One-Pot Synthesis and Surfactant Removal from MCM-41 Using Microwave Irradiation.

This research pioneers the application of microwave irradiation as an innovative strategy for one-pot synthesis and surfactant elimination (cetyltrimethylammonium bromide-CTAB) from MCM-41, introducing a rapid and efficient methodology. MCM-41 silica is widely utilized in various applications due to its unique textural and structural properties. Nonetheless, the presence of residual surfactants after synthesis poses a challenge to its effective application. MCM-41 synthesis, conducted in a microwave reactor at 60 °C, provided a result within 0.5 to 1 h. Comprehensive analyses of structural, chemical, morphological, and surface characteristics were undertaken, with a focus on the impact of synthesis time on these properties. Surfactant extraction involved the use of ethanol as a solvent at 120 °C for 6 min within the microwave reactor. The acquired particles, coupled with the properties of textural and structural features, affirmed the efficacy of the synthesis process, resulting in the synthesis of MCM-41 within 36 min. This study presents the first instance of one-pot synthesis and surfactant removal from MCM-41 using a microwave reactor. The proposed method not only addresses the surfactant removal challenge, but also substantially accelerates the synthesis process, thereby enhancing the potential for MCM-41's application in diverse fields.

Synthesis of TiO2-incorporated activated carbon as an effective Ion electrosorption material.

Efficient, chemically stable and cheap materials are highly required as electrodes in the ions-electrosorption-based technologies such as supercapacitors and capacitive deionization desalination. Herein, facile preparation of titanium oxide-incorporated activated carbon using cheap precursors is introduced for this regard. The proposed material was synthesized using the solubility power of the subcritical water to partially dissolve titanium oxide particles to be adsorbable on the surface of the activated carbon. Typically, an aqueous suspension of commercial TiO2 particles (P25) and activated carbon was autoclaved at 180°C for 10 h. The physiochemical characterizations indicated high and uniform distribution of the inorganic material on the surface of the activated carbon. The ionic electrosorption capacity was highly improved as the specific capacitance increased from 76 to 515 F/g for the pristine and modified activated carbon, respectively at 5 mV/s in 0.5 M sodium chloride solution. However, the weight content of titanium oxide has to be adjusted; 0.01% is the optimum value. Overall, the study introduces novel and simple one-pot procedure to synthesis powerful titanium oxide-based functional materials from cheap solid titanium precursor without utilization of additional chemicals.

Burnout syndrome in healthcare workers during the COVID-19 pandemic: a systematic review.

There is evidence that harm to the mental health of healthcare workers has occurred during the pandemic caused by COVID-19. The burnout syndrome is a form of exhaustion that occurs in occupational settings and is a condition caused by long-term stress in the workplace. The objectives of this systematic review of observational studies were to present data from research into the prevalence of burnout syndrome in healthcare workers during the COVID-19 pandemic and observe its prevalence among frontline workers. The search was conducted on the MEDLINE, LILACS, and Embase databases from 2019 to May of 2021 and returned 538 publications, which underwent a two-stage process of selection by independent peers, resulting in selection of a sample of 29 articles. Data were then extracted and synthesized for presentation in narrative form. Cross-sectional designs were more prevalent (n = 26) than longitudinal studies (n = 3). The sample included research from 19 different countries, with one Brazilian study. A wide range of different instruments were administered by study authors to assess burnout syndrome, the most common of which was the Maslach Burnout Inventory (n = 13). The prevalence of burnout syndrome in the studies varied from 76 to 14.7%. Data on the relationship between development of burnout syndrome and working on the frontline were controversial. The lack of standardization of burnout syndrome assessment was a source of considerable difficulty, compromising comparability of the results, and should therefore be targeted for improvement by researchers. We suggest that more investigations should be conducted into prevalence and the associated factors of risk and protection.

Role of ADMA/DDAH-1 and iNOS/eNOS signaling in the gastroprotective effect of tadalafil against indomethacin-induced gastric injury.

