Assessment of Prescription Adherence to Secondary Prevention Guideline Recommendations and Patient Adherence to Pharmacotherapy and Lifestyle Modifications in Acute Coronary Syndrome and Chronic Coronary Syndrome Patients.

BACKGROUND: Coronary artery diseases (CADs) contribute to the majority of deaths and disabilities worldwide. People who have suffered an acute myocardial infarction (AMI) are at a higher risk of having a further attack. Hence, prolonged secondary prevention is necessary following index myocardial infarction (MI) for long-term cardiovascular protection as it reduces the morbidity and mortality associated with reinfarction, improves the quality of life, and is cost-effective. METHODS: An observational, ambidirectional study was carried out in a tertiary care hospital for 6 months. A total of 200 patients above 18 years of age with a confirmed diagnosis of acute coronary syndrome (ACS) or chronic coronary syndrome (CCS) were included in the study. Prospective data were collected using a self-designed patient profile form and by interviewing patients in the cardiac outpatient department while retrospective data were collected from the medical records department of the hospital. RESULTS AND CONCLUSION: Sex-wise distribution showed that males and females constituted 79 and 21% of the study participants, respectively, while the age-wise distribution revealed that the majority of patients were in the age-group of 60 years and above (63.5%). Hypertension and diabetes mellitus were the most common comorbid conditions, while dyslipidemia was the least observed comorbidity. Prescription adherence to secondary prevention guideline recommendations was studied, which revealed that 26.5% of the prescriptions were adherent to all four guideline recommendations. On evaluating adherence to pharmacotherapy, the maximum proportion of patients demonstrated moderate adherence (45%).

Management of Cylindrical Battery Ingestion.

Presentation A female presented to the Emergency Department following ingestion of an unknown number of cylindrical batteries. Diagnosis Abdominal X-ray confirmed the presence of multiple batteries located throughout the abdomen. Treatment A trial of conservative management was pursued, and five AA batteries were successfully passed per rectum. Serial X-rays over three weeks revealed that the majority of batteries failed to pass. A decision was made to perform a laparotomy, and 46 cylindrical batteries were removed from the stomach through a small gastrotomy. Four batteries located in the colon were milked into the rectum and removed via the transanal route. Discussion Using daily clinical exams and weekly plain films of the abdomen, conservative management is possible if a small number of batteries are ingested and make it to the stomach. However, the potential of cylindrical batteries to result in acute surgical emergencies should not be underestimated.

Morpho-physiological and biochemical responses of cotton (Gossypium hirsutum L.) genotypes upon sucking insect-pest infestations.

The effects of sucking insect-pests on the morpho-physiological and biochemical changes in the leaves of four cotton genotypes-Bio 100 BG-II and GCH-3 (highly tolerant); KDCHH-9810 BG-II and HS-6 (highly susceptible)-were examined. Compared to tolerant genotypes, susceptible genotypes showed a decrease in relative water content, specific leaf weight, leaf area, photosynthetic rate, and total chlorophyll content, with an increase in electrolyte leakage. Hydrogen peroxide and total soluble sugar content were higher in susceptible plants. In contrast, resistant plants had higher levels of total soluble protein, total phenolic content, gossypol content, tannin content, peroxidase activity, and polyphenol oxidase. The findings demonstrated that the Bio 100 BG-II and GCH-3 genotypes effectively offset the impact of sucking insect-pests by modifying the factors mentioned above. The KDCHH-9810 BG-II and HS-6 genotypes could not completely negate the effects of sucking insect-pests. Customized metabolites and total soluble protein are more efficient in protecting cotton plants from damage brought on by infestations of sucking insects and pests. Supplementary Information: The online version contains supplementary material available at 10.1007/s12298-022-01253-w.

IL-37-induced activation of glycogen synthase kinase 3ß promotes IL-1R8/Sigirr phosphorylation, internalization, and degradation in lung epithelial cells.

