Limits of antibacterial activity of triangular silver nanoplates and photothermal enhancement thereof for Bacillus subtilis.

Currently, nanoparticles are being actively explored for antimicrobial applications involving variety of pathogens. Bacillus subtilis is a major concern considering its sporulation and biofilm formation capability which involves high bacteria loadings. Also, there is natural ability of B subtilis to adapt and develop resistance to the silver nanoparticles alone. So, this study reports the limits of antibacterial activity of triangular silver nanoplates (∆AgNPs) and further photothermal enhancement for B. subtilis ATCC 6051 for considerably high bacterial load of 2.5 × 107 to 5 × 108 CFU/ml. Triangular silver nanoplates were synthesized using one pot synthesis method and showed significant photothermal response i.e., ∼36 °C temperature rise on near infrared irradiation as well as photothermal stability. Triangular silver nanoplates alone showed absolute destruction for 2.5 × 107 CFU/ml initial B. subtilis load in 5 min. Whereas, for further higher bacterial loads, the antibacterial efficacy of ∆AgNPs is observed to be insignificant. For higher initial bacterial loads of 5 × 107 CFU/ml and 5 × 108 CFU/ml, photothermally enhanced triangular silver nanoplates resulted in complete destruction of bacteria in about 5 and 10 min, respectively. Antibacterial efficacy and mechanism of the destruction assessed via scanning electron microscopy and LIVE/DEAD assay confirmed morphological deformities. Further the generation of higher levels of reactive oxygen species is also confirmed due to photothermal activation of ∆AgNPs. The study concludes that ∆AgNPs alone are effective only up to bacterial load of 2.5 × 107 CFU/ml. Whereas, for higher bacterial loads of B. subtilis, photothermally activated ∆AgNPs lead to irreversible damage due to multiple targeting mechanisms leading to absolute elimination in short span of 5-10 min for the chosen irradiation conditions. Ultimately, this study demonstrates photothermally enhanced silver nanoplates as a potential antimicrobial agent for considerably high bacterial loads of B. subtilis. Overall, the broader window of considered high bacterial loadings and its irradiation by this technique shows the full-proof nature of photothermal applications for scenarios involving high cell density such as biofilms and wound infections etc. Further, the concept may be useful for sterilization or decontamination of samples, devices, etc. because B. subtilis and its spores are the challenges during sterilization.

Assessment of Cardiovascular Parameters on Submaximal Treadmill Exercise in Obese versus Nonobese Adults.

Background: Obesity and overweight, irrespective of metabolic status, confer an increased risk of adverse consequences including cardiovascular diseases (CVDs). The mechanisms underlying altered cardiovascular responses in obese individuals during and after submaximal treadmill exercise are the subjects of great interest to public health. After graded exercise, delayed heart rate recovery (HRR), exaggerated blood pressure (BP) response, and prolongation of QT interval are the powerful predictors of cardiovascular morbidity and mortality that may facilitate timely identification of individuals at risk of CVD and help to evaluate the effectiveness of treatment interventions. Aim: To compare the cardiovascular parameters on submaximal treadmill exercise in obese and nonobese adults. Materials and Methods: This study was conducted on 80 subjects, 40 obese (cases) and 40 normal-weight individuals (controls), belonging to the age group of 18-60 years. Each participant was subjected to submaximal treadmill exercise according to the Bruce protocol. Heart rate (HR), systolic BP and diastolic BP (SBP and DBP), mean arterial pressure (MAP), QT and corrected QT (QTc) intervals, and rate pressure product (RPP) were measured preexercise, immediately after exercise, and during passive recovery at 1 min and 5 min after exercise. The Chi-square test and Mann-Whitney U-test, whichever is appropriate, were employed for the comparison of variables between the two study groups. P < 0.05 was considered statistically significant. Results: Mean HR immediately after exercise, at 1 min and 5 min postexercise was significantly higher in obese when compared to nonobese participants (P = 0.006, P = 0.001, P = 0.001) despite similar resting HR in both the groups (P = 0.874). Mean SBP, DBP, MAP, and RPP were significantly higher in obese in comparison to nonobese subjects in all stages, i.e. before exercise, immediately after exercise, at 1 min and 5 min after exercise. QT and QTc intervals were also found to be significantly greater in obese than nonobese subjects in all stages (P = 0.001 each). Conclusion: Obese subjects had higher resting BP (SBP, DBP, and MAP), QT/QTc interval, RPP, and increased response to submaximal treadmill exercise activity. Delayed HRR after exercise was also noted in obese subjects which indicates that obese populations are at risk of developing CVDs due to alteration in autonomic functions with sympathetic hyperactivity.

