Association of Vitamin D Levels and type 2 Diabetes Mellitus in Asian Indians is Independent of Obesity

Background A large proportion of subjects with type 2 diabetes mellitus (T2DM) in India are non-obese. Asian-Indian subjects with diabetes have been shown to have low vitamin D levels. Whether low vitamin D levels and T2DM in Asian-Indians is attributable to the associated obesity as in caucasians is unclear. Hence we studied the association of vitamin D levels and T2DM in Asian-Indians with or without obesity.

Methods Total of 213 subjects were recruited in four groups, group 1-Non-obese diabetic, group 2-Non-obese non-diabetic, group 3-Obese diabetic and group 4-Obese non-diabetic. Subjects recruited under various groups were matched for age and sex. Anthropometry, skin-fold thickness, fasting and postprandial plasma glucose, HbA1c, fasting insulin, lipids and vitamin D levels were measured in all study subjects and were compared between the groups.

Results Mean age of study population was 41.23±7.43 years. Mean BMI in groups 1,2,3 and 4 was 21.34±1.41, 20.53±2.27, 27.72±2.94 and 27.62±3.37 kg/m2 respectively. Overall 64.3% study subjects had vitamin D deficiency and 27.7% had insufficient vitamin D levels. Significantly lower vitamin D levels were found in diabetic groups 1 and 3 compared to non-diabetic groups 2 and 4. No significant difference was observed in vitamin D levels between groups 1 and 3. Similarly, no significant difference was observed in vitamin D levels between groups 2 and 4. Vitamin D levels did not show any significant correlation with BMI, waist or body fat.

Conclusion Vitamin D levels do not appear to be related to obesity in diabetic as well non-diabetic Asian-Indian individuals.

Preclinical Evaluation of Haemosorbents

The selection of assessment procedures for the preclinical evaluation of haemosorbents and the relationship between such procedures and the intended application are exemplified by examination of the design and utilization of procedures based on the rat. Procedures are described for haemoperfusion and for membrane plasma separation followed by on-line sorbent treatment of plasma (plasma perfusion).

These procedures are suitable for single or repeated use, with the animal in an unrestrained and conscious state. The relevance to the intended application is demonstrated with respect to artificial liver support by the ability of rat extracorporeal circuits to provide information on the relationship between sorbent properties and liver regeneration as determined by the proliferative response following partial hepatectomy.

Pilot feasibility study to detect mesenchymal stem cell biomarkers of bronchopulmonary dysplasia in the tracheal aspirate fluid of preterm infants

OBJECTIVE

This study aimed to detect novel mesenchymal stem cell peptides/biomarkers of bronchopulmonary dysplasia (BPD) in the tracheal aspirate fluid (TAF) of preterm infants.

STUDY DESIGN

Participants included infants less than 32 weeks' gestational age or birth weight under 1500 grams who required endotracheal intubation and mechanical ventilation within first 24 hours of life. TAF sample collection was performed at the time of the first clinically indicated routine suctioning. Standardization curves for human levels of osteopontin (Opn), macrophage colony stimulating factor 1 (Csf1), transforming growth factor beta 1 (TGF-β1), and secretory immunoglobulin A (sIgA) were generated for 15 enrolled participants.

RESULTS

We demonstrated that stem cell biomarkers are secreted into the TAF of preterm infants and their concentrations can be easily measured during the first week of life.

CONCLUSIONS

Further studies are warranted to determine a causal relationship between these biomarkers and BPD development and severity.

Development of metabolic syndrome in high-sucrose diet fed rats is not associated with decrease in adiponectin levels

PURPOSE

Association of circulating adiponectin levels with metabolic syndrome has been controversial, with studies reporting low as well as high circulating adiponectin levels in metabolic syndrome. Present study aims to examine prospectively the course of circulating adiponectin levels during development of metabolic syndrome in a diet-induced rat model of metabolic syndrome.

METHODS

In a prospective study, eight-week-old male wistar rats were randomized into two groups (n = 24 each). Group A: standard chow diet and group B: high sucrose diet. Body weight, total and high molecular weight (HMW) adiponectin and insulin levels were measured during the study. Oral fat and glucose tolerance tests were done during the study at various time points from weeks 2 to 26. Visceral fat, subcutaneous fat, and adiponectin levels were also measured at week 48 in some of the rats.

