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Delivering specialised care for major burns requires a multidisciplinary health workforce. While health systems 'hardware' issues, such as shortages of the healthcare workforce and training gaps in burn care are widely acknowledged, there is limited evidence around the systems 'software' aspects, such as interest, power dynamics, and relationships that impact the healthcare workforce performance. This study explored challenges faced by the health workforce in burn care to identify issues affecting their performance. Qualitative in-depth interviews were conducted with a purposively selected sample (n = 31, 18 women and 13 men) of various cadres of the burn care health workforce in Uttar Pradesh, India. Inductive coding and thematic analysis identified three major themes. First, the dynamics within the multidisciplinary team where complex relations, power and normative hierarchy hampered performance. Second, the dynamics between health workers and patients due to the clinical and emotional challenges of dealing with burn injuries and multitasking. Third, dynamics between specialised burn units and broader health systems are narrated in challenges due to inadequate first response and delayed referral from primary care facilities. These findings indicate that burn care health workers in India face multiple challenges that need systemic intervention with a multipronged human resource for health framework.
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Quemaduras , Entrevistas como Asunto , Investigación Cualitativa , Humanos , India , Femenino , Masculino , Adulto , Fuerza Laboral en Salud , Persona de Mediana Edad , Personal de Salud , Grupo de Atención al PacienteAsunto(s)
COVID-19 , Oxigenoterapia Hiperbárica , Mucormicosis , Humanos , Mucormicosis/terapia , COVID-19/terapia , Terapia CombinadaRESUMEN
BACKGROUND: India has one of the highest burden of burns. The health systems response to burn care is sometimes patchy and highly influenced by social determinants. Delay in access to acute care and rehabilitation adversely affects recovery outcomes. Evidence on underlying factors for delays in care are limited. In this study, we aim to explore patients' journeys to analyse their experiences in accessing burn care in Uttar Pradesh, India. METHODS: We conducted qualitative inquiry using the patient journey mapping approach and in-depth interviews (IDI). We purposively selected a referral burn centre in Uttar Pradesh, India and included a diverse group of patients. A chronological plot of the patient's journey was drawn and confirmed with respondents at the end of the interview. A detailed patient journey map was drawn for each patient based on interview transcripts and notes. Further analysis was done in NVivo 12 using a combination of inductive and deductive coding. Similar codes were categorised into sub-themes, which were distributed to one of the major themes of the 'three delays' framework. RESULTS: Six major burns patients (4 female and 2 males) aged between 2 and 43 years were included in the study. Two patients had flame burns, and one had chemical, electric, hot liquid, and blast injury, respectively. Delay in seeking care (delay 1) was less common for acute care but was a concern for rehabilitation. Accessibility and availability of services, costs of care and lack of financial support influenced delay (1) for rehabilitation. Delay in reaching an appropriate facility (delay 2) was common due to multiple referrals before reaching an appropriate burn facility. Lack of clarity on referral systems and proper triaging influenced this delay. Delay in getting adequate care (delay 3) was mainly due to inadequate infrastructure at various levels of health facilities, shortage of skilled health providers, and high costs of care. COVID-19-related protocols and restrictions influenced all three delays. CONCLUSIONS: Burn care pathways are adversely affected by barriers to timely access. We propose using the modified 3-delays framework to analyse delays in burns care. There is a need to strengthen referral linkage systems, ensure financial risk protection, and integrate burn care at all levels of health care delivery systems.
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Quemaduras , Masculino , Humanos , Femenino , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Quemaduras/terapia , Accesibilidad a los Servicios de Salud , Investigación Cualitativa , Derivación y Consulta , IndiaRESUMEN
Chirality is a very important characteristic of optically active molecules and polyaromatics with helical structures, and plays a vital role in various applications in material science. In the present work, we show the effects of fluorine substitution at various positions in a figure-8-shaped [5]helicene dimer on the ground and excited state g-factors. Calculations for the ground and excited states are performed at the MP2 and ADC(2) levels of theory, respectively. The results reveal that fluorination has a large effect on the excited state structures. The values of the excited state dissymmetry factors for the molecules with fluorinations at both ends of the figure-8 systems are smaller than that of the parent system. On the other hand, fluorinations only in the stacked-phenyl region results in an increase in the value of g cpl ${\left| {g_{{\rm{cpl}}} } \right|}$ . The perfluorinated system shows the smallest g cpl ${\left| {g_{{\rm{cpl}}} } \right|}$ .
