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1.
Sci Rep ; 14(1): 8420, 2024 04 10.
Article in English | MEDLINE | ID: mdl-38600155

ABSTRACT

In recent years biochar (BC) has gained importance for its huge carbon (C) sequestration potential and positive effects on various soil functions. However, there is a paucity of information on the long-term impact of BC on the priming effect and nutrient availability in soil with different properties. This study investigates the effects of BC prepared from rice husk (RBC4, RBC6), sugarcane bagasse (SBC4, SBC6) and mustard stalk (MBC4, MBC6) at 400 and 600 °C on soil C priming and nitrogen (N), phosphorus (P), and potassium (K) availability in an Alfisol, Inceptisol, and Mollisol. BC properties were analyzed, and its decomposition in three soil orders was studied for 290 days in an incubation experiment. Post-incubation, available N, P, and K in soil were estimated. CO2 evolution from BC and soil alone was also studied to determine the direction of priming effect on native soil C. Increasing pyrolysis temperature enhanced pH and EC of most of the BC. The pyrolysis temperature did not show clear trend with respect to priming effect and nutrient availability across feedstock and soil type. MBC6 increased C mineralization in all the soil orders while RBC6 in Alfisol and SBC6 in both Inceptisol and Mollisol demonstrated high negative priming, making them potential amendments for preserving native soil C. Most of the BC showed negative priming of native SOC in long run (290 days) but all these BC enhanced the available N, P, and K in soil. SBC4 enhanced N availability in Alfisol and Inceptisol, RBC4 improved N and P availability in Mollisol and P in Alfisol and MBC6 increased K availability in all the soils. Thus, based on management goals, tailored BC or blending different BC can efficiently improve C sequestration and boost soil fertility.


Subject(s)
Carbon , Saccharum , Carbon/analysis , Soil/chemistry , Cellulose , Charcoal/chemistry , Nutrients , India
2.
ACS Biomater Sci Eng ; 10(4): 2116-2132, 2024 Apr 08.
Article in English | MEDLINE | ID: mdl-38498674

ABSTRACT

Due to excellent biocompatibility, bioactivities, and osteoconductivity, hydroxyapatite (HAp) is considered as one of the most suitable biomaterials for numerous biomedical applications. Herein, HAp was fabricated using a bottom-up approach, i.e., a wet chemical method, and its composites with TiC, h-BN, and ZrO2 were fabricated by a solid-state reaction method with enhanced mechanical and biological performances. Structural, surface morphology, and mechanical behavior of the fabricated composites were characterized using various characterization techniques. Furthermore, transmission electron microscopy study revealed a randomly oriented rod-like morphology, with the length and width of these nanorods ranging from 78 to 122 and from 9 to 13 nm. Moreover, the mechanical characterizations of the composite HZBT4 (80HAp-10TiC-5h-BN-5ZrO2) reveal a very high compressive strength (246 MPa), which is comparable to that of the steel (250 MPa), fracture toughness (14.78 MPa m1/2), and Young's modulus (1.02 GPa). In order to check the biocompatibility of the composites, numerous biological tests were also performed on different body organs of healthy adult Sprague-Dawley rats. This study suggests that the composite HZBT4 could not reveal any significant influence on the hematological, serum biochemical, and histopathological parameters. Hence, the fabricated composite can be used for several biological applications, such as bone implants, bone grafting, and bone regeneration.


Subject(s)
Durapatite , Nanocomposites , Rats , Animals , Durapatite/toxicity , Durapatite/chemistry , Rats, Sprague-Dawley , Biocompatible Materials/toxicity , Bone and Bones , Nanocomposites/toxicity
3.
Waste Manag Res ; : 734242X241227379, 2024 Feb 14.
Article in English | MEDLINE | ID: mdl-38353237

ABSTRACT

This study addresses the urgent issue of water pollution caused by iron (Fe) and manganese (Mn) ions. It introduces an innovative approach using graphene oxide (GO) and GO-decorated polyethersulphone (PES) membranes to efficiently remove these ions from contaminated water. The process involves integrating GO into PES membranes to enhance their adsorption capacity. Characterization techniques, including scanning electron microscopy, Fourier-transform infrared, and contact angle measurements, were used to assess structural and surface properties. The modified membranes demonstrated significantly improved adsorption compared to pristine PES. Notably, they achieved over 94% removal of Mn2+ and 93.6% of Fe2+ in the first filtration cycle for water with an initial concentration of 100 ppm. Continuous filtration for up to five cycles maintained removal rates above 60%. This research advances water purification materials, offering a promising solution for heavy metal ion removal. GO-decorated PES membranes may find application in large-scale water treatment, addressing environmental and public health concerns.

