P1496Use of strain, strain rate, tissue velocity imaging and endothelial function for early detection of cardiovascular involvement in young diabetics

Background

Subtle structural and functional changes may precede the onset of overt global left ventricular dysfunction and obvious reduction of ejection fraction (EF), especially in young diabetics. Data pertaining to tissue velocity indices (TVI) and strain imaging to assess regional myocardial function and flow mediated vasodilatation is limited in young patients with diabetes.

Purpose

To evaluate conventional echocardiography parameters, tissue doppler indices, global and regional strain, carotid intimal medial thickness (CIMT), endothelial dependent (FMD) and independent function (NMD) of brachial artery in young patients (age <18 years) with type 1 diabetes and compare them with matched controls.

Methods

Conventional echocardiography parameters, tissue velocity indices (TVI) parameters along with strain (S), and strain rate (SR) in basal and mid left ventricular (LV) lateral wall, right ventricular (RV) lateral wall and septum were measured in 50 young diabetics (age 15.16±2.95 years, mean HBA1c 8.15±1.37 gm %) and 25 controls (age 15.60±2.51 years). Flow-mediated dilatation (FMD), nitrate mediated dilatation and carotid intimal media thickness (CIMT) were also estimated.

Results

Conventional echocardiography parameters were similar in patients and controls however deceleration time of the mitral inflow velocity (EDT) was significantly shorter in patients when compared with controls (149.06±31.66 vs. 184.56±19.27 ms, p<0.05). Lateral early diastolic myocardial velocity (LV-Em) was significantly lower (10.30±0.99 vs. 11.67±3.21, p<0.05) whereas lateral late diastolic myocardial velocity (LV-Am) was significantly higher than controls (11.73±1.44 vs. 8.82±1.69, p<0.05), thus a significantly lower ratio of early/late diastolic velocity at the basal segment of lateral LV (LV-Em/Am). Lower strain values at the basal lateral LV (21.39±4.12 vs. 23.78±2.02; p<0.05), mid lateral LV (21.43±4.27 vs. 23.17±1.92; p<0.05), basal septum (20.59±5.28 vs. 22.91±2.00; p<0.05), and mid septum (22.06±4.75 vs. 24.10±1.99; p<0.05) as compared to controls. SR at the basal and mid segments of the lateral LV wall and at the basal septum were also significantly lower in diabetic subjects. Strain rate (SR) in mid septal, basal and mid RV were lower than controls although not statistically significant. Patients also had significantly lower flow mediated dilatation (FMD) (8.36±4.27 vs. 10.57±4.12, p<0.05) implying endothelial dysfunction.

Strain rate in diabetic patient

Conclusion

Left ventricular strain indices are impaired in asymptomatic children and adolescents with type 1 DM despite absence of overt heart failure and normal ejection fraction. Early detection of subclinical regional myocardial dysfunction by deformation analysis including strain and strain rate may be useful in the asymptomatic diabetic population. In addition, evidence of endothelial dysfunction in the form of impaired flow mediated vasodilatation was observed in the diabetic children.

Acknowledgement/Funding

None

Activated carbon from sugarcane bagasse ash for melanoidins recovery

This work investigates the value added utilization of two sugar-distillery wastes: (i) melanoidins, which are complex Maillard reaction products in molasses distillery wastewater, and (ii) unburnt carbon in sugarcane bagasse ash. Activated unburnt carbon (AUC), prepared by deashing and steam activation, had properties comparable to commercial activated carbon (CAC). Both carbons are suitable for melanoidins adsorption followed by desorption using 25% pyridine solution. For AUC, the equilibrium adsorption data is well described by Langmuir isotherm up to 35 °C while Freundlich model fits better at higher temperature. Adsorption using CAC followed Freundlich isotherm at all temperatures. Both carbons followed pseudo second order kinetics and displayed endothermic physisorption. Recovery of melanoidins from AUC (78%) was close to that observed with CAC (80%).

A portable magneto-optical trap with prospects for atom interferometry in civil engineering

The high precision and scalable technology offered by atom interferometry has the opportunity to profoundly affect gravity surveys, enabling the detection of features of either smaller size or greater depth. While such systems are already starting to enter into the commercial market, significant reductions are required in order to reach the size, weight and power of conventional devices. In this article, the potential for atom interferometry based gravimetry is assessed, suggesting that the key opportunity resides within the development of gravity gradiometry sensors to enable drastic improvements in measurement time. To push forward in realizing more compact systems, techniques have been pursued to realize a highly portable magneto-optical trap system, which represents the core package of an atom interferometry system. This can create clouds of 10⁷ atoms within a system package of 20 l and 10 kg, consuming 80 W of power.This article is part of the themed issue 'Quantum technology for the 21st century'.

