Validation of satisfaction questionnaire for services provided in the labour rooms of government health facilities.

INTRODUCTION AND OBJECTIVES: Using the assessment of satisfaction of patients of labour room services, the caregiver or policymakers can identify the gaps in the implemented programmes and health policies. This study was aimed to design a valid and reliable satisfaction questionnaire that will help in identifying the aspects of gaps that need improvement. METHODS: A facility and community-based observational cross-sectional study was conducted in the district of western Uttar Pradesh (India) between January 2019 and August 2020. Validation of the structured questionnaire with 34 dichotomous questions categorized under five subscales was performed by evaluating its validity and reliability. A total of 380 beneficiaries were selected from 48 government health facilities. RESULTS: The calculated Content validity index was calculated to be 9.5 which was adequate as per the guidelines. The reliability analysis of the questionnaire showed that the internal consistency was high with an overall Cronbach's alpha of 0.710. The variation in Cronbach's alpha on the elimination of any question from the questionnaire ranged from 0.676 to 0.767. The mean patient satisfaction score in the total surveyed population was 24.39±4.684 (total score=34) and there was a greater variation in the satisfaction score of infrastructure when compared with other subscales. CONCLUSION: The findings from this study support the reliability and validity of the patient satisfaction questionnaire as it is capable of evaluating the satisfaction in terms of delivery services provided in labour rooms as a whole.

Positive Retrospective SARS-CoV-2 Testing in a Case of Acute Respiratory Distress Syndrome of Unknown Etiology.

In order to elucidate the cause of acute respiratory distress syndrome of unknown etiology in a pre-pandemic patient, molecular techniques were used for detection of SARS-CoV-2. We used a SARS-CoV-2 nucleocapsid protein immunofluorescence stain to retrospectively identify an individual with diffuse alveolar damage on autopsy histology who had negative respiratory virus panel results in February, 2020, in Birmingham, Alabama. In situ hybridization for SARS-CoV-2 RNA revealed evidence of widespread multiorgan SARS-CoV-2 infection. This death antecedes the first reported death of a State of Alabama resident diagnosed with SARS-CoV-2 by 26 days.

Seed dispersal of wild radishes and its association with within-population spatial distribution.

BACKGROUND: The wild radishes, Raphanus raphanistrum and R. pugioniformis (Brassicaceae) are native to the East Mediterranean region. However, whereas R. raphanistrum is widely distributed worldwide, the endemic R. pugioniformis is limited to specific habitats. In R. raphanistrum the diaspores of the indehiscent fruits comprise glabrous, light, single-seeded segments, whereas the intact fruits of R. pugioniformis are heavy and covered with spiny backward-pointing trichomes. We aimed to investigate whether the structure of the diaspores was directly associated with long- and short-range dispersal in R. raphanistrum and R. pugioniformis, respectively. We further surveyed within-population spatial distributions, to test the hypothesis that short- and long-range dispersal contribute to a patchy vs. uniform distribution patterns of R. pugioniformis and R. raphanistrum, respectively. RESULTS: The results indicated that dispersal by wind and run-off water was substantially lower for diaspores of R. pugioniformis than for those of R. raphanistrum diaspores. Supporting the hypothesis that backward-pointing trichomes promote adherence to soil particles, the displacement on soil surface of R. pugioniformis fruits depended on their orientation relative to wind direction. Furthermore, trichome removal from fruits of R. pugioniformis significantly reduced wind velocity needed to remove fruits that were placed on soils typical of the species' natural habitats. The spatial-distribution survey results indicated a patchy distribution of R. pugioniformis populations as compared with the more uniform arrangement in the studied populations of R. raphanistrum; consistent with the unidirectional vs. homogeneous wind dispersal of the respective diaspores, with respect to wind direction. In addition, R. pugioniformis population sizes changed less between years than those of R. raphanistrum. CONCLUSIONS: Overall, our results indicate that fruit structure is strongly linked to dispersal ability and spatial distribution of the two closely related wild radish species. Whereas R. raphanistrum inhabits homogenous sandy soil habitats, the distribution range of R. pugioniformis includes heterogeneous environments in which growth niches are scarcer. We suggest that the different modes of dispersal have evolved as adaptive traits appropriate to the species' specific habitats.