Interleukin (IL)-37 diminishes a variety of inflammatory responses through ligation to its receptor IL-1R8/Sigirr. Sigirr is a Toll like receptor/IL-1R family member. We have shown that Sigirr is not stable in response to IL-37 treatment. IL-37-induced Sigirr degradation is mediated by the ubiquitin-proteasome system, and the process is reversed by a deubiquitinase, USP13. However, the molecular mechanisms by which USP13 regulates Sigirr stability have not been revealed. In this study, we investigate the roles of glycogen synthesis kinase 3ß (GSK3ß) in Sigirr phosphorylation and stability. IL-37 stimulation induced Sigirr phosphorylation and degradation, as well as activation of GSK3ß. Inhibition of GSK3ß attenuated IL-37-induced Sigirr phosphorylation, while exogenous expressed GSK3ß promoted Sigirr phosphorylation at threonine (T)372 residue. Sigirr association with GSK3ß was detected. Amino acid residues 51-101 in GSK3ß were identified as the Sigirr binding domain. These data indicate that GSK3ß mediates IL-37-induced threonine phosphorylation of Sigirr. Further, we investigated the role of GSK3ß-mediated phosphorylation of Sigirr in Sigirr degradation. Inhibition of GSK3ß attenuated IL-37-induced Sigirr degradation, while T372 mutant of Sigirr was resistant to IL-37-mediated degradation. Furthermore, inhibition of Sigirr phosphorylation prevented Sigirr internalization and association with USP13, suggesting GSK3ß promotes Sigirr degradation through disrupting Sigirr association with USP13.

Health risks associated with fluoride intake from rural drinking water supply and inverse mass balance modeling to decipher hydrogeochemical processes in Vattamalaikarai River basin, South India.

Preliminary investigation reveals that fluorosis is reported due to the continuous intake of fluoride-rich groundwater in Vattamalikarai River basin, Tamil Nadu, India. A detailed study was attempted for evaluating the health risks associated with the intake of fluoride-rich groundwater supplied to the rural community. Groundwater samples were collected from 60 and 58 dug and tube wells during winter and southwest (SW) monsoon seasons respectively. The samples were analyzed for the determination of fluoride and other chemical parameters to examine the fitness for drinking water. Spatio-temporal variation maps reveal that fluoride concentration is high during SW monsoon season when compared with the winter season in this region. The fluoride bearing minerals present in hornblende-biotite gneiss and charnockite rock formations leached into the groundwater during rock-water interaction. To understand the subsurface hydrogeochemical reactions, inverse mass balance model was developed using NETPATH code. The model output indicates that calcite dilution, silicate (hornblende and biotite) weathering, ion exchange (Ca/Na and Mg/Na) and illite precipitation are the dominant processes controlling the groundwater chemistry along the flow paths. Non-carcinogenic risks to children and adults (women and men) were evaluated by working out intake exposure of groundwater. Hazard quotient (HQ) based on fluoride intake was calculated for children and adults. It varied from 0.08 to 2.21 with an average of 1.07 for adults. For children, it varied from 0.01 to 2.99 with the mean of 1.44. About 78%, 69% and 61% of the samples fall under the risk category for children, women and men during winter season. However, more number of samples possessed health risks (83% of samples for children, 73% of samples for women and 64% of samples for men) during SW monsoon season.

Donor demographics and factors affecting corneal utilisation in Eye Bank of North India.

INTRODUCTION: Nearly 6.8 million people in India have vision less than 6/60 in at least one eye due to corneal diseases; of these, about a million had bilateral involvement. PURPOSE: To identify the challenges faced; the trends in collection, storage and utilisation of corneal tissues in an eye bank in north India. MATERIALS AND METHODS: The past records of Eye Bank linked to a tertiary hospital in northern India were analysed from November'1999 to October'2015 with respect to number of eye donations per year, donor demographics and utilisation of corneal tissues. RESULTS: The number of donations during the first 6 years were 100, 279 in the next 5 years and 473 in the last 5 years. The mean donor age was 63.2 ± 19.5 years. The percentage of donors less than 30, 31-60 and more than 60 years was 10%, 28% and 62%. Forty-two percent donations were from the hospital. The average time between the death and enucleation was 4.74 ± 5.31 hours. The percentage of corneas used in the donor age groups less than 30, 31-60 and above 60 years was 61.9%, 61.6% and 53.8%, respectively. The usability rate of the corneas from home and hospital was 63.7% and 55.3%, respectively. CONCLUSIONS: The eye bank had a lukewarm response in the beginning, but gained momentum with time. The myths and beliefs prevalent in our society deter people from donating eyes freely. Each eye bank needs to individualise its problems and find solutions for adequate procurement and utilisation of tissue.

