Dark fermentation of pretreated hydrolysates of pineapple fruit waste for the production of biohydrogen using bacteria isolated from wastewater sources.

In the present study, both acidic and alkaline hydrolysate of pineapple waste was utilised for the production of biohydrogen using locally isolated bacterial strains. The bacteria were isolated from different wastewater sources and were identified as Proteus mirabilis, Pseudomonas aeruginosa, Bacillus altitudinus, Bacillus subtilis, Paenibacillus alvei, and Lysinibacillus sphaericus. Experimental results showed that the highest biohydrogen yield of 836.33 ± 48.02 mL H2 was produced from alkaline hydrolysate with Bacillus altitudinis during the 96thhr of fermentation. Among the different bacterial strains, B. altitudinis showed higher H2 production. Comparatively alkaline hydrolysates exhibited a higher yield of hydrogen than acidic hydrolysates. The final pH of the experiment was found to be in acidic range. The total VFA concentration ranged between 930 ± 207.85 mg/L to 3050 ± 476.97 mg/L. Both sugar degradation and COD reduction were more than 80% in the acidic and alkaline hydrolysates while the lowest sugar degradation and COD reduction were observed for the untreated biomass. The rationale behind this study was to convert the waste biomass into energy by utilising the potential of native bacterial communities.

How does Indian news media report smokeless tobacco control? A content analysis of the gutka ban enforcement.

Smokeless tobacco (SLT) products like gutka and paan masala are a growing public health crisis in India. Despite enacting a ban-the highest form of regulation-little is known about implementation progress. The purpose of this study was to look at how enforcement of gutka ban is covered in Indian news media and if media is a reliable source of data. We conducted a content analysis of online news reports (n = 192) from 2011 to 2019. News characteristics such as name and type of publication, language, location, slant and beat coverage, visuals, and administrative focus were quantified. Similarly, news contents were inductively coded to examine dominant themes and the implementation landscape. We found that coverage was initially low but increased after 2016. Overall, news reports were in favor of the ban. Five leading English newspapers covered the majority of the ban enforcement reports. Prominent themes like consumption, health hazards, tobacco control responses, impact on livelihoods, and illicit trade were drawn from the textual analysis as the main arguments in relation to the ban. Gutka is largely seen as an issue of crime reflected by the contents, sources, and frequent use of pictures depicting law enforcement. The interconnected distribution channels of the gutka industry hindered enforcement, highlighting the need to study the complexities of regional and local SLT supply chains.

Severe localized re-expansion pulmonary oedema: An unusual instance.

A lobar re-expansion pulmonary oedema (REPO) after pleural drainage procedure is rare and usually asymptomatic. We report a 56-year-old man with severe left lower lobar REPO after tube thoracostomy drainage of a loculated hydro-pneumothorax of 2 days' duration with underlying chronic obstructive pulmonary disease. The clinical manifestations were immediate and disproportionate to the radiological extent of REPO. The severity of lobar REPO was probably related to the pre-existing emphysematous changes and airway obstruction. Supplemental oxygen and intermittent pleural drainage led to clinical recovery within 24 hours, followed by radiological clearance of alveolar opacities within 3 days.

Traumatic Optic Neuropathy: Analysis of Demographic and Clinical Parameters Over Three Years in a Tertiary Care Hospital in India.

Background Treatment options for traumatic optic neuropathy (TON) are limited and the role of steroids in the treatment of TON is still controversial. Hence this study was planned to highlight the role of steroids in the treatment of TON. Purpose The study aims to highlight the epidemiological and clinical characteristics, as well as the role of steroids, in TON cases seen during a three-year period at a tertiary care center in India. Methods This was a retrospective study that reviewed records of all cases of TON between January 2018 to January 2020. Results Twenty-three cases of TON were seen representing 1.26% cases of head injuries. The median age was 18 years. One patient (4.34%) had bilateral TON and 18 patients (78.26%) were referred from accident and trauma care. None of the patients presented directly to an ophthalmologist. The most common cause of injury was automobile accident (69.56%). Visual acuity at presentation was 20/80-20/100 in six (26.08%) cases. Fifteen (65.4%) patients had associated closed globe injury. Seven (30.43%) patients had ocular adnexal involvement and 10 (43.47%) patients had orbital fractures. Seventeen (73.91%) received steroid treatment and six of these patients showed visual improvement. Conclusions The study showed that there was no significant association between presenting visual acuity and treatment. The presence of significant ocular injury and orbital injury increased the likelihood of treatment. There was no difference between the treated and untreated groups with respect to final visual acuity.