4.
Sci Rep ; 14(1): 2128, 2024 01 25.
Article in English | MEDLINE | ID: mdl-38267527

ABSTRACT

The most common denture material used for dentistry is poly-methyl-methacrylate (PMMA). Usually, the polymeric PMMA material has numerous biological, mechanical and cost-effective shortcomings. Hence, to resolve such types of drawbacks, attempts have been made to investigate fillers of the PMMA like alumina (Al2O3), silica (SiO2), zirconia (ZrO2) etc. For the enhancement of the PMMA properties a suitable additive is required for its orthopedic applications. Herein, the main motive of this study was to synthesize a magnesium oxide (MgO) reinforced polymer-based hybrid nano-composites by using heat cure method with superior optical, biological and mechanical characteristics. For the structural and vibrational studies of the composites, XRD and FT-IR were carried out. Herein, the percentage of crystallinity for all the fabricated composites were also calculated and found to be 14.79-30.31. Various physical and optical parameters such as density, band gap, Urbach energy, cutoff energy, cutoff wavelength, steepness parameter, electron-phonon interaction, refractive index, and optical dielectric constant were also studied and their values are found to be in the range of 1.21-1.394 g/cm3, 5.44-5.48 eV, 0.167-0.027 eV, 5.68 eV, 218 nm, 0.156-0.962, 4.273-0.693, 1.937-1.932, and 3.752-3.731 respectively. To evaluate the mechanical properties like compressive strength, flexural strength, and fracture toughness of the composites a Universal Testing Machine (UTM) was used and their values were 60.3 and 101 MPa, 78 and 40.3 MPa, 5.85 and 9.8 MPa-m1/2 respectively. Tribological tests of the composites were also carried out. In order to check the toxicity, MTT assay was also carried out for the PM0 and PM15 [(x)MgO + (100 - x) (C5O2H8)n] (x = 0 and 15) composites. This study provides a comprehensive insight into the structural, physical, optical, and biological features of the fabricated PMMA-MgO composites, highlighting the potential of the PM15 composite with its enhanced density, mechanical strength, and excellent biocompatibility for denture applications.


Subject(s)
Magnesium Oxide , Polymethyl Methacrylate , Silicon Dioxide , Spectroscopy, Fourier Transform Infrared , Polymers , Dental Materials
5.
Indian J Med Res ; 157(6): 498-508, 2023 06.
Article in English | MEDLINE | ID: mdl-37530305

ABSTRACT

Background & objectives: The Government of India has initiated a population based screening (PBS) for noncommunicable diseases (NCDs). A health technology assessment agency in India commissioned a study to assess the cost-effectiveness of screening diabetes and hypertension. The present study was undertaken to estimate the cost of PBS for Type II diabetes and hypertension. Second, out-of-pocket expenditure (OOPE) for outpatient care and health-related quality of life (HRQoL) among diabetes and hypertension patients were estimated. Methods: Economic cost of PBS of diabetes and hypertension was assessed using micro-costing methodology from a health system perspective in two States. A total of 165 outpatients with diabetes, 300 with hypertension and 497 with both were recruited to collect data on OOPE and HRQoL. Results: On coverage of 50 per cent, the PBS of diabetes and hypertension incurred a cost of ₹ 45.2 per person screened. The mean OOPE on outpatient consultation for a patient with diabetes, hypertension and both diabetes and hypertension was ₹ 4381 (95% confidence interval [CI]: 3786-4976), ₹ 1427 (95% CI: 1278-1576) and ₹ 3932 (95% CI: 3614-4250), respectively. Catastrophic health expenditure was incurred by 20, 1.3 and 14.8 per cent of patients with diabetes, hypertension and both diabetes and hypertension, respectively. The mean HRQoL score of patients with diabetes, hypertension and both was 0.76 (95% CI: 0.72-0.8), 0.89 (95% CI: 0.87-0.91) and 0.68 (95% CI: 0.66-0.7), respectively. Interpretations & conclusions: The findings of our study are useful for assessing cost-effectiveness of screening strategies for diabetes and hypertension.


