Association between Parvovirus B19 and thyroid/celiac autoantibodies among T1DM pediatric patients

OBJECTIVE

In recent years, an overwhelming association between Pediatric Type 1 Diabetes Mellitus (T1DM) and autoimmune diseases has been largely reported. The current study was designed to determine a possible association between autoimmune thyroiditis (AIT), celiac disease (CD) - associated autoantibodies, and Parvovirus B19 infection among pediatric T1DM cases in the southwestern region of Saudi Arabia.

PATIENTS AND METHODS

Blood samples from age groups 1-18 years attending the Diabetic Clinic were collected over a period of 12 months. Serum anti-thyroid peroxidase (TPO), anti-thyroglobulin (TG), anti-tissue transglutaminase immunoglobulin A (TG-IgA), endomysial IgA (EMA-IgA), Parvovirus B19-IgG and IgM antibodies were detected by standard methods.

RESULTS

The results showed the prevalence of autoantibodies against thyroid and CD among pediatric T1DM patients to be 44 (25%) and 25 (14.4%), respectively. The prevalence of antibodies against B19 was 70 (40%). Further determination of the prevalence of Parvovirus B19-IgG antibodies and thyroid antibodies among T1DM pediatric patients revealed that there was a significant association between them with a p<0.0491.

CONCLUSIONS

The prevalence of autoantibodies against the thyroid was higher among the seropositive Parvovirus B19 children with T1DM. A positive association between the prevalence of autoantibodies against thyroid disease and the increase in the duration of diabetes was also noted. Hence, periodic screening of T1DM patients for B19 antibodies and autoantibodies for thyroid is crucial.

Clinical Outcomes Following Transcatheter Mitral Valve-in-Valve Replacement Using a Meril Myval Transcatheter Heart Valve

AIM

Transcatheter mitral valve-in-valve (TMViV) replacement for degenerated surgically implanted bioprosthetic valves has been described by both transseptal and transapical approaches. The balloon-expandable Myval transcatheter valve (Meril Life Sciences, Vapi, India) is commonly used for transcatheter valve-in-valve procedures in India. This study aimed to report in-hospital, 30-day, and 1-year outcomes of Myval patients who underwent TMViV in a single tertiary care centre in India.

METHODS

Symptomatic patients with surgical bioprosthetic mitral valve failure with New York Heart Association (NYHA) class III-IV symptoms, despite optimal medical therapy and high or very high risk for redo surgery, were assigned to TMViV following heart team discussions. Data were retrospectively collected and outcomes assessed.

RESULTS

Twenty patients were treated, with mean age 64.4 years, 60% were female, and mean Society of Thoracic Surgeons (STS) predicted risk of operative mortality score was 8.1. The failure mechanism was combined stenosis and regurgitation in 60% of patients. Technical success was achieved in 100% of patients. The mean postprocedure and 30-day gradients were 4.6±2.7 and 6.3±2.1, respectively. None of them had significant valvular or paravalvular leaks or left ventricular outflow tract obstruction. All-cause mortality at 1 year was 10%, and all survivors were in New York Heart Association (NYHA) class I or II.

CONCLUSION

TMViV replacement with a Meril Myval can be safely performed with high technical success, and low 30-day and 1-year mortality.

An impactful prospective study on pulmonary tuberculosis in geriatric populations besides its clinical outcomes and implications in the Indian subcontinent

OBJECTIVE

Geriatric populations are most at risk for the tuberculosis pandemic, and as people age, the rate of infection rises steadily and drastically. Geriatric individuals frequently experience diagnostic challenges with a wide range of comorbidities, but employing all available standard and novel methods to diagnose any infection is crucial. The prophylactic and therapeutic management for the geriatric population presents a significant difficulty and challenge in assessing an appropriate and effective therapeutic outcome due to prolonged drug therapy and adverse drug reactions. The present study aims to determine the prevalence of tuberculosis in the geriatric population in the Indian subcontinent, its risk factors, clinical outcomes, and adherence to the medication.

PATIENTS AND METHODS

A prospective observational investigation was conducted in a tertiary care Hospital in Erode, Tamil Nadu, India, from April 2021 to September 2022. A total of 1,014 patients were screened, and 176 participants were selected. The participants were then subjected to medication adherence evaluation, and clinical data was collected.  The statistical analysis was performed using SPSS version 20.0.

RESULTS

Among 176 participants, 135 (76.70%) were old (65-74 age), 37 (21.02%) were very old (75-84 age) TB patients, and 4 (2.27%) patients were extremely old TB patients (>85). Medication adherence was improved from baseline to the end of the study (p≤0.000). 110 patients completed the treatment (62.5%). 41 patients were cured in between treatments (23.29%), 13 patients died during the treatment (7.38%), 9 patients lost their follow-up (5.11%), 3 patients failed to respond to the treatment (1.70%).

CONCLUSIONS

The effectiveness of therapy critically depends on the patient's medication adherence to anti-TB therapy. In addition to having a higher likelihood of therapy failure, elderly patients did not appropriately respond to the treatment and completely recovered from the infection even after effective pharmacotherapy.

