Electrochemical, Ultrasensitive, and Selective Detection of Nitrite and H2O2: Novel Macrostructured Phthalocyanine with Composite MWCNTs on a Modified GCE.

In the current study, the synthesis of tetra-4-(2-methoxyphenoxy) carboxamide cobalt(II) amide-bridged phthalocyanine (CoTMePhCAPc) is described, as well as its characterization by Fourier transform infrared (FT-IR), UV-visible, and mass spectroscopy; powder X-ray diffraction (PXRD); thermogravimetric analysis (TGA); scanning electron microscopy (SEM); and electrochemistry. Sensing of nitrite (NO2-) and hydrogen peroxide (H2O2) simultaneously was done on CoTMePhCAPc with the composite multiwalled carbon nanotube (MWCNT)-modified glassy carbon electrode (CoTMePhCAPc/MWCNT/GCE) in the range of linear absorption (NO2- and H2O2: CV 50-750, differential pulse voltammetry (DPV) 50-750, CA 50-500 nmol L-1), lower detection limit (NO2- and H2O2: CV 10.5 and 12.5, DPV 10.5 and 11.2, CA 6.0 and 5.5 nmol L-1), and sensitivity (NO2- and H2O2: CV 0.379 and 0.529, DPV 0.043 and 0.049, CA 0.033 and 0.040 µA nM-1 cm-2). The composite electrode exhibits improved electrocatalytic behavior compared to modified electrodes for nitrite and H2O2. The CoTMePhCAPc/MWCNT/GCE sensor displays good selectivity even in the presence of an excess of interfering metal ions and biomolecules at the applied potentials of +400 mV (nitrite) and -400 mV (H2O2). Moreover, the fabricated sensor was studied with various phosphate-buffered saline (PBS) (pH 5-9) electrolyte solutions. The unknown H2O2 concentration in blood samples and apple juice and nitrite concentration in drinking water and butter leaf lettuce were all measured using the usual addition method. Docking analysis clearly indicates that the ligand shows excellent inhibition activity toward the three subjected protein molecules.

Influence of Vegetation on Long-term Phosphorus Sequestration in Subtropical Treatment Wetlands.

Sustainable operation of a treatment wetland depends on its continued treatment of influent water to achieve desired outflow water quality targets. Water treatment or nutrient reduction is attained by a combination of biotic and abiotic processes. We studied one of the world's largest treatment wetlands established to revive the Florida Everglades from impacts of excessive phosphorus (P) inputs. Phosphorus retained in the treatment wetlands is sequestered within the accumulated material via biotic and abiotic pathways that are influenced by the existing wetland vegetation. Recently accreted soils (RAS) provide a major sink for stored P, and long-term P removal efficiency of treatment wetlands is governed by the stability of accreted P because more stable P pools are less susceptible to mobilization and loss. We quantified reactive P (extracted with acid and alkali) and nonreactive P (not extracted with acid and alkali) pools in wetland soils by using an operationally defined P fractionation scheme and assessed the effect of emergent vs. submerged vegetation communities on stability of sequestered P. Reactive P comprised 63 to 79% of total P in wetland soils without a clear difference between two vegetation groups. The quantities of reactive P forms (inorganic vs. organic P) were significantly different between two vegetation types. A higher proportion of reactive P was stored as organic P in flocculent detrital organic matter (floc) and RAS under emergent vegetation (46-47% total P) in comparison with submerged vegetation (21-34% total P). The dominant P removal pathway in the submerged vegetation system was associated with calcium whereas plant uptake and peat burial appeared to be the main pathway in the emergent vegetation system.

Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trial.

BACKGROUND AND AIMS: The study was conceived to elucidate the effects of dexmedetomidine as an anesthetic adjunct to propofol (total intravenous anesthesia) on anesthetic dose reduction and anesthesia recovery parameters in cerebello-pontine angle (CPA) surgeries. MATERIAL AND METHODS: This prospective randomized study was conducted on 49 patients (25 with dexmedetomidine, 24 without). After standardized anesthetic induction, anesthesia was maintained using propofol (via target controlled infusion, titrated to maintain BIS between 40 and 60), fentanyl (0.5 µg/kg/hour) and either dexmedetomidine (0.5 µg/kg/hour) or a sham infusion. Neuromuscular blocking agents were excluded to allow cranial nerve EMG monitoring. Adverse hemodynamic events, recovery parameters (time to opening eyes, obeying commands, and extubation) and postoperative sedation score, shivering score, nausea, and vomiting score were recorded. RESULTS: Propofol and fentanyl utilization (as total dose, adjusted for duration of surgery and body weight, and number of extra boluses) was significantly lower in the dexmedetomidine group. There was no difference in any of the recovery parameters between the two groups. Incidence of bradycardia was significantly higher with dexmedetomidine, while no difference was found for hypotension, hypertension, and tachycardia. CONCLUSION: Dexmedetomidine-fentanyl-propofol anesthesia compares favorably with fentanyl-propofol anesthesia during CPA neurosurgical procedures with regard to anesthesia recovery times, but with lower intraoperative opioid and hypnotic utilization rates.

