Diagnostic Accuracy of Serum Glycosylated Fibronectin in Prediction of Preeclampsia: A Nested Case-Control Study.

BACKGROUND: Preeclampsia is a life-threatening complication of pregnancy that occurs in approximately 7% of all pregnancies. In India, the incidence of preeclampsia is 8%-10% and the prevalence is 5.4%, whereas the prevalence of hypertensive disorders of pregnancy is 7.8%. AIM AND OBJECTIVES: This study was aimed at evaluating the diagnostic accuracy of serum glycosylated fibronectin (S. GlyFn) in the prediction of preeclampsia. METHODS: A nested case-control study was carried out for 16 months in the department of obstetrics and gynecology. A total of 240 women were recruited and followed after written consent and ethical clearance. Six were lost to follow-up, 15 had second-trimester abortions (excluded from the study), and 32 women developed hypertensive disorders of pregnancy (cases), out of which 1 woman developed antepartum eclampsia, 10 women developed preeclampsia with severe features, and 21 women developed preeclampsia without severe features. One hundred and eighty-seven women remained normotensive throughout the pregnancy until 6 weeks postpartum. After randomization, out of these samples, 54 were analyzed and considered controls. Levels of S. GlyFn were estimated using an ELISA kit using the ELISA technique. RESULTS: The mean S. GlyFn level was significantly higher at the time of enrollment among those women who later developed preeclampsia (127.59 ± 27.68 ng/m) as compared to controls (107.79-53.51 ng/mL). GlyFn at a cutoff value of 126.70 ng/mL significantly (P = 0.034) discriminates cases of preeclampsia with severe features from healthy controls with a sensitivity of 90.00%, a specificity of 63.00%, a 31.03% positive predictive value, and 97.14% negative predictive value. CONCLUSION: S. GlyFn, at a cutoff value of 126.70 ng/mL, had good sensitivity to discriminate PE from normotensive and was also a good prognostic marker.

Résumé Contexte:La prééclampsie est une complication potentiellement mortelle de la grossesse qui survient dans environ 7 % de toutes les grossesses. En Inde, l'incidence de la prééclampsie est de 8 % à 10 % et la prévalence est de 5,4 %, alors que la prévalence des troubles hypertensifs de la grossesse est 7,8 %. But et objectifs : Cette étude visait à évaluer la précision diagnostique de la fibronectine sérique glycosylée (S. GlyFn) chez la prédiction de la prééclampsie.Méthodes:Une étude cas-témoin nichée a été menée pendant 16 mois dans le service d'obstétrique et gynécologie. Au total, 240 femmes ont été recrutées et suivies après consentement écrit et autorisation éthique. Six ont été perdus de vue, 15 avaient avortements au deuxième trimestre (exclus de l'étude), et 32 femmes ont développé des troubles hypertensifs de la grossesse (cas), dont 1 femme a développé une éclampsie antepartum, 10 femmes ont développé une prééclampsie avec des caractéristiques sévères et 21 femmes ont développé une prééclampsie sans traits sévères. Cent quatre-vingt sept femmes sont restées normotendues tout au long de la grossesse jusqu'à 6 semaines après l'accouchement. Après randomisation, sur ces échantillons, 54 ont été analysés et considérés comme témoins. Les niveaux de S. GlyFn ont été estimés à l'aide d'un kit ELISA en utilisant la technique ELISA.Résultats:Le niveau moyen de S. GlyFn était significativement plus élevé au moment de l'inscription chez les femmes qui ont développé plus tard une prééclampsie (127,59 ± 27,68 ng/m) par rapport aux témoins (107,79­53,51 ng/mL). GlyFn à une valeur seuil de 126,70 ng/mL de manière significative (P = 0,034) discrimine les cas de prééclampsie avec des caractéristiques sévères des témoins sains avec une sensibilité de 90,00 %, un spécificité de 63,00 %, une valeur prédictive positive de 31,03 % et une valeur prédictive négative de 97,14 %.Conclusion:S. GlyFn, à une valeur seuil de 126,70 ng/mL, avait une bonne sensibilité pour distinguer l'EP du normotendu et était également un bon marqueur pronostique.

Salivary and serum estrogen level assessment in oral lichen planus patients and its correlative analysis with OLP and stress.

