Stringent glycemic control by using insulin as a replacement or in addition to oral hypoglycemic agents (OHAs) has been recommended for people with tuberculosis and diabetes mellitus (TB-DM). This ...systematic review (PROSPERO 2016:CRD42016039101) analyses whether this improves TB treatment outcomes.
Among people with drug-susceptible TB and DM on anti-TB treatment, to determine the effect of i) glycemic control (stringent or less stringent) compared to poor glycemic control and ii) insulin (only or with OHAs) compared to 'OHAs only' on unsuccessful TB treatment outcome(s). We looked for unfavourable TB treatment outcomes at the end of intensive phase and/or end of TB treatment (minimum six months and maximum 12 months follow up). Secondary outcomes were development of MDR-TB during the course of treatment, recurrence after 6 months and/or after 1 year post successful treatment completion and development of adverse events related to glucose lowering treatment (including hypoglycemic episodes).
All interventional studies (with comparison arm) and cohort studies on people with TB-DM on anti-TB treatment reporting glycemic control, DM treatment details and TB treatment outcomes were eligible. We searched electronic databases (EMBASE, PubMed, Google Scholar) and grey literature between 1996 and April 2017. Screening, data extraction and risk of bias assessment were done independently by two investigators and recourse to a third investigator, for resolution of differences.
After removal of duplicates from 2326 identified articles, 2054 underwent title and abstract screening. Following full text screening of 56 articles, nine cohort studies were included. Considering high methodological and clinical heterogeneity, we decided to report the results qualitatively and not perform a meta-analysis. Eight studies dealt with glycemic control, of which only two were free of the risk of bias (with confounder-adjusted measures of effect). An Indian study reported 30% fewer unsuccessful treatment outcomes (aOR (0.95 CI): 0.72 (0.64-0.81)) and 2.8 times higher odds of 'no recurrence' (aOR (0.95 CI): 2.83 (2.60-2.92)) among patients with optimal glycemic control at baseline. A Peruvian study reported faster culture conversion among those with glycemic control (aHR (0.95 CI): 2.2 (1.1,4)). Two poor quality studies reported the effect of insulin on TB treatment outcomes.
We identified few studies that were free of the risk of bias. There were limited data and inconsistent findings among available studies. We recommend robustly designed and analyzed studies including randomized controlled trials on the effect of glucose lowering treatment options on TB treatment outcomes.
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Mass spectra of excited states of the singly charmed baryons are calculated using the hypercentral description of the three-body system. The baryons consist of a charm quark and light quarks (
u
,
...d
and
s
) are studied in the framework of QCD motivated constituent quark model. The form of the confinement potential is hyper-Coloumb plus power potential with potential index
ν
, varying from 0.5 to 2.0. The first-order correction to the confinement potential is also incorporated in this approach. The radial as well as orbital excited state masses of
Σ
c
+
+
,
Σ
c
+
,
Σ
c
0
,
Ξ
c
+
,
Ξ
c
0
,
Λ
c
+
,
Ω
c
0
baryons, are reported in this paper. We have incorporated spin-spin, spin-orbit and tensor interactions perturbatively in the present study. The semi-electronic decay of
Ω
c
and
Ξ
c
are also calculated using the spectroscopic parameters of these baryons. The computed results are compared with other theoretical predictions as well as with the available experimental observations. We also construct the Regge trajectory in (
n
r
,
M
2
) and (
J
,
M
2
) planes for these baryons.
We present the mass spectra of radial and orbital excited states of singly heavy bottom baryons; Σb+, Σb−, Ξb−, Ξb0, Λb0 and Ωb−. The QCD motivated hypercentral quark model is employed for the three ...body description of baryons and the form of confinement potential is hyper Coulomb plus linear. The first order correction to the confinement potential is also incorporated in this work. The semi-electronic decay of Ωb and Ξb are calculated using the spectroscopic parameters of the baryons. The computed results are compared with other theoretical predictions as well as with the available experimental observations. The Regge trajectories are plotted in (n,M2) plane.
Private Practitioners (PP) are the primary source of health care for patients in India. Limited representative information is available on TB management practices of Indian PP or on the efficacy of ...India's Revised National Tuberculosis Control Programme (RNTCP) to improve the quality of TB management through training of PP.