Acute Kidney Injury in Cirrhosis: Baseline Serum Creatinine Predicts Patient Outcomes.

OBJECTIVES: The International Ascites Club (IAC) recently defined Stage 1 acute kidney injury (AKI) for cirrhosis as an acute increase in serum creatinine (SCr) by ≥0.3 mg/dl or by ≥50% in <48 h from a stable value within 3 months. The baseline SCr may influence AKI risk and patient outcomes. The objective of this study is to determine in cirrhosis whether the baseline SCr has any effect on the in-hospital AKI course and patient survival. METHODS: North American Consortium for the Study of End-Stage Liver Disease is a consortium of tertiary-care hepatology centers prospectively enroling non-elective cirrhotic inpatients. Patients with different baseline SCr levels (≤0.5, 0.51-1.0, 1.01-1.5, >1.5 mg/dl) were evaluated for the development of AKI, and compared for AKI outcomes and 30-day survival. RESULTS: 653 hospitalized cirrhotics (56.7±10years, 64% men, 30% with infection) were included. The incidence of AKI was 47% of enrolled patients. Patients with higher baseline SCr were more likely to develop AKI, with significantly higher delta and peak SCr (P<0.001) than the other groups, more likely to have a progressive AKI course (P<0.0001), associated with a significantly reduced 30-day survival (P<0.0001). Multivariate logistic regression showed that the delta SCr during an AKI episode to be the strongest factor impacting AKI outcomes and survival (P<0.001), with a delta SCr of 0.70 mg/dl having a 68% sensitivity and 80% specificity for predicting 30-day mortality. CONCLUSIONS: Admitted cirrhotic patients with higher baseline SCr are at higher risk for in-hospital development of AKI, and more likely to have AKI progression with reduced survival. Therefore, such patients should be closely monitored and treated promptly for their AKI.

The Natural History of Severe Acute Liver Injury.

OBJECTIVES: Acute liver failure (ALF) is classically defined by coagulopathy and hepatic encephalopathy (HE); however, acute liver injury (ALI), i.e., severe acute hepatocyte necrosis without HE, has not been carefully defined nor studied. Our aim is to describe the clinical course of specifically defined ALI, including the risk and clinical predictors of poor outcomes, namely progression to ALF, the need for liver transplantation (LT) and death. METHODS: 386 subjects prospectively enrolled in the Acute Liver Failure Study Group registry between 1 September 2008 through 25 October 2013, met criteria for ALI: International Normalized Ratio (INR)≥2.0 and alanine aminotransferase (ALT)≥10 × elevated (irrespective of bilirubin level) for acetaminophen (N-acetyl-p-aminophenol, APAP) ALI, or INR≥2.0, ALT≥10x elevated, and bilirubin≥3.0 mg/dl for non-APAP ALI, both groups without any discernible HE. Subjects who progressed to poor outcomes (ALF, death, LT) were compared, by univariate analysis, with those who recovered. A model to predict poor outcome was developed using the random forest (RF) procedure. RESULTS: Progression to a poor outcome occurred in 90/386 (23%), primarily in non-APAP (71/179, 40%) vs. only 14/194 (7.2%) in APAP patients comprising 52% of all cases (13 cases did not have an etiology assigned; 5 of whom had a poor outcome). Of 82 variables entered into the RF procedure: etiology, bilirubin, INR, APAP level and duration of jaundice were the most predictive of progression to ALF, LT, or death. CONCLUSIONS: A majority of ALI cases are due to APAP, 93% of whom will improve rapidly and fully recover, while non-APAP patients have a far greater risk of poor outcome and should be targeted for early referral to a liver transplant center.

