Search results for: occupational diseases

Authors: P. S. Rajinikanth, Shobana Mariappan, Jestin Chellian

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The objective of the study was to prepare and characterize a water-in-oil nano emulsion of 5-Fluorouracil (5FU) to enhance the skin penetration. The present study describes a nano emulsion of 5FU using Capyrol PGMC, Transcutol HP and PEG 400 as oil, surfactant and co-surfactant, respectively. The optimized formulations were further evaluated for heating cooling cycle, centrifugation studies, freeze thaw cycling, particle size distribution and zeta potential in order to confirm the stability of the optimized nano emulsions. The in-vitro characterization results showed that the droplets of prepared formulation were ~100 nm with ± 15 zeta potential. In vitro skin permeation studies was conducted in albino mice skin. Significant increase in permeability parameters was also observed in nano emulsion formulations (P<0.05). The steady-state flux (Jss), enhancement ration and permeability coefficient (Kp) for optimized nano emulsion formulation (FU2, FU1, 1:1 S mix were found to be 24.21 ±2.45 μg/cm2/h, 3.28±0.87 & 19.52±1.87 cm/h, respectively), which were significant compared with conventional gel. The in vitro and in vivo skin deposition studies in rat indicated that the amount of drug deposited from the nano emulsion (292.45 µg/cm2) in skin was significant (P<0.05) an increased as compared to a conventional 5FU gel (121.42 µg/cm2). The skin irritation study using rat skin showed that the mean irritation index of the nano emulsion reduced significantly (P<0.05) as compared with conventional gel contain 1% 5FU. The results from this study suggest that a water-in-oil nano emulsion could be safely used to promote skin penetration of 5FU following topical application.

Keywords: nano emulsion, controlled release, 5 fluorouracil, skin penetration, skin irritation

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Authors: Wessam H. Abd-Elsalam, Mona M. Saber, Samar M. Abouelatta

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Non-steroidal anti-inflammatory drugs (NSAIDs) are considered a double edged sword in inflammatory bowel diseases (IBDs). Some studies reported their advantageous effect in decreasing inflammation, and other studies reported that their use is associated with colitis aggravation. This study aimed to use specifically formulated trehalose-based nano-carriers that targets the colon in an attempt to alleviate inflammation caused by NSAIDs. L-α-phosphatidylcholine (PL), trehalose, and transcutol were used to prepare the trehalosomes (THs), which were also loaded with Tenoxicam(TXM) as a model NSAID. To optimize the formulation variables, a full 23 factorial design, using Design-Expert® software, was performed. The optimized formulation composed of trehalose: PL at a weight ratio of 1:1, 377.72 mg transcutol, and sonicated for 4 min, possessed a spherical shape with a size of 268.61 nm and EE% of 97.83% and released 70.22% of its drug content over 24 h. The superior protective action of TXM loaded THs compared to TXM suspension and drug-free THs was shown by the inhibition of the inflammatory biomarkers, namely; IL-1ß, IL-6, and TNF-alpha levels, as well as oxidative stress markers, measured as GSH and MDA. Improved histopathology of the colonic tissue in male New Zealand rabbits also confirmed the superiority of the TXM loaded THs compared to the unformulated drug or the drug free nano-carriers. Our findings highlight the prosperous role of THs in colon targeting and its anti-inflammatory characteristics in guarding against possible NSAIDs-driven exacerbation of colitis.

Keywords: inflammatory bowel disease, trehalose, trehalosomes, colon targeting

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Authors: Olumuyiwa I. Ojo, Kola Amao, Josiah A. Adeyemo, Fred A. O. Otieno

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A study was carried out to assess the environmental impact of Kampe (Omi) irrigation scheme with respect to public health hazards, the rising water table, salinity and alkalinity problems on the project site. A structured questionnaire was used as the main tool to gather information on the effect of the irrigation project on the various communities around the project site. The different sections of the questionnaire enabled the gathering of information ranging from general to more specific information. The results obtained from the study showed that the two effects are obvious: the 'positive effects' which include increasing the socioeconomic development of the entire communities, resulting in an increase in employment opportunities and better lifestyle and the 'negative effects' in which malaria (100% occurrence) and schistosomiasis (66.7%) were found to be active diseases caused by irrigation activities. Increase in height of water table and salinity is eminent in the irrigation site unless adequate drainage is provided. The collection and experimental analyses of representation soil and water samples from each scheme were used to assess the current status of each receptor. Results obtained indicate the absence of soil with sodium adsorption ration (SAR) values ranging from 3.0 to 3.89, exchangeable sodium percentage (ESP) ranged from 3.8% to 5.5% while pH values ranged from 6.60 to 7.00. Drainage facilities of the project site are inadequate, therefore making it difficult to leach the soil and flood history is occasional.

Keywords: irrigation, impact, soil analysis, Nigeria

Procedia PDF Downloads 269

Authors: Laura Gantley, Vanessa M. Conn, Stuart Webb, Kirsty Kirk, Marta Gabryelska, Duncan Holds, Brett W. Stringer, Simon J. Conn

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Trinucleotide repeat disorders comprise ~20 severe, inherited human neuromuscular and neurodegenerative disorders, which are a result of an abnormal expansion of repetitive sequences in the DNA. The most common of these, Huntington’s disease, results from the expansion of the CAG repeat region in exon 1 of the HTT gene via an unknown mechanism. Non-coding RNAs have been implicated in the initiation and progression of many diseases; thus, we focus on one circular RNA (circRNA) molecule arising from non-canonical splicing (back splicing) of HTT pre-mRNA. This circRNA and its mouse orthologue were transgenically overexpressed in human cells (SHSY-5Y and HEK293T) and mouse cells (Mb1), respectively. High-content imaging and flow cytometry demonstrated the overexpression of this circRNA reduces cell proliferation, reduces nuclear size independent of cellular size, and alters cell cycle progression. Analysis of protein by western blot and immunofluorescence demonstrated no change to HTT protein levels but altered nuclear-cytoplasmic distribution without impacting the expansion of the HTT repeat region. As these phenotypic and genotypic changes are found in Huntington’s disease patients, these results may suggest that this circRNA may play a functional role in the progression of Huntington’s disease.

