Cognitive impairments in type 2 diabetes, risk factors and preventive strategies.

Mild cognitive impairment (MCI) is a modifiable risk factor in progression of several diseases including dementia and type 2 diabetes. If cognitive impairments are not reversed at an early stage of appearance of symptoms, then the prolonged pathogenesis can lead to dementia and Alzheimer's disease (AD). Therefore, it is necessary to detect the risk factors and mechanism of prevention of cognitive dysfunction at an early stage of disease. Poor lifestyle, age, hyperglycemia, hypercholesterolemia, and inflammation are some of the major risk factors that contribute to cognitive and memory impairments in diabetic patients. Mild cognitive impairment was seen in those individuals of type 2 diabetes, who are on an unhealthy diet. Physical inactivity, frequent alcohol consumptions, and use of packed food products that provides an excess of cheap calories are found associated with cognitive impairment and depression in diabetic patients. Omega fatty acids (FAs) and polyphenol-rich foods, especially flavonoids, can reduce the bad effects of an unhealthy lifestyle; therefore, the consumption of omega FAs and flavonoids may be beneficial in maintaining normal cognitive function. These functional foods may improve cognitive functions by targeting many enzymes and molecules in cells chiefly through their anti-inflammatory, antioxidant, or signaling actions. Here, we provide the current concepts on the risk factors of cognitive impairments in type 2 diabetes and the mechanism of prevention, using omega FAs and bioactive compounds obtained from fruits and vegetables. The knowledge derived from such studies may assist physicians in managing the health care of patients with cognitive difficulties.

Umbilical Cord Milking and Hematological Parameters in Moderate to Late Preterm Neonates: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effect of umbilical cord milking on hematological parameters at 6 weeks of age in late preterm neonates. DESIGN: Randomized controlled trial. SETTING: A tertiary care center of Northern India during 2013-14. PARTICIPANTS: 200 moderate to late preterm neonates randomly allocated to early cord clamping or umbilical cord milking group (100 in each). INTERVENTION: In milking group, 25 cm length of cord was milked towards the baby thrice after separating (within 30 s) it from placenta. MAIN OUTCOME MEASURES: Hemoglobin and serum ferritin at 6 weeks of age. RESULTS: Mean (SD) serum ferritin [428.9 (217.6) vs. 237.5 (118.6) ng/mL; P< 0.01] and hemoglobin [12.1 (1.5) vs. 10.4 (1.2) gm/dL; P<0.01] at 6 weeks were significantly higher in umbilical cord milking group. In early neonatal period, hemodynamic and hematological parameters were not significantly different. Higher incidence of jaundice with higher phototherapy rates (33% vs. 9%; P<0.01) were noted in umbilical cord milking group. CONCLUSIONS: In preterm neonates, umbilical cord milking at birth enhances iron stores at 6 weeks of age. Higher phototherapy rates with this intervention are a matter of concern.

Comparison of two types of intervention to enhance placental redistribution in term infants: randomized control trial.

The objective of the study was to compare the effect of umbilical cord milking (UCM) and delayed cord clamping (DCC) on hematological parameters (serum ferritin and hemoglobin) at 6 weeks of life in term neonates. It was a randomized controlled trail conducted at a teaching hospital in North India during August 2012 to August 2013. Babies born at >36 weeks of gestation were randomized in two groups, UCM and DCC (100 in each group). Umbilical cord milking was done after cutting and clamping the cord at 25 cm from the umbilicus. In DCC group, clamping was delayed by 60 to 90 s before cutting the cord. The baseline characteristics were comparable in the two groups. Mean serum ferritin (134.0 ng/ml [89.8]) and mean hemoglobin (11.0 gm/dl [2.4]) in umbilical cord milking group was comparable to mean serum ferritin (142.7 ng/ml [87.1]) and hemoglobin (11.3 gm/dl [2.6]) in DCC group at 6 weeks of age. There was no difference in hemodynamic status, cranial Doppler indices, and adverse neonatal outcomes among the two groups. CONCLUSION: In term neonates, the DCC and UCM had comparable effect on hematological parameters at 6 weeks of life. WHAT IS KNOWN: • Delayed cord blood clamping improves certain hematologic parameters for neonates, which is potentially important in populations with high rates of neonatal and childhood anemia, but that delayed cord blood clamping may not be feasible in clinical situations when neonatal resuscitation is urgent. WHAT IS NEW: • There is no significant difference in ferritin and hemoglobin levels at 6 weeks among term, Indian neonates who had UCM and DCC and that this study may give support to the practice of UCM in term deliveries when DCC is not feasible.