The direct-writing of low cost paper based flexible electrodes and touch pad devices using silver nano-ink and ZnO nanoparticles.

We report a novel and simple approach for the synthesis of silver nanoparticles capped with inositol (Ag NPs/Ino) by the reduction of silver salt with ascorbic acid under basic conditions. UV-vis, TEM, FTIR and TGA techniques were used to characterize the Ag NPs/Ino to determine the size, shape and surface modification of the NPs. Stable silver nano-ink was prepared in aqueous solution containing 1% PVP (stabilizer) and glycerol (cosolvent) and was used for the direct-writing of a paper electrode with a roller ball-point pen for electrochemical applications. The solvent, stabilizing agents, concentration of NPs (10%), paper substrate, sintering temperature (40 °C) and sintering time (15 min) were optimized to obtain a uniform coating of Ag NPs on the paper substrate. Further, the synthesis and fabrication of ZnO NPs on a paper substrate was put forward to design a touch pad device based on the piezoelectric effect. The preparation of paper based devices suggests a direction for the development of a simple, low cost and compatible approach for the direct-writing of paper based flexible electrodes and electronics for future applications.

Practical consensus recommendations on Her2 +ve breast cancer with solitary brain mets.

Breast cancer is a common cause of brain metastases, with metastases occurring in at least 10-16% of patients. Longer survival of patients with metastatic breast cancer and the use of better imaging techniques are associated with an increased incidence of brain metastases. Current therapies include surgery, whole-brain radiation therapy, stereotactic radiosurgery, chemotherapy and targeted therapies. However, the timing and appropriate use of these therapies is controversial and careful patient selection by using available prognostic tools is extremely important. Expert oncologist discussed on the mode of treatment to extend the OS and improve the quality of life ofHER2-positivebreast cancer patients with Solitary brain metastases. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

HLA-B27 subtypes in enthesitis-related arthritis category of juvenile idiopathic arthritis and ankylosing spondylitis in northern India.

OBJECTIVES: Enthesitis-related arthritis (ERA) is the most common form of juvenile idiopathic arthritis (JIA) in the Asian and Indian populations. The presence of HLA-B27 has a strong association with JIA-ERA similar to that with adult ankylosing spondylitis (AS). The HLA-B27gene is highly polymorphic. Susceptibility to AS varies between different HLA-B27 subtypes; data on the relationship of susceptibility to JIA-ERA with HLA-B27 types are scant. In this study, we determined HLA-B27 subtypes in patients with JIA-ERA and AS to find out whether there is any difference in the HLA-B27 subtypes prevalent in these two diseases. METHODS: Genomic DNA from 135 patients with JIA-ERA and 121 with AS was tested for the presence of HLA-B27. In patients testing positive, HLA-B27subtyping was done by sequencing a genomic region that contained second and third exons and the intervening intron of this gene; this method permitted identification of common HLA-B27 subtypes (HLA-B*27:01 to HLA-B*27:09). RESULTS: One hundred and seven (79%) patients with JIA-ERA and 102 (84%) patients with AS tested positive for HLA-B27. In both groups, HLA-B*27:05 and HLA-B*27:04 were the common subtypes; some patients had HLA-B*27:07(7.4%) and HLA-B*27:18. Patients with JIA-ERA had a higher frequency of HLA-B*27:05 than those with AS (70% vs. 57%, p=0.047), and a lower frequency of HLA-B*27:04 (21% vs. 36%, p=0.018). CONCLUSIONS: HLA-B*27:05 and HLA-B*27:04 were the most common HLA-27 subtypes in both JIA-ERA and AS. However, HLA-B*27:05 was more frequent and HLA-B*27:04 was less frequent in JIA-ERA. It is possible that HLA-B*27:05 being the ancestral HLA-27 subtype leads to expression of disease early in life.

Molecular dynamics of glycine ions in alanine doped TGS single crystal as probed by polarized laser Raman spectroscopy.

Polarized Raman spectra of pure and alanine doped tri-glycine sulfate (TGS) single crystals at 12 K in different scattering geometries are analyzed. Sub species modes due to three crystallographically distinguishable glycine ions G (I), G (II) and G (III) are assigned. It is observed that alanine doping does not change the crystalline field and acts as local perturbation only. The major changes due to doping are observed in the relative intensities of different modes; most of the modes associated with G (I) and SO(4)(2-) ions show reversal behavior in relative intensity at high doping concentration. The observed spectral changes are analyzed in terms of reorientation of G (I) ions with sub species modes of G (II)/ G (III) following the reorientation due to complex hydrogen bonding network.

