Prevalence of thyroid hormone abnormalities in stage 5 chronic kidney disease: a tertiary care center study of Nepal

Background: Chronic kidney disease (CKD) implies progressive, long-standing and irreversible impairment in renal function that results in end stage renal disease (ESRD). ESRD is a frequent cause of Non-thyroidal illness (NTI) with low free triidothyronine (fT3), usually elevated reverse T3 (rT3), normal or low thyroid stimulating hormone (TSH), and if prolonged, low free thyroxine (fT4), despite patient remaining clinically euthyroid. Present study aimed to estimate the prevalence of thyroid hormone abnormalities in stage 5 CKD patients and also to compare these changes with healthy controls.Methods: The present cross-sectional observational study was conducted on thirty eight stage 5 CKD patients and 38 age-sexes matched healthy volunteers as control. The demographic data, medical history, etiology, physical examination and laboratory results were recorded on a special form developed by the researchers.Results: The mean age of male and female stage 5 CKD patients were 50.81±17.30. 44.73% of the stage 5 CKD patients had low fT3 whereas 28.94% had low fT4 values below the reference range. 5.26% patients had increased TSH values above the normal reference limit. The mean TSH values were not significantly differing among diseased and control groups. Among the risk factors for CKD, diabetic nephropathy (44.73%) was found to be the lead primary cause followed by chronic glomerulonephritis (26.31%) and hypertension (21.05%).Conclusions: From this study, it was concluded that the prevalence of thyroid hormone abnormalities especially low fT3 and fT4 is very common in stage 5 CKD patients. Diabetic nephropathy was among the lead cause of stage 5 CKD

Role of ultrasound guided suprascapular nerve block aided mobilization physiotherapy in frozen shoulder recovery: a prospective study

Background: Frozen shoulder is debilitating condition marked by progressive shoulder pain and restricted mobility, affecting sleep and activities of daily living of a person. The objective of this study was to evaluate the efficacy of USG guided suprascapular nerve block aided mobilization physiotherapy for management of frozen shoulder so as to improve the quality of living of patients. Methods: This prospective interventional study was conducted at the Department of Orthopaedics of a teaching institute of Central India from January 2021 to April 2023 after obtaining ethical clearance. Patients diagnosed with frozen shoulder and giving written consent were included in this study after considering the inclusion and exclusion criteria. Baseline demographics, symptom duration, degree of active and passive shoulder range of movement, Shoulder pain and disability index (SPADI) score were documented on day of presentation (preintervention) after which USG guided suprascapular nerve block was given. Post SSNB, 10 sessions of supervised mobilization physiotherapy was given. SPADI scores and degree of active and passive range of movement were noted at 3rd, 6th and 12th week and compared using statistical tests namely repeated measure ANOVA and chi square test of independence. Results: A total of 54 patients enrolled in the study after meeting inclusion criteria, only 46 completed the follow up and their mean SPADI pain score and mean SPADI disability score at presentation significantly reduced at 12 weeks post intervention. Range of flexion, abduction and external rotation of shoulder also showed significant increase (p value<0.05). Number of participants with severe restriction of shoulder internal rotation also decreased after SSNB aided physiotherapy. Conclusions: USG guided suprascapular nerve block aided physiotherapy exercise schedule is a safe and effective outpatient treatment for frozen shoulder providing early pain relief and improving shoulder mobility

Predicting Unsteady Loads in Marine Propulsor Crashback Using Large Eddy Simulation

Propulsor crashback is an off-design operating condition where a propulsor rotates in the reverse direction to yield negative thrust. Crashback is characterized by the interaction of the free stream with the reverse flow generated by propulsor rotation. This causes a highly unsteady vortex ring which leads to flow separation and unsteady forces and moments on the blades. Large eddy simulation (LES) is performed for marine propulsors in crashback for various configurations and advance ratios and validated against experiments. The predictive capability of LES as a tool for propulsor crashback is demonstrated on an open propulsor, open propulsor with a submarine hull, and ducted propulsor with and without stator blades. LES is in good agreement with experiments for the mean and RMS levels, and spectra of the unsteady loads on the propulsors