Keywords: cell biology, circular RNAs, Huntington’s disease, molecular biology, neurodegenerative disorders

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Authors: Arleta Rifati Nixha, Mustafa Arslan, Adem Ergün, Nahit Gencer

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Polyphenol oxidase (PPO), sometimes referred to as phenol oxidase, catecholase, phenolase, catechol oxidase, or even tyrosinase, is considered to be an o-dipenol. PPO (EC 1.14.18.1), a multifunctional copper containing enzyme, is widely distributed in nature. It catalyzes two distinct reactions of melanin synthesis: a hydroxylation of monophenols to o-diphenols (monophenolase activity) and an oxidation of o-diphenols to o-quinones (diphenolase activity), both using molecular oxygen. Additionaly, investigation demonstrated that various dermatological disorders, such as age spots and freckle, were caused by the accumulation of an excessive level of epidermal pigmentation. Tyrosinase has also been linked to Parkinson’s and other neurodegenerative diseases. Nitrogen heterocycles have received a great deal of attention in the literature because of biological properties. Especially, among these heterocyclic systems, pyridine containing compounds have been the subject of expanding research efforts in heteroaromatic and biological chemistry. The pyrido [2,3-d] pyrimidine heterocycles, which are those annelated to a pyrimidine ring, are important because of their wide range of biological and pharmaceutical applications (i.e., bronchodilators, vasodilators) and their anti-allergic, cardiotonic, antihypertensive, and hepatoprotective activities. In this study series of 12 new carbazole substituted pyridopyrimidine urea(thiourea) derivatives were synthesized and evaluated effect on PPO. Additionally, we presented structure-activity relationship analyses and theoretical calculations of the compounds.

Keywords: carbazole, pyridopyrimidine, urea, thiourea, tyrosinase inhibitors

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Authors: Mfaniseni Wiseman Mbatha

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The extension officers are regarded as the key role players in the provision of agricultural facilities to farmers across the world. The government of South Africa has shown a commitment to provide extensive support to farmers by the means of disseminating information and other agricultural facilities. This qualitative study on the experiences of extension officers on the provision of agricultural facilities to rural farmers towards improving agricultural practice was conducted in Msinga Local Municipality. The data was collected through the use of semi-structured interviews with extension officers who were sampled using the purposive sampling method. The qualitative data was analysed through the use of content analysis. The critical part of the findings reveals that the availability of arable land for agricultural practice, availability of agricultural schemes and availability of proper functioning community gardens were indicators of the high level of agricultural practice in the Msinga area. Therefore, the extension officers from the municipality department have shown to provide the agricultural budget to support rural farmers. Whereas, the department of agriculture provides well knowledgeable staff to train farmers about the process of farming and how they can address issues of livestock and crop diseases and also adapting to issues of climate change. The rural farmers, however, find it very difficult to learn and put into practice things that were thought by extension officers during training. There is, therefore, a need for recruitment of more extension staff and the involvement of Non-Government Organizations to increase access to extension facilities to the farmers.

Keywords: agricultural facilities, agricultural practice, extension officers, rural farmers

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Authors: Xia Huo

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Children are more vulnerable to environmental toxicants compared to adults, and their developing immune system is among the most sensitive targets regarding toxicity of environmental toxicants. Studies have found that exposure to environmental toxicants is associated with impaired immune function in children, but only a few studies have focused on the relationship between environmental toxicant exposure and vaccine antibody potency and immunoglobulin (Ig) levels in children. These studies investigated the associations of exposure to polychlorinated biphenyls (PCBs), perfluorinated compounds (PFCs), heavy metals (Pb, Cd, As, Hg) and PM2.5 with the serum-specific antibody concentrations and Ig levels against different vaccines, such as anti-Hib, tetanus, diphtheria toxoid, and analyze the possible mechanisms underlying exposure-related alterations of antibody titers and Ig levels against different vaccines. Results suggest that exposure to these toxicants is generally associated with decreased potency of antibodies produced from childhood immunizations and an overall deficiency in the protection the vaccines provide. Toxicant exposure is associated with vaccination failure and decreased antibody titers, and increased risk of immune-related diseases in children by altering specific immunoglobulin levels. Age, sex, nutritional status, and co-exposure may influence the effects of toxicants on the immune function in children. Epidemiological evidence suggests that exposure-induced changes to humoral immunerelated tissue/cells/molecules response to vaccines may have predominant roles in the inverse associations between antibody responsiveness to vaccines and environmental toxicants. These results help us to conduct better immunization policies for children under environmental toxicant burden.