Lady with Long Eyelashes !

A sixty years postmenopausal lady presented with growing longer eyelashes for 8 years. She had thick, dark, curly eyelashes measuring 23 mm and 15 mm at the centre and periphery respectively suggesting marked trichomegaly. Increased vellus hair was noticed above lips and chin suggesting hypertrichosis. An important clue in history was the use of chemotherapeutic agent Erlotinib after bronchoscopic surgery for non-small cell lung carcinoma for the past 8 years. Erlotinib competitively binds to the tyrosine kinase domain of Epidermal Growth Factor Receptor inhibiting receptor activation and blocking the signal transduction. Thus, disrupting the transition of hair growth from anagen to telogen phase, leading to aberrant anagen phase and consequently abnormal hair growth. Trichomegaly is seen after 2-5 months of treatment. Mostly innocuous, it can lead to eyelid infections and rarely corneal ulceration. EGFR inhibitors are associated with hypertrichosis in other areas, as was the case in this patient. This case highlights the significance of detailed history including drugs, thus abating additional work-up for trichomegaly.

Role of heavy metal tolerant rhizosphere bacteria in the phytoremediation of Cu and Pb using Eichhornia crassipes (Mart.) Solms.

The role of multi-heavy metal tolerant bacteria isolated from the rhizosphere of Eichhornia crassipes in the phytoremediation of Cu and Pb under laboratory conditions was investigated. The heavy metal tolerant rhizosphere bacteria were identified as Bacillus cereus, Paenibacillus alvei, Aeromonas caviae, Paenibacillus taiwanensis, and Achromobacter spanius. Results showed a significant variation in wet weight, Heterotrophic Plate Count (HPC) of the rhizosphere, HPC of water, removal and uptake of Cu and Pb by E. crassipes, either alone or in association with the rhizosphere bacteria. The removal of Cu by E. crassipes in different experimental conditions showed that OTC (Oxytetracycline) untreated E. crassipes with rhizosphere bacteria has maximum removal with 95%, followed by E. crassipes alone with 84%. The OTC treated E. crassipes with rhizosphere bacteria could remove 81% of Cu. The maximum Pb removal efficiency of 93.4% was shown by OTC untreated E. crassipes with rhizosphere bacteria, followed by E. crassipes alone with 86.8%. The OTC treated E. crassipes with rhizosphere bacteria showed the least removal efficiency with 82.32%. The translocation factor (TF) values for Cu and Pb were lower than 1 indicated that the absorption was mainly accomplished in the roots of E. crassipes. The order of accumulation of Cu and Pb in E. crassipes was noted as root > leaf > petiole.

The present work reveals the role of rhizosphere bacteria of E. crassipes in removing both Cu and Pb from an aqueous solution. Comparatively, the plants inoculated with rhizosphere bacteria have shown higher removal efficiency than both normal and OTC treated plants under the experimental conditions.

Adsorption characteristics of magnetic nanoparticles coated mixed fungal biomass for toxic Cr(VI) ions in aquatic environment.