Family violence during COVID-19 and its impact on mental health of children: A systematic review.

Purpose: The COVID-19 pandemic posed unanticipated challenges that could impact how the family system operates across the world. Restrictions imposed to control the rapid spread of the virus substantially increased violence in families. The current study aims to review violence in the family and its impact on the mental health of children during the pandemic.Method: A systematic search was conducted using keywords in the electronic databases PubMed, PsycINFO, and Web of Science, and a manual search was conducted on Google Scholar for articles from January 2020 to January 2021. Of the 50 records identified, seven studies that met eligibility criteria were selected for final analysis.Results: Results revealed that family violence during the pandemic has escalated the mental health problems of children, including aggressive and self-harming behaviours. Lockdown restrictions, social detachment, financial instability, fear of infection, and unemployment led to increased parental stress. Parents with a higher level of stress were more likely to maltreat their children.Conclusions: Exposure to short and long-term family violence can adversely impact the mental health of children and can negatively affect a child's present and future life. Recommendations for researchers, mental health practitioners, public health authorities, and other service providers are also outlined.

Chemometric approach-based characterization and screening of gluten free flours for development of Indian unleavened flatbread.

The objective of the study was to screen amongst various gluten free flours to prepare Indian unleavened flatbread using principal component analysis (PCA) and hierarchical cluster analysis (HCA) as a mathematical tool. Gluten free flours studied in this work were, rice, sorghum, moong, amaranth, sama, ragi, water chestnut, buckwheat, soy, tamatind kernel, chickpea, black gram and unripe banana flour. The characteristics of sorghum: rice flatbread was analyzed such as dough making ability, subjective rollability, puffing and acceptability with respect to wheat. Interrelationship between the parameters analyzed and the different gluten free flours were investigated by using PCA and HCA. PCA revealed that the first two components represented 92.56% of the total variability in flatbread making characteristics. HCA classified samples into 6 clusters on the basis of measured flatbread making characteristics. From the results, moong, water chestnut and unripe banana flour in addition to mixture sorghum: rice (30:70) flour were chosen as ingredients for the preparation of Indian unleavened flatbread.

Recent advances in the technology of chapatti: an Indian traditional unleavened flatbread.

Chapatti is a flattened circular flatbread also known as roti, poli, safari, and phulka, usually baked on a hot iron griddle. It is a staple diet of India and hence the quality of chapatti plays a major role in its acceptance. The overall quality of chapatti is dependent on various attributes such as pliability, handfeel, chapatti eating quality, and taste. These attributes are influenced by numerous factors, including wheat genotypes, wheat varieties, the molecular weight distribution of proteins, and processing techniques. This staple food has been extensively studied for various aspects, including processing, mechanism, fractionation, and reconstitution, quality improver, shelf life extension and also the mechanization of processing. This review focus on all the above-mentioned aspects and innovations carried out in this area.

Effect of type 1 tympanoplasty on the quality of life of patients suffering from chronic otitis media (safe type).

BACKGROUND: Chronic otitis media (COM) remains a major public health issue and is associated with relentless discharge from the ear, pain, significant functional limitation of hearing, leading to communication problems and frequent specialist visits. AIMS: To assess the improvement in quality of life of patients of COM (safe type) and surgical success in terms of graft uptake and improvement in hearing. PATIENTS AND METHODS: A prospective questionnaire-based outcome study was directed in 100 patients with COM who were treated with Type I Tympanoplasty at our institution between May 2018 and May 2020. All patients were asked to fill Modified Chronic Otitis Media 4 (COM-4) survey before operation and 3 months after operation. Preoperative and postoperative total ear scores, audiological results, postoperative graft uptake were assessed. RESULTS: The correlation between preoperative and postoperative assessment by questionnaire was statistically critical (P < 0.001). There was significant improvement in hearing postoperatively (P < 0.001). Effective graft uptake was seen in 80%. CONCLUSION: The current study emphasizes that Type 1 Tympanoplasty fundamentally improves quality of life of patients in terms of physical suffering, hearing loss, emotional distress postoperatively.