Non-steroidal anti-inflammatory drugs (NSAIDs)-induced gastric ulcers represent a significant clinical concern and adversely affect the quality of life. Inducible nitric oxide synthase/endothelial nitric oxide synthase (iNOS/eNOS) and asymmetric dimethylarginine/ dimethylarginine dimethylaminohydrolase-1 (ADMA/DDAH-1) signaling are key players in gastric ulcer pathogenesis. This work was planned to explore the role of iNOS/eNOS and ADMA/DDAH-1 signaling in rats with indomethacin-induced gastric ulcer, as potential pathways for the gastro-protective effect of tadalafil. Split into 5 separate groups, rats were assigned to control, tadalafil (10 mg/kg, p.o), indomethacin (single oral dose of 60 mg/kg), indomethacin + pantoprazole (40 mg/kg, p.o), and indomethacin + tadalafil (10 mg/kg, p.o). The results indicated that pretreatment with tadalafil significantly reduced ulcer index (UI), increased preventive index (PI), and counteracted indomethacin-induced histopathological aberrations. Tadalafil significantly reduced the gastric content of NO while it significantly elevated that of GSH and enhanced SOD activity. It significantly reduced the gastric expression of TNF-α and ADMA while it significantly elevated that of COX-2, PGE-2, and DDAH-1. Western blot analysis revealed that pretreatment with tadalafil significantly reduced iNOS protein expression while it significantly elevated that of eNOS. Collectively, these data suggest that tadalafil exerts potential protective effect against indomethacin-induced ulcer through suppression of inflammation, attenuation of oxidative stress, and boosting of antioxidants. Moreover, tadalafil protective effects are mediated via upregulation of PGE-2 with modulating the signaling pathways of ADMA/DDAH-1, and iNOS/eNOS. As a result, the current evidence corroborates the use of tadalafil in controlling gastric ulcers and preventing NSAID gastric side effects.

Growth Characteristics of Female Radiation/Clinical Oncologists in South Asia: Assessment of Gender Neutrality and Leadership Position.

AIM: To evaluate the temporal growth pattern of female radiation/clinical oncologists (FRCOs) and, if applicable, predict the gender neutrality in different countries of South Asia. MATERIALS AND METHODS: South Asia is composed of Afghanistan, Bhutan, Maldives, Bangladesh, India, Nepal, Pakistan and Sri Lanka. The growth pattern of FRCOs in the latter five countries having radiation oncology facilities was evaluated from respective national registration data. Based on the average annual differential growth rate, together with the already existing female and male radiation/clinical oncologists (MRCOs), the cumulative numbers of FRCOs and MRCOs were forecasted for the next 10 years. The data regarding FRCOs in a leadership position were also calculated from different sources. RESULTS: The total number of radiation/clinical oncologists in the region was 4074, of which 91.8% were in India, because of its vast population. The overall number of FRCOs and MRCOs stood at 1370 and 2704, with a 1:2 female:male ratio. The average incremental annual growth of FRCOs in India was the highest (12.7 persons/year) and Nepal was the lowest (0.4 persons/year), with no data from Pakistan. If the current growth rate is sustained, Indian gender neutrality will be achieved by 2027-2030. In other countries, gender neutrality is unlikely to be achieved in the near future. With regards to leadership positions, 56-77 radiation oncology departments in India, one each in Bangladesh and Sri Lanka are headed by FRCOs, whereas Nepal and Pakistan have none. CONCLUSIONS: With the current growth rate of FRCOs and MRCOs, India will achieve gender parity within a decade; however, the rest of the countries will not achieve this in the near future. Analysis of radiation/clinical oncologists' registration data with their respective national bodies revealed an encouraging growth in the number of FRCOs as against their male counterparts in the last 5 years, compared with previous decades, especially in Bangladesh, Sri Lanka and India. Sri Lanka show high gender neutrality and adopted a multi-tasking and holistic approach of clinical oncology practices as also seen in Scandinavian countries. Such practice may be helpful to improve gender equality in radiation/clinical oncology practice for the other countries in the South Asian region.

Protective effects of perindopril against indomethacin-induced gastric mucosal damage through modulation of DDAH-1/ADMA and ACE-2/ANG-(1-7) signaling pathways.