Background: Lichen planus is a chronic inflammatory disease of the skin and mucous membrane with higher predilection seen in the female population. Oral lichen planus (OLP) has been associated with various etiological factors, such as stress, hormonal imbalance, and immunological variation. The purpose of this study was to assess serum and salivary estrogen (E2) levels in OLP patients and correlate them with stress levels. Objectives: This study aimed to evaluate serum and salivary estrogen levels in female patients with OLP, along with the assessment of stress and its correlation with estrogen levels. Methods: A total of 78 females, 39 clinically diagnosed with OLP and 39 healthy females, were included in the study as the case and control groups, respectively. 2 ml each of salivary and serum samples was obtained from each participant to measure the estrogen levels. Stress levels in the study group patients were assessed using the Depression Anxiety Stress Scale (DASS-21) and the Perceived Stress Scale (PSS). The nonparametric Mann-Whitney test was used for intergroup comparisons. Results: Significantly higher serum estrogen levels with higher DASS-21 and PSS scores were noted in patients with OLP. Overall, significant positive correlations were observed between salivary E2 and serum E2 (r = 0.361, P = 0.001). There was a positive correlation between salivary and serum E2 and DASS score (r = 0.410, P < 0.001, and r = 0.768, P < 0.001, respectively), serum/salivary E2 and PSS score (r = 0.745, P < 0.001, and r = 0.410, P < 0.001, respectively), and DASS score and PSS score (r = 0.878, P < 0.001). Conclusion: Estrogen can be used as a useful biomarker for OLP in the future. Salivary samples can prove to be an accurate and feasible alternative to serum estrogen level determination. We also suggest that OLP patients must be given supportive psychological treatment for improved life quality and disease management.

Synthesis and characterization of X (X = Ni or Fe) modified BaTiO3 for effective degradation of Reactive Red 120 dye under UV-A light and its biological activity.

For the sustainable advancement of industrial expansion that is environmentally conscious, harmful dyes must be removed from wastewater. Untreated effluents containing colors have the potential to harm the ecosystem and pose major health risks to people, animals, and aquatic life. Here, we have fabricated Ni or Fe modified with BaTiO3 materials and effectively utilized them for Reactive Red 120 (RR 120) dye degradation under UV-A light. The synthesized materials were characterized, and their structural, and photo-physical properties were reported. Phase segregation was not present in the XRD pattern, as evidenced by the absence of secondary phase peaks linked to iron, nickel, or oxides. Low metal ion concentrations may be the cause of this, and the presence of those elements was confirmed by XPS measurements. The Raman spectra of the BaTiO3/Ni and BaTiO3/Fe samples show a widened peak at 500 cm-1, which suggests that Ni or Fe are efficiently loaded onto the BaTiO3. RR 120 dye photodegradation under UV light conditions was effectively catalyzed by BaTiO3/Fe, as evidenced by its superior performance in the UV irradiation technique over both BaTiO3 and BaTiO3/Ni. Compared to bare BaTiO3, both metal-modified materials efficiently degraded the RR 120 dye. Acidic pH facilitated the degradation process, which makes sense given that the heterogeneous photo-Fenton reaction was the mechanism of degradation along with BaTiO3 sensitization. High-acidity sewage can be dangerous and carcinogenic, and conventional biological treatment methods are not appropriate for managing it. In the current investigation, it may be used to treat color effluents with extremely low pH levels. Additionally, the ability of the produced nanocomposites to inhibit the growth of twenty pathogens was examined, along with two fungi, fifteen Gram-negative Bacilli (GNB), one Gram-positive Bacilli (GPB), and two Gram-positive Cocci (GBC).

Vitamin D Deficiency in Professional Football Players during Competitive Season of Italian First Division (Serie A).

BACKGROUND: Data in the literature have demonstrated the crucial role that vitamin D plays in the human organism, and recent studies also emphasize this essential role of vitamin D in athletes. Indeed, vitamin D acts on the skeletal muscles and plays a fundamental role in numerous physiological processes involved in immune function. Many factors such as sun exposure, skin tone, body mass index and chronic illness affect vitamin D levels. The aim of the study is to evaluate vitamin D levels in professional football players in Italy and investigate the variations in vitamin D values in footballers who train at different latitudes. METHODS: The study performed is a retrospective observational study analyzing 25-OH vitamin D values in professional football players of the Italian First Division (Serie A). Two teams during the competitive season were selected: team A (latitude of 41° N in southern Italy) and team B (latitude of 45° N in northern Italy). Three time periods were identified and were classified as follows: the first quarter (May, June, July, and August), the second quarter (September, October, November, and December) and the third quarter (January, February, March, and April). The purpose of this was to study the average values of vitamin D during the year corresponding to different levels of sunlight exposure. Each athlete was subjected to at least one sampling during the three quarters of the competitive season. RESULTS: Both vitamin D insufficiency (10.1%) and overt deficiency (1.93%) were found in Italian Serie A players. Insufficient vitamin D values are between 20 ng/mL and 29 ng/mL and overt deficiency values <20 ng/mL. At the same time, the data demonstrated a significant variation in vitamin D values depending on the period of the competitive season and the latitude of the cities of the two teams. In detail, there was no significant difference in the first quarter, while there was a significant increase in vitamin D values in team B in the second and third quarter, at p < 0.01 and p < 0.05, respectively. CONCLUSIONS: Latitude and seasons have a significant impact on vitamin D levels. Therefore, it is essential to measure vitamin D in professional football players, especially during the spring and winter months, so as to monitor changes in levels in relation to the season and latitude and evaluate any supplements. Further studies should be performed to evaluate the relationship between vitamin D deficiency and football players' athletic performance.

