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Acute chest syndrome (ACS) is a frequent cause of acute lung disease in children with sickle cell disease (SCD). Patients may present with ACS or may develop this complication during the course of a hospitalization for acute vaso-occlusive crises (VOC). ACS is associated with prolonged hospitalization, increased risk of respiratory failure, and the potential for developing chronic lung disease. ACS in SCD is defined as the presence of fever and/or new respiratory symptoms accompanied by the presence of a new pulmonary infiltrate on chest X-ray. The spectrum of clinical manifestations can range from mild respiratory illness to acute respiratory distress syndrome. The presence of severe hypoxemia is a useful predictor of severity and outcome. The etiology of ACS is often multifactorial. One of the proposed mechanisms involves increased adhesion of sickle red cells to pulmonary microvasculature in the presence of hypoxia. Other commonly associated etiologies include infection, pulmonary fat embolism, and infarction. Infection is a common cause in children, whereas adults usually present with pain crises. Several risk factors have been identified in children to be associated with increased incidence of ACS. These include younger age, severe SCD genotypes (SS or Sβ0 thalassemia), lower fetal hemoglobin concentrations, higher steady-state hemoglobin levels, higher steady-state white blood cell counts, history of asthma, and tobacco smoke exposure. Opiate overdose and resulting hypoventilation can also trigger ACS. Prompt diagnosis and management with intravenous fluids, analgesics, aggressive incentive spirometry, supplemental oxygen or respiratory support, antibiotics, and transfusion therapy, are key to the prevention of clinical deterioration. Bronchodilators should be considered if there is history of asthma or in the presence of acute bronchospasm. Treatment with hydroxyurea should be considered for prevention of recurrent episodes. This review evaluates the etiology, pathophysiology, risk factors, clinical presentation of ACS, and preventive and treatment strategies for effective management of ACS.

Marker compounds quantification with new analytical tools and methods is necessary for establishing the authenticity and usage of Ayurvedic or herbal formulations. Simhanada guggulu or guggul is one of the supportive Ayurvedic medicines for treatment of rheumatoid arthritis and used in various disorders in Ayurveda such as limping, anemia, gout, disease of skin, cough, abdominal lump, pain digestive impairment. Simhanada guggulu is an Ayurvedic herbal formulation made by some selected herbs. The rejuvenating and tonic properties of ‘Simhanada guggulu’ are considered majorly due to their antioxidant principles, which in turn is due to the presence of phenolic compounds. A high-performance liquid chromatography (HPLC) method has been developed for quantitative determination of the gallic acid in ‘Simhanada guggulu’. The acidic mobile phase used in RP18 column which enabled efficient separation of gallic acid. A binary gradient with mobile phase containing solvent A (Acetonitrile) and solvent B (water: 0.3% O-Phosphoric Acid) was used for analysis. Elution was carried out at flow rate of 0.8 mL/min. Pure gallic acid Rt was found to be 5.29 min and peak with same Rt was also observed in prepared formulation. Gallic acid content of prepared formulation was found to be 2.28 %. The developed HPLC-UV method is simple, rapid and help as tool for the standardization of Simhanda guggulu.

Silver-polypyrrole nanocomposite (Ag-Ppy) films with different silver concentrations were synthesized without using any external oxidant i.e., with in-situ oxidation of pyrrole in the presence of silver nanoparticles. The gas sensing performance of all the films were investigated for NO, NO 2 , NH 3 , H 2 S , ethanol and methanol gases/vapours. The nanocomposite film was further doped with 05–25% p -toluenesulfonic acid (pTSA). Among various compositions, 15% pTSA doped Ag-Ppy thin films were found to be most sensitive and selective towards NO 2 gas at room temperatures. The films exhibited a chemiresitive response of 68% at 100 ppm NO 2 with a response time of 148 s and a recovery time of 500 s. The films exhibited 21% response for NO 2 even at low concentration levels at 5 ppm. The improved response kinematics is attributed to porous structure with faster charge transfer through ohmic contacts between polymer and silver nanoparticles upon interaction with gas.

Nanocomposites of polypyrrole (PPy) with varying concentration of ZnO nanorods (ZnO NRs) were synthesized using in-situ oxidative polymerization technique. The prepared nanocomposites (PPy, PPy-ZnO and CSA doped PPy-ZnO) were studied for various oxidizing and reducing gases at room temperature and found to be more selective towards ammonia gas. Various concentrations of ZnO NRs in Ppy matrix were studied and 15% was found to be optimum in terms of sensor response (66% towards 120 ppm NH 3 ). Further, with 15% doping of camphor sulphonic acid (CSA) in PPy-ZnO nanocomposite for 15% ZnO NRs in Ppy matrix, sensor response increased from 66 to 79% towards 120 ppm of NH 3 . Structural, Optical and thermal behavior of nanocomposites were studied using powder X-ray diffraction (XRD), Fourier Transform Infra-Red (FTIR) spectroscopy, X-ray Photoelectron Spectroscopy (XPS), UV–vis (UV–vis) absorption spectroscopy, room temperature Photoluminescence (PL) Spectroscopy, Thermo-gravimetric analysis (TGA) and Field Emission Scanning Electron Microscopy (FESEM). ZnO has been completely embedded inside the polymeric chains as observed from in SEM. Meanwhile, FT-IR spectra indicate better conjugation and interaction in nanocomposites. With CSA doping interaction grows stronger due to extended delocalization over π electrons leading to higher sensor response and with response time and recovery time of 24 s and 34 s respectively. CSA doped PPy-ZnO (15%) nanocomposites observed to be a potential candidate for ammonia detection at lower ppm level.