Keywords: environmental toxicants, immunotoxicity, vaccination, antibodies, children's health

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Authors: Naveed Ahmad Fazili

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More than 20 human diseases involve the fibrillation of a specific protein/peptide which forms pathological deposits at various sites. Hereditary lysozyme amyloidosis is a systemic disorder which mostly affects liver, spleen and kidney. This conformational disorder is featured by lysozyme fibril formation. In vivo lysozyme fibrillation was simulated under in vitro conditions using a strong denaturant GdHCl at 3M concentration. Sharp decline in the ANS fluorescence intensity compared to the partially unfolded states, almost 20 fold increase in ThT fluorescence intensity, increase in absorbance at 450 nm suggesting turbidity, negative ellipticity peak in the far-UVCD at 217 nm, red shift of 50 nm compared to the native state in congo red assay and appearance of a network of long rope like fibrils in TEM analysis suggested HEWL fibrillation. Anti-fibrillation potency of baicalein against the preformed fibrils of HEWL was investigated following ThT assay in which there was a dose dependent decrease in ThT fluorescence intensity compared to the fibrillar state of HEWL with the maximum effect observed at 150 μM baicalein concentration, loss of negative ellipticity peak in the far-UVCD region, dip in the Rayleigh scattering intensity and absorbance at 350 nm and 450 nm respectively together with a reduction in the density of fibrillar structure in TEM imaging. Thus, it could be suggested that baicalein could prove to be a positive therapeutics for hereditary human lysozyme amyloidosis.

Keywords: amyloid fibrils, baicalein, congo red, negative ellipticity, therapeutics

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Authors: Zainab M. Almutairi, Amjad Alharbi

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The use of engineered nanomaterials has increased as a result of their positive impact on many sectors of the economy, including agriculture. Silver nanoparticles (AgNPs) are now used to enhance seed germination, plant growth, and photosynthetic quantum efficiency and as antimicrobial agents to control plant diseases. In this study, we examined the effect of AgNP dosage on the seed germination of three plant species: corn (Zea mays L.), watermelon (Citrullus lanatus [Thunb.] Matsum. & Nakai) and zucchini (Cucurbita pepo L.). This experiment was designed to study the effect of AgNPs on germination percentage, germination rate, mean germination time, root length and fresh and dry weight of seedlings for the three species. Seven concentrations (0.05, 0.1, 0.5, 1, 1.5, 2, and 2.5 mg/ml) of AgNPs were examined at the seed germination stage. The three species had different dose responses to AgNPs in terms of germination parameters and the measured growth characteristics. The germination rates of the three plants were enhanced in response to AgNPs. Significant enhancement of the germination percentage values was observed after treatment of the watermelon and zucchini plants with AgNPs in comparison with untreated seeds. AgNPs showed a toxic effect on corn root elongation, whereas watermelon and zucchini seedling growth were positively affected by certain concentrations of AgNPs. This study showed that exposure to AgNPs caused both positive and negative effects on plant growth and germination.

Keywords: citrullus lanatus, cucurbita pepo, seed germination, seedling growth, silver nanoparticles, zea mays

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Authors: Lyanne rodriguez, Eduardo Fuentes, AndrésTrostchansky, Felipe Lagos

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Nutrition is a crucial strategy to combat cardiovascular diseases (CVD), which remain a leading global cause of mortality. Various studies have demonstrated the antiplatelet properties of commonly consumed fruit and vegetable extracts, particularly tomato and bean extracts. Previous research has indicated potent antiplatelet activity in tomato and common bean pomace, attributed to their high fatty acid content (>30%). Notably, fatty acids can undergo nitration during digestion, catalyzed by the reaction of nitrogen dioxide with unsaturated fatty acids. Understanding the mechanisms underlying the formation of nitrated fatty acids from dietary sources is essential to comprehending their antiplatelet action. This research aims to evaluate the formation of nitrated fatty acids (NO₂-FA) from different foods (tomato pulp and common beans). Specifically, tomato pomace and nitrated bean extracts exhibited concentration-dependent antiplatelet effects when platelets were stimulated with TRAP-6 and collagen (1.18±0.04 and 0.7±0.02 mg/mL, respectively). Furthermore, the antiplatelet potential was associated with the modulation of platelet activation markers, as both nitrated extracts suppressed p-selectin expression, CD63 secretion, and fibrinogen modulation. Additionally, a synergistic effect was observed between both nitrated extracts. Our results suggest that NO₂-FA obtained from different food sources has a promising antiplatelet effect for preventing and treating blood clots. This study adds value to these foods in terms of reducing cardiovascular events.

Keywords: foods, nitrated fatty acids, nitration, platelets

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Authors: P. Bharathiraja

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Computer Aided decision making system is used to enhance diagnosis and prognosis of diseases and also to assist clinicians and junior doctors in clinical decision making. Medical Data used for decision making should be definite and consistent. Data Mining and soft computing techniques are used for cleaning the data and for incorporating human reasoning in decision making systems. Fuzzy rule based inference technique can be used for classification in order to incorporate human reasoning in the decision making process. In this work, missing values are imputed using the mean or mode of the attribute. The data are normalized using min-ma normalization to improve the design and efficiency of the fuzzy inference system. The fuzzy inference system is used to handle the uncertainties that exist in the medical data. Equal-width-partitioning is used to partition the attribute values into appropriate fuzzy intervals. Fuzzy rules are generated using Class Based Associative rule mining algorithm. The system is trained and tested using heart disease data set from the University of California at Irvine (UCI) Machine Learning Repository. The data was split using a hold out approach into training and testing data. From the experimental results it can be inferred that classification using fuzzy inference system performs better than trivial IF-THEN rule based classification approaches. Furthermore it is observed that the use of fuzzy logic and fuzzy inference mechanism handles uncertainty and also resembles human decision making. The system can be used in the absence of a clinical expert to assist junior doctors and clinicians in clinical decision making.

