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1.
Mol Cell Biochem ; 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33649985

RESUMO

The continuous rise in relapse rate and mortality for multiple myeloma (MM) demands an effective treatment option. The microRNAs are emerging nowadays for their promising therapeutic potential. Earlier, we reported involvement of Versican (VCAN) in myeloma pathogenesis which could be inhibited by miR-144 and miR-199 in stroma. However, there is dearth of literature showcasing the direct effect of these miRs in association with VCAN in MM. Expression of miR-144 and miR-199 was determined in myeloma cell lines (RPMI8226 & U266). These miRs were inhibited by small oligos to elucidate changes in expression of VCAN along with variation in parameters such as proliferation, apoptosis, migration and invasion in vitro. Moreover, effect on certain downstream signaling cascades was also evaluated. Lastly, interaction of miRs with VCAN was assessed by reporter luciferase assay. microRNAs expression were found significantly elevated in myeloma cells in comparison to stromal levels reported previously. The antagomirs-mediated inhibition of miR-144 and miR-199 significantly induced VCAN expression in myeloma cells along with alteration in myeloma-associated parameters in favor of myeloma pathogenesis with downstream activation of FAK/STAT3 signaling. Interestingly, miR-144 found to have direct binding with VCAN 3' UTR while miR-199 possess different mechanism. The inhibition of miR-144 and miR-199 contributed in myeloma progression via upregulation of VCAN in vitro affirming the translational significance of VCAN and associated microRNAs in MM. These miRs, hence might be employed for targeting VCAN and might emerge as an effective therapy for the better outcome of MM in clinical settings in future.

2.
ISA Trans ; 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33518221

RESUMO

In present study, artificial intelligence systems intertwine with mechanical systems for reducing the manufacturing time and cost of products. In Fused Deposition Modeling (FDM) optimum value of deposition angle significantly varies with product geometry; hence, prediction and validation is performed using ensemble based random forest machine learning model. The training data is generated using different shapes and geometries whereas correlation based feature selection technique is employed to explore the crucial features of products. To check the effectiveness of the random forest model K-fold cross validation method is used. The empirical evaluation shows a prediction accuracy of 94.57%, remarkably superior than other methods. The proposed robust model efficiently predicts the optimum deposition angle for any geometry which would further enhance the applicability of digitally manufactured products.

3.
Indian J Clin Biochem ; : 1-20, 2021 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-33424145

RESUMO

In December 2019, Wuhan city in the Hubei province of China reported for the first time a cluster of patients infected with a novel coronavirus, since then there has been an outburst of this disease across the globe affecting millions of human inhabitants. Severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), is a member of beta coronavirus family which upon exposure caused a highly infectious disease called novel coronavirus disease-2019 (COVID-19). COVID-19, a probably bat originated disease was declared by World Health Organization (WHO) as a global pandemic in March 2020. Since then, despite rigorous global containment and quarantine efforts, the disease has affected nearly 56,261,952 laboratory confirmed human population and caused deaths of over 1,349,506 lives worldwide. Virus passes in majority through respiratory droplets and then enters lung epithelial cells by binding to angiotensin converting enzyme 2 (ACE2) receptor and there it undergoes replication and targeting host cells causing severe pathogenesis. Majority of human population exposed to SARS-CoV-2 having fully functional immune system undergo asymptomatic infection while 5-10% are symptomatic and only 1-2% are critically affected and requires ventilation support. Older people or people with co-morbidities are severely affected by COVID-19. These categories of patients also display cytokine storm due to dysfunctional immune response which brutally destroys the affected organs and may lead to death in some. Real time PCR is still considered as standard method of diagnosis along with other serology, radiological and biochemical investigations. Till date, no specific validated medication is available for the treatment of COVID-19 patients. Thus, this review provides detailed knowledge about the different landscapes of disease incidence, etiopathogenesis, involvement of various organs, diagnostic criteria's and treatment guidelines followed for management of COVID-19 infection since its inception. In conclusion, extensive research to recognize novel pathways and their cross talk to combat this virus in precarious settings is our future positive hope.