Introduction: Low von Willebrand factor (VWF) activity is prevalent in adolescents with heavy menstrual bleeding (HMB). There is a need to better genetically characterize these patients and improve our understanding of the pathophysiology of their bleeding risk. Methods: One of the main objectives of this multi-center, single arm, observational cohort study was to genotype adolescent females with HMB and low VWF (≥ 30 and ≤ 50 IU/dL) by means of whole exome sequencing (WES), to identify variants throughout the exome that may modulate risk for bleeding. Post-menarchal females < 21 years with HMB (defined as PBAC score >100) and low VWF were eligible for the study. All patients were enrolled by participating centers where blood samples were collected. Exome data for 86 cases and 900 unrelated pediatric (0.8, GQ>20, AB between 0.3-0.7 and min DP>8. Case/control analyses included common and rare SNP associations, gene burden analysis of both rare nonsynonymous variants and ClinVar 'pathogenic' variants, and gene-set burden analyses. Variants were considered rare if they had a minor allele frequency of Results: Of the 113 subjects enrolled, 86 had sufficient blood samples collected for WES. The median age was 16.2 years (range: 11.5-19.6). 36% of cases showed variants in VWF vs. 26% of controls (p=0.14). After multiple test correction, WES revealed a significant common variant association in FERMT2 with an LD block with a frequency of 24% in cases and 6% in controls (p=7.5x10-7). Rare variant analysis showed a significant association with an intronic variant in ABCA13 (p=1.6x10-7). Among the gene burden analysis using rare nonsynonymous variants, 2 genes of interest passed multiple test correction: IL12B and DTNBP1. When using ClinVar 'pathogenic' variants as the input for the gene burden analysis, 4 genes of interest passed multiple test correction: HBM, MYLK, RUNX1 and CD36. Gene-set burden analysis revealed 5 significant pathways of interest, including platelet degranulation, platelet alpha granule lumen and erythrocyte differentiation. We then focused a subset of known risk genes and compared the number of missense, nonsense and ClinVar 'pathogenic' variants between cases and controls. GP6, and MTHFR had significantly more missense variants in controls vs. cases (p=0.003 and 0.01, respectively), and F13B approached significance, with more missense variants in controls than cases (p=0.07). Conclusion: We found VWF variants in 36% of subjects, in accordance with previous reports. We found novel SNP associations with variants in FERMT2 and ABCA13.FERMT2 encodes for the integrin, Kindlin 2, which has been shown to be critical for supporting vascular integrity. Several other relevant genes passed multiple test correction in gene burden analyses, including genes known to cause Hermansky-Pudlak syndrome (DTNBP1), familial platelet disorder (RUNX1), platelet glycoprotein IV deficiency (CD36) and aortic aneurysm (MYLK). This association with platelet disorders was strengthened by our gene-set burden results, which implicate several platelet-related pathways. These data suggest that while a subset of HMB patients may have their bleeding explained by variants in VWF, there is a role for other hemostasis, platelet biology and vascular integrity related gene variants which can contribute to the variation in bleeding severity in adolescents with low-VWF related HMB. Study supported by an investigator-initiated research grant from Shire US Inc., now part of Takeda Disclosures O'Brien: Bristol Myers Squibb: Consultancy, Membership on an entity's Board of Directors or advisory committees. Mullins:Takeda, Bayer: Other: Advisory Board. Sidonio:Takeda: Research Funding. Ragni:Sangamo: Consultancy, Research Funding; Takeda: Research Funding; Bioverativ: Consultancy, Research Funding; Spark: Consultancy, Research Funding; BioMarin: Consultancy, Research Funding; Alnylam/Sanofi, ATHN, BioMarin, Bioverativ, Sangamo, Spark: Research Funding; Alnylam/Sanofi, BioMarin, Bioverativ, Spark: Consultancy; Alnylam Pharmaceuticals Inc., Baxalta/Takeda, BioMarin, Bioverativ, and Spark Therapeutics: Membership on an entity's Board of Directors or advisory committees; American Thrombosis Hemostasis Network: Other: Committee work; Baxalta/Takeda, CSL Behring, Genentech, a member of the Roche Group, OPKO Biologics, and Vascular Medicine Institute: Research Funding. Kulkarni:Sanofi/ Bioverativ, Bayer, Biomarin, Shire/Takeda, Novo Nordisk, Freeline: Other: clinical trial research grants ; Bioverativ/Sanofi, BPL, Genentech, Kedrion, Novo Nordisk, Octapharma, Pfizer, Takeda, Catalyst Bioscience Bayer: Membership on an entity's Board of Directors or advisory committees. Srivaths:Shire US Inc., now part of Takeda: Research Funding.

