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Introduction: In transplantation, accurate estimation of the donor glomerular filtration rate (GFR) is crucial. While various creatinine-based equations are in use, none are validated in Indians. Objectives: This study was conducted to judge the accuracy of creatinine-based GFR estimation equations and urinary creatinine clearance. Patients and Methods: A single-centre, observational and retrospective study at a tertiary care hospital. Adult voluntary donors GFR measured (mGFR) by technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA) were included. The primary outcome was the performance of estimated GFR (eGFR) by "Cockcroft-Gault’s formula corrected for body surface area (CG-BSA) formula", "modification of diet in renal disease (MDRD) 4 and 6 variable equation" and "Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation"; secondary outcome was the performance of "24-hour urinary creatinine clearance (Cr Cl)". Results: 102 kidney donors were analysed with mean age of 45.89 ± 9.98 years and 85.3% females. Mean ± SD mGFR by Tc-99m DTPA was 82.11 ± 14.32 mL/min/1.73 m2 . Mean ± SD eGFR by "CGBSA" was 99.68 ± 23.71 mL/min/1.73 m2 , by "MDRD-4 variable equation" was 98.25 ± 28.61 mL/ min/1.73 m2 , by "MDRD-6 variable equation" was 93.66 ± 19.44 ml/min/1.73 m2 and by "CKD-EPI" was 111.14 ± 31.61 mL/min/1.73 m2 . The lowest bias (2.3), highest precision (16.23), and accuracy (97.1%) were with "MDRD-6 variable equation"; "24-hour urinary Cr Cl" highly overestimated GFR (158.27 mL/min/1.73 m2 ) with the highest bias, lowest precision, and accuracy. Conclusion: The "MDRD-6 variable equation" was the most precise and accurate of the equations, whereas "24-hour urinary Cr Cl" was the least dependable. This study highlights the need for a correction factor or a new GFR estimation equation and not to consider urinary Cr Cl to assess donor GFR.

The adverse effects of oxalic acid (OA) on human health linked with its excessive consumption necessitates an improved sensor. Here, we demonstrate an electrochemical sensor for oxalic acid detection based on silver nanoparticles (Ag-Nps) and nitrogen-doped graphene oxide (N-GO) nanocomposite. N-GO, which was synthesized using atmospheric pressure microwave plasma has been first time employed for electrochemical application. The nanocomposite formation was confirmed through scanning electron microscopy and EDS elemental analysis. The nanocomposite-based sensor showed a higher current response, good selectivity and stability which can be attributed to the synergistic-effect of Ag-Nps and N-GO. Amperometric responses were proportional to the concentration of OA between 10 and 300 μM, and the detection limit was 2 μM.

Ranjit Unnikrishnan,1 Venkatesan Radha,2 Viswanathan Mohan1 1Department of Diabetology, Dr. Mohan’s Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India; 2Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai, IndiaCorrespondence: Viswanathan MohanDr. Mohan’s Diabetes Specialities Centre, IDF Centre of Excellence in Diabetes Care & Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes No 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, IndiaTel +9144 4396 8888Fax +9144 2835 0935Email drmohans@diabetes.ind.inAbstract: Diabetes is a heterogenous disorder, and patients with this disorder vary considerably in their clinical presentation, response to therapy and risk of complications. Expanding knowledge about the pathophysiology of various forms of diabetes has raised the possibility that diagnostic and therapeutic modalities can be tailored to the individual patient in a personalized manner. The recent publication of a Consensus Statement on precision diabetes care underlines the major strides made in this field in the recent past. However, while personalized diabetes care has the potential to significantly improve outcomes in patients with diabetes in a safe and cost-effective manner, its wider application presents several challenges, especially in resource-strained settings. These challenges pertain equally to precision diagnostics, precision therapeutics and precision monitoring. This article discusses some of the important challenges that care providers are likely to face in applying the personalized approach in caring for their patients with diabetes, in the context of diagnosis and management of type 1 diabetes, type 2 diabetes and monogenic forms of diabetes. Suggestions are also presented for overcoming some of these challenges.Keywords: type 1 diabetes, type 2 diabetes, monogenic forms of diabetes, personalised treatment

