The Young Myocardial Infarction Study of the Western Indians: YOUTH Registry.

BACKGROUND: Myocardial infarction is among the leading causes of morbidity and mortality in young adults around the world. OBJECTIVES: In the YOUTH (Young Myocardial Infarction Study of the Western Indians) registry, we aimed to evaluate risk factor profile and angiographic outcomes of reperfusion therapies of infarct-related artery in young western Indians (≤40 years) having ST-segment elevation myocardial infarction. METHODS: A total of 1,179 consecutive patients aged ≤40 years who presented with ischemic heart disease from June 2012 to December 2014 were enrolled in the YOUTH registry. A total of 787 patients with ST-segment elevation myocardial infarction were further evaluated. Categorical data was assessed using chi-square test, whereas continuous data was assessed using Student's t test. Regression analysis was performed to investigate the strength of association. RESULTS: In the YOUTH registry, the study population was predominantly male (93%) with tobacco consumption as major prevalent risk factor (49.7%). Of 787 patients, 451 (57.31%) were thrombolyzed, 326 (41.42%) did not receive any reperfusion therapy, and 10 patients (1.27%) underwent primary angioplasty. Younger age, window period <6 h, and lower lipoprotein (a) level were observed in patients with a recanalized infarct-related artery. Regression analysis showed window period of thrombolysis as strongest predictor (odds ratio: 1.790, 95% confidence interval: 1.144-2.802; p < 0.011) of successful reperfusion. Patients (n = 235) being thrombolyzed in a window period of <6 h, had higher rate of infarct-related artery recanalization (77%) as compared to those with ≥6 h window period (23%). In-hospital mortality was 0.38% (n = 3), whereas bleeding complication was noted only in 1 patient. CONCLUSIONS: We herewith conclude that acute short-term outcome is favorable in young ST-segment elevation myocardial infarction patients, particularly in those who had received timely thrombolytic therapy. Though tobacco consumption was a major contributor of risk in young adults, prevalence of other risk factors was low in young Western Indians.

Novel indexes for diagnosing metabolic syndrome in apparently healthy Gujarati Asian Indians: a cross-sectional study.

BACKGROUND: We aimed to compare the diagnostic accuracy of four novel indexes-triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio, weight height ratio (WHtR), lipid accumulation product (LAP) and visceral adiposity index (VAI) with conventional components of metabolic syndrome (MetS) in order to identify a single index for the diagnosis of MetS in Gujarati Indian population. METHODS: This observational and cross sectional study involved a total of 3329 healthy adults of 18-79 years of age. Demographic and clinical data such as body mass index, waist circumference, blood pressure were measured along with the levels of lipids and fasting blood glucose. RESULTS: The overall prevalence of MetS was 34.32%, which was almost double in older individuals (45.5% vs. 20.8%) and slightly higher in males (37% vs. 31.2%). In comparison to individual components of MetS, three novel indexes-VAI, LAP and TG/HDL-C ratio showed superior diagnostic efficacy yielding an area under curve of 0.856, 0.821 and 0.821 respectively. The optimal cut-offs for VAI, LAP and TG/HDL Ratios for male, females, young and old population are (79.71, 88.12, 75.42, 87.4), (35.62, 34.73, 35.88, 34.7) and (2.249, 3.16, 2.49, 2.79) respectively. The diagnostic effectiveness of novel markers was unaffected by the age and gender of an individual. However, the efficacy of WHtR was comparable with the other conventional markers. CONCLUSION: Three novel markers-LAP, VAI and TG/HDL-C ratio could be effectively used as a single 'Surrogate marker' for screening of asymptomatic Gujarati Asian Indians with MetS.

Study of clinical and aetiological profile of 100 patients of pancytopenia at a tertiary care centre in India.

Pancytopenia is not a disease but an important clinico-haematological entity encountered in our day-to-day clinical practice with findings that may result from a number of disease processes. A total of 100 patients of pancytopenia admitted in medicine wards of Civil Hospital, Ahmedabad, Gujuarat, India, were studied. The most common cause of pancytopenia was megaloblastic anaemia (45%) followed by infections (20%) and hypersplenism (15%). As compared with other causes, megaloblastic anaemia was statistically significant cause (P < 0.01) of pancytopenia, in our study. The most common clinical presentation of patients with megaloblastic anaemia was lethargy (100%) and pallor (100%). In patients with megaloblastic anaemia, mean haemoglobin (Hb) was 5.6 ± 1.7 g/dl, mean white blood corpuscle (WBC) count was 2735 ± 4152 and mean platelet count was 52,250 ± 24,213. Mean corpuscular volume (MCV) was 101.2 ± 11 in patients of megaloblastic anaemia. Morphology of RBC was marocytic in 95% of patients with megaloblastic anaemia, whereas hypersegmented neutrophils and macrovalocytes were seen in 60-65% patients of megaloblastic anaemia.