Urban wind field analysis from the Jack Rabbit II Special Sonic Anemometer Study.

The Jack Rabbit II Special Sonic Anemometer Study (JRII-S), a field project designed to examine the flow and turbulence within a systematically arranged mock-urban environment constructed from CONEX shipping containers, is described in detail. The study involved the deployment of 35 sonic anemometers at multiple heights and locations, including a 32 m tall, unobstructed tower located about 115 m outside the building array to document the approach wind flow characteristics. The purpose of this work was to describe the experimental design, analyze the sonic data, and report observed wind flow patterns within the urban canopy in comparison to the approaching boundary layer flow. We show that the flow within the building array follows a tendency towards one of three generalized flow regimes displaying channeling over a wide range of wind speeds, directions, and stabilities. Two or more sonic anemometers positioned only a few meters apart can have vastly different flow patterns that are dictated by the building structures. Within the building array, turbulence values represented by normalized vertical velocity variance ( σ w 2 ) are at least two to three times greater than that in the approach flow. There is also little evidence that σ w 2 measured at various heights or locations within the JRII array is a strong function of stability type in contrast to the approach flow. The results reinforce how urban areas create complicated wind patterns, channeling effects, and localized turbulence that can impact the dispersion of an effluent release. These findings can be used to inform the development of improved wind flow algorithms to better characterize pollutant dispersion in fast-response models.

Novel, energy efficient and green cloud point extraction: technology and applications in food processing.

Recently, a novel technique for extraction of functional thermally sensitive bioactive components from food has been developed due to its green efficacy (no toxic chemicals) and cost effectiveness. Cloud point extraction (CPE) is one of the such best alternative techniques that can be used for extraction of wide range of organic and inorganic components using green surfactants. It is a simple, rapid and inexpensive extraction technique which involves clustering of non-ionic surfactant monomers to form a hydrophobic core (micelle), which then entraps the hydrophobic bioactive compounds within it. CPE can be applied for extraction of bioactives from food processing waste as well as separation and purification of proteins. Besides that, research has received special attention on sample preparation for analysis of food constituents in the last decade. The scope of CPE is very vast in these sectors because of the advantages of CPE over other methods. This review deals with significance of CPE method and their potential green applications in food processing.

Persistent involvement of anterior mesorectal fascia in carcinoma rectum - extended resection of rectum vs total pelvic exenteration: results from a single-centre retrospective study.

AIM: Involvement of the anterior mesorectal fascia (iAMRF) after neoadjuvant treatment leads to either resection of the involved organ alone [extended resection of the rectum (ERR)] or total pelvic exenteration (TPE). The purpose of this study was to compare the rate of recurrence and survival of patients undergoing ERR or TPE for iAMRF after neoadjuvant treatment. The outcome of patients who underwent total mesorectal excision after downstaging was also compared. METHOD: This was a retrospective study of primary rectal cancer patients. RESULTS: Of 237 patients, 61 (21.5%) patients with nonmetastatic carcinoma rectum had iAMRF at baseline. Ten patients defaulted before completion of neoadjuvant chemoradiotherapy. After neoadjuvant chemoradiotherapy, 22 patients (43.1%) developed systemic metastases, seven patients (13.8%) were downstaged to free anterior mesorectal fascia and underwent total mesorectal excision (anterior resection/abdominoperineal resection) and the remaining 22 patients (43.1%) had persistent iAMRF. Thirteen patients with persistent iAMRF underwent ERR, whereas nine patients underwent TPE. The median duration of hospital stay in the TPE group was 13 days (10-26), whereas it was 7 days (5-21) in the ERR group. A clear circumferential resection margin, R0 resection, was achieved in all patients with TPE and ERR. After a median follow-up of 31.6 months, five patients with TPE (55.6%), four patients with ERR (30.7%) and three patients in the downstaged group (42.9%) developed systemic recurrence. None of the patients with TPE and the downstaged group developed local recurrence, whereas three patients with ERR (23.1%) developed local recurrence. Median disease-free survival was 12.3 months in the TPE group, 18.9 months in the ERR group and 10.6 months in the downstaged group, whereas mean overall survival was 36.2, 32.8 and 27.9 months, respectively. CONCLUSION: Although there is no significant difference in the overall survival and disease-free survival, ERR is associated with a high risk of local recurrence compared to TPE and the downstaged group.