Subject(s)
Diabetes Mellitus, Type 2 , Hypertension , Humans , Health Expenditures , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Quality of Life , Hypertension/diagnosis , Hypertension/epidemiology , India/epidemiology
6.
Soft Matter ; 19(34): 6446-6457, 2023 Aug 30.
Article in English | MEDLINE | ID: mdl-37606542

ABSTRACT

We report a two-layer microfluidic device to study the combined effect of confinement and chemical gradient on the motility of wild-type E. coli. We track individual E. coli in 50 µm and 10 µm wide microchannels, with a channel height of 2 µm, to generate quasi-2D conditions. We find that contrary to expectations, bacterial trajectories are superdiffusive even in the absence of a chemical (glucose) gradient. The superdiffusive behaviour becomes more pronounced upon introducing a chemical gradient or strengthening the lateral confinement. Run length distributions for weak lateral confinement in the absence of chemical gradients follow an exponential distribution. Both confinement and chemoattraction induce deviations from this behaviour, with the run length distributions approaching a power-law form under these conditions. Both confinement and chemoattraction suppress large-angle tumbles as well. Our results suggest that wild-type E. coli modulates both its runs and tumbles in a similar manner under physical confinement and chemical gradient. Our findings have implications for understanding how bacteria modulate their motility behaviour in natural habitats.


Subject(s)
Escherichia coli , Microfluidics , Escherichia coli/genetics , Chemotaxis , Diffusion , Glucose
7.
J Mech Behav Biomed Mater ; 145: 106032, 2023 09.
Article in English | MEDLINE | ID: mdl-37506567

ABSTRACT

Herein, present study mainly focuses on the synthesis and characterizations of boron nitride reinforced waste zirconia (wZrO2) with different concentrations. Composites were prepared via a scalable solid-state reaction method. Various physical parameters such as density, ionic concentration, polaron radius, and field strength were evaluated. XRD results reveal crystalline nature with a major phase of tetragonal zirconia and as boron nitride is reinforced, the tetragonal transforms into a monoclinic zirconia. Interconnected spherical grains and nanosheets were observed using FESEM. Mechanical characterizations revealed the highest compressive strength of 266 MPa. The latent fingerprints were visualized using a composite on different surfaces, implementing the powder dusting and solution techniques. MTT assay was performed and revealed good biocompatible nature. These results reveal that composite is suitable for fabrication of bioceramics with acceptable mechanical and biological performances. The composite can also be utilized for latent fingerprint detection in forensic science.


Subject(s)
Ceramics , Zirconium , Materials Testing , Ceramics/chemistry , Surface Properties , Zirconium/chemistry
8.
Behav Brain Res ; 438: 114158, 2023 02 13.
Article in English | MEDLINE | ID: mdl-36243243

ABSTRACT

In the past decades, zebrafish have gathered immense attention and importance in the field of neurological sciences. In the case of epilepsy, zebrafish have appeared as a promising acute animal model for the screening and identification of potential antiepileptic molecules. However, the necessity for establishing competent chronic models of epilepsy in zebrafish is apparent. In this regard, recently we developed a chemo-kindling zebrafish model with a better clinical resemblance. In the present study, an attempt to examine the effect of pentylenetetrazole (PTZ)-induced kindling on the cognitive functions of zebrafish was made. In brief, adult zebrafish were repetitively given a sub-effective concentration of PTZ, till the onset of clonic-tonic seizures, entitled as kindled. Thereafter, T-maze test and social recognition memory test were conducted to evaluate spatial memory and social novelty recognition memory of the fish. At the end, both the groups were sacrificed and the brains were isolated to estimate neurotransmitter and gene expression levels. It was observed that PTZ kindling induced spatial cognition deficits and lower social exploration in zebrafish. However, it didn't change the novelty recognition memory of kindled zebrafish. The results of genes and neurotransmitters estimations in the brain also supported the behavioural findings. The results concluded that PTZ kindling alters spatial cognitive functions in adult zebrafish without affecting the social novelty recognition memory.


