The prevalence of depression in people following limb amputation: A systematic review and meta-analysis

OBJECTIVE

To estimate the prevalence of depression in people with limb amputation. Additionally, factors affecting the prevalence or pattern of depression following limb amputation were explored.

METHODS

Systematic literature search to identify all relevant studies assessing prevalence of depression following limb amputations was conducted through following databases: PubMed/ MEDLINE, Scopus, Embase, and Web of Science. Search period was since inception of database till December 2021. Meta-analyses using random-effects model were conducted to estimate pooled prevalence of depression.

RESULTS

A total of 61 studies comprising 9852 limb amputees were included. Pooled prevalence of depression following limb amputations was 33.85% (95% CI: 27.15% to 40.54%), with significant heterogeneity (I2 = 98.57%; p < 0.001). Sub-group meta-analysis showed that pooled prevalence of depression was significantly higher in studies conducted from middle-income (45.31%, 95% CI: 28.92% to 61.70%) as compared high income countries (28.31%, 95% CI: 23.97% to 32.64%). Greater activity restriction, amputation-related body image disturbances, social discomfort, perceived vulnerability regarding disability, and avoidant coping style were commonly reported factors associated with greater depression symptomatology. Whereas, good perceived social support, and use of more active coping strategies were commonly reported protective factors.

CONCLUSION

About one-third of all limb amputees suffered from clinically significant depression. This emphasizes need to sensitize health care professionals involved in providing care to people following limb amputation regarding the importance of periodically screening this vulnerable group of patients for depression and liaising with psychiatrists. Further, addressing risk factors identified in this review could help in reducing the rates of depression post-amputation.

Effectiveness of electroconvulsive therapy in acute management of delirious mania in COVID-19 positive woman in second trimester pregnancy

Delirious mania has been described as a state of acute excitement, fluctuating sensorium, affective and catatonic symptoms. Electroconvulsive therapy (ECT) despite being an effective treatment modality in such cases, has been under-utilised during pregnancy, mainly due to safety concerns. Here, we report the effectiveness of ECT in acute management of delirious mania in a 24 weeks pregnant woman who also tested COVID-19 positive during hospitalisation. Patient presented with three weeks history of acute manic excitement with period of altered sensorium and catatonic symptoms with no response to trials of two antipsychotic agents. After organic causes ruled out, patient was planned for ECT while ongoing antipsychotic was continued. After the first ECT session, patient tested positive for COVID-19, though asymptomatic and had to be shifted to COVID-19 isolation facility. Complete resolution of psychiatric symptoms occurred after fifth ECT. All five ECT sessions, including those in COVID-19 isolation facility were carried out under supervision of a multidisciplinary team. None of the ECT sessions had any major adverse event. Symptom remission sustained even following ECT discontinuation. No neonatal or maternal adverse effects observed after an uneventful delivery at 35 weeks. Both mother and child continued to maintain well in follow-up period of one year on oral olanzapine. In this unusual concurrent presentation of mania, delirium and catatonic symptoms during second trimester pregnancy, we highlighted the effectiveness and safety of ECT as a viable treatment modality. Additionally, management challenges posed by patient testing COVID-19 positive and then, administering ECT in COVID-19 isolation facility using personal protective equipment by multidisciplinary team has been highlighted.

Quality of online news media reports of child sexual abuse in India

BACKGROUND

Media plays an important role in creating awareness and shaping public opinion about child sexual abuse (CSA). Research suggests that sensible media reportage on CSA is important for positive impacts of media. However, most of the studies assessing the quality of CSA news reports are from western countries.

AIM

To systematically assess the pattern of online news media reportage of CSA in India.

METHODOLOGY

A total of 149 news reports on the topic of CSA in India, published online over a one-year period were analyzed. Framing of CSA and other news media characteristics were evaluated.

RESULTS

Framing of CSA was episodic in majority of news reports, with criminal-justice system-related details about individual cases mentioned in about 90% reports. Further, more than two-third news reports did not mention possible causes or reasons of CSA, and possible steps that people could take to prevent CSA. About one-fifth of news reports provided statistics, research findings, or correct information to dispel myths or wrong public stereotypes about CSA. Inclusion of child helpline or contact information of any child welfare/support services was missing in most of the news reports.

CONCLUSION

This is the first study to systematically assess the quality of news media reports on CSA in India. It provides valuable baseline information about existing media practices and helps in identifying areas for further improvement of media reporting on CSA. There is a need to conduct regular workshops with media professionals to provide them adequate training and support for improving media reporting of CSA.

Quality of web-based information on attention deficit hyperactivity disorder

BACKGROUND AND OBJECTIVE

The limited literature available on quality of online health information about attention deficit hyperactivity disorder (ADHD), reported mixed findings and was more than five years old. This study aimed to assess the content quality, readability, aesthetics, and interactivity of current web-based information on ADHD.

