Real-World Study of Definisse Threads for Facial Reshaping in Indian Patients: REDEFINE FACE Study.

INTRODUCTION: In recent years, thread lifting has gained popularity as a less invasive cosmetic surgery. It helps raise and realign sagging tissue. The newest thread type for thread lifting procedure is poly-lactic acid-polycaprolactone (PLCL) Definisse threads (RELIFE S.r.l., Florence, Italy). These are fourth-generation absorbable suspended barbed threads. Their double action involves an immediate elevating impact through mechanical action and, over time, the promotion of histological rejuvenating activity through inducing fibroblasts and the synthesis of elastin, hyaluronic acid, and collagen. OBJECTIVES: The REDEFINE FACE study assessed the effectiveness and tolerance of Definisse threads in a real-world setting for facial reshaping in patients in India. METHODS: This multicenter, retrospective observational research included patients treated with Definisse threads for face contouring. RESULTS: Three hundred seventeen patients with a mean follow-up of 4.9 months and an average age of 48.6 years participated in the study. All patients underwent thread lifts using either a single or a combination of Definisse thread reshaping techniques. The Global Aesthetic Improvement Scale for Physicians and Subjects (PGAIS and SGAIS) reported improvement instantly following the treatment (mean score- 3.23 and 3.18, respectively). Improvements continued to enhance during the follow-up visits (mean score- 4.09 and 4.03, respectively). Following the procedure, 96% of patients on the PGAIS and SGAIS exhibited enhancement. Most procedure-related side effects were minor and went away on their own in a few days without the need for proactive care. CONCLUSION: The results of this real-world analysis showed that the latest Definisse threads effectively achieve facial reshaping on patients in India and have both immediate and long-term effects. Treatment was generally well tolerated, and no patient experienced serious adverse events.

Practical Aspects of Acne Scar Management: ASAP 2024.

Acne scars are one of the most common complications of acne. They can significantly affect the patient's quality of life. Often, several types of atrophic acne scars are observed simultaneously; therefore, consideration must be given to the type of scar while choosing the treatment modality. Effective treatment is not only important to prevent and improve acne scars but also crucial in preventing psychosocial effects. Treatment of acne scars requires an algorithmic approach that targets each component of the scars, and combination therapy on a patient-specific basis may offer the best chance for significant improvement. The goal of the current article is to discuss the practical aspects of management of atrophic acne scars using the vast modalities of treatment available. The panel of dermatologists and plastic surgeons, each one with at least 20 years of experience in acne scar treatment, participated in a series of 'Practical Aspects of Acne Scar Management' (ASAP) meetings: ASAP 2024. ASAP meetings were organized by "Scar Forum India" from March 2023 to July 2023 in four Indian cities (Mumbai, Delhi, Bengaluru, and Kolkata), each one for a duration of at least three hours. During these meetings and discussions, panelists reviewed and discussed the acne scar-related literature, their clinical experience in its management, available treatment options, along with recent advances. Consequently, a summary of the discussion and practical approach for the management of acne scars is developed. It was concluded that, though there is no specific guideline available to optimize acne scar management despite the multitude of treatment options, the best results can be achieved through the synergy of multiple treatment modalities and using the algorithmic approach.

Drip irrigation and sulphur fertilization influenced fodder yield, quality and water use efficiency of groundnut in arid region.

Availability of ample and nutritious fodder for livestock is always a challenge in arid region. Choice of crops such as groundnut that can fulfil the requirement of fodder with its crop residues along with human needs can be a viable option to bridge the gap between availability and requirement of fodder. The fodder yield and quality largely depend on soil moisture and nutrient supply especially sulphur (S), a key nutrient for improving groundnut fodder quality. However, no researchers have given emphasis on coupling effect of drip irrigation (DI) and sulphur on fodder yield, quality, digestibility and water use efficiency (WUE). Therefore, the study was conducted to determine the effects of different regimes of DI and S on productivity and quality of fodder. Results revealed that higher regimes of DI i.e. 0.8 +1.0 PE(pan evaporation) and 1.0 PE level of irrigation along with 40 kg S ha-1 significantly improved the yield, primary quality traits (crude protein, ether extract and ash), digestibility indices and significant reduction in Fibers which indicates improvement in quality of fodder. Fodder productivity was 27.0 and 25.6% higher in 1.0 PE and 0.8+1.0 PE level of irrigation, respectively, as compared to 0.6 PE level (lower water regime) of irrigation, although 0.6 PE level of irrigation recorded higher WUE and was at par with 0.8 PE and 0.6 +1.0 PE level of DI. By changing the levels of DI from 1.0 PE to 0.8+1.0 PE, considerable water can be saved without affecting the yield and quality of fodder. Similarly, crop responded to S up to 60 kg ha-1 but at par with 40 kg S ha-1 indicating that application of extra S after 40 kg did not warrant any extra benefit in terms of fodder yield, WUE and quality of fodder. Thus, adjusting the PE levels of DI for water saving and optimal S application can be a sustainable strategy to improve the productivity and quality of groundnut fodder in arid region.