Association of stress and primary hypothyroidism.

Background: Hypothyroidism is the result of impaired production and secretion of thyroid hormones. The cardiovascular system is affected by fluctuations in thyroid hormone levels. Stressful events or stressors can affect the hypothalamic-pituitary-thyroid (HPT) axis and psychological and physiological responses. Stress increases thyroid hormone levels while decreasing TSH levels, which exacerbates autoimmune thyroid disease. Aim: To evaluate the relationship between stress and primary hypothyroidism. Methods: A total of 77 newly diagnosed hypothyroid patients (TSH >5.0 mIU/L) and 77 healthy adults (TSH 0.5-5.0 mIU/L) were enrolled. During a brief general physical examination, the following values were measured: height, weight, blood pressure, pulse, and pulse rate. A brief systemic examination of the cardiovascular system and lungs was also performed to rule out systemic diseases. Heart rate variability (HRV) processing and analysis were performed using Pro LabChart (PowerLab 8Pro) data analysis software from AD Instrument. Results: Mean Avg. RR was significantly higher, RM SSD and pRR50 were significantly lower in cases than in controls. Mean HF was significantly lower and LF/HF (frequency range) was significantly higher in cases than in controls. Mean PSS was significantly higher in cases (25.82 ± 2.83) than in controls (22.47 ± 2.10). The majority of cases (54.5%) had a high stress level. The TSH level showed a highly significant correlation with the LF/HF ratio and with the PSS score. Conclusion: The mean Avg. RR and HF were significantly higher, RM SSD and pRR50 and LF/HF (frequency range) were significantly lower in hypothyroid patients.

Preparation and Spectrochemical characterization of Ni-doped ZnS nanocomposite for effective removal of emerging contaminants and hydrogen Production: Reaction Kinetics, mechanistic insights.

In this study, we report the successful synthesis of Ni-doped ZnS nanocomposite via a green route using ethanolic crude extract of Avena fatua. The as-synthesized nanocomposite was comprehensively characterized using Dynamic light scattering (DLS), Zeta potential, scanning electron microscopy (SEM), Transmission electron microscopy (TEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FTIR), and Atomic force microscopy (AFM). These analyses provided detailed insights into the size, morphology, composition, surface properties, and structural characteristics of the nanocomposite. Subsequently, the synthesized nanocomposite was evaluated for their photocatalytic performance against the organic dye Methyl orange. Remarkably, the nanocomposite exhibited rapid and efficient degradation of Methyl orange, achieving 90 % degradation within only 30 min of irradiation under UV light. Moreover, the photocatalyst demonstrated an exceptional hydrogen production rate, reaching 167.73 µmolg-1h-1, which is approximately 4.5 times higher than that of its pristine counterparts. These findings highlight the significant potential of Ni-doped ZnS nanocomposite as highly efficient photocatalysts for wastewater treatment and hydrogen production applications.

Insight into mechanism of excellent visible-light photocatalytic activity of CuO/MgO/ZnO nanocomposite for advanced solution of environmental remediation.