METHODS

We screened first 50 links obtained on searching for ADHD using two popular search engines (Google and Bing), out of which 44 websites were selected for quality assessment. They were analysed using pre-decided study Performa, which included previously validated DISCERN instrument for content quality. Flesch-Kincaid grade level score and Flesch-Kincaid readability index were calculated for assessing readability.

RESULTS

About 61.4% of websites had DISCERN score ≥40, suggestive of good content quality. However, only 38.6% and 13.6% of websites were written at recommended reading level of eighth and sixth grade respectively. The DISCERN score had significant positive correlation with aesthetics and interactivity scores. Websites with the Health On Net (HON) label had better content quality. No significant difference in the readability, aesthetics, and interactivity of websites with and without the HON label.

CONCLUSION

This study underscores the need for improving readability of web-based information on ADHD, and highlight important areas for improving the overall quality of websites. The use of HONCode label might guide general public in gauging the content quality of online health information, but not its readability or presentation.

Identification of plant beneficial Bacillus spp. for Resilient agricultural ecosystem

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The plant beneficial microbes from rhizosphere soils in cauliflower fields were characterized for plants beneficial attributes such as phosphorus solubilization, siderophore, chitinase and protease activity, and indole acetic acid type of growth regulator.

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The antagonistic behavior of these isolates against fusarium oxysporum and sclerotinia sclerotiorum revealed their potential in combating the biotic stresses.

The use of synthetic pesticides and chemicals to continuously increase agricultural productivity is causing severe damage to our ecosystem. Therefore, there is need to enhance our understanding about the factors which can contribute to soil processes and play key role in developing sustainable agricultural ecosystem. In this context, the bacteria from cauliflower rhizosphere were isolated and characterized for different plants beneficial attributes. The relationship of soil bacteria and its elemental composition was examined using canonical correspondence analysis. The elemental composition analysis of soil samples revealed presence of Mg, Al, Si, P, K, Ca, Fe and their oxides. In addition, the isolates were found positive for phosphorus solubilization, siderophore, chitinase and protease activity, and indole acetic acid type of growth regulator. The direct confrontation assay revealed antagonistic behavior of these isolates against Fusarium oxysporum and Sclerotinia sclerotiorum. The promising isolates were identified and affiliated to closely related species of genus Bacillus in phylogenetic relationship. The canonical correspondence analysis revealed distribution of elements and their relationship with the identified species in particular area. The characteristics of these isolates revealed their potential in alleviating the biotic and abiotic stresses and hence enhancing crops yield without the usage of synthetic fertilizers and pesticides. The present study is first of its kind and will open new avenues to explore microbial community structure across different farmlands soils to develop resilience agricultural ecosystem.

Gender medicine: the impact of probiotics on male patients

PURPOSE

Numerous studies in the literature confirm the importance of the use of probiotics in inflammatory states of the prostate in humans. Our pilot study aimed to test probiotics strains ability to improve urinary bacterial load in male subjects.

METHODS

Twenty healthy men aged 55-65 years, with recurrent urinatory infections were enrolled and randomized into 2 groups. Urine culturing to detect Enterobacteriaceae (Escherichia Coli and Enterococcus faecalis) was performed at baseline and at 12 weeks after the starting of the study.

RESULTS

We found that taking the probiotic reduces the bacterial load of E. coli and E. faecalis in urine cultures. The use of the probiotic in these inflammatory states does not affect the change in weight in the tested subjects.

CONCLUSIONS

Our data confirm and improve the main results reported in the scientific literature on the importance of taking probiotics in prostatitis.

Should Internet gaming disorder be considered a subtype of generalized problematic internet use? Findings from a study among medical college students

PURPOSE

The current study aimed to explore whether Internet gaming disorder (IGD) should be considered a subtype of generalised problematic Internet use (PIU) by assessing the degree of overlap between them and comparing their correlates. The sociodemographic profile and presence of depressive symptoms were studied as correlates for IGD and generalised PIU.

DESIGN AND METHODS

This was a self-report survey administered online among medical students (n = 306).

FINDING

Less than half of the participants with IGD (45.45%; 5 out of 11) also met the criteria for generalised PIU. Only 6.67% (5 out of 75) of subjects with generalised PIU were also classified as having IGD. Male gender and time spent on digital gaming per day were associated with greater risk of IGD; whereas the time spent on Internet per day and more frequent use of the Internet for social networking rather than academic purposes were associated with greater risk of generalised PIU. The regression models built for IGD and generalised PIU were statistically significant (F = 64.10; P < .01 and F = 80.97; P < .01, respectively). The two models explained 66.1% and 57.4% of the variance in IGDS-SF and GPIUS2 scores, respectively.