Indomethacin is a widely used nonsteroidal anti-inflammatory drug; however, its clinical utility is accompanied by serious adverse reactions including peptic ulcers. The current study aims to investigate the protective potential of perindopril against indomethacin-induced gastric injury in rats. Perindopril (4 mg/kg) was administered orally for 7 days and indomethacin (60 mg/kg, single oral dose) was administered on the 7th day, 1 h after perindopril administration. Pantoprazole was used as a standard agent. Ulcer index (UI), preventive index ratio (PI), histopathological examination, oxidative stress, and inflammatory biomarkers were investigated. Perindopril significantly decreased UI while increased PI and counteracted histopathological aberrations induced by indomethacin. It alleviated indomethacin-induced oxidative stress by lowering NO while increasing GSH content and superoxide dismutase activity. Perindopril significantly downregulated TNF-α and asymmetric dimethylarginine (ADMA), while significantly upregulated COX-2, PGE-2, dimethylarginine dimethylaminohydrolase-1 (DDAH-1), ANG-(1-7), and ACE-2 expression. Together, these findings suggest the gastroprotective effects of perindopril through modulation of DDAH-1/ADMA and ACE-2/ANG-(1-7) signaling.HIGHLIGHTSPerindopril attenuated gastric histopathological damage.It increased GSH content and SOD activity while decreased NO content.It modulated gastric ADMA and DDAH-1 activity.It reduced TNF-α, while increased COX-2 and PGE-2 expression.It upregulated ACE-2 activity and ANG-(1-7) protein expression.

No evidence for an association between facial fluctuating asymmetry and vocal attractiveness in men or women.

Facial fluctuating asymmetry (FA), presumably a proxy measure of developmental instability, has been proposed to inversely relate to vocal attractiveness, which may convey information on heritable fitness benefits. Using an improved method of measuring facial FA, we sought to replicate two recent studies that showed an inverse correlation of facial FA with vocal attractiveness. In two samples of men (N = 165) and women (N = 157), we investigated the association of automatically measured facial FA based on 3D face scans with male and female observer-rated attractiveness of voice recordings. No significant associations were found for men or women, also when controlling for facial attractiveness, age, and body mass index. Equivalence tests show that effect sizes were significantly smaller than previous meta-analytic effects, providing robust evidence against a link of facial FA with vocal attractiveness. Thus, our study contradicts earlier findings that vocal attractiveness may signal genetic quality in humans via an association with FA.

Towards water sensitive cities in Asia: an interdisciplinary journey.

Rapid urbanisation, population growth and the effects of climate change drive the need for sustainable urban water management (SUWM) in Asian cities. The complexity of this challenge calls for the integration of knowledge from different disciplines and collaborative approaches. This paper identifies key issues and sets the stage for interdisciplinary research on SUWM in Asia. It reports on the initial stages of a SUWM research programme being undertaken at Monash University, Australia, and proposes a framework to guide the process of interdisciplinary research in urban water management. Three key themes are identified: (1) Technology and Innovation, (2) Urban Planning and Design, and (3) Governance and Society. Within these themes 12 research projects are being undertaken across Indonesia, China, India and Bangladesh. This outward-looking, interdisciplinary approach guides our research in an effort to transgress single-discipline solutions and contribute on-ground impact to SUWM practices in Asia.

B and T Cell Epitope-Based Peptides Predicted from Evolutionarily Conserved and Whole Protein Sequences of Ebola Virus as Vaccine Targets.

Ebola virus (EBV) has become a serious threat to public health. Different approaches were applied to predict continuous and discontinuous B cell epitopes as well as T cell epitopes from the sequence-based and available three-dimensional structural analyses of each protein of EBV. Peptides '(79) VPSATKRWGFRSGVPP(94) ' from GP1 and '(515) LHYWTTQDEGAAIGLA(530) ' from GP2 of Ebola were found to be the consensus peptidic sequences predicted as linear B cell epitope of which the latter contains a region (519) TTQDEG(524) that fulfilled all the criteria of accessibility, hydrophilicity, flexibility and beta turn region for becoming an ideal B cell epitope. Different nonamers as T cell epitopes were obtained that interacted with different numbers of MHC class I and class II alleles with a binding affinity of <100 nm. Interestingly, these alleles also bound to the MHC class I alleles mostly prevalent in African and South Asian regions. Of these, 'LANETTQAL' and 'FLYDRLAST' nonamers were predicted to be the most potent T cell epitopes and they, respectively, interacted with eight and twelve class I alleles that covered 63.79% and 54.16% of world population, respectively. These nonamers were found to be the core sequences of 15mer peptides that interacted with the most common class II allele, HLA-DRB1*01:01. They were further validated for their binding to specific class I alleles using docking technique. Thus, these predicted epitopes may be used as vaccine targets against EBV and can be validated in model hosts to verify their efficacy as vaccine.