Chronic hepatitis C and chronic kidney disease: Advances, limitations and unchartered territories.

Over the past few years, treatment options for chronic hepatitis C virus (HCV) infection have evolved dramatically. The current approved interferon-free direct-acting antiviral (DAA) regimens have been shown to be safe and effective with sustained virologic response (SVR) rates of >90% in most patients. Unique issues yet remain such as the challenges in patients with impaired renal function or decompensated cirrhosis. Patients with stages 4-5 chronic kidney disease (CKD) have a higher prevalence of HCV infection compared with the general population. Chronic HCV in those on dialysis and in kidney transplant recipients is associated with higher morbidity and mortality than uninfected patients. The HCV-infected population is also at risk of developing extrahepatic manifestations associated with altered immune system function and chronic inflammation with cryoglobulinaemic vasculitis being the most common of these manifestations. Therefore, patients with CKD stages 4-5 have to be considered priority patients for HCV therapy. New antiviral therapies have the potential to improve outcomes in this vulnerable patient population, including those on haemodialysis. Recently published studies conducted in kidney transplant recipients have demonstrated successful outcomes. It is thus essential that we carefully select the most appropriate DAA regimen and the best time for treatment in the context of kidney transplantation or cryoglobulinaemic vasculitis. While sofosbuvir, the only approved nucleotide NS5B inhibitor, has been the backbone of most pangenotypic therapeutic regimens, it has a limitation in those with advanced kidney disease. The currently approved regimens for those with stage 4/5 CKD, while effective, have challenges in that they apply to genotype 1/4 and may require RBV for genotype 1a. Globally, genotype 3 is a common infection, and thus, this group with CKD presents a huge unmet need for effective therapies. As therapy of HCV in renal transplant recipients has been highly successful, it provides an opportunity to expand the use of HCV-infected organs in solid organ transplantation.

Safety and efficacy of sofosbuvir-based direct-acting antiviral regimens for hepatitis C virus genotypes 1-4 and 6 in Myanmar: Real-world experience.

This open-label, clinical experience investigated the safety and efficacy of direct-acting antiviral (DAA) hepatitis C virus (HCV) therapy in Myanmar; 344 patients completed treatment between June 2015 and May 2016. Patients with HCV genotypes 1-4 and 6 received one of four treatments: (i) Peg-interferon (PEG-IFN)+sofosbuvir (SOF)+ribavirin (RBV) for 12 weeks, (ii) SOF+RBV for 24 weeks, (iii) ledipasvir (LDV)+SOF for 12 weeks or (iv) daclatasvir (DCV)+SOF+RBV for 12 or 24 weeks. Genotype 3 was most common (n=133, 38.7%), followed by genotype 6 (n=122, 35.5%) and genotype 1 (n=86, 25%). Overall, 91% of patients achieved sustained virologic response (SVR); 99% in group 1, (n=148/149), 90% in group 2 (n=95/106), 78% in group 3 (n=65/83) and 100% in group 4 (n=6/6). In group 3, SVR rates were 96.8% in genotype 1 (n=30/31) and 64.1% in genotype 6 (n=25/39). Multivariable regression analysis identified advanced fibrosis (F3-4) (OR=.16 CI: 0.05-0.57, P=.005), genotype 6 (OR=.35, CI: 0.16-0.79, P=.012) and diabetes (OR=.29, CI: 0.12-0.71, P=.007) as negative independent predictors of response. Adverse events were mild with all-oral therapy. CONCLUSION: DAA therapy ±PEG-IFN achieved high SVR rates. Genotype 6 patients had a low SVR to 12 weeks of LDV and SOF raising the need for other regimens, RBV or longer treatment duration in this population.

Effect of viral suppression on hepatic venous pressure gradient in hepatitis C with cirrhosis and portal hypertension.

Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mm Hg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period. The primary endpoint was sustained virologic response 12 weeks after therapy (SVR12) in patients who received ≥1 dose of treatment. Secondary endpoints included changes in HVPG, laboratory parameters, and MELD and CPT scores. A subset of patients was followed 48 weeks posttreatment to determine late changes in HVPG. SVR12 occurred in 72% of patients (33/46). In the 37 patients with paired HVPG measurements at baseline and the end of treatment, mean HVPG decreased by -1.0 (SD 3.97) mm Hg. Nine patients (24%) had ≥20% decreases in HVPG during treatment. Among 39 patients with pretreatment HVPG ≥12 mm Hg, 27 (69%) achieved SVR12. Four of the 33 (12%) patients with baseline HVPG ≥12 mm Hg had HVPG <12 mm Hg at the end of treatment. Of nine patients with pretreatment HVPG ≥12 mm Hg who achieved SVR12 and completed 48 weeks of follow-up, eight (89%) had a ≥20% reduction in HVPG, and three reduced their pressure to <12 mm Hg. Patients with chronic HCV and compensated or decompensated cirrhosis who achieve SVR can have clinically meaningful reductions in HVPG at long-term follow-up. (EudraCT 2012-002457-29).

Ledipasvir-sofosbuvir and sofosbuvir plus ribavirin in patients with chronic hepatitis C and bleeding disorders.

INTRODUCTION: Chronic hepatitis C virus (HCV) infection is prevalent among patients with inherited bleeding disorders and is a leading cause of mortality in those with haemophilia. AIM: We evaluated the efficacy and safety of ledipasvir-sofosbuvir and sofosbuvir plus ribavirin in patients with chronic HCV genotype 1-4 infection and an inherited bleeding disorder. METHODS: Ledipasvir-sofosbuvir was administered for 12 weeks to patients with genotype 1 or 4 infection and for 12 or 24 weeks to treatment-experienced cirrhotic patients with genotype 1 infection. Patients with genotype 2 and 3 infection received sofosbuvir plus ribavirin for 12 and 24 weeks respectively. RESULTS: The majority of the 120 treated patients had a severe bleeding disorder (55%); overall, 65% of patients had haemophilia A and 26% of patients had haemophilia B; 22% were HIV coinfected. Sustained virologic response at 12 weeks posttreatment was 99% (98/99) in patients with genotype 1 or 4 infection; 100% (5/5) in treatment-experienced cirrhotic patients with genotype 1 infection; 100% (10/10) in patients with genotype 2 infection; and 83% (5/6) in patients with genotype 3 infection. There were no treatment discontinuations due to adverse events (AEs). The most frequent non-bleeding AEs were fatigue, headache, diarrhoea, nausea and insomnia. Bleeding AEs occurred in 22 patients, of which all but one were considered unrelated to treatment. CONCLUSION: Treatment with ledipasvir-sofosbuvir for patients with HCV genotype 1 or 4 infection or sofosbuvir plus ribavirin for patients with genotype 2 or 3 infection was highly effective and well tolerated among those with inherited bleeding disorders.

Effect of Atropine Premedication on Cardiac Autonomic Function During Electroconvulsive Therapy: A Randomized Crossover Study.

OBJECTIVES: Electroconvulsive therapy (ECT) results in significant cardiovascular changes. The acute cardiac autonomic changes during ECT remain unexplored. The primary objective of this study was to compare autonomic dysfunction with and without atropine premedication during ECT and secondarily to evaluate dysautonomia across psychiatric diagnoses before and after ECT. METHODS: In this crossover study, 41 psychiatric patients were monitored during 82 ECT sessions. Patients were randomized either to receive atropine or not to receive atropine during their second ECT session and were crossed over during their third session. Heart rate, blood pressure, and oxygen saturation were continuously monitored from stimulus application until 300 seconds after ECT. Demographic characteristics and ANSiscope indices derived pre- and post-ECT were collected. RESULTS: Autonomic dysfunction (%) before ECT was similar between atropine and no-atropine sessions (32.4 ± 15.7 vs 32.8 ± 16.7; 95% confidence interval, -7.6 to 6.7; P = 0.90) but increased significantly after ECT to 60.9 ± 16.3 and to 47.0 ± 17.3, respectively, and this difference was significant (95% confidence interval, 6.5-21.3; P < 0.001). There was no difference in the autonomic function across psychiatric diagnoses both before (P = 0.07) and after ECT (P = 0.12). CONCLUSIONS: Cardiac autonomic dysfunction worsens after ECT in patients with psychiatric illnesses and to a significantly greater extent with atropine premedication. The degree of dysautonomia is similar across various psychiatric diagnoses both before and after ECT. Atropine premedication during ECT should be restricted to select patients susceptible to bradyarrhythmia and could be avoided in others.

Evaluation of Ageratum conyzoides in field scale constructed wetlands (CWs) for domestic wastewater treatment.