In this research, the adsorptive removal of Cr(VI) ions from the aquatic environment have been studied using newly synthesized magnetic nanoparticles coated mixed fungal biomass (MNP-FB). Two fungal biomass such as Aspergillus fumigatus and Aspergillus niger were isolated, screened, and utilized as a precursor for making an adsorbent. Molecular characterization of isolated fungal species was recognized using 18S rRNA sequencing. The characterization studies of the MNP-FB were evaluated using Fourier Transform Infrared Spectrophotometer (FTIR) and Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray (EDX) analyses. Optimization studies were studied to check the effect of different operating variables such as pH (2.0-9.0), equilibrium time (10-90 min), MNP-FB dosage (0.1-1.0 g/L), temperature (30-60 °C) and concentration of Cr(VI) ions (50-500 mg/L). Additionally, Freundlich isotherm model fits well for the adsorption of Cr(VI) ion using MNP-FB. The adsorption kinetics was interpreted well by Pseudo-first order model. The thermodynamic study concluded that Cr(VI) ions removal by MNP-FB was exothermic and appreciative at low temperatures. The monolayer adsorption efficiency of MNP-FB for Cr(VI) ions was measured as 249.9 mg/g. The current results reveal that MNP-FB has considered being a proficient and economically suitable material for the Cr(VI) ions removal from the water environment.

COVID-19-related strokes are associated with increased mortality and morbidity: A multicenter comparative study from Bengaluru, South India.

BACKGROUND: COVID-19-related strokes are increasingly being diagnosed across the world. Knowledge about the clinical profile, imaging findings, and outcomes is still evolving. Here we describe the characteristics of a cohort of 62 COVID-19-related stroke patients from 13 hospitals, from Bangalore city, south India. OBJECTIVE: To describe the clinical profile, neuroimaging findings, interventions, and outcomes in COVID-19-related stroke patients. METHODS: This is a multicenter retrospective study of all COVID-19-related stroke patients from 13 hospitals from south India; 1st June 2020-31st August 2020. The demographic, clinical, laboratory, and neuroimaging data were collected along with treatment administered and outcomes. SARS-CoV-2 infection was confirmed in all cases by RT-PCR testing. The data obtained from the case records were entered in SPSS 25 for statistical analysis. RESULTS: During the three-month period, we had 62 COVID-19-related stroke patients, across 13 centers; 60 (97%) had ischemic strokes, while 2 (3%) had hemorrhagic strokes. The mean age of patients was 55.66 ± 13.20 years, with 34 (77.4%) males. Twenty-six percent (16/62) of patients did not have any conventional risk factors for stroke. Diabetes mellitus was seen in 54.8%, hypertension was present in 61.3%, coronary artery disease in 8%, and atrial fibrillation in 4.8%. Baseline National Institutes of Health Stroke Scale score was 12.7 ± 6.44. Stroke severity was moderate (National Institutes of Health Stroke Scale 5-15) in 27 (61.3%) patients, moderate to severe (National Institutes of Health Stroke Scale 16-20) in 13 (20.9%) patients and severe (National Institutes of Health Stroke Scale 21-42) in 11 (17.7%) patients. According to TOAST classification, 48.3% was stroke of undetermined etiology, 36.6% had large artery atherosclerosis, 10% had small vessel occlusion, and 5% had cardioembolic strokes. Three (5%) received intravenous thrombolysis with tenecteplase 0.2 mg/kg and 3 (5%) underwent mechanical thrombectomy, two endovascular and one surgical. Duration of hospital stay was 16.16 ± 6.39 days; 21% (13/62) died in hospital, while 37 (59.7%) had a modified Rankin score of 3-5 at discharge. Hypertension, atrial fibrillation, and higher baseline National Institutes of Health Stroke Scale scores were associated with increased mortality. A comparison to 111 historical controls during the non-COVID period showed a higher proportion of strokes of undetermined etiology, higher mortality, and higher morbidity in COVID-19-related stroke patients. CONCLUSION: COVID-19-related strokes are increasingly being recognized in developing countries, like India. Stroke of undetermined etiology appears to be the most common TOAST subtype of COVID-19-related strokes. COVID-19-related strokes were more severe in nature and resulted in higher mortality and morbidity. Hypertension, atrial fibrillation, and higher baseline National Institutes of Health Stroke Scale scores were associated with increased mortality.

Evaluation of HCP5 and Chemokine C Receptor type 5 Gene Polymorphisms in Indian Psoriatic Patients.