PRACTICE IMPLICATIONS

The IGD and generalised PIU appear to be conceptually distinct entities. The IGD should not be assumed as a subtype of generalised PIU. Thus, health care providers need to focus on IGD beyond and besides generalised PIU. There is a need to specifically enquire about IGD while screening for behavioural addictions involving use of Internet.

Effect of probiotics on the occurrence of nutrition absorption capacities in healthy children: a randomized double-blinded placebo-controlled pilot study

OBJECTIVE

Recent advances in the translational research showed that dietary nutrients have critical importance to the microbioma balance in the gastrointestinal tract. Therefore, the alteration of the intestinal microbiota in order to achieve, restore, and maintain favorable balance in the ecosystem, and the activity of microorganisms present in the gastrointestinal tract is necessary for the improved health condition of the host. The objective of this translational study was to evaluate, in a pediatric population, the efficacy and safety of prophylactic probiotics for a better nutritional absorption capacity in the view to enhance their overall health and immunity.

PATIENTS AND METHODS

A total of 40 pediatric patients between the ages of 14 and 18 years were enrolled in the study and divided under two categories (treated/active group and placebo group). Three-time points clinical evaluations were performed: a baseline assessment (Time 0), a second evaluation at 5 weeks after the start of probiotic use (Time 1), and a final evaluation at the timeline after 10 weeks (Time 2). In the initial phase of the study, the recruited subjects underwent a panel of initial T0 clinical tests. For each of the patients, a blood sample was taken in order to evaluate the following biochemical measurements: Vitamin D, Vitamin A, Calcium, Zinc, and Iron. Moreover, an initial nutritional evaluation was carried out through which the nutritionist estimated the body composition of the subject (weight and body mass index), the caloric needs and dietary behaviour of each recruited patient.

RESULTS

Eligible participants were randomized into placebo (n = 20) or treated/active (n = 20) treatment conditions by random allocation using a computerized random number generator, ensuring all investigators remained blind to the treatment distribution. The data were compared within and between groups using statistical methods. The results confirmed that the probiotic supplementation was effective in increasing the overall blood biomarkers levels of vitamins, calcium, and mineral absorption from baseline to 10 weeks of treatment, compared with the placebo.

CONCLUSIONS

Probiotics may be suggested as supplements to improve biomarkers serum concentration if administered for a period of at least ≥ 5 weeks. However, further studies are required for optimal recommendations in patient treatment.

Proteomics of transforming growth factor β1 (TGF β1) signaling in 184A1 human breast epithelial cells suggests the involvement of casein kinase 2α in TGF β1-dependent p53 phosphorylation at Ser392

AIM

Transforming growth factor β1 (TGF β1) is a potent regulator of breast tumorigenesis. It inhibits proliferation of carcinoma cells, but the strength of its inhibitory action varies for cells from benigh, non-metastatic or metastatic tumors. The aim of this work was to generate a proteome profile of TGF β1 action on non-tumorigenic human breast epithelial cells 184A1, and validate predicted involvement of casein kinase 2α (CK2α), p53 and structure-specific recognition protein-1 (SSRP1).

MATERIALS AND METHODS

Two-dimensional gel electrophoresis and mass spectrometry were used to identify TGF β1-regulated proteins in 184A1 human breast immortalized non-tumorigenic cells. 184A1 cells may serve as a model of benign breast neoplasia. These cells were obtained from normal mammary tissue, were immortalized but are not malignant, and were obtained from the American Type Culture Collection. The systemic analysis was performed by using the Cytoscape tool. Transfection of cells with CK2α construct and small interfering RNAs to CK2α and SSRP1 were used to assess an impact of CK2α and SSRP1 on phosphorylation of the p53 and cell proliferation.

RESULTS

Proliferation of 184A1 cells was transiently inhibited by TGF β1. We identified 100 and 47 unique proteins which changed their expression and/or ³⁵S-incorporation, respectively, upon treatment with TGF β1 for 2 h, 8 h or 24 h. Cell proliferation, death, migration, and metabolism were among the biological regulatory processes retrieved by the network analysis as affected by the identified proteins. The network analysis suggested that TGF β1 may affect the phosphorylation of p53 at Ser392 by engaging CK2α. This was confirmed by the immunoblotting and cell proliferation assays.

CONCLUSION

We report here the list of 147 TGF β1-regulated proteins in immortalized non-tumorigenic human breast epithelial cells, and show involvement of CK2α in the regulation of p53 Ser392 phosphorylation.

The alteration of stress-related physiological parameters after probiotics administration in oral surgeons with different degrees of surgical experience

PURPOSE

Stress is a multifactorial and complex pathway, gaining growing attention from the healthcare community. Surgeons are subjected to higher levels of stress, due to surgical procedures that are demanding and repetitive; unfortunately, high-stress levels may also cause side-effects, as surgical mistakes. This study aimed to evaluate the efficacy of specific probiotics strains formula on stress levels in oral and maxillofacial surgeons, to improve their quality of life.