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Aim: TCF7L2 gene is believed to increase the risk of T2DM by its effects on insulin secretion. However, the exact mechanism of this enhanced risk is not clearly known. While TCF7L2 gene has been shown to affect lipid metabolism, these effects have remained largely unexplored in the context of diabetes risk. Methods: Postprandial lipid responses to a standardized fat challenge test were performed in 620 Asian Indian subjects (310 with NGT and 310 with T2DM/prediabetes) and compared between the risk and wild genotypes of the rs7903146 TCF7L2 gene. In 30 subjects scheduled to undergo abdominal surgery (10 each with NGT, Prediabetes and T2DM), adipocyte TCF7L2 gene expression was also performed by real time qPCR and confirmed by protein expression in western blot. Results: T allele of rs7903146 TCF7L2 gene was confirmed as the risk allele for T2DM (OR=1.8(1.2-2.74), p=0.005). TT+CT genotypes of rs7903146 TCF7L2 gene showed significantly higher 4hrTg (p<0.01), TgAUC (p<0.01), peakTg (p<0.01) as well as higher postprandial plasma glucose (p=.006) levels and HOMA-IR (p=0.03) and significantly lower adiponectin levels (p=0.02) as compared to CC genotype. The expression of TCF7L2 gene in VAT was 11-fold higher in prediabetes group as compared to NGT (P<0.01) and 5.7-fold higher in T2DM group as compared to NGT group(P=0.003) and was significantly associated with PPTg and glucose levels. Conclusion: There is significant PPTg dysmetabolism associated with the risk allele of rs7903146 polymorphism as well as adipocyte expression of TCF7L2 gene. Significant upregulation of TCF7L2 gene expression in VAT that correlates with PPTg and glycaemia is also seen in Asian Indians with glucose intolerance. Modulation of PPTg metabolism by TCF7L2 gene and the resultant PPHTg may be a novel mechanism that contributes to its diabetes risk in them.
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Diabetes Mellitus Tipo 2 , Proteína 2 Similar al Factor de Transcripción 7 , Humanos , Adiponectina , Glucemia/análisis , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/genética , Polimorfismo de Nucleótido Simple , Estado Prediabético/epidemiología , Estado Prediabético/genética , Proteína 2 Similar al Factor de Transcripción 7/genética , Triglicéridos , India , Población Blanca/genéticaRESUMEN
One of the rarer manifestations of constriction band syndrome (CBS) is peripheral nerve palsy. We report a 6-year-old child presenting with motor deficits of the median, ulnar and radial nerves and atrophy of the biceps and brachialis atrophy due to CBS. We were unable to find any similar reports in the literature. He had a constriction ring at the upper arm that had undergone multiple z-plasty by another surgeon. On examination, he had medical research council (MRC) grade 1 elbow flexion, weak flexion of fingers and absent extension of fingers and wrist. We used a pedicled pectoralis major myocutaneous flap to restore elbow flexion and the patient achieved M4 flexion of the elbow. Level of Evidence: Level V (Therapeutic).
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Neuropatías del Plexo Braquial , Transferencia de Nervios , Masculino , Niño , Humanos , Nervio Cubital/cirugía , Neuropatías del Plexo Braquial/cirugía , Constricción , AtrofiaRESUMEN
Endohedral fullerenes have evinced much interest from the fundamental and applications points of view. However, given the nature of the weak interaction between the guest species and the host cage in these confined systems, the interaction energy values obtained using various theoretical methods, and different basis sets vary over a wide range. For example, the reported interaction energy for the HF@C60 system ranges from -2.5â kcal/mol to -14.9â kcal/mol. In the present manuscript, we report reliable interaction energy values for different endohedral fullerenes (He@C60 , Ne@C60 , Ar@C60 , Kr@C60 , H2 @C60 , HF@C60 , H2 O@C60 , NH3 @C60 , CH4 @C60 , Li+ @C60 , Na+ @C60 , and K+ @C60 ) obtained using the domain-based local pair natural orbital coupled-cluster singles, doubles, and perturbative triples (DLPNO-CCSD(T)) method and the def2-TZVP basis set. We believe that these energy values could be considered as benchmark values, and the performance of other quantum chemical methods could be assessed accordingly. Local energy decomposition analysis within the DLPNO-CCSD(T) framework is used to estimate the electrostatic, exchange, and dispersion components of the interaction energy for some of the endohedral fullerenes.