Antioxidant capacities and total polyphenol contents of hydro-ethanolic extract of phytococktail from trans-Himalaya.

The aim of this study was to evaluate the in vitro antioxidant potential of hydro-ethanolic extract of a novel phytococktail comprising of sea buckthorn, apricot, and Rhodiola (SAR) from trans-Himalaya. The 1,1-diphenyl-2-picrylhydrazyl (DPPH) activity of the extract increased in a dose-dependent manner (upto 0.1 mg/mL), and was found to be about 38% of that of ascorbic acid at 0.1 mg/mL. The hydro-ethanolic extract of SAR also scavenged the ABTS(.+) radical generated by ABTS/potassium persulfate (PPS) system and was found to be about 62% of that of ascorbic acid at 0.1 mg/ mL. The total antioxidant power of the extract was determined by ferric reducing antioxidant power (FRAP) assay. Total phenolic content was found to be 1.28016 × 10(-3) mol gallic acid equivalent (GAE)/g extract. Total flavonoid and flavonol contents were estimated to be 2.5970 × 10(-4) mol and 4.87 × 10(-4) mol quercetin equivalent/g extract, respectively. The hydro-ethanolic extract of this phytococktail indicated presence of essential phytoconstituents of polyphenols, flavonoids, flavonols, and ascorbic acid, which contributed significantly to its antioxidant capacity. The combination of the 3 plants may well support their use in traditional medicine to combat oxidative stress and high-altitude sickness.

Determination of persistent organochlorine residues in a commercial fresh water catfish by GLC and study of their accumulation pattern.

Concentrations of various organochlorine pesticides in a commercial fresh water catfish, Heteropneustes fossilis, were measured. This study reveals possible toxicological exposure of human beings by way of consuming such fish containing pesticide and that will amount to possible exposure. Tissue extracts obtained by Soxhlet apparatus were used for analysis and the concentrations of analytes were determined by gas chromatography with electron capture detection. The major organochlorines found in blood sample were Endosulfan, Alpha-HCH, Beta-HCH and Gamma-HCH. However, the organochlorines found in edible portion of fish (i.e.flesh) were mainly--Endosulfan, Delta-HCH, Aldrine, pp-DDE etc. The concentrations of these organochlorines were at or above the theoretical threshold limit and hence are supposed to be effectively toxic to fish eaters, due to biomagnification.

Etched multimode microfiber knot-type loop interferometer refractive index sensor.

We propose a novel refractive index sensor based on multimode microfiber knot-type loop (NL) interferometer. The middle portion (~5 cm) of a 15 cm long multimode fiber is etched in 48% hydrofluoric acid to reduce its diameter to ~12 µm. A NL of diameter <1 mm is made from the etched fiber. The ends of etched fiber are spliced with single-mode fibers for launching and detecting light from the NL interferometer. The NL introduces path differences to produce interferometric spectra with free spectral range ~16 nm. The spectrum shifts as the surrounding refractive index of the loop is changed by adding chemicals. We observe the highest sensitivity of the NL interferometer ~172 nm/RIU (refractive index unit) at a refractive index value 1.370 as obtained experimentally using commonly available chemicals. The design could be used as simple, low cost, and highly sensitive biological and chemical sensor.

Macrophages in the development of protective immunity against experimental Brugia malayi infection.

The present report compares the macrophage function in rodent hosts susceptible and resistant to the human lymphatic filariid Brugia malayi. Macrophages from both mastomys (resistant) and gerbil (susceptible) infected intraperitoneally (i.p.) with the infective larvae (L3) of B. malayi were isolated from peritoneal lavage at different time-intervals and formation rate of NO, H2O2, O2-, TNF-alpha, glutathione peroxidase and reductase was assayed. NO release was found to be significantly increased in resistant mastomys as compared to gerbils and the release was markedly suppressed by i.p. administration of the NOS inhibitor aminoguanidine (AG). The AG-treated mastomys also demonstrated significantly greater establishment of larvae which correlated well with suppressed formation of NO. Nitric oxide synergizes with superoxide to form peroxynitrite radical (potent oxidant), which is known to be more toxic per se than NO. Results indicate the possible involvement of peroxynitrite in the rapid killing of larvae in the peritoneal cavity of mastomys. In contrast, the production of H2O2 was found to be enhanced in both species indicating that B. malayi L3 could withstand the toxic effects of H2O2. The higher level of glutathione peroxidase and reductase, as observed in mastomys compared with the gerbil after larval introduction, possibly protects the cell against the injurious effect of H2O2. The TNF-alpha level remained virtually unchanged in both the hosts, suggesting an insignificant role for this cytokine in parasite establishment.

