Diabetes was estimated to be responsible for 109 thousand deaths, 1157 thousand years of life lost and for 2263 thousand disability adjusted life years (DALYs) in India during 2004. However, health ...systems have not matured to manage diabetes effectively. The limited studies available on diabetes care in India indicate that 50 to 60% of diabetic patients do not achieve the glycemic target of HbA1c below 7%. Awareness about and understanding of the disease is less than satisfactory among patients, leading to delayed recognition of complications. The cost of treatment, need for lifelong medication, coupled with limited availability of anti-diabetic medications in the public sector and cost in the private sector are important issues for treatment compliance. This article attempts to highlight the current constraints in the health system to effectively manage diabetes and the need for developing workable strategies for ensuring timely and appropriate management with extensive linkage and support for enhancing the availability of trained manpower, investigational facilities and drugs.
Abstract Serum toxic metals have been implicated in development of many diseases. This study investigated the association between blood levels of lead and cadmium with abnormal bone mineral density ...(BMD) and incidence of osteoporosis. Sixty Saudi male adults age matching were assigned into two groups: A healthy control group (n = 30) and osteoporosis patients diagnosed according to T-score (n = 30). Serum calcium, vitamin D, osteocalcin, lead, cadmium were measured. Osteoporotic group showed a highly significant elevation of blood lead and cadmium levels compared to the control group (p <0.001). BMD was negatively correlated with serum osteocalcin level compared with control. There was a significant negative correlation between the cadmium and lead levels (r=-0.465 and p-value = 0.01) and calcium (p < 0.004). Our findings suggested that high cadmium and lead were negative correlated to BMD and increased the risk factor for osteoporosis.
Resumo Os metais tóxicos do soro têm sido implicados no desenvolvimento de muitas doenças. Este estudo investigou a associação entre os níveis sanguíneos de chumbo e cádmio com densidade mineral óssea anormal (DMO) e incidência de osteoporose. Sessenta adultos sauditas do sexo masculino com idades iguais foram divididos em dois grupos: um grupo de controle saudável (n = 30) e pacientes com osteoporose diagnosticados de acordo com o T-score (n = 30). Cálcio sérico, vitamina D, osteocalcina, chumbo, cádmio foram medidos. O grupo osteoporótico apresentou elevação altamente significativa dos níveis de chumbo e cádmio no sangue em comparação ao grupo controle (p < 0,001). A DMO foi negativamente correlacionada com o nível de osteocalcina sérica em comparação com o controle. Houve correlação negativa significativa entre os níveis de cádmio e chumbo (r = -0,465 ep = 0,01) e cálcio (p < 0,004). Nossos achados sugeriram que cádmio e chumbo elevados foram correlacionados negativamente à DMO e aumentaram o fator de risco para osteoporose.
Glioblastoma (GBM) is a highly aggressive type of glioma with poor prognosis. However, a small number of patients live much longer than the median survival. A better understanding of these long-term ...survivors (LTSs) may provide important insight into the biology of GBM.
We identified 7 patients with GBM, treated at Memorial Sloan-Kettering Cancer Center (MSKCC), with survival >48 months. We characterized the transcriptome of each patient and determined rates of MGMT promoter methylation and IDH1 and IDH2 mutational status. We identified LTSs in 2 independent cohorts (The Cancer Genome Atlas TCGA and NCI Repository for Molecular Brain Neoplasia Data REMBRANDT) and analyzed the transcriptomal characteristics of these LTSs.
The median overall survival of our cohort was 62.5 months. LTSs were distributed between the proneural (n = 2), neural (n = 2), classical (n = 2), and mesenchymal (n = 1) subtypes. Similarly, LTS in the TCGA and REMBRANDT cohorts demonstrated diverse transcriptomal subclassification identities. The majority of the MSKCC LTSs (71%) were found to have methylation of the MGMT promoter. None of the patients had an IDH1 or IDH2 mutation, and IDH mutation occurred in a minority of the TCGA LTSs as well. A set of 60 genes was found to be differentially expressed in the MSKCC and TCGA LTSs.
While IDH mutant proneural tumors impart a better prognosis in the short-term, survival beyond 4 years does not require IDH mutation and is not dictated by a single transcriptional subclass. In contrast, MGMT methylation continues to have strong prognostic value for survival beyond 4 years. These findings have substantial impact for understanding GBM biology and progression.