Role of gastric lavage in vigorous neonates born with meconium stained amniotic fluid.

OBJECTIVE: To compare reduction in incidence of feed intolerance in neonates born with meconium stained amniotic fluid (MSAF) by use of gastric lavage to those who did not receive lavage. METHODS: This Randomized controlled trial was conducted in all vigorous newborns delivered through MSAF, with birth weight ≥1800 g and gestation ≥34 wk. In the lavage group, gastric lavage with 10 ml/kg of normal saline was done. RESULTS: Twelve neonates in the lavage group (n = 124) developed feed intolerance compared to 16 neonates in control group (n = 120), (p = .309; OR 0.69; 95%CI 0.27-1.58). No difference in any other morbidity was noted. CONCLUSIONS: Gastric lavage in neonates with MSAF does not reduce feed intolerance, irrespective of thickness of MSAF and it confers no advantages.

Surface-active potential of biosurfactants produced in curd whey by Pseudomonas aeruginosa strain-PP2 and Kocuria turfanesis strain-J at extreme environmental conditions.

Surface-active potential of biosurfactants produced cost-effectively in curd whey by Pseudomonas aeruginosa strain-PP2 and Kocuria turfanesis strain-J were tested using parameters viz. surface tension (ST) reduction, F(CMC) (highest dilution factor to reach critical micelle concentration) and emulsification index (EI-24) of pesticides; monocrotophos and imidacloprid at extreme environmental conditions. Results have shown that ST reduction of biosurfactants was stable at pH 2-11. High F(CMC) of the biosurfactant in the fermented whey at low pH improved emulsification of pesticides. ST marginally increased at 5% and 15% NaCl, resulting in high EI-24 and F(CMC). Over a range of temperatures 30-121 °C, ST remained low with a higher F(CMC) and EI-24 at 60 °C than at 121 and 30 °C. The biosurfactants have shown differences in their surface-active property and have marked specificity to emulsify pesticides in extreme environmental conditions.

Bioremediation of multi-metal contaminated soil using biosurfactant - a novel approach.

An unconventional nutrient medium, distillery spent wash (1:3) diluted) was used to produce di-rhamnolipid biosurfactant by Pseudomonas aeruginosa strain BS2. This research further assessed the potential of the biosurfactant as a washing agent for metal removal from multimetal contaminated soil (Cr-940 ppm; Pb-900 ppm; Cd-430 ppm; Ni-880 ppm; Cu-480 ppm). Out of the treatments of contaminated soil with tap water and rhamnolipid biosurfactant, the latter was found to be potent in mobilization of metal and decontamination of contaminated soil. Within 36 hours of leaching study, di-rhamnolipid as compared to tap water facilitated 13 folds higher removal of Cr from the heavy metal spiked soil whereas removal of Pb and Cu was 9-10 and 14 folds higher respectively. Leaching of Cd and Ni was 25 folds higher from the spiked soil. This shows that leaching behavior of biosurfactant was different for different metals. The use of wastewater for production of biosurfactant and its efficient use in metal removal make it a strong applicant for bioremediation.

Biosurfactant technology for remediation of cadmium and lead contaminated soils.