METHODS

We have investigated the hormonal (salivary Cortisol; sC), immune (salivary Immunoglobulin A; sIgA) and cardiovascular (Heart rate, HR, and systolic blood pressure, SBP) responses induced by stress conditions in 40 oral surgeons, randomly selected and allocated, according to their experience level, in three categories: senior, expert, and junior.

RESULTS

The results described how the number of heartbeats/ minute and SBP are slightly raised in all surgeons at different timepoints. Such data allow us to assess that work-related stress can induce an increase in cardiovascular parameters, even if they are not significantly modified by the use of probiotics. On the other hand, our data indicate that 10 weeks of probiotic integration may induce the improvement of other stress-related physiological parameters in oral surgeons with different degrees of surgical experience, such as the salivary cortisol levels, even under stress conditions. Moreover, in the test group (probiotics administration), the immunoglobulin levels were higher than the control (placebo administration) group: this happens as a consequence of the regular use of probiotics, which may induce an increased number of IgA producing cells.

DISCUSSION

Our data indicated that 10 weeks of probiotics-enriched diet modify some stress-related physiological parameters in oral surgeons with different degrees of surgical experience, but it does not impact on the overall cardiovascular risk.

Factors influencing the release of potentially toxic elements (PTEs) during thermal processing of electronic waste

The release of potentially toxic elements as airborne fine particulates is a significant environmental risk associated with recycling e-waste. Some of these may redeposit near emission sites or be transported over long distances causing wide-spread pollution. With an aim to identify key factors affecting particulate emissions, we report novel investigations on the adsorptive capture of particulate matter (PM) released during low temperature pyrolysis (600 °C; 15 min) of waste printed circuit boards (PCBs). A significant proportion of the released particulates (5.3 to 37%) were captured by adsorbents located downstream and in close proximity to the emitting source. Data was collected for four different PCBs and three adsorbents: alumina, silica-gel and activated carbon. With sizes ranging from nanoparticles to over 10 µm, adsorbed particulates were present as fines, spheres, oblongs, clusters and larger particles with no specific shape. Of the 24 elements identified initially in waste PCBs, only 14 were detected in released particulates: major PTEs- Zn, Sn, Pb and Cu (up to 400 ppm); minor PTEs- Ni, Mn, Cd, Cr and Ba (up to 10 ppm); trace PTEs- Co, In, Bi, Be and Sb (up to 1 ppm). Key factors influencing the release of PTEs during thermal processing were identified as basic elemental characteristics, densities, melting points, vapor pressures, initial concentrations, local bonding and mechanical strength. These results show that the presence of low melting point/high vapour pressure elements (Zn, Pb, Sn) should be minimised for a significant reduction in PTE emissions during e-waste processing.

Effects of sea salt rinses on subjects undergone to oral surgery: a single blinded randomized controlled trial

PURPOSE

It has been customary to explain the dentally beneficial effects of xylitol and certain other natural compound as lysozyme and seas salt in terms of microbiological effects only. Several studies have tested the use of natural ingredients, alcohol and fluoride free, in mouthwashes. The purpose of this study was to evaluate a combined mouthwash formulation containing natural antibiofilm agents in oral care wound healing after routinely oral surgery (extraction) procedures.

METHODS

Patients were assigned following a blinded randomized controlled trial and divided into two groups, an experimental group (I = 15) and a control (placebo) group (II = 15). Any infectious complications, wound healing, plaque accumulation in the stitches, and presence of trismus and inflammation were evaluated at ten and thirty days after extraction procedure. Pain and swelling were evaluated using the well-known visual analogue scale (VAS) scale throughout study period following extraction. The mean difference in Pre and Post values were compared among the groups. The change in pre-post score was analyzed using the paired t test.

RESULTS

An appreciable wound healing was seen in the experimental group when compared to the control sites, with no reported adverse effects. Four weeks postoperative patient's satisfaction level, to subjective and objective outcome measurements in documenting the result of a mouthwash treatment showed an interesting difference between groups.

CONCLUSIONS

Since combined mouthwash formulations, containing natural/bioactive substances, could provide a cheap, safe and acceptable alternative in oral care, further studies will also be required to study these effects and their mechanism of action in detail.

Rates, knowledge and risk factors of non-fatal opioid overdose among people who inject drugs in India: A community-based study

INTRODUCTION AND AIMS

Non-fatal opioid overdose (NFOO) predicts future fatal opioid overdose and is associated with significant morbidity. There is limited literature on the rates and risk factors for NFOO in people who inject drugs (PWID) from India. We aimed to study the rates of NFOO and documented risk factors for NFOO, as well as knowledge-level of NFOO among PWID from India.

