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This research work investigates the two body wear behavior of natural fiber reinforced composites using a pin on disc test set-up. Natural fibers such as Polyalthia Longifolia, Mangifera Indica and Jute were used as reinforcements with epoxy matrix. Four types of composites with 30% fiber weight fraction were fabricated using hand layup and compression molding technique. Taguchi experimental design with L16 orthogonal array was considered. Four factors viz. fiber type, normal load, sliding speed and sliding distance at four levels were analyzed for obtaining minimum specific wear rate. Normal load was the most significant factor influencing the response with percentage contribution of 56.21% while the least contribution was the factor sliding speed (2.30%). Based on the optimum combination, confirmation experiments were conducted, the results of which were obtained with a minimal error of 4.64%. Micrographs revealed different wear mechanisms like fiber-matrix de-bonding, fiber pull-out, matrix cracking, furrows and crater formation.

Fever is one of the major clinical symptoms of undifferentiated fever cases. Early diagnosis of undifferentiated fever is a challenging task for the physician. The aim of this study was to classify infectious and noninfectious diseases from 24-hour continuous tympanic temperature recordings of patients with undifferentiated fever using a machine learning algorithm (artificial neural network). This was an observational study conducted in 103 patients who presented with undifferentiated fever. Twenty-four-hour continuous tympanic temperature was recorded from each patient. Features were extracted from temperature signals and classified into infectious and noninfectious diseases using an artificial neural network (ANN). The ANN classifier provided the highest accuracy at 91.3% for differentiating infectious and noninfectious diseases from undifferentiated fever cases. Significant kappa agreement (κ = 0.777) was found between the final diagnosis as determined by the physician and the classification obtained using an ANN classifier. Based on our results, we conclude that the continuous 24-hour temperature monitoring and application of an ANN classifier provides a simple noninvasive and inexpensive supplementary diagnostic method to differentiate infectious and noninfectious diseases.

Hashimoto’s thyroiditis, the commonest cause of hypothyroidism has been proposed as a risk factor for atherosclerosis independent of thyroid function. The aim of this study was to investigate whether Hashimoto’s thyroiditis validated by their anti-TPO positivity have any effect on hyperlipidemia, Hemoglobin, vitamin D independent of thyroid function in newly diagnosed subclinical hypothyroid patients (SCH) subjects with TSH < 10μIU/ml. 40 newly diagnosed SCH and 40 healthy euthyroid controls were included in this study. Based on anti-TPO status, the SCH subjects was divided into TPO positive and negative groups. Serum lipid, hemoglobin and vitamin D levels were determined and compared between among the TPO positive and negative SCH subjects. Subjects with and without anti-TPO had significant differences in levels of low-density lipoprotein, total cholesterol, and nonHDL cholesterol. In correlation analysis, anti-TPO showed statistically significant association with Hb, LDL and vitamin D. Subclinical hypothyroidism with thyroid autoimmunity is associated with a marginal decrease in hemoglobin and elevation in LDL. Whether this holds, any bearing on promoting cardiovascular risk needs to be considered further

Body temperature monitoring in most healthcare institutions is limited to checking the presence or absence of fever. Our present study evaluated the 24h continuous tympanic temperature pattern in patients with fever in order to detect typical patterns seen in tuberculosis (TB). This observational study was conducted on 81 undifferentiated fever patients whose recordings were stored using the TherCom device. Unique temperature patterns were analysed and compared. TB patients exhibited a unique temperature pattern, namely a slow temperature elevation followed by slow temperature fall seen in 78.5% (22/28) compared to 24.52% (13/53) of non-TB patients. Recognition of this pattern may therefore be useful as a valuable diagnostic aid in the early diagnosis of TB.

Dengue fever is an acute febrile illness with a duration of 2-12 days. Our observational study observed the 24-h continuous tympanic temperature pattern of 15 patients with dengue fever and compared this with 26 others with fever due to a non-dengue aetiology. A tri-phasic fever pattern was seen among two-thirds of dengue fever patients, but in only one with an inflammatory disease. One-third of dengue fever patients exhibited a single peak temperature. Continuous temperature monitoring and temperature pattern analysis in clinical settings can aid in the early differentiation of dengue fever from non-dengue aetiology.