Environmental remediation has sought several innovative ways for the treatment of wastewater and captivated researchers around the globe towards it. Through this study, we aim to proceed with the efforts to foster sustainable and feasible ways for the treatment of wastewater. In this work, we report the sol-gel synthesis of CuO/MgO/ZnO nanocomposite and carry out their systematic characterization with the help of state-of-the-art analytical techniques, such as FTIR, SEM, TEM, PL, XRD, Raman, and AFM. The SEM along with TEM and AFM provided useful insights into the surface morphology of the synthesized nanocomposite on both 2D and 3D surfaces and concluded the well-dispersed behavior of the nanocomposite. The characteristic functional groups responsible for carrying out the reaction of Cu-O, Mg-O, and Zn-O were identified by FTIR spectroscopy. On the other hand, crystal size, dislocation density, and microstrain of the nanocomposite were calculated by XRD. For optical studies, photoluminescence spectroscopy was performed. Once the characterization of the nanocomposite was done, they were eventually treated against the toxic organic dye, methylene blue. The calculated rate constant values of k for CuO was 2.48 × 10-3 min-1, for CuO/MgO (2.04 × 10-3 min-1), for CuO/ZnO (1.82 × 10-3 min-1) and CuO/MgO/ZnO was found to be 2.00 × 10-3 min-1. It has become increasingly evident that nanotechnology can be used in various facets of modern life, and its implementation in wastewater treatment has recently received much attention.

Fabrication and characterization of binary composite MgO/CuO nanostructures for the efficient photocatalytic ability to eliminate organic contaminants: A detailed spectroscopic analysis.

Design and eco-friendly fabrication of affordable and sustainable materials for the treatment of wastewater consisting of dyes, antibiotics, and other harmful substances has always been demanding. Untreated wastewater being released from industries imposes serious threats to our ecosystem, seeking convenient approaches to diminish this alarming issue. Here in this work, we synthesized MgO/CuO nanocomposites from a plant extract of Ammi visnaga L. and then employed these nanocomposites for the treatment of organic dye (methylene blue). We characterized the synthesized nanocomposites by dynamic light scattering (DLS), zeta potential, scanning electron microscopy (SEM), atomic force microscopy (AFM), transmission electron microscopy (TEM), x-ray diffraction (XRD), and X-ray photoelectron microscopy (XPS). DLS presented information about the explicit size of nanocomposites, while the surface charge was examined by zeta potential. XRD provided detailed information about the crystalline behavior and the information regarding surface morphology and size was extracted by SEM, TEM, and AFM. Moreover, the fabricated nanocomposites were used as a photocatalyst in the treatment of methylene blue. The overall catalytic reaction took an hour to complete, and the value of percentage degradation was 98 %. Substantially, a detailed account of the kinetics, rate of reaction, and mechanism is also fostered in the context. The presented study can assist scientists and researchers around the world to reproduce the results and use them to apply them on a broader scale.

Solving the fouling mechanisms in composite membranes for water purification: An advance approach.

With the increasing population worldwide more wastewater is created by human activities and discharged into the waterbodies. This is causing the contamination of aquatic bodies, thus disturbing the marine ecosystems. The rising population is also posing a challenge to meet the demands of fresh drinking water in the water-scarce regions of the world, where drinking water is made available to people by desalination process. The fouling of composite membranes remains a major challenge in water desalination. In this innovative study, we present a novel probabilistic approach to analyse and anticipate the predominant fouling mechanisms in the filtration process. Our establishment of a robust theoretical framework hinges upon the utilization of both the geometric law and the Hermia model, elucidating the concept of resistance in series (RIS). By manipulating the transmembrane pressure, we demonstrate effective management of permeate flux rate and overall product quality. Our investigations reveal a decrease in permeate flux in three distinct phases over time, with the final stage marked by a significant reduction due to the accumulation of a denser cake layer. Additionally, an increase in transmembrane pressure leads to a correlative rise in permeate flux, while also exerting negative effects such as membrane ruptures. Our study highlights the minimal immediate impact of the intermediate blocking mechanism (n = 1) on permeate flux, necessitating continuous monitoring for potential long-term effects. Additionally, we note a reduced membrane selectivity across all three fouling types (n = 0, n = 1.5, n = 2). Ultimately, our findings indicate that the membrane undergoes complete fouling with a probability of P = 0.9 in the presence of all three fouling mechanisms. This situation renders the membrane unable to produce water at its previous flow rate, resulting in a significant reduction in the desalination plant's productivity. I have demonstrated that higher pressure values notably correlate with increased permeate flux across all four membrane types. This correlation highlights the significant role of TMP in enhancing the production rate of purified water or desired substances through membrane filtration systems. Our innovative approach opens new perspectives for water desalination management and optimization, providing crucial insights into fouling mechanisms and proposing potential strategies to address associated challenges.

S100B as a predictor of delirium in critically ill obstetric patients: A nested case-control study.