We conducted a cross-sectional survey of a systematic random sample of PP in one urban area in Western India (Pune, Maharashtra). We presented sample clinical vignettes and determined the proportions of PPs who reported practices consistent with International Standards of TB Care (ISTC). We examined the association between RNTCP training and adherence to ISTC by calculating odds ratios and 95% confidence intervals.
Of 3,391 PP practicing allopathic medicine, 249 were interviewed. Of these, 55% had been exposed to RNTCP. For new pulmonary TB patients, 63% (158/249) of provider responses were consistent with ISTC diagnostic practices, and 34% (84/249) of responses were consistent with ISTC treatment practices. However, 48% (120/249) PP also reported use of serological tests for TB diagnosis. In the new TB case vignette, 38% (94/249) PP reported use of at least one second line anti-TB drug in the treatment regimen. RNTCP training was not associated with diagnostic or treatment practices.
In Pune, India, despite a decade of training activities by the RNTCP, high proportions of providers resorted to TB serology for diagnosis and second-line anti-TB drug use in new TB patients. Efforts to achieve universal access to quality TB management must account for the low quality of care by PP and the lack of demonstrated effect of current training efforts.
Ocimum tenuiflorum is a widely used medicinal plant since ancient times and still continues to be irreplaceable due to its properties. The plant has been explored chemically and pharmacologically, ...however, the molecular studies have been started lately. In an attempt to get a comprehensive overview of the abiotic stress response in O. tenuiflorum, de novo transcriptome sequencing of plant leaves under the cold, drought, flood and salinity stresses was carried out. A comparative differential gene expression (DGE) study was carried out between the common transcripts in each stress with respect to the control. KEGG pathway analysis and gene ontology (GO) enrichment studies exhibited several modifications in metabolic pathways as the result of four abiotic stresses. Besides this, a comparative metabolite profiling of stress and control samples was performed. Among the cold, drought, flood and salinity stresses, the plant was most susceptible to the cold stress. Severe treatments of all these abiotic stresses also decreased eugenol which is the main secondary metabolite present in the O. tenuiflorum plant. This investigation presents a comprehensive analysis of the abiotic stress effects in O. tenuiflorum. Current study provides an insight to the status of pathway genes' expression that help synthesizing economically valuable phenylpropanoids and terpenoids related to the adaptation of the plant. This study identified several putative abiotic stress tolerant genes which can be utilized to either breed stress tolerant O. tenuiflorum through pyramiding or generating transgenic plants.
We study the masses of radial and orbital excited states of nonstrange singly charmed baryons in the framework of hypercentral Constituent Quark Model (hCQM). To obtain the mass spectra, the Coulomb ...plus screened potential is employed with the first order correction, which gives a relativistic effect of order
O
(1/
m
). The spin-spin, spin-orbit and tensor interactions are included (perturbatively as a spin dependent potential) in order to generate the splitting in mass spectra. We compare our computed mass spectra of nonstrange singly charmed baryons with the other theoretical predictions as well as with the experimental observations. We construct the Regge trajectories of these baryons in the (
J
,
M
2
) plane. Further, we analyze the strong one pion decay rates for
S
,
P
and the
D
-wave transitions in the framework of Heavy Hadron Chiral Perturbation Theory (HHChPT). Moreover, the electromagnetic properties like magnetic moments, transition magnetic moments and the radiative decay widths are determined for the ground state of these baryons in the constituent quark model.
The World Health Organization recommends direct observation of treatment (DOT) to support patients with tuberculosis (TB) and to ensure treatment completion. As per national programme guidelines in ...India, a DOT provider can be anyone who is acceptable and accessible to the patient and accountable to the health system, except a family member. This poses challenges among children with TB who may be more comfortable receiving medicines from their parents or family members than from unfamiliar DOT providers. We conducted a non-inferiority trial to assess the effect of family DOT on treatment success rates among children with newly diagnosed TB registered for treatment during June-September 2012.
We randomly assigned all districts (n = 30) in Gujarat to the intervention (n = 15) or usual-practice group (n = 15). Adult family members in the intervention districts were given the choice to become their child's DOT provider. DOT was provided by a non-family member in the usual-practice districts. Using routinely collected clinic-based TB treatment cards, we compared treatment success rates (cured and treatment completed) between the two groups and the non-inferiority limit was kept at 5%.
