Clinico-social parameters of diabetes among patientsutilizing emergency medical services

Background: Diabetes mellitus (DM) is increasing in its potential in developing countries. Rise in diabetic patients calling emergency medical services (EMS) is expected. It calls for thorough assessment of patients with DM utilizing EMS. In the present study, was to assess magnitude of DM among patients utilizing EMS and its clinico-social parameters.Methods: It was hospital record based observational study of patients calling EMS delivered by a tertiary care hospital in Pune, Maharashtra, India during 1st January 2013 to 31st December 2014. Patients with incomplete records were excluded. A person with medical background was trained to extract required information from hospital records. Patients with previously diagnosed DM were considered those who were on diet, oral hypoglycemic agents or taking insulin therapy and newly diagnosed patients with DM were considered those with the value of glycemia on admission >200 mg/dl in first 24 hours. Data analysis was done using SPSS 15.0 software.Results: 45.8% (894/1951) were Patients with DM out of that 78.19% (699/894) were known to have DM while 28.81% (195/1951) were new cases of DM. 5.1% (100/1951) patients had uncontrolled DM. DM was significantly more in >60 years age group and in urban residents (p<0.001). Patients with DM were significantly more to have breathlessness, altered sensorium and dyspnoea as major purpose to call EMS (p<0.001, <0.001 and 0.045 respectively). Other co-morbidities in the form of Hypertension, other cardiovascular abnormalities, COPD, CKD and history of CVA were significantly more among Patients with DM (p<0.001, except for COPD, p=0.027).Conclusions: There was a high burden of patients with DM on EMS. EMS teams should be well trained to diagnose and manage such emergencies. Mass awareness of screening for DM and its proper management will help to decrease such burden

Degradation of dyes by fungi: an insight into mycoremediation

Currently, globalization, urbanization and industrialization have led to several environmental issues. In many industries, particularly in textile industries, the extensive use of synthetic dyes has increased. Dye is an integral element used to impart color to textile materials. Wastes generated during the processing and treatment of the dye contain inorganic and organic compounds that are hazardous, thereby posing a serious threat to the ecosystem. It is therefore important to implement cost-efficient and successful measures against these emissions in order to preserve habitats and natural resources. In this context, biodegradation by fungi or mycoremediation of dyes using potential fungi is a fairly inexpensive and environmental friendly method for decomposing or mineralizing barely or less decaying dye compounds. Fungi play a crucial role in degrading and decolorizing organic dyes by enzymes and processes such as absorption, adsorption and aggregation of effluent colorants. The factors affecting the decolorization and biodegradation of dye compounds through fungal bioremediation, such as pH, temperature, dye concentration, agitation, effects of carbon and nitrogen sources, dye structure, enzymes, electron donor and redox mediators are discussed in this review. The review also includes a summary on the mechanism and kinetics of dye degradation as well as recent advances and future perspectives in mycoremediation of dyes

Center-to-limb Variation of Transition-region Doppler Shifts in Active Regions

Studying Doppler shifts provides deep insights into the flow of mass and energy in the solar atmosphere. We perform a comprehensive measurement of Doppler shifts in the transition region and its center-to-limb variation (CLV) in the strong-field regions (∣ B ∣ ≥ 50 G) of 50 active regions (ARs), using the Si iv 1394 Å line recorded by the Interface Region Imaging Spectrometer. To locate the ARs and identify strong-field regions, we have used the magnetograms obtained by the Helioseismic and Magnetic Imager (HMI). We find that in strong-field regions, on average, all the ARs show a mean redshift ranging between 4 and 11 km s ^−1 , which varies with ARs. These flows show a mild CLV, with sizable magnitudes at the limb and substantial scatter in the mid-longitude range. Our observations do not support the idea that redshifts in the lower transition region ( T ≲ 0.1 MK) are produced by field-aligned downflows as a result of impulsive heating and they warrant an alternative interpretation, such as a downflow of type-II spicules in the presence of a chromospheric wall created by cooler type-I spicules

Positive impact of knowledge about tuberculosis and its treatment on treatment adherence among new smear-positive tuberculosis patients in ward E of Mumbai, Maharashtra, India