A comprehensive statistical model is described for ultrawideband (UWB) propagation channels that is valid for a frequency range from 3-10 GHz. It is based on measurements and simulations in the ...following environments: residential indoor, office indoor, builtup outdoor, industrial indoor, farm environments, and body area networks. The model is independent of the used antennas. It includes the frequency dependence of the path gain as well as several generalizations of the Saleh-Valenzuela model, like mixed Poisson times of arrival and delay-dependent cluster decay constants. A separate model is specified for the frequency range below 1 GHz. The model can thus be used for realistic performance assessment of UWB systems. It was accepted by the IEEE 802.15.4a Task Group as standard model for evaluation of UWB system proposals. This paper also presents a critical assessment of the applicability of the model and possible generalizations and improvements
Background
Given India's high rate of TB, rising burden of non-communicable diseases (NCDs) and growing elderly population, elderly TB patients may be at higher risk of adverse outcomes including ...death, loss-to-follow-up (LTFU) and treatment failure. This may call for modifications in their management. This study thus aimed to compare the profile and treatment outcomes between elderly (≥60 years) and non-elderly (15-59 years) TB patients.
Methods
This was a retrospective cohort study using routinely-collected programme data from a chest clinic in Delhi, India. It included all elderly and selected non-elderly TB patients registered for treatment between 2005 and 2010. Data on patients' clinical and demographic characteristics and treatment outcomes were analysed.
Results
There were 812 elderly and 1624 non-elderly TB patients. Elderly patients were more likely to be male (63.2% vs 51.1%) and have smear-positive TB (56.0% vs 47.4%). Adverse outcomes were more frequent among elderly patients (adjusted OR 1.9, 95% CI: 1.5-2.4), specifically deaths (adjusted OR 5.0, 95% CI: 3.1-8.1) and lost-to-follow-up (adjusted OR 1.4, 95% CI: 1.0-1.9).
Conclusions
The profile and worse outcomes of elderly Indian TB patients may be indicative of co-existing NCDs. This needs further investigation and likely calls for a more comprehensive and intensive approach to their management.
This article reports about the development of various discrete (single sensor) surface acoustic wave (SAW) handheld sensor systems, for detection and quantification of explosives and chemical warfare ...agents (CWA). The sensing element is a SAW device of delay line, resonator or dispersive delay line type with frequency of operation ranging from 36
MHz to 434
MHz. The SAW devices are coated with various polymers having good selectivity to explosives and CWA. Oscillator with the SAW device in the feedback loop as a frequency determining element is used. Dual oscillator configuration with one coated and one uncoated SAW device is used. The outputs of the oscillators are mixed and signal conditioned before frequency measurement. The frequency measurement is carried out by a high-speed high-resolution reciprocal counting method using microcontroller-based readout circuitry. Data acquisition software written in Visual Basic performs online display and storage. The performance of various parts and the sensor systems is analyzed for their stability, resolution, accuracy and sensitivity.
•A total of 148 samples were collected from cattle for isolation with and without lesions, of which 67 isolates were obtained by culture. Fifty one isolates were identified as Mycobacterium ...tuberculosis complex (MTBC) using IS6110 PCR.•Forty three isolates (84.3%) were identified as M. tuberculosis and 08 (15.6%) were identified as M. bovis by using 12.7kb fragment multiplex PCR. Among this, 31 isolates which were positive for IS6110 PCR were subjected to spoligotyping and revealed 28 isolates belonging to MANU1 strain of M. tuberculosis.•In this study a high percentage of M. tuberculosis isolates were identified rather than M. bovis from cattle samples.•M. tuberculosis MANU 1 strain identified by spoligotyping suggests a possible spill over either from human or other hosts has taken place which requires further confirmation. Hence further studies need to be carried out to have a spoligotyping database for animal isolates.
Bovine tuberculosis continued to be a re-emerging problem in some countries especially in endemic areas due to the fact that human and animal health surveillance system is not adopted to diagnose the infection. This crisis can be attributed due to sharing of the same habitat especially in rural areas. In the present study, a total of 148 samples were collected from cattle for isolation over a period of 3 years from cattle with and without lesions, of which 67 isolates were obtained by culture. Fifty one isolates were identified as Mycobacterium tuberculosis complex (MTBC) by IS6110 PCR of which 43 (84.3%) were identified as M. tuberculosis and 08 (15.6%) were identified as M. bovis by using 12.7kb fragment multiplex PCR. Among this, 31 isolates which were positive for IS6110 PCR were subjected to spoligotyping and revealed 28 isolates belonging to MANU1 strain of M. tuberculosis. This study clearly indicates that high prevalence of M. tuberculosis than M. bovis in bovine was identified by means of culture and by molecular methods M. tuberculosis can affect cattle producing lesion in contradiction to the earlier thoughts. This study speculates that M. tuberculosis MANU1 strain infection in cattle could be due to spill over from human or other non specific hosts in tuberculosis endemic areas. Though bovine tuberculosis due to M. tuberculosis in cattle is not considered a serious threat worldwide, in countries where human TB is endemic, M. tuberculosis infection of cattle needs to be considered.