An unusual photohaemolytic property of riboflavin.

Riboflavin (RF) is a known photoreactive and phototoxic molecule. However, unlike other photosensitizers, it does not induce photohaemolysis of erythrocytes by itself. On the other hand, illuminated RF caused haemolysis but in the presence of serum or plasma. The kinetics of photohaemolysis in the presence of serum/plasma has been studied by monitoring the rate of haemolysis spectrophotometrically and morphological changes at erythrocytes membrane by scanning electron microscopy. We found that the extent of mammalian RBC membrane damage was dependent on the concentration of RF or hematoporphyrin (HP) (0-20 microgram/ml) and dose of sunlight (0-20 min). The RBC membrane-damaging potential of illuminated HP was not affected by the presence of plasma in the reaction system. Furthermore, RF showed a protective role against photohaemolysis caused by photoexcited HP if erythrocytes were preincubated with RF in the absence of serum/plasma. For mechanistic studies, biochemical parameters such as acetylcholinesterase activity (AChE) and formation of TBA-reactive substance (TBA-RS) were analysed in RBC and RBC+plasma under a similar set of experimental conditions. We observed about a 25% decrease in AchE activity as a synergistic action of RF or HP (20 microgram/ml) and sunlight (30 min) in both cases (RBC or RBC+plasma). Interestingly, illuminated RF caused about a 125% increase of TBA-RS in a reaction system consisting of RBC+plasma. On the other hand, an increase in the production of TBA-RS by illuminated RF was not observed in the absence of plasma/serum, in the reaction system. These results suggested that photooxidation of RBC membrane lipids by illuminated RF, under the influence of plasma/serum, may be one of the causes of membrane modification leading to RBC lysis.

Binding of 5-(2'-carboxyphenyl)azoquinolin-8-ol to bovine serum albumin: a spectroscopic study.

Dye-protein interactions are of immense importance in dye-ligand chromatography of protein purification. In this type of interactions, the structure of the dye molecules has a significant role. However, studies on the structure of these ligands are scanty. Therefore, we have spectroscopically investigated interactions of three 5-(aryl)azoquinolin-8-ol derivatives, which could be used as potent chelate forming agents, with bovine serum albumin (BSA). Among these, the carboxy derivative, 5-(2'-carboxyphenyl)azoquinolin-8-ol (CPAQ) has been selected for resonance Raman study. It has been shown that BSA has six independent binding sites for CPAQ at pH 7.2, the binding constant being 6.2 x 10(3) M(-1). Assignments of Raman modes of bound CPAQ are also presented. It has also been shown that bound CPAQ exists exclusively in hydrazone form. Results further demonstrate that the azo group nitrogen adjacent to the phenyl ring probably participated in the formation of a BSA-CPAQ complex.

Biphasic biomethanation of wood-hydrolysate effluent.

The dissolving pulp industry, spread throughout the world, is the principal source of wood-hydrolysate effluent rich in hemicelluloses. This effluent is the major source of pollution in the industry. COD and BOD5 values of the effluent range from 60,000 to 103,000 and 42,000 to 78,000 mg/l respectively. Biomethanation of this effluent is the best possible treatment option for reducing the COD load and recovering the bioenergy embedded in the effluent. This paper deals with the study on the biphasic biomethanation of the wood-hydrolysate in upflow acidogenic reactor coupled with anaerobic filter methanogenic reactor. The two reactors were operated at organic loading rates of 69.6 and 30.1 g COD/l/d respectively. The overall COD, hemicelluloses and lignin reductions, and methane generation were observed to be 88%, 92%, 82% and 6.5 l/l reactor volume/d respectively. The relative size of the biphasic, anaerobic filter (mono-phasic) and upflow anaerobic sludge blanket (mono-phasic) reactors is found to be 1:1.6:2.03 respectively.