4.
Salwa Naushin; Viren Sardana; Rajat Ujjainiya; Nitin Bhatheja; Rintu Kutum; Akash Kumar Bhaskar; Shalini Pradhan; Satyartha Prakash; Raju Khan; Birendra Singh Rawat; Giriraj Ratan Chandak; Karthik Bharadwaj Tallapaka; Mahesh Anumalla; Amit Lahiri; Susanta Kar; Shrikant Ramesh Mulay; Madhav Nilakanth Mugale; Mrigank Srivastava; Shaziya Khan; Anjali Srivastava; Bhawna Tomar; Murugan Veerapandian; Ganesh Venkatachalam; Selvamani Raja Vijayakumar; Ajay Agarwal; Dinesh Gupta; Prakash M Halami; Muthukumar Serva Peddha; Gopinath M; Ravindra P Veeranna; Anirban Pal; Vinay Kumar Agarwal; Anil Ku Maurya; Ranvijay Kumar Singh; Ashok Kumar Raman; Suresh Kumar Anandasadagopan; Parimala Karupannan; Subramanian Venkatesan; Harish Kumar Sardana; Anamika Kothari; Rishabh Jain; Anupma Thakur; Devendra Singh Parihar; Anas Saifi; Jasleen Kaur; Virendra Kumar; Avinash Mishra; Iranna Gogeri; Geetha Vani Rayasam; Praveen Singh; Rahul Chakraborty; Gaura Chaturvedi; Pinreddy Karunakar; Rohit Yadav; Sunanda Singhmar; Dayanidhi Singh; Sharmistha Sarkar; Purbasha Bhattacharya; Sundaram Acharya; Vandana Singh; Shweta Verma; Drishti Soni; Surabhi Seth; Firdaus Fatima; Shakshi Vashisht; Sarita Thakran; Akash Pratap Singh; Akanksha Sharma; Babita Sharma; Manikandan Subramanian; Yogendra Padwad; Vipin Hallan; Vikram Patial; Damanpreet Singh; Narendra Vijay Tirpude; Partha Chakrabarti; Sujay Krishna Maity; Dipyaman Ganguly; Jit Sarkar; Sistla Ramakrishna; Balthu Narender Kumar; Kiran A Kumar; Sumit G. Gandhi; Piyush Singh Jamwal; Rekha Chouhan; Vijay Lakshmi Jamwal; Nitika Kapoor; Debashish Ghosh; Ghanshyam Thakkar; Umakanta Subudhi; Pradip Sen; Saumya Raychaudhri; Amit Tuli; Pawan Gupta; Rashmi Kumar; Deepak Sharma; Rajesh P. Ringe; Amarnarayan D; Mahesh Kulkarni; Dhanasekaran Shanmugam; Mahesh Dharne; Syed G Dastager; Rakesh Joshi; Amita P. Patil; Sachin N Mahajan; Abu Junaid Khan; Vasudev Wagh; Rakeshkumar Yadav; Ajinkya Khilari; Mayuri Bhadange; Arvindkumar H. Chaurasiya; Shabda E Kulsange; Krishna khairnar; Shilpa Paranjape; Jatin Kalita; G.Narahari Sastry; Tridip Phukan; Prasenjit Manna; Wahengbam Romi; Pankaj Bharali; Dibyajyoti Ozah; Ravi Kumar Sahu; Elapaval VSSK Babu; Rajeev K Sukumaran; Aishwarya R Nair; Anoop Puthiyamadam; Prajeesh Kooloth Valappil; Adarsh Velayudhanpillai; Kalpana Chodankar; Samir Damare; Yennapu Madhavi; Ved Varun Agrawal; Sumit Dahiya; Anurag Agrawal; Debasis Dash; Shantanu Sengupta.
Preprint | medRxiv | ID: ppmedrxiv-21249713

