Sulfamethoxazole removal in membrane-photocatalytic reactor system - experimentation and modelling.

In this study, the efficacy of membrane-photocatalytic reactor (MPR) in sulfamethoxazole (SMX) removal was explored at a fixed initial SMX concentration, i.e. 100 mg/L. A supported catalyst, i.e. TiO2 on granular activated carbon (GAC-TiO2), was used for MPR experiments. The SMX removal efficiency of the MPR was investigated under a range of hydraulic retention time (i.e. HRT from 51 to 152.5 min) and TiO2 catalyst dosage (55-50 mg/L). A maximum SMX removal efficiency of 83.6% was observed under 220 mg/L catalyst dosage and 80 min HRT. The increase in catalyst dosage from 55 to 550 mg/L has increased the transmembrane pressure of the reactor from 9.8 to 22.2 kPa. A multiple non-linear regression model was developed based on the experimental data and its significance was analyzed using two-way ANOVA. Based on the model, the optimal HRT and catalyst dosage for complete SMX removal (100%) were found out. The comparison of photocatalytic degradation experiments with sorption experiments conducted earlier revealed that SMX removal in the MPR was mainly by photocatalytic degradation and not by adsorption onto GAC-TiO2 catalyst. However, the performance of MPR in removing other emerging pollutants from real-time wastewaters could be explored before its field-scale application.

Clinical safety profile of ticagrelor compared to clopidogrel in 1208 patients: Real world evidence.

INTRODUCTION: Dual antiplatelet treatment is recommended by current clinical practice guidelines for patients undergoing PCI. The PLATO trial showed superiority of ticagrelor to clopidogrel in reducing the rate of death from vascular causes, myocardial infarction and stroke without increase in the rate of overall major bleeding in ACS patients. However, real world evidence in Indian patients is limited. The objective of this study is to compare safety profile of ticagrelor with clopidogrel in real world settings. METHODOLOGY: In this single centered retrospective observational study, a total of 1208 serial patient records undergoing PCI (ACS and stable angina patients as well) treated with Ticagrelor or Clopidogrel were collected and analyzed to look into in hospital outcomes. We excluded the patient's data that were incomplete. RESULTS: In total of 1208 patients, 604 patients received ticagrelor and similarly 604 patient received clopidogrel. No significant differences in the rates of major life threatening bleeding and any major bleeding were observed between ticagrelor and clopidogrel group (0.2% (n = 1) vs. 0.7% (n = 4), p = 0.18 and 2.8% (n = 17) vs. 3% (n = 18), p = 0.86 respectively). There was increase in minor bleeding rate with ticagrelor compared to clopidogrel (21.4% & 13.6%, p = 0.00). CONCLUSION: In the real world settings, patients undergoing PCI treated with ticagrelor showed similar safety profile compared to clopidogrel but with increase in minor bleeding rate. The observed results were in alignment with PLATO clinical trial.

Photocatalytic-oxidation and photo-persulfate-oxidation of sulfadiazine in a laboratory-scale reactor: Analysis of catalyst support, oxidant dosage, removal-rate and degradation pathway.