Assessment of factors affecting response of direct-acting antivirals in chronic hepatitis C patients.

Background: Hepatitis C virus (HCV) is a universally prevalent pathogen and a major cause of liver-related morbidity and mortality worldwide. The evolution of antiviral therapy for HCV has rapidly progressed from interferon (IFN)-based therapies to IFN-free combinations of direct-acting antivirals (DAAs). Aims: This study aims to assess the response of DAAs in chronic hepatitis C (CHC) patients and to study the various factors affecting the response of DAAs in CHC. Settings and Design: This longitudinal observational study spanning over a year was conducted in the Medicine department of a tertiary care teaching hospital. Materials and Methods: The study was conducted on 400 adult CHC patients, diagnosed by a positive anti-HCV antibody test and a detectable viral load (HCV RNA) by real time polymerase chain reaction (RT-PCR), registered for treatment with DAAs. The first 400 patients satisfying the eligibility criteria were enrolled by non-probability consecutive sampling. All the participants were treated as per the National Viral Hepatitis Control Programme (NVHCP) guidelines. Repeat HCV viral load was done at or after 12 weeks of completion of anti-viral therapy to ascertain sustained virological response (SVR). Various factors which might predict treatment response were analyzed. Statistical Analysis Used: The continuous variables were expressed as mean and standard deviation, while the categorical variables were summarized as frequencies and percentages. The Student's independent t-test was employed for the comparison of continuous variables. The Chi-square or Fisher's exact test, whichever is appropriate, was employed for the comparison of categorical variables. Multivariate Logistic Regression was used to identify the independent predictors of treatment nonresponse. A P < 0.05 was considered statistically significant. Results: The mean age of the subjects was 42.3 ± 15.23 years with a male-to-female ratio of 1.96:1. Most of the patients (80.5%) were non-cirrhotic; among 19.5% cirrhotic, 13% were compensated while 6.5% were decompensated cirrhotic. The overall SVR done at or after 12 weeks of completion of treatment was 88.75%. Age, gender distribution, occupation, socioeconomic status, educational status, body mass index, treatment regimen, duration of treatment, and baseline viral load did not alter the treatment response. Among comorbidities, only diabetes mellitus (DM) and human immunodeficiency virus (HIV) co-infection adversely affected the treatment response (P = 0.009 and P < 0.001, respectively). Intravenous (IV) drug abuse was significantly associated with treatment failure (P < 0.001). The presence of liver cirrhosis (P < 0.001), thrombocytopenia (P < 0.001), elevated transaminases (alanine transaminase: P = 0.021, aspartate transaminase: P < 0.001), and previous treatment experience (P = 0.038) were other significant predictors of treatment failure. Conclusions: DAAs are highly efficacious drugs in the treatment of CHC with a high rate of treatment response. Significant predictors of CHC treatment failure included comorbidities especially DM and HIV co-infection, IV drug abuse, presence of liver cirrhosis, thrombocytopenia, elevated transaminases, and previous treatment experience. However, independent predictors of treatment nonresponse observed in this study were thrombocytopenia, IV drug abuse, and liver cirrhosis.