Subject(s)
Epilepsy , Kindling, Neurologic , Animals , Zebrafish , Pentylenetetrazole/pharmacology , Cognition , Anticonvulsants/pharmacology , Epilepsy/chemically induced
9.
Natl Med J India ; 35(3): 172-176, 2022.
Article in English | MEDLINE | ID: mdl-36461865

ABSTRACT

Background The Covid-19 pandemic has posed a challenge to organizing a safe clinical assessment for postgraduate degree candidates completing the residency programmes in various specialties. Although minimizing the risk of Covid-19 transmission is a priority, fulfilling the objectives of the assessment is equally important. Methods We conducted this study in the Department of Internal Medicine at our institute. Instead of physically examining patients, case scenarios that included history, clinical and investigational data of the cardiovascular system (CVS) were presented to the candidates. Performance was scored by both the conventional and the CVS objective-structured clinical examination (CVS-OSCE) method and compared. Results Clinical assessment examination of 27 candidates for the degree of Doctor of Medicine showed that the median cumulative score gained in narrating and analysing various differential diagnoses was lower compared to the mean cumulative score gained in arriving at a single correct diagnosis (50% [interquartile range-IQR 39%-64%] v. 79% [IQR 64%-100%], p<0.01). Most of the candidates agreed that case scenarios were good alternatives to the conventional physical examination amidst the pandemic. Conclusion CVS-OSCE-based assessment using structured case scenarios is a feasible and effective alternative for clinical skill assessment in high-stake examinations.


Subject(s)
COVID-19 , Cardiovascular System , Internship and Residency , Humans , COVID-19/epidemiology , Pandemics/prevention & control , Physical Examination
10.
J Agric Food Chem ; 70(25): 7674-7682, 2022 Jun 29.
Article in English | MEDLINE | ID: mdl-35713421

ABSTRACT

α-Lipoic acid (LA), a dithiol micronutrient, acts as a vital cofactor in various cellular catabolic reactions and is also known as a universal antioxidant. The therapeutic efficacy of LA is compromised by a poor aqueous solubility as well as a short half-life. In the present study, LA was conjugated to d-α-tocopherol polyethylene glycol succinate (TPGS) using carbodiimideacid-alcohol coupling reaction. The synthesized conjugate (TPGS-LA) was characterized using 1H and 13C nuclear magnetic resonance (NMR), Fourier transform infrared spectroscopy (FT-IR), UV-vis spectroscopy, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The TPGS-LA conjugate was demonstrated to be biocompatible and to have better anticonvulsion activity as compared to native LA in pentylenetetrazol (PTZ)-induced convulsions in zebrafish. Moreover, zebrafish larvae pretreated with TPGS-LA conjugate demonstrated a significant (p < 0.05) reduction of protein carbonylation levels and downregulation of c-fos expression during seizures as compared to native LA. Conclusively, the present findings demonstrate that the TPGS-LA conjugate can be a promising approach for the delivery of LA.


Subject(s)
Thioctic Acid , Animals , Polyethylene Glycols/chemistry , Spectroscopy, Fourier Transform Infrared , Succinates , Thioctic Acid/pharmacology , Vitamin E/chemistry , Vitamin E/pharmacology , Zebrafish , alpha-Tocopherol/pharmacology
11.
Curr Neuropharmacol ; 20(11): 2034-2049, 2022.
Article in English | MEDLINE | ID: mdl-35450526