Background: Delirium is a neuropsychiatric illness that lasts for a short period of time. The incidence of delirium in the intensive care unit (ICU) varies from 20% to 80%. Methods: A nested case-control study was carried out in the obstetric ICU. Individuals were divided into three groups: critically ill obstetric women who had delirium on admission (Group A), women who developed delirium within follow-up of 7 days (Group B), and women who did not develop delirium after follow-up of 7 days (Group C). The APACHE II score was used to assess critical illness severity. The Richmond Agitation-Sedation Scale was used to assess the alertness or sedation level of patients, and the Confusion Assessment Method (ICU scale) was used to assess the presence of delirium. S100B was measured by human S100B calcium-binding protein B ELISA kit (Elabscience Biotechnology, Houston, USA). Results: Severe preeclampsia and antepartum eclampsia were significantly associated with delirium. S100B levels in Group B were found to be significantly higher than those in Group C. S100B levels were higher in patients with >2 morbidities in comparison to patients with two morbidities. At a cutoff value of >169.25 pg/ml, S100B had a sensitivity of 74% and a specificity of 87.2% to discriminate cases of delirium from nondelirium. Conclusion: The rise in S100B levels was approximately three times greater in those who developed delirium as compared to those who did not. It is a more specific predictor of delirium.

Algae-based approaches for Holistic wastewater management: A low-cost paradigm.

Aquatic algal communities demonstrated their appeal for diverse industrial applications due to their vast availability, ease of harvest, lower production costs, and ability to biosynthesize valuable molecules. Algal biomass is promising because it can multiply in water and on land. Integrated algal systems have a significant advantage in wastewater treatment due to their ability to use phosphorus and nitrogen, simultaneously accumulating heavy metals and toxic substances. Several species of microalgae have adapted to thrive in these harsh environmental circumstances. The potential of algal communities contributes to achieving the United Nations' sustainable development goals in improving aquaculture, combating climate change, reducing carbon dioxide (CO2) emissions, and providing biomass as a biofuel feedstock. Algal-based biomass processing technology facilitates the development of a circular bio-economy that is both commercially and ecologically viable. An integrated bio-refinery process featuring zero waste discharge could be a sustainable solution. In the current review, we will highlight wastewater management by algal species. In addition, designing and optimizing algal bioreactors for wastewater treatment have also been incorporated.

Urinary Neutrophil Gelatinase-associated Lipocalin as a Diagnostic and Prognostic Marker for Acute Kidney Injury in Hospitalized Cirrhotic Patients: A Study from North Indian Population.

Background: A serious problem in cirrhosis is acute renal injury. The study aimed to examine the urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a diagnostic and prognostic marker of acute kidney injury (AKI) in cirrhotic patients. Methods: A prospective study was carried out over a period of 1 year. A total of 490 patients suffering from cirrhosis who visited an indoor hospital were screened, and after the exclusion, a total of 90 subjects admitted to the medicine intensive care unit (MICU) fulfilling inclusion criteria were enrolled. Those having a history of renal diseases, on nephrotoxic drugs, in septic shock, peritonitis, UTI, and no urine output were excluded. On admission, for the estimation of uNGAL, urinary levels of sodium, creatinine, fresh urine samples were obtained, and blood samples were taken for serum creatinine estimation. Results: Out of 90 patients, 33.3% did not develop AKI, and 66.7% developed AKI. Urinary neutrophil gelatinase-associated lipocalin levels were six times higher in patients with acute tubular necrosis (259.08 ± 118.41 ng/mL) and three times higher in Hepatorenal syndrome (HRS)-AKI (124.97 ± 16.38) as compared with patients with normal kidney function (39.76 + 5.7). Those who died had a higher uNGAL (171.6 ng/mL) in comparison to those who survived (133.7 ng/mL). At a cutoff value of ≥114.9 (ng/mL), urinary NGAL represents a sensitivity of 86.92% and specificity of 100% to diagnose AKI and AUC 0.966 (95% CI: 0.919-0.990) in cirrhotic patients. Conclusion: Urinary NGAL is good for diagnosing AKI and is a marker to distinguish the types of AKI in liver cirrhosis. How to cite this article: Patel ML, Shyam R, Chaudhary A, Sachan R, Ali W. Urinary Neutrophil Gelatinase-associated Lipocalin as a Diagnostic and Prognostic Marker for Acute Kidney Injury in Hospitalized Cirrhotic Patients: A Study from North Indian Population. Indian J Crit Care Med 2023;27(8):545-551.

Synthesis of activated biochar from sustainable bamboo resources: An environment-friendly and low-cost solution for palladium (II) removal from wastewater.