Synergistic antibacterial and mosquitocidal effect of Passiflora foetida synthesized silver nanoparticles

Silver nanoparticles are opted to have various applications in different fields ranging from traditional medicines to culinary items. It is toxic and most effective against bacteria, fungi viruses, parasites, parasite carrying vectors such as mosquitoes and their larvae and other eukaryotic microorganisms at low concentration without any side effects and toxicity to humans. In view of these data, the present research has been investigated by synthesizing silver nanoparticles using 1mM silver nitrate and aqueous extract of Passiflora foetida. The variation of nanoparticles in size and shape concerning the concentration of extract prepared were analysed. The formation of silver nanoparticles was confirmed by colour changing from yellowish green to reddish-brown implicating the surface plasmon resonance. Further, it was concluded by obtaining an absorbance peak at 420 nm using UV-Visible spectrophotometer analysis. FTIR analysis was used to identify the capping ligands, which included alkanes, aromatic groups and nitro compounds. The average grain size of ~12 nm to 14 nm with crystalline phase was revealed by X-ray Diffraction studies. The SEM images depicted the surface morphology with agglomeration; TEM studies showed the shape of nanoparticles as spherical and hexagonal with sizes ranging from 40 nm to 100 nm and EDAX analysis confirmed the presence of elemental silver as the principal constituent. The characterized silver nanoparticles were then tested for synergistic antibacterial effects with tetracycline, and the results show that they are more active against E. coli and S. aureus, but moderately effective against B. cereus and K. pneumoniae . It also had a strong larval and pupal toxic effects on the dengue vector, Aedes aegypti with the highest mortality. As a result, silver nanoparticles could be a viable alternative for a variety of applications.

Comparing heart risk scores to identify the most important risk factors for cardiovascular diseases

OBJECTIVE

Cardiovascular disease (CVD) is the most common non-communicable disease and the leading cause of death worldwide. To reduce the global burden of CVD and related morbidity and mortality, early prediction of CVD risk is essential. Various tools are available to access the risk of cardiovascular disorders. In the present study, we evaluated four risk score calculators associated to CVD for superiority and most reliable CVD prognosis parameters.

PATIENTS AND METHODS

In the present prospective study, we investigated the probability of CVD in 150 individuals, including both men and women, using four different cardiovascular risk assessment estimators (Framingham Risk Score [FRS] Calculator, Q-RISK calculator, Reynolds score calculator, and atherosclerotic cardiovascular disease (ASCVD) risk calculator) and evaluated how closely they were related to 16 selected parameters. The four risk estimators shared several common parameters, such as age, smoking status, and blood pressure; however, each of them also used some unique parameters. We used statistical analysis to reduce the number of parameters necessary to predict CVD.

RESULTS

Statistical analysis revealed a significant correlation between the main factors responsible for CVD risk. The analysis revealed that out of the four risk calculators tested, the FRS calculator was superior to the others because it showed more significant corroboration with statistical tools and could better predict the most important prognostic factors in CVD.

CONCLUSIONS

In all four risk estimators, the parameters that affected risk most significantly and conferred the most reliable CVD prognosis were age, weight, total cholesterol, and hemoglobin levels. With that FRS calculator was superior to the others.

Normative Transesophageal Echocardiographic Values of Cardiac Structures in the Indian Population-Indian Normative TEE Measurements (INTEEM) Study

OBJECTIVES

Information on normative reference values for cardiac structures is critical for the accurate application of echocardiography for guiding clinical decision-making. Many studies using transthoracic echocardiography (TTE) have shown that Indians have smaller diameters of various cardiac structures. There are no normative studies for transesophageal echocardiography (TEE). The authors observed dimensions of various cardiac structures in healthy Indian patients under general anesthesia using TEE and compared them with existing guidelines from non-Indian data.

DESIGN

The Indian Normative TEE Measurements study was a multicenter, prospective observational study conducted in India.

SETTING

Operating rooms for noncardiac surgeries in tertiary care-level hospitals.

PARTICIPANTS

Adult patients undergoing noncardiac surgery who were free from any cardiac, respiratory, and renal diseases and had no contraindications for TEE.

INTERVENTIONS

After inducing general anesthesia and achieving stable hemodynamic conditions, a comprehensive TEE examination was performed and various measurements were made.

MEASUREMENTS AND MAIN RESULTS

For each of the 83 patients undergoing noncardiac surgery, 39 various measurements for left ventricle, right ventricle, both atria, and all valves were made. This included diameters and functional parameters. They were analyzed in a vendor-neutral software off-line. The absolute values of many of the measurements were higher in men, but when indexed to body surface area (BSA) they were similar in both sexes. The values were lower than most of the Western data but matched previous Indian studies using TTE.

CONCLUSIONS

The authors present normative values of various echocardiographic parameters using TEE. Because of its variations, it is recommended to use India-specific data to make decisions in Indian patients. It may be prudent to use BSA-indexed values during decision-making.