ABSTRACT

A high-fat diet with appropriate protein and low carbohydrate content, widely known as the ketogenic diet (KD), is considered as an effective non-pharmacotherapeutic treatment option for certain types of epilepsies. Several preclinical and clinical studies have been carried out to elucidate its mechanism of antiepileptic action. Ketone bodies produced after KD's breakdown interact with cellular excito-inhibitory processes and inhibit abnormal neuronal firing. The generated ketone bodies decrease glutamate release by inhibiting the vesicular glutamate transporter 1 and alter the transmembrane potential by hyperpolarization. Apart from their effect on the well-known pathogenic mechanisms of epilepsy, some recent studies have shown the interaction of KD metabolites with novel neuronal targets, particularly adenosine receptors, adenosine triphosphate-sensitive potassium channel, mammalian target of rapamycin, histone deacetylase, hydroxycarboxylic acid receptors, and the NLR family pyrin domain containing 3 inflammasomes to suppress seizures. The role of KD in augmenting gut microbiota as a potential mechanism for epileptic seizure suppression has been established. Furthermore, some recent findings also support the beneficial effect of KD against epilepsy- associated comorbidities. Despite several advantages of the KD in epilepsy management, its use is also associated with a wide range of side effects. Hypoglycemia, excessive ketosis, acidosis, renal stones, cardiomyopathies, and other metabolic disturbances are the primary adverse effects observed with the use of KD. However, in some recent studies, modified KD has been tested with lesser side effects and better tolerability. The present review discusses the molecular mechanism of KD and its role in managing epilepsy and its associated comorbidities.


Subject(s)
Diet, Ketogenic , Epilepsy , Humans , Epilepsy/metabolism , Seizures , Ketone Bodies/metabolism , Anticonvulsants
13.
J Assoc Physicians India ; 69(10): 11-12, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34781653

ABSTRACT

OBJECTIVES: Fever of unknown origin (FUO) has different etiology in different age groups. We aimed to determine the spectrum of FUO in older patients and to establish the underlying etiology. METHODS: This was a hospital-based prospective observational study conducted between January 2018 to June 2019 at Postgraduate Institute of Medical Education and Research, Chandigarh, India. Fifty-one consecutive patients aged 60 years and above met the qualitative criteria of FUO. RESULTS: The etiological distribution was infections in 21 patients (41.2%), malignancies in 16 (31.4%) and noninfectious inflammatory disorders in 8 (15.7%). Six patients (11.8%) remained undiagnosed. Among infections, 15 patients (29.4%) had tuberculosis, and 10 had an extrapulmonary disease. Twelve out of 16 cases with malignancies had a hematological cause, and eight had lymphoma. ;Regarding decisive methods of diagnosis, 18F-fluorodeoxyglucose positron emission tomography was diagnostic in 17 out of 27 patients (63%) and computed tomography in 21 out of 42 cases (50%). Imaging or endoscopy-guided procedures provided a diagnostic clue in 12 out of 14 patients (85.7%), and bone marrow examination results were useful in 9 out of 19 (47.4%). CONCLUSIONS: Infections and malignancies contributed to about three-fourths of cases, with tuberculosis and lymphoma being the commonest etiologies.


Subject(s)
Fever of Unknown Origin , Aged , Fever of Unknown Origin/epidemiology , Fever of Unknown Origin/etiology , Fluorodeoxyglucose F18 , Humans , India/epidemiology , Positron-Emission Tomography , Prospective Studies , Tomography, X-Ray Computed
14.
J Diabetes Metab Disord ; 20(1): 571-582, 2021 Jun.
Article in English | MEDLINE | ID: mdl-34222078

ABSTRACT

PURPOSE: To investigate the protective effect of vanillic acid (VA) in streptozotocin (STZ)-induced diabetic nephropathy (DN) in rats. METHODS: Experimental diabetes mellitus in rats was induced by intraperitoneally administration of single dose of STZ (55 mg/kg). The animals were divided into 5 groups viz., normal control, diabetic control, glimepiride (0.5 mg/kg, orally) and VA treatment (50 and 100 mg/kg, orally) groups. The treatment was started after the confirmation of hyperglycemia (> 250 mg/dl) and continued for 6 weeks. Serum glucose level, and body weight were measured weekly. At the end of study, HbA1c in whole blood, insulin, lipid profile, urea, creatinine and albumin in serum. Creatinine and albumin were measured in urine along with creatinine clearance. In addition, kidney weight and histopathology were assessed. RESULTS: Treatment with VA markedly attenuated STZ-induced body weight loss and hyperglycemia, along with improved lipid profile and HbA1c, without significant alteration of serum insulin levels. It also decreased urea, creatinine and increased albumin in serum. Moreover, VA, significantly reduced urine volume, urinary albumin along with marked improvement in creatinine clearance. Further, the VA treatment significantly reverse the raised levels of oxidative stress markers, pro-inflammatory and fibrotic markers viz. TNF-α, IL-1ß, IL-6, TGF-ß1 and NFκB activity in kidney tissue. These effects are associated with amelioration of histopathological alterations compared to diabetic control rats. While glimepiride produced similar antihyperglycemic effect but the effect on albuminuria, oxidative stress markers and cytokine levels were less significant as compared to VA (100 mg/kg). CONCLUSIONS: In conclusion, VA exhibited nephroprotective effect through amelioration of kidney dysfunction and damage in diabetic rats. The observed nephroprotective effect of VA may be ascribed to inhibition of hyperglycemia induced oxido-inflammatory stress and necroptosis of renal tissue possibly due to its antihyperglycemic, antioxidant and anti-inflammatory actions.