RESUMO

To understand the spread of SARS-CoV2, in August and September 2020, the Council of Scientific and Industrial Research (India), conducted a sero-survey across its constituent laboratories and centers across India. Of 10,427 volunteers, 1058 (10.14%) tested positive for SARS CoV2 anti-nucleocapsid (anti-NC) antibodies; 95% with surrogate neutralization activity. Three-fourth recalled no symptoms. Repeat serology tests at 3 (n=346) and 6 (n=35) months confirmed stability of antibody response and neutralization potential. Local sero-positivity was higher in densely populated cities and was inversely correlated with a 30 day change in regional test positivity rates (TPR). Regional seropositivity above 10% was associated with declining TPR. Personal factors associated with higher odds of sero-positivity were high-exposure work (Odds Ratio, 95% CI, p value; 2{middle dot}23, 1{middle dot}92-2{middle dot}59, 6{middle dot}5E-26), use of public transport (1{middle dot}79, 1{middle dot}43-2{middle dot}24, 2{middle dot}8E-06), not smoking (1{middle dot}52, 1{middle dot}16-1{middle dot}99, 0{middle dot}02), non-vegetarian diet (1{middle dot}67, 1{middle dot}41-1{middle dot}99, 3{middle dot}0E-08), and B blood group (1{middle dot}36,1{middle dot}15-1{middle dot}61, 0{middle dot}001). Impact StatementWidespread asymptomatic and undetected SARS-CoV2 infection affected more than a 100 million Indians by September 2020. Declining new cases thereafter may be due to persisting humoral immunity amongst sub-communities with high exposure. FundingCouncil of Scientific and Industrial Research, India (CSIR)

5.
Light Sci Appl ; 9(1): 196, 2020 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-33298832

RESUMO

Direct laser writing (DLW) has been shown to render 3D polymeric optical components, including lenses, beam expanders, and mirrors, with submicrometer precision. However, these printed structures are limited to the refractive index and dispersive properties of the photopolymer. Here, we present the subsurface controllable refractive index via beam exposure (SCRIBE) method, a lithographic approach that enables the tuning of the refractive index over a range of greater than 0.3 by performing DLW inside photoresist-filled nanoporous silicon and silica scaffolds. Adjusting the laser exposure during printing enables 3D submicron control of the polymer infilling and thus the refractive index and chromatic dispersion. Combining SCRIBE's unprecedented index range and 3D writing accuracy has realized the world's smallest (15 µm diameter) spherical Luneburg lens operating at visible wavelengths. SCRIBE's ability to tune the chromatic dispersion alongside the refractive index was leveraged to render achromatic doublets in a single printing step, eliminating the need for multiple photoresins and writing sequences. SCRIBE also has the potential to form multicomponent optics by cascading optical elements within a scaffold. As a demonstration, stacked focusing structures that generate photonic nanojets were fabricated inside porous silicon. Finally, an all-pass ring resonator was coupled to a subsurface 3D waveguide. The measured quality factor of 4600 at 1550 nm suggests the possibility of compact photonic systems with optical interconnects that traverse multiple planes. SCRIBE is uniquely suited for constructing such photonic integrated circuits due to its ability to integrate multiple optical components, including lenses and waveguides, without additional printed supports.

6.
Am J Hum Genet ; 107(6): 1157-1169, 2020 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-33159883

RESUMO

Interpretation of the significance of maternally inherited X chromosome variants in males with neurocognitive phenotypes continues to present a challenge to clinical geneticists and diagnostic laboratories. Here we report 14 males from 9 families with duplications at the Xq13.2-q13.3 locus with a common facial phenotype, intellectual disability (ID), distinctive behavioral features, and a seizure disorder in two cases. All tested carrier mothers had normal intelligence. The duplication arose de novo in three mothers where grandparental testing was possible. In one family the duplication segregated with ID across three generations. RLIM is the only gene common to our duplications. However, flanking genes duplicated in some but not all the affected individuals included the brain-expressed genes NEXMIF, SLC16A2, and the long non-coding RNA gene FTX. The contribution of the RLIM-flanking genes to the phenotypes of individuals with different size duplications has not been fully resolved. Missense variants in RLIM have recently been identified to cause X-linked ID in males, with heterozygous females typically having normal intelligence and highly skewed X chromosome inactivation. We detected consistent and significant increase of RLIM mRNA and protein levels in cells derived from seven affected males from five families with the duplication. Subsequent analysis of MDM2, one of the targets of the RLIM E3 ligase activity, showed consistent downregulation in cells from the affected males. All the carrier mothers displayed normal RLIM mRNA levels and had highly skewed X chromosome inactivation. We propose that duplications at Xq13.2-13.3 including RLIM cause a recognizable but mild neurocognitive phenotype in hemizygous males.