Aim: To investigate relationship between serum TSH and lipid parameters in subjects with different levels of TSH. Study Design: Cross-sectional study. Place and Duration of Study: Clinical Biochemistry Department of Kasturba Medical College, Hospital Mangalore, between January 2014 to June 2014. Methodology: 348 subjects were screened of which 194 were selected. Lipid parameters, TSH, T3, T4 and glycemic status were determined. Association between TSH and serum lipids were studied by categorizing subjects into three groups based on their thyroid status. Group 1 [TSH= 0.27-2.5 mIU/L], Group 2 [TSH= 2.6-4.12 mIU/L] and Group 3 [TSH= 4.13-9.9mIU/L].Statistical analysis was performed by ANOVA followed by Tukey’s multiple comparison test. The relationships between TSH and different parameters were evaluated by Pearson’s correlation analysis. Results: TSH showed a significant positive linear correlation with total cholesterol (r=0.288; P = 0.001), Triglycerides (r=0.129; P=0.016), LDL cholesterol (r=0.305; P =0.001) and negative correlation with HDL (r = - 0.129; P=0.750). Increasing TSH showed a consistent linear association with altered lipids quite evident from the uppermost part of the reference range that is considered clinically normal and there on. Conclusion: A subtle variations of TSH alone in clinically normal thyroid state can alter serum lipids and hence asserts the role of TSH in maintaining lipid homeostasis.

Previous studies have not adequately captured the heterogeneous nature of the diabetes epidemic in India. The aim of the ongoing national Indian Council of Medical Research-INdia DIABetes study is to estimate the national prevalence of diabetes and prediabetes in India by estimating the prevalence by state.We used a stratified multistage design to obtain a community-based sample of 57 117 individuals aged 20 years or older. The sample population represented 14 of India's 28 states (eight from the mainland and six from the northeast of the country) and one union territory. States were sampled in a phased manner: phase I included Tamil Nadu, Chandigarh, Jharkhand, and Maharashtra, sampled between Nov 17, 2008, and April 16, 2010; phase II included Andhra Pradesh, Bihar, Gujarat, Karnataka, and Punjab, sampled between Sept 24, 2012, and July 26, 2013; and the northeastern phase included Assam, Mizoram, Arunachal Pradesh, Tripura, Manipur, and Meghalaya, with sampling done between Jan 5, 2012, and July 3, 2015. Capillary oral glucose tolerance tests were used to diagnose diabetes and prediabetes in accordance with WHO criteria. Our methods did not allow us to differentiate between type 1 and type 2 diabetes. The prevalence of diabetes in different states was assessed in relation to socioeconomic status (SES) of individuals and the per-capita gross domestic product (GDP) of each state. We used multiple logistic regression analysis to examine the association of various factors with the prevalence of diabetes and prediabetes.The overall prevalence of diabetes in all 15 states of India was 7·3% (95% CI 7·0-7·5). The prevalence of diabetes varied from 4·3% in Bihar (95% CI 3·7-5·0) to 10·0% (8·7-11·2) in Punjab and was higher in urban areas (11·2%, 10·6-11·8) than in rural areas (5·2%, 4·9-5·4; p0·0001) and higher in mainland states (8·3%, 7·9-8·7) than in the northeast (5·9%, 5·5-6·2; p0·0001). Overall, 1862 (47·3%) of 3938 individuals identified as having diabetes had not been diagnosed previously. States with higher per-capita GDP seemed to have a higher prevalence of diabetes (eg, Chandigarh, which had the highest GDP of US$ 3433, had the highest prevalence of 13·6%, 12.8-15·2). In rural areas of all states, diabetes was more prevalent in individuals of higher SES. However, in urban areas of some of the more affluent states (Chandigarh, Maharashtra, and Tamil Nadu), diabetes prevalence was higher in people with lower SES. The overall prevalence of prediabetes in all 15 states was 10·3% (10·0-10·6). The prevalence of prediabetes varied from 6·0% (5·1-6·8) in Mizoram to 14·7% (13·6-15·9) in Tripura, and the prevalence of impaired fasting glucose was generally higher than the prevalence of impaired glucose tolerance. Age, male sex, obesity, hypertension, and family history of diabetes were independent risk factors for diabetes in both urban and rural areas.There are large differences in diabetes prevalence between states in India. Our results show evidence of an epidemiological transition, with a higher prevalence of diabetes in low SES groups in the urban areas of the more economically developed states. The spread of diabetes to economically disadvantaged sections of society is a matter of great concern, warranting urgent preventive measures.Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare, Government of India.