This article highlights the developing capabilities of low-cost activated biochar from bamboo waste used for Palladium (II) (Pd(II)) separation from man-made electroless plating solutions (ELP). From a novelty perspective, this article addresses the effect of coupled sonication and surfactant for the adsorptive elimination of Pd(II) on Bamboo stem activated carbon (BSAC) from ELP. The optimal activation procedure referred to an acid-to-bamboo ratio of 4:1 at sintering of 600-900 °C, which provided an activated carbon (AC) adsorbent with surface area analysis (BET) of 1014.36 m2/g, a value comparable to the commercially procured AC. Pd(II) adsorption characteristics in the solution of Pd with 50-500 mg/L concentration range were evaluated utilizing both agitation and sonication. Adsorption time, pH, dose, and adsorbate concentration were among the pertinent optimal batch adsorption parameters that were found. When utilizing ELP solutions without surfactant, the proposed adsorbent for agitation-assisted adsorption had a simultaneous improvement in metal intake of 6.68-43.2 mg/g and removal efficiency of 72.96-54.5% (cTAB). For cTAB-containing solutions, sonication and agitation-assisted adsorption were outperformed in terms of removal efficiency of 80.32-60.16% and metal uptake of 6.69-50.13 mg/g. Equilibrium, kinetic, and thermodynamic models with good fitting to the reported Pd(II) adsorption properties have been developed.

Serum CRP biomarker detection by using carbon nanotube field-effect transistor (CNT-FET) immunosensor.

C-reactive protein (CRP) is produced by the liver in response to systemic inflammation caused by bacterial infection, trauma and internal organ failures. CRP serves as a potential biomarker in the precise diagnosis of cardiovascular risk, type-2 diabetes, metabolic syndrome, hypertension and various types of cancers. The pathogenic conditions indicated above are diagnosed by an elevated CRP level in the serum. In this study, we successfully fabricated a highly sensitive and selective carbon nanotube field-effect transistor (CNT-FET) immunosensor for the detection of CRP. The CNTs were deposited on the Si/SiO2 surface, between source-drain electrodes, afterwards modified with well-known linker PBASE and then anti-CRP was immobilized. This anti-CRP functionalized CNT-FET immunosensor exhibits a wide dynamic detection range (0.01-1000 µg/mL) CRP detection, rapid response time (2-3 min) and low variation (<3 %) which can be delivered as a low-cost and rapid clinical detection technology for the early diagnosis of coronary heart disease (CHD). For the clinical applications, our sensor was tested using CRP fortified serum samples and sensing performance was validated using enzyme-linked immune-sorbent assay (ELISA). This CNT-FET immunosensor will be helpful in taking over the complex laboratory-based expensive traditional CRP diagnostic procedures practiced in the hospitals.

Post-mortem interval estimation using miRNAs of road traffic accident cases: A forensic molecular approach.

In forensic examination accurate estimation of post-mortem interval (PMI) is a challenging task, particularly in the advanced stages of decomposition. The existing methods (algor mortis, livor mortis, rigor mortis, putrefaction etc) used for estimating PMI rely on analyzing the physical, biochemical, and metabolic changes that occur in the corpse after death. While these methods have shown some level of effectiveness in estimating PMI during the early stages of decomposition, accurate estimation becomes increasingly challenging during the later stages of putrefaction when the body undergoes significant changes. Recently, microRNA (miRNA) profiling due to its relatively small size and stability has emerged as a promising tool in several areas of forensics. This study demonstrates the potential of miRNA for PMI estimation in advanced stages of death. In this study, miRNA-195, miRNA-206, and miRNA-378 were selected as target miRNAs and miRNA-1 as reference miRNA. Left ventricle tissue (5 g) of the heart from 20 forensic autopsies of traffic accident victims (18-32 years) were collected and processed. The samples were held at room temperature for eight different time intervals (12, 24, 48, 72, 96, 120, 168 and 196 h), and RNA was extracted from all the samples using Trizol-based RNA isolation protocol, followed by cDNA synthesis and amplification with commercially available specific miRNA probes in Real-Time PCR (RT-PCR), Ct was calculated. The result showed that miRNAs were associated with PMI. Over time, there were substantial changes in the Ct values of all three miRNAs, with significant reductions observed at 196 h compared to 12 h. miRNA-206 demonstrated significant changes at multiple time intervals, while miRNA-1 remained stable for up to 196 h and thus holds caas an endogenous marker. In conclusion, miRNA has the potential to serve as a valuable tool for estimating PMI, especially during the advanced stages of decomposition, when used in conjunction with established techniques. However, further validation of the study is required to obtain more accurate estimates of PMI.

