Background
End-stage renal disease (ESRD) poses a significant burden globally and in India. However, access to treatment remains limited due to resource and cost constraints. This study aimed to ...evaluate the health-related quality of life (HRQoL) and economic burden among haemodialysis patients.
Methods
A descriptive cross-sectional study using European Quality of life, EQ-5D-5L, to measure health-related quality of life across 5 domains, i.e. mobility, self-care, usual activities, pain/discomfort and anxiety/depression, was administered, across three settings—government dialysis centre, private dialysis centre and charity based dialysis centre. The health utility values were also calculated. Also, the costs incurred in dialysis were done.
Results
The mean (± SD) age of the participants was 55 (± 11) years, the majority of the participants were male (
n
= 61), 80% (
n
= 64) of the participants were employed before and 40% of them had lost a job, due to the morbidity of the disease. Upon analyzing the EQ-5D-5L data, it is inferred that all five domains were the same across all three setups. The direct cost incurred on the haemodialysis ranged from INR.600 to INR.3500 per month, and the indirect cost ranged fromINR.50 to INR. 3000, which is borne by the participants, in about 70% of the cases. Chief Minister Health Insurance Scheme was found to be extremely useful, wherein only 30% (
n
= 25) of the study participants (
n
=81) were insured beneficiaries.
Conclusion
HRQoL was moderately impaired, and treatment posed substantial financial hardship among hemodialysis patients. Expanding access to decentralized and community-based care models could help address the challenges of regular treatment and lost productivity.
Owing to the emergence of antibiotic-resistant strains, bacterial infection and biofilm formation are growing concerns in healthcare management. Herein, we report an eco-benign strategy for the ...synthesis and functionalization of graphene-silver (rGOAg) nanocomposites with an antimicrobial peptide (AMP) for the treatment of
infection. The synthesis of rGOAg nanocomposites was carried out by simple microwave reduction, and the as-synthesized rGOAg was covalently functionalized with an AMP. As a natural AMP, poly-l-lysine (PLL) functionalization of rGOAg enhanced the antibacterial efficacy and target specificity against the
biofilm. The robust bactericidal efficiency and biofilm disruption by AMP-functionalized rGOAg (designated as GAAP) occurred through the "contact-kill-release" mode of action, where the electrostatic interaction with bacterial cells together with intracellular ROS generation induced physical disruption to the cell membrane. The internalization of GAAP into the cytoplasm through the damaged cell membrane caused an outburst of intracellular proteins and DNA. Crystal violet staining along with fluorescence and confocal microscopic images showed an effective inhibition and disruption of the
biofilm upon treatment with GAAP. PLL functionalization also prevented the dissolution of Ag
ions and thereby minimized the in vitro toxicity of GAAP to the 3 T6 fibroblast and human red blood cells. The ex vivo rat skin disinfection model further demonstrated the potency of GAAP in eliminating the biofilm formation and disruption of the
biofilm. The obtained results demonstrated a general approach for designing a functional nanocomposite material to disrupt the mature biofilm and provided a promising strategy for treating bacterial infection.
The aim of this in vivo study was to determine the effect of topical fluoride agents on the mechanical properties of NiTi and copper NiTi archwires.
Thirty patients with fixed appliances were ...randomly divided into three groups: Group I (Control group) used no topical fluoride agents; Group II used a fluoride rinse; Group III applied a fluoride gel to the teeth. After 30 days, the archwires were retrieved and the moduli of elasticity and yield strengths measured. The groups were compared with the oneway ANOVA, and Tukey's HSD test was used to identify the significant groups. One wire was randomly selected from each group and the surface examined with a scanning electron microscope.
During unloading the modulus of elasticity of the NiTi archwire fell significantly in the gel group. The moduli of elasticity and yield strengths of the NiTi archwires during loading, and the copper NiTi archwires during loading and unloading, were not affected by either the gel or the rinse. Scanning electron microscopic analysis revealed that the copper NiTi archwires in the gel group had the most pitting.
Topical fluoride agents alter the mechanical properties of NiTi wires and, hence, may prolong orthodontic treatment.
