Providing Diabetes Education through Phone Calls Assisted in the Better Control of Hyperglycemia and Improved the Knowledge of Patients on Diabetes Management.

Purpose: A recent single-arm pilot study from our group showed a significant decrease in HbA1C in Type-2 diabetes individuals provided with SMS and phone call-based education on glycemic control. Considering the preference of participants to phone call-based education, a randomized control trial (RCT) with parallel design was conducted to determine the impact of phone call-based diabetes educational intervention on the control of hyperglycemia and improvement in the knowledge about diabetes management. Objectives: To determine the impact of phone call-based educational intervention on the control of hyperglycemia and improvement in the knowledge about diabetes management. Methodology: The study was conducted for a period of 12 months on a total of 273 Type-2 diabetic patients (interventional group (n = 135); non-interventional group (n = 138)) who had provided consent to participate. Subjects in the case group received weekly phone calls on diabetes education; whereas the control group received no education. HbA1C investigations were carried out at baseline and at every fourth month until the completion of the study period for the subjects in both the groups. The impact of phone call-based education was measured by comparing HbA1C values as well as by measuring the questionnaire-based knowledge scores on diabetes management. Results: At the end of the study period, there was a significant reduction in HbA1C in 58.8% participants (n = 65) and a manifold (2-5-fold) increase in knowledge on diabetes management among participants in the case group (n = 110). However, no significant difference in HbA1C and knowledge score was observed in participants from the control group (n = 115). Conclusion: Phone call-based diabetes education is a viable option to empower patients for better management of Type-2 diabetes.

Femtomolar Detection of Spermidine Using Au Decorated SiO2 Nanohybrid on Plasmon-Coupled Extended Cavity Nanointerface: A Smartphone-Based Fluorescence Dequenching Approach.

Coupling of photons with molecular emitters in different nanocavities have resulted in transformative plasmonic applications. The rapidly expanding field of surface plasmon-coupled emission (SPCE) has synergistically employed subwavelength optical properties of localized surface plasmon resonance (LSPR) supported by nanoparticles (NPs) and propagating surface plasmon polaritons assisted by metal thin films for diagnostic and point-of-care analysis. Gold nanoparticles (AuNPs) significantly quench the molecular emission from fluorescent molecules (at close distances <5 nm). More often, complex strategies are employed for providing a spacer layer around the AuNPs to avoid direct contact with fluorescent molecules, thereby preventing quenching. In this study we demonstrate a rapid and facile strategy with the use of Au-decorated SiO2 NPs (AuSil), a metal (Au)-dielectric (SiO2) hybrid material for dequenching the otherwise quenched fluorescence emission from radiating dipoles and to realize 88-fold enhancement using the SPCE platform. Different loading of AuNPs were studied to tailor fluorescence emission enhancements in spacer, cavity, and extended (ext.) cavity nanointerfaces. We also present femtomolar detection of spermidine using this nanohybrid in a highly desirable ext. cavity interface. This interface serves as an efficient coupling configuration with dual benefits of spacer and cavity architectures that has been widely explored hitherto. The multifold hot-spots rendered by the AuSil nanohybrids assist in augmented electromagnetic (EM)-field intensity that can be captured using a smartphone-based SPCE platform presenting excellent reliability and reproducibility in spermidine detection.

A comparison of hepatoprotective activity of Bacoside to Silymarin treatment against a combined Isoniazid and Rifampin-induced hepatotoxicity in female Wistar rats.

The liver is an important organ that plays a vital role in homeostasis maintenance and regulation. Any liver damage or injury caused by drugs or chemicals is called hepatotoxicity. Isoniazid and rifampin are drugs used separately to treat tuberculosis but have unique side effects and potential hepatotoxicity. The metabolism of isoniazid (INH) and rifampin (RIF) takes place in liver hence hepatotoxicity is the main cause of their continuous use. Bacoside was obtained from the plant Bacopa monnieri, a dammarene type triterpenoid saponin, found distributed throughout India. Bacoside has been used as a nerve tonic, a free radical scavenger, and antioxidant. It is known that the combined INH-RIF induced hepatotoxicity can be antagonized by maintaining hepatocyte membrane integrity in rats. Silymarin, an herbal drug, and its component silybin were reported to work as lipid peroxidation inhibitors and antioxidants which scavenge free radicals. Due to minimal toxicity and no adverse drug interactions, Silymarin is used to treat various medically confirmed hepatic disorders. The aim of this study was to evaluate the beneficial effect of Bacoside against INH- and RIF-induced toxicity in livers of Wistar albino rats. Four experimental groups of rats were used to study four parameters; bodyweight, liver enzyme markers, liver antioxidant, and liver histopathology. INH- and RIF-treated rats showed abnormalities in liver markers which were normalized by Bacoside and that seems similar to the normal control and Silymarin-treated groups. Thus, the current study demonstrated the hepatoprotective effect of Bacoside against INH- and RIF-induced toxicity in Wistar albino rats.

Unusual effect of an atrial septal aneurysm on venous drainage during cardiopulmonary bypass.

Atrial septal aneurysm is an uncommon cardiac anomaly that is usually asymptomatic or occasionally associated with cardioembolic events. We present the unusual impeding effect of an atrial septal aneurysm on venous drainage during cardiopulmonary bypass in a 70-year-old man who underwent aortic valve replacement and coronary artery bypass graft surgery.

Dendritic effect of ligand-coated nanoparticles: enhanced apoptotic activity of silica-berberine nanoconjugates.