Résumé Contexte: Le virus de l'hépatite C (VHC) est un agent pathogène universellement répandu et une cause majeure de morbidité et de mortalité liées au foie dans le monde. L'évolution de la thérapie antivirale pour le VHC a rapidement progressé des thérapies à base d'interféron (IFN) à des combinaisons sans IFN de médicaments à action directe antiviraux (AAD). Objectifs: Cette étude vise à évaluer la réponse des AAD chez les patients atteints d'hépatite C chronique (HCC) et à étudier les différents facteurs affectant la réponse des AAD dans les CHC. Cadres et conception : Cette étude observationnelle longitudinale s'étalant sur un an a été menée dans le département de médecine d'un hôpital universitaire de soins tertiaires. Matériels et méthodes: L'étude a été menée sur 400 patients adultes atteints d'HCC, diagnostiqués par un test d'anticorps anti-VHC positif et une charge virale détectable (ARN du VHC) par réaction en chaîne par polymérase en temps réel, inscrit pour le traitement par DAA. Les 400 premiers patients répondant aux critères d'éligibilité ont été enrôlés par échantillonnage consécutif non probabiliste. Tous les participants étaient traités conformément aux directives du programme national de contrôle de l'hépatite virale. La charge virale répétée du VHC a été effectuée à ou après 12 semaines d'achèvement traitement antiviral pour déterminer la réponse virologique soutenue (RVS). Divers facteurs susceptibles de prédire la réponse au traitement ont été analysés. Analyse statistique utilisée: les variables continues ont été exprimées sous forme de moyenne et d'écart-type, tandis que les variables catégorielles ont été résumés sous forme de fréquences et de pourcentages. Le test t indépendant de Student a été utilisé pour la comparaison des variables continues. Le chi carré ou Le test exact de Fisher, selon le cas, a été utilisé pour la comparaison des variables catégorielles. La régression logistique multivariée a été utilisée identifier les prédicteurs indépendants de la non-réponse au traitement. A P < 0.05 était considéré comme statistiquement significatif. Résultats: L'âge moyen des sujets était de 42.3 ± 15.23 ans avec un ratio hommes-femmes de 1.96:1. La plupart des patients (80.5%) étaient non cirrhotiques ; parmi 19.5% de cirrhose, 13% étaient compensés alors que 6.5% étaient cirrhotiques décompensés. La RVS globale effectuée à 12 semaines ou après la fin du traitement était 88.75%. Âge, répartition par sexe, profession, statut socio-économique, niveau d'instruction, indice de masse corporelle, schéma thérapeutique, durée du traitement, et la charge virale de base n'a pas modifié la réponse au traitement. Parmi les comorbidités, seuls le diabète sucré (DM) et l'immunodéficience humaine la co-infection par le virus (VIH) a affecté négativement la réponse au traitement (P = 0.009 et P < 0.001, respectivement). L'abus de drogues par voie intraveineuse (IV) a été significativement associée à l'échec du traitement (P < 0.001). La présence de cirrhose du foie (P < 0.001), thrombocytopénie (P < 0.001), élévation les transaminases (alanine transaminase: P = 0.021, aspartate aminotransférase: P < 0.001) et l'expérience de traitement antérieure (P = 0.038) étaient d'autres facteurs prédictifs significatifs d'échec thérapeutique. Conclusions: les AAD sont des médicaments très efficaces dans le traitement de l'HCC avec un taux de traitement élevé réponse. Les facteurs prédictifs significatifs d'échec du traitement des CHC comprenaient les comorbidités, en particulier la co-infection par le diabète et le VIH, l'abus de drogues par voie intraveineuse, la presence de cirrhose du foie, de thrombocytopénie, d'élévation des transaminases et d'antécédents de traitement. Cependant, des prédicteurs indépendants du traitement les non-réponses observées dans cette étude étaient la thrombocytopénie, l'abus de drogues intraveineuses et la cirrhose du foie. Mots-clés: Cirrhose, antiviraux à action directe, virus de l'hépatite C, toxicomanie par voie intraveineuse, réponse virologique soutenue, thrombocytopénie.

Photo-thermally enhanced antimicrobial efficacy of silver nanoplates against Gram-negative, Gram-positive bacterial and fungal pathogens.

AIM: This paper aims to investigate the photo-thermally enhanced antimicrobial efficacy of triangular silver nanoplates for a broad range of harmful pathogens viz., Gram-negative bacteria (Escherichia coli), Gram-positive bacteria (Staphylococcus aureus), and fungus (Candida albicans). METHODS AND RESULTS: Triangular silver nanoplates were synthesized using the chemical method and were characterized for optical absorption, size and morphology, surface charge and concentration via UV-Vis spectroscopy, transmission electron microscopy, zeta potential analysis and inductively coupled plasma mass spectrometry, respectively. Furthermore, the photo-thermally enhanced antimicrobial efficacy of the triangular silver nanoplates (10 µg/ml concentration) was evaluated on broadband near-infrared irradiation. The photothermal response shows that for the fixed concentration of silver nanoplates, the smaller-sized nanoplates (~52 nm) lead to higher temperature rise than larger-sized nanoplates (~68 nm). It is demonstrated that within a short exposure duration of 15 min, the photothermal activation of silver nanoplates led to ~5 log10 CFU/ml reduction for E. coli and C. albicans, and ~7 log10 CFU/ml reduction for S. aureus from a considerably high initial load of 5 × 108  CFU/ml. CONCLUSIONS: The present study demonstrates that photo-thermally enhanced triangular silver nanoplates possess much stronger antimicrobial efficacy over a short exposure duration of few minutes and exhibits the applicability for a broad range of pathogens. SIGNIFICANCE AND IMPACT OF STUDY: The study is highly significant and explains the eradication of broad-spectrum of microbial pathogens by photo-thermally enhanced silver nanoplates in short exposure duration with low nanoparticle concentration, which is useful for diverse antibacterial and antifungal applications.