DESIGN AND METHODS

Community-based, cross-sectional and observational study. We interviewed 104 adult male participants receiving HIV prevention services. Drug use patterns, rates of NFOO and opioid overdose risk factors, knowledge about opioid overdose and its management were assessed.

RESULTS

The mean age of the participants was 27.9 years. The most common opioid used for injecting was heroin followed by buprenorphine. About 45% (n = 47) participants had experienced an opioid overdose at least once in their lifetime. Around 25% (n = 26) participants had overdosed in the past year, while 21% (n = 22) participants had overdosed within the past 3 months. The majority had risk factors that could predispose them to NFOO. No participant was aware of the use of naloxone for opioid overdose.

DISCUSSION AND CONCLUSION

The rates of NFOO as well as risk factors for overdose among PWID from India are high, with poor knowledge on overdose management. There is urgent need for a program to prevent and manage opioid overdose among PWID in India.

Oral probiotics influence oral and respiratory tract infections in pediatric population: a randomized double-blinded placebo-controlled pilot study

OBJECTIVE

Acute oral and respiratory tract infections (RTIs) are highly present in the general population, and they represent one of the most impacting causes of morbidity and mortality every year. The aim of our study was to assess the clinical impact of oral probiotics on acute oral and respiratory tract infections affecting paediatric patients.

PATIENTS AND METHODS

This is a randomized, double-blinded placebo-controlled clinical study, where probiotics have been compared with placebo in a double-blinded investigation. 40 subjects with a recent clinical history reporting oral and respiratory tract infections were randomly selected and assigned to control (n=20) or the probiotics (n=20) group. During the 3 months before the starting, all subjects were assessed with several salivary examinations.

RESULTS

We found significant differences in the incidence of oral and respiratory tract infections between control and probiotic group, with a marked reduction of oral and respiratory tract infections episodes in the probiotic group. Salivary examinations gave similar results in both the groups, however, despite the salivary flow, viscosity and buffering were similar, on the contrary, pH values were found to be more alkaline in patients of probiotic group.

CONCLUSIONS

This study showed the main positive effects related to a supplementation with probiotics in order to prevent or reduce the incidence of infections onset in oral and respiratory tracts without any drugs-related adverse effects.

Diffuse, fracturing systemic skeletal histiocytosis of unknown type: a novel metabolic bone disease

We describe a novel disease of diffuse skeletal histiocytosis associated with multiple fragility fractures and high osteoclast activity. Clinical, radiographic, biochemical, genetic, and histopathological investigations were performed to characterize the diagnosis of an Asian man who presented with hip fracture and diffuse skeletal lytic lesions. After excluding malignancy and other common metabolic bone diseases, open bone biopsy yielded several pathological samples all showing extensive skeletal histiocytosis likely to explain the diffuse axial and appendicular lytic lesions. Rare disorders such as Langerhans histiocytosis, Erdheim-Chester disease, and diffuse cystic skeletal angiomatosis were excluded through careful pathological examination and lack of CD1a and S-100 staining. Whole exome sequencing did not yield diagnostic findings to explain this likely acquired disease. High markers of osteoclast activity suggested excessive focal bone resorption but normalized after zoledronic acid treatment. A novel disease of skeletal histiocytosis with high bone turnover is differentiated from other histiocytic and lytic skeletal diseases.

Anti-calculus efficacy of Periogen® oral rinse in gingivitis patients

Dental biofilm is a complex, organized microbial community that is the primary etiologic factor for plaque, the most frequently occurring oral contamination for gingivitis, dental caries and periodontal diseases. In dentistry, calculus is a form of hardened dental plaque, caused by precipitation of calcium (Ca) and phosphorous (P) ions deposited from saliva and gingival crevicular fluid. Although the dental biofilm cannot be eliminated, it can be controlled with comprehensive mechanical and chemotherapeutic oral hygiene practices. Chemotherapeutic agents have difficulty penetrating the polysaccharide matrix to reach and affect the microorganisms. The purpose of the present study was to evaluate the anti-calculus efficiency of a mouthwash containing an association of sodium tripolyphosphate, tetrapotassium pyrophosphate, sodium bicarbonate and citric acid in patients affected with gingivitis.

Microbiological results of improvement in periodontal condition by administration of oral probiotics

Oral bacteria that degrade sulphur-containing amino acids (cysteine, cystine, and methionine) produce volatile sulphur compounds (VSCs = hydrogen sulphide, methyl mercaptan, and dimethyl sulphide) highly correlated with halitosis. When these bacteria are given the right environment, i.e. periodontal disease, cariogenic biofilm or food source they can grow in number very quickly and will start to convert proteins to VSC that, together with volatile fatty acids are largely responsible for oral malodor. Recently, the prevention of dental caries and periodontal diseases using various probiotics has been attempted. The purpose of this study was to investigate the effects of probiotics based on in vitro analysis, such as antibacterial activity, and to evaluate the neutralizing effect of probiotics on halitosis, the levels of VSCs were measured by gas chromatography. .