An In Vitro Study to Evaluate and Compare the Hemocompatibility of Titanium and Zirconia Implant Materials after Sandblasted and Acid-etched Surface Treatment.

AIM: This study was aimed to investigate the hemocompatibility of zirconia and titanium implant materials after surface treatment with sandblasting and acid etching (SLA). MATERIALS AND METHODS: Sixty specimens were procured from manufacturers of dimension 10mm × 3mm, thirty of each were prefabricated medical grade titanium (Ti-6Al-4V) and thirty of sintered zirconia. Silicon carbide grit papers of 240 to 1200pm, was used to polish the specimen surface. The surfaces were rinsed with water to remove any remnant particles after polishing. Later ultrasonic cleaning was done for 5 minutes using distilled water. The control specimens included 15 specimens each from titanium (groups A1) and zirconia (groups B1). The remaining 15 specimens (groups A2 and B2) were sandblasted using alumina particles of 150 microns particle size and using 20% hydrochloric acid, acid etching was done for 30 seconds. The specimens were scanned under electron microscope after surface treatment for analysis purpose and evaluated for surface characteristics. Before the exposure of specimens to blood, percentage hemolysis, prothrombin, platelet aggregation and activation, and thrombin time values were calculated. one mL of blood was added to each specimen for testing. The values before and after the exposure of specimens to blood were noted. Using a t-test, the values noted were statistically Results: A1 (polished titanium) showed highest mean values after exposure, in platelet count (184.67 ± 1.29), leucocyte count (7.27 ± 0.08), and thrombin time (10.15 ± 0.34) while prothrombin time's highest mean value after exposure were showed by A2 (SLA treated titanium) with a mean value of 10.04 ± 0.24. CONCLUSION: Surface treatment with sandblasting and acid etching (SLA) using 150 microns alumina particles and 20% hydrochloric acid increased the surface roughness of the titanium and zirconia implant materials and polished titanium showed maximum hemocompatibility. CLINICAL SIGNIFICANCE: The implant's success depends on its biocompatibility and its property of osseointegration. The adverse interaction between blood and the artificial surface is detected by the hemocompatibility test for medical materials, to know if the surface can activate or destruct the blood components. The success of implant placement also depends on the interaction between the blood and the specimen.

Enhanced Photoelectrochemical Water Splitting Behaviour of Tuned Band Gap CdSe QDs Sensitized LaB6.

We report the fabrication of tuned band gap quantum dots sensitized LaB6 hybrid nanostructures and their application as a photoanode for photoelectrochemical water splitting. The lanthanum hexaboride (LaB6) obtained by molten salt electrolysis method is sensitized with different sized CdSe quantum dots, which form a multiple-level hierarchical heterostructure and such design enhance the light absorption and charge carrier separation, which in turn showed higher photocurrent density compared to that of pristine LaB6. When LaB6 is sensitized with CdSe quantum dots of different band gaps, which have the absorption in the green and red (530 and 605 nm) regions in visible light, developed a ten times higher photocurrent density (11.0 mA cm(−2)) compared to that of pristine LaB6 (0.5 mA cm(−2) at 0.75 V vs. Ag/AgCl) in 1 M Na2S electrolyte under illumination. These results prove that the tuned band gap quantum dots sensitized LaB6 heterostructures are an ideal candidate for a photoanode in solar water splitting applications.

Changing trend in bacterial etiology and antibiotic resistance in sepsis of intramural neonates at a tertiary care hospital.