Role of ultrasonography in diagnosis of solid space occupying lesion in the liver correlation with FNAC.

This cross sectional study was carried enrolling 47 subjects with suspected solid liver mass, in the Department of Radiology and Imaging, Dhaka Medical College Hospital, Dhaka, over a period of twelve months. The aim of this study was to evaluate the diagnostic usefulness of transabdominal ultrasonography in the diagnosis of solid SOL in the liver. Majority of the respondents (42.55%) were found between 41-60 years of age. Five (10.63%) subjects were found below 20 years of age. There were 31 men (65.95%) and 16 women (34.05%). Majority of the metastasis were multiple (85%), hypoechoic (35%) and only 15% had internal calcifications. HCC was single lesion (61.53%) with hyperechoic (38.35%) echogenicity, with a central halo (76.92%) and 15.38% had internal calcifications. Majority of the cholangiocarcinoma were solitary (80%), hypoechoic (60%) and 60% had internal calcifications. Hepatoblastoma were solitary and had calcifications (60%) with mixed echogenicity (60%). Majority of the adenomas were solitary (80%), hypoechoic (60%) and only 20 % had internal calcifications. The validity of transabdominal sonography for the diagnosis of metastasis was confirmed by calculating sensitivity (100%), specificity (96.42%), accuracy (97.87%), positive (95%) and negative predictive (100%) values by using the standard formula given. The sensitivity, specificity, accuracy, positive and negative predictive values for HCC were 92.3%, 97.05%, 95.74%, 92.3% and 97.05% respectively. The sensitivity, specificity, accuracy, positive and negative predictive values for cholangiocarcinoma and hepatoblastoma were 80%, 97.61%, 95.74%, 80% and 97.61% respectively. Sensitivity, specificity, accuracy, positive and negative predictive values were 80%, 100%, 97.87%, 100% and 97.67% respectively for adenoma. From the study result it was concluded that transabdominal ultrasonography could be reliable, non- ionizing and relatively cheap procedure for diagnosis solid hepatic mass lesion.

Culture of pathogenic campylobacter species at Mymensingh Medical College.

Childhood diarrhea represents a major public health problem in developing countries, where campylobacteriosis is widespread and causes significant morbidity and mortality in infants and children. Despite the increasing importance of campylobacteriosis, most developing countries and even many developed countries do not have surveillance systems to measure the health and economic burden of human campylobacteriosis, nor detect trends in outbreaks. The present study was carried out to diagnose etiology of diarrhea caused by Campylobacter species. A total of 150 clinically diagnosed diarrheal pediatric patients were included in this study, of which 98(65.3%) were male and 52(34.6%) female from the Department of Pediatrics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2011 to April 2012. Stool specimens were collected from each of the cases. The specimens were cultured in appropriate media and Campylobacters were isolated and identified by recommended tests. Among 150 cases, 17(11.3%) were culture positive for Campylobacter species, of which 15(88.2%) were C. jejuni and 02(11.7%) were C. coli. Of the cases, below 1 year of age group were 106(70.6%) cases showing 12(70.5%) positive for Campylobacters and 44(29.33%) cases were above 1 year of age group showing 05(29.41%) positive. The prevalence of Campylobacter infection found in the present study was higher below 1 year age group and was very much close to other countries of this subcontinent.

Detection of TEM, SHV and CTX-M in Mymensingh region in Bangladesh.