Keywords: decision making, data mining, normalization, fuzzy rule, classification

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Authors: Mohammed Abdelsabour-Khalaf, F. Yusuf , B Brand-Saberi

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Purpose: Applications of nanotechnology nowadays extended to include a wide range of scientific areas such electron micrscopy and gene expression. The aim of the current study was to investigate the developmental expression pattern of genes involved in human glomerulo-nephropathies associated with massive proteinuria and podocyte differentiation using the chicken mesonephros as a model system. Method: We performed in situ hybridization using chicken specific mRNA probes for genes expressed in the early nephron and slit diaphragm genes. The probes used were cNeph1, cNeph2, cSim1, cLmx1b, and cAtoh8. Chicken embryos from Hamburger Hamilton developmental stage HH19 (E3) to HH 34 (E9) were used for the in situ hybridization (ISH). ISH was performed on whole mount embryos which were sectioned by vibratome. Results: Our result show that Neph1, Neph2, Sim1. Lmx1b and Atoh8 genes are dynamically expressed during nephron morphogenesis and Neph1 and Atoh8 are also specifically expressed in the podocytes during late stages of differentiation. Conclusion: We conclude from our results that the genes implicated in congenital and acquired glomerulo-nephropathies like Neph1 and Neph2 are dynamically expressed during mesonephros development pointing towards a role in the formation of the filtration barrier and the differentiation of the mesonephric podocytes. Thus the avian mesonephros could serve as a model to study human kidney diseases.

Keywords: mesonephros, chicken embryo, gene expression, immunohistochemistry

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Authors: M. B. Sokoto, L. Tanko, Y. M. Abdullahi

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The study aimed at examining the impact of climatic factors (rainfall, minimum and maximum temperature) on the productivity of major cereals in Sokoto state, Nigeria. Secondary data from 1997-2008 were used in respect of annual yield of Major cereals crops (maize, millet, rice, and sorghum (t ha-1). Data in respect of climate was collected from Sokoto Energy Research Centre (SERC) for the period under review. Data collected was analyzed using descriptive statistics, correlation and regression analysis. The result of the research reveals that there is variation in the trend of the climatic factors and also variation in cereals output. The effect of average temperature on yields has a negative effect on crop yields. Similarly, rainfall is not significant in explaining the effect of climate on cereal crops production. The study has revealed to some extend the effect of climatic variables, such as rainfall, relative humidity, maximum and minimum temperature on major cereals production in Sokoto State. This will assist in planning ahead in cereals production in the area. Other factors such as soil fertility, correct timing of planting and good cultural practices (such as spacing of strands), protection of crops from weeds, pests and diseases and planting of high yielding varieties should also be taken into consideration for increase yield of cereals.

Keywords: cereals, climate, impact, major, productivity

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Authors: Fatemeh Keshavarz

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Background: Schizophrenia is a disease of the nervous system, and immune system disorders can affect its pathogenesis. Activation of microglia, proinflammatory cytokines, disruption of the blood-brain barrier (BBB) due to inflammation, activation of autoreactive B cells, and consequently the production of autoantibodies against system antigens are among the immune processes involved in neurological diseases. interleukin 32 (IL-32) a proinflammatory cytokine that important player in the activation of the innate and adaptive immune responses. This study aimed to measure the serum level of IL-32 as well as the frequency of autoantibody positivity against several nervous system antigens in patients with schizophrenia. Material and Methods: This study was conducted on 40 patients with schizophrenia and 40 healthy individuals in the control group. Serum IL-32 levels were measured by ELISA. The frequency of autoantibodies against Hu, Ri, Yo, Tr, CV2, Amphiphysin, SOX1, Zic4, ITPR1, CARP, GAD, Recoverin, Titin, and Ganglioside antigens were measured by indirect immunofluorescence method. Results: Serum IL-32 levels in patients with schizophrenia were significantly higher compared to the control group. Autoantibodies were positive in 8 patients for GAD antigen and 5 patients for Ri antigen, which showed a significant relationship compared to the control group. Autoantibodies were also positive in 2 patients for CV2, in 1 patient for Hu, and in 1 patient for CARP. Negative results were reported for other antigens. Conclusion: Our findings suggest that elevated the serum IL-32 level and autoantibody positivity against several nervous system antigens may be involved in the pathogenesis of schizophrenia.

Keywords: schizophrenia, microglia, autoantibodies, IL-32

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Authors: Sudha Shukla, Bablu Kumar, Gyan Prakash Gupta, U. C. Kulshrestha

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Air pollutants emitted from solid biofuels during cooking are the major contributors to poor air quality, respiratory problems, and radiative forcing, etc. in rural areas of most of developing countries. The present study reports the chemical characteristics and sources of ambient aerosols and traces gases during cooking and non-cooking hours emitted during biofuel combustion in a village in North-Central India. Fine aerosol samples along with gaseous species (Sox, NOx, and NH₃) were collected during September 2010-March 2011 at Khairatpur village (KPV) which is located in the Uttar Pradesh state in North-Central India. Results indicated that most of the major ions in aerosols and Sox, NOx, and NH₃ gases were found to be higher during cooking hours as compared to non-cooking hours suggesting that solid biofuel combustion is an important source of air pollution. Results of Principal Component Analysis (PCA) revealed that combustion of solid biofuel, vehicular emissions, and brick kilns were the major sources of fine aerosols and trace gases in the village. A health survey was conducted to find out the relation between users of biofuels and their health effects and the results revealed that most of the women in the village were suffering from diseases associated with biofuel combustion during cooking.