Ageratum conyzoides were evaluated in field scale subsurface flow constructed wetlands (CWs) to quantify its nitrogen (N) and phosphorus (P) uptake and compare with wetland plants (Pistia stratiotes, Typha latifolia and Canna indica). The two-field scale subsurface flow CWs, located in the International Crops Research Institute for Semi-Arid Tropics, received wastewater from an urban colony. The CW1 and CW2 had the same dimensions (length:10 m, width:3 m, total depth:1.5 m and sand and gravel:1 m), similar flow rates (3 m3/d), hydraulic loading rates (HLRs-10 cm/d) and hydraulic retention time (HRT-5 days) from July 2014-August 2015. The vegetation in both CWs consisted of Pistia stratiotes, Typha latifolia, Canna indica, and Ageratum conyzoides, respectively. The CW1 (% reduction with respect to concentrations) reduced total suspended solids (TSS) (68%), NH4-N (26%), NO3-N (30%), soluble reactive P (SRP) (20%), chemical oxygen demand (COD) (45%) and fecal coliforms (71%), while the CW2 (%-reduction with respect to concentrations) reduced TSS (63%), NH4-N (32%), NO3-N (26%), SRP (35%), COD (39%) and fecal coliforms (70%). Ageratum conyzoides can be used in combination with Pistia stratiotes, Typha latifolia and Canna indica to enhance removal of excessive N, P and fecal coliforms from domestic wastewater.

Targeting chitinase gene of Helicoverpa armigera by host-induced RNA interference confers insect resistance in tobacco and tomato.

Helicoverpa armigera Hübner (Lepidoptera: Noctuidae) is a devastating agricultural insect pest with broad spectrum of host range, causing million dollars crop loss annually. Limitations in the present conventional and transgenic approaches have made it crucial to develop sustainable and environmental friendly methods for crop improvement. In the present study, host-induced RNA interference (HI-RNAi) approach was used to develop H. armigera resistant tobacco and tomato plants. Chitinase (HaCHI) gene, critically required for insect molting and metamorphosis was selected as a potential target. Hair-pin RNAi construct was prepared from the conserved off-target free partial HaCHI gene sequence and was used to generate several HaCHI-RNAi tobacco and tomato plants. Northern hybridization confirmed the production of HaCHI gene-specific siRNAs in HaCHI-RNAi tobacco and tomato lines. Continuous feeding on leaves of RNAi lines drastically reduced the target gene transcripts and consequently, affected the overall growth and survival of H. armigera. Various developmental deformities were also manifested in H. armigera larvae after feeding on the leaves of RNAi lines. These results demonstrated the role of chitinase in insect development and potential of HI-RNAi for effective management of H. armigera.

Evaluation of Legacy Phosphorus Storage and Release from Wetland Soils.

To better manage legacy phosphorus (P) in watersheds, reliable techniques to predict P storage and release from uplands, ditches, streams, and wetlands must be developed. Techniques such as the P saturation ratio (PSR) and the soil P storage capacity (SPSC), originally developed for upland soils, are hypothesized to be applicable to wetland soils as well. Surface soils were collected from eight beef ranches within the Lake Okeechobee Watershed, FL, to obtain a threshold PSR value and to evaluate the use of PSR and SPSC for identifying legacy P storage and release from wetland soils. Water-soluble P (WSP) was determined for all soils; the equilibrium P concentration (EPC) was determined for selected soils through the generation of Langmuir isotherms. The threshold PSR for wetland soils, calculated from P, Fe, and Al in a Mehlich 1 solution, was determined to be 0.1; SPSC, calculated using the threshold PSR, was found to be related to WSP. When SPSC was positive, WSP and EPC were minimal. However, both WSP and EPC increased once SPSC became negative. Organic matter (OM) varied from 0.4 to 90 g kg for both positive and negative SPSC, suggesting that OM in wetland soils does not have any effect on P retention and release below the threshold PSR. Moreover, when a wetland or drainage ditch is heavily P impacted, it could be a P source; wetland vegetation may no longer be able to assimilate additional P, resulting in P loss from the soil. This study suggests that the PSR-SPSC concept could be a valuable tool for evaluating legacy P release from wetlands.

Donor hemosiderosis does not affect liver function and regeneration in the setting of living donor liver transplantation.