Clinical results of improvement in periodontal condition by administration of oral probiotics

Dental plaque-related diseases (cavities, gingivitis, periodontitis and halitosis) have been traditionally controlled by mechanical non-specific removal of plaque. However, many novel treatment approaches aim to inhibit the growth of pathogenic bacteria or to remove their toxins. Probiotics are viable microorganisms which, when administered in adequate amounts, provide a health benefit to the host. Recently, probiotics have been applied as new tools for the improvement of dental health. They have been used to substitute existing antibiotic treatments due to increased resistant bacteria. Probiotics not only have antibacterial activity, but they also have inhibitory effects on the reappearance of oral pathogenic bacteria. The aim of this study was to assess the clinical effect of the administration of probiotics agents in the treatment of mild to moderate periodontitis.

Diastereoselectivity in the Aza-Michael Reaction of Chiral α-Methylbenzylamines with α,β-Unsaturated Carbonyl Compounds

The aza-Michael reaction of (S)-(–)- and (R)-(+)-α-methylbenzylamines with trans-cinnamaldehyde and other α,β-unsaturated carbonyl compounds occurs with 52–98% diastereoselectivity (de); however, in the reaction with crotonaldehyde, the de is lower (20–38%). In the products obtained from the reaction with α,β-unsaturated aldehydes, the de could be determined on the basis of the relative intensities of the aldehydic protons of the two diastereomers. Theoretical investigations of the reaction of (S)-(–)-α-methylbenzylamine with trans-cinnamaldehyde at the DFT (B3LYP/6-31+G*) level reveal that the diastereomer formed from the attack of the amine on the Re face is thermodynamically more stable. The calculations also show that the aldehydic proton of this diastereomer is expected to be more deshielded, which on the basis of the 1H NMR spectrum is the major product.

High temperature investigations on optimising the recovery of copper from waste printed circuit boards

High temperature pyrolysis investigations were carried out on waste printed circuit boards (PCBs) in the temperature range 800-1000°C under inert conditions, with an aim to determine optimal operating conditions for the recovery of copper. Pyrolysis residues were characterized using ICP-OES analysis, SEM/EDS and XRD investigations. Copper foils were successfully recovered after pyrolysis at 800°C for 10-20 min; the levels of Pb and Sn present were found to be quite low and these were generally present near the foil edges. The relative proportions of Pb and Sn became progressively higher at longer heating times due to enhanced diffusion of these molten metals in solid copper. While a similar behaviour was observed at 900°C, the pyrolysis at 1000°C resulted in copper forming Cu-Sn-Pb alloys; copper foils could no longer be recovered. Optimal conditions were identified for the direct recovery of copper from waste PCBs with minimal processing. This approach is expected to make significant contributions towards enhancing material recovery, process efficiency and the environmental sustainability of recycling e-waste. Pyrolysis at lower temperatures, short heating times, coupled with reductions in process steps are expected to significantly reduce energy consumption and pollution associated with the handling and processing of waste PCBs.

A novel approach for reducing toxic emissions during high temperature processing of electronic waste

A novel approach is presented to capture some of the potentially toxic elements (PTEs), other particulates and emissions during the heat treatment of e-waste using alumina adsorbents. Waste PCBs from mobile phones were mechanically crushed to sizes less than 1mm; their thermal degradation was investigated using thermo-gravimetric analysis. Observed weight loss was attributed to the degradation of polymers and the vaporization of organic constituents and volatile metals. The sample assembly containing PCB powder and adsorbent was heat treated at 600°C for times ranging between 10 and 30min with air, nitrogen and argon as carrier gases. Weight gains up to ∼17% were recorded in the adsorbent thereby indicating the capture of significant amounts of particulates. The highest level of adsorption was observed in N₂ atmosphere for small particle sizes of alumina. SEM/EDS results on the adsorbent indicated the presence of Cu, Pb, Si, Mg and C. These studies were supplemented with ICP-OES analysis to determine the extent of various species captured as a function of operating parameters. This innovative, low-cost approach has the potential for utilization in the informal sector and/or developing countries, and could play a significant role in reducing toxic emissions from e-waste processing towards environmentally safe limits.

Orthodontic forces modulate insulin-like growth factor binding protein-5 changes in gingival crevicular fluid

Orthodontic tooth movement results from the response of the periodontal tissue to orthodontic force, which leads to modeling and remodeling of the surrounding alveolar bone. The response is considered to occur through the activation of specific signaling pathways, many of which are known, all acting to ultimately result in tooth movement. Much is known about the actions of these two cells, and the signaling pathways that affect them, both in bone and orthodontic literature, however, to date, little work has been carried out to examine the effect of the insulin-like growth factor binding proteins (IGFBP) in orthodontics. Therefore, we investigated the presence of IGFBP-5 in the gingival crevicular fluid (GCF) of 6 healthy subjects, and assessed the effects of orthodontic treatment on the levels and molecular state of this protein.