7.
Materials (Basel) ; 13(22)2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33212794

RESUMO

Despite several additive manufacturing techniques are commercially available in market, Fused Deposition Modeling (FDM) is increasingly used by researchers and engineers for new product development. FDM is an established process with a plethora of advantages, but the visible surface roughness (SR), being an intrinsic limitation, is major barrier against utilization of fabricated parts for practical applications. In the present study, the chemical finishing method, using vapour of acetone mixed with heated air, is being used. The combined impact of orientation angle, finishing temperature and finishing time has been studied using Taguchi and ANOVA, whereas multi-criteria optimization is performed using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). The surface finish was highly responsive to increase in temperature while orientation angle of 0° yielded maximum strength; increase in finishing time led to weight gain of FDM parts. As the temperature increases, the percentage change in surface roughness increases as higher temperature assists the melt down process. On the other hand, anisotropic behaviour plays a major role during tensile testing. The Signal-to-noise (S/N) ratio plots, and ANOVA results indicated that surface finish is directly proportionate to finishing time because a longer exposure results in complete layer reflowing and settlement.

8.
J Family Med Prim Care ; 9(9): 4505-4506, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33209752

RESUMO

India was not born on 15th August. India was always there and will remain so as the 'most ancient living civilization in continuity' free in spirit, despite centuries of colonization. Let us celebrate every day as 'India Day' and contribute towards a better future for all citizens. We are not just a nation or country but a civilization - a cultural biodiversity repository from prehistory to modern times!

9.
Virus Res ; 292: 198235, 2020 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-33232783

RESUMO

The first incidence of COVID-19 was reported in the Wuhan city of Hubei province in China in late December 2019. Because of failure in timely closing of borders of the affected region, COVID-19 spread across like a wildfire through air travel initiating a pandemic. It is a serious lower respiratory track viral infection caused by highly contagious, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Coronavirus including COVID-19 causing SARS-CoV-2 causes zoonotic diseases and thought to be originated from bats. Since its first incidence, the virus has spread all across the world, causing serious human casualties, economic losses, and disrupting global supply chains. As with SARS-CoV, COVID-19 causing SARS-CoV-2 follows a similar path of airborne infection, but is less lethal and more infectious than SARS and MERS. This review focusses on the pathogenesis of SARS-CoV-2, especially on the dysfunctional immune responses following a cytokine storm in severely affected persons. The mode of entry of SARS-CoV-2 is via the angiotensin converting enzyme 2 (ACE-2) receptors present on the epithelial lining of lungs, gastrointestinal tract, and mucus membranes. Older persons with weaker immune system and associated co-morbidities are more vulnerable to have dysfunctional immune responses, as most of them concomitantly have severe hypovitaminosis D. Consequently, causing severe damage to key organs of the body including lungs and the cardiovascular system. Since, vast majority of persons enters to the intensive care units and died, had severe vitamin D deficiency, thus, this area must be investigated seriously. In addition, this article assesses the role of vitamin D in reducing the risk of COVID-19. Vitamin D is a key regulator of the renin-angiotensin system that is exploited by SARS-CoV-2 for entry into the host cells. Further, vitamin D modulates multiple mechanisms of the immune system to contain the virus that includes dampening the entry and replication of SARS-CoV-2, reduces concentration of pro-inflammatory cytokines and increases levels of anti-inflammatory cytokines, enhances the production of natural antimicrobial peptide and activates defensive cells such as macrophages that could destroy SARS-CoV-2. Thus, this article provides the urgency of needed evidences through large population based randomized controlled trials and ecological studies to evaluate the potential role of vitamin D in COVID-19.