Living donor liver transplantation (LDLT) demands a careful assessment of abnormal findings discovered during the evaluation process to determine if there will be any potential risks to the donor or recipient. Varying degrees of elevated hepatic iron levels are not uncommonly seen in otherwise healthy individuals. We questioned whether mild expression of hemosiderin deposition presents a safety concern when considering outcomes of living donation for both the donor and the recipient. We report on three LDLT patients who were found to have low- to moderate-grade hemosiderin deposition on liver biopsy. All other aspects of their evaluation proved satisfactory, and the decision was made to proceed with donation. There were no significant complications in the donors, and all demonstrated complete normalization of liver function postoperatively, with appropriate parenchymal regeneration. The recipients also had unremarkable postoperative recovery. We conclude that these individuals can be considered as potential donors after careful evaluation.

Peginterferon and ribavirin for treatment of recurrent hepatitis C disease in HCV-HIV coinfected liver transplant recipients.

Achievement of a sustained virologic response (SVR) with antiviral therapy significantly improves graft survival in hepatitis C virus (HCV) monoinfected liver transplant (LT) patients. Risks and benefits of HCV therapy in HCV-human immunodeficiency virus (HIV) coinfected LT recipients are not well established. Among 89 HCV-HIV LT recipients in the HIVTR cohort, 39 (23% Black, 79% genotype 1, 83% fibrosis stage ≤ 1) were treated with peginterferon-a2a or a2b plus ribavirin for a median 363 days (14-1373). On intent-to-treat basis, 22% (95% CI: 10-39) and 14% (95% CI: 5-30) achieved an end-of-treatment response (EOTR) and SVR, respectively. By per-protocol analysis (completed 48 weeks of therapy ± dose reductions), 42% and 26% had EOTR and SVR, respectively. Severe adverse events occurred in 85%, with 26% hospitalized with infections and 13% developing acute rejection. Early discontinuations and dose reductions occurred in 38% and 82%, respectively, despite use of growth factors in 85%. Eighteen of 39 treated patients (46%) subsequently died/had graft loss, with 10 (26%) attributed to recurrent HCV. In conclusion, SVR rates are low and tolerability is poor in HCV-HIV coinfected transplant recipients treated with peginterferon and ribavirin. These results highlight the critical need for better tolerated and more efficacious HCV therapies for HCV-HIV coinfected transplant recipients.

Successful anesthetic management for microsurgical excision of ruptured cerebellar arteriovenous malformation with trapped endovascular microcatheter.

Microsurgical excision and good anesthetic management of arteriovenous malformation (AVM) that ruptures during endovascular embolization can ensure good outcome despite per-procedural catastrophe. This case report illustrates the successful anesthetic management of microsurgical excision of ruptured AVM with entrapped microcatheter and highlights the role of the anesthesiologist in careful monitoring of the patient's hemodynamic status and communicating any changes to the radiology team to facilitate check angiography to diagnose the intracranial complication. This case highlights the need for anticipating and defining a catastrophe plan in advance of each interventional neuroradiology procedure as complications are rapid and require good multidisciplinary communication to ensure safe and successful outcomes.

Plastic Pandemic after COVID-19: A Global Health Concern.

Abstract: COVID-19 pandemic has increased the amount of plastic burden to environment and complexities of plastic waste management. Change in behavioral pattern with advent of this pandemic led to increased practice of hygiene and increased use of different types of personal protective equipment. Unfortunately, rapid rise in production of the PPEs (like Hazmat suit, gloves, etc.) and single-use plastics used in RT-PCR and other testing are the biggest source for increased non-biodegradable plastic waste leading to amplified burden on plastic waste management. A number of measures like prioritizing the policies directed towards changes at behavioral, social and institutional level need to be started. Also, reduction in plastic waste along with proper plastic waste management policies should be implemented. To prevent the transition from one pandemic to other; improvement in government policies with public private partnership are the need of the hour.

Ultrasonography as a tool in predicting the severity of dengue fever in children--a useful aid in a developing country.