RESULTS

Significantly higher total adiponectin levels were found from week 2 to 26 in group B compared to group A (P = <0.05), whereas HMW adiponectin levels were similar in both the groups. Postprandial triglycerides, obesity, insulin resistance, and glucose intolerance were also found to be significantly higher in group B compared to group A during this period (P = <0.05). Total adiponectin levels of week 26 showed significant positive correlation with preceding postprandial triglyceride burden in group B (r = 0.60, P = 0.002).

CONCLUSION

In conclusion, the present study finds that development of metabolic syndrome in high-sucrose diet fed rats is not associated with decrease in circulating adiponectin levels.

Correlations between preparation methods, structural features and electrochemical Li-storage behavior of reduced graphene oxide

Wide differences in the structural features of graphenic carbon, especially in the case of reduced graphene oxides (rGO), are expected to have considerable impacts on the properties, thus leading to significant scatter and poor understanding/prediction of their performances for various applications, including as electrode materials for electrochemical Li-storage. In this context, the present work develops a comprehensive understanding (via thorough experimentation, including in situ X-ray diffraction studies, and analysis) on the effects of graphene oxide (GO) reduction methods/conditions on the structural features (mainly 'graphenic' ordering) and concomitant influences of the same on electrochemical Li-storage behavior. 'Moderately oxidized' GO (O/C ∼0.41) was reduced via three different methods, viz., (i) using hydrazine hydrate vapor at room temperature (rGO-H; O/C ∼0.23), (ii) thermal reduction by annealing at just 500 °C (rGO-A; O/C ∼0.20) and (iii) hydrazine treatment, followed by the same annealing treatment (rGO-HA; O/C ∼0.17). Raman spectroscopy, in situ X-ray diffraction recorded during annealing and high resolution TEM imaging indicate that while GO and rGO-H had considerable defect contents [I(D)/I(G) ∼1.4 for rGO-H], including a very non-uniform interlayer spacing (varying between 3.1 and 3.6 Å), the 500 °C annealed rGO-A and rGO-HA had significantly reduced defect contents [I(D)/I(G) ∼0.6] and near-perfect 'graphenic' ordering with a uniform interlayer spacing of ∼3.35 Å. Despite the nanoscaled dimensions, defect structures, especially the non-uniform interlayer spacing, resulted in relatively poor reversible Li-capacity and rate capability for the non-annealed rGO-H, even in comparison to the bulk graphitic carbon. By contrast, the annealed rGOs, especially the rGO-HA, not only possessed a superior reversible Li-capacity of ∼450 mA h g^-1 (at C/20), but also exhibited a significantly improved rate capability (even compared to most rGOs reported in the literature), retaining ∼120 mA h g^-1 along with flat potential profile (below ∼0.2 V against Li/Li⁺) even at 10C (as possibly never reported before with graphitic/graphenic carbons).

Comparative Study of Outcome of Endoscopic Myringoplasty in Active and Inactive Mucosal Chronic Otitis Media Patients

The objective of this study was to compare graft uptake and hearing improvement in active and inactive mucosal chronic otitis media patients after endoscopic myringoplasty. This is prospective study conducted at a government medical college and hospital from February 2014 to August 2015. A total of 40 active (wet) ears with mucoid discharge and 40 inactive (dry) ears (at least 6 weeks dry before surgery) with mucosal chronic otitis media were operated on by endoscopic myringoplasty by transcanal approach. Graft uptake and hearing gain rates 3 months after surgery were compared for both groups. Endoscopic myringoplasty using temporal fascia graft via transcanal approach was used. The graft take rate was 77.5% for the active ear group and 85% for the inactive ear group. The hearing gain rate was 82.5% for the inactive ear group and 72.5% for the active ear group. Differences were found to be statistically insignificant for both graft uptake and hearing gain. The success of endoscopic myringoplasty is not adversely affected by the presence of mucoid ear discharge at the time of surgery, and outcomes are comparable to those of the operation done for inactive ear.

Prevalence of hypogonadism in male Type 2 diabetes mellitus patients with and without coronary artery disease

AIM

The present study is carried out to investigate hypogonadism using serum testosterone levels in male Type 2 diabetes mellitus (T2DM) subjects with and without coronary artery disease (CAD).