Improved NDVI based proxy leaf-fall indicator to assess rainfall sensitivity of deciduousness in the central Indian forests through remote sensing.

Quantifying the leaf-fall dynamics in the tropical deciduous forest will help in modeling regional energy balance and nutrient recycle pattern, but the traditional ground-based leaf-fall enumeration is a tedious and geographically limited approach. Therefore, there is a need for a reliable spatial proxy leaf-fall (i.e., deciduousness) indicator. In this context, this study attempted to improve the existing deciduousness metric using time-series NDVI data (MOD13Q1; 250 m; 16 days interval) and investigated its spatio-temporal variability and sensitivity to rainfall anomalies across the central Indian tropical forest over 18 years (2001-2018). The study also analysed the magnitude of deciduousness during extreme (i.e., dry and wet) and normal rainfall years, and compared its variability with the old metric. The improved NDVI based deciduousness metric performed satisfactorily, as its observed variations were in tandem with ground observations in different forest types, and for different pheno-classes. This is the first kind of study in India revealing the spatio-temporal character of leaf-fall in different ecoregions, elevation gradients and vegetation fraction.

Potential of native shrubs Haloxylon salicornicum and Calligonum Polygonoides for restoration of degraded lands in Arid Western Rajasthan, India.

Shrub-induced soil property spatial heterogeneity is common in arid and semi-arid ecosystems and aids desertified land restoration. However, the effectiveness of this technique may rely on the plant species used and the habitat conditions present. To assess the degree to which planting two native species, Haloxylon salicornicum and Calligonum polygonoides, facilitates degraded land restoration, soil and herbaceous plant community properties were measured 7 years after planting. Soil samples were extracted at two depths (0-5 and 5-20 cm) from three sub-habitats, i.e., under the shrub canopy, from alleys between shrubs and from the open area. Shrub planting increased the quantity of silt + clay content (30-39 %); enhanced water holding capacities (24-30 %); increased the levels of organic carbon (48-69 %), available nitrogen (31-47 %), available phosphorus (32-41 %), and electrical conductivity (21-33 %); and decreased the pH (7-12 %) and bulk density levels (5-6 %) in the surface layer of soils beneath the canopy. Soil property changes were more significant at the surface (0-5 cm) than in the deeper layer (5-20 cm), and were more pronounced under H. salicornicum than under C. polygonoides. Furthermore, the density and biomass levels of herbaceous plants were 1.1 to 1.2 and 1.4 to 1.6 times greater, respectively, in the shrub alleys than in open area. H. salicornicum induced more robust soil amelioration and herbaceous plant facilitative properties than did C. polygonoides. Artificially planting these shrubs may thus be employed to restore degraded areas of arid regions.

Blood leak alarm interference by hydoxocobalamin is hemodialysis machine dependent.

CONTEXT: Hydroxocobalamin has been reported to interfere with the blood leak alarm on hemodialysis machines making it difficult to use this treatment modality after hydroxocobalamin infusion. OBJECTIVE: The objective was to determine if this interference with hydroxocobalamin occurs across hemodialysis machines by different manufacturers. Additionally, we aimed to see if this represented a colorimetric interference alone or if it is the optical properties of hydroxocobalamin. MATERIALS AND METHODS: Hydroxocobalamin was reconstituted per package insert. Food coloring was added to 0.9% saline to create the colors of the visual spectrum. Optical properties of absorbance and transmittance were measured. Hydroxocobalamin and the saline solutions were infused into the Fresenius 2008K™ and the Gambro Phoenix X36™ machines. Times were recorded from the start of the machine until the solution finished or the alarm triggered. RESULTS: When evaluating the Gambro Phoenix X36™ machine and dialysis circuit; the alarm did not trigger. In contrast, the blood leak alarm on the Fresenius 2008K™ machine was tripped by both the red solution and hydoxocobalamin infused per the package insert. The alarm stopped the machine between 128 and 132 seconds for the red solution and between 30 and 35 seconds with the hydroxocobalamin. Membranes of the circuits where the alarm tripped were examined and remained intact without blood. Results were validated on different machines with new circuits. DISCUSSION: Hydroxocobalamin infusion per package insert and the red saline solution prepared with Red Dye 40 both triggered the blood leak alarm and stopped the Fresenius 2008K™ machine. However, this was not true for the Gambro Phoenix X36™ machine as the alarm never triggered. The interference with the Fresenius 2008K™ appears colorimetric due to normal saline with Red Dye 40 triggering the alarm. CONCLUSION: We alert physicians to become familiar with the properties of individual dialysis machines prior to use of hydroxocobalamin. When facing difficulties with hemodialysis after the administration of hydroxocobalamin, consider attempting with a different manufactures machine or model if available or contact the manufacturer directly.