Towards probabilistic decision support in public health practice: Predicting recent transmission of tuberculosis from patient attributes

AbstractObjectiveInvestigating the contacts of a newly diagnosed tuberculosis (TB) case to prevent TB transmission is a core public health activity. In the context of limited resources, it is often necessary to prioritize investigation when multiple cases are reported. Public health personnel currently prioritize contact investigation intuitively based on past experience. Decision-support software using patient attributes to predict the probability of a TB case being involved in recent transmission could aid in this prioritization, but a prediction model is needed to drive such software.MethodsWe developed a logistic regression model using the clinical and demographic information of TB cases reported to Montreal Public Health between 1997 and 2007. The reference standard for transmission was DNA fingerprint analysis. We measured the predictive performance, in terms of sensitivity, specificity, negative predictive value, positive predictive value, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC (AUC).ResultsAmong 1552 TB cases enrolled in the study, 314 (20.2%) were involved in recent transmission. The AUC of the model was 0.65 (95% confidence interval: 0.61–0.68), which is significantly better than random prediction. The maximized values of sensitivity and specificity on the ROC were 0.53 and 0.67, respectively.ConclusionsThe characteristics of a TB patient reported to public health can be used to predict whether the newly diagnosed case is associated with recent transmission as opposed to reactivation of latent infection

STABILITY INDICATING METHOD DEVELOPMENT AND VALIDATION FOR ESTIMATION OF DORIPENEM IN BULK AND IN SOLID DOSAGE FORM BY RP-HPLC

A robust and reliable high performance liquid chromatographic (HPLC) approach was developed and validated for the analysis of Doripenem in pharmaceutical dosage form. The method is characterised by its simplicity, selectivity, precision, and capacity to accurately determine the stability of Doripenem. The experimental setup included the use of a Hypersil BDS-C18 column (250 X 4.6 mm ID, 5 µm) as the stationary phase in a chromatographic system. The mobile phase consisted of a combination of methanol and potassium dihydrogen orthophosphate with a pH of 6.7, in a ratio of 20:80. The flow rate of the mobile phase was set at 1 ml/min. The detection of the eluents occurred at a wavelength of 290 nm. The observed retention time for Doripenem was 5.56 minutes. Doripenem underwent acid and alkali hydrolysis, oxidation, photochemical degradation, and heat degradation. The results obtained from the linear regression analysis of the calibration plot demonstrated a strong linear connection within the concentration range of 70 – 130 µg/ml, as shown by a correlation coefficient value of 0.9995. The methodology was assessed to determine its precision, accuracy, ruggedness, and robustness. The medication experiences deterioration when exposed to environments characterised by acidity, alkalinity, photochemical reactions, and thermal stress. The active medicinal component exhibited distinct retention periods for each of its degradation product peaks, indicating successful resolution. The approach's ability to successfully isolate the medication from its degradation products renders it suitable for use as a stability-indicating method

Socio-Economic Disparities in the Burden of Seasonal Influenza: The Effect of Social and Material Deprivation on Rates of Influenza Infection

There is little empirical evidence in support of a relationship between rates of influenza infection and level of material deprivation (i.e., lack of access to goods and services) and social deprivation (i.e. lack of social cohesion and support).Using validated population-level indices of material and social deprivation and medical billing claims for outpatient clinic and emergency department visits for influenza from 1996 to 2006, we assessed the relationship between neighbourhood rates of influenza and neighbourhood levels of deprivation using Bayesian ecological regression models. Then, by pooling data from neighbourhoods in the top decile (i.e., most deprived) and the bottom decile, we compared rates in the most deprived populations to the least deprived populations using age- and sex-standardized rate ratios.Deprivation scores ranged from one to five with five representing the highest level of deprivation. We found a 21% reduction in rates for every 1 unit increase in social deprivation score (rate ratio [RR] 0.79, 95% Credible Interval [CrI] 0.66, 0.97). There was little evidence of a meaningful linear relationship with material deprivation (RR 1.06, 95% CrI 0.93, 1.24). However, relative to neighbourhoods with deprivation scores in the bottom decile, those in the top decile (i.e., most materially deprived) had substantially higher rates (RR 2.02, 95% Confidence Interval 1.99, 2.05).Though it is hypothesized that social and material deprivation increase risk of acute respiratory infection, we found decreasing healthcare utilization rates for influenza with increasing social deprivation. This finding may be explained by the fewer social contacts and, thus, fewer influenza exposure opportunities of the socially deprived. Though there was no evidence of a linear relationship with material deprivation, when comparing the least to the most materially deprived populations, we observed higher rates in the most materially deprived populations