SUBJECTS AND METHODS

A total of 150 age and body mass index-matched male subjects in the age group of 30-70 years were recruited in three groups; Group A - subjects with normal glucose tolerance, Group B - T2DM subjects without CAD, and Group C - T2DM subjects with CAD (n = 50 each group). Subjects with CAD were diagnosed on the basis of electrocardiogram, treadmill testing, stress echocardiography, or coronary angiography. Total testosterone (TT), free testosterone (FT), bioavailable testosterone, calculated FT and glycemic parameters were measured and compared between all the three study groups. One-way ANOVA followed by post hoc Tukey's test and Pearson's coefficient of correlation tests were used for analysis.

RESULTS

Hypogonadism (TT <3 ng/ml) was observed in 40% (20/50) of subjects in Group C and 32% (16/50) of subjects in Group B as compared to only 14% (7/50) of subjects in Group A (Groups A vs. B; P = 0.055, Groups A vs. C; P = 0.006 and Groups B vs. C; P = 0.53). Group C subjects had significantly lower levels of TT (3.55 ± 1.46 ng/ml vs. 4.73 ± 2.17 ng/ml, P = 0.005), calculated FT (0.062 ± 0.0255 pg/ml vs. 0.0951 ± 0.0508 pg/ml, P ≤ 0.001), and bioavailable testosterone (1.48 ± 0.65 ng/ml vs. 2.18 ± 1.20 ng/ml, P ≤ 0.001) compared to control Group A subjects. There was no significant difference in any of the testosterone parameters between Groups A and B. Furthermore, an overall positive correlation was found between hypogonadism and CAD (r = 0.177, P = 0.030, n = 150).

CONCLUSION

We observed hypogonadism as indicated by low testosterone levels in a significant proportion of male T2DM subjects with CAD.

Cation/Anion Substitution in Cu2ZnSnS4 for Improved Photovoltaic Performance

Cations and anions are replaced with Fe, Mn, and Se in CZTS in order to control the formations of the secondary phase, the band gap, and the micro structure of Cu2ZnSnS4. We demonstrate a simplified synthesis strategy for a range of quaternary chalcogenide nanoparticles such as Cu2ZnSnS4 (CZTS), Cu2FeSnS4 (CFTS), Cu2MnSnS4 (CMTS), Cu2ZnSnSe4 (CZTSe), and Cu2ZnSn(S0.5Se0.5)4 (CZTSSe) by thermolysis of metal chloride precursors using long chain amine molecules. It is observed that the crystal structure, band gap and micro structure of the CZTS thin films are affected by the substitution of anion/cations. Moreover, secondary phases are not observed and grain sizes are enhanced significantly with selenium doping (grain size ~1 μm). The earth-abundant Cu2MSnS4/Se4 (M = Zn, Mn and Fe) nanoparticles have band gaps in the range of 1.04-1.51 eV with high optical-absorption coefficients (~104 cm-1) in the visible region. The power conversion efficiency of a CZTS solar cell is enhanced significantly, from 0.4% to 7.4% with selenium doping, within an active area of 1.1 ± 0.1 cm2. The observed changes in the device performance parameters might be ascribed to the variation of optical band gap and microstructure of the thin films. The performance of the device is at par with sputtered fabricated films, at similar scales.

Photocatalytic activity of V doped ZnO nanoparticles thin films for the removal of 2- chlorophenol from the aquatic environment under natural sunlight exposure

Vanadium doped ZnO powders were used as precursors to deposit thin films of V(5+) incorporated ZnO nanoparticles on glass substrates by the pulsed laser deposition technique. The observed variations in Raman signals, visible region shift in the diffuse reflectance spectra along with a small shift in the (101) reflections of the X-ray diffraction (XRD) confirmed the insertion of V(5+) ions in ZnO lattice. No other additional reflection in the XRD results other than ZnO further endorsed the occupation of lattice positions by V entities rather than independent oxide formation. The asymmetric XPS peaks of Zn2p and V2p core levels confirmed the existence of both in the vicinity. The existence of minimal proportion of V(3+) along with V(5+) states varied the alteration of the oxidation states V in the synthetic route. The SEM images at various resolutions displayed the uniform distribution identical nanoparticles without the presence of additional phases in the deposited films. The SEM cross-section measurements revealed the uniform thickness of ∼90 nm of each film, whereas the surface studies of the films were performed by AFM. The as-synthesized films were tested for photocatalytic activity in sunlight illumination for the removal of 2-chlorophenol. The unique feature of the study was the estimation of the photocatalytic activity 20 ppm of 2-chlorophenol by exposing the low exposed area. The degradation of the substrate was measured by liquid phase UV-vis spectroscopy, whereas total organic carbon measurement revealed the mineralization of the substrate. The released Cl(-) ions were also measured by ion chromatography. The estimated flatband potentials and pHzpc values of the V doped materials, by Mott-Schottky analysis and zeta potential measurements respectively, were correlated with the photocatalytic activity. The kinetics of the photocatalytic degradation/mineralization process was estimated and results were correlated with the plausible mechanism.