Keywords: ambient aerosols, biofuel combustion, cooking, health survey, rural area

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Authors: Ben Salah Nahla

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The problem of water in Tunisia affects the quality and quantity. Tunisia is in a situation of water shortage. It was estimated that 4.6 Mm3/an. Moreover, the quality of water in Tunisia is also mediocre. In fact, 50% of the water has a high salinity (> 1.5g/l). There are several parameters which affect water quality such as sodium, fluoride. An excess of this parameter may induce some human health. Furthermore, the mining basin area has a problem of industrial waste. This problem may affect the water quality of the groundwater. Therefore, the purpose of this work is to assess the water quality in Basin Mining and the impact of fluorine. For this research, some water samples were done in the field and specific water analysis was implemented in the laboratory. Sampling is carried out on eight drilling in the area of the mining region. In the following, we will look at water view composition, physical and chemical quality. A physical-chemical analysis of water from a survey of the Mining area of Tunisia was performed and showed an excess for the following items: fluorine, sodium, sulfate. So many chemicals may be present in water. However, only a small number of them immediately concern in terms of health in all circumstances. Fluorine (F) is one particular chemical that is considered both necessary for the human body, but an excess of the rate of this chemical causes serious diseases. Sodium fluoride and sodium silicofluoride are more soluble and may spread in animals and plants where their toxicity largest organizations. The more complex particles such as cryolite and fluorite, almost insoluble, are more stable and less toxic. Thereafter, we will study the problem of excess fluorine in the water. The latter intended for human consumption must always comply with the limits for microbiological quality parameters and physical-chemical parameters defined by European standards (1.5 mg/l) and Tunisian (2 mg/l).

Keywords: water, minier basin, fluorine, silicofluoride

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Authors: Priyanka Jain, Sushila Pareek

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Skin disease is often considered to be ‘only cosmetic’ by many medical professionals and lay-people alike but unlike most internal illnesses, skin disease is often immediately visible to others and therefore people suffering from dermatological conditions may suffer serious social and emotional consequences. The purpose of this research was to compare patients suffering from acne, alopecia areata (AA) and melanosis on perceived stress, social appearance anxiety and coping. The study included 120 patients (acne = 40 AA = 40 melanosis = 40) ages ranged from 15 to 25 years. Perceived Stress Scale (PSS), Social Appearance Anxiety Scale (SAAS), and The Brief COPE were administered to the patients. Analytical evaluation was done by Kruskal Wallis and ANOVA-tests. The results of the present study clearly revealed that perceived stress and social appearance anxiety were highest in patients with AA followed by acne patients and found least in patients with melanosis. With regard to coping, self-distraction as a coping technique was found highest in patients suffering from AA followed by acne and then melanosis. Denial was highest in acne patients followed by AA and experienced least by patients with melanosis. Behavioural disengagement was almost equal in patients with melanosis and acne and a little less in patients suffering from AA Acceptance was highest in patients with melanosis, followed by AA and least in acne patients. Self-blame was found highest in patients with acne, followed by AA patients further followed by patients suffering from melanosis. This study is an attempt to stimulate professionals working in the field of dermatology and mental health to explore their supportive communication and increase awareness regarding the difficulties that patients with skin disease can face.

Keywords: coping, dermatology, perceived stress, psychosocial impact, social appearance anxiety

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Authors: N. Rambabu, H. Gururaj, Reynold Washington, Oommen George

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Motivation: Under the USAID Strengthening Health Outcomes through Private Sector (SHOPS-TB) initiative, Karnataka Health Promotion Trust (KHPT) with technical support of Abt associates is implementing a TB prevention and care model in Karnataka State, South India. KHPT is the interface agency between the public and private sectors, and providers and the target community facilitating early TB case detection and enhancing treatment compliance through private health care providers (pHCP) engagement in RNTCP. The project coverage is 0.84 million urban poor from 663 slums in 12 districts of Karnataka. Problem Statement: India with the highest burden of global TB (26%) and two million cases annually, accounts for approximately one fifth of the global incidence. WHO estimates 300,000 people die from TB annually in India. India expanded the coverage of Directly Observed Treatment, Short-course chemotherapy (DOTS) to the entire country as early as 2006. However, the performance of RNTCP has not been uniform across states. While the national annual new smear-positive (NSP) case notification rate is 53, it is much lower at 47 in Karnataka. A third of TB patients in India reside in urban slums. Approach: Under SHOPS, KHPT actively engages with communities through key opinion leaders and community structures. Interpersonal communication, by Outreach workers through house-to-house visits and at aggregation points, is the primary method used for communication about TB and its management and to increase demand for sputum examination and DOTS. pHCP are mapped, trained and mentored by KHPT. ORWs also provide patient and family counseling on TB treatment, side effects and adherence, screen close contacts of index patients especially children under 6 years of age and screen co-morbidities including HIV, diabetes and malnutrition and risk factors including alcoholism, tobacco use, occupational hazards making appropriate accompanied or documented referrals. A treatment ‘buddy’ system for the patients involving close friends or family members, ICT-based support, DOTS Prerana (inspiration) groups of TB patients, family members and community, DOTS Mitra (friend) helpline services are also used for care and support services. Results: The intervention educated 39988 slum dwellers, referred 1731 chest symptomatics, tested 1061 patients and initiated 248 patients on anti-TB treatment within three months of intervention through continuous community engagement. Conclusions: The intervention’s potential to increase access to preferred health care providers, reduce patient and health system delays in diagnosis and initiation of treatment, improve health seeking behaviour and enhance compliance of pHCPs to standard treatment protocols is being monitored. Initial results are promising.