BACKGROUND: Genetic variations associated with nonprogression of HIV infection to AIDS are enriched in psoriasis patients. HCP5 gene 335 T > G and chemokine C receptor type 5 (CCR5) gene Δ32 polymorphisms are associated with HIV nonprogression phenotype. AIM: The aim of this study was to determine the association of HCP5 gene 335 T > G (rs2395029) and CCR5 gene Δ32 (rs333) polymorphisms with psoriasis vulgaris (PV). MATERIALS AND METHODS: Genotype of HCP5 gene 335 T > G and CCR5 gene Δ32 polymorphisms were determined by polymerase chain reaction (PCR)-restriction fragment length polymorphism and allele-specific PCR methods, respectively. RESULTS: The frequency of HCP5 gene 335 T > G SNP was ~7 times higher in PV patients than in the control group (P = 1.49 × 10-8; odds ratio [OR] = 10.2; 0.95 confidence interval [CI]: 3.9-26.8). OR for the occurrence of HCP5 335 G allele in either homozygous or heterozygous genotype in PV patients was 13.1 (0.95 CI: 4.7-36.1). The strength of association was higher with moderate-to-severe subgroup (P = 3.29 × 10-9; OR = 18.4; 0.95 CI: 6.2-54.9) than with mild subgroup (P = 2.1 × 10-4; OR = 8.3; 0.95 CI: 2.6-23.3). In addition, the strength of association was higher with Type I (P = 9.53 × 10-8; OR = 15.3; 0.95 CI: 5.1-46.5) than with Type II subgroup (P = 6.8 × 10-6; OR = 11.0; 0.95 CI: 3.6-33.9). Type I gene Δ32 polymorphism was observed neither among psoriatic nor among healthy individuals. CONCLUSIONS: Our results indicate that HCP5 gene 335 T > G polymorphism and not CCR5 gene Δ32 polymorphism is associated with the increased risk of developing PV.

Novel association of SNP rs479200 in EGLN1 gene with predisposition to preeclampsia.

OBJECTIVES: Placental hypoxia is a hallmark of preeclampsia. SNP rs479200 in the EGLN1 gene is associated with reduced responsiveness to hypoxia. Whether this translates into an association between SNP rs479200 and preeclampsia is not known. We evaluated the association of SNP rs479200 (T>C) with the risk of preeclampsia. METHODS: This case-control study involved 600 pregnant women of whom 300 were preeclamptic and 300 were normotensive. SNP rs479200 was genotyped by PCR-RFLP method. RESULT: Minor allele frequency was 44% in preeclamptic women and 53% in normotensive pregnant women (P = 1.8 × 10-3; odds ratio = 1.43). The odds ratio was heterogeneous when compared after categorization of the preeclamptic group into clinical sub-groups. The association was significant with both mild (P = 6.2 × 10-5) and severe (3.8 × 10-3) preeclampsia. However, the odds ratio was 0.52 for mild preeclampsia and 1.43 for severe preeclampsia. CONCLUSION: The minor allele of SNP rs479200 is associated with the predisposition to preeclampsia. This association underlines the importance of oxygen sensing in the pathogenesis of preeclampsia.

Impact of epilepsy and antiepileptic drugs on health and quality of life in Indian children.

BACKGROUND AND OBJECTIVES: Epilepsy affects the physical, cognitive, emotional, social wellbeing, and thereby the overall quality of life (QOL). Epilepsy is the most prevalent neurological disorder in the pediatric age group with a prevalence of 3.13 to 3.73 per 1000 in India. It is imperative for the primary caregiver to look beyond seizure control for improving wellbeing of children with epilepsy (CWE). Hence, there is a need to understand the predictors of QOL in Indian CWE. The objective of this study was to assess the impact of epilepsy and antiepileptic medications on the child's development, health, scholastic performance, and QOL and to identify the predictors of QOL. METHODS: This study was a cross-sectional hospital-based prospective study with sociodemographic, clinical data collected from 110 children (age 4-18 years). Seizure severity was assessed with the Hague Seizure Severity Scale, and adverse effects of antiepileptic drugs (AEDs) were assessed using the Adverse Event Profile Scale. The QOL was measured employing the Quality of Life in Children with Epilepsy (QOLCE) questionnaire. RESULTS: The mean total QOLCE score was 72.6 ±â€¯13.6. Among the subscale scores, memory had the highest mean of 86.5, and the lowest mean was observed for QOL item (40.4). There was no significant association of the total QOLCE score with any of the sociodemographic variables such as gender, place, socioeconomic status, paternal/maternal education, or family type. Children with more severe seizures had significantly lower energy and QOL subscale scores and greater depression and anxiety. Prolonged duration of epilepsy, frequent seizures, and recent seizures had a significant negative correlation with the mean total QOLCE score. Children with epilepsy who are on multiple AEDs, prolonged duration of AED intake, or poor adherence to AEDs have significantly lower total QOLCE score. Children manifesting adverse effects to AEDs had significantly lower overall QOL affecting all domains. CONCLUSION: Overall QOL in CWE is most compromised by polytherapy, poor adherence to medication, adverse effects of AEDs, hospitalization, and presence of developmental delay.