The extent of sulfadiazine (SDZ) removal via photo-degradation (UV-C), photocatalysis with TiO2 (UV-C/TiO2) and photo-persulfate-oxidation (UV-C/PS) was investigated in a batch reactor under different UV-C power levels (i.e. 14, 28, 42 and 56 W). Moreover, effects of suspended/immobilized catalyst, i.e. TiO2 slurry/TiO2 supported on granular activated carbon (GAC-TiO2), on SDZ removal and corresponding SDZ degradation kinetics under different catalyst loading (1-6 g/L) were explored. Around 41.7% SDZ removal was observed after 120 min in UV-C system at the highest power level, i.e. 56 W. On the other hand, photocatalysis with TiO2 and GAC-TiO2 has shown better SDZ removal than photo-degradation. In UV-C/TiO2 (4 g/L and 28 W) and UV-C/GAC-TiO2 (5 g/L and 28 W) systems, SDZ removals were 91.8% after 120 min and 100% after 60 min, respectively; however, TOC analysis has revealed that 45.4% and 60.8% SDZ was mineralized in these systems, respectively. In UV-C/PS system, near complete degradation of SDZ (99.8%) was observed within 10 min under 50 mg/L of PS and 28 W UV illumination. On the other hand, complete SDZ removal was observed in PS alone system at a dosage of 1000 mg/L but the formation of SO42- was found to be a drawback. In photolysis and photocatalysis systems, SDZ removal followed pseudo-first-order kinetics whereas the kinetics followed pseudo-second-order in UV-C/PS system. The comparison of electrical energy consumed (EEO) in different systems revealed that UV-C/GAC-TiO2 and UV-C/PS system were energy efficient compared with other systems. The LC-MS analysis has confirmed the cleavage of C-N bonds in the pyrimidine ring followed by S-N bonds in the sulfonyl group, which was found to be the major degradation pathway of SDZ.

Demonstration of acid-fast bacilli in buffy coat and bone marrow smear--a diagnostic tool in pulmonary tuberculosis.

Buffy coat smears prepared from peripheral blood and bone marrow aspirate obtained from proved 60 untreated cases of pulmonary tuberculosis were stained with Ziehl-Neelsen method and thoroughly screened for presence of tubercle bacilli. Acid-fast bacilli were detected in 55% cases in buffy coat, 48.3% cases in bone marrow, 38.3% cases both in buffy coat and bone marrow and 65% cases either in buffy coat or in bone marrow or in both. Considering the fact that demonstration of acid-fast bacilli may not be possible in more than 25-50% of the suspected cases of tuberculosis, these techniques are recommended for evaluation of their utility in establishing diagnosis of tuberculosis, particularly in reference to sputum negative cases of pulmonary tuberculosis and tuberculosis of inaccessible extrapulmonary sites.

Effect of adenosine and inosine on carbon tetrachloride-induced liver damage in rats.

Liver damage induced in rats by carbon tetrachloride (CCL4) was obvious macroscopically as well as microscopically in stained sections. Levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamyl transpeptidase (gamma-GT) were also significantly raised. Adenosine and inosine effectively countered the damage when these were given before and during the period during which CCl4 produces the typical damage. The beneficial effect was seen in biochemical as well as pathological studies.

Patterns of erythropoiesis and anaemia in malaria.

Of 138 patients with malaria, 90 were found to be having Plasmodium falciparum in their peripheral blood smears. Megaloblastosis alone or in combination with the other patterns of erythropoiesis was observed in 82.1 percent cases of chronic P. falciparum malaria as compared to 36.3 and 26.5 per cent cases of acute P. falciparum and P. vivax malaria respectively. Iron deficiency was observed in 15.5 percent cases of chronic P. falciparum, 18.2 per cent cases of acute P. falciparum and 13.3 per cent patients of P. vivax infection. Of patients with chronic falciparum malaria, 33.3 percent revealed features of both megaloblastosis and defective iron utilization and transient hypoplasia of marrow was observed in 8.9 per cent of these cases.

Carcinoembryonic antigen and human chorionic gonadotrophin in breast carcinoma and prostatic specific acid phosphatase in prostate carcinoma.

Tumour markers viz carcinoembryonic antigen (CEA), human chorionic gonadotrophin (HCG) in 30 cases of carcinoma breast and prostatic specific acid phosphatase (PSAP) in 30 cases of carcinoma prostate were studied by peroxidase antiperoxidase technique in paraffin blocks of tissue. Twenty three (76.7%) and 20 (66.7%) cases were positive for CEA and HCG respectively. No correlation was observed between CEA and HCG status, and histological differentiation of the tumours. All the 29 cases (100%) of adenocarcinoma prostate were PSAP positive while a single case, negative for PSAP, was of transitional cell carcinoma.