Bioassays for toxicological risk assessment of landfill leachate: A review

Landfilling is the most common solid waste management practice. However, there exist a potential environmental risk to the surface and ground waters due to the possible leaching of contaminants from the landfill leachates. Current municipal solid waste landfill regulatory approaches consider physicochemical characterization of the leachate and do not assess their potential toxicity. However, assessment of toxic effects of the leachates using rapid, sensitive and cost-effective biological assays is more useful in assessing the risks as they measure the overall toxicity of the chemicals in the leachate. Nevertheless, more research is needed to develop an appropriate matrix of bioassays based on their sensitivity to various toxicants in order to evaluate leachate toxicity. There is a need for a multispecies approach using organisms representing different trophic levels so as to understand the potential impacts of leachate on different trophic organisms. The article reviews different bioassays available for assessing the hazard posed by landfill leachates. From the review it appears that there is a need for a multispecies approach to evaluate leachate toxicity.

Statistical assessment of dumpsite soil suitability to enhance methane bio-oxidation under interactive influence of substrates and temperature

Biocovers are considered as the most effective and efficient way to treat methane (CH₄) emission from dumpsites and landfills. Active methanotrophs in the biocovers play a crucial role in reduction of emissions through microbiological methane oxidation. Several factors affecting methane bio-oxidation (MOX) have been well documented, however, their interactive effect on the oxidation process needs to be explored. Therefore, the present study was undertaken to investigate the suitability of a dumpsite soil to be employed as biocover, under the influence of substrate concentrations (CH₄ and O₂) and temperature at variable incubation periods. Statistical design matrix of Response Surface Methodology (RSM) revealed that MOX rate up to 69.58μgCH₄g^-1_dwh^-1 could be achieved under optimum conditions. MOX was found to be more dependent on CH₄ concentration at higher level (30-40%, v/v), in comparison to O₂ concentration. However, unlike other studies MOX was found in direct proportionality relationship with temperature within a range of 25-35°C. The results obtained with the dumpsite soil biocover open up a new possibility to provide improved, sustained and environmental friendly systems to control even high CH₄ emissions from the waste sector.

FTIR spectroscopy and scanning electron microscopic analysis of pretreated biosorbent to observe the effect on Cr (VI) remediation

Various chemical and physical treatments have been applied to indigenously isolated cyanobacterial strain, Lyngbya putealis HH-15, to observe the effect on chromium removal capacity. Pretreatment with hydrochloric acid (99.1%) and nitric acid (98.5%) resulted in enhanced chromium removal as compared to untreated control biosorbent (98.1%). Pretreatment with acetic acid (97.9%), methanol (97.0%), calcium chloride (96.0%), hot water (95.2%), and sodium hydroxide (93.9%) did not improve the chromium removal capacity of biosorbent. Fourier transform infrared spectrometry (FTIR) and scanning electron microscopy (SEM) analysis identified changes in biomass functionality and availability after physical and chemical modification-the results of which were in agreement with metal removal studies. In conclusion, this acid-treated biosorbent represents a suitable candidate to replace conventional removal technologies for metal-bearing wastewaters.

Evaluation and statistical optimization of methane oxidation using rice husk amended dumpsite soil as biocover

A laboratory scale study was conducted to investigate the effect of rice husk amended biocover to mitigate the CH4 emission from landfills. Various physico-chemical and environmental variables like proportion of amended biocover material (rice husk), temperature, moisture content, CH4 concentration, CO2 concentration, O2 concentration and incubation time were considered in the study which affect the CH4 bio-oxidation. For the present study, sequential statistical approach with Placket Burman Design (PBD) was used to identify significant variables, having influential role on CH4 bio-oxidation, from all variables. Further, interactive effect of four selected variables including rice husk proportion, temperature, CH4 concentration and incubation time was studied with Box-Behnken Design (BBD) adopting Response Surface Methodology (RSM) to optimize the conditions for CH4 oxidation. In this study, the maximum CH4 oxidation potential of 76.83μgCH4g(-1)dwh(-1) was observed under optimum conditions with rice husk amendment of 6% (w/w), 5h incubation time at 40°C temperature with 40% (v/v) initial CH4 concentration. The results for CH4 oxidation potential also advocated the suitability of rice husk amendment in biocover system to curb emitted CH4 from landfills/open dumpsite over conventional clay or sand cover on supplying CH4 and O2 to microbes on maintaining proper aeration.