This research focuses on column experiments conducted to evaluate the potential of environmentally compatible rhamnolipid biosurfactant produced by Pseudomonas aeruginosa strain BS2 to remove heavy metals (Cd and Pb) from artificially contaminated soil. Results have shown that di-rhamnolipid removes not only the leachable or available fraction of Cd and Pb but also the bound metals as compared to tap water which removed the mobile fraction only. Washing of contaminated soil with tap water revealed that approximately 2.7% of Cd and 9.8% of Pb in contaminated soil was in freely available or weakly bound forms whereas washing with rhamnolipid removed 92% of Cd and 88% of Pb after 36 h of leaching. This indicated that di-rhamnolipid selectively favours mobilization of metals in the order of Cd>Pb. Biosurfactant specificity observed towards specific metal will help in preferential elution of specific contaminant using di-rhamnolipid. It was further observed that pH of the leachates collected from heavy metal contaminated soil column treated with di-rhamnolipid solution was low (6.60-6.78) as compared to that of leachates from heavy metal contaminated soil column treated with tap water (pH 6.90-7.25), which showed high dissolution of metal species from the contaminated soil and effective leaching of metals with treatment with biosurfactant. The microbial population of the contaminated soil was increased after removal of metals by biosurfactant indicating the decrease of toxicity of metals to soil microflora. This study shows that biosurfactant technology can be an effective and nondestructive method for bioremediation of cadmium and lead contaminated soil.

Adsorption-desorption process using wood-based activated carbon for recovery of biosurfactant from fermented distillery wastewater.

Methods used for biosurfactant recovery include solvent extraction, precipitation, crystallization, centrifugation and foam fractionation. These methods cannot be used when distillery wastewater (DW) is used as the nutrient medium for biosurfactant production by Pseudomonas aeruginosa strain BS2, because recovery of biosurfactant by any of these methods imparts color to the biosurfactant. The biosurfactant has a nonaesthetic appearance with lowered surface active properties. These methods cannot be used for continuous recovery of biosurfactant during cultivation. Hence, a new downstream technique for biosurfactant recovery from fermented DW comprised of adsorption-desorption processes using wood-based activated carbon (WAC) was developed. This study involves batch experiments to standardize the factors affecting the rate of biosurfactant adsorption onto WAC. WAC was the most efficient adsorbent among various ones tested (i.e., silica gel, activated alumina and zeolite). The WAC (1% w v(-1)), equilibrium time (90 min), pH range of 5-10 and temperature of 40 degrees C were optimum to achieve 99.5% adsorption efficiency. Adsorption kinetics and intraparticle diffusion studies revealed the involvement of both boundary layer diffusion and intraparticle diffusion. The Langmuir adsorption isotherm of WAC indicated the formation of a monolayer coverage of the biosurfactant over a homogeneous carbon surface, while the Freundlich isotherm showed high adsorption at strong solute concentrations and low adsorption at dilute solute concentrations. WAC concentration of 4% w v(-1) facilitated complete removal of the biosurfactant from collapsed foam (contained 5-fold higher concentration of biosurfactant than was present in fermented DW). Biosurfactant adsorption was of chemisorption type. Acetone (polar solvent) was a specific viable eluant screened among various ones tested because it selectively facilitated maximum recovery, i.e., 89% biosurfactant from WAC. By acetone treatment, complete regeneration of WAC was feasible and WAC can be reused for biosurfactant recovery up to 3 cycles. The recovered biosurfactant showed improved surface-active property (i.e., much lower critical micelle concentration value of 0.013 verses 0.028 mg mL(-1) for biosurfactant recovered by classical methods). The reuse potential of WAC was assessed and results suggest that the carbon can be reused for three consecutive cycles for biosurfactant adsorption from fermented wastewater without any decrease in adsorption efficiency. Thus, this process forms a basis for continuous recovery of biosurfactant from fermented DW and concentrated foam. This process reduces the use of high cost solvent, avoids end product inhibition and minimizes product degradation.