Background: Treatment nonadherence is major challenge before tuberculosis (TB) control activities. Treatment adherence is the result of interactions of various factors related to the patient, provider, health setup, type of illness, and sociocultural factors. Aim: The aim was to assess baseline knowledge of new smear-positive TB patients about their disease and treatment and to find its impact on treatment adherence. Methods: New sputum-positive TB patients initiated directly observed treatment short-course in ward E of Mumbai district in first two-quarters of the calendar year were enrolled in the study. They were interviewed by trained interviewer as per pretested semi-structured interview schedules to collect sociodemographic information and to assess their knowledge after verbal consent. Treatment adherence was noted by screening treatment cards after any final outcome of the treatment as per Revised National Tuberculosis Control Program. Data were entered in Microsoft excel and analyzed using SPSS 15.0 software (developed by IBM, Chicago, USA in 2007). Results: Out of 157 patients enrolled, 150 could be interviewed. The majority were in reproductive age group and from class IV and V socioeconomic class. Good knowledge about infectiousness, reasons behind TB, its spread, curability, and treatment duration was found in 29.5%, 28.8%, 16%, 59%, and 22.3%, respectively. 72/150 were treatment adherent and good knowledge about all these aspects was significantly associated with treatment adherence. Most significant association was found with good knowledge about infectiousness of TB (odds ratio: 1.764, P < 0.001). Conclusions: Thorough knowledge regarding TB and its treatment should be given to the TB patients at the initiation of the treatment may help to improve treatment adherence

Conquering 2‑Aminopurine’s Deficiencies: Highly Emissive Isomorphic Guanosine Surrogate Faithfully Monitors Guanosine Conformation and Dynamics in DNA

The archetypical fluorescent nucleoside analog, 2-aminopurine (2Ap), has been used in countless assays, though it suffers from very low quantum yield, especially when included in double strands, and from the fact that its residual emission frequently does not represent biologically relevant conformations. To conquer 2Ap's deficiencies, deoxythienoguanosine (d(th)G) was recently developed. Here, steady-state and time-resolved fluorescence spectroscopy was used to compare the ability of 2Ap and d(th)G, to substitute and provide relevant structural and dynamical information on a key G residue in the (-) DNA copy of the HIV-1 primer binding site, (-)PBS, both in its stem loop conformation and in the corresponding (-)/(+)PBS duplex. In contrast to 2Ap, this fluorescent nucleoside when included in (-)PBS or (-)/(+)PBS duplex fully preserves their stability and exhibits a respectable quantum yield and a simple fluorescence decay, with marginal amounts of dark species. In further contrast to 2Ap, the fluorescently detected d(th)G species reflect the predominantly populated G conformers, which allows exploring their relevant dynamics. Being able to perfectly substitute G residues, d(th)G will transform nucleic acid biophysics by allowing, for the first time, to selectively and faithfully monitor the conformations and dynamics of a given G residue in a DNA sequence

Clinico-social parameters of diabetes among patientsutilizing emergency medical services

Background: Diabetes mellitus (DM) is increasing in its potential in developing countries. Rise in diabetic patients calling emergency medical services (EMS) is expected. It calls for thorough assessment of patients with DM utilizing EMS. In the present study, was to assess magnitude of DM among patients utilizing EMS and its clinico-social parameters.Methods: It was hospital record based observational study of patients calling EMS delivered by a tertiary care hospital in Pune, Maharashtra, India during 1st January 2013 to 31st December 2014. Patients with incomplete records were excluded. A person with medical background was trained to extract required information from hospital records. Patients with previously diagnosed DM were considered those who were on diet, oral hypoglycemic agents or taking insulin therapy and newly diagnosed patients with DM were considered those with the value of glycemia on admission &gt;200 mg/dl in first 24 hours. Data analysis was done using SPSS 15.0 software.Results: 45.8% (894/1951) were Patients with DM out of that 78.19% (699/894) were known to have DM while 28.81% (195/1951) were new cases of DM. 5.1% (100/1951) patients had uncontrolled DM. DM was significantly more in &gt;60 years age group and in urban residents (p&lt;0.001). Patients with DM were significantly more to have breathlessness, altered sensorium and dyspnoea as major purpose to call EMS (p&lt;0.001, &lt;0.001 and 0.045 respectively). Other co-morbidities in the form of Hypertension, other cardiovascular abnormalities, COPD, CKD and history of CVA were significantly more among Patients with DM (p&lt;0.001, except for COPD, p=0.027).Conclusions: There was a high burden of patients with DM on EMS. EMS teams should be well trained to diagnose and manage such emergencies. Mass awareness of screening for DM and its proper management will help to decrease such burden

Hybrid simulation for cyber physical systems – A panel on where are we going regarding complexity, intelligence, and adaptability of CPS using simulation

During the Spring Simulation Multi-Conference 2017, a group of invited experts discussed challenges in M&amp;S of cyber physical systems. This 2018 panel is a follow-on activity, asking how the combination of various simulation paradigms, methods – so-called hybrid simulation – can be utilized regarding complexity, intelligence, and adaptability of cyber physical systems. This paper is a collection of position papers of the participating experts, supporting their viewpoints represented in the discussion