Anomalous toluene transport in model segmented polyurethane-urea/clay nanocomposites.

The kinetics of liquid solvent sorption in polymeric systems and their nanocomposites often deviate from normal Fickian behaviour. This needs to be understood and interpreted, in terms of their underlying mechanistic origins. In the present study, the results of time dependent toluene sorption measurements in model segmented polyurethane-urea/clay nanocomposites have been analysed at room temperature. The studies revealed pronounced S-shaped sorption curves and unusually higher swelling of the nanocomposites compared to the neat polyurethane-urea matrix. Dynamic mechanical analysis (DMA) and small angle X-ray scattering (SAXS) measurements on the nanocomposites in the dry and liquid toluene saturated state have been carried out. The DMA studies revealed a significant decrease in the α relaxation temperature and storage modulus of the nanocomposites in the swollen state compared to the dry samples. The SAXS results showed that the nanoclay dispersion morphology transformed from intercalation in the dry state to exfoliation in the swollen state and the interdomain distance between hard segments increased upon swelling. Thermodynamic analysis of the Flory-Huggins interaction parameter (χ) of nanocomposite/toluene systems revealed increasingly negative χ values with increased clay loading. These results imply a significant plasticization effect of toluene on the nanocomposites. An interpretation of these data, which relates the abovementioned results, is presented in the framework of differential swelling stress (DSS) induced deviation from Fickian transport characteristics. We expect that these findings and methods may provide new insight into the analysis of the solvent diffusion process in heterogeneous polymers and their nanocomposites.

Knowledge,attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City,India / 世界急诊医学杂志（英文）

BACKGROUND:This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India. METHODS:The study subjects comprised of interns who volunteered from the four dental col eges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistical y significant differences (P<0.05) between assessed knowledge and anxiety. RESULTS:Out of 183 interns, 39.89％ had below average knowledge. A total of 123 (67.21％) reported unavailability of professional training. The majority (180, 98.36％) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1％ participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant (P=0.983). CONCLUSION:There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Bilateral acute angle closure glaucoma following a snake bite: Are we missing it?

INTRODUCTION: We report a case series of acute angle closure following snake bite, their clinical features, treatment, and the outcomes. MATERIALS AND METHODS: Ocular examination was done in all the snake bite victims admitted over 1-year period. The systemic status, presenting intraocular pressure (IOP), treatment instituted, and outcomes were recorded for all cases of acute angle closure. RESULTS: Six patients developed angle closure following snake bite. Average IOP was in the range of 32-56 mmHg. Treatment was initiated as for cases of acute angle closure. Two patients succumbed and the other four recovered, had normal IOP at follow-up. CONCLUSION: Acute angle closure glaucoma is a rare complication of snake bite. Timely detection and management will result in good visual prognosis. Treating physicians should be aware of this rare sight-threatening complication so that a preliminary ophthalmic examination can be sought and the visual morbidity be prevented.

Nonpseudomonal ecthyma gangrenosum of the upper lid treated with lid reconstruction.

Ecthyma gangrenosum (EG) is a cutaneous infection which usually occurs in immunocompromised patients. We report a case of EG of the eyelid treated with escharotomy and skin grafting, highlighting the importance of surgical management. A 2-year-old Asian Indian female presented to us with right upper lid edema with a large necrotic area. The child received intravenous cefotaxime for a week and the necrotic area turned to a well-defined eschar. Escharotomy with wound debridement and skin grafting was done. The present case highlights the importance of surgical intervention to prevent the sequelae of scarring of upper lid.