Risk factors associated with increased prevalence of abdominal aortic aneurysm in women

Background

Four randomized trials of men aged 65–80 years showed that aneurysm-related mortality was reduced by 40 per cent by ultrasound screening. Screening is considered economically viable when the prevalence of abdominal aortic aneurysm (AAA) is 1·0 per cent or higher. This is not the case for women, in whom the prevalence of AAA is less than 1 per cent. The aim of the present investigation was to determine the prevalence of AAA 3·0 cm or larger in women screened with ultrasound imaging, the risk factors associated with AAA in this population, and whether high-risk groups can be identified with an AAA prevalence of 1 per cent or greater.

Methods

Demographic data and risk factors were collected from the first 50 000 women who attended for private cardiovascular screening in the UK. Tests included ultrasound screening for AAA, ankle : brachial pressure index (ABPI), carotid duplex imaging for carotid atherosclerosis, and electrocardiography for atrial fibrillation.

Results

AAA was detected in 82 of 50 000 women screened; these aneurysms were rare below the age of 66 years (7 of 24 499). In the 66–85-years age group there were 72 AAAs in 25 170 women (0·29 per cent). Univariable analysis demonstrated that a history of stroke/transient ischaemic attack (TIA), hypertension, smoking, atrial fibrillation, ABPI of less than 0·9 and internal carotid artery stenosis of at least 50 per cent were associated with an increased prevalence of AAA (P &lt; 0·001). In multivariable linear logistic regression of risk factors, age 76 years or more, history of stroke/TIA, hypertension and smoking were independent predictors of AAA. This model had an area under the receiver operating characteristic (ROC) curve (AUC) of 0·711 (95 per cent c.i. 0·649 to 0·772) and could identify 2235 women who had 22 AAAs (prevalence 0·98 per cent). By adding ABPI, atrial fibrillation and carotid stenosis, the prediction improved to an AUC of 0·775 (0·724 to 0·826). This model could identify 3701 women who had 58 AAAs (prevalence 1·57 per cent).

Conclusion

This report should stimulate consideration of a targeted AAA screening programme for women aged over 65 years.

An Unexpected Complication of Residual Fibular Strut Graft While Performing A Press fit Hemiarthroplasty for A Secondary Nonunion Fracture Neck of the Femur

INTRODUCTION

Perioperative complications are well known during partial and total hip arthroplasty. One of the common categories of these complications is an intraoperative fractures of the proximal femur. Here we discuss a case of perforation of posteromedial cortex of the proximal femur, while doing a press fit modular bipolar hemiarthroplasty, in a young adult with secondary nonunion of the femoral neck fracture. The cause of this proximal femur perforation was residual fibular strut graft that, redirected the femoral stem into undesirable direction. This complication of residual fibular strut graft has not been disscussed much in the orthopedic literature previously.

CASE REPORT

A press fit modular bipolar hiparthroplasty was performed in a young adult male with nonunion fracture neck of the femur secondary to initial fixation using 6.5mm cannulated hip screws and nonvascularized free fibular strut grafting. Failure to completely remove the fibular strut from the proximal femur lead to difficult negotiation of the femoral stem into the femoral canal and ultimately a perforation in the proximal femur at the level of the lesser trochanter. A revision procedure was done to completely remove the residual fibular graft, and then a fresh press fit modular bipolar hemiarthroplasty was done.

CONCLUSION

Complete removal of fibular strut graft should be done, while performing hip arthroplasty in patients with failed fibular grafting for fracture neck of the femur.

The effect of cerium alteration on the photocatalytic performance of WO3 in sunlight exposure for water decontamination

In an effort to enhance the photocatalytic activity of cubic WO₃ in sunlight exposure, its surface was modified by impregnating the Ce³⁺ ions ranging from 1% to 25% with a step of 5% with respect to the weight of WO₃.