A randomised controlled trial comparing StarClose and AngioSeal vascular closure devices in a district general hospital--the SCOAST study.

AIMS: AngioSeal and StarClose are vascular closure devices (VCDs) that can be used following cardiac catheterisation via the femoral artery to achieve haemostasis. Both devices have been demonstrated to be superior to conventional manual pressure, which reduce time to haemostasis and time to patient ambulation. We sought to compare these devices in a prospective, randomised trial. METHODS: Patients undergoing elective coronary angiography were randomised to receive either AngioSeal VIP or StarClose VCD with immediate postprocedure mobilisation. Bruising was recorded at 30 min, 60 min and at 1 week postprocedure. Patient satisfaction surveys were taken at 1 h and 1 week postprocedure. Complications for both groups were compared. RESULTS: Four hundred and one patients were included. Arteriotomy closure was achieved in 144 of 208 (69.2%) patients randomised to AngioSeal and 134 of 193 (69.3%) patients randomised to StarClose (p = ns). There was no significant bruising in either group at either 30 or 60 min postprocedure. However, at 1 week, there was significantly more bruising in the AngioSeal group than the StarClose group (63.1 vs. 38.5cm2, p = 0.02). Patient satisfaction and pain perception with the procedure at closure were not significantly different between the groups. Deployment success and instant mobilisation rates were significantly lower for junior, as compared with senior, operators. CONCLUSION: Achievement of haemostasis is similar with both AngioSeal and StarClose. The StarClose vascular closure device results in significantly less bruising at 1 week postprocedure as compared with AngioSeal, with no significant differences in complication rates. Patients' pain perception and satisfaction are similar with both VCDs.

Seasonal variations in different physico-chemical parameters of the effluents of Century Pulp and Paper Mill, Lal Kuan, Uttarakhand.

The present study was undertaken with the objective to study the characteristics of the effluent of Century Pulp and Paper Mill, Lalkuan (Uttarakhand) in different seasons. The variations in the physicochemical characteristics were observed and monitored up to 12 months at three different sites. Mean values of temperature, pH, chlorides and total phenols of the effluent were found below, whereas colour, BOD5, COD and lignin concentrations were above the minimum national standards (MINAS).

Bioremediation of pulp and paper mill effluent by a novel fungal consortium isolated from polluted soil.

Two basidiomycetous fungi (Merulius aureus syn. Phlebia sp. and an unidentified genus) and a deuteromycetous fungus (Fusarium sambucinum Fuckel MTCC 3788) were isolated from soils affected with effluents of a pulp and paper mill over several years. These isolates were immobilized on nylon mesh and the consortium was used for bioremediation of pulp and paper mill effluent in a continuously aerated bench-top bioreactor. The treatment resulted in the reduction of color, lignin and COD of the effluent in the order of 78.6%, 79.0% and 89.4% in 4 days. A major part of reductions in these parameters occurred within first 24h of the treatment, which was also characterized by a steep decline in the pH of the effluent. During this period, total dissolved solids, electrical conductivity and salinity of the effluent also registered marked decline. It is pertinent to note that this is the first report of bioremediation of pulp and paper mill effluent by an immobilized fungal consortium.

Management of acute atrial fibrillation.

Atrial fibrillation (AF) is the most common cardiac arrhythmia; despite many available guidelines the optimal management strategy remains elusive. The most common presentations of acute AF are palpitations, breathlessness, syncope, dizziness, chest pain, transient ischaemic attack (TIA) and stroke. Patients may need urgent electrical cardioversion (ECV) or pharmacological cardioversion (PCV) and long term anticoagulation therapy. This review aims to discuss some issues surrounding the early management of acute AF in the Acute Medical Unit.

Changes in renal function with percutaneous transluminal coronary angioplasty.