11.
J Matern Fetal Neonatal Med ; : 1-7, 2020 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-33070681

RESUMO

OBJECTIVE: To describe maternal and fetal outcomes and N Terminal pro-brain natriuretic peptide (NT-proBNP) trends in pregnancy with pulmonary arterial hypertension (PAH). METHODS: The medical records of all pregnant women with PAH referred to Pulmonary Hypertension Clinic were retrospectively reviewed and analyzed. RESULTS: We identified 35 pregnancies in 22 women (mean age 27.9 ± 4.7 years, mean weight 50.6 ± 8.1 kg). The diagnoses were Eisenmenger syndrome (16, 72.7%), postoperative residual PAH (3, 13.6%), idiopathic PAH (2, 9.1%), and one (4.5%) had systemic lupus erythematosus. About 23 babies (65.7%) were born alive, gestational age of 35.1 ± 2.9 weeks, 47.8% at term, with a birth weight of 2.1 ± 0.8 kg. There was an elevation of NT-proBNP in the initial 72 h postdelivery (median 138 pg/ml, IQR 112-561). Those with a persistent rise beyond 72 h (median 686 pg/ml, IQR 370-3691) had prolonged recovery postpartum (median postdelivery hospital stay 18 days, IQR 12-22) reflecting continued right ventricular stress and maladaptation. There was single maternal mortality (4.5%). CONCLUSIONS: Maternal and fetal outcomes of pregnancy associated with PAH are better with strict surveillance and multidisciplinary team effort. Postpartum period remains the most vulnerable time. NT-proBNP trends during this period may be a promising objective monitoring tool in identifying at-risk subsets thus improving outcomes.

12.
Circulation ; 142(20): e337-e357, 2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33073615

RESUMO

The global burden of rheumatic heart disease continues to be significant although it is largely limited to poor and marginalized populations. In most endemic regions, affected patients present with heart failure. This statement will seek to examine the current state-of-the-art recommendations and to identify gaps in diagnosis and treatment globally that can inform strategies for reducing disease burden. Echocardiography screening based on World Heart Federation echocardiographic criteria holds promise to identify patients earlier, when prophylaxis is more likely to be effective; however, several important questions need to be answered before this can translate into public policy. Population-based registries effectively enable optimal care and secondary penicillin prophylaxis within available resources. Benzathine penicillin injections remain the cornerstone of secondary prevention. Challenges with penicillin procurement and concern with adverse reactions in patients with advanced disease remain important issues. Heart failure management, prevention, early diagnosis and treatment of endocarditis, oral anticoagulation for atrial fibrillation, and prosthetic valves are vital therapeutic adjuncts. Management of health of women with unoperated and operated rheumatic heart disease before, during, and after pregnancy is a significant challenge that requires a multidisciplinary team effort. Patients with isolated mitral stenosis often benefit from percutaneous balloon mitral valvuloplasty. Timely heart valve surgery can mitigate the progression to heart failure, disability, and death. Valve repair is preferable over replacement for rheumatic mitral regurgitation but is not available to the vast majority of patients in endemic regions. This body of work forms a foundation on which a companion document on advocacy for rheumatic heart disease has been developed. Ultimately, the combination of expanded treatment options, research, and advocacy built on existing knowledge and science provides the best opportunity to address the burden of rheumatic heart disease.

13.
Ecotoxicol Environ Saf ; 208: 111484, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33120265

RESUMO

Industrial wastes, for instance, tannery wastes are rich soups of resistant and bioremediation-potent bacteria. In the present work, Chromium (Cr) and tannic acid (TA) resistance bacterial strains were isolated from tannery effluent and identified as Bacillus subtilis (MCC 3275) and Bacillus safensis (MCC 3283) based on its 16S Ribosomal RNA homology. Hexavalent Cr is highly toxic and mutagenic due to its high mobility and reactivity. Whereas, TA is known to inhibit enzyme activity, substrate deprivation, and interaction with membranes and matrix-metal ions. The developed In vitro co-cultured microcosm of B. subtilis and B. safensis was able to remove Cr(VI) up to 95% and TA up to 23%. The bacteria cultures separately were able to degrade Cr(VI) to 88% by B. subtilis and 91% by B. safensis and TA up to 27%. Plackett Burman design (PBD) followed by Response surface methodology (RSM) was applied for the optimization of physio-chemical parameters. The optimized conditions for co-culture development were recorded as K2HPO4 = 0.2 g/L, MgSO4 = 0.2 g/L, NH4Cl = 0.5 g/L, glucose - 0.2 g/L, TA - 5%, Cr = 200 ppm, incubation period of 96 h, agitation speed of 110 rpm, pH = 5.0, temperature= 30 °C and inoculum size = 3%. Scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) revealed the thorough mechanism of cellular uptake followed by degradation of Cr(VI) and TA. The efficiency of co-culture for other heavy metals was observed as follows: Zn 65%, Pb 63%, Cd 65%, and Ni 65%. Bioremediation using bacteria is an economical and environmentally better alternative to conventional remediation methods. The isolated bacteria are useful in the effluent treatment of tannery or related industries and in metal recovery in mining processes.