BACKGROUND: Dengue fever accounts for significant mortality in developing countries. Dengue fever serology takes a week at least to be reported positive, thus necessitating the need for other markers of diagnosis and prognosis. OBJECTIVE: The purpose of this study was to investigate the role of ultrasonography as a tool in diagnosing and predicting the severity of dengue fever in children. MATERIALS AND METHODS: This was a prospective study conducted in a tertiary pediatric centre from September 2010 to July 2012. Three hundred twenty-four children with confirmed dengue fever were compared with 422 children of suspected dengue fever. Severity of illness was graded as per WHO criteria and sonography findings were correlated to the grade of illness. RESULTS: Gallbladder wall thickening was seen in 75% of the children with confirmed dengue fever. A significant difference was seen between survivors and non-survivors with respect to pericholecystic fluid collection (P = 0.002), hepatic intraparenchymal fluid (P < 0.001), splenomegaly (P = 0.002), splenic subcapsular fluid (P < 0.001), peripancreatic fluid (P < 0.001), perirenal fluid (P < 0.001) and pericardial fluid (P < 0.001). Other findings included ascites, pleural effusion, hepatomegaly and splenomegaly, which were present irrespective of grade of illness. CONCLUSIONS: Ultrasonography can be used as a useful tool in developing countries to predict the severity of dengue fever in children.

Safety Assessment of TLPL/AY/03/2008, A Polyherbal Formulation in Sprague Dawley Rats.

OBJECTIVES: TLPL/AY/03/2008 is a polyherbal formulation intended for treatment of osteoarthritis, rheumatoid arthritis, lumbago, spondylitis etc., Acute and repeated dose 90-days studies were conducted to evaluate the safety profile of TLPL/AY/03/2008 in rats. MATERIALS AND METHODS: In acute study, TLPL/AY/03/2008 was orally administered to Sprague Dawley rats at 2000 mg/kg. In repeated dose study, TLPL/AY/03/2008 was administered to rats at 200, 500 and 1000 mg/kg through oral gavage for 90 days and assessed for treatment related changes in body weight, feed consumption, hematological, biochemical and pathological parameters. Histopathological examination was conducted for tissues from control and the high dose groups and was extended to target organs from the lower dose and recovery groups. RESULTS: In acute study, the test item did not produce any mortality or adverse clinical signs. In the 90-days oral toxicity study, animals did not exhibit any toxicity symptoms and no deaths were observed. No significant changes were found in hematological and biochemical endpoints. Also, toxicologically significant alterations in relative organ weights were not observed. Microscopic findings of mild to marked, diffuse hepatocellular degeneration (vacuolar changes with granular of cytoplasm and pyknotic nuclei of hepatocytes) was noticed in males at 1000 mg/kg body weight. Animals of recovery group (1000 mg/kg) did not show any changes when compared with control group animals indicating the complete reversal. CONCLUSIONS: Based on the findings of the study, the median lethal dose of TLPL/AY/03/2008 was found to be more than 2000 mg/kg. The No Observed Adverse Effect Level (NOAEL) of TLPL/AY/03/2008 can be considered as 1000 mg/kg in both male and female rats, under the experimental conditions and doses employed.

Novel decorated aluminium(iii) phthalocyanine complex with the application of MWCNTs on electrodes: electrochemical non-enzymatic oxidation and reduction of glucose and hydrogen peroxide.

In this study, we performed the physicochemical and electrochemical characterization of a decorated macrocyclic aluminium(iii) phthalocyanine complex (AlTMQNCAPc). Subsequently, the AlTMQNCAPc@MWCNT/GC electrode was used for the electrochemical detection of glucose and hydrogen peroxide (H2O2) by cyclic voltammetry (CV), differential pulse voltammetry (DPV), and chronoamperometry (CA). Moreover, the limit of detection, linear range, and sensitivity for glucose and H2O2 were investigated (CV: 2.5 nM L-1 and 25 nM L-1, 50-500 µM, 0.052 and 0.072 µA µmol cm-2; DPV: 3.1 nM L-1 and 18 nM L-1, 50-500 µM, 0.062 and 0.066 µA µmol cm-2 and CA: 10 nM L-1 and 20 nM L-1, 50-500 µM, 0.098 and 0.07 µA µmol cm-2, respectively). In addition, the AlTMQNCAPc@MWCNT/GC electrode showed good selectivity for the detection of glucose and H2O2 in the presence of common interfering substances, such as AA, DA, UA, glycine, l-cysteine, nitrite, Pb(ii), Cd(ii), Cu(ii), Co(ii), Hg(ii), Zn(ii), and glucose. For the detection of glucose and H2O2, the kinetic parameters, including the electron transfer coefficient and catalytic reaction rate constant, were also established. Finally, for usage in practical applications, the modified electrode was employed to achieve the quantitative detection of glucose and H2O2 in human urine and commercial samples of 3% H2O2, respectively.