Synthesis of NiS–Graphene Nanocomposites and its Electrochemical Performance for Supercapacitors

The aim of this work is to synthesize nickel sulfide–graphene (NiS/G) nanocomposites with different compositions and to analyze the structural and electrochemical capacity and compatibility for their application as supercapacitor material with enhanced charge storage capacity and reduced impedance. NiS nanoparticles (NPs) loaded on graphene were synthesized at various concentrations of graphene by a simple hydrothermal route from nickel sulphate and graphene oxide as precursors in the presence of PVP as surfactant and thioacetamide (TAA) as sulfur source. The composites structural, morphological and physical properties were analyzed by X-ray diffraction (XRD), Field Emission Scanning Electron Microscopy (FE-SEM), Energy-dispersive X-ray spectroscopy, X-ray photoelectron spectroscopy (XPS) and Fourier Transform-infrared (FT-IR) analysis. SEM measurements showed the presence of surface attachment of the NiS NPs onto the graphene sheets. To assess the properties of the nanocomposites for their applicability in supercapacitors, electrochemical analysis was carried out in 6[Formula: see text]M KOH electrolyte. Three different samples with different graphene contents — GNiS-10 with 10 wt.%, GNiS-20 with 20 wt.% and GNiS-40 with 40 wt.% were prepared. The specific capacitances obtained for the nanocomposites were calculated to be 84.33[Formula: see text]F/g, 129.66[Formula: see text]F/g, 187.53[Formula: see text]F/g at 10[Formula: see text]mV/s scan rate, respectively. The EIS data showed that the loading of NiS NPs on graphene caused the reduction in impedance at high frequency and has a long cycle life (over 1000 cycles).

Effect of Thrombotic Microangiopathy on Clinical Outcomes in Indian Patients With Lupus Nephritis

INTRODUCTION

In addition to glomerular lesion, renal vascular lesion is also an important prognostic marker of lupus nephritis (LN). Among patients with various vascular changes, individuals with thrombotic microangiopathy (TMA) present with severe clinical manifestations and have a high mortality. The aim of the present study was to assess the spectrum and impact of TMA on the outcomes of LN. In a prospective observational study of 2.5 years' duration, clinical and renal histopathological data regarding biopsy-proven LN were noted, and evaluation for antiphospholipid syndrome (APS) as a cause of TMA in LN was also carried out.

METHODS

Study subjects were followed up actively for 6 months, and various outcomes were noted. Cases were divided into 2 groups as LN with TMA and LN without TMA, and various features were compared between the 2 groups. Outcomes recorded were complete response (CR), partial response (PR), treatment failure, and death.

RESULTS

Of the 197 patients with LN, 50 patients (25.4%) were diagnosed with co-existing renal TMA. Five patients (10%) were found to have concomitant APS. As compared to patients without TMA, those with TMA had significantly higher rates of oliguria (P = 0.035), advanced renal injury, that is, serum creatinine > 3mg/dl (P = 0.002), fibrocellular and fibrous crescents (P = 0.01), and tubular atrophy (P = 0.001). Outcomes included CR in 15 patients (30%), PR in 10 (20%), failure in 19 (38%), and death in 6 (12%). Patients with LN with TMA had higher rates of treatment failure (P = 0.02) compared to the group without TMA.

DISCUSSION

The presence of TMA in patients with LN is associated with adverse clinicopathological presentation and poor outcome.

Noise-induced cochlear synaptopathy in rhesus monkeys (Macaca mulatta)

