A Study of Insulin Resistance and its Clinico.Metabolic Associations Among Apparently Healthy Individuals Attending a Tertiary Care Hospital

Background: Insulin resistance (IR), as a result of unhealthy life.styles and westernization, most likely contributes to the increased incidence of metabolic abnormalities and consequently, the development of metabolic syndrome (MS). Aim: The present study was undertaken to determine the magnitude of IR and associated clinico.metabolic risk factors among the out-patients of a tertiary care hospital in Bihar, India. Subjects and Methods: Anthropometric profile, lipid profile, fasting blood glucose, C-reactive protein (CRP) and C-peptide of 112 individuals were measured using the standard procedures. IR was assessed using the homeostasis model (Homeostatic model assessment [HOMA]-IR).Results: The mean IR was 1.5 (1.0). Individuals with MS, higher body mass index and CRP ≥6 mg/l had higher IR. Linear regression showed, among the components of MS, waist circumference had the highest contribution toward IR. The optimal cut-off value to detect IR by HOMA2-IR was 1.35.Conclusion: IR was found to have a strong association with various clinico-metabolic risk factors. Keywords: C-reactive protein, Homeostatic model assessment insulin resistance, Insulin resistance, Metabolic syndrom

Cervical Cancer in Women with Unhealthy Cervix in a Rural Population of a Developing Country

Background: Cervical cancer, the most common malignancy among Indian women, is the second most common and fi fth most fatal cancer in women world-wide.Aim: The study is aimed to determine the risk factors, incidence of cervical malignancy in women with grossly unhealthy cervix in a rural population and to get an overview of eff ectiveness of the existing screening programs.Subjects and Methods: This cross-sectional prospective pilot study was carried in a tertiary care hospital in a span of 6 months. A total of 300 females with grossly unhealthy cervix with suspicions of malignancy, who had never undergone cervical cytology or any other cervical neoplasia screening procedure, were included. Unaided visual inspection with Cusco’s speculum was performed followed by digital examination. Clinical staging was carried out in patients according to International Federation of Gynecology and Obstetrics (FIGO’S) Classifi cation. Cervical punch biopsy was taken under colposcopic guidance and histopathological examinations were done. Data were analyzed using SPSS, version 15.0 (Chicago Illinois, USA) and presented as simple percentages.Results: Among 300 females, 63.4% (190/300) were aged between 40 and 59 years. Nearly, 70.7% were illiterate and 52.6% had monthly family income between Rs. 2,000 and 5,000. Majority was married and 72.7% had parity between 1 and 3 and 58.7% had early marriages. Unaided visual examination of the women showed 62.7% of them had visible growth and 48.7% of them had bleeding erosions. Visible growths along with bleeding erosions were present in 11.3% cases. Histopathological examination of cervical biopsy specimens revealed mild, moderate and severe dysplasia in 14, 22 and 36 cases, respectively. A total of 212 patients had invasive squamous cell carcinoma. Only 16 patients had normal histopathology fi ndings. Nearly, 56.61% had Stage II disease; among them 27 had Stage IIa and 33 had Stage IIb disease, 26 patients had Stage I disease. Stage IIIa and IIIb have been found in 50 and 12 cases respectively. Four cases had cancer extending to urinary bladder and rectum (Stage IVa). Conclusions: Cervical carcinoma not only has a biomedical spectrum, but also has a wide cultural and socio-economic background. Extensive screening campaigns needs to be implemented with immediate eff ect to early diagnose cases to decrease the social burden of the disease.  Keywords: Africa, cervical cancer, screening procedure