The development of antibiotic resistance in bacteria following introduction of antimicrobial agents has emerged as an important medical problem everywhere in the world including Bangladesh. Extended spectrum ß-lactamases (ESBLs) are rapidly evolving group of ß-lactamase enzymes produced by the Gram negative bacteria. This study was undertaken to characterize ESBL producing gram negative bacilli from urine, skin wound (pus and wound infection). A total of 300 gram negative bacilli were screened for resistance to third generation Cephalosporins (3GCs) by disc diffusion test. The ESBL status was confirmed by double disc diffusion test (DDDT), minimum inhibitory concentration (MIC) by agar dilution method as recommended by Clinical Laboratory Standard Institute 2010 (CLSI) and multiplex PCR for TEM, SHV and CTX-M, CTX-M-3, CTX-M-14 genes. The present study revealed a higher occurrence of multi drugs resistant ESBLs production among gram negative isolates where Klebsiella spp. were the leading bacteria 36/45 (80%), followed by Proteus spp. 40/55 (72.7%), Esch. coli 105/156 (67.3%) and others 25/35 (71.4 %). Rate of TEM, SHV and CTX-M genes present in study population were 50.46%, 18.69% and 46.72% respectively. Among the CTX-M positive genes CTX-M-3 and CTX-M-14 were 78.0% (39/50) and 80.0% (40/50) respectively. Results indicate that routine ESBL detection should be made mandatory and irrational use of third generation cephalosporins must be discouraged to reduce multi drugs resistance bacteria, to increase patients' compliance and to make an antibiotic policy.

Methicillin resistant Staphylococcus epidermidis.

Staphylococcus epidermidis is an emerging nosocomial pathogen. Due to its increasing incidence in many countries of the world it is a burning issue now a day. There is marked geographic variation in prevalence of methicillin resistant Staphylococcus epidermidis. Though it as is an endogenous human skin flora, it is therefore easily transmissible in the hospital environment well as in a community. Skin of patients and health care workers, medical equipment, clothing of personnel and environment surfaces can be sources of antibiotic-resistant S. epidermidis strains. This opportunistic pathogen causing different types of infections linked to implanted medical devices especially in immunocompromised patients. Early and specific diagnosis is important to ensure a favourable outcome. So Staphylococcus epidermidis found in culture should not always be ignored as contaminant and proper medical treatment and preventive guidelines should be applied against this alarming pathogen.

Safety of a Novel Calcium/Potassium Salt of Hydroxycitric Acid (HCA-SX): I. Two-Generation Reproduction Toxicity Study.

ABSTRACT (-)-Hydroxycitric acid (HCA), a natural plant extract from the dried fruit rind of Garcinia cambogia, has been reported to inhibit fat synthesis and reduce food intake. The objective of this study was to evaluate the effects of a novel calcium/potassium salt of (-)-hydroxycitric acid (HCA-SX) on the reproductive systems of male and female rats, the postnatal maturation and reproductive capacity of their offspring, and possible cumulative effects through multiple generations. Sprague-Dawley rats (30/sex/group) were maintained on feed containing HCA-SX at dose levels of 0, 1000, 3000, or 10,000 ppm for 10 weeks prior to mating, during mating, and, for females, through gestation and lactation, across two generations. During the period of study, animals were examined daily for signs of clinical toxicity and their body weight and feed consumption were recorded twice a week. For the parents (F(0) and F(1)) and the offspring (F(1) and F(2a)), reproductive parameters such as fertility and mating, gestation, parturition, litters, lactation, sexual maturity, and development of offspring were assessed. At termination, necropsy and histopathological examinations were performed on all animals. Dietary exposure of HCA-SX to parental male and female rats of both (F(0) and F(1)) the generations during the premating and mating periods, for both sexes, and during gestation and lactation in case of female rats, did not reveal any remarkable incidence of mortality or abnormal clinical signs. Compared to respective controls, HCA-SX exposure did not affect feed consumption or body weight at any of the exposure levels. HCA-SX exposure did not affect reproductive performance as evaluated by sexual maturity, fertility and mating, gestation, parturition, litter properties, lactation, and development of the offspring. Based on the results of this study, the parental as well as the offspring no-observed-adverse-effect level for HCA-SX was determined to be greater than 10,000 ppm in diet or equivalent to 1018 and 1524 mg/kg body weight/day in male and female rats, respectively.