Microglia-derived HIV Nef+ exosome impairment of the blood-brain barrier is treatable by nanomedicine-based delivery of Nef peptides

The negative factor (Nef) of human immunodeficiency virus (HIV) is an accessory protein that is thought to be integral to HIV-associated immune- and neuroimmune pathogenesis. Here, we show that nef-transfected microglia-released Nef+ exosome (exNef) disrupts the apical blood-brain barrier (BBB) and that only nef-transfected microglia release Nef in exosomes. nef-gfp-transduced neurons and astrocytes release exosomes but did not release exNef in the extracellular space. Apical administration of exNef derived from nef-transfected 293T cells reduced transendothelial electrical resistance (TEER) and increased permeability of the BBB. Microglia-derived exNef applied to either the apical/basal BBB significantly reduced expression of the tight junction protein, ZO-1, suggesting a mechanism of exNef-mediated neuropathogenesis. Microglia exposed to exNef release elevated levels of Toll-like receptor-induced cytokines and chemokines IL-12, IL-8, IL-6, RANTES, and IL-17A. Magnetic nanoparticle delivery of Nef peptides containing the Nef myrisolation site across an in vitro BBB ultimately reduced nef-transfected microglia release of Nef exosomes and prevented the loss of BBB integrity and permeability as measured by TEER and dextran-FITC transport studies, respectively. Overall, we show that exNef is released from nef-gfp-transfected microglia; exNef disrupts integrity and permeability, and tight junctions of the BBB, and induces microglial cytokine/chemokine secretion. These exNef-mediated effects were significantly restricted by Nef peptides. Taken together, this study provides preliminary evidence of the role of exNef in HIV neuroimmune pathogenesis and the feasibility of a nanomedicine-based therapeutics targeting exNef to treat HIV-associated neuropathogenesis.

Dentigerous Cysts of Maxillofacial Region– Clinical, Radiographic and Biochemical Analysis

Background Dentigerous cyst is the second most common type of odontogenic cysts that encloses the crown of an unerupted tooth by expansion of its follicle due to the collection of cystic fluid. In view of the capability of these lesions attaining a marked size if not diagnosed early and treated properly, the present study was done based on the clinical and radiographic presentation of the dentigerous cyst in addition to the analysis of the cystic contents.Objective The present study reported 14 cases of dentigerous cysts (DC) with their incidence and relative distribution of the maxillofacial region along with the clinical and radiographic features and biochemical analysis of cystic fluid.Method The study was conducted at Sri Govind Tricentenary Dental College, Hospital and Research Institute, Gurgaon, Haryana for a period of one year and six months. A detailed case history and thorough clinical examination was done for the patients who were provisionally found to have odontogenic cysts. Necessary radiographs, aspiration of the cystic fluid and incisional biopsy were performed to the 14 patients who were provisionally diagnosed with dentigerous cysts (DC) after obtaining the informed consent and the cystic fluid was subjected to biochemical analysis.Results Majority of the affected patients with DC were in their second decade and showed more predilection for mandible with a male predominance. The area of predilection was third molar region in the mandible and it is the canine region in maxilla. All the cases were associated with impacted teeth and majority showed expansion of the buccal/labial cortical plate. The various biochemical variables (total protein content, albumin, globulin and albumin: globulin ratio) were also assessed in the present study.Conclusion The awareness of protean features of DC evident through this study is essential for the general as well as specialty practitioners for the accurate diagnosis and proper treatment planning of these non cancerous but potentially destructive lesions and also opens new avenues for further research.Kathmandu University Medical Journal Vol.13(1) 2015; 8-11

Association of Mycobacterium tuberculosis in the causation of Eales' disease: an institutional experience

BACKGROUND

Eales' disease is an idiopathic retinal vasculitis characterized by retinal inflammation, ischemia, and neo-vascularisation. It frequently causes massive vitreous haemorrhage and retinal detachment leading to blindness. Although the exact etiology is unknown, this condition is considered to be a consequence of hypersensitivity reaction to tubercular protein due to previous Mycobacterium tuberculosis (M. tuberculosis) infection. This study is aimed at the detection of association of M. tuberculosis in patients with Eales' disease.

MATERIALS AND METHODS

A prospective case-control study was undertaken in 65 clinically diagnosed cases of Eales' disease. Patients with proliferative diabetic retinopathy, neo-vascular proliferation, macular oedema, premacular fibrosis and tractional retinal detachment were taken as controls. M. tuberculosis DNA was detected (MPT64 gene by polymerase chain reaction, PCR) in patients with Eales' disease. Clinical symptoms along with tuberculin skin test (TST) and erythrocyte sedimentation rate (ESR) were used as gold standard for comparing results of PCR.

RESULT

PCR positivity was found in 12 (38.7%) patients with Eales' disease. The PCR positivity was significantly associated with the patients with high TST reading and high ESR values.

CONCLUSION

Patients with a high TST reading and ESR value and a positive PCR in vitreous samples have a high likelihood of having M. tuberculosis as an etiology.