Keywords: DOTS, KHPT, health outcomes, public and private sector

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Authors: Chandra Mukherjee

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The prevalent knowledge of the biological systems is based on the standard scientific perception of natural equilibrium, determination and predictability. Recently, a rethinking of concepts was presented and a new scientific perspective emerged that involves complexity theory with deterministic chaos theory, nonlinear dynamics and theory of fractals. The unpredictability of the chaotic processes probably would change our understanding of diseases and their management. The mathematical definition of chaos is defined by deterministic behavior with irregular patterns that obey mathematical equations which are critically dependent on initial conditions. The chaos theory is the branch of sciences with an interest in nonlinear dynamics, fractals, bifurcations, periodic oscillations and complexity. Recently, the biomedical interest for this scientific field made these mathematical concepts available to medical researchers and practitioners. Any biological network system is considered to have a nominal state, which is recognized as a homeostatic state. In reality, the different physiological systems are not under normal conditions in a stable state of homeostatic balance, but they are in a dynamically stable state with a chaotic behavior and complexity. Biological systems like heart rhythm and brain electrical activity are dynamical systems that can be classified as chaotic systems with sensitive dependence on initial conditions. In biological systems, the state of a disease is characterized by a loss of the complexity and chaotic behavior, and by the presence of pathological periodicity and regulatory behavior. The failure or the collapse of nonlinear dynamics is an indication of disease rather than a characteristic of health.

Keywords: HRV, HRVI, LF, HF, DII

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Authors: Ibraheem Husain, Abul Kalam Najmi, Karishma Chester

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First-in-human (FIH) studies are a critical step in clinical development of any molecule that has shown therapeutic promise in preclinical evaluations, since preclinical research and safety studies into clinical development is a crucial step for successful development of monoclonal antibodies for guidance in pharmaceutical industry for the treatment of human diseases. Therefore, comparison between USFDA and nine pharmacologically guided approaches (PGA) (simple allometry, maximum life span potential, brain weight, rule of exponent (ROE), two species methods and one species methods) were made to determine maximum recommended starting dose (MRSD) for first in human clinical trials using four drugs namely Denosumab, Bevacizumab, Anakinra and Omalizumab. In our study, the predicted pharmacokinetic (pk) parameters and the estimated first-in-human dose of antibodies were compared with the observed human values. The study indicated that the clearance and volume of distribution of antibodies can be predicted with reasonable accuracy in human and a good estimate of first human dose can be obtained from the predicted human clearance and volume of distribution. A pictorial method evaluation chart was also developed based on fold errors for simultaneous evaluation of various methods.

Keywords: clinical pharmacology (CPH), clinical research (CRE), clinical trials (CTR), maximum recommended starting dose (MRSD), clearance and volume of distribution

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Authors: Viacheslav Sushko, Viktor Sushko

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Pre-cancerous breast diseases are pathological changes that precede the appearance of adenocarcinoma. The most common benign breast disease is mastopathy. We examined the life and disease history of 114 women aged 58-69 who were diagnosed with adenocarcinoma of the breast at different stages of development. They filled out the Reeder Scale to determine the level of stress. The results of the study revealed that 62 of them had mastopathy at the age of 30-45 years old. These women refused surgical treatment for mastopathy. Five to six years before their diagnosis of adenocarcinoma of the mammary gland, 84 women had experienced severe stress (death of a beloved close relative, torture accompanied by rape, prolonged stay in extreme conditions (under bombardment and bombardment). In the assessment of data from completed Reeder scales, 114 women had a high level of mental stress, with a score from 1-1.72. The 84 women who suffered from severe stress showed overeating or a significant decrease in food intake, insomnia, apathy, increased irritability and restlessness, loss of interest in sexual relationships, forgetfulness, difficulty in performing routine work, prolonged uncontrollable headaches, unexplained fatigue, heart pain, reduced capacity for work. In conclusion, it is important to provide psychotherapy for breast cancer patients as the diagnosis, and the different stages of treatment are very stressful. It is also advisable to see a psychiatrist at an early stage and prevent distress and treat precancerous breast disease.

Keywords: breast cancer, distress, mastopathy, severe stress

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Authors: Nahida Sultana

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Globally, an estimated 58 million people have chronic hepatitis C virus infection, with about 1.5 million new infections occurring per year. The hepatitis C virus is a blood-borne virus, and most infections occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusion, injection drug use, and sexual practices that lead to exposure to blood. Hepatitis C virus (HCV) causes chronic infections that mainly affect the liver leading to liver diseases. This study aimed to determine whether there is any significant association between HCV transmission risk factors in relation to genotypes in HCV-infected Bangladeshi patients. After quantification of HCV viral load, 36 samples were randomly selected for HCV genotyping and risk factor measurement. A greater proportion of genotype 1 (p > 0.05) patients (40%) underwent blood transfusion compared to patients (22.6%) with genotype 3 infections. More genotype 1 patient underwent surgery and invasive procedures (20%), and rather than those with genotype 3 patients (16.1%). The history of IDUs (25.8%) and sexual exposure (3.2%) are only prevalent in genotype 3 patients and absent in patients with genotype 1 (p >0.05). There was no significant statistical difference found in HCV transmission risk factors (blood transfusion, IDUs, Surgery& interventions, sexual transmission) between patients infected with genotypes 1 and 3. In HCV infection, genotype may have no relation to transmission risk factors among Bangladeshi patients.