Investigating the interface of superhydrophobic surfaces in contact with water.

Neutron reflectivity (NR) is used to probe the solid, liquid, vapor interface of a porous superhydrophobic (SH) surface submerged in water. A low-temperature, low-pressure technique was used to prepare a rough, highly porous organosilica aerogel-like film. UV/ozone treatments were used to control the surface coverage of hydrophobic organic ligands on the silica framework, allowing the contact angle with water to be continuously varied over the range of 160 degrees (superhydrophobic) to <10 degrees (hydrophilic). NR shows that the superhydrophobic nature of the surface prevents infiltration of water into the porous film. Atomic force microscopy and density functional theory simulations are used in combination to interpret the NR results and help establish the location, width, and nature of the SH film-water interface.

Reduced water density at hydrophobic surfaces: effect of dissolved gases.

Here, direct noninvasive neutron reflectivity measurements reveal the presence of a reduced (deuterated) water density region, with a sigmoidal density profile at the hydrophobic silane-water interface that depends on the type and concentration of dissolved gases in the water. Removal of dissolved gases decreases the width of the reduced water density region, and their reintroduction leads to its increase. When compared with recent computer simulations, a locally fluctuating density profile is proposed, whereas preexisting nanobubbles are excluded. The presence of a fluctuating reduced water density region between two hydrophobic surfaces and the attractive "depletion force" to which it leads may help explain the hydrophobic force and its reported diminution in deaerated water. Our results are also quantitatively consistent with recent dynamic surface force apparatus results that drastically revise previous estimates of the slip length of water flowing past hydrophobic surfaces from microns to approximately 20 nm. Our observations, therefore, go a long way toward reconciling three quite different types of experiments and phenomena: water depletion at hydrophobic surfaces, water slip at hydrophobic surfaces, and the hydrophobic interaction.

Neutron reflectivity study of lipid membranes assembled on ordered nanocomposite and nanoporous silica thin films.

Single bilayer membranes of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) were formed on ordered nanocomposite and nanoporous silica thin films by fusion of small unilamellar vesicles. The structure of these membranes was investigated using neutron reflectivity. The underlying thin films were formed by evaporation induced self-assembly to obtain periodic arrangements of silica and surfactant molecules in the nanocomposite thin films, followed by photocalcination to oxidatively remove the organics and render the films nanoporous. We show that this platform affords homogeneous and continuous bilayer membranes that have promising applications as model membranes and sensors.

Peering into the self-assembly of surfactant templated thin-film silica mesophases.

It is now recognized that self-assembly is a powerful synthetic approach to the fabrication of nanostructures with feature sizes smaller than achievable with state of the art lithography and with a complexity approaching that of biological systems. For example, recent research has shown that silica/surfactant self-assembly combined with evaporation (so-called evaporation induced self-assembly EISA) can direct the formation of porous and composite thin-film mesostructures characterized by precise periodic arrangements of inorganic and organic constituents on the 1-50-nm scale. Despite the potential utility of these films for a diverse range of applications such as sensors, membranes, catalysts, waveguides, lasers, nano-fluidic systems, and low dielectric constant (so-called low k) insulators, the mechanism of EISA is not yet completely understood. Here, using time-resolved grazing incidence small-angle X-ray scattering (GISAXS) combined with gravimetric analysis and infrared spectroscopy, we structurally and compositionally characterize in situ the evaporation induced self-assembly of a homogeneous silica/surfactant/solvent solution into a highly ordered surfactant-templated mesostructure. Using CTAB (cetyltrimethylammonium bromide) as the structure-directing surfactant, a two-dimensional (2-D) hexagonal thin-film mesophase (p6mm) with cylinder axes oriented parallel to the substrate surface forms from an incipient lamellar mesophase through a correlated micellar intermediate. Comparison with the corresponding CTAB/water/alcohol system (prepared without silica) shows that, for acidic conditions in which the siloxane condensation rate is minimized, the hydrophilic and nonvolatile silicic acid components replace water maintaining a fluidlike state that avoids kinetic barriers to self-assembly.