Clinico-hematological profile of pancytopenic adult patients in a tertiary care teaching hospital.

OBJECTIVE: The causes of pancytopenia vary in different populations depending on age, gender, nutrition, geographic location, standard of living, and exposure to certain infections and drugs. As the severity of pancytopenia and its underlying etiology determine the management and prognosis, identifying the correct etiology in a given case is crucial and helps in implementing timely and appropriate treatment. The objectives of this study were to study the clinical profile and hematological parameters of pancytopenic adults and to identify different etiologies of pancytopenia. This observational study was conducted in the Medicine department of a tertiary care teaching hospital. MATERIALS AND METHODS: The study was conducted on 100 adult patients aged 18-65 years presenting with pancytopenia. All the participants were subjected to detailed clinical examination and relevant investigations including bone marrow (BM) examination. Categorical variables were presented in number and percentage (%). Qualitative variables were correlated using the Chi-square test. A P =0.05 was considered statistically significant. RESULTS: A female preponderance was observed, and the majority of patients were aged between 18 and 40 years. The most common clinical features were generalized weakness, fever, and pallor. Seventy-four percent of patients were vegetarians; 58% had vitamin B12 deficiency, 25% had folic acid deficiency and 19% had a deficiency of both. The most common cause of pancytopenia was megaloblastic anemia (MA) (37%), followed by dimorphic anemia (DA) (26%), aplastic anemia (AA) (20%), and hematological malignancies (11%). CONCLUSION: MA, DA, and AA are the most prevalent etiologies of pancytopenia. BM examination is of utmost importance in the definitive diagnosis of pancytopenia and is useful in initiating timely treatment as a significant number of causes of pancytopenia are potentially curable.

Dosimetric impact of natural terrestrial radioactivity on residents of lower Himalayas, India.

A comprehensive radio-ecological evaluation of soil samples of Solan and Shimla districts of Himachal Pradesh has been carried out for risk and dose assessment. Twenty-six randomly selected environmental soil samples were analysed for natural radionuclide concentrations (226Ra, 232Th and 40K) using NaI(Tl) scintillator detector. The average concentration of 226Ra, 232Th and 40K was observed as 37, 59 and 430 Bq kg-1, respectively, which exceeded the worldwide average of 33, 45 and 412 Bq kg-1 reported by UNSCEAR (Sources and effects of ionizing radiation. Report to the general assembly with scientific annexes, New York, 2008). Radium equivalent activity (Raeq), hazard indices (Hex, Hin) and radioactivity level indices (Iϒr, Iα, AUI) and Clark value were checked against their threshold limits, and their mean values were safely below the recommended criteria. This confirms the soil applicability for construction purposes. Indoor and outdoor dose rates (D), age-dependent annual effective doses (AED), organ-specific doses and lifetime attributable cancer risk (both cancer incidence and cancer mortality) were also computed. Strong positive correlation was established between radon/thoron exhalation rate and their parent radionuclides. Multivariate statistical technique was employed to explore spatial distribution of radionuclides and homogeneity between various radiological parameters.

Role of serum ferritin as a prognostic marker in acute ischemic stroke: A preliminary observation.

Background: Acute ischemic stroke is an important cause of morbidity and mortality. Search has been on to find out the factors which can help in formulating the prognosis of acute ischemic stroke. One of the prognostic indicators, which has gained great clinical interest in recent times, is serum ferritin. Aims: To assess the serum ferritin levels in patients with acute ischemic stroke and to study the role of serum ferritin as a prognostic marker in these patients. Materials and Methods: This prospective, observational study was conducted on 50 patients of acute ischemic stroke aged ≥18 years who presented within 48 hours of onset of symptoms. Clinical severity of stroke was assessed at admission and on the 6th day using Canadian Stroke Scale (CSS), and serum ferritin levels were measured at admission and on the 6th day in all these subjects. Results: The mean serum ferritin levels at admission in patients with "more severe stroke" (CSS score at admission ≤7) and "less severe stroke" (CSS score at admission >7) were 282.77 ± 120.53 and 205.12 ± 110.96 ng/mL, respectively. The mean serum ferritin levels at admission were 173.71 ± 109.69 ng/mL in subjects who did not deteriorate and 336.86 ± 57.28 ng/mL in those who deteriorated, while the mean serum ferritin levels on the 6th day were 193.29 ± 101.88 and 343.95 ± 52.34 ng/mL in subjects who did not deteriorate and those who deteriorated, respectively. Conclusions: Serum ferritin has a significant positive correlation with the severity of acute ischemic stroke (P < 0.001), and the levels correlate with the outcome of the disease (P < 0.001); the patients with higher serum ferritin at admission tend to deteriorate more as compared to those with lower levels. Thus, serum ferritin can be used as a prognostic marker in acute ischemic stroke.