Cochlear synaptopathy can result from various insults, including acoustic trauma, aging, ototoxicity, or chronic conductive hearing loss. For example, moderate noise exposure in mice can destroy up to ∼50% of synapses between auditory nerve fibers (ANFs) and inner hair cells (IHCs) without affecting outer hair cells (OHCs) or thresholds, because the synaptopathy occurs first in high-threshold ANFs. However, the fiber loss likely impairs temporal processing and hearing-in-noise, a classic complaint of those with sensorineural hearing loss. Non-human primates appear to be less vulnerable to noise-induced hair-cell loss than rodents, but their susceptibility to synaptopathy has not been studied. Because establishing a non-human primate model may be important in the development of diagnostics and therapeutics, we examined cochlear innervation and the damaging effects of acoustic overexposure in young adult rhesus macaques. Anesthetized animals were exposed bilaterally to narrow-band noise centered at 2 kHz at various sound-pressure levels for 4 h. Cochlear function was assayed for up to 8 weeks following exposure via auditory brainstem responses (ABRs) and otoacoustic emissions (OAEs). A moderate loss of synaptic connections (mean of 12-27% in the basal half of the cochlea) followed temporary threshold shifts (TTS), despite minimal hair-cell loss. A dramatic loss of synapses (mean of 50-75% in the basal half of the cochlea) was seen on IHCs surviving noise exposures that produced permanent threshold shifts (PTS) and widespread hair-cell loss. Higher noise levels were required to produce PTS in macaques compared to rodents, suggesting that primates are less vulnerable to hair-cell loss. However, the phenomenon of noise-induced cochlear synaptopathy in primates is similar to that seen in rodents.

Cockroach allergen serine proteinases: Isolation, sequencing and signalling via proteinase-activated receptor-2

BACKGROUND

Allergy to the German cockroach (Blattella germanica) is a significant asthma risk factor for inner-city communities. Cockroach, like other allergens, contains trypsin-like enzyme activity that contributes to allergenicity and airway inflammation by activating proteinase-activated receptors (PARs). To date, the enzymes responsible for the proteolytic activity of German cockroach allergen have not been characterized.

OBJECTIVES

We aimed to identify, isolate and characterize the trypsin-like proteinases in German cockroach allergen extracts used for clinical skin tests. For each enzyme, we sought to determine (1) its substrate and inhibitor enzyme kinetics (Km and IC50), (2) its amino acid sequence and (3) its ability to activate calcium signalling and/or ERK1/2 phosphorylation via PAR2.

METHODS

Using a trypsin-specific activity-based probe, we detected three distinct enzymes that were isolated using ion-exchange chromatography. Each enzyme was sequenced by mass spectometery (deconvoluted with an expressed sequence tag library), evaluated kinetically for its substrate/inhibitor profile and assessed for its ability to activate PAR2 signalling.

FINDINGS

Each of the three serine proteinase activity-based probe-labelled enzymes isolated was biochemically distinct, with different enzyme kinetic profiles and primary amino acid sequences. The three enzymes showed a 57%-71% sequence identity with a proteinase previously cloned from the American cockroach (Per a 10). Each enzyme was found to activate both Ca⁺⁺ and MAPK signalling via PAR2.

CONCLUSIONS AND RELEVANCE

We have identified three different serine proteinases from the German cockroach that may, via PAR2 activation, play different roles for allergen sensitization in vivo and may represent attractive therapeutic targets for asthma.

Erythema Necroticans - A Case Report

Erythema Nodosum Leprosum (ENL) is characterized by evanescent, erythematous, painful raised nodules which fade within 48-72 hours. Necrotic and ulcerative forms are rare presentations of severe ENL. A 27 year old male patient presented with multiple erythematous nodules on trunk and extremities associated with high grade fever, joint pain and pedal edema. Patient developed ulceration of nodules associated with pain and burning sensation over another 3 days. Slit smear showed clumps of granular bacilli. Biopsy showed superficial dermis showing edema with dense focal perivascular infiltrate of lymphocytes, macrophages and few scattered neutrophils. Fite-Faraco stain was negative. Patient was diagnosed as a case of erythema necroticans and started on oral steroids and thalidomide. The histological findings illustrate the need to consider leprosy diagnosis in necrotizing vasculitis even when Virchow's cells are not found in the infiltrate. Thalidomide is the drug of choice in such cases. This patient showed a marked response to the drug with healing of all ulcers within 2 weeks of starting thalidomide.