Incidental Diagnosis of Healed Aortic Abscess Cavity

In infective endocarditis, the perivalvular abscess is a known complication with an incidence of more than 22%-29%, but the primary presentation of a healed aortic abscess without any clinical features of infective endocarditis is very rare. These sorts of cases are scarcely documented throughout literature. We present a successful surgical closure of healed perivalvular abscess cavity with aortic valve replacement and mitral valve repair.

Optical Analysis of Iron-Doped Lead Sulfide Thin Films for Opto-Electronic Applications

Iron-doped lead sulfide thin films were deposited on glass substrates using successive ionic layer adsorption and reaction method (SILAR) at room temperature. The X-ray diffraction pattern of the film shows a well formed crystalline thin film with face-centered cubic structure along the preferential orientation (1 1 1). The lattice constant is determined using Nelson Riley plots. Using X-ray broadening, the crystallite size is determined by Scherrer formula. Morphology of the thin film was studied using a scanning electron microscope. The optical properties of the film were investigated using a UV–vis spectrophotometer. We observed an increase in the optical band gap from 2.45 to 3.03[Formula: see text]eV after doping iron in the lead sulfide thin film. The cutoff wavelength lies in the visible region, and hence the grown thin films can be used for optoelectronic and sensor applications. The results from the photoluminescence study show the emission at 500–720[Formula: see text]nm. The vibrating sample magnetometer measurements confirmed that the lead sulfide thin film becomes weakly ferromagnetic material after doping with iron.

Studies on the Electrical Properties of Graphene Oxide-Reinforced Poly (4-Styrene Sulfonic Acid) and Polyvinyl Alcohol Blend Composites

In the present study, graphene oxide (GO)-reinforced poly (4-styrenesulfonic acid) (PSSA)/polyvinyl alcohol (PVA) blend composite films were prepared using colloidal blending technique at various concentrations of GO (0–3[Formula: see text]wt.%). The morphological investigations of the prepared composites were carried out using polarized optical microscopy and scanning electron microscopy. The electrical properties of composites were evaluated using an impedance analyzer in the frequency range 50[Formula: see text]Hz to 20[Formula: see text]MHz and temperature in the range 40–150[Formula: see text]C. Morphological studies infer that GO was homogeneously dispersed in the PSSA/PVA blend matrix. Investigations of electrical property indicate that the incorporation of GO into PSSA/PVA blend matrix resulted in the enhancement of the impedance ([Formula: see text] and the quality factor ([Formula: see text]-factor) values. A maximum impedance of about 4.32[Formula: see text][Formula: see text][Formula: see text]10[Formula: see text] was observed at 50[Formula: see text]Hz and 90[Formula: see text]C for PSSA/PVA/GO composites with 3[Formula: see text]wt.% GO loading. The [Formula: see text]-factor also increased from 8.37 for PSSA/PVA blend to 59.8 for PSSA/PVA/GO composites with 3[Formula: see text]wt.% GO loading. These results indicate that PSSA/PVA/GO composites can be used for high-[Formula: see text] capacitor applications.

Vasoplegic syndrome after off pump coronary artery bypass grafting surgery

We report a case of 48-years-old man who developed nor-epinephrine resistant vasoplegic syndrome after elective off pump coronary artery bypass grafting surgery. The failure of norepinephrine to improve the patients’ hemodynamics promted us to start treatment with vasopressin. Within an hour, the hemodynamics begin to improve. After 4 hours, patient was stable enough to be weaned from vasopressin, extubated at the end of 24 hrs and shifted to ward at the end of 48 hours. Vasoplegic syndrome can occur commonly after cardiopulmonary bypass and incidence can go up to 10%. This case was reported to insist upon the fact that vasoplegic syndrome can occur even after off pump surgeries. Herein we discuss the aetiology, risk factors, pathophysiology and prophylactic measures to be taken, for the prevention of vasoplegic syndrome.

Repair of a Submitral Aneurysm with associated left atrial wall dissection

We describe a case of submitral aneurysm in a 40-year-old man, which was distinctive in its anatomy and pathophysiology. The patient had a congenital submitral aneurysm located in the anterolateral part of the mitral annulus, complicated by dissection of the left atrial wall, severe mitral regurgitation, and compression of the left circumflex artery. He was managed successfully with aid of a comprehensive preoperative evaluation with all available imaging guidance and methodical surgical techniques, resulting in exclusion of the aneurysm, mitral valve replacement, and a graft to the left circumflex artery.

One-step, low-temperature fabrication of CdS quantum dots by watermelon rind: a green approach

We investigated the one-step synthesis of CdS nanoparticles via green synthesis that used aqueous extract of watermelon rind as a capping and stabilizing agent. Preliminary phytochemical analysis depicted the presence of carbohydrates which can act as capping and stabilizing agents. Synthesized CdS nanoparticles were characterized using UV-visible, Fourier transform infrared spectroscopy, X-ray diffraction, EDX, dynamic light scattering, transmission electron microscopy, and atomic force microscopy techniques. The CdS nanoparticles were found to be size- and shape-controlled and were stable even after 3 months of synthesis. The results suggest that watermelon rind, an agro-waste, can be used for synthesis of CdS nanoparticles without any addition of stabilizing and capping agents.