14.
J Family Med Prim Care ; 9(8): 3856-3862, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33110779

RESUMO

COVID-19 is one of the deadliest viral infections to have hit the planet. There is urgent need to bridge the gaps in handling this pandemic by methodically synthesising available literature through a unique holistic perspective. A systematic review of articles regarding emergency and primary care during COVID-19 pandemic was carried out. PubMed, Scopus, Science Direct, Web of Science, and Google Scholar were screened for articles and qualitative data across various studies were coded and thematically analyzed. Narrative synthesis was achieved by themes identified from findings of studies. Out of n = 953 articles retrieved, we identified and critically appraised n = 7 articles of which n = 5 were narrative reviews, one was systematic review and one was scoping review from researchers across ten countries. Nine overlapping themes were identified under three broad domains - clinical understanding of the disease, social aspects of the disease, and its contextual implications during pandemic. This narrative synthesis draws up a holistic picture of recent reviews on clinical and social understanding of COVID-19 as a disease and as a pandemic. The overlap among nine themes identified in this review could mean that primary care-level screening, triaging, referral, and emergency care of COVID-19 patients in the backdrop of current clinical understanding of the pandemic are all intertwined. Coping with COVID-19 co-habitation and managing undifferentiated illnesses require a syndromic approach and deft handling at grass root levels. Inclusive health policy empowering inherent holistic specialties like family medicine and emergency medicine could be the prudent way forward during this pandemic.

15.
Polymers (Basel) ; 12(10)2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33007848

RESUMO

Fused filament fabrication (FFF), a portable, clean, low cost and flexible 3D printing technique, finds enormous applications in different sectors. The process has the ability to create ready to use tailor-made products within a few hours, and acrylonitrile butadiene styrene (ABS) is extensively employed in FFF due to high impact resistance and toughness. However, this technology has certain inherent process limitations, such as poor mechanical strength and surface finish, which can be improved by optimizing the process parameters. As the results of optimization studies primarily depend upon the efficiency of the mathematical tools, in this work, an attempt is made to investigate a novel optimization tool. This paper illustrates an optimization study of process parameters of FFF using neural network algorithm (NNA) based optimization to determine the tensile strength, flexural strength and impact strength of ABS parts. The study also compares the efficacy of NNA over conventional optimization tools. The advanced optimization successfully optimizes the process parameters of FFF and predicts maximum mechanical properties at the suggested parameter settings.

16.
J Cardiol Cases ; 22(4): 166-169, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33014197

RESUMO

Pulmonary artery to the left atrial fistula is a rare anomaly. Two young males presented with effort intolerance and cyanosis and had large pulmonary artery to left atrial fistula from right and left pulmonary artery, respectively. The right-sided fistula was closed with a large duct occluder device in transseptal approach whereas the left-sided fistula was closed with a large muscular ventricular septal device. Complete occlusion and symptomatic relief was achieved in both cases. In the follow up the patients were doing well.

17.
J Family Med Prim Care ; 9(7): 3169-3175, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33102264

RESUMO

Novel Coronavirus (COVID 19) has usurped human peace and mobility. Since December 2019, the virus has claimed the lives of 87,816 people across the globe as of April 9, 2020 with India reporting a high case fatality of 3.4%. Among the vulnerable population, elderly people, and patients with comorbidities such as diabetes, chronic life-threatening illnesses, such as COPD and advanced malignancies are susceptible to COVID-19 infection and may have poor clinical outcomes. Considering the imbalance in demand and supply of healthcare resources, initiating palliative care will be essential to alleviate the suffering of such patients. The current paper deliberates on the following aspects of palliative care delivery in the community; the need for palliative care in a pandemic crisis, the role of telemedicine in palliative care delivery in the community, the vital role of a family physician in providing primary palliative care in the community and a "wholistic" community palliative care package to serve the needy in the community.