Neuropathies in the Rheumatoid Patient: A Case of the Heavy Hand

Rheumatoid Arthritis (RA) is a common inflammatory arthritis' with pain and loss of function among its most disabling symptoms. These are mostly secondary to inflammation or mechanical damage to the joints. However it is also important to consider disease complications as a cause of symptoms, especially when the response to treatment is suboptimal. We report an RA patient whose symptoms were resistant to standard therapy, and were actually due to peripheral neuropathy.

Collapsing glomerulopathy in a case of anti-neutrophil cytoplasmic antibody associated vasculitis

Collapsing glomerulopathy (CG) is a pathological entity characterized by collapse and wrinkling of glomerular tuft, podocyte dedifferentiation and hyperplasia. CG may be idiopathic or secondary to other diseases. CG has been described with IgA nephropathy, membranous glomerulopathy, diabetic nephropathy, and lupus nephritis. However, till date there is no report of CG in association with the anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Here, we present a case of CG that developed during follow-up in a case of AAV with biopsy proven pauci-immune glomerulonephritis.

An unusual case of cocoon abdomen in a patient on hemodialysis

“Cocoon abdomen” or sclerosing encapsulating peritonitis is a rare cause of intestinal obstruction. It has been described in patients on continuous ambulatory peritoneal dialysis. The exact etiology is unknown, but pathogenesis rests on chronic peritoneal inflammation. No case has been reported so far in patients on hemodialysis. We hereby report a case of cocoon abdomen presenting as refractory ascites with intestinal obstruction in a patient on maintenance hemodialysis.

Plasma exchange in Immunoglobulin A nephropathy with thrombotic microangiopathy and acute cortical necrosis

A 25-year-old female presented with decreased urine output, deranged renal function, thrombocytopenia, and hemolytic anemia. Kidney biopsy was consistent with thrombotic microangiopathy with acute cortical necrosis and Immunoglobulin A nephropathy (IgAN). Hemolytic anemia, thrombocytopenia and urine output improved after five sessions of plasma exchange. Renal function showed a delayed recovery and serum creatinine normalized by 3 months. This is first case of successful use of plasma exchange in hemolytic uremic syndrome with cortical necrosis associated with IgAN.

Standards for TB care in India: A tool for universal access to TB care

In 2014, Government of India in collaboration with World Health Organization Country Office for India released the policy document on Standards for tuberculosis (TB) care in India after in-depth deliberation with national and international experts. The standards for TB care represent what is expected for quality TB care from the Indian healthcare system including both public and private systems. The details of each standard have been compiled in this review article. It is envisioned that the standards detailed in the manuscript are adapted by all TB care providers across the country.

Modulating role of pheromonal cues from oestrus-specific urine on 3-methylcholanthrene-induced male reproductive toxicity

Polyaromatic hydrocarbons (PAHs) are persistent organic pollutants that contribute to endocrine/gonadal disruption. This study was designed to investigate the endocrine modulating role of pheromones in alleviating the reproductive toxic effects of 3-MC (3-methylcholanthrene), one of the common PAHs, in rat model. The rats were injected intraperitoneally with 3-MC at a dose of 25 mg kg(-1) BW. The serum levels of testosterone and other biochemical parameters were altered to significant levels in 3-MC-treated rats and oestrus-specific urine exposure restored all these effects to near normal. Although testis weight did not indicate any significant change, sperm and spermatid counts were significantly reduced in 3-MC-treated rats, which became normal in oestrus-urine-exposed rats. Hence, this study suggests that oestrus-specific urinary pheromones have the potential to modulate the endocrine system and alleviate the male reproductive toxic effects produced by 3-MC.

A study on male homosexual behavior

INTRODUCTION

Male homosexual behavior carries a high risk of transmitting sexually transmitted infections (STIs). Ignorance regarding the associated high risk, indulgence inspite of no natural homosexual orientation and not using protective barrier methods can affect the sexual health of adolescents and adults.