Correlation Between Maternal Age and Cytokine (IL-6 and TGF-Beta) Levels in Colostrum.

BACKGROUND: Cytokines are small proteins that play an important role in cell signaling, particularly in inflammatory pathways. There are both pro- as well as anti-inflammatory cytokines that regulate this pathway and modulate the immune responses. Advancing maternal age is associated with systemic inflammation. The present study intends to evaluate the effect of advancing maternal age on cytokine (IL-6 and TGF-ß) levels in colostrum, the first breast milk secreted by mothers. METHODOLOGY: A total of 77 term deliveries were enrolled in the study. Colostrum specimens were collected and evaluated for cytokine IL-6 and TGF-ß levels. Colostrum IL-6 and TGF-ß levels were correlated with maternal age and were assessed using the Spearman rank correlation coefficient. Multivariate analysis was done using a linear regression model comprising age, parity, and mode of delivery. RESULTS: Mean colostrum IL-6 and TGF-ß levels were 113.3±73.1 pg/ml and 20.9±23.6 pg/ml, respectively. No significant correlation between maternal age and colostrum IL-6 levels was observed (r=0.137; p=0.314). However, there was a significant positive correlation between maternal age and colostrum TGF-ß levels (r=0.452; p<0.001). CONCLUSIONS: The findings of the study show a significant association between maternal age and colostrum TGF-ß levels. The impact of colostrum cytokine levels on neonatal growth and development in context with advancing maternal age needs to be evaluated.

Correlation of C-reactive Protein with Delirium in Obstetrics Intensive Care Unit: A Tertiary Center Experience.

Background: Delirium is a neuropsychiatric illness. It affects critically ill patients on ventilator and increases mortality. The aim of this study was to evaluate the association of C-reactive protein (CRP) level with delirium in critically obstetrics women and its role in prediction of delirium. Materials and methods: Arospective observational study was conducted in the intensive care unit (ICU), and the duration of study was one year. Total 145 subjects were recruited, 33 patients were excluded, and 112 subjects were studied. For study, group A (n = 36) includes critically ill obstetric women who had delirium on admission; group B (n = 37) includes critically ill obstetric women who developed delirium within 7 days; and group C (n = 39) that includes critically ill obstetric women who did not develop delirium after follow-up of 7 days was served as control. Disease severity was assessed by using acute physiologic assessment and chronic health evaluation (APACHE) II score, and Richmond Agitation-Sedation Scale (RASS) was used to assess awakeness. In awake patients (RASS of ≥3), delirium was assessed by the use of confusion assessment method for ICU tools. C-reactive protein measured by particle enhanced turbidimetric immunoassay-two point kinetic method. Results: The mean ages of group A, B, and C were 26.44 ± 4.72, 27.46 ± 4.97, and 28.26 ± 5.67 years, respectively. C-reactive protein levels on the day of delirium development (group B) were found to be significantly higher than day 1 CRP levels of groups A and C. The mean Global Attentiveness Rating (GAR) was significantly lower in groups A and B as compared to that in group C (p < 0.001). On evaluating the correlation of CRP with GAR, it was found to be inverse and mild in strength for the correlation between CRP and GAR (r = -0.403, p < 0.001). At a cut-off value of >181 mg/L, CRP had sensitivity of 93.2% and specificity of 69.2%. The positive predictive value was 85% and the negative predictive value was 84.4% that differentiate delirium from non-delirium. Conclusion: C-reactive protein is a useful tool for screening and prediction of delirium in critically ill obstetric patients. How to cite this article: Shyam R, Patel ML, Solanki M, Sachan R, Ali W. Correlation of C-reactive Protein with Delirium in Obstetrics Intensive Care Unit: A Tertiary Center Experience. Indian J Crit Care Med 2023;27(5):315-321.

Severe COVID-19-associated hyperinflammatory syndrome versus classic hemophagocytic lymphohistiocytosis: similarities, differences, and the way forward.