Of 624 children with newly diagnosed TB, 359 (58%) were from intervention districts and 265 (42%) were from usual-practice districts. The two groups were similar with respect to baseline characteristics including age, sex, type of TB, and initial body weight. The treatment success rates were 344 (95.8%) and 247 (93.2%) (p = 0.11) among the intervention and usual-practice groups respectively.
DOT provided by a family member is not inferior to DOT provided by a non-family member among new TB cases in children and can attain international targets for treatment success.
Clinical Trials Registry-India, National Institute of Medical Statistics (Indian Council of Medical Research) CTRI/2015/09/006229.
Zinc oxide nanoparticles (ZnO-NPs) have piqued the curiosity of researchers all over the world due to their extensive biological activity. They are less toxic and biodegradable with the capacity to ...greatly boost pharmacophore bioactivity. ZnO-NPs are the most extensively used metal oxide nanoparticles in electronic and optoelectronics because of their distinctive optical and chemical properties which can be readily modified by altering the morphology and the wide bandgap. The biosynthesis of nanoparticles using extracts of therapeutic plants, fungi, bacteria, algae, etc., improves their stability and biocompatibility in many biological settings, and its biofabrication alters its physiochemical behavior, contributing to biological potency. As such, ZnO-NPs can be used as an effective nanocarrier for conventional drugs due to their cost-effectiveness and benefits of being biodegradable and biocompatible. This article covers a comprehensive review of different synthesis approaches of ZnO-NPs including physical, chemical, biochemical, and green synthesis techniques, and also emphasizes their biopotency through antibacterial, antifungal, anticancer, anti-inflammatory, antidiabetic, antioxidant, antiviral, wound healing, and cardioprotective activity. Green synthesis from plants, bacteria, and fungus is given special attention, with a particular emphasis on extraction techniques, precursors used for the synthesis and reaction conditions, characterization techniques, and surface morphology of the particles.
Like the world over, Nepal was also hard hit by the second wave of COVID-19. We audited the clinical care provided to COVID-19 patients admitted from April to June 2021 in a tertiary care hospital of ...Nepal. This was a cohort study using routinely collected hospital data. There were 620 patients, and most (458, 74%) had severe illness. The majority (600, 97%) of the patients were eligible for admission as per national guidelines. Laboratory tests helping to predict the outcome of COVID-19, such as D-dimer and C-reactive protein, were missing in about 25% of patients. Nearly all (>95%) patients with severe disease received corticosteroids, anticoagulants and oxygen. The use of remdesivir was low (22%). About 70% of the patients received antibiotics. Hospital exit outcomes of most (>95%) patients with mild and moderate illness were favorable (alive and discharged). Among patients with severe illness, about 25% died and 4% were critically ill, needing further referral. This is the first study from Nepal to audit and document COVID-19 clinical care provision in a tertiary care hospital, thus filling the evidence gap in this area from resource-limited settings. Adherence to admission guidelines was excellent. Laboratory testing, access to essential drugs and data management needs to be improved.
With the increasing demand for high-speed data, rapid deployments of the 5G terrestrial heterogeneous wireless networks are expected worldwide in the next decade. In such networks, sub-6 GHz ...macro-cells overlapped by mmWave small-cells are being used to cater to densely populated regions.As a result, several challenges arise with the antenna design technologies used at the mobile terminal, access points, or backhaul/front haul levels. These challenges are being addressed using multiple-input multiple-output (MIMO), massive-MIMO, and phased array antenna technologies. In order to implement these antenna technologies, considering the expanding 5G scenario, substrate integrated waveguide (SIW) offers a viable solution due to its low-cost, low-profile, high-power handling, low transmission loss, and ease of integration with the radio circuits; therefore, the SIW plays a vital role in developing the modern radio systems. The proposed study aimed to provide a comprehensive overview of SIW MIMO and phased array antennas operating in the 5G sub-6 GHz and mmWave bands. It deliberates the specific issues related to the band of operations and challenges in designing different antenna structures. After careful investigation and detailed analysis, this paper identified existing research gaps and suggested possible antenna design solutions for prospective researchers who intend to explore further the aforementioned promising area and present future research directions.
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