AIM

(1) To assess the proportion of men who have sex with men (MSM) having a natural homosexual orientation compared to those who had acquired the homosexual behavior initially under various circumstances (such as due to certain misconceptions, fear of having heterosexual contact, peer pressure, and influence of alcohol). (2) To assess the level of awareness regarding increased risk of transmission of STIs associated with homosexual behavior and regarding protective barrier methods.

MATERIALS AND METHODS

After obtaining consent from the subjects, questionnaire - based interview used for obtaining data for this observational (cross-sectional) study.

RESULTS

(1) Of the 50 subjects, only about 25% had interest in homosexual behavior prior to initial episode. (2) About 50% subjects indulged in homosexual behavior due to lack/fear of having heterosexual contact. (3) About 60% subjects believed that homosexual behavior carried relatively lower risk of acquiring STIs and 68% subjects have had unprotected contact. (4) About 70% subjects had only acquired this behavior and nearly 60% subjects were interested in heterosexual marriage and not interested in further homosexual behavior.

CONCLUSION

(1) Homosexuality is a natural orientation in some and an acquired behavior in the rest. (2) If homosexual behavior is acquired, due to misconceptions, then imparting sex education and awareness regarding involved risks, and the importance of protective barrier methods will prevent ignorance driven behavior. For those with natural homosexual orientation, the importance of protective barrier methods in homosexual behavior needs emphasis.

Proliferative glomerulonephritis with monoclonal immunoglobulin deposition disease: The utility of routine staining with immunoglobulin light chains

Proliferative glomerulonephritis occurring as a consequence of monoclonal glomerular deposits of IgG is uncommon. It is a form of renal involvement in monoclonal gammopathy that mimics immune complex glomerulonephritis. Here, we report the first series of proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) from the Indian subcontinent highlighting use of light chain immunofluorescence (IF) in routine renal biopsy interpretation. We retrieved 6 patients diagnosed as proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) out of 160 biopsies (3.7%) with membranoproliferative patterns over 5 1/2 years (2009-2014), one of whom had recurrence 6 months post-renal transplant. Four (67%) patients presented with rapidly progressive renal failure and two (33%) with nephrotic syndrome. None of these patients had overt multiple myeloma. The predominant histologic pattern was membranoproliferative with all the biopsies showing IgG3 Kappa deposits on IF. The deposits were primarily subendothelial on electron microscopy.

Drug-induced acute interstitial nephritis: A clinicopathological study and comparative trial of steroid regimens

Steroids are used in the management of drug-induced acute interstitial nephritis (AIN). The present study was undertaken to compare the efficacy of pulse methyl prednisolone with oral prednisolone in the treatment of drug-induced AIN. Patients with biopsy-proven AIN with a history of drug intake were randomized to oral prednisolone (Group 1) 1 mg/kg for 3 weeks or a pulse methyl prednisolone (Group II) 30 mg/kg for 3 days followed by oral prednisolone 1 mg/kg for 2 weeks, tapered over 3 weeks. Kidney biopsy scoring was done for interstitial edema, infiltration and tubular damage. The response was reported as complete remission (CR) (improvement in estimated glomerular filtration rate [eGFR] to ≥60 ml/min/1.73 m(2)), partial remission (PR) (improvement but eGFR <60 ml/min/1.73 m(2)) or resistance (no CR/PR). A total of 29 patients, Group I: 16 and Group II: 13 were studied. Offending drugs included nonsteroidal anti-inflammatory drugs, herbal drugs, antibiotics, diuretic, rifampicin and omeprazole. There was no difference in the baseline parameters between the two groups. The biopsy score in Groups I and II was 5.9 ± 1.1 and 5.1 ± 1.2, respectively. At 3 months in Group I, eight patients each (50%) achieved CR and PR. In Group II, 8 (61%) achieved CR and 5 (39%) PR. This was not significantly different. Percentage fall in serum creatinine at 1 week (56%) was higher in CR as compared to (42%) those with PR. (P = 0.14). Patients with neutrophil infiltration had higher CR compared to patients with no neutrophil infiltration (P = 0.01). Early steroid therapy, both oral and pulse steroid, is equally effective in achieving remission in drug-induced AIN.

