Pandemic (H1N1) 2009 influenza: Experience from a critical care unit in India

This case series details our experience with seven patients with pandemic (H1N1) 2009 influenza from an intensive care unit in India.All the patients had respiratory failure requiring ventilation except one;two patients developed pneumothorax. Of the seven patients, two died (28.5%) and five recovered. Four patients had co-morbid conditions and one was morbidly obese; all the five patients were discharged alive.     

Evaluation of Polyherbal formulation for Diuretic activity in albino rats

ObjectiveTo investigate the diuretic potential of Polyherbal formulations prepared from the seeds of Vitis venifera, Duranta repens and Centratherum anthelminticum in Albino rats.MethodsDifferent concentrations of Polyherbal formulations (100, 200 and 400 mg/kg), furosemide (10 mg/kg) and vehicle were orally administered to rat (n = 6 animals per group) and their urine output was collected after 24h. The Urinary output, Osmolarity, pH, Na⁺, K⁺ and Cl^? concentrations of urine were estimated.ResultsThe Polyherbal formulations produced significant increase in Na⁺, K⁺, Cl^? excretion, caused alkalinization of urine, showed strong Diuretic index, saluretic index and Natruretic index. All the concentrations of Polyherbal formulation showed dose-dependent relationship when compared to control animals.ConclusionsThese finding strongly suggests that the Polyherbal formulations have a good diuretic activity on rats in the above experimental model.     

Vanadium pentaoxide-doped waste plastic-derived graphene nanocomposite for supercapacitors: a comparative electrochemical study of low and high metal oxide doping

We report the bulk phase synthesis of graphene sheets using waste plastic (WP) as a precursor following a modified pyrolysis approach. Furthermore, the low and high mass loading of vanadium pentaoxide was performed on graphene sheets in 1 : 10 and 1 : 1 ratios, respectively. Advanced characterization techniques such as Raman spectroscopy, FT-IR spectroscopy, X-ray diffraction (XRD) analysis, thermogravimetric analysis (TGA) analysis, and SEM imaging were used to confirm the synthesis of graphene. FT-IR spectroscopy confirmed that the resonating structure affects the bond strength in the composite, which enables peak shifting in the FT-IR spectrum of the composite. Furthermore, bandgap analysis has been performed using UV-Vis spectroscopy, which confirmed the synthesis of the composites. The developed vanadium-doped graphene was used as the active material for the fabrication of supercapacitor electrodes. The electrochemical performance of these devices was evaluated in 1 M H₃PO₄ solution using cyclic voltammetry (CV), galvanic charge–discharge (GCD) analysis, and electrochemical impedance spectroscopy (EIS). Fabricated cells 1 and 2 showed exceptional specific capacitances of 139.7 F g⁻¹ and 51.2 F g⁻¹ at 5 mV s⁻¹ scan rate, respectively. Cell 1 showed a huge power density of 5312 W kg⁻¹ and an energy density of 19.7 W h kg⁻¹. Conversely, cell 2 showed a comparatively lower power density of 1941 W kg⁻¹ and an energy density of 7.2 W h kg⁻¹ at a 5 mV s⁻¹ scan rate. Moreover, we disclose some brief conclusions on the performance, mechanism, and required modifications that can improve the performance of such devices. This approach can surely help with universal WP problems as well as the development of high-performance supercapacitors.

We report the bulk phase synthesis of graphene sheets using waste plastic (WP) as a precursor following a modified pyrolysis approach.     

Fine-needle aspiration cytology in a case of isolated involvement of thyroid with Langerhans cell histiocytosis

We present an unusual case of isolated thyroid involvement with Langerhans cell histiocytosis (LCH), diagnosed presumptively by fine-needle aspiration (FNA) cytology and subsequently confirmed by immunohistochemistry in a 13-yr-old boy. The cytologic findings include high cellularity in a hemorrhagic background, the presence of characteristic mononucleated and multinucleated Langerhans cells with prominent nuclear grooves, and abundant foamy cytoplasm in a background of mixed eosinophilic and lymphocytic infiltrate, along with the presence of few focal aggregates of benign thyroid follicular cells. Further diagnostic confirmation was obtained by positive S-100 protein immunohistochemistry of the Langerhans histiocytes on paraffin-embedded sections of open thyroid biopsy of the prominently enlarged left lobe. We present the complete clinicopathologic features of this case, along with ultrasound, computerized axial tomographic, and technetium-99 scan findings. We also discuss possible differential diagnostic consideration in light of a review of the literature and the role of FNA cytologic diagnosis in such a rare yet cytomorphologically characteristic case. Diagn. Cytopathol. 1998;19:33–37. © 1998 Wiley-Liss, Inc.     