Safety of a Novel Calcium/Potassium Saltof (-)-Hydroxycitric Acid (HCA-SX): II.Developmental Toxicity Study in Rats.

ABSTRACT (-)-Hydroxycitric acid (HCA), active constituent (10%-30%) of the dried fruit rind of Garcinia cambogia, is commonly used as a dietary supplement for weight management. The objective of the present study was to evaluate the teratogenic potential of a novel calcium/potassium salt of HCA (HCA-SX) in Sprague-Dawley rats. Due to its potential to affect fat synthesis and reduce food intake, processes that are often crucial in normal fetal development, this teratology study was undertaken as part of a multigeneration reproductive investigation. The animals in this study were selected randomly after weaning from each F(2b) litter of the F(1) generation from the two-generation reproductive toxicity study. To start the teratology study, Sprague-Dawley rat pups ( approximately 30/sex/group) from the F(2b) generation were allowed to grow up to 10 to 12 weeks of age before mating. The rats in the treatment group were exposed directly to HCA-SX through feed, while prior to their weaning, they had indirect exposure to the test material during lactation. The dietary exposure levels were the same as those employed for the two-generation reproductive toxicity study, viz. 1000, 3000, or 10,000 ppm. Following mating at maturity, the pregnant rats were observed daily for clinical signs of adverse effects, and body weight and feed consumption were recorded. On day 20 of gestation, animals were subjected to a necropsy and cesarean section to examine the uterus, ovaries, and fetuses for assessment of different parameters of pregnancy and embryo-fetal defects. Despite a slight (13%) lowering of maternal body weight gain during gestation period in the group receiving 10,000 ppm HCA-SX, no evidence of maternal toxicity, adverse effects on the parameters evaluated for the gravid uteri, external abnormalities in the fetuses, soft tissue abnormalities in the fetuses, or skeletal abnormalities in the fetuses were noted. Based on the results of this developmental toxicity study, conducted in continuation of a two-generation reproductive toxicity study, HCA-SX was not found to be teratogenic in the Sprague-Dawley rat at the dietary exposure levels of 1000, 3000, and 10,000 ppm, equivalent to the dose levels of 103, 352, or 1240 mg/kg/day, respectively.

Safety assessment of a novel niacin-bound chromium-based energy formulation.

Over 35 million adults suffer from fatigue or lack of energy. In this study, we assessed the safety of a novel niacin-bound chromium-based Energy Formulation, which also contained caffeine, D-ribose, Withania somnifera extract, and selected amino acids. Niacin-bound chromium is a novel source of bioavailable chromium (III), and known to promote healthy lipid profile. Male and female Sprague-Dawley rats were fed 125 ppm Energy Formulation for 90 consecutive days. Body weight, feed, and water intake were monitored over the period of 90 days. No significant changes were observed between the control and treatment groups following subchronic supplementation with this Energy Formulation. Furthermore, no significant changes were observed in selected organ weights individually and as percentages of body and brain weights. The Energy Formulation supplementation did not cause changes in hepatic lipid peroxidation or DNA fragmentation after 30, 60, or 90 days of treatment. Hematology, clinical chemistry, and histopathological evaluations revealed no adverse effects in the treatment group. These findings demonstrate the safety of this Energy Formulation.

Inmovilización covalente de glucosa oxidasa y peroxidasa / Covalent immobilization of oxidase glucose and peroxidase

Las enzimas por su función catalítica tienen amplia aplicación en infinidad de procesos tecnológicos y en los últimos 15 a han marcado avances significativos en la industria. Dentro de la Industria Farmacéutica y Biológica, la dedicada a los medios diagnósticos ha recibido también el impacto de la introducción de este tipo de productos, soportando en la actualidad tecnologías tan importantes como el inmunoensayo enzimático, el diagnóstico en química clínica y la química seca, donde las técnicas de inmovilización alcanzan un desarrollo cada vez mayor por el incremento de la estabilidad que se logra con estos sistemas. Se presentan ensayos de inmovilización covalente de las enzimas glucosa oxidasa y peroxidasa sobre papel de filtro Whatman No. 2. Fueron ensayadas 2 variantes: la inmovilización covalente de un polímero soluble de las enzimas y la inmovilización covalente de una solución de las enzimas libres. Los resultados del proceso se evaluaron frente a soluciones de referencia de glucosa en concentraciones entre 2,0 y 55,0 mmol/L. Las mejores respuestas se encontraron con el más bajo porcentaje de inmovilización en el caso del enlazamiento del polímero, y para la solución de las enzimas libres correspondió al más alto grado de inmovilización logrado (AU)

Nutritional treatment for acquired immunodeficiency virus-associated wasting using beta-hydroxy beta-methylbutyrate, glutamine, and arginine: a randomized, double-blind, placebo-controlled study.