RésuméContexte: L'AVC ischémique aigu est une cause importante de morbidité et de mortalité. Des recherches sont en cours pour découvrir les facteurs qui peuvent aider à formuler le pronostic d'un AVC ischémique aigu. L'un des indicateurs pronostiques, qui a suscité un grand intérêt clinique ces derniers temps, est la ferritine sérique. Objectifs: Évaluer les taux sériques de ferritine chez les patients ayant subi un AVC ischémique aigu et étudier le rôle de la ferritine sérique comme marqueur pronostique chez ces patients. Matériel et méthodes: Cette étude observationnelle prospective a été menée sur 50 patients ayant subi un AVC ischémique aigu âgés de ≥18 ans et qui se sont présentés dans les 48 heures suivant l'apparition des symptômes. La gravité clinique de l'AVC a été évaluée à l'admission et au 6e jour à l'aide de l'échelle canadienne de l'AVC (CSS), et les taux sériques de ferritine ont été mesurés à l'admission et au 6e jour chez tous ces sujets. Résultats: Les taux moyens de ferritine sérique à l'admission chez les patients avec "AVC plus severe" (score CSS à l'admission ≤7) et "AVC moins severe" (score CSS à l'admission >7) étaient de 282.77 ± 120.53 et 205.12 ± 110.96 ng/mL , respectivement. Les niveaux moyens de ferritine sérique à l'admission étaient de 173.71 ± 109.69 ng/mL chez les sujets qui ne se sont pas détériorés et de 336.86 ± 57.28 ng/mL chez ceux qui se sont détériorés, tandis que les niveaux moyens de ferritine sérique au 6ème jour étaient de 193.29 ± 101.88 et 343.95 ± 52.34 ng/mL chez les sujets qui ne se sont pas détériorés et ceux qui se sont détériorés, respectivement. Conclusions: La ferritine sérique a une corrélation positive significative avec la gravité de l'AVC ischémique aigu (P <0.001), et les niveaux sont en corrélation avec l'issue de la maladie (P <0.001); les patients avec une ferritine sérique plus élevée à l'admission ont tendance à se détériorer davantage par rapport à ceux avec des niveaux inférieurs. Ainsi, la ferritine sérique peut être utilisée comme marqueur pronostique dans un AVC ischémique aigu.

DOSE ASSESSMENT OF NATURAL TERRESTRIAL RADIONUCLIDES IN COMMONLY CONSUMED FOODS IN NORTH INDIA.

The present study aimed to record natural radionuclide content in branded food samples representative of a typical North Indian diet. Forty samples of various food items falling into three categories namely, cereal grains, pulses and beverages were collected from the local markets of Punjab. The radiometric analysis was performed using NaI(Tl) scintillator detector. The activity concentrations ranged between 10 ± 1 and 20 ± 5 Bq kg-1 for 226Ra, Below Detectable Limit (BDL) and 10 ± 2 Bq kg-1 for 232Th and 440 ± 56 and 562 ± 70 Bq kg-1 for 40K. The radium equivalent (Raeq) varied from 55 Bq kg-1(corn) to 70 Bq kg-1 (tea) with an average of 62 Bq kg-1. Internal hazard index (HI) was also calculated (0.18-0.24), which was well below the prescribed threshold of one (24). Age-specific annual effective doses were estimated for infants, children and adults. Children were the most sensitive group of population to radionuclide doses from cereal grains. The annual effective doses were further used to calculate the lifetime cancer risk which exceeded the world average of 2.9$\times$10-4 (24). However, the overall results showed that the intake of these dietary products by the general public did not pose any serious health risk.

Evaluation of obstructive sleep apnea in metabolic syndrome.