Effect of thyroid on lipid profile and renal function: an observational study from tertiary care centre of tribal region of bastar

Background:

Thyroid hormone is a key substance in normal homeostasis, having variable influence on cell metabolism on different organs. Very little is known about the prevalence of thyroid disorders from our region.

Aim:

This study was conducted with the aim of finding prevalence of thyroid disorder and relation of thyroid hormone with renal function and cholesterol metabolism.

Subjects and Methods:

A total of 96 ambulatory patients were taken for study. Serum samples were collected and evaluated for triiodothyronine, thyroxine, thyroid-stimulating hormone, urea, creatinine, total cholesterol, triglyceride (TG), low density lipoprotein (LDL), very low density lipoprotein and high density lipoprotein (HDL). Analysis of variance and t-test were used to find a significant difference among the groups.

Results:

Prevalance of thyroid disorder among suspected patients was 64/96 (66%), of which 36/64 (56.3%) were hypothyroid and 28/64 (43.8%) were hyperthyroid. No relation was found with renal function, but cholesterol was found high (>250 mg/dl) among hypothyroid patients and significant increase in TG, LDL levels and significant decrease was in HDL.

Conclusion:

Thyroid disorder is high among subjects with hypercholesterolemia. This underscores the need to evaluate for thyroid disorder in hypercholesterolemic patients and vice-versa.

Seasonal trends in organochlorine pesticide residues in raw bovine milk from rural areas of Haryana, India

Seasonal trends in organochlorine pesticides residues namely, 1,2,3,4,5,6-hexachlorocyclohexane (HCH) isomers, 1,1,1-trichloro-2,2-bis (p-chlorophenyl) ethane (DDT) and its metabolites and endosulfan stereo isomers were investigated in raw bovine milk samples from rural areas of Ambala, Gurgaon and Hisar districts of the state of Haryana for winter, summer, and post-monsoon seasons. Highest concentration of HCH and DDT was found in 43 % and 53 % milk samples, respectively in post-monsoon season whereas highest values of endosulfan was reported in 36 % samples during winter season. During the study period only 2 % milk samples exceeded the maximum residue limit recommended by WHO for ΣHCH, 1 % samples each for α-HCH and γ-HCH, 9 % samples for β-HCH as recommended by PFAA and 30 % samples for ΣDDT as prescribed by FAO. No statistical difference in the mean concentration of ∑HCH and ∑Endosulfan could be observed in any of the three districts. However, ∑DDT concentration showed marked difference [F(2, 25) = 12.42, p = 0.00018)] among the three districts.

Power generation in microbial fuel cell fed with post methanation distillery effluent as a function of pH microenvironment

The effect of anolyte and catholyte pH on power generation in an MFC using post methanation distillery effluent (PMDE) was studied in batch mode. Higher anodic pH (7-9) and low cathodic pH (2) were more favorable and at the optimal cathode:anode pH ratio of 2:8, power density attained was 0.457 W/m(3). An initial feed solution pH up to 10 was tolerated by the MFC. However, internal resistance increased 1.5 times and power density decreased by 60% at pH 10 as compared to that at pH 7, the normal anolyte pH. Internal resistance of the MFC was minimum (266 ohms) at cathodic pH 2, thus favoring better power generation. Under low cathodic and high anodic pH ratio of the MFC, a low internal resistance favored both high current density and power density.

Management of children with severe acute malnutrition: experience of Nutrition Rehabilitation Centers in Uttar Pradesh, India

OBJECTIVE

To assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in Nutrition Rehabilitation Centers (NRC).

DESIGN

Review of data.

SETTING

12 NRCs in Uttar Pradesh, India.

PARTICIPANTS

Children admitted to NRCs (Jan 1, 2010 - Dec 31, 2011).

INTERVENTION

Detection and treatment of SAM with locally-adapted protocols.

OUTCOMES

Survival, default, discharge, and recovery rates.

RESULTS

54.6% of the total 1,229 children admitted were boys, 81.6% were in the age group 6-23 months old, 86% belonged to scheduled tribes, scheduled castes, or other backward castes, and 42% had edema or medical complications. Of the 1,181 program exits, 14 (1.2%) children died, 657 (47.2%) children defaulted, and 610 (51.7%) children were discharged The average (SD) weight gain was 12.1 (7.3)g/kg body weight/day and the average (SD) length of stay was 13.2 (5.6) days. 206 (46.8%) children were discharged after recovery (weight gain >15%) while 324 (53.2%) were discharged, non-recovered (weight gain <15%).

CONCLUSIONS

NRCs provide life-saving care for children with SAM; however, the protocols and therapeutic foods currently used need to be improved to ensure the full recovery of all children admitted.