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The key designing of new breeds of the adsorbents aimed to improve the physical, chemical and textural morphology along with surface functionalization, selectivity toward the contaminants, and regenerations efficiency. In this aspect, two adsorbents named wet oxidative and ultrasonicated zirconium impregnated composite, have been synthesized through two routes, i.e., wet oxidation and ultrasonication. In wet oxidation method, carbon-based materials are oxidized using an oxidant followed by impregnation, while in ultrasonication assisted route, the impregnation is carried out using acoustic phenomenon. The characterization study revealed that the wet oxidation process is more competent in impregnating zirconium and developing diverse porosity and functionalities. The maximum adsorption capacity of wet oxidative adsorbent was 812 mg/g for Reactive Blue 19 and 203.18 mg/g for Methylene Blue, that accentuated the efficiency of the adsorbent over raw activated carbon. The electrostatic interaction, hydrogen-bonding and ligand exchange phenomenon are the involved adsorption mechanism for dyes. The regeneration study finally asserts that the wet oxidative adsorbent shows an insignificant decrease in its capacity up to the 5th-cycle (i.e., 87.67% removal at 5th cycle) as compared to raw AC (46.71% removal at 5th cycle). Further, a continuous fixed-bed column study revealed a significant correlation between experimental breakthrough data and kinetic data. Thus, the developed adsorbent has a sedulous adsorption capacity to remove the most stubborn toxic dyes and can be used in industrial-scale applications.
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Colorantes , Contaminantes Químicos del Agua , Adsorción , Carbón Orgánico/química , Concentración de Iones de Hidrógeno , Cinética , Azul de Metileno/química , Agua/química , Contaminantes Químicos del Agua/química , CirconioRESUMEN
Synthesis and characterization of dual functioning material is an effective approach for the promotion of organic pollutant degradation through adsorption as well as photocatalysis. Herein, graphene oxide was modified by the addition of barium nitrate and iron to construct a smooth sheet-like structure (BaFe2O4/rGO) for the removal of chlorhexidine digluconate (CHD). Compared with GO (75.69%-UV light; 88.17%-visible light), BaFe2O4/rGO showed significant adsorption-photocatalysis effect under visible light (93.95%) than that under UV light (78.17%). The introduction of barium nitrate and iron into graphene oxide leads to a smooth porous structure with increased surface area (93.66 m2 g-1), which resulted in a large number of adsorption active sites and great photocatalytic activity with efficient charge separation. Although catalysts did not mineralize CHD completely, but the parent compound mineralized to some extent, which was confirmed by the TOC measurement and UV254 absorbance variation. In addition, toxicity of degraded products was analysed by bacterial susceptibility test on Bacillus cereus DPAML065, suggesting that nontoxic by-products of CHD were formed, which leads to their safe disposal. Based on the identified transformed products, the possible degradation pathway was proposed. Batch studies demonstrated that BaFe2O4/rGO is highly photoactive based on reaction rate constant (R2 = 0.984), where the kinetics data were well-fitted using the pseudo-first order. Moreover, efficiency of catalysts was examined under solar light to achieve the sustainability.