Abstract Two novel types of anion exchange membranes (AEMs) having imidazolium-type functionalised nanofibrous substrates were prepared using the facile and potentially scalable method. The membranes’ precursors were prepared by graft copolymerization of vinylbenzyl chloride (VBC) onto syndiotactic polypropylene (syn-PP) and polyamide-66 (PA-66) nanofibrous networks followed by crosslinking with 1,8-octanediamine, thermal treatment and subsequent functionalisation of imidazolium groups. The obtained membranes displayed an ion exchange capacity (IEC) close to 1.9 mmol g–1 and ionic (OH-) conductivity as high as 130 mS cm–1 at 80 °C. This was coupled with a reasonable alkaline stability representing more than 70% of their original conductivity under accelerated degradation test in 1 M KOH at 80 °C for 360 h. The effect of ionomer binder on the performance of the membrane electrode assembly (MEA) in AEM fuel cell was evaluated with the optimum membrane. The MEA showed a power density of as high as 440 mW cm−2 at a current density is 910 mA cm−2 with diamine crosslinked quaternized polysulfone (DAPSF) binder at 80 °C with 90% humidified H2 and O2 gases. Such performance was 2.3 folds higher than the corresponding MEA performance with quaternary ammonium polysulfone (QAPS) binder at the same operating conditions. Overall, the newly developed membrane was found to possess not only an excellent combination of physico-chemical properties and a reasonable stability but also to have a facile preparation procedure and cheap ingredients making it a promising candidate for application in AEM fuel cell.

Introduction: Intradialytic hypertension (IDH) is associated with significant vascular and cardiac adverse outcomes. Objectives: This study was performed to know the prevalence and factors predicting IDH. Patients and Methods: A single-center cross-sectional observational study at a tertiary care hospital. After ethics committee approval and informed consent, all patients over 18 years on twice weekly hemodialysis were included, those on peritoneal dialysis and acute kidney injury excluded. Primary outcome was prevalence of IDH based on three definitions and secondary outcome was predictive factors. IDH was defined as ≥10 mm Hg surge in systolic blood pressure (SBP) between pre-and postdialysis in 4 of 6 successive sessions or >15 mm Hg rise in mean arterial pressure (MAP) between start and end of dialysis or symptomatic rise in blood pressure requiring intervention. SBP and MAP were measured on standardized monitors before, hourly and 30 minutes post dialysis. Results: Of 136 patients, prevalence of intra-dialytic hypertension was 78/136 (57%), 33/136 (24%), 15/136 (11%) based on systolic rise, rise in MAP and symptomatic rise in BP respectively. Among those with systolic rise, diabetes mellitus (P= 0.03), undernourishment (P=0.03), inter-dialytic weight gain >3 kg (P< 0.001) and dialysis vintage > 3 years (P< 0.001) were significantly associated with IDH. Conclusion: IDH prevalence varied from 11 to 57% with different definitions. Diabetes mellitus, under nutrition, inter-dialytic weight gain >3 kg and dialysis vintage >3 years predicted IDH.

Graphene nanostructures exhibit a wide range of remarkable properties suitable for many applications, including those in the field of biomedical engineering. In this work, plasma-enhanced chemical vapor deposition was utilized at different applied RF power for the fabrication of vertical graphene nanowalls on silicon and quartz substrates from an inherently volatile carbon precursor without the use of any catalyst. AFM confirmed the presence of very sharp exposed graphene edges, with associated high surface roughness. The hydrophobicity of the material increased with the power of deposition, reaching the water contact angle of 123 ˚ for 500 W. Confocal scanning laser microscopy demonstrated that the viability of gram-negative Escherichia coli and gram-positive Staphylococcus aureus cells were 33% and 37% when incubated on graphene samples, respectively, compared to controls (quartz) that showed the viability of 82% and 84%, respectively. SEM verified significant morphological damage to bacterial cell walls by the sharp edges of graphene walls, with cells appearing abnormal and deformed. The presented data clearly contributed to the current understanding of the mechanical-bactericidal mechanism of vertically oriented graphene nanowalls upon direct contact with microorganisms.