India became independent in 1947 and adopted a Constitution in 1950, which remains in force today.1 Part III of the Constitution protects fundamental rights, including the right to life, which has been interpreted to mean the right to live a life with dignity and free from violence.2 The Constitution also empowers the State to take affirmative measures to protect women under Article 15.3 The Indian Parliament has often invoked Article 15 to pass special legislative or executive measures to protect women, which have generally been upheld by the CourtsIt took India fourteen years after independence to pass its first law directly relating to violence against women. In 1961, the Dowry Prohibition Act (DPA) came into effect which penalized not only taking but giving of dowry. However, the Act did not effectively curb the practice of dowry.5 The Indian Parliament later passed Dowry Prohibition (Amendment) Acts in 1984 and 1986, but their impact was as negligible as that of the 1961 Act.6

ZnO nanopencils (NPCs) were prepared by a novel wet chemical process, using triethanolamine (TEA) as a mild base, which is relatively simple and cost effective method as compared to hydrothermal method. ZnO NPCs were characterized using powder X-ray diffraction (XRD), Fourier Transform Infra-Red (FTIR) spectroscopy in mid-IR and far-IR regions, X-ray Photoelectron Spectroscopy (XPS), UV–vis (UV–vis) absorption spectroscopy, room temperature Photoluminescence (PL) spectroscopy and Field Emission Scanning Electron Microscopy (FESEM). ZnO NPCs obtained, were highly pure, uniform and monodispersed.XRD pattern indicated hexagonal unit cell structure with preferred orientation along the c-axis. Sensing behaviour of ZnO NPCs was studied towards Liquefied Petroleum Gas (LPG) at different operating temperatures. The study shows that ZnO NPCs were most sensitive and promising candidate for detection of LPG at 250 °C with gas sensitivity > 60%. The high response towards LPG is due to high surface area of ZnO NPCs and their parallel alignment.

Colorectal cancer is the third most common cancer in the United States in both men and women, and the second leading cause of cancer-related deaths. Whereas the overall incidence of colon and rectal cancer has been decreasing over the past two decades, due in large part to improved colorectal screening and surveillance of patients who are at risk, incidence rates of colorectal cancer in young adults ages 20 to 50 have actually been increasing. Recently, the American Cancer Society updated their guidelines with recommendations that everyone, not just African Americans or those with a strong family history of colon cancer, should begin colorectal screening at age 45 rather than age 50. However, the United States Multi-Society Task Force on Colorectal Cancer, which is comprised of the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy, felt that there is still insufficient evidence to support early screening in the absence of known risk factors. Previous authors have examined the epidemiology and natural history of early onset colorectal cancer but none of these studies are specific to the state of Hawai‘i, which has a unique ethnic profile. The purpose of this article is to review the most recently reported incidence rate and demographics of early onset colorectal cancer in Hawai‘i and to discuss our own experience with colon cancer in patients younger than age 50. If we can determine specific characteristics of young patients with early onset colorectal cancer in Hawai‘i, we can better identify those patients who would benefit most from earlier screening.

Vitamin K (VK) is needed for the synthesis of procoagulants FII, FVII, FIX, and FX as well as endogenous inhibitors of coagulation, proteins C and S, collectively referred to as VK-dependent clotting factors. Deficiency of VK can result in mucocutaneous bleeding along with serious gastrointestinal and intracranial hemorrhage. Deficiency of VK is seen commonly in exclusively breastfed infants, related to decreased concentrations of VK in breast milk and low stores. Deficiency can also occur with malabsorption syndromes, decreased production of bile salts, and drugs such as warfarin and antibiotics. The diagnosis is usually suspected when the prothrombin time (PT) and activated partial thromboplastin time (aPTT) are prolonged along with decreased levels of VK-dependent clotting factors. Measurement of PIVKA-II (protein induced by the absence of VK) levels can offer confirmation of the diagnosis even days after treatment. Prophylaxis with VK at birth is effective in preventing early VK deficiency–associated bleeding. Parenteral administration of VK typically improves the PT and aPTT within a day.

Aim: To compare the rise in temperature using trephines over conventional ones during bone site preparation. Setting and Design: An-vitro, evaluative study Materials and Methods: Twenty implant sites were prepared using pilot drill up to depth of 10 mm on bovine femoral bone. In first part, no irrigation was used. Five sites were prepared using conventional drill of 2.8 mm, and other five were prepared with help of trephine drills. On completion of each drill, infrared thermometer was used to measure temperature on both the drill tip and the shaft. The same procedure was repeated with bone immersed in saline. Statistical Analysis Used: Student t test was used to evaluate the significance of difference. Result: Study showed that the temperature rise at drill tip was significantly higher for trephine drill (52.98 ± 1.67 °C) than conventional drills (48.20 ± 0.67 °C), however the temperature difference in trephine and conventional drills was statistically insignificant. Conclusion: The temperature increase was more distributed in conventional drills than trephine. Copious irrigation is thus mandatory for trephine drills. Intermittent drilling is preferred with conventional drills.

