (front and rear; left-sided and right-sided). Each udder quarter was screened with California Mastitis Test (CMT) for the purpose of defining quarter health status. Data were analysed using Chi-square test and multivariable logistic regression procedure. An overall prevalence of SCM (CMT positive) at quarter level was 30.6%. Most of the teats had normal or cylindrical shapes (48%), dished teat-ends (40.7%), and aligned (central or squared) in orientation (65%). At bivariable level, significant association of SCM with teat shape, teat position, teat orientation, parity, and stage of lactation was observed (P < 0.05 to P < 0.001). Teat-end shapes showed some association with SCM (P = 0.07). Results of multivariable analysis showed that pencil-shaped teats were least associated with SCM (P < 0.05) as compared to other teat shapes. Prevalence of SCM was also higher in rear teats (P = 0.015), misaligned teats (P = 0.01), and cows in second or higher parities (P < 0.01) and late stage of lactation (P < 0.001). The results of the present study indicate that selected morphological traits of teat are associated with SCM in Frieswal crossbred cows; therefore, selection towards desirable morphological traits could help reduce mastitis in this breed.

Risk-based Management of Non-muscle Invasive Bladder Cancer: Experience from Tribhuvan University Teaching Hospital.

Background Most of the recent evidences suggest for risk-based management of non muscle invasive bladder cancer (NMIBC) to reduce the risk of recurrence and progression. Objective This study was conducted to assess the recurrence and progression of non muscle invasive bladder cancer in Nepalese patients using European Organization for Research and Treatment of Cancer (EORTC) risk tables and to assess the effectiveness of intravesical therapy to reduce the risk of recurrence. Method A prospective observational single centre study was conducted at Tribhuvan University Teaching Hospital from January 2010- December 2012. Forty six patients with non muscle invasive bladder cancer who underwent transurethral resection of bladder tumor and completed two years follow up were included. According to the European Organization for Research and Treatment of Cancer (EORTC) risk table, the patients were divided into low, intermediate and high risk groups. The patients received postoperative adjuvant therapy and surveillance as per the European Association of Urology guidelines. Result Among the 46 patients, the overall two year recurrence and progression rate was 8 (17%) and 1 (2%) respectively. Out of seven patients in low risk category, none of them developed recurrence or progression of disease. Out of 15 patients in intermediate risk category the one year and two year recurrence rate was 13% and 20% respectively. Out of 24 patients in high risk category the one and two year recurrence rate was 17% and 21% respectively. The risk reduction by use of intravesical Bacillus Calmette Guerin (BCG) for recurrence in high risk category was 58% and 60% in first and second year respectively. In our study, the overall and individual risk group, the one and two year recurrence rate was lower than that predicted by European Organization for Research and Treatment of Cancer risk table. Conclusion Risk-based management of non muscle invasive bladder cancer by using the European Organization for Research and Treatment of Cancer risk table is a useful method of management, though its prediction rates are lower in Nepalese population.

A new sixth order method for nonlinear equations in R.

A new iterative method is described for finding the real roots of nonlinear equations in R. Starting with a suitably chosen x 0, the method generates a sequence of iterates converging to the root. The convergence analysis is provided to establish its sixth order of convergence. The number of iterations and the total number of function evaluations used to get a simple root are taken as performance measure of our method. The efficacy of the method is tested on a number of numerical examples and the results obtained are summarized in tables. It is observed that our method is superior to Newton's method and other sixth order methods considered.

Neonatal necrotising fasciitis managed conservatively: an experience from a tertiary centre.

OBJECTIVE: Conventional therapy for neonatal necrotising fasciitis (NF) involves resuscitation and aggressive surgical debridement of necrotic tissue. This approach adds surgical stress in septicaemic neonates with low reserves. The present study reports a more conservative approach to the management of neonatal NF. METHOD: A prospective study was conducted between July 2010 and June 2013 and included 11 cases of neonatal NF. Demographic characteristics of patients were noted. No debridement was performed. Dressings were applied after cleaning with normal saline every 24 hours. The necrotic slough was allowed to separate spontaneously. A record was made of type and duration of supportive modalities and complications. The primary outcome was recorded as final recovery, need of surgical intervention or need of grafting. RESULTS: Out of 11 neonates, 6 were males and 5 were females. Age ranged from 13 to 24 days (mean age 18.45±3.24 days), and weight varied from 1.8 to 2.6 kg (mean weight 2.12±0.24kg) at presentation. Duration of illness before admission to hospital ranged from 3 to 9 days (mean 4.84±2.13 days). The most common site of the initial involvement was the neck and upper thoracic region (n=4), scalp (n=3), lower back (n=2), face (n=1) and extremities (n=1). In all cases, the wound was cleaned with normal saline, dressed, necrotic slough was allowed to separate spontaneously and granulation tissue was allowed to develop; this took approximately 14 to 28 days (mean 20.45±5.78 days). CONCLUSION: As opposed to the conventional approach of aggressive debridement in neonatal NF, these cases can be managed conservatively without increase in morbidity or mortality. This approach also minimises the surgical risk and requirement of blood transfusion. Antifungal drugs have a definitive role in management of these immunologically deficient babies.