Vaccine effectiveness for first-generation coronavirus disease (COVID-19) vaccines among People Living with HIV (PLHIV) in India remains unexplored. This study entails the estimation of the ...real-world effectiveness of COVID-19 vaccines (AZD1222/Covishield, BBV152/Covaxin) among PLHIV and the identification of variants of SARS-CoV-2 among those infected with COVID-19.
An ambi-directional cohort study was conducted among 925 PLHIV above 18 years of age in two districts of central Kerala, India, from February 2022 to March 2023. Selected PLHIV were recruited as Participant Liaison Officers (PLOs) for the follow-up on the study participants. At enrolment, basic details, baseline CD4 count, and a Nasopharyngeal (NP) swab for RT-PCR were collected. In the follow-up phase, NP swabs were collected from subjects with COVID-19 symptoms. Positive subjects had a CD4 count and genomic sequencing performed.
The mean age of the participants was 46.93 ± 11.00 years. The majority, 819 (93.6%), of participants had received at least one dose of any vaccine, while 56 (6.4%) were unvaccinated. A total of 649 (79.24%) participants were vaccinated with Covishield and 169 (20.63%) with Covaxin. In the vaccinated group, 158 (19.3%) reported COVID-19 infection. Vaccine Effectiveness (VE) for one dose of any vaccine was 43.2% (95% CI: 11.8-64.5),
= 0.015. The effectiveness of full vaccination with Covishied was 63.8% (95% CI: 39.3-79.2),
< 0.001, and Covaxin was 73.4% (95% CI: 44.3-87.3). VE was highest, at 60.7% (95% CI: 23.6-81.3), when the two doses of the vaccine were given at an interval of less than 6 weeks. Participants with a baseline CD4 count > 350 had greater protection from COVID-19, at 53.4% (95% CI: 19.6-75.3)
= 0.004. The incident cases were sub-variants of Omicron (BA.2, BA.2.38, BA.2.10).
Full vaccination with Covishield and Covaxin was effective against COVID-19 infection among PLHIV on treatment; albeit, that of Covaxin was higher. A gap of 4 to 6 weeks between the two doses of COVID-19 vaccine was found to have higher VE among PLHIV.
The outbreak of coronavirus disease, 2019 (COVID-19), which started from Wuhan, China, in late 2019, have spread worldwide. A total of 5,91,971 cases and 2,70,90 deaths were registered till 28th ...March, 2020. We aimed to predict the impact of duration of exposure to COVID-19 on the mortality rates increment.
In the present study, data on COVID-19 infected top seven countries viz., Germany, China, France, United Kingdom, Iran, Italy and Spain, and World as a whole, were used for modeling. The analytical procedure of generalized linear model followed by Gompertz link function was used to predict the impact lethal duration of exposure on the mortality rates.
Of the selected countries and World as whole, the projection based on 21st March, 2020 cases, suggest that a total (95% Cl) of 76 (65-151) days of exposure in Germany, mortality rate will increase by 5 times to 1%. In countries like France and United Kingdom, our projection suggests that additional exposure of 48 days and 7 days, respectively, will raise the mortality rates to10%. Regarding Iran, Italy and Spain, mortality rate will rise to 10% with an additional 3-10 days of exposure. World's mortality rates will continue increase by 1% in every three weeks. The predicted interval of lethal duration corresponding to each country has found to be consistent with the mortality rates observed on 28th March, 2020.
The prediction of lethal duration was found to have apparently effective in predicting mortality, and shows concordance with prevailing rates. In absence of any vaccine against COVID-19 infection, the present study adds information about the quantum of the severity and time elapsed to death will help the Government to take necessary and appropriate steps to control this pandemic.
Background: Madras Red sheep is a well-recognized meat type breed reared only on free range system to yield tasty meat. The aim of this study was to determine the gross, microanatomical and ...ultrastructural details of the interdigital gland in Madras Red sheep.
Methods: The interdigital glands were removed immediately after slaughter and subjected for gross morphological, histological, immunohistochemical studies and ultrastructural observations. Result: The results revealed that a well-developed tobacco-pipe shaped interdigital gland was present in all the four limbs which was composed of an orifice, excretory duct, body and bent or flexure. Histologically, wall of the gland was composed of epidermis, dermis and capsule from within outward. Epidermis was made of stratified squamous keratinized epithelium. Dermis was composed of dense irregular connective tissue with sweat, sebaceous glands, arrectores pili muscle and hair follicles were embedded within. The sweat gland appeared as group of tortuous tubules under scanning electron microscope. The oily secretion of the gland helps in maintaining the healthiness of foot during movement of the animal.
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