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Grafito , Rayos Ultravioleta , Catálisis , Clorhexidina/análogos & derivados , Grafito/química , Hierro , Luz , AguaRESUMEN
Insensate flaps are used in several reconstructions. A search of the literature showed that most studies are limited to particular flaps in specific body areas. There is a lack of uniform scientific data on the pattern of sensory recovery in various body parts for different kinds of flaps. We conducted a prospective observational study for over one year to study the pattern of sensory return in 74 flaps and studied the disparity in the return of sensation of touch, pain, warmth and cold. After that, we analyzed the relationship between sensory return in flaps and the region of the body (head and neck/upper limb/lower limb), type of flap (cutaneous/fasciocutaneous/musculocutaneous), age of patient and type of wound bed (surgically created defect/raw area such as post trauma, post debridement). Touch sensations were assessed by Semmes-Weinstein (SW) monofilament of 5.01 number, pain was assessed using a sterile 26 G needle, cold sensation was assessed using water at 4 °C and warm sensation was assessed using water at 44 °C. The sensations were evaluated at one-fourth and one-half of distance from the periphery to the center, at eight equidistant points along the circumference and at the center of the flap. Sensations were observed to return in the periphery of the flap earlier and in the center later. Touch sensation was recovered the earliest (three months onwards), followed by sensations of pain, warmth and cold (around the sixth month). Flaps performed in the head and neck showed the best recovery of sensation. Best recovery of sensation was observed in cutaneous flaps. Flaps performed on surgically created defects showed better recovery of sensation compared with flaps performed to cover raw areas; however, the differences were statistically nonsignificant. Children showed better recovery of sensations; however, this was not statistically significant. Sensory nerve coaptation is recommended in flaps folded on themselves and in fasciocutaneous flaps of the lower limb.
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Mamoplastia , Niño , Humanos , Estudios Prospectivos , Sensación/fisiología , Piel , Colgajos Quirúrgicos/inervación , TactoRESUMEN
BACKGROUND: Exposure to dichlorodiphenyltrichloroethane (DDT), a potent lipophilic organochlorine pesticide, has long been linked as a risk factor for type 2 diabetes mellitus (T2DM). However, its presence in the adipose tissues of the T2DM subjects has not been explored in the Indian population, where this long-banned pesticide is still in use. The present study was conducted to evaluate the possible association of DDT and its metabolites in obese and non-obese T2DM subjects. METHODS: Subjects with normal glucose tolerance (n = 50) and T2DM (n = 50) were divided into equal numbers in obese and non-obese groups. Their plasma glucose levels, HbA1c, and lipid profile were measured. The adipose tissues were collected intraoperatively, and DDT and its metabolites were measured using a gas chromatograph equipped with an electron capture detector. RESULTS: Obese subjects, irrespective of their glycemic status, and T2DM subjects had higher concentrations of DDT. p, p' DDT was found to increase the odds for diabetes, and o, p' DDT for central obesity. p, p' DDD was also strongly correlated with central obesity, glycemic parameters, and triglycerides. CONCLUSION: The excess deposition of p, p' DDD, o, p' DDT, and p, p' DDT in obese subjects may proceed to T2DM by disrupting triglycerides and glycemic parameters.
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Exosomes are nano-vesicles of endosomal origin inherited with characteristics of drug delivery and cargo loading. Exosomes offer a diverse range of opportunities that can be exploited in the treatment of various diseases post-functionalization. This membrane engineering is recently being used in the management of bacteria-associated diabetic foot ulcers (DFUs). Diabetes mellitus (DM) is among the most crippling disease of society with a large share of its imposing economic burden. DM in a chronic state is associated with the development of micro- and macrovascular complications. DFU is among the diabetic microvascular complications with the consequent occurrence of diabetic peripheral neuropathy. Mesenchymal stromal cell (MSC)-derived exosomes post-tailoring hold promise to accelerate the diabetic wound repair in DFU associated with bacterial inhabitant. These exosomes promote the antibacterial properties with regenerative activity by loading bioactive molecules like growth factors, nucleic acids, and proteins, and non-bioactive substances like antibiotics. Functionalization of MSC-derived exosomes is mediated by various physical, chemical, and biological processes that effectively load the desired cargo into the exosomes for targeted delivery at specific bacterial DFUs and wound. The present study focused on the application of the cargo-loaded exosomes in the treatment of DFU and also emphasizes the different approaches for loading the desired cargo/drug inside exosomes. However, more studies and clinical trials are needed in the domain to explore this membrane engineering.
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Even before the onslaught of COVID-19 pandemic could settle, the unprecedented rise in cases with COVID-19 associated mucormycosis pushed the medical health to the fringe. Hyperglycaemia and corticosteroids appear to be the most consistent associations leading to the commonest manifestation of mucormycosis, Rhino-Orbito-Cerebral Mucormycosis. To address challenges right from categorisation and staging of the disease to the management of relentless progression, a multi-disciplinary expert committee was formed to handle the task in an evidence-based format to enforce best practices. The report of the committee on one hand attempts to succinctly present the currently available evidence while at the other also attempts to bridge the evidence-deficient gaps with the specialty-specific virtuosity of experts.