Vanishing bone disease is a rare clinical entity with unknown etiology. This disease affects individual irrespective of age or sex. Various names have been used in the literature to describe this condition such as Gorham's disease, phantom bone disease, massive osteolysis, disappearing bone disease and acute spontaneous absorption of bone. The pathogenesis is unknown and the treatment still remains controversial. Considering the rarity of the disease, we report here an interesting and unique case of massive osteolysis of the lower jaw that affected the mandibular basal and alveolar bone. The diagnoses lead on the association of clinical, radiological and histological features.

Mechanisms that may regulate the storage of energy as triacylglycerol in Saccharomyces cerevisiae were examined. First, the kinetics of Dga1p, which mediates the majority of diacylglycerol esterification, the lone committed step in triacylglycerol synthesis, was measured in vitro. With an apparent K m of 17.0 μM, Dga1p has higher affinity for oleoyl-CoA than the only S. cerevisiae acyltransferase previously kinetically characterized, Lpt1p. Lpt1p is a 1-acylglycerol-3-phosphate O-acyltransferase that produces phosphatidate, a precursor to diacylglycerol. Therefore, limiting triacylglycerol synthesis to situations of elevated acyl-CoA concentration is unlikely. However, Dga1p’s apparent V max of 5.8 nmol/min/mg was 20 times lower than Lpt1p’s. This supports Dga1p being rate limiting for TAG synthesis. Dga1p activity was not activated or inhibited when seven different molecules (e.g., ATP) which reflect cellular energy status were provided at physiological concentrations. Thus, allosteric regulation was not found. Coordination between triacylglycerol and glycogen synthesis was also tested. Yeast genetically deficient in triacylglycerol synthesis did not store more energy in glycogen and vice versa. Lastly, we tested whether genetically limiting energy storage in triacylglycerol, glycogen, steryl esters, or combinations of these will increase ethanol production efficiency. In nutrient-rich media containing 5 % glucose, solely limiting glycogen synthesis had the greatest affect, increasing ethanol production efficiency by 12 %. Since limiting glycogen synthesis only had a modest effect on growth in media containing 10 % ethanol, such genetic manipulation may improve commercial ethanol production.

BACKGROUND As a part of Internal Quality Assessment, it is a usual practice in Clinical Biochemistry Laboratories to run Internal Quality Control (IQC) sera and check the results for any violation of Westgard rules. A mean and standard deviation (SD) of minimum 20 values of IQC results is taken for plotting Levey-Jennings (LJ) chart, but results of extended period (60 or 90 days) can also be used to calculate mean and SD. AIMS  To derive mean and SD of IQC results for a period of 20 days and 90 days.  To monitor daily IQC results for violation of Westgard rules using mean and SD of 20 days and 90 days.  To compare frequency of violation of Westgard rules and EQAS performance while using these two means and SDs. METHODOLOGY This study was conducted in the Clinical Biochemistry Laboratory of S.S.G. Hospital and Medical College, Vadodara, where two levels of IQC sera are run twice daily. When a new lot of IQC sera was put into use, means and SDs were derived using 20 days (Protocol-I) and 90 days (Protocol-II) results. Both were used for daily monitoring of IQC for 3 months. We compared frequency of violation of Westgard rules (13s, 22s, R4s, 10x) and EQAS Standard Deviation Index (SDI) for 10 different biochemical parameters while using these two protocols. RESULTS The Westgard rules were violated for a total of 48 times while using Protocol-I as compared to only 5 times while Protocol-II was used. No significant difference was found in EQAS results in terms of SDI. CONCLUSION From the current study, it is concluded that for IQC daily monitoring, if mean and SD are derived from longer period (90 days) results of IQC sera, there are fewer incidences of violations of Westgard rules without any compromising effect on EQAS results. Hence, by using more number of values over a longer period, one can reduce unnecessary rejections of run, re-run of IQC and repeated calibration of test parameters, thereby reducing the overall cost of testing and improving the turn-around time (TAT)

Extended release of drugs is extremely essential for patients who require medicinal treatment round the clock. Depressed patients are one of such patients who suffer from recurrent and chronic disorder requiring long-term treatment. The treatment for such disease lies in the use of anti-depressants. Venlafaxine hydrochloride (VF) is an effective third generation drug which is capable of inhibiting the reuptake of serotonin, norepinephrine and dopamine. This highly water soluble drug (534 mg/ml) has a short steady state elimination half-life of 4–5 h due to which this drug needs to be administrated 2 to 3 times in a day in order to maintain its required concentration in the blood plasma. The present study aimed at developing montmorillonite (Mt) alginate (ALG) biopolymeric composites as micro beads with 97% encapsulation efficiency for an oral extended release of VF. These micro beads were synthesized using in situ ion-exchange followed by ionotropic gelation technique. The in - vitro release profile of pure drug shows a rapid burst release followed by 100% cumulative release within 5.5 h and 3.5 h in the gastric and intestinal fluid respectively. Whereas, the in - vitro release profile of VF from Mt biopolymeric beads show substantially less burst release with cumulative release of 20% (over a period of 26 h) and 22% (over a period of 29 h) in the gastric and intestinal fluid respectively. The presence of clay not only reduces the burst effect but also results in extended release of drug. Thus, there is possibility of making a formulation for oral extended release dosage forms for Venlafaxine with better patient compliance as repeated intake (every 3–4 h) of drug will not be necessary.