Internet addiction, behavioural aspects, and health related problems associated with it: a cross sectional study among engineering students of Jabalpur district

Background: With the rise of new generation gadgets, the risk of “internet addiction” is emerging as a significant behavioral addiction pandemic to be tackled worldwide. Internet addiction can be defined as an impulse disorder. Objective of the study was to determines the level of Internet addiction in Students. To identify the behavioural and any health-related problems associated with internet addiction among students.Methods: This study was a cross sectional study carried out in 7 different engineering colleges of Jabalpur city during the period of 1st July 2016 to 30th September 2016.Results: In present study the prevalence of internet addiction was found to be 74 %. 26 % of the participants were found with no internet addictions whereas 55 % and 17.67 % of the participants were found to be mild and moderate addicted whereas only 1.33 % of the participants were severely addicted to internet addiction. Participant who has internet addiction has 84.8 % of yelling and annoying behavior while 86.5 % participants with internet addiction have secretive and defensive behavior. Association was found to be highly significant (p = <0.001). Ill effects like problem related to eye have significant effect on the participants with internet addiction i.e. 66.17 %. Association of problem related to eye problems with internet addiction was significant with the p = 0.02.Conclusions: The problem is alarming and progressing to an addictive state in the near future Interventions like setting boundaries and detecting early warning signs of underlying psychopathology at the earliest are require

Novel composite multilayer face masks for protection against airborne microorganisms

13-19This research focuses on the development of polyurethane (PU)/silica (SiO2) nanofibrous membranes for the filtration of PM2.5 and bacteria, which has been further incorporated in three-layered face mask comprising cotton fabric, nanofibre membrane and polyester fabric. The surface morphology, PM2.5 filtration efficiency and bacterial filtration efficiency of PU/SiO2 nanofibrous membranes have been investigated to find out applicability of nanofibrous membranes in the filtration application. PU/SiO2 nanofibrous membranes (0.5%) are found to have a pressure drop of 126 Pa with filtration efficiency of 95.37% and bacterial filtration efficiency of 99.3% against E. coli bacteria strain. Two- and three-layered fabric structures are developed comprising PU/SiO2 nanofibrous membranes and their contact angle, water vapor transmission rate and air permeability are studied to observe the breathability and waterproof behaviour of the fabric structure. Three- layered PU/SiO2 nanofibrous membranes have contact angle, water vapor transmission rate and air permeability of 145±1°, 109 g/m2/day and 8.56 cm3/s/cm2 respectively

Novel composite multilayer face masks for protection against airborne microorganisms

This research focuses on the development of polyurethane (PU)/silica (SiO2) nanofibrous membranes for the filtration of PM2.5 and bacteria, which has been further incorporated in three-layered face mask comprising cotton fabric, nanofibre membrane and polyester fabric. The surface morphology, PM2.5 filtration efficiency and bacterial filtration efficiency of PU/SiO2 nanofibrous membranes have been investigated to find out applicability of nanofibrous membranes in the filtration application. PU/SiO2 nanofibrous membranes (0.5%) are found to have a pressure drop of 126 Pa with filtration efficiency of 95.37% and bacterial filtration efficiency of 99.3% against E. coli bacteria strain. Two- and three-layered fabric structures are developed comprising PU/SiO2 nanofibrous membranes and their contact angle, water vapor transmission rate and air permeability are studied to observe the breathability and waterproof behaviour of the fabric structure. Three- layered PU/SiO2 nanofibrous membranes have contact angle, water vapor transmission rate and air permeability of 145±1°, 109 g/m2/day and 8.56 cm3/s/cm2 respectively