Septic Abortion Managed in a Tertiary Hospital in West Bengal

Background: Septic abortion is still a challenging problem and a major cause of maternal mortality and morbidity in developing countries.Aim: The present study was conducted to estimate incidence, causes, risk factors, associated microorganisms, and treatment modalities of cases of septic abortion managed in a tertiary health care in West Bengal.Subjects and Methods: It was a cross‑sectional study carried out in Burdwan Medical College and Hospital in West Bengal between July 2011 and June 2012. On admission a thorough history was taken, examination was done, and investigations were carried. Depending on the examination findings the cases were grouped into three grades‑grade I: The infection localized in the uterus; grade II: The infection spread beyond the uterus to the parametrium, tubes, and ovaries or pelvic peritoneum; grade III: Generalized peritonitis and/or endotoxic shock or jaundice or acute renal failure. Statistical analysis was done by using Epi Info™ software (Version 3.5.1, CDC) after proper arrangement of all the data in tabular form and presented as simple percentage.Results: During the period, 1297 cases of abortion were admitted among which 107 were septic abortions, thus giving the incidence of the latter as 8.2% (107/1297). Forty‑three percent cases of septic abortion (46/107) were in grade I, 21.5% (23/107) in grade II, and 35.5% (38/107) in grade III. The modal age group of the patients was 15‑25 years (49.5%). Majority of the subjects were married (77.6%; 83/107) and multiparous (60.7%; 65/107). Similarly, most of them (71%; 76/107) were from low socioeconomic class. Ninety percent of the patients (96/107) had induced abortion. The common clinical features at presentation were pallor (88.8%; 95/107) and fever (86.0%; 92/107). Escherichia coli (62.6%; 67/107) and Klebsiella pneumonia (32.75%; 35/107) were the most common organism isolated. The case fatality from septic abortion in this study was 13.1% and the condition accounted for 15.4% of total maternal mortality within the period reviewed.Conclusion: The incidence of septic abortion in this study is relatively high, and majority of the cases resulted from attempted termination of pregnancy. It is a significant contributor to maternal mortality. Promotion of family planning and legalization of abortion services will go a long way in reducing the incidence of septic abortion and itsassociated complications. Keywords: Asia, management, maternal mortality, outcome, septic abortio

A Prospective Study of Doppler Velocimetry in Pregnancy-induced Hypertension in a Rural Population of a Developing Country

Background: Pregnancy-induced hypertension (PIH) remains a great challenge to obstetricians. Doppler velocimetry can detect fetal compromise much before other antepartum tests.Aim: The aim of this study is to detect the changes of uterine artery, umbilical artery and middle cerebral artery in PIH by Doppler velocimetry.Subjects and Methods: This prospective study was conducted on hundred subjects with PIH. Doppler studies were carried, and parameters recorded in uterine, umbilical and middle cerebral artery (MCA) were Systolic/Diastolic ratio, Resistance Index, Cerebro Placental Index (CPI). Fetal outcomes were monitored. Statistical analysis was performed using Epi InfoTM software (Version 3.5.1, CDC, Atlanta). Test for significance was done with student’s t-test and Chi-square where applicable. A P- value of<0.05 was considered as significant.Results: Among the 100 subjects, 76 (76%) of fetuses had abnormal and 24% normal umbilical artery Doppler velocimetry; 62% had abnormal and 38% normal MCA Doppler velocimetry; 64% fetuses had abnormal and 36% normal CPI. In 95% of subjects having abnormal umbilical Doppler studies, caesarean section had to be done for acute fetal distress. Incidence of caesarean section was 61% in abnormal MCA group and 63% in abnormal CPI group. Among 14 patients who had abnormal uterine artery Doppler, four developed pre-eclampsia, 2 IUGR. In patients with notches in uterine artery Doppler, 38% developed pre-eclampsia, 38% had IUGR, 13% babies were still born and 25% of newborns required NICU admission. In umbilical artery Doppler, when S/D ratio was abnormal, 60% developed pre-eclampsia, 40% had IUGR and 40% of newborns had to be admitted in NICU.Conclusion: Doppler study for fetal surveillance in pregnancy-induced hypertension is a very useful device and abnormal umbilical artery and uterine artery velocimetry seems to have worse pregnancy outcomes in the present study. Notch as a single parameter is the best indicator with highest sensitivity and positive predicative values. However, combination of parameters is the best indicator.  Keywords: Doppler study, fetomaternal outcome, pregnancy-induced hypertensio

Size tuning of Au nanoparticles formed by electron beam irradiation of Au<SUB>25</SUB> quantum clusters anchored within and outside of dipeptide nanotubes

Glutathione protected Au25 quantum clusters, exhibiting characteristic fluorescence, have been uniformly coated inside and outside of &#946;-Ala-L-Ile dipeptide nanotubes. These coated structures have been imaged using the inherent fluorescence of Au25. Upon exposure to an electron beam, in a transmission electron microscope, the quantum clusters gradually transform to gold nanoparticles, of the metallic size regime. The nanoparticles grow to a size of 4.5 nm and thereafter the particle size is unaffected by electron beam exposure. The nanotubes are intact and this template is shown to control the uniformity of the size of the nanoparticles grown. The quantum clusters can be loaded selectively inside the tubes using capillarity of the nanotubes. The sizes of the nanoparticles grown are tuned using electron beam exposure