Osteogenic differentiation and gene expression of dental pulp stem cells under low-level laser irradiation: a good promise for tissue engineering

The effects of low-level laser therapy (LLLT) has been the focus of recent studies as being assumed responsible for promoting photostimulatory and photobiomodulatory effects in vivo and in vitro, increasing cell metabolism, improving cell regeneration and invoking an anti-inflammatory response. A positive effect of LLLT on the bone proliferation of some cell types has been observed, but little is known about its effect on dental pulp stem cells (DPSCs). Here, we accurately describe the technical procedure to isolate mesenchymal DPSCs, and assay their osteogenic capacity when irradiated with an LLLT source. These preliminary results show that LLLT irradiation influences the in vitro proliferation of DPSCs and increases the expression of essential proteins for bone formation, although it is necessary to carry out further experiments on other cell types and to uniform the methodological designs.

Photodynamic therapy: a review and its prospective role in the management of oral potentially malignant disorders

With the unreliability of epithelial dysplasia as a predictor to determine the risk of future malignant development, subjectivity associated in evaluating dysplasia by pathologists and paucity of biomarkers that could accurately predict the progression risks in oral potentially malignant disorders (PMDs), eradication of the lesions appears to be the most desirable approach to minimize the risk of invasive cancer formation. Interventions, such as surgery and chemoprevention, have not shown promising long-term results in the treatment of these lesions, and lack of guidelines and general consensus on their management has incited much anxiety and doubts in both patients and community clinicians. Topical photodynamic therapy (PDT) is a minimally invasive and minimally toxic technique that in recent years has shown great promise in the management of PMDs. In this review, we describe the historical developments in the field of PDT, its basic mechanisms, as well as related clinical studies, and its challenges in the management of oral PMDs. Based on its high efficacy and low side effects, its high patient acceptance/compliance, the simplicity of the procedure and its minimal pretreatment preparation, topical PDT is believed to have potential to play an important role in the management of PMDs, especially of the low-grade dysplasia.

MicroRNAs in an oral cancer context - from basic biology to clinical utility

Oral cancer is one of the most commonly diagnosed malignancies worldwide. Its dismal five-year survival rate of ~50% has barely changed for decades. A better understanding of the molecular basis of tumorigenesis - with particular emphasis on disease initiation and progression - is needed to improve clinical outcomes, since this will facilitate the development of drugs and management strategies based on the specific genetic changes underpinning disease behaviors. MicroRNAs (miRNAs), a class of short non-coding RNAs that down-regulate gene expression, have been demonstrated to play essential roles in human cancers. miRNA deregulation has been observed in many tumor types and is implicated in oncogenic cell processes, including proliferation, survival, apoptosis, metastasis, and chemoresistance. In addition, miRNA alterations have been associated with specific clinical phenotypes such as disease progression or recurrence, development of metastases, and post-operative survival. Recent studies have explored the utility of miRNAs as diagnostic and prognostic tools and as potential therapeutic targets. Herein, we discuss miRNA biology and provide a summary of the key findings on the role of miRNAs in oral malignancies.

Psychiatric Morbidity Pattern in a Child Guidance Clinic

BACKGROUND

There is a paucity of Indian studies on psychiatric morbidity in children. Present work was undertaken in a child guidance clinic in armed forces.

METHODS

Retrospective analysis of 213 patients who attended a child guidance clinic was done.

RESULTS

Majority (n=138) were boys. 55.9% were referred from paediatric outpatient department while medical officers in periphery referred 38.5%. The diagnoses was mental retardation in 30.97%, behavioral and emotional disorders in 23.06% and neurotic, stress related and somatoform disorders in 15.98% cases.

Microelectromechanical system assembled ion optics: An advance to miniaturization and assembly of electron and ion optics

Deep-reactive ion etching of n-doped silicon-on-insulator is utilized to make ion optical components to aid in the miniaturization of mass analyzers. The microelectromechanical system components are bound to aluminum nitride substrates and employed three-dimensional assembly. The assembly methods are tested for breakdown (V(b)), durability, and alignment. Demonstration of ion manipulation is shown with a 1 mm Bradbury-Nielsen gate, 500 mum Einzel lens, 500 mum coaxial ring ion trap, and reflectron optics. Data are presented showing the resolution, attenuation, and performance of each of these devices. We demonstrate advantages and disadvantages of this technology and its applications to mass analysis.