18.
J Family Med Prim Care ; 9(6): 2593-2599, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32984092

RESUMO

There is abundant literature on domestic safe water supply and hygienic sanitation. Yet, there is a paucity of research studies on adequate supply of safe drinking water and toilet facilities in places of population movement and congregation in India. This study stresses on the importance of availability of safe water and sanitation facilities in all the places of human congregation and movement in India. 49 research studies were identified from 169 potentially relevant publications. Studies were selected: first, all protocols of water and toilet facilities among published literature were meticulously searched. Second, information sources on sanitation facilities in public life, viz., railways, roadways, waterways, market places and shopping complexes, schools, and other higher educational institutions, fairs and festivals, entertainment establishments, healthcare facilities, were explored from publications of various resources of different levels. Third, published reports from apex bodies of national and international importance like Indian Council of Medical Research, World Health Organization (WHO), UNICEF, USAID, etc. were given due weightage. Of late, the concept of cleanliness and making communities free from open defecation are in limelight as the Government of India has taken up Swachh Bharat Mission (SBM); even then, contextual gaps remain. This is the cause for concern as both safe water supply and basic sanitation are directly linked to health promotion of the community. Further, this research group have noted that due importance has not been integrated in the planning of SBM regarding availability of safe water and scientific sanitation facilities in all the places of human movement and congregation. Hence, there is more need for creating awareness among general population as well as stakeholders regarding this aspect of cleanliness. It is noted that despite considerable improvement in safe water and sanitation facilities in domestic life, there is considerable population left, who are still lacking access to these facilities in public space.

19.
Arch Dis Child ; 2020 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-32883659

RESUMO

OBJECTIVES: Severe pulmonary hypertension (PH) causing right heart failure can occur due to thiamine deficiency in exclusively breastfeeding infants. This study describes the clinical profile and management of thiamine-responsive acute pulmonary hypertension. METHODS: A prospective observational study of infants presenting with severe PH without any other significant heart or lung disease. History of symptoms, clinical examination, echocardiography and basic investigations were performed. Dietary patterns of mothers were recorded. Thiamine was administered and serial echocardiography was performed. RESULTS: A total of 250 infants had severe PH and 231 infants responded to thiamine. The mean age was 3.2±1.2 months. Fast breathing, poor feeding, vomiting and aphonia were the main symptoms. Tachypnoea, tachycardia and hepatomegaly were found on examination. Echocardiogram revealed grossly dilated right heart with severe PH. Intravenous thiamine was administered to all the babies based on clinical suspicion. Clinical improvement with complete resolution of PH was noticed within 24-48 hours. Babies were followed up to a maximum of 60 months with no recurrence of PH. All the mothers consumed polished rice and followed postpartum food restriction. CONCLUSION: Thiamine deficiency is still prevalent in selected parts of India. It can cause life-threatening PH in exclusively breastfeeding infants of mothers who are on a restricted diet predominantly consisting of polished rice. It can contribute to infant mortality. Thiamine administration based on clinical suspicion leads to remarkable recovery. High degree of awareness and thiamine supplementation in relevant geographical areas is required to tackle this fatal disease.

20.
J Family Med Prim Care ; 9(5): 2149-2157, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32754463

RESUMO

The latest threat to global health is the form of the ongoing Coronavirus Disease 2019 (COVID-19) pandemic. This new coronavirus (SARS-COV-2) started as a local outbreak in Wuhan, China but soon tightened its grip on human lives around the globe. So far, we do not have a particularly effective anti-SARS-COV-2 vaccine or antiviral agent against COVID-19. Across the globe, many research organizations such as the National Institutes of Health (NIH), United States are studying and testing various drugs and vaccines for their effectiveness against SARS-COV-2. Currently, the principle fighting tool being promoted by the World Health Organization (WHO) is the prevention of acquiring SARS-COV-2 infection by following basic health hygiene rules and social distancing. We hereby discuss major non-pharmacological and pharmacological interventions.

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