Keywords: HCV genotype, alanine aminotransferase (ALT), HCV viral load, IDUs

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Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

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Introduction: Diabetes is a chronic health problem and a major risk factor of stroke. A number of therapeutic modalities exist for diabetes management. It’s still unknown whether the different oral hypoglycemic agents would ameliorate the detrimental effect of diabetes on stroke severity. The objective of this work is to assess the effect of pretreatment with oral hypoglycemic agents, insulin and their combination on stroke severity at presentation. Patients and Methods: Patients admitted to the King Abdullah University Hospital (KAUH)-Jordan with ischemic stroke between January 2015 and December 2016 were evaluated and their comorbid diseases, treatment on admission and their neurologic severity was assessed using the National Institute of Health Stroke Scale (NIHSS) were documented. Stroke severity was compared for non-diabetic patients and diabetic patients treated with different antidiabetic agents. Results: Data from 324 patients with acute stroke was documented. The median age of participants was 69 years. Diabetes was documented in about 50% of the patients. Multinomial regression analysis identified diabetes treatment status as an independent predictor of neurological severity of stroke (p=0.032). Patients treated with oral hypoglycemic agents had a significantly lower NIHSS as compared to nondiabetic patients and insulin treated patients (p < 0.02). The positive effect of oral hypoglycemic agents was blunted by insulin co-treatment. Insulin did not alter the severity of stroke as compared to non-diabetics. Conclusion: Oral hypoglycemic agents may reduce the severity of neurologic deficit of ischemic stroke and may have neuroprotective effect.

Keywords: diabetes, stroke, neuroprotection, oral hypoglycemic agents

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Authors: Sana Fatima, Paul Sadler, Jon Cooper, David Mendel, Ayesha Jameel

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Background: Neurodiversity refers to intrinsic differences between human minds and encompasses dyspraxia, dyslexia, attention deficit hyperactivity disorder, dyscalculia, autism spectrum disorder, and Tourette syndrome. There is increasing recognition of neurodiversity in relation to disability/diversity in medical education and the associated impact on training, career progression, and personal and professional wellbeing. In addition, documented and anecdotal evidence suggests that medical educators and training providers in all four nations (UK) are increasingly concerned about understanding neurodiversity and identifying and providing support for neurodivergent trainees. Summary of Work: A national Neurodiversity Task and Finish group were established to survey Health Education England local office Professional Support teams about insights into infrastructure, training for educators, triggers for assessment, resources, and intervention protocols. This group drew from educational leadership, professional and personal neurodiverse expertise, occupational medicine, employer human resource, and trainees. An online, exploratory survey was conducted to gather insights from supervisors and trainers across England using the Professional Support Units' platform. Summary of Results: This survey highlighted marked heterogeneity in the identification, assessment, and approaches to support and management of neurodivergent trainees and highlighted a 'deficit' approach to neurodiversity. It also demonstrated a paucity of educational and protocol resources for educators and supervisors in supporting neurodivergent trainees. Discussions and Conclusions: In phase one, we focused on faculty development. An educational repository for all supervising trainees using a thematic approach was formalised. This was guided by our survey findings specific for neurodiversity and took a triple 'A' approach: awareness, assessment, and action. This is further supported by video material incorporating stories in training as well as mobile workshops for trainers for more immersive learning. The subtle theme from both the survey and Task and finish group suggested a move away from deficit-focused methods toward a positive holistic, interdisciplinary approach within a biopsychosocial framework. Contributions: 1. Faculty Knowledge and basic understanding of neurodiversity are key to supporting trainees with known or underlying Neurodiverse conditions. This is further complicated by challenges around non-disclosure, varied presentations, stigma, and intersectionality. 2. There is national (and international) inconsistency in the approach to how trainees are managed once a neurodiverse condition is suspected or diagnosed. 3. A carefully constituted and focussed Task and Finish group can rapidly identify national inconsistencies in neurodiversity and implement rapid educational interventions. 4. Nuanced findings from surveys and discussion can reframe the approach to neurodiversity; from a medical model to a more comprehensive, asset-based, biopsychosocial model of support, fostering a cultural shift, accepting 'diversity' in all its manifestations, visible and hidden.

Keywords: neurodiversity, professional support, human considerations, workplace wellbeing

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Authors: Sanjeeb Sutradhar, Archita Patnaik

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Histidine is one of the twenty-two naturally occurring essential amino acids exhibiting two conformations, L-histidine and D-histidine. D-Histidine is biologically inert, while L-histidine is bioactive because of its conversion to neurotransmitter or neuromodulator histamine in both brain as well as central nervous system. The deficiency of L-histidine causes serious diseases like Parkinson’s disease, epilepsy and the failure of normal erythropoiesis development. Gold nanocomposites are attractive materials due to their excellent biocompatibility and are easy to adsorb on the electrode surface. In the present investigation, hydrophobic fullerene-C60 was functionalized with homocysteine via nucleophilic addition reaction to make it hydrophilic and to successively make the nanocomposite with in-situ prepared gold nanoparticles with ascorbic acid as reducing agent. The electronic structure calculations of the AuNPs@Hcys-C60 nanocomposite showed a drastic reduction of HOMO-LUMO gap compared to the corresponding molecules of interest, indicating enhanced electron transportability to the electrode surface. In addition, the electrostatic potential map of the nanocomposite showed the charge was distributed over either end of the nanocomposite, evidencing faster direct electron transfer from nanocomposite to the electrode surface. This nanocomposite showed catalytic activity; the nanocomposite modified glassy carbon electrode showed a tenfold higher kₑt, the electron transfer rate constant than the bare glassy carbon electrode. Significant improvement in its sensing behavior by square wave voltammetry was noted.