BACKGROUND: Septicemia is an important cause of neonatal morbidity and mortality. However, organized data on causative organisms and their resistant pattern are scanty from developing countries. The changing trend in causative organisms and their antibiotic resistance is yet to be documented in India. The present study examines the trends in bacterial profile and antibiotic resistance of the organisms causing sepsis in hospitalized neonates. MATERIALS AND METHODS: A retrospective laboratory-based analysis of blood cultures obtained from Neonatal Intensive Care Unit of a tertiary care hospital in New Delhi was done for the period of 1999-2014, divided into five phases. RESULTS: A total of 4700 isolates were considered. Over time, Gram-negative organisms have replaced Gram-positives as frequent isolates. Initially, there was predominance of Klebsiella pneumoniae, then of Staphylococcus aureus which recently has been changed with coagulase negative-Staphylococcus and Acinetobacter. Growing resistance against the first and second line of drugs has been noted, including methicillin-resistant S. aureus and vancomycin-resistant Enterococcus. CONCLUSION: The etiological profile of neonatal sepsis has changed tremendously in the past 15 years. High resistance against common drugs necessitates continued surveillance and review of empirical antibiotic policy for neonatal sepsis. These steps are important to effectively curtail the surge of further antibiotic resistance.

Perceived functional impairment and spirituality/religiosity as predictors of depression in a Sri Lankan spinal cord injury patient population.

STUDY DESIGN: Cross-sectional, questionnaire-based study. OBJECTIVES: To test the hypothesis that self-perceived functional impairment and religiosity/spirituality (S/R) predict depression among traumatic spinal cord injury (SCI) patients in Sri Lanka. SETTING: Ragama Rheumatology and Rehabilitation Hospital, Ragama, Sri Lanka. METHODS: The Spinal Cord Independence Measure, Benefit Through Spirituality/Religiosity Scale, Sheehan Disability Inventory and Beck Depression Inventory-II (BDI-II) were administered to 61 consenting in-patients with traumatic SCI between June and July 2014. A linear regression model on BDI-II score was developed to examine the impact of self-perceived functional impairment and S/R activities on psychiatric outcomes in context of various sociodemographic variables. RESULTS: Psychiatric consequences of SCI were reflected in a 41% prevalence of depression. Thirty-six percent (R2=0.36) of the variance in BDI-II scores (F(5, 55)=6.07, P<0.001) was explained by the regression model. Functional impairment (ß=0.54, t(55)=4.73, P<0.001) and perceived benefit through S/R activities (ß=-0.31, t(55)=-2.55, P<0.05) emerged as the strongest predictors for depression severity. CONCLUSIONS: Perceived functional impairment in work, social and family domains predicted depressive symptomatology among SCI inpatients in Sri Lanka, while perceived benefit through S/R protected against depression. The findings emphasize the need for rehabilitative programming to support patients' S/R activities and mental wellbeing, promoting reintegration into their community roles.

Phytoremediation potential of some halophytic species for soil salinity.

Phytoremediation potential of six halophytic species i.e. Suaeda nudiflora, Suaeda fruticosa, Portulaca oleracea, Atriplex lentiformis, Parkinsonia aculeata and Xanthium strumarium was assessed under screen house conditions. Plants were raised at 8.0, 12.0, 16.0, and 20.0 dSm(-1) of chloride-dominated salinity. The control plants were irrigated with canal water. Sampling was done at vegetative stage (60-75 DAS). About 95 percent seed germination occurred up to 12 dSm(-1) and thereafter declined slightly. Mean plant height and dry weight plant(-1) were significantly decreased from 48.71 to 32.44 cm and from 1.73 to 0.61g plant(-1) respectively upon salinization. Na(+)/K(+) ratio (0.87 to 2.72), Na(+)/ Ca(2+) + Mg(2+) (0.48 to 1.54) and Cl(-)/SO4(2-) (0.94 to 5.04) ratio showed increasing trend. Salinity susceptibility index was found minimum in Suaeda fruticosa (0.72) and maximum in Parkinsonia aculeata (1.17). Total ionic content also declined and magnitude of decline varied from 8.51 to 18.91% at 8 dSm(-1) and 1.85 to 7.12% at 20 dSm(-1) of salinity. On the basis of phytoremediation potential Suaeda fruticosa (1170.02 mg plant(-1)), Atriplex lentiformis (777.87 mg plant(-1)) were the best salt hyperaccumulator plants whereas Xanthium strumarium (349.61 mg plant(-1)) and Parkinsonia aculeata (310.59 mg plant(-1)) were the least hyperaccumulator plants.