Application of enzymes in the pulp and paper industry

The pulp and paper industry processes huge quantities of lignocellulosic biomass every year. The technology for pulp manufacture is highly diverse, and numerous opportunities exist for the application of microbial enzymes. Historically, enzymes have found some uses in the paper industry, but these have been mainly confined to areas such as modifications of raw starch. However, a wide range of applications in the pulp and paper industry have now been identified. The use of enzymes in the pulp and paper industry has grown rapidly since the mid 1980s. While many applications of enzymes in the pulp and paper industry are still in the research and development stage, several applications have found their way into the mills in an unprecedented short period of time. Currently the most important application of enzymes is in the prebleaching of kraft pulp. Xylanase enzymes have been found to be most effective for that purpose. Xylanase prebleaching technology is now in use at several mills worldwide. This technology has been successfully transferred to full industrial scale in just a few years. The enzymatic pitch control method using lipase was put into practice in a large-scale paper-making process as a routine operation in the early 1990s and was the first case in the world in which an enzyme was successfully applied in the actual paper-making process. Improvement of pulp drainage with enzymes is practiced routinely at mill scale. Enzymatic deinking has also been successfully applied during mill trials and can be expected to expand in application as increasing amounts of newsprint must be deinked and recycled. The University of Georgia has recently opened a pilot plant for deinking of recycled paper. Pulp bleaching with a laccase mediator system has reached pilot plant stage and is expected to be commercialized soon. Enzymatic debarking, enzymatic beating, and reduction of vessel picking with enzymes are still in the R&D stage but hold great promise for reducing energy. Other enzymatic applications, i.e., removal of shives and slime, retting of flax fibers, and selective removal of xylan, are also expected to have a profound impact on the future technology of the pulp and paper-making process.

Decolorization and detoxification of extraction-stage effluent from chlorine bleaching of kraft pulp by Rhizopus oryzae.

Rhizopus oryzae, a zygomycete, was found to decolorize, dechlorinate, and detoxify bleach plant effluent at lower cosubstrate concentrations than the basidiomycetes previously investigated. With glucose at 1 g/liter, this fungus removed 92 to 95% of the color, 50% of the chemical oxygen demand, 72% of the adsorbable organic halide, and 37% of the extractable organic halide in 24 h at temperatures of 25 to 45 degrees C and a pH of 3 to 5. Even without added cosubstrate the fungus removed up to 78% of the color. Monomeric chlorinated aromatic compounds were removed almost completely, and toxicity to zebra fish was eliminated. The fungal mycelium could be immobilized in polyurethane foam and used repeatedly to treat batches of effluent. The residue after treatment was not further improved by exposure to fresh R. oryzae mycelium.

Spectroscopic characterization of gelonin--assignments secondary structure and thermal denaturation.

Gelonin, a type 1 ribosome inactivating protein (RIP), having only one polypeptide chain, and which could be used against deadly diseases like cancer and AIDS is investigated spectroscopically through infrared (IR), diffused reflectance infrared fourier transform (DRIFT) and Raman techniques and observed vibrational modes are assigned. It is found that gelonin is having mainly alpha-helix and beta-sheet structure with some turn and disordered structure, the estimated percentage structure using Raman data being approximately 32% alpha-helix, approximately 20% beta-sheet, approximately 26% turn and approximately 22% disorder type. The temperature dependent infrared study of gelonin reveals its thermal stability, the denaturation temperature being around 60 degrees C and disordered contribution increasing with heating.

Ceramic drug-delivery devices.

A variety of ceramics and delivery systems have been used to deliver chemicals, biologicals, and drugs at various rates for desired periods of time from different sites of implantation. In vitro and in vivo studies have shown that ceramics can successfully be used as drug-delivery devices. Matrices, inserts, reservoirs, cements, and particles have been used to deliver a large variety of therapeutic agents such as antibiotics, anticancer drugs, anticoagulants, analgesics, growth factors, hormones, steroids, and vaccines. In this article, the advantages and disadvantages of conventional drug-delivery systems and the different approaches used to deliver chemical and biological agents by means of ceramic systems will be reviewed.