BACKGROUND: The current study was designed to examine whether a combination of three nutrients, consisting of beta-hydroxy-beta-methylbutyrate (HMB), a metabolite of leucine, L-glutamine (Gln) and L-arginine (Arg), each of which has been previously shown to slow muscle proteolysis, could synergistically alter the course of muscle wasting in patients with established acquired immunodeficiency syndrome (AIDS). METHODS: Sixty-eight human immunodeficiency virus (HIV)-infected patients with a documented weight loss of at least 5% in the previous 3 months were recruited from the HIV clinic at Nassau County Medical Center. The subjects were randomly assigned in a double-blind fashion to receive either placebo containing maltodextrin or the nutrient mixture (HMB/Arg/Gln) containing 3 g HMB, 14 g L-glutamine, and 14 g L-arginine given in two divided doses daily for 8 weeks. Body weights (BW) were recorded weekly and lean body mass (LBM) and fat mass (FM) were measured by air displacement plethysmography and by a single computerized tomography (CT) slice through the thigh at 0, 4, and 8 weeks. RESULTS: Forty-three subjects completed the 8-week protocol, (placebo, n = 21; HMB/Arg/Gln, n = 22). At 8 weeks, the subjects consuming the HMB/Arg/Gln mixture gained 3.0 +/- 0.5 kg of BW while those supplemented with the placebo gained 0.37 +/- 0.84 kg (p = .009). The BW gain in the HMB/Arg/Gln-treated subjects was predominantly LBM (2.55 +/- 0.75 kg) compared with the placebo-supplemented subjects who lost lean mass (-0.70 +/- 0.69 kg, p = .003). No significant change in FM gain was observed (0.43 +/- 0.83 kg for the group receiving HMB/Arg/Gln and 1.07 +/- 0.64 kg for the group receiving the placebo, p > .20). Similar percentage changes in muscle mass and fat mass were observed with CT scans. Immune status was also improved as evident by an increase in CD3 and CD8 cells and a decrease in the HIV viral load with HMB/Arg/Gln supplementation. CONCLUSIONS: The data indicate that the HMB/Arg/Gln mixture can markedly alter the course of lean tissue loss in patients with AIDS-associated wasting.

Saptagram opens up windows of opportunity in Bangladesh.

PIP: In Bangladesh, nongovernmental organizations (NGOs) such as Saptagram Nari Swanirvar Parishad help the poorest women living in rural areas by challenging their traditional roles. In these societies, no one counts the work of women as "real work." "Real work" involves cash transitions and only occurs when men sell the agricultural and household products produced by women. The "male sphere" of the market-place is clearly separated from the domestic "female sphere." The invisibility of women's work deluded development planners during the 1970s into proposing inappropriate "spare" time income-generating schemes for women. It was reasoned that women working in their "spare" time would not expect or require to be compensated according to any recognized standard for work done in time which would otherwise be "wasted." Saptagram sponsors regular meetings in which women can discuss their problems. The women make time to attend the meetings because each group has a savings kitty which members manage jointly. While the funds are too small to generate income, their existence allows the groups to develop financial skills and devise creative uses for the capital. This meeting technique also helps break the isolation and immobility of the rural women. When women begin to earn cash incomes, they often find that their husbands become willing to help in household chores. Saptagram also provides credit, widens access to raw materials and markets, provides literacy training, and oversees mass employment schemes. In some cases, macro-economic policies have threatened economic development schemes which depend upon the prices of raw material remaining low enough for products to be profitable. Gender disparities are another major barrier which NGOs like Saptagram must continue to attempt to overcome.^ieng