15.
Mol Divers ; 25(1): 131-142, 2021 Feb.
Article in English | MEDLINE | ID: mdl-31919739

ABSTRACT

A facile and efficient multicomponent synthesis of benzodiazepine ring in water under ultrasound irradiation is reported first time. The current procedure escapes traditional chromatography and purification process and provided the product in excellent yields of 95% as compared to conventional methods. The approach was also validated on gram-scale synthesis.


Subject(s)
Benzodiazepines/chemistry , Benzodiazepines/chemical synthesis , Water/chemistry , Ultrasonic Waves
16.
Arch Endocrinol Metab ; 64(6): 810-815, 2021 Nov 01.
Article in English | MEDLINE | ID: mdl-33085991

ABSTRACT

OBJECTIVE: We conducted a study to examine the association of endothelial dysfunction and oxidative stress with uric acid levels in patients of metabolic syndrome. METHODS: One hundred and two patients of Metabolic Syndrome (International Diabetes Federation definition) were included in the study. Anthropometric measurements, serum uric acid levels, fasting blood sugar levels and lipid levels, as well as malondialdehyde and reactive nitrogen intermediates were measured after an 8-hour fasting period. Flow mediated vasodilation (FMD) of the brachial artery was measured and endothelial dysfunction was defined as an increase in diameter < 10% post compression. RESULTS: A total of 102 patients were included in the study. Mean uric acid level was 5.49 ± 1.61 mg%. A total of 59 patients in the study had endothelial dysfunction, defined by an abnormal FMD. Patients with an abnormal FMD had higher levels of serum uric acid which was statistically significant (p value = 0.010). Serum RNI and MDA levels were negatively correlated with uric acid, but did not reach statistical significance. Patients with an abnormal FMD had a lower RNI level, but this did not reach statistical significance. Serum MDA levels were significantly higher in patients with an abnormal FMD (p value = 0.038). CONCLUSION: Uric acid was significantly associated with endothelial dysfunction in patients with metabolic syndrome in our study. It was inversely correlated with serum RNI and MDA levels, but this did not reach statistical significance.


Subject(s)
Metabolic Syndrome , Uric Acid , Brachial Artery/diagnostic imaging , Endothelium, Vascular , Humans , Vasodilation
18.
Trop Doct ; 51(1): 34-40, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32807027

ABSTRACT

The aetiology of pyrexia of unknown origin (PUO) varies dramatically according to epidemiology. We studied the cause and spectrum of PUO in Indian adults. A total of 152 patients (112 prospectively and 40 retrospectively) met Petersdorf and Beeson's criteria. The diagnostic evaluation was guided by potentially diagnostic clues, based on a 'step-wise' approach. The five main categories, i.e. infectious, neoplastic, non-infectious inflammatory, miscellaneous and undiagnosed comprised 43.4%, 21.5%, 19.7%, 2.0% and 12.5%, respectively. The top three causes were tuberculosis (n = 43, 28.3%), lymphoma (n = 19, 12.5%) and adult-onset Still's disease (n = 12, 7.9%). Tuberculosis predominated in all age groups, and about 70% of cases had the extrapulmonary form, the most common being gastrointestinal. Hodgkin and non-Hodgkin lymphomas were equally distributed, but solid malignancies were uncommon. Adult-onset Still's disease was the second commonest cause in adults aged ≤ 40 years. Fever resolved spontaneously in 12/19 cases of undiagnosed cause. Extrapulmonary tuberculosis remains the most prevalent PUO in India.