Chronic granulocytic leukaemia presenting with mandibular mass.

A case of chronic granulocytic leukaemia with extramedullary deposits in the mandible is reported. Systemic chemotherapy coupled with local irradiation resulted in regression of the mandibular mass.

Bacillaemia and bone marrow involvement in leprosy.

Fifty patients (24 new and 26 receiving specific treatment) of leprosy were investigated to study the concentration and morphological index (MI) of the lepra bacilli in skin, peripheral blood and bone marrow. The organisms were detected in 28 cases on skin slit smear examination, in 38 cases on bone marrow examination and in 38 cases on examination of smears made from buffy coat of peripheral blood. Out of 22 cases negative for the bacilli on skin slit smears, 15 had the organisms either in buffy coat or bone marrow or both. Acid fast bacilli in peripheral blood and bone marrow with skin smear negativity were mainly observed in patients with paucibacillary type of the disease and in those who were receiving treatment. Examination of buffy coat and bone marrow for presence of lepra bacilli is suggested to establish the diagnosis in doubtful cases.

Sex chromatin in female breast tumour.

The incidence of sex chromatin in tumour cell nuclei was estimated in twenty five cases each of carcinoma and fibroadenoma breast using haematoxylin and eosin, thionine, aceto-orcein and Papanicolaou's stains on imprint-smears. The sex chromatin incidence in fibroadenoma was found similar to that of normal breast tissue but the incidence markedly decreased in carcinoma breast. Undifferentiated tumours with histologic grade III, nuclear grade I, no lymphocytic infiltrate and involvement of overlying skin, nipple and areola were more often associated with low sex chromatin incidence. No relationship was observed between sex chromatin incidence and tumour size or axillary lymph node metastasis.

Development of immunity to Epstein-Barr virus in Malaysian children.

The pattern of seroconversion to Epstein-Barr virus (EBV) was determined in 98 Malaysian children aged 2 weeks to 12 years. Maternal IgG antibodies to EBV viral capsid antigen, ranging between 1:10 to 1:160 titer, were found in 70.6 percent of infants less than three months old, and dropped to 26 percent by seven to nine months. Primary infection, as denoted by emergence of EBV-IgM antibody, occurred at 4 to 6 months, and by eight years all children were seropositive. Maternal antibody titers to EBV nuclear antigen were detected in 52.9 percent of infants less than 3 months old, declined to undetectable levels by 4 to 12 months, and then increased to 40 percent by the age of 12 years. The IgA antibody to viral capsid antigen was absent in all but one infant aged one year; the child also had IgG anti-early antigen, The IgG antibody to EBV early antigen were present in 17.7 percent of the infants aged 3 months or less. This seroconversion to EBV in early life explains the absence of infectious mononucleosis in the Malaysian population. The data suggest that a subunit vaccine to protect against EBV-associated diseases, most notably nasopharyngeal carcinoma, commonly observed in Malaysians would have to be administered to infants 6-12 months of age.

Semen sponge for post-vasectomy confirmation of sterilization.

PIP: Due to various factors--shyness, failure of patients to return for follow-up, poor postal services--few sperm counts are conducted following vasectomies in India to assess the success of the operation. A semen sponge technique has been developed which overcomes most previous difficulties and objections. At the time of vasectomy, the patient is given a stamped envelope with a sponge piece. The patient is instructed to smear the sponge with a little semen after 12 ejaculations or after 3 months, to let the sponge dry, and then to mail it back to the health center. Laboratory procedures on the sponge at the health center are explained. If evidence of sperm are found, the patient is advised to continue use of contraception until a negative sponge is obtained. A comparative study was done using different blotting materials. Sponges were found to be the best material. Results from the dried sponges were found consistent with direct semen examination. The method has been found to be reliable and convenient.^ieng