BACKGROUND: Metabolic syndrome has become one of the most important public health problems with a growing prevalence in both developed and developing countries. Obesity is a major risk factor for obstructive sleep apnea (OSA), which is associated with significant cardiorespiratory morbidity. AIMS: The aims of this study were to find out the prevalence of OSA in patients with metabolic syndrome and to highlight the importance of assessment of OSA in these patients. METHODS: This cross-sectional analytical study was conducted on 100 subjects aged 30-60 years, comprising 50 cases of metabolic syndrome and 50 controls without metabolic syndrome. Overnight polysomnography was done in all the subjects. Prevalence and severity of OSA were assessed and compared between the two groups. RESULTS: Prevalence of OSA was significantly higher (66%) in patients with metabolic syndrome than in subjects without metabolic syndrome (12%). Out of 33 (66%) OSA patients with metabolic syndrome, 8 (16%) had mild OSA, 11 (22%) had moderate OSA, and 14 (28%) had severe OSA. Increasing severity of OSA was associated with higher mean levels of all the metabolic syndrome parameters except serum high density lipoprotein (HDL). CONCLUSIONS: OSA is highly prevalent in patients with metabolic syndrome. Also, the increasing severity of OSA is associated with poorer control of diabetes, hypertension, and dyslipidemia, which are all components of metabolic syndrome. Therefore, effective treatment of metabolic syndrome can prevent and control OSA in these patients. Similarly, reducing the severity of OSA (by early diagnosis and treatment) in patients with metabolic syndrome might help to optimize control of blood sugar, blood pressure, and serum lipids, thereby reducing the risk of cardiovascular disease. Therefore, the need for screening metabolic syndrome patients for OSA has been reinforced by this study.

Asymptomatic bacteriuria among the patients of type 2 diabetes mellitus.

BACKGROUND: Asymptomatic bacteriuria (ASB) is common in neonates, preschool children, pregnant women, elderly, diabetics, catheterized patients, and patients with abnormal urinary tracts or renal diseases. Though there is currently no consensus on treatment of ASB in various population groups, it is advisable to treat the same in patients with diabetes mellitus (DM). AIMS: To determine the prevalence of ASB in patients with type 2 DM and to study the spectrum of uro-pathogens causing ASB along with their antibiotic susceptibility profile. SETTINGS AND DESIGN: This prospective, observational study was conducted in the department of Medicine of a tertiary care teaching hospital. METHODS: The study was conducted on 100 patients with type 2 DM. Urine wet mount and gram stain examination was done for all to detect the presence of pus cells and bacteria in urine. Antibiotic sensitivity testing was performed in patients with significant bacteriuria to determine the sensitivity profile of isolated uro-pathogens. The data were analyzed to determine the association between diabetes and ASB. RESULTS: ASB was common among diabetics, as evident by a prevalence of 21%. Presence of ASB showed positive correlation with poor glycemic control. Escherichia coli (E. coli) was the most common organism causing ASB followed by Candida, Pseudomonas, Klebsiella, and Citrobacter. E. coli isolated from study patients was most sensitive to imipenem and nitrofurantoin (NFT). CONCLUSIONS: ASB is common among diabetics, with poor glycemic control being a significant risk factor. E. coli is the most common organism causing ASB in diabetics, and it is most sensitive to imipenem and NFT.

Impact of health education on knowledge, attitude, practices and glycemic control in type 2 diabetes mellitus.

BACKGROUND: Effective health education consequently improves knowledge, attitude, and practices (KAP) leading to better glycemic control and is widely accepted as an integral part of comprehensive diabetes care for affected individuals and their families in primary care settings. AIMS: To assess the impact of health education on knowledge, attitude, practices, and glycemic control in type 2 diabetes mellitus patients. SETTINGS AND DESIGN: This case control study was conducted in the department of Medicine of a tertiary care teaching hospital. METHODS: The study was conducted on 100 diabetic subjects aged more than 40 years comprising of 50 cases and 50 controls. Cases were given education on their disease, drugs, dietary, and lifestyle modifications along with patient education leaflet at baseline and at first follow-up, while controls received neither of these. Subjects were assessed for KAP by administering KAP questionnaire and for glycemic control by measuring glycated hemoglobin (HbA1C) at baseline and at the end of the study. RESULTS: In this study, end mean knowledge, attitude, practice, and KAP SUM scores of cases (10.28 ± 1.78, 3.46 ± 0.93, 3.14 ± 0.86, and 16.82 ± 3.40, respectively) showed significant increase from the baseline (3.86 ± 0.93, 1.00 ± 0.83, 0.40 ± 0.64, and 5.26 ± 2.10, respectively) compared to controls, accompanied by significant reduction in HbA1C of cases at the end of the study compared to the controls. CONCLUSIONS: Effective health education improves knowledge, attitude, and practices, particularly with regard to lifestyle modifications and dietary management, culminating into better glycemic control that can slow down the progression of diabetes and prevent downstream complications.

Toxicological risk assessment of protracted ingestion of uranium in groundwater.