Non-operative management of giant omphalocele with topical povidone-iodine and powdered antibiotic combination: early experience from a tertiary centre.

PURPOSE: The aim of the study was to evaluate topical povidone-iodine and topical powdered antibiotic combination (Polymyxin, Bacitracin and Neomycin) in initial non-operative management with delayed closure of the defect of giant omphaloceles. METHODS: A prospective study was conducted between July 2010 and June 2013 including all neonates with giant omphalocele without signs of intestinal obstruction. All cases were managed by daily application of povidone-iodine (5% solution) followed by spraying topical powdered antibiotic combination to promote eschar formation and eventual epithelialisation. Record was made of sex, associated anomalies, length of stay, and thyroid function tests. RESULTS: Twenty-four neonates with giant omphaloceles were treated with topical povidone-iodine and topical powdered antibiotic combination. No sac ruptures were observed in our series. All patients had a normal thyroid function test at presentation and after 10 days of initiation of treatment. Six patients have undergone delayed repair. CONCLUSION: Topical povidone-iodine and powdered antibiotic combination promotes more rapid escharification and epithelialisation of the omphalocele than povidone-iodine alone. We also hypothesise that combination minimises the chances of hypothyroidism associated with use of povidone-iodine alone.

Effect of stem cells on renal recovery in rat model of partial unilateral upper ureteric obstruction.

BACKGROUND: Untreated obstructive uropathy produces irreversible renal damage and is an important cause of pediatric renal insufficiency. This study was designed to evaluate the effects of stem cell injection on morphological and pathological changes in the rat kidneys with partial unilateral upper ureteric obstruction (PUUUO). METHODS: Wistar rats (n = 30) were operated upon to create a PUUUO by the psoas hitch method and were randomized into Group I (control, n = 15) and Group II (stem cell, n = 15); at day 5, 10 and 15, a subgroup of rats (n = 5) from each group was killed and the kidneys harvested. Pathological and morphological changes in the harvested kidneys were studied and compared between the two groups. RESULTS: Morphologically, at day 15, Group II had significantly (p = 0.04) greater cortical thickness (0.48 ± 0.17 vs. 0.38 ± 0.09 mm). Histologically, at day 5, Group II had significantly (p = 0.032) lower peri-pelvic fibrosis. Group II group showed greater peri-pelvic inflammation as compared to Group I (p = 0.05). At day 10, lower grades of peri-pelvic fibrosis (p = 0.08), interstitial fibrosis (p = 0.037) and tubular atrophy (p = 0.05) were seen in the Group II. At day 15, Group II demonstrated significantly lower parenchymal loss (p = 0.037), glomerulosclerosis (p = 0.08), interstitial fibrosis (p = 0.08), tubular atrophy (p = 0.08) and peri-pelvic fibrosis (p = 0.08). CONCLUSIONS: In a rat model of PUUUO, stem cell injection prevented detrimental changes in renal pathology and preserved renal parenchymal mass.

Process optimization for osmo-dehydrated carambola (Averrhoa carambola L) slices and its storage studies.

An osmotic-dehydration process protocol for Carambola (Averrhoacarambola L.,), an exotic star shaped tropical fruit, was developed. The process was optimized using Response Surface Methodology (RSM) following Central Composite Rotatable Design (CCRD). The experimental variables selected for the optimization were soak solution concentration (°Brix), soaking temperature (°C) and soaking time (min) with 6 experiments at central point. The effect of process variables was studied on solid gain and water loss during osmotic dehydration process. The data obtained were analyzed employing multiple regression technique to generate suitable mathematical models. Quadratic models were found to fit well (R(2), 95.58 - 98.64 %) in describing the effect of variables on the responses studied. The optimized levels of the process variables were achieved at 70°Brix, 48 °C and 144 min for soak solution concentration, soaking temperature and soaking time, respectively. The predicted and experimental results at optimized levels of variables showed high correlation. The osmo-dehydrated product prepared at optimized conditions showed a shelf-life of 10, 8 and 6 months at 5 °C, ambient (30 ± 2 °C) and 37 °C, respectively.