Mycosynthesis of silver and gold nanoparticles: Optimization, characterization and antimicrobial activity against human pathogens

This study was aimed to isolate soil fungi from Kolli and Yercaud Hills, South India with the ultimate objective of producing antimicrobial nanoparticles. Among 65 fungi tested, the isolate, Bios PTK 6 extracellularly synthesized both silver and gold nanoparticles with good monodispersity. Under optimized reaction conditions, the strain Bios PTK 6 identified as Aspergillus terreus has produced extremely stable nanoparticles within 12h. These nanoparticles were characterized by UV-vis. spectrophotometer, HR-TEM, FTIR, XRD, EDX, SAED, ICP-AES and Zetasizer analyses. A. terreus synthesized 8-20 nm sized, spherical shaped silver nanoparticles whereas gold nanoparticles showed many interesting morphologies with a size of 10-50 nm. The presence and binding of proteins with nanoparticles was confirmed by FTIR study. Interestingly, the myco derived silver nanoparticles exhibited superior antimicrobial activity than the standard antibiotic, streptomycin except against Staphylococcus aureus and Bacillus subtilis. The leakage of intracellular components such as protein and nucleic acid demonstrated that silver nanoparticles damage the bacterial cells by formation of pores, which affects membrane permeability and finally leads to cell death. Further, presence of nanoparticles in the bacterial membrane and the breakage of cell wall were also observed using SEM. Thus, the obtained results clearly reveal that these antimicrobial nanoparticles could be explored as promising candidates for a variety of biomedical and pharmaceutical applications.

Age-related differences in the use of total shoulder arthroplasty over time

We assessed the age-related differences in the use of total shoulder arthroplasty (TSA) and outcomes, and associated time-trends using the United States Nationwide Inpatient Sample (NIS) between 1998 and 2010. Age was categorised as < 50, 50 to 64, 65 to 79 and ≥ 80 years. Time-trends in the use of TSA were compared using logistic regression or the Cochran Armitage test.

The overall use of TSA increased from 2.96/100 000 in 1998 to 12.68/100 000 in 2010. Significantly lower rates were noted between 2009 and 2010, compared with between 1998 and 2000, for: mortality, 0.1% versus 0.2% (p = 0.004); discharge to an inpatient facility, 13.3% versus 14.5% (p = 0.039), and hospital stay > median, 29.4% versus 51.2% (p < 0.001).

The rates of use of TSA/100 000 by age groups, < 50, 50 to 64, 65 to 79 and ≥ 80 years were: 0.32, 4.62, 17.82 and 12.56, respectively in 1998 (p < 0.001); and 0.65, 17.49, 75.27 and 49.05, respectively in 2010 (p < 0.001) with an increasing age-related difference over time (p <  0.001). Across the age categories, there were significant differences in the proportion: discharged to an inpatient facility, 3.2% versus 4.2% versus 14.7% versus 36.5%, respectively in 1998 (p < 0.001) and 1.8% versus 4.3% versus 12.5% versus 35.5%, respectively in 2010 (p <  0.001) and the proportion with hospital stay > median, 39.7% versus 40.2% versus 53% versus 69%, respectively in 1998 (p < 0.001) and 17.2% versus 20.6% versus 28.7% versus 50.7%, respectively in 2010 (p < 0.001).

In a nationally representative sample, we noted a time-related increase in the use of TSA and increasing age-related differences in outcomes indicating a changing epidemiology of the use of TSA. Age-related differences in outcomes suggest that attention should focus on groups with the worst outcomes.

Cite this article: Bone Joint J 2015;97-B:1385–9.

Transitioning to daily treatment for drug-sensitive TB in India

World Health Organization in its treatment guideline for tuberculosis 2010 recommended daily dosing as the preferred regimen in treatment of drug-sensitive TB patients. The Revised National Tuberculosis Control Program took a decision to implement daily regimen in five states of India in 2015. This article describes the policy-making chronology, evidences used, stakeholders involved, and process of decision making.