Long-term effects of metformin use in gestational diabetes mellitus on offspring health

Metformin is the first-line drug for the treatment of type 2 diabetes mellitus, but its role in gestational diabetes mellitus (GDM) management is not clear. Recent evidence suggests a certain beneficial effect of metformin in the treatment of GDM, but a high treatment failure rate leads to the initiation of additional medications, such as insulin. Moreover, since metformin crosses the placental barrier and reaches a significant level in the fetus, it is likely to influence the fetal metabolic milieu. The evidence indicates the long-term safety in children exposed to metformin in utero except for mild adverse anthropometric profiles. Diligent follow-up of metformin-exposed offspring is warranted from the clinician’s point of view.     

Outcomes of juvenile myelomonocytic leukemia patients after sequential therapy with cytarabine and 6-mercaptopurine

Abstract

Juvenile myelomonocytic leukemia(JMML) is a pediatric myeloproliferative disorder. Allogeneic hematopoietic stem cell transplant (HSCT) is the only curative treatment for JMML. Pre-transplant therapy is a matter of controversy, and there are no firm recommendations. Whether chemotherapy is effective in achieving durable remission is questionable. Patients diagnosed as JMML at our center from January-2014 to December-2019 were retrospectively analyzed. All patients treated with at least one cycle of sequential therapy with subcutaneous cytarabine and oral 6-mercaptopurine were further assessed. The total number of patients diagnosed during the study period was 33. Patients were divided into two groups: patients who did not get any chemotherapy (n?=?13) and ones who received at least one cycle of chemotherapy(n?=?20). Age, total leukocyte count (TLC), monocyte percent, platelet count and spleen size were comparable between the two groups. There was no difference in the overall survival between the two groups, but 6 out of 20 patients showed a response to chemotherapy (2 complete remission, 4 partial remission). Two patients out of 20 underwent hematopoietic stem cell transplant (HSCT). The patients who achieved complete remission received 12 cycles of chemotherapy and have been in follow up for 28?months and 50?months respectively. Our results showed that sequential therapy with 6-mercaptopurine and cytarabine may be offered to patients in whom HSCT is not feasible or as a bridge therapy in those awaiting HSCT. The advantages of this approach include low cost, out-patient management and decreased requirement of blood components. In a subset of patients it may achieve remission.     

Gene therapy in retinal diseases: A review

Over 2 million people worldwide are suffering from gene-related retinal diseases, inherited or acquired, and over 270 genes have been identified which are found to be responsible for these conditions. This review article touches upon the mechanisms of gene therapy, various enzymes of the visual cycle responsible for different genetic diseases, Luxturna—the first US Food and Drug Administration (FDA)-approved therapeutic gene product, and several ongoing trials of gene therapy for age-related macular degeneration. Gene therapy has tremendous potential for retinal conditions due to its ease of accessibility, immune-privileged status, and tight blood-retinal barriers, limiting systemic side effects of the drug. In recent years, advances in gene therapy in retinal conditions have increasing significantly, with progress in cell-specific targeting and transduction efficiency of gene products through the use of adeno-associated viral vectors (AAVs), suggesting that even greater success in future clinical trials is possible.     

Impact of age-related macular degeneration on diabetic retinopathy: An electronic health record based big data analysis from a tertiary eye centre in South India

Purpose:To determine whether the presence of age-related macular degeneration (AMD) decreases the risk of diabetic retinopathy.Methods:This was a retrospective, case-cohort study performed in patients with a systemic diagnosis of diabetes at a tertiary health care center from May 2011 to April 2020. A total of 43,153 patients (1,024 AMD patients and 42,129 non-AMD patients) were included in the analysis. A total of 1,024 age and diabetes mellitus (DM) duration-matched controls were chosen from the non-AMD group for risk factor analysis. The severity of diabetic retinopathy was compared between the patients with AMD and the patients without AMD.Results:Out of the enrolled 43,153 diabetic patients, 26,906 were males and 16,247 were females. A total of 1,024 patients had AMD and 42,129 had no AMD. The mean age of the cohort was 58.60 ± 0.09 years. The overall prevalence of DR was noted to be 22.8% (9,825 out of 43,153 eyes). A significantly lower prevalence of diabetic retinopathy (DR) (23% in non-AMD, 11.4% in AMD, OR = −0.43, P < 0.001), non-proliferative diabetic retinopathy (NPDR) (12% in non-AMD, 8.2% in AMD, OR = −0.66, P < 0.001), and proliferative diabetic retinopathy (PDR) (11% in non-AMD, 3.2% in AMD, OR = −0.27, P < 0.001) was seen in the AMD patients. No significant difference was seen between the dry and wet AMD. On multivariate logistic regression analysis, the lower age, absence of AMD, and male gender were associated with a higher risk of PDR.Conclusion:The presence of AMD was noted to statistically reduce the risk of DR. Our results may be useful in the field of resource allocation and awareness of DR.