Background: Dyslipidaemia is one of major risk factor contributing to cardiovascular disease, which further causes mortality and morbidity, so requires a long course of treatment. Physicians should be aware of the cost of drugs.Methods: Cost of the oral anti-dyslipidaemic drug, either as single drug or in combination manufactured by different pharmaceutical companies in the same strength and dosage form was obtained from current index of medical specialities (CIMS) April-July 2019. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage cost variation per 10 tablets was calculated.Results: In this study, existing findings showed a wide cost variation among different brands of the same oral anti-dyslipidaemic drug. Percentage cost variation for individual oral anti-dyslipidaemic drug was found to be highest with atorvastatin (80 mg film coated (FC) tablet): 358.84% followed by atorvastatin (5 mg FC tablet): 247%, fenofibrate (200 mg FC tablet): 134.22%, lovastatin (10 mg FC tablet): 108.56%, rosuvastatin (10 mg FC tablet): 78.60%, while lowest cost variation is seen with rosuvastatin 40 mg FC Tb: 1.598%. Among fixed dose combination therapy percentage cost variation was found to be highest with atorvastatin and fenofibrate (10 mg and 160 mg, FC tablet): 256%, followed by atorvastatin and ezetimibe (10 mg and 10 mg, tablet): 132.39%, while minimum cost variation was for rosuvastatin and fenofibrate (10 mg and 67 mg, tablet): 22.6%.Conclusions: These study findings showed that there is a wide variation in the cost of the same oral anti-dyslipidaemic drug. So, it is very necessary for regulatory authorities to regulate the wide variation in the cost, as well as physicians, should be sensitized to be aware of their cost variations to reduce the economic burden of drug-therapy to the patients.

Ternary compounds are found to be more thermally stable with high electron mobility and hence higher efficiency towards sensing, photocatalysis and optoelectronic devices as compared to binary compounds (ZnO, SnO2). An elegant approach was made to synthesis one dimensional zinc stannate (Zn2SnO4) using microwave technique, which is energy efficient, less time consuming and economically viable for large scale production. The cubic spinel structure was confirmed using X-ray diffraction (XRD) and rod shaped morphology was observed on field emission scanning electron microscope (FESEM). Nanorods obtained were pure, monodispersed and uniform. Structural composition, oxidation state and binding energy were studied using X-ray photoelectron spectroscopy (XPS). Optical properties were studied using UV–Vis and photoluminescence (PL) spectroscopy. Band gap was found to be 3.74 eV, which shows quantum confinement and was calculated using Tauc’s equation. Moreover, the growth mechanism is discussed with role of microwave radiation over conventional heating methods. Under visible light irradiation, Zn2SnO 4 nanorods have excellent photocatalytic activity for the degradation of cationic rhodamine dye (60 mins, 98%) and anionic methyl orange dye (75 min, 82%), respectively. Even at fifth cycle Zn2SnO4 shows 92% efficiency.

Background: India is the world capital for chronic lung diseases, asthma mortality and has the second largest number of deaths in COPD. Chronic respiratory diseases are the second leading cause of death in India. The under diagnosis and improper management has led to poorly controlled disease condition. Thus, it is important to sensitize the practicing physicians with appropriate management approach Aim: To describe the implementation experiences of a training model for building capacities of PCPs in management of COPD & Asthma Methods: The joint certificate program was designed and delivered by Public Health Foundation of India along with academic partners and funding partner with the objective to upgrade the skills and core competencies of PCPs by means of evidence based curriculum developed by academic partners, contextualized by a panel of 16 national experts and delivered by pulmonologists at 24 centers across the country. The course had a strong monitoring and evaluation component that assured standardized delivery and quality. Results: A total of 503 physicians were trained and covered 15 states, 145 districts & 23 cities. This model has been adopted by state governments of Gujarat, Assam and Kolkata Municipal Corporation for training medical officers. It has been endorsed by International Primary Care Respiratory Group for 5 years and various countries are going to adopt this model for training of physicians in their respective countries globally. Conclusion: Building capacity of PCPs could help reduce the burden on the tertiary care system. The unique model presented can be easily replicated in other LMICs with similar health system settings.