The hyperinflammatory immune response in severe COVID-19 infection shares features with secondary hemophagocytic lymphohistiocytosis (sHLH) in the form of fever, cytopenia, elevated inflammatory markers, and high mortality. There are contrasting opinions regarding utility of HLH 2004 or HScore in the diagnosis of severe COVID-19-related hyperinflammatory syndrome (COVID-HIS). This was a retrospective study of 47 patients of severe COVID-19 infection, suspected to have COVID-HIS and 22 patients of sHLH to other illnesses, to evaluate the diagnostic utility and limitations of HLH 2004 and/or HScore in context to COVID-HIS and to also evaluate the utility of Temple criteria for predicting severity and outcome in COVID-HIS. Clinical findings, hematological, and biochemical parameters along with the predictor of mortality were compared between two groups. Only 6.4% (3/47) of cases fulfilled ≥5/8 HLH 2004 criteria and only 40.52% (19/47) of patients showed HScore >169 in COVID-HIS group. 65.9% (31/47) satisfied the Temple criteria in COVID-HIS as compared with 40.9% (9/22) in the non-COVID group (p = 0.04). Serum ferritin (p = 0.02), lactate dehydrogenase (p = 0.02), direct bilirubin (p = 0.02), and C-reactive protein (p = 0.03) were associated with mortality in COVID-HIS. Both HScore and HLH-2004 criteria perform poorly for identifying COVID-HIS. Presence of bone marrow hemophagocytosis may help to identify about one-third of COVID-HIS missed by the Temple Criteria.

Spinach-derived boron-doped g-C3N4/TiO2 composites for efficient photo-degradation of methylene blue dye.

Green synthesis of nanoparticles can be beneficial due to their low toxicity, cost-effectiveness, and environment-friendliness. Its synthesis involves the use of eco-friendly and biodegradable materials such as plant extracts, natural products, and microorganisms to reduce the negative environmental impacts of traditional nanoparticle synthesis methods. Herein, Spinacia oleracea leaves are used as a boron source, and a visible light active photo-catalyst is produced. The effect of Co-Catalyst Boron in Graphitic carbon nitride based nanocomposites for methylene blue dye photo-degradation in water is examined. Titanium dioxide (TiO2) was activated by changing the hydrogen potential value while utilizing a typical orange dye as a sensitizer. The graphitic carbon nitride/TiO2 nanocomposites were synthesized through a hydrothermal technique. To improve their performance, Boron used as a co-catalyst and B-doped g-C3N4/TiO2nanocomposites prepared through wet chemical co-percipitate mathod. UV-visible spectroscopy, SEM and FTIR spectroscopy were used to analyze the photocatalyst and boron-doped composites in detail. The photocatalytic performance of pristine photocatalyst CNTx (x = 2%,4%,6%,8%) and B-doped CNTx composites were examined for Methylene Blue degradation in the presence of a light source. The spectroscopy analysis showed that B-doped g-C3N4/TiO2 -8% nano-composites performed better than all other synthesized pristine catalysts and composites in this research. This research has demonstrated that B-doped g-C3N4/TiO2 composites can provide an ideal solution for treating polluted water using visible light as a source to activate these photocatalysts.

Immune-dysregulation in subacute sclerosing panencephalitis: An exploratory case-control study.

Subacute sclerosing panencephalitis (SSPE) is a chronic progressive neurological condition caused by a defective measles virus. It is postulated that immune-dysregulation might result in persistent infection (immune evasion) as well as initiation of autoimmune phenomenon (via natural killer cells) leading to panencephalitis. The primary objective of this case-control study was to analyse the pattern of immune dysregulation in cases with SSPE. The secondary objective was to assess the correlation between the measured immunological variables and disability/death at 6 months. This was an exploratory case-control study conducted at a tertiary-care referral-facility from January 2020 to September 2021. Thirty consecutive patients fulfilling the Dyken's criteria for SSPE and 30 age-and-sex-matched healthy controls were enrolled. Immunological profile constituted by lymphocyte subset analysis, immunoglobulin levels and complement levels were done in all cases and controls. Cases were staged as per Jabbour's system; disability was assessed using the modified Rankin Scale (mRS). Patients with SSPE had a mean age of 14.76 years (±6.9 years). There were 25 males and 5 females; 6.7% cases belonged to Jabbour's first stage, 40% to second stage and 53.3% to third stage. At least 1/4th had evidence of measles vaccination. Levels of absolute lymphocyte count, B-cells, T cells, helper T-cells, and cytotoxic T-cells were significantly higher in cases. IgG, IgM, and IgE levels were significantly higher while IgD levels were significantly lower in cases. At baseline, 13.3% of cases had a mRS score of 0-2 and 86.7% had a score of 3-6; at 6 months 10% had a mRS score 0-2 (favorable outcome) while 90% had a mRS score 3-6 (poor outcome). Higher IgE levels were found to correlate significantly with favorable outcome. Immune-dysregulation may play a significant role in shaping one's response to measles infection as well as in determining vaccine-efficacy.