Patterns of maxillofacial fractures in goa.

BACKGROUND: The maxillofacial skeleton is commonly fractured due to its prominent position. The pattern of maxillofacial fractures varies from one country to another. The aim of this retrospective study was to analyze the patterns of maxillofacial injuries in the state of Goa and compare the results with similar studies in India and rest of the world. PATIENTS AND METHODS: The data were collected from the records of the patients who reported to the Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital between 2005 and 2010. The site of fracture, age of patient, etiology of trauma, daily and monthly variation of the fractures was analysed. RESULTS: Records of 2,731 patients sustaining maxillofacial injury were examined. The most commonly fractured facial bone was the mandible followed by zygomaticomaxillary complex. Most fractures occurred in the third and fourth decade of life with male and female ratio of 6:1. Main etiology was road traffic accidents. CONCLUSION: Despite strict traffic legislation, road traffic accidents are the main cause of maxillofacial injuries.

Unusual foreign body in a routine lateral cephalogram.

Routine radiographs made in the orthodontic office can often give way to detection and diagnosis of unusual syndromes, signs or foreign bodies. A case report of one such accidental detection of a very unusual foreign body within the nasal cavity of an orthodontic patient has been presented here to emphasize the importance of routine radiographic views, which over and above aiding in Orthodontic diagnosis, can also often detect potentially life threatening problems in the Oro-facial region.

Synthesis and characterization of chromium(III) Schiff base complexes: antimicrobial activity and its electrocatalytic sensing ability of catechol.

A series of acyclic Schiff base chromium(III) complexes were synthesized with the aid of microwave irradiation method. The complexes were characterized on the basis of elemental analysis, spectral analysis such as UV-Visible, Fourier transform infrared (FT-IR), nuclear magnetic resonance (NMR), electron paramagnetic resonance (EPR) spectroscopies and electrospray ionization (ESI) mass spectrometry. Electrochemical analysis of the complexes indicates the presence of chromium ion in +3 oxidation state. Cr (III) ion is stabilized by the tetradentate Schiff base ligand through its nitrogen and phenolic oxygen. From the spectral studies it is understood that the synthesized chromium(III) complexes exhibits octahedral geometry. Antimicrobial activity of chromium complexes was investigated towards the Gram positive and Gram negative bacteria. In the present work, an attempt was made to fabricate a new kind of modified electrode based on chromium Schiff base complexes for the detection of catechol at nanomolar level.

Ocular Manifestations of Venomous Snake Bite over a One-year Period in a Tertiary Care Hospital

PURPOSE: Ocular manifestations in snake-bite injuries are quite rare. However, the unusual presentations, diagnosis and their management can pose challenges when they present to the ophthalmologist. Early detection of these treatable conditions can prevent visual loss in these patients who are systemically unstable and are unaware of their ocular condition. To address this, a study was conducted with the aim of identifying the various ocular manifestations of snake bite in a tertiary care center. METHODS: This is a one-year institute-based prospective study report of 12 snake bite victims admitted to a tertiary hospital with ocular manifestations between June 2013 to June 2014, which provides data about the demographic characteristics, clinical profiles, ocular manifestations, and their outcomes. RESULTS: Twelve cases of snake bite with ocular manifestations were included of which six were viper bites, three were cobra bites and three were unknown bites. Six patients presented with bilateral acute angle closure glaucoma (50%), two patients had anterior uveitis (16.6%) of which one patient had concomitant optic neuritis. One patient had exudative retinal detachment (8.3%), one patient had thrombocytopenia with subconjunctival hemorrhage (8.3%) and two patients had external ophthalmoplegia (16.6%). CONCLUSIONS: Bilateral angle closure glaucoma was the most common ocular manifestation followed by anterior uveitis and external ophthalmoplegia. Snake bite can result in significant ocular morbidity in a majority of patients but spontaneous recovery with anti-snake venom, steroids and conservative management results in good visual prognosis.