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Introduction Reconstruction forms the primary tenet in plastic surgery. Venous flaps are a known option but the survival is limited. Arterialization of venous flap can enhance its survival. While various techniques of arterialization of venous flaps are described, there are very few studies comparing them. Material and methods The current study was conducted among 34 rats weighing 160 to 200 grams. The rats were divided into four groups. Group I-islanded epigastric flap was raised with superficial caudal epigastric vessels as pedicle. Group II-arterialized flow through venous flap was raised with superficial caudal epigastric vein (SCEV) as afferent and lateral thoracic vein as drainage vein. Side-to-side anastomosis was done between femoral artery and vein, lateral to the origin of superficial caudal epigastric artery. Group III-after raising the flap, as in group II, femoral vein was ligated proximal to superficial caudal epigastric vessels. Group IV-an arterialized flow through venous flap was raised with superficial caudal epigastric vein as afferent and lateral thoracic vein as drainage vein. End-to-side anastomosis was done between femoral artery and superficial caudal epigastric vein. Animals that died before completion of the study were excluded. The color changes of flaps were noted. Flap survival was expressed as a percentage of the total flap surface area. The patency of anastomosis was seen on postoperative day 5. Results There was no total flap failure. On statical analysis, the flap survival area on day 5 between Group I and Group IV was not significant ( p value 0.431). The survival area in Group I (78.85 ± 10.54%) was comparable to Group IV (65.71 ± 20.70%). Group II and III had poor results as compared with Group I. In four rats, thrombosis of arteriovenous anastomosis was noted with flap survival area of 30 to 33%. Conclusion It was noted that epigastric venous flaps with end-to-side anastomosis between femoral artery and superficial caudal epigastric vein (group IV) have survival area comparable to islanded flaps.
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The novel coronavirus severe acute respiratory syndrome-CoV-2 (SARS-CoV-2) is responsible for COVID-19 infection. The COVID-19 pandemic represents one of the worst global threats in the 21st century since World War II. This pandemic has led to a worldwide economic recession and crisis due to lockdown. Biomedical researchers, pharmaceutical companies, and premier institutes throughout the world are claiming that new clinical trials are in progress. During the severe phase of this disease, mechanical ventilators are used to assist in the management of outcomes; however, their use can lead to the development of pneumonia. In this context, mesenchymal stem cell (MSC)-derived exosomes can serve as an immunomodulation treatment for COVID-19 patients. Exosomes possess anti-inflammatory, pro-angiogenic, and immunomodulatory properties that can be explored in an effort to improve the outcomes of SARS-CoV-2-infected patients. Currently, only one ongoing clinical trial (NCT04276987) is specifically exploring the use of MSC-derived exosomes as a therapy to treat SARS-CoV-2-associated pneumonia. The purpose of this review is to provide insights of using exosomes derived from mesenchymal stem cells in management of the co-morbidities associated with SARS-CoV-2-infected persons in direction of improving their health outcome. There is limited knowledge of using exosomes in SARS-CoV-2; the clinicians and researchers should exploit exosomes as therapeutic regime.
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COVID-19/terapia , Exosomas/metabolismo , Vesículas Extracelulares/metabolismo , Inmunomodulación , Células Madre Mesenquimatosas/metabolismo , Neumonía Viral/terapia , COVID-19/complicaciones , COVID-19/metabolismo , COVID-19/patología , Citocinas/metabolismo , Citocinas/farmacología , Exosomas/química , Exosomas/genética , Humanos , Inflamación/inmunología , Inflamación/terapia , Inflamación/virología , Células Madre Mesenquimatosas/inmunología , Neovascularización Fisiológica/inmunología , Neumonía Viral/complicaciones , Neumonía Viral/virología , Infecciones del Sistema Respiratorio/complicaciones , Infecciones del Sistema Respiratorio/terapia , Infecciones del Sistema Respiratorio/virologíaRESUMEN
Oxidation of phenol, cyanide and aniline have been analyzed by the enhanced electro-oxidation process in which sodium chlorite was used as an electrolyte and results were validated using statistical tool based on Box-Behnken design. The mineralization efficiency of 78.4%, and 98.18% were predicted at optimized variables condition for phenol, and aniline respectively, whereas complete mineralization has been observed for the cyanide at the optimized conditions, which describes the significance of the design model approach.The process mineralizes the higher phenol concentration revealing a drastic reduction in power consumption in comparison of direct oxidation, i.e., 799.36 kWh/kg to 138.18 kWh/kg for more than 90% mineralization of phenol even at a higher current density of 13.63 mA/cm2. The kinetic modelling approach justified that higher current density has also played a role in higher mineralization of pollutants at the specific operating conditions. The by-product formation and toxicity effect on microalgae in wastewater were assessed by the full scan mass spectrometry and microalgae pigment inhibition test after the electro-oxidation of coking wastewater. The pigment growth inhibition rate of Chlorella sp. NCQ and Micractinium sp. NCS2 suggests that sodium chlorite as an electrolyte aid can also effectively used as an oxidizing agent and algal inhibiter in the coking wastewater.