Rickettsial diseases in Haryana: not an uncommon entity

Rickettsioses have not been reported from the plains of North India and Haryana in particular. Here we are reporting three cases of scrub typhus and one cases of Indian tick typhus in the state of Haryana, all of which presented with fever and multi organ dysfunction, rash and without eschar. All were successfully treated with doxycycline.

A comparison of fosinopril and hydrochlorothiazide with hydrochlorothiazide in non-insulin-dependent diabetes mellitus patients with mild to moderate hypertension

A multicentre, randomised, double-blind, parallel-group study of the tolerability and antihypertensive efficacy of once-daily fosinopril 20 mg/hydrochlorothiazide 12.5mg (FOS/HCTZ) compared with once-daily hydrochlorothiazide 25mg (HCTZ) was conducted in 142 patients with non-insulin-dependent diabetes mellitus (NIDDM) and mild to moderate essential hypertension. After 12 weeks of treatment, both groups had statistically significant mean changes from baseline in seated diastolic and systolic blood pressures (FOS/HCTZ, -15.0mm Hg; HCTZ, -11.9mm Hg for seated diastolic blood pressure). The difference between treatment groups was statistically significant (p < 0.001). In addition, normalisation of seated diastolic blood pressure was achieved in 85% of FOS/HCTZ patients compared with 71% of HCTZ patients. A statistically significant difference (p < 0.05) in favour of FOS/HCTZ was observed for the total number of favourable responses (normalisation or >/=10mm Hg reduction in seated diastolic blood pressure) at week 12 and for the end-point analysis. One FOS/HCTZ patient and 5 HCTZ patients discontinued treatment because of adverse events. No clinically significant changes in serum glucose, potassium or cholesterol were observed. A slight but statistically significant increase in fasting triglycerides occurred with FOS/HCTZ compared with HCTZ (+26.1 vs +13.5 mg/dl, respectively; p < 0.05). These results show that the combination of fosinopril and hydrochlorothiazide has considerable potential as an effective antihypertensive regimen that does not significantly alter glucose or lipid metabolism in patients with NIDDM.

Microscopic features of enamel and dentinal caries under confocal laser scanning microscopy (CLSM) and image analyzer: preliminary experimental study

This study was designed to identify surface and subsurface microscopic changes in different carious lesions by using Confocal Laser Scanning Microscope (CLSM) and Image analyzer (light microscopy). Thirty extracted carious posterior teeth were fixed, embedded and polymerized in plastic fixation medium. The final thin sections (80mm) were stained with H&E and Masson Goldner's Tricome while others were left unstained. Under Confocal, marked differences between control sound enamel and dentin, and carious area of the samples were observed which illustrated that a correlation existed between the zone of autofluoresence, demineralization and carious enamel and dentin. Compared to CLSM, Image Analyzer only produce two-dimensional images but the histopathological changes were better appreciated by using various staining methods.

Evaluation of polymerase chain reaction (PCR) method and hybrid capture II (HCII) assay for the detection of human papillomavirus in cervical scrapings

In order to investigate the reliability of detecting HPV DNA in cervical smears, we compared the performance of nested MY/GP PCR and FDA approved-Hybrid Capture II (HCII) using clinical cervical scrapings from 40 patients. It was found that PCR was more sensitive (81.8%) in comparison to HCII (36.4%) in detecting HPV although specificity of HCII was much higher (96.6%) than PCR (58.6%). The Negative Predictive Value (NPV) of both the techniques were quite similar but Positive Predictive Value (PPV) of HCII was much higher (80.0%) compared to PCR (42.9%). While the HCII method showed good specificity for HPV detection, its lack of sensitivity as compared to PCR may be a drawback for diagnostic use.

Nitric oxide synthase localization in the rat neutrophils: immunocytochemical, molecular, and biochemical studies

Nitric oxide (NO) modulates diverse functions of polymorphonuclear neutrophils (PMNs), but localization of NO synthase (NOS) and identification of its interacting proteins remain the least defined. The present study discerns subcellular distribution of NOS and caveolin-1, a prominent NOS-interacting protein in rat PMNs. Localization of NOS was explored by confocal and immunogold electron microscopy, and its activity was assessed by L-[3H] arginine and 4,5-diaminofluorescein diacetate (DAF-2DA). Reverse transcriptase-polymerase chain reaction using NOS primers and Western blotting demonstrated the presence of neuronal NOS (nNOS) and inducible NOS (iNOS) in PMNs. Immunocytochemical studies exhibited distribution of nNOS and iNOS in cytoplasm and nucleus, and L-[3H] citrulline formation and DAF fluorescence confirmed NOS activity in both fractions. NOS activity correlated positively with calmodulin concentration in both of the fractions. nNOS and iNOS colocalized with caveolin-1, as evidenced by immunocytochemical and immunoprecipitation studies. The results thus provide first evidence of nNOS and iNOS in the nuclear compartment and suggest NOS interaction with caveolin-1 in rat PMNs.