Blood clotting at the vascular injury site is a complex process that involves platelet adhesion and clot stiffening/contraction in the milieu of fluid flow. An integrated understanding of the hemodynamics and tissue mechanics regulating this process is currently lacking due to the absence of an experimental system that can simultaneously model clot formation and measure clot mechanics under shear flow. Here we develop a microfluidic-integrated microclot-array-elastometry system (clotMAT) that recapitulates dynamic changes in clot mechanics under physiological shear. Treatments with procoagulants and platelet antagonists and studies with diseased patient plasma demonstrate the ability of the system to assay clot biomechanics associated with common antiplatelet treatments and bleeding disorders. The changes of clot mechanics under biochemical treatments and shear flow demonstrate independent yet equally strong effects of these two stimulants on clot stiffening. This microtissue force sensing system may have future research and diagnostic potential for various bleeding disorders., Blood clotting is a complex process involving platelet adhesion and clot stiffening. Here the authors present a microfluidic system to recapitulate the dynamic changes in clot mechanics under physiological shear.

Empowerment of women is important for decision making in relation to health seeking, family planning, nutrition and economic issues not only for her but also for the family. Women’s empowerment in India is heavily dependent on many different variables which include geographical location (urban/rural), educational status, social status (caste and class) and age. Policies on empowerment of women exist at national, state and local (panchayat) levels. Still women face differentiation in many sectors like health, education, economic opportunities and political participation which shows that there are significant gaps between policy advancements and actual practice at the community level. This paper reveals current status of women empowerment indicators in India. It focuses on various laws and policies framed for women empowerment for women. The reasons for discrimination of women in society are given despite adequate laws for protection of their rights. The study is concluded by making appropriate recommendations to ameliorate the status of women. Framing and implementation of sound policy framework, education and disseminating social awareness regarding empowerment of women can lead to achieve the desired goals in removing the plight of women in Indian society.

Solitary fibrous tumors are rare spindle cell tumors of mesenchymal origin most commonly found in the pleura and peritoneum. In contrast, extra-serosal locations are rare. We present a 41-year-old female with a progressively enlarging left-sided neck mass of one-year duration with subsequent rapid-onset growth over two months, and was pathologically confirmed to be a benign solitary fibrous tumor of the thyroid gland.

Large animal models are important tools for hepatocellular carcinoma (HCC) research, especially in studies of hepatic vasculature, interventional techniques, and radiofrequency or microwave hyperthermia. Currently, diethylnitrosamine (DENA)-induced HCC in pigs is the only large animal model for in situ HCC with a tumor latency of 10–26 months. While phenobarbital (PB) is often used to accelerate DENA-induced HCC in rodents, it has not been previously studied in the porcine model. Therefore, we hypothesize that the addition of PB in the DENA-induced HCC porcine model will accelerate tumor latency compared to DENA alone. HCC and benign lesions were seen on serial MRI and confirmed on histopathology. Liver and tumors were further characterized by CT angiography, vascular corrosion casting, and permittivity measurements.

Characterization of manufacturing processes is key to understanding the effects of process parameters on process performance and product quality. These studies are generally conducted using small-scale model systems. Because of the importance of the results derived from these studies, the small-scale model should be predictive of large scale. Typically, small-scale bioreactors, which are considered superior to shake flasks in simulating large-scale bioreactors, are used as the scale-down models for characterizing mammalian cell culture processes. In this article, we describe a case study where a cell culture unit operation in bioreactors using one-sided pH control and their satellites (small-scale runs conducted using the same post-inoculation cultures and nutrient feeds) in 3-L bioreactors and shake flasks indicated that shake flasks mimicked the large-scale performance better than 3-L bioreactors. We detail here how multivariate analysis was used to make the pertinent assessment and to generate the hypothesis for refining the existing 3-L scale-down model. Relevant statistical techniques such as principal component analysis, partial least square, orthogonal partial least square, and discriminant analysis were used to identify the outliers and to determine the discriminatory variables responsible for performance differences at different scales. The resulting analysis, in combination with mass transfer principles, led to the hypothesis that observed similarities between 15,000-L and shake flask runs, and differences between 15,000-L and 3-L runs, were due to pCO2 and pH values. This hypothesis was confirmed by changing the aeration strategy at 3-L scale. By reducing the initial sparge rate in 3-L bioreactor, process performance and product quality data moved closer to that of large scale.

Entrepreneurship is the back bone of economic growth of any country. Entrepreneurship can be fostered by inculcating entrepreneurial skills right at the stage of education. The presence of Entrepreneurship Development Cell (EDC) in educational institutes helps in developing entrepreneurial culture in academic institutions so as to foster growth of innovation and entrepreneurship. With this premise a study was conducted on 1254 students of government and private institutes pursuing post graduation in Commerce, Science and Humanities with/without exposure to EDC in the national capital region of India. The results of the present study show that the students exposed to the activities of EDC are significantly higher on Innovation as compared to the students who do not get any such exposure. Also results shows that even the students of courses like science and humanities (these courses do not include business subjects) in private institutes are higher on Frequency of Entrepreneurial Activities where they are exposed to Entrepreneurial Development Cells.