There is concern about adverse effects on renal function in patients with prolonged cardiac intervention procedures, when contrast media is used. To investigate this further we studied changes in renal function in 104 patients (79 male, 25 female; mean age 59.2, SD 9.8) undergoing routine elective percutaneous transluminal coronary angioplasty (PTCA), where 28 (27%) patients had concomitant stent implantation. There was associated diabetes in 15 patients (14%) and previous hypertension in 44 (blood pressure >160/90 mmHg, 44%). None of the patients were known to have congestive heart failure at the time of procedure or chronic renal failure (defined as serum creatinine >200 pmol/l). There was no significant change in mean serum urea pre- and post-PTCA (mean change -0.04 mmol/l, paired t-test P=0.90). However, there was a small rise in serum creatinine pre- and post-PTCA of borderline significance (mean change +5.8 micromol/l, P=0.051). Of the whole cohort, 65 patients (63%) had a rise in mean serum creatinine, whilst 45 (43%) showed a rise in serum urea levels. This deterioration in renal function was related to a difference in the procedure duration, but there were no statistically significant differences in mean age or volume of contrast media (Iopamide 340) between patients with or without deterioration in renal function. Patients with a rise in serum creatinine had lower baseline (pre-PTCA) serum urea and serum creatinine levels. In patients undergoing stent implantation, there was a higher quantity of contrast media, screening time and procedure duration. There were no significant differences in age, pre-PTCA serum urea and creatinine levels, and mean change in serum urea or creatinine levels in patients with and without stent usage. Whilst severe renal dysfunction following PTCA is uncommon, we suggest that some caution is necessary during PTCA or other cardiac interventions where more complex or prolonged procedures necessitating large volumes of contrast media use.

Do Indo-Asians have smaller coronary arteries?

There is a widespread belief that coronary arteries are smaller in Indo-Asians. The aim of the present study was to compare the size of atheroma-free proximal and distal epicardial coronary arteries of Indo-Asians and Caucasians. We analysed normal coronary angiograms from 77 Caucasians and 39 Indo-Asians. The two groups were comparable for dominance of the coronary arteries. Indo-Asian patients had generally smaller coronary arteries, with a statistically significant difference in the mean diameters of the left main coronary artery, proximal, mid and left anterior descending, and proximal and distal right coronary artery segments. There was a non-significant trend towards smaller coronary artery segment diameters for the distal left anterior descending, proximal and distal circumflex, and obtuse marginal artery segments. However, after correction for body surface area, none of these differences in size were statistically significant. Thus, the smaller coronary arteries in Indo-Asian patients were explained by body size alone and were not due to ethnic origin per se. This finding nevertheless has important therapeutic implications, since smaller coronary arteries may give rise to technical difficulties during bypass graft and intervention procedures such as percutaneous transluminal coronary angioplasty, stents and atherectomy. On smaller arteries, atheroma may also give an impression of more severe disease than on larger diameter arteries.

Modification of glutamine synthetase in Bacillus brevis AG 4.

The various forms of glutamine synthetase obtained from Bacillus brevis have been found to be antigenically identical. Alkaline phosphatase treatment of the fast moving form (GS4) reduced the electrophoretic mobility of the enzyme. Radiolabelling and autoradiographic studies have also indicated that 32P-incorporation is high in the form depicting high Rm value. Thus, it appears that these forms arise due to covalent modification of the enzyme involving a phosphate group.

Subcellular Localization of Zinc and Calcium in Bean (Phaseolus vulgaris L.) Tissues.

Two bean (Phaseolus vulgaris L.) cultivars differing in growth responses to zinc were examined for differences in uptake and subcellular localization of (65)Zn during a 15-day growth period. The zinc-sensitive cultivar Sanilac showed initially a much higher rate of absorption, which declined after 24 hours. The zinc-tolerant cultivar Saginaw showed a slow but steady rate of absorption for 10 days. In roots as well as in stem callus tissues of both cultivars, three-fourths of the absorbed (65)Zn was localized in the "cytoplasmic" supernatant fractions (containing ribosomes and vacuolar sap). Very little (less than 7%) (65)Zn was localized in the cell wall fraction. There was a much greater proportion of the absorbed (65)Zn localized in root mitochondria and nuclei of the zinc-sensitive Sanilac than in the zinc-tolerant Saginaw. Stem callus tissues, however, did not show such cultivar differences in zinc accumulation at the sub-cellular level.Calcium-45 distribution in the cultivar Redkote showed preferential affinity for cell walls both in roots and stem cellus tissue. The percentage of absorbed (45)Ca associated with cell wall fractions of roots gradually increased with a corresponding decline in the percentage of radioactivity associated with the cytoplasmic fraction. At 15 days, 57% of the total (45)Ca in the roots was localized in the cell walls. A similar, albeit less pronounced, preferential (45)Ca sorption on cell walls occurred for the callus tissue. Calcium-45 also accumulated at later stages in the nuclear fraction, but there was no mitochondrial accumulation.