Groundwater samples have been collected from far-reaching locations in Solan and Shimla districts of Himachal Pradesh, India, and studied for uranium concentration using LED fluorimetry. In this region, uranium in groundwater varies from 0.12 to 19.43 µg L-1. Radiological and chemical toxicity is accounted for different uranium isotopes. The average mortality risk for uranium isotopes 234U, 235U, and 238U are 2.6 × 10-12, 3.5 × 10-10, and 5.9 × 10-8, respectively. Similarly, the mean morbidity risk for 234U, 235U and 238U are 4.1 × 10-12, 5.6 × 10-10 and 9.5 × 10-8, respectively. An attempt has also been made to calculate doses for different age-groups. Highest doses, ranging from 0.30 to 48.23 µSv year-1, are imparted to infants of 7-12 months of age which makes them the most vulnerable group of population. Using Hair Compartmental Model for uranium and mean daily uranium intake of 3.406 µg for 60-year exposure period, organ-specific doses due to uranium radioisotopes, retention in prime organs/tissues and excretion rates via urine, feces and hair pathway are estimated. In this manuscript, the transfer coefficients for kidney, liver, skeleton, GI tract, soft tissues, urinary bladder, and blood are analyzed. Hair compartment model and ICRP's biokinetic model are compared in terms of uranium load in different organs after 60 years of protracted ingestion. The study on biokinetic behavior of uranium is the first of its kind in the area which is dedicated to environmental and social cause.

Self-assembling, macroscopically oriented, polymer filaments; a doubly nematic organogel.

Nanoscale phase separation and self-organisation in liquid crystals leads to the formation of remarkable hierarchical structures. There are several examples of heliconical nanofilament structures including in the nematic twist-bend (NTB) phase, the B4 phase and liquid crystal gels formed from the B4 phase. Both the formation of the polymer-like structures that permeate the soft-solids and their hierarchical structures are fascinating, not least because of the analogies that can be drawn with naturally-occurring structures. Here, we report a remarkably simple binary system formed from a non-symmetric BC molecule and the rod-like liquid crystal, 5CB. The pure bent-core system exhibits both nematic and dark conglomerate liquid crystal phases. At very low concentrations of the BC material (5-10%) this binary system spontaneously self-assembles into a soft solid formed from nanoscale filaments that are aligned by their nematic environment. Macroscopically, the soft solid shows behaviour that can be associated with both polymers and gels. Interestingly, the sub-micron scale structure of the filaments appears remarkably similar to some organised fibrous structures in nature (e.g. chitin, cellulose, insect cuticle, plant cell walls) something we attribute to self-assembly and self-organisation in an aligned liquid crystalline environment. The nanoscale structure of the filaments shows no features that can be associated with heliconical ordering down to length scales of tens of nanometers. However, the X-ray data suggest that a metastable rectangular columnar phase which is highly ordered in one dimension initially forms, changing to a hexagonal lattice on a timescale of tens of minutes.

Adult onset seizures: Clinical, etiological, and radiological profile.

INTRODUCTION: Adult onset seizure disorder is a major public health concern in terms of burden of disease, nature of illness, and its impact on individual, family, and community. This study was done to assess the clinical profile and etiology of adult onset seizures and correlates of clinical and radiological pattern. MATERIALS AND METHODS: This was a prospective cross-sectional hospital-based study conducted on 100 cases presenting with adult onset seizures. RESULTS: Adult onset seizures were most prevalent in the young and middle-aged adults than elderly; generalized seizures were more common than focal seizures. However, the incidence of generalized seizures showed a falling trend as the age advanced whereas focal seizures increased in incidence with advancing age. Overall, the most common etiology of seizures was stroke, followed by idiopathic and central nervous system infections; yet, most common etiology of adult onset generalized and focal seizures was idiopathic and stroke, respectively. Regarding etiology, among younger adults, idiopathic seizures were predominant, whereas among middle aged and elderly, stroke was the most common etiology. CONCLUSIONS: It is mandatory to deal carefully with each case of adult onset seizure with a tailor-made approach. Identification and awareness about the etiological factors and seizure type help in better management of these patients. Primary care physicians play a pivotal role in identifying patients with adult onset seizures and should encourage these patients to undergo neuroimaging so as to arrive at an appropriate etiological diagnosis. In the face of recent advances in neuroimaging techniques, the future prospective management of adult onset seizures appears bright and convincing.

Assessment of Vitamin D in Rheumatoid Arthritis and Its Correlation with Disease Activity.