Dexamethasone (DEX) is a potent synthetic member of the glucocorticoid class of steroid drugs that has anti-inflammatory and immunosuppressant effects. It is 25 times more potent than cortisol in its glucocorticoid effect, while having a minimal mineralocorticoid effect. Due to the hydrophobicity and short half-life of the drug, high doses are required to maintain its therapeutic level in the blood plasma which has undesirable side effects. Therefore, a new drug delivery system capable of overcoming the drawbacks associated with dexamethasone is required at present. The present study is aimed at developing an extended release carrier for DEX using montmorillonite (Mt) and polylactic-co-glycolic acid (PLGA) nanocomposites suitable for oral administration. The synthesized clay polymer nanocomposites (CPN) were characterized with respect to morphology, particle size, physical status etc. The in-vitro drug release behavior of DEX from Mt–PLGA nanocomposites and PLGA particles in simulated gastrointestinal fluids has been investigated. In-vitro drug release profiles of CPN in simulated gastrointestinal fluid indicate an extended release of DEX as compared to DEX–PLGA particles and pure DEX.

Barrett’s esophagus (BE) is a premalignant condition. The incidence of adenocarcinoma in BE has been reported to be between 0.1-3%. Dysplasia in BE is patchy and extensive biopsy sampling is labor intensive, low yield and does not eliminate the sampling error completely. Volumetric laser endomicroscopy (VLE) is expected to enable endoscopists to do targeted biopsy of dysplastic/cancerous lesions (not visible on white light endoscopy) among patients with BE. We reviewed 7 studies with a total of 62 subjects who had undergone VLE. Of 34 patients with available data, VLE correlated with histology in 17 subjects (50%). It missed the underlying diagnosis in one subject (2.9%). VLE led to inadvertent biopsy in 16 patients (47.1%), and led or would have led to upstaging of disease in 11 subjects (32.4%). In the entire cohort, the sensitivity, specificity, positive predictive value and negative predictive value (NPV) of VLE for diagnosis of dysplasia, buried Barrett’s or intramucosal carcinoma was 92.3%, 23.8%, 42.9% and 83.3%, respectively. High sensitivity and NPV can potentially help space out the surveillance intervals. Low specificity does lead to a high number of biopsies, which are likely less than non targeted biopsies. Volumetric laser endomicroscopy is a safe and sensitive test to identify mucosal lesions in patients with BE which are invisible under standard white light endoscopy.Abbreviations: BE: Barrett’s Esophagus; BB: Buried Barrett’s; EAC: Esophageal adenocarcinoma; EDS: Evans Dysplasia Score; EMR: Endoscopic Mucosal Resection; GERD: Gastro-esophageal reflux disease; HGD: High grade dysplasia; IMC: Intra-mucosal adenocarcinoma; LGD: Low grade dysplasia; NBI: Narrow Band Imaging; OCT-SI: Optical Coherence Tomography Scoring Index; RFA: Radiofrequency ablation; SGS: Sub-squamous glandular structures; VLE: Volumetric Laser Endomicroscopy; WLE: White Light Endoscopy.

India leads the world in asthma mortality and has the second largest number of deaths in Chronic Obstructive Pulmonary Disease (COPD). In response to this need, Certificate Course in Management of COPD and Asthma (CCCA), a joint certification course by Public Health Foundation of India, Chest Research Foundation, Narayana Health & supported by an education grant from GSK Pharmaceuticals Pvt. Ltd. was designed & delivered Objectives: CCCA aims to enhance knowledge, skills and core competencies of PCPs to address management of COPD and Asthma Methodology: This comprehensive program is designed by a panel of 16 National Experts (NE) to train 503 Primary Care Physicians (PCPs) in 24 regional centers by Regional Faculty (RF). A robust and innovative “Program Management” has been designed to ensure quality and standardized delivery of training. Program management involves coordination with NE and RF in developing a standardized modules along with the academic partners. It is an 8 modular course with once a month contact session on designated weekends delivered by a pulmonologist at each center. The training includes judicious mix of case-studies, group discussion, assignments, activities and hands- on training A total of 503 PCP’s have enrolled in the first cycle of the program. The participants have an average clinical experience of 14 years. Over one-third of the PCP’s represent government and not-for -profit organizations,. The program aim to train more than 1000 PCPs in two years CCCA, a unique and sustainable initiative is an effort to build a trained cadre of PCPs in India and has been designed with great potential to reduce the rising burden of chronic respiratory disorders in India

Both fine needle aspiration (FNA) and needle core biopsy (NCB) are widely accepted methods for obtaining diagnostic material. There is variability in how different institutions use these techniques in assessing liver masses. The aim of this study is to compare the diagnostic accuracy and tissue quality between FNA and NCB, and create a cost-effective algorithm for evaluating liver masses.A database search was performed to detect all liver FNA cases and their corresponding NCB between January 2014 and August 2016. A retrospective chart review was performed to gather pertinent clinicopathologic information.Seventy-seven FNA and 68 corresponding NCB were reviewed from 74 patients. Diagnoses in the 74 patients included 36 hepatocellular carcinomas (HCC), 29 metastatic malignancies (MET), 5 poorly differentiated carcinomas (PDC), 2 cholangiocarcinomas (CHO), and 2 benign lesions (BEN). More immunohistochemical (IHC) studies (P0.05) were performed on NCB tissues than FNA tissues in HCC (mean, 2.1 versus 0.8), MET (2.5 versus 0.5), and PDC groups (11.2 versus 0.2). The false negative rate (FNR) of NCB was lower (P0.05) than that of FNA in the HCC group; and FNR of NCB was higher (P0.05) than that of FNA in the MET group.For HCC, NCB usually has better tissue quality and diagnostic accuracy than FNA; for metastatic lesions in the liver, FNA has better diagnostic accuracy than NCB, although NCB can provide more tissue for ancillary testing and has better diagnostic quality. Appropriate diagnostic method is important for improving diagnostic accuracy and saving medical resources.