Diagnosis of undifferentiated fever is a major challenging task to the physician which often remains undiagnosed and delays the treatment. The aim of the study was to record and analyze a 24-hour continuous tympanic temperature and evaluate its utility in the diagnosis of undifferentiated fevers. This was an observational study conducted in the Kasturba Medical College and Hospitals, Mangaluru, India. A total of ninety-six (n=96) patients were presented with undifferentiated fever. Their tympanic temperature was recorded continuously for 24 hours. Temperature data were preprocessed and various signal characteristic features were extracted and trained in classification machine learning algorithms using MATLAB software. The quadratic support vector machine algorithm yielded an overall accuracy of 71.9% in differentiating the fevers into four major categories, namely, tuberculosis, intracellular bacterial infections, dengue fever, and noninfectious diseases. The area under ROC curve for tuberculosis, intracellular bacterial infections, dengue fever, and noninfectious diseases was found to be 0.961, 0.801, 0.815, and 0.818, respectively. Good agreement was observed [kappa = 0.618 (p<0.001, 95% CI (0.498–0.737))] between the actual diagnosis of cases and the quadratic support vector machine learning algorithm. The 24-hour continuous tympanic temperature recording with supervised machine learning algorithm appears to be a promising noninvasive and reliable diagnostic tool.

Background Depression in Human Immunodeficiency Virus (HIV) positives has implications such as poor drug compliance, lower quality of life, faster progression to full blown Acquired Immunodeficiency Syndrome (AIDS) and higher mortality. Aims To assess depression, social support and self-esteem in HIV positives and to find out the association of depression with social support and self-esteem among HIV positive patients. Setting and design Kasturba Medical College (KMC) Hospital, a tertiary care hospital, Mangalore, India and cross-sectional design. Methods and materials Study constituted of 105 HIV positive subjects; depression was assessed using BDI (Beck depression inventory), social support was assessed using Lubben social network scale and self-esteem was assessed using Rosenberg self-esteem scale. Statistical analysis Kappa statistics was used to measure the agreement of depression assessed by BDI with clinical diagnosis of depression. Logistic regression analyses were done to find out predictors of depression among HIV positives. All analyses were conducted using Statistical Package for Social Sciences (SPSS) version 11.5. Results Depression was found to be present in 43.8% of HIV positives. Among the study subjects, 10.5% had high risk for isolation and low self-esteem was found only among 5.7%. In univariate analysis both gender and self-esteem were significantly associated with depression whereas in multivariate analysis only self-esteem was found to be significantly associated with depression. Conclusion The present study shows a high prevalence of depression in HIV positive patients along with the importance of self-esteem.

Aim Subclinical hypothyroidism (SCH) with TSH less than (10µIU/ml) is a common finding discovered during routine thyroid function testing. Thyroxine substitution and its benefits to alleviate dyslipidemia and oxidative stress (OS) markers at this stage are a matter of debate.Material and Methods This study aimed to investigate the influence of thyroxine substitution on lipid profile and oxidative stress markers in newly diagnosed SCH subjects. The study included a total number of 50 newly diagnosed, (20 treated and 30 untreated) SCH subjects aged 20-50 years with (TSH < 10 μIU/ml) and FT4 levels in the normal range. Patients on medications that could cause thyroid hormone dysfunction, diabetes mellitus and current or pregnancy during the last two years were excluded. Serum TSH, T3, T4, FT4, Anti-thyroid peroxidase (TPO) antibodies, Total cholesterol (TC), High-density lipoprotein cholesterol (HDL), Triglycerides (TG), low-density lipoprotein cholesterol (LDL), ischemia-modified albumin (IMA) were determined in all subjects at baseline and after nine months.Results After Thyroxine replacement, a significant decrease in TSH, LDL, IMA and an increase in FT4 was observed. The decrease in TC was not statistically evident. There was no significant change in T3, T4, TG, HDL, after treatment. The untreated group showed an insignificant increase only in TSH.Conclusion Thyroid substitution therapy has a favorable influence on lipid profile and oxidative stress where it particularly reduced LDL and IMA.Key Words: Subclinical hypothyroidism, L-Thyroxine, Lipids, IMA, oxidative stress

Adrenal insufficiency is a serious complication of AIDS. Usually the integrity of HPA (Hypothalamo pituitary) axis is assessed by measuring cortisol response to 250µg of ACTH. Recent studies have shown that lower ACTH dose increases the sensitivity of the procedure. In the present study we have tried to estimate prevelance of adrenal insufficiency using low dose ACTH test (1µg).