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Eliminación de Residuos Líquidos/métodos , Contaminantes Químicos del Agua/toxicidad , Compuestos de Anilina , Chlorella , Compuestos de Cloro , Coque/análisis , Cianuros/análisis , Contaminantes Ambientales/análisis , Peróxido de Hidrógeno/química , Microalgas , Oxidación-Reducción , Óxidos , Fenol/análisis , Aguas Residuales/química , Contaminantes Químicos del Agua/análisisRESUMEN
BACKGROUND: Organochlorine pesticides (OCPs) exposure may induce an endocrine disruption which may lead to the risk of developing diabetes through alteration and disturbance of glucose metabolism, insulin resistance, and destruction of ß-cells. The present study determines the recent trend of OCPs residue in blood samples and their association with the known risk factors responsible for developing the risk of diabetes among the North Indian population. METHODS: Blood sample of 300 patients (100 each of normal glucose tolerance [NGT], prediabetes and newly detected diabetes mellitus [DM]) between the age group of 30 to 70 years were collected. OCPs residue in whole blood samples was analyzed by using gas chromatography equipped with a 63Ni selective electron capture detector. RESULTS: Significantly higher levels of ß-hexachlorocyclohexane (HCH), dieldrin, and p,p'-dichloro-diphenyl-dichloroethylene (DDE) were found in the prediabetes and newly detected DM groups as compared to NGT group. Insulin resistance showed to be significantly positive correlation with ß-HCH and dieldrin. Also, fasting and postprandial glucose levels were significantly positively correlated with levels of ß-HCH, dieldrin, and p,p'-DDE. Further, when OCPs level was adjusted for age and body mass index (BMI), it was found that ß-HCH, dieldrin, and p,p'-DDE levels in blood increases the risk of diabetes by 2.70, 2.83, and 2.55 times respectively. Moreover, when we adjust OCPs level based on BMI categories (BMI <23, ≥23, and ≤25, and >25 kg/m2); ß-HCH and p,p'-DDE showed a significant risk of developing newly detected DM with BMI >25 and ≥23 and ≤25 kg/m2. CONCLUSION: The OCPs level present in the environment may be responsible for biological, metabolic, and endocrine disruptions within the human body which may increase the risk of developing newly detected DM. Hence, OCPs exposure can play a crucial role in the etiology of diabetes.