Genetic Algorithm (GA) forms a subset of evolutionary computing, rapidly growing area of Artificial Intelligence (A.I.). Some variants of GA are binary GA, real GA, messy GA, micro GA, saw tooth GA, differential evolution GA. This research article presents a real coded GA for predicting enrollments of University of Alabama. Data of Alabama University is a fuzzy time series. Here, fuzzy logic is used to predict enrollments of Alabama University and genetic algorithm optimizes fuzzy intervals. Results are compared to other eminent author works and found satisfactory, and states that real coded GA are fast and accurate.Genetic Algorithm (GA) forms a subset of evolutionary computing, rapidly growing area of Artificial Intelligence (A.I.). Some variants of GA are binary GA, real GA, messy GA, micro GA, saw tooth GA, differential evolution GA. This research article presents a real coded GA for predicting enrollments of University of Alabama. Data of Alabama University is a fuzzy time series. Here, fuzzy logic is used to predict enrollments of Alabama University and genetic algorithm optimizes fuzzy intervals. Results are compared to other eminent author works and found satisfactory, and states that real coded GA are fast and accurate.

The objective of the present study is to develop montmorillonite (Mt) based PLGA nanocomposites for oral and controlled release carrier for an antidepressant drug, venlafaxine hydrochloride (VF). VF loaded CPN were prepared using double emulsion solvent evaporation technique. The synthesized CPN were compared with respect to morphology, particle size, physical status of VF and Mt and in vitro drug release to the corresponding biodegradable PLGA nanoparticles. Mt based VF-PLGA nanocomposites suggest the possibility of designing the oral and controlled release formulations to minimize the drug administration frequency and the occurrence of side effect thereby increasing the effectiveness of drug and hence improving patient compliance.

Malnutrition is one of the most common causes of morbidity in patients undergoing maxillofacial surgery. In these patients, normal food intake is impaired because of the disease state and is complicated further by the surgical procedures. Surgery imparts controlled injury and delays wound healing capacity. Consideration should be given to the nutritional status of these patients in both preoperative and postoperative period so as to reduce postoperative complications. It should be imperative upon the part of dental professional to identify patients at nutritional risk, perform nutritional screening tests and provide dietary guidelines. In this paper we have focused on nutritional risk, nutritional assessment, and recommendations for such kind of patients.

Bioenergetic dysfunction, although central to the pathogenesis of numerous diseases, remains uncharacterized in many patient populations because of the invasiveness of obtaining tissue for mitochondrial studies. Although platelets are an accessible source of mitochondria, the role of bioenergetics in regulating platelet function remains unclear. Herein, we validate extracellular flux analysis in human platelets and use this technique to screen for mitochondrial dysfunction in sickle cell disease (SCD) patients, a population with aberrant platelet activation of an unknown mechanism and in which mitochondrial function has never been assessed. We identify a bioenergetic alteration in SCD patients characterized by deficient complex V activity, leading to decreased mitochondrial respiration, membrane hyperpolarization, and augmented oxidant production compared with healthy subjects. This dysfunction correlates with platelet activation and hemolysis in vivo and can be recapitulated in vitro by exposing healthy platelets to hemoglobin or a complex V inhibitor. Further, reproduction of this dysfunction in vitro activates healthy platelets, an effect prevented by attenuation of mitochondrial hyperpolarization or by scavenging mitochondrial oxidants. These data identify bioenergetic dysfunction in SCD patients for the first time and establish mitochondrial hyperpolarization and oxidant generation as potential pathogenic mechanism in SCD as well as a modulator of healthy platelet function.

Tin and its derivatives are extensively used in modern technology tools which lead requirement for development of green methods for its waste management and profitable recycling. Presence of tin in water bodies causes enormous environmental concern due to its acute toxicity to living beings. We demonstrate a simple and zero emission process for extraction of tin ions from aqueous solution using dithiocarbamate-based copolymer and its single step quantitative recovery and transformation into SnS nanoparticles. The polymer shows high metal extraction capacity, 1.06 g SnCl2 per gram of polymer. The polymer metal composite and SnS nanoparticles are analyzed using TEM, FTIR, XRD spectroscopy techniques. The FTIR shows formation of Sn-S bonding in the polymer metal composite. This study has implication for cost effective and green approach for purification of water and waste management.