Keywords: fullerene-C60, gold nanocomposites, L-Histidine, square wave voltammetry

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Authors: Meltem Agar, Maisem Laabei, Hannah Leese, Pedro Estrela

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Pathogenic bacteria and the diseases they cause have become a global problem. Their early detection is vital and can only be possible by detecting the bacteria causing the disease accurately and rapidly. Great progress has been made in this field with the use of biosensors. Molecularly imprinted polymers have gain broad interest because of their excellent properties over natural receptors, such as being stable in a variety of conditions, inexpensive, biocompatible and having long shelf life. These properties make molecularly imprinted polymers an attractive candidate to be used in biosensors. In this study it is aimed to produce an aptamer-molecularly imprinted polymer based electrochemical sensor by utilizing the properties of molecularly imprinted polymers coupled with the enhanced specificity offered by DNA aptamers. These ‘apta-MIP’ sensors were used for the detection of Staphylococcus aureus and Escherichia coli. The experimental parameters for the fabrication of sensor were optimized, and detection of the bacteria was evaluated via Electrochemical Impedance Spectroscopy. Sensitivity and selectivity experiments were conducted. Furthermore, molecularly imprinted polymer only and aptamer only electrochemical sensors were produced separately, and their performance were compared with the electrochemical sensor produced in this study. Aptamer-molecularly imprinted polymer based electrochemical sensor showed good sensitivity and selectivity in terms of detection of Staphylococcus aureus and Escherichia coli. The performance of the sensor was assessed in buffer solution and tap water.

Keywords: aptamer, electrochemical sensor, staphylococcus aureus, molecularly imprinted polymer

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Authors: Gehan Hussein, Hams Ahmad, Baher Matta, Yasmeen Mansi, Mohamad Fawzi

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Background: Congenital heart disease (CHD) is a common problem worldwide with variable incidence in different countries. The exact etiology is unknown, suggested to be multifactorial. We aimed to study the incidence of various CHD in a neonatal intensive care unit (NICU) in a tertiary care hospital in Egypt and the possible associations with variable risk factors. Methods: Prospective study was conducted over a period of one year (2013 /2014) at NICU KasrAlAini School of Medicine, Cairo University. Questionnaire about possible maternal and/or paternal risk factors for CHD, clinical examination, bedside echocardiography were done. Cases were classified into groups: group 1 without CHD and group 2 with CHD. Results: from 723 neonates admitted to NICU, 180 cases were proved to have CHD, 58 % of them were males. patent ductus arteriosus(PDA) was the most common CHD (70%), followed by an atrial septal defect (ASD8%), while Fallot tetralogy and single ventricle were the least common (0.45 %) for each. CHD was found in 30 % of consanguineous parents Maternal age ≥ 35 years at the time of conception was associated with increased incidence of PDA (p= 0.45 %). Maternal diabetes and insulin intake were significantly associated with cases of CHD (p=0.02 &0.001 respectively), maternal hypertension and hypothyroidism were both associated with VSD, but the difference did not reach statistical significance (P=0.36 &0.44respectively). Maternal passive smoking was significantly associated with PDA (p=0.03). Conclusion: The most frequent CHD in the studied population was PDA, followed by ASD. Maternal conditions as diabetes was associated with VSD occurrence.

Keywords: NICU, risk factors, congenital heart disease, echocardiography

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Authors: Giovanni Matheus Rech, Gilberto Zan, Filipe P. Aguiar

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The current pandemic scenario raises questions that many times would have previously gone unnoticed. One of these issues is the quality of the air we breathe in the most diverse environments in which we are inserted in an everyday. It is plausible to suppose that, at times like this, there is apprehension regarding the possibility of contamination by pathological agents such as viruses and bacterias through the airways. However, the renewal of indoor air, combined with a properly sanitized air conditioning system, are important tools for the prevention of viral diseases, as is the case with COVID-19. The bus is an example of an environment where renovation is applied to improve the quality of indoor air, helping to reduce the possibility of spreading pathological agents. Together with other care, such as an alcohol gel dispenser, curtains to separate the passengers, cleaning the environment more frequently, and mandatory use of masks, help to reduce the transmission of pathologies, such as COVID-19. Knowing the reality of a large part of the population regarding the need for public transport, there are standards and devices dedicated to promoting air quality, ensuring greater comfort and safety for users. This paper seeks to present such standards and recommendations to improve the quality of indoor air, as well as the equipment responsible for the renewal of the air in the body of a bus. Experimental measurement of the flow rates of the renewal devices present in the bus body allows quantifying the average volume of external air admitted in each type of body. This way, it was possible to compare, in terms of airflow per person, the values of a bus in relation to a series of other environments, using recommendations for air renewal are described through the Brazilian standard ABNT NBR 16401.

Keywords: air quality, air renewal, buses, Covid-19

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Authors: Abu Salim Mustafa

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Water plays a major role in maintaining life on earth, but it can also serve as a matrix for pathogenic organisms, posing substantial health threats to humans. Although, outbreaks of diseases attributable to drinking water may not be common in industrialized countries, they still occur and can lead to serious acute, chronic, or sometimes fatal health consequences. The analysis of drinking water samples from different regions of Kuwait was performed in this study for bacterial and viral contaminations. Drinking tap water samples were collected from 15 different locations of the six Kuwait governorates. All samples were analyzed by confocal microscopy for the presence of bacteria. The samples were cultured in vitro to detect cultivable organisms. DNA was isolated from the cultured organisms and the identity of the bacteria was determined by sequencing the bacterial 16S rRNA genes, followed by BLAST analysis in the database of NCBI, USA. RNA was extracted from water samples and analyzed by real-time PCR for the detection of viruses with potential health risks, i.e. Astrovirus, Enterovirus, Norovirus, Rotavirus, and Hepatitis A. Confocal microscopy showed the presence of bacteria in some water samples. The 16S rRNA gene sequencing of culture grown organisms, followed by BLAST analysis, identified the presence of several non-pathogenic bacterial species. However, one sample had Acinetobacter baumannii, which often causes opportunistic infections in immunocompromised people, but none of the studied viruses could be detected in the drinking water samples analyzed. The results indicate that drinking water samples analyzed from various locations in Kuwait are relatively safe for drinking and do not contain many harmful pathogens.

Keywords: drinking water, microbial contaminant, 16S rDNA, Kuwait

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Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

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The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

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