Subject(s)
Fever of Unknown Origin/diagnosis , Fever of Unknown Origin/etiology , Adult , Diagnosis, Differential , Female , Fever of Unknown Origin/epidemiology , Humans , India/epidemiology , Male , Prospective Studies , Retrospective Studies
19.
Trop Doct ; 51(1): 48-57, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33019910

ABSTRACT

Infections of the central nervous system (CNS) are a leading cause of mortality in low- and middle-income countries. We studied the spectrum, aetiology and outcome of CNS infections in 401 consecutive patients aged ≥12 years admitted at the medical emergency centre of PGIMER, Chandigarh, India. An aetiological diagnosis was made in 365 (91.0%) patients, with 149 (40.8%) microbiologically confirmed cases. CNS tuberculosis was the most prevalent cause (51.5%), followed by viral meningoencephalitis (13.9%), community-acquired bacterial meningitis (9.7%), cryptococcal meningitis (6.2%), scrub typhus meningoencephalitis (1.7%), neurocysticercosis (1.7%) and fungal brain abscess (1.7%). Human immunodeficiency virus (11.0%) and diabetes mellitus (6.2%) remained the usual predisposing conditions. We found a mortality rate of 27.9%, highest in cases without an aetiology (64.5%). Tuberculosis remained the most common cause; however, an increasing number of scrub typhus, dengue, fungal infections and non-classical bacterial pathogens may indicate a change in the epidemiology of community-acquired CNS infections in India.


Subject(s)
Central Nervous System Infections/epidemiology , Central Nervous System Infections/etiology , Adult , Central Nervous System Infections/diagnosis , Central Nervous System Infections/mortality , Emergency Service, Hospital , Female , Humans , India/epidemiology , Male , Mortality , Risk Factors
20.
ANZ J Surg ; 91(9): 1819-1825, 2021 09.
Article in English | MEDLINE | ID: mdl-33369845

ABSTRACT

BACKGROUND: Splenic abscess has been an uncommon entity which is now being encountered more frequently due to increased prevalence of immunodeficiency disorders and chronic illnesses. This study was aimed to audit our experience with splenic abscesses at a tertiary care centre in India highlighting usefulness of an algorithmic approach. METHODS: Retrospective analysis of data of patients (January 2014 to December 2019) with splenic abscess was done. Data were retrieved for clinical characteristics, radiological findings, organism spectra, abscess characteristics, therapeutic measures and clinical outcome. RESULTS: The mean age of the study population (n = 36) was 41.3 ± 19.0 years with 50% males. Comorbidities were identified in 17 (47.2%) patients, with diabetes mellitus being the commonest. Fever and abdominal pain were the most common presenting features. Multiple splenic abscesses were present in 21 (58.3%) patients. Extra-splenic abscesses in liver were seen in five (13.9%) patients while nine (25%) patients had ruptured splenic abscess. Microorganisms were identified in 24 (66.7%) patients, with Salmonella typhi being the commonest (n = 9, 25%) followed by Escherichia coli (n = 7, 19.4%) and Staphylococcus aureus (n = 4, 11.1%). Six patients received only antimicrobials, 24 were managed with percutaneous aspiration or catheter drainage and six required surgery. Five (13.9%) patients died, with highest mortality being seen in those who received only antimicrobial (50%), compared to percutaneous aspiration or catheter drainage (8.3%) and surgery (0%), P = 0.017. CONCLUSION: Using percutaneous aspiration or drainage in conjunction with antibiotics, followed by surgery in non-responder, patients with splenic abscesses can be managed successfully with acceptable mortality.


Subject(s)
Splenic Diseases , Abscess/diagnosis , Abscess/epidemiology , Abscess/therapy , Adult , Drainage , Female , Humans , India/epidemiology , Male , Middle Aged , Prognosis , Retrospective Studies , Splenic Diseases/diagnosis , Splenic Diseases/epidemiology , Splenic Diseases/therapy , Tertiary Care Centers , Young Adult
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