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Intolerancia a la Glucosa , Hidrocarburos Clorados , Resistencia a la Insulina , Plaguicidas , Estado Prediabético , Adulto , Anciano , Intolerancia a la Glucosa/inducido químicamente , Intolerancia a la Glucosa/diagnóstico , Intolerancia a la Glucosa/epidemiología , Humanos , Hidrocarburos Clorados/análisis , Hidrocarburos Clorados/toxicidad , Persona de Mediana Edad , Plaguicidas/efectos adversos , Plaguicidas/análisis , Estado Prediabético/inducido químicamente , Estado Prediabético/diagnóstico , Estado Prediabético/epidemiologíaRESUMEN
Organochlorine pesticides (OCPs) are well known synthetic pesticides widely used in agricultural practices and public health program. Higher toxicity, slow degradation, and bioaccumulation are the significant challenges of OCPs. Due to its uses in agricultural and public health, contamination of drinking water and water table also increases day by day. Contaminated drinking water has become a significant issue and alarming signal for public health globally. The purpose of this study was to assess the recent trend of organochlorine pesticides (OCPs) level in drinking water and blood samples of the North Indian population and also to find out its association with glucose intolerance, lipid metabolism, and insulin resistance, which are known risk factors of type 2 diabetes mellitus (T2DM). A case-control study was conducted on 130 Non-Glucose intolerance (NGT), 130 pre-diabetes and 130 recently diagnosed T2DM subjects of the age group of 30-70 years. Patients consuming drinking water from the same source for at least ten years were included in this study for blood and water samples collection. Significantly higher levels of α-HCH, ß-HCH, γ-HCH, p,p'-DDE, and o,p'-DDT were found in groundwater samples. However, in tap water samples, the level of α-HCH was found to be slightly higher than the permissible limit of 0.001. Among all recruited subjects consuming contaminated groundwater, 42% had T2DM, 38% pre-diabetes, and the remaining 20% were found normal. We also observed that OCP contamination in groundwater is higher than tap and filter water. The levels of ß-HCH, p,p'-DDE, and o,p'-DDT were higher in the pre-diabetes and T2DM group than the NGT group. With an increase of OCPs level in groundwater, the blood OCPs level tends to increase T2DM risk. It depicts that the elevated OCPs level in consumed groundwater may contribute to increased risk for the development of T2DM after a certain period of exposure.
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Diabetes Mellitus Tipo 2 , Agua Potable , Hidrocarburos Clorados , Plaguicidas , Adulto , Anciano , Estudios de Casos y Controles , Diabetes Mellitus Tipo 2/epidemiología , Monitoreo del Ambiente , Humanos , Hidrocarburos Clorados/análisis , India/epidemiología , Persona de Mediana Edad , Plaguicidas/análisis , Factores de RiesgoRESUMEN
Advanced oxidation processes have gained colossal attention owing to the prospect of accessible mineralization, but by-product formation and its toxicity evaluation are still inconclusive. The present study demonstrated the performance of electrochemical oxidation process supported with graphite electrodes for the oxidation of phenol from modulated coke oven wastewater. The results suggested that the hydrogen peroxide along with the in-situ synthesized oxidizing agents has the ability to increase the phenol mineralization 1.5 times and by-product toxicity potential on microalgae, Scenedesmus sp. CBIIT(ISM) also revealed that chlorophyll-a synthesis has increased after the electro-oxidation process in coke oven wastewater. The experimental results for phenol mineralization and by-product formation were validated using a mass spectrophotometer.
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Coque , Microalgas , Contaminantes Químicos del Agua , Electrodos , Peróxido de Hidrógeno , Oxidación-Reducción , Fenol/análisis , Fenoles , Contaminantes Químicos del Agua/análisisRESUMEN
In the present study, the performance of biochar-based filtration bed was assessed to enhance the removal efficiency of Cr(VI), from the pre-treated synthetic tannery wastewater. The pre-treatment of wastewater was carried out with aluminium formate (AF) as a coagulant and 80% Cr(VI) removal was observed which might be due to the formation of carboxylic complexation reaction. The purity of coagulant and the sludge components were validated with XRD analysis and the results revealed the formation of pure aluminium formate compound as well as a clear change in the crystalline structure in the treated sludge. FT-IR spectra demonstrated the carboxylic compound participated in the removal of Cr(VI) during the coagulation process. The pre-treated wastewater having 20â mg/L (residual) Cr(VI) was passed through a three-layered filtration bed containing biochar, which showed complete removal of Cr(VI) â¼ 99.99% by precipitating into bind form under the influence of CaCO3 and formate ions. The possible mechanistic approach might be due to the presence of formate ions in the pre-treated wastewater, the precipitation of Cr(VI) occurred in the form of Cr(OH)2 by the release of bicarbonate (HCO3-), carbonate ion (CO3 2-) and hydroxide (OH-) ions in the filtration bed. The properties of the biochar were investigated by XRD and FTIR analysis and the results revealed the existence of hydroxyl, carboxyl and carbonyl groups, which participated during the removal of Cr(VI). The results suggest that biochar-based filtration bed could be a promising method for the treatment of pre-treated tannery wastewater.