BACKGROUND: Vitamin D is believed to have an immunomodulatory and anti-inflammatory action, and its deficiency has been linked with several autoimmune disorders, including rheumatoid arthritis (RA). The relationship between the severity of RA and serum levels of Vitamin D is a subject of immense interest and therapeutic implications. MATERIALS AND METHODS: This was a prospective, comparative study conducted on 100 participants, 50 cases of RA and 50 healthy controls, all in the age group of 18-75 years. Serum Vitamin D levels were measured and compared in cases and controls. Vitamin D levels in RA patients were also assessed in different stages of disease activity to assess the correlation between the two. RESULTS: Eighty-four percent patients of RA were Vitamin D deficient versus only 34% of controls. The serum Vitamin D levels were also significantly lower in the RA patients (mean value of 21.05 ± 10.02 ng/ml), as compared to the controls (mean value of 32.87 ± 14.16 ng/ml). There was a significant inverse correlation between serum Vitamin D levels and RA disease activity. The mean serum Vitamin D levels were 35.28 ± 9.0 ng/ml, 33.80 ± 4.1 ng/ml, 22.47 ± 6.18 ng/ml, and 14.21 ± 6.97 ng/ml in the remission, low disease activity, moderate disease activity, and high disease activity groups, respectively. CONCLUSIONS: Vitamin D deficiency is more common in RA patients and may be one of the causes leading to development or worsening of the disease.

Novel switching mode in a vertically aligned liquid crystal contact lens.

Liquid crystal (LC) contact lenses are emerging as an exciting technology for vision correction. A homeotropically (vertical) aligned LC lens is reported that offers improved optical quality and simplified construction techniques over previously reported LC contact lens designs. The lens has no polarization dependence in the off state and produces a continuous change in optical power of up to 2.00 ± 0.25 D with a voltage applied. The variation in optical power results from the voltage-induced change in refractive index of the nematic LC layer, from 1.52 to a maximum of 1.72. One device substrate is treated with an alignment layer that is a mixture of planar and homeotropic polyimides, rubbed to induce a preferred director orientation in the switched state. Defects that could occur during switching are thus avoided and the lens exhibits excellent optical quality with a continuous variation in focal power.

The nematic phases of bent-core liquid crystals.

Over the last ten years, the nematic phases of liquid crystals formed from bent-core structures have provoked considerable research because of their remarkable properties. This Minireview summarises some recent measurements of the physical properties of these systems, as well as describing some new data. We concentrate on oxadiazole-based materials as exemplars of this class of nematogens, but also describe some other bent-core systems. The influence of molecular structure on the stability of the nematic phase is described, together with progress in reducing the nematic transition temperatures by modifications to the molecular structure. The physical properties of bent-core nematic materials have proven difficult to study, but patterns are emerging regarding their optical and dielectric properties. Recent breakthroughs in understanding the elastic and flexoelectric behaviour are summarised. Finally, some exemplars of unusual electric field behaviour are described.

Hepatitis B & C among farmers - a seroprevalence study.

BACKGROUND: Hepatitis B & C are the two major causes of chronic liver disease, having the similar parenteral route of transmission, thereby responsible for significant morbidity and mortality. OBJECTIVE: Agriculture being the backbone of this part of country, the present study was undertaken to assess the seroprevalence of these diseases among the farmers which form the major occupation class in the Malwa belt of Punjab, India. MATERIALS AND METHODS: Screening camp was organized at Kisan Mela at the regional station of Punjab Agriculture University at Faridkot, Punjab. Blood samples were collected, and tested for HBsAg and anti-HCV. RESULTS: Total of 1219 subjects, 63% being in the age group of 30-50 years, were screened of which the seroprevalence of HCV & HBV was 5% and 0.32% respectively, and 72% of HCV positive cases were between 30-50 years of age. CONCLUSION: The study stresses on the need of safe injection practices especially in villages and control on addiction, a more effective vaccination program for HBV, strict check on commercial blood banks, and community education regarding tattooing and sexual behaviour.

Optical memory effect in a deformed helix ferroelectric liquid crystal.

Optical memory in a deformed-helix ferroelectric liquid crystal is proposed by deforming the helix under the application of a square-voltage pulse of known magnitude and frequency. This effect is based on the electromechanical effect of helix deformation due to the electric field. When the interaction between the electric field and the dipole is sufficiently strong, all of the dipoles align along the electric field. In such a situation the interlayer dipole-dipole interaction is strong enough to balance the elastic deformation energy. When the electric field is switched off, the molecules remain in a static, balanced state owing to the dipole-dipole interaction and hence the memory effect.