We describe the synthesis and biological characterization of a novel prototype, namely, silica nanoconjugates bearing a covalently linked berberine, a plant alkaloid known to have antiproliferative activity. The effect of synthesized nanoconjugates on cell proliferation, the cell cycle profile, and apoptosis in the human cervical carcinoma cell line (HeLa), human hepatocellular liver carcinoma cell line (HepG2), and human embryonic kidney (HEK) 293T cell line has been studied and compared with the results obtained for free berberine. Our results show that all the nanoconjugates display higher antiproliferative activity than free berberine. The ability of these nanoconjugates to inhibit cellular proliferation is mediated by the cell cycle arrest at the G1 phase. Moreover, silica nanoconugates caused selective apoptotic arrest with a higher efficiency than free berberine followed by apoptotic cell death as shown by quantitative fluorescence-activated cell sorting analyses. Efficiency of the nanoconjugates increases upon an increase in the linker chain length, demonstrating the distinct role of the spacer chain that conjugates nanoparticles and ligands. The actual reason to show enhanced efficiency by the nanoconjugates has not been elucidated in the present study; however, we hypothesize that an increase in local concentration due to the confinement of a ligand on the nanosurface ("dendritic" effect) might have led to the observed effect.

Fractured inferior vena cava filter strut presenting as a penetrating foreign body in the right ventricle: report of a case.

Migration of a fractured strut of an inferior vena cava (IVC) filter to the heart is a rare complication. We report the case of a 40-year-old woman who had this complication eight months after infrarenal IVC filter placement. She presented with chest pain. The broken arm of the IVC filter had migrated to the heart and penetrated the free wall of the right ventricle. It was removed successfully by cardiac surgery without the aid of cardiopulmonary bypass.

Synthesis of gold nanorods in organic media.

A seed mediated approach for the synthesis of anisotropic rod shaped gold nanoparticles in organic media (toluene) is demonstrated. Pre-formed gold nanoparticles stabilized in toluene by 4-hexadecylaniline (HDA) are used as seeds. These when reacted with 1-octadecylamine (ODA) hydrophobised chloroaurate ions in toluene lead to the formation of gold nanorods. ODA or alkylamines of different chain lengths which are the chloroaurate ion phase transfer agent have been found to play a key role in the formation of the nanorods. The gold nanorods that have a five-fold symmetry evolve from multiply twinned particles and are bound at the tips by [1 11] faces and at the sides by [100] faces. The gold nanorods have been shown to grow under the shape directing effect of the alkylamines which stabilize the high energy [100] faces. The concentration of the alkylamines has been found to play a critical role in the formation of the gold nanorods. Higher concentrations of the alkylamines lead to formation of spherical particles, at times of narrow size distribution.

Synthesis of gold nanotriangles and silver nanoparticles using Aloe vera plant extract.

Biogenic gold nanotriangles and spherical silver nanoparticles were synthesized by a simple procedure using Aloe vera leaf extract as the reducing agent. This procedure offers control over the size of the gold nanotriangle and thereby a handle to tune their optical properties, particularly the position of the longitudinal surface plasmon resonance. The kinetics of gold nanotriangle formation was followed by UV-vis-NIR absorption spectroscopy and transmission electron microscopy (TEM). The effect of reducing agent concentration in the reaction mixture on the yield and size of the gold nanotriangles was studied using transmission electron microscopy. Monitoring the formation of gold nanotriangles as a function of time using TEM reveals that multiply twinned particles (MTPs) play an important role in the formation of gold nanotriangles. It is observed that the slow rate of the reaction along with the shape directing effect of the constituents of the extract are responsible for the formation of single crystalline gold nanotriangles. Reduction of silver ions by Aloe vera extract however, led to the formation of spherical silver nanoparticles of 15.2 nm +/- 4.2 nm size.

Lateral tunnel versus extracardiac conduit Fontan procedure: a concurrent comparison.

BACKGROUND: The aim of this study was to compare the outcomes of the lateral tunnel (LT) and extracardiac conduit (ECC) Fontan procedures at a single institution over the same time period. METHODS: From November 1995 through October 2002, 70 Fontan procedures were performed: 37 LT and 33 ECC. All were fenestrated; 96% were staged with a prior superior cavopulmonary connection. Compared with the ECC patients, the LT patients were younger (2.7 +/- 1.1 vs 3.9 +/- 2.5 years; p = 0.01), had a higher incidence of hypoplastic left heart syndrome (57% vs 21%; p < 0.01), and a longer aortic cross-clamp time (55 +/- 13 vs 26 +/- 15 min; p < 0.01). Weight, gender, preoperative cardiac catheterization values, and cardiopulmonary bypass time did not differ between the two groups. RESULTS: Operative mortality was 2.8%, 1 patient in each group (p = 1.0). Over the first 24 hours following operation the mean Fontan pressure, transpulmonary gradient, and common atrial pressure did not differ between LT and ECC patients. The median duration of mechanical ventilation (LT 12 vs ECC 18 hours), intensive care unit stay (LT 2 vs ECC 3 days), chest tube drainage (LT 10 vs ECC 8 days), and hospital stay (LT 11 vs ECC 12 days) did not differ. The ECC patients had a higher incidence of sinus node dysfunction both in the postoperative period (27% vs LT 8%; p = 0.09), and persisting at hospital discharge (10% vs LT 0%; p = 0.02). Mean follow-up was 3.6 +/- 1.6 years in LT, and 3.0 +/- 2.2 years in ECC patients (p = 0.2). There was one late death. Actuarial survival at 5 years is 97% for LT, and 91% for ECC patients (p = 0.4); 96% of patients are in NYHA class I, and 4% in class II, with no difference between groups. Sinus node dysfunction was seen during follow-up in 15% LT vs 28% ECC patients (p = 0.2). CONCLUSIONS: The LT and ECC approaches had comparable early and mid-term outcomes, including operative morbidity and mortality, postoperative hemodynamics, resource use, and mid-term survival and functional status. ECC patients had a higher incidence of sinus node dysfunction early after operation.