Abstract Cardiac vasculitis is recognized as a heterogeneous disease process with a wide spectrum of manifestations including pericarditis, myocarditis, valvular heart disease and less frequently, coronary artery vasculitis (CAV). CAV encompasses an emerging field of diseases which differ from conventional atherosclerotic disease and have a proclivity for the younger population groups. CAV portends multiple complications including the development of coronary artery aneurysms, coronary stenotic lesions, and thrombosis, all which may result in acute coronary syndromes. There are several aetiologies for CAV; with Kawasaki’s disease, Takayasu's arteritis, Polyarteritis Nodosa, and Giant-Cell Arteritis more frequently described clinically, and in literature. There is a growing role for multi-modality imaging in assisting the diagnostic process; including transthoracic echocardiography, cardiac magnetic resonance imaging, computed tomography coronary angiography, fluorodeoxyglucose-positron emission tomography and conventional coronary angiogram with intravascular ultrasound. Whilst the treatment paradigms fundamentally vary between different aetiologies, there are overlaps with pharmacological regimes in immunosuppressive agents and anti-platelet therapies. Interventional and surgical management are is a consideration in select populations groups, within a multi-disciplinary context. Further large-scale studies are required to better appropriately outline management protocols in this niche population.

Congenital talipes equinovarus is one of the most prevalent birth defects, affecting approximately 0.6 to 1.5 children per 1000 live births. Currently, the Ponseti method is the gold-standard treatment for idiopathic clubfeet, with good results reported globally. This literature review focuses on common errors encountered during different stages of the management of idiopathic clubfeet, namely diagnosis, manipulation, serial casting, Achilles tenotomy, and bracing. The purpose is to update clinicians and provide broad guidelines that can be followed to avoid and manage these errors to optimize short- and long-term outcomes of treatment of idiopathic clubfeet using the Ponseti method. A literature search was performed using the following keywords: “Idiopathic Clubfoot” (All Fields) AND “Management” OR “Outcomes” (All Fields). Databases searched included PubMed, EMBASE, Cochrane Library, Google Scholar, and SCOPUS (age range: 0–12 months). A full-text review of these articles was then performed looking for “complications” or “errors” reported during the treatment process. A total of 61 articles were included in the final review: 28 from PubMed, 8 from EMBASE, 17 from Google Scholar, 2 from Cochrane Library, and 6 from SCOPUS. We then grouped the errors encountered during the treatment process under the different stages of the treatment protocol (diagnosis, manipulation and casting, tenotomy, and bracing) to facilitate discussion and highlight solutions. While the Ponseti method is currently the gold standard in clubfoot treatment, its precise and intensive nature can present clinicians, health care providers, and patients with potential problems if proper diligence and attention to detail is lacking. The purpose of this paper is to highlight common mistakes made throughout the Ponseti treatment protocol from diagnosis to bracing to optimize care for these patients.

Soil salinity is a major abiotic stress that adversely affects plant growth, and productivity. About 20% of irrigated lands are affected by salinity worldwide, In India, there are 6.74 million hectares of salt-affected lands. Salt-tolerant Plant Growth Promoting (PGP) microorganisms can enhance the growth of plants in such salt-stressed areas. Therefore, this study aimed to investigate the diversity of beneficial fungal communities, screen for their ability to support plant growth, and evaluate the production of various essential compounds in view of plant growth in salt-stressed lands. A total of 68 fungal colonies were isolated from 5 different agroforestry plantation sites in Karur, Tamil Nadu, South India at quarterly intervals. The isolates were screened for sodium chloride (NaCl) tolerance (0%, 5%, 10%, 15%, and 20% concentration). A total of 7 isolates showed considerable salt tolerance and were tested qualitatively in-vitro, for PGP traits such as phosphate, potassium, and zinc solubilization, nitrogen fixation, hydrogen cyanide production, siderophore production, and ACC deaminase production. Finally, 5 isolates with maximum values for PGP properties under 20% NaCl concentration were tested for the quantity of Indole-3-Acetic Acid (IAA) and Exo-polysaccharide (EPS) production. All 5 isolates were identified up to the species level using 18S rRNA gene sequencing. To the best of our knowledge, this is the first report on isolating saline-tolerant PGP Fungi (PGPF) from the rhizosphere region of Casuarina equisetifolia and Eucalyptus camaldulensis in Karur, Tamil Nadu, India. In the future, the bioformulation of PGPF and its application will boost the cultivation of tree saplings in this salt affected regions. [ABSTRACT FROM AUTHOR]