Optical Modeling of a-Si Solar Cells

The authors describe applications of PV Optics to analyze the behavior of a metallic back-reflector on an a-Si solar cell. The calculated results from PV Optics agree well with the measured data on solar cells. Several unexpected results obtained from these calculations are qualitatively explained

BOVINE PLASMA FIBRINOGEN AS MARKER IN CLINICAL AND SUB-CLINICAL MASTITIS

Plasma samples were collected from healthy as well as clinical and sub-clinical mastitis affected cows from Barasat, West Bengal, India. Plasma samples, after ammonium sulphate precipitation, were dialyzed against several changes of PBS (pH 7.2) to remove the excess ammonium sulphate. Then plasma fibrinogens were purified by gel filtration chromatography on Sephacryl S-200 HR. SDS-PAGE (10%) of purified fibrinogen from plasma of healthy cow revealed polypeptide bands of 74, 67 and 57 kDa which represent the α (alpha), β (beta) and γ (gamma)- chains respectively. On the other hand, purified fibrinogen from plasma of sub-clinical and clinical mastitis affected cow revealed polypeptide bands of 73 (α-chain), 68 kDa (β-chain) and 72 (γ-chain), 68 kDa (β-chain) respectively. The SDS-PAGE analysis showed the absence of gamma (γ)- chain of fibrinogen in both the samples of sub-clinical and clinical mastitis positive cow. Single precipitin line was observed in double immunodiffusion test when purified fibrinogen from healthy, clinical and subclinical mastitis positive cows reacted with hyper immune sera raised in rabbit. No precipitin line was found against the normal control serum. These purified fibrinogens also showed cross reactivity against antibody raised in rabbit when analyzed by western blot technique

Socio-Economic Burden of Myocardial Infarction Among Cancer Patients

Cancer patients face a higher risk of future myocardial infarction (MI), even after completion of anticancer therapies. MI is a critical source of physical and financial stress in non-cancer patients, but its impacts associated with cancer patients also saddled with the worry (stress) of potential reoccurrence is unknown. Therefore, we aimed to quantify MI's stress and financial burden after surviving cancer and compare to those never diagnosed with cancer. Utilizing cross-sectional national survey data from 2013-2018 derived from publicly available U.S. datasets, the National Health Interview Survey (NHIS), and economic data from the National Inpatient Sample (NIS), we compared the socio-economic outcomes among those with MI by cancer-status. We adjusted for social, demographic, and clinical factors. Overall, 19,504 (10.2%) of the 189,836 NHIS survey responders reported having cancer for more than 1 year. There was an increased prevalence of MI among cancer survivors compared to non-cancer patients (8.8% vs. 3.2%, P0.05). There was no difference in annual residual family income by cancer status; however, 3 lowest deciles of residual income representing 21.1% cancer-survivor with MI had a residual income of <$9,000. Myocardial infarction continues to represent an immense source of financial and perceived stress. In conclusion, although cancer patients face a higher risk of subsequent MI, this does not appear to advance their reported stress significantly

Birthing practices of traditional birth attendants in South Asia in the context of training programmes

Traditional Birth Attendants (TBA) training has been an important component of public health policy interventions to improve maternal and child health in developing countries since the 1970s. More recently, since the 1990s, the TBA training strategy has been increasingly seen as irrelevant, ineffective or, on the whole, a failure due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Although, worldwide data show that, by choice or out of necessity, 47 percent of births in the developing world are assisted by TBAs and/or family members, funding for TBA training has been reduced and moved to providing skilled birth attendants for all births. Any shift in policy needs to be supported by appropriate evidence on TBA roles in providing maternal and infant health care service and effectiveness of the training programmes. This article reviews literature on the characteristics and role of TBAs in South Asia with an emphasis on India. The aim was to assess the contribution of TBAs in providing maternal and infant health care service at different stages of pregnancy and after-delivery and birthing practices adopted in home births. The review of role revealed that apart from TBAs, there are various other people in the community also involved in making decisions about the welfare and health of the birthing mother and new born baby. However, TBAs have changing, localised but nonetheless significant roles in delivery, postnatal and infant care in India. Certain traditional birthing practices such as bathing babies immediately after birth, not weighing babies after birth and not feeding with colostrum are adopted in home births as well as health institutions in India. There is therefore a thin precarious balance between the application of biomedical and traditional knowledge. Customary rituals and perceptions essentially affect practices in home and institutional births and hence training of TBAs need to be implemented in conjunction with community awareness programmes

Spectroscopic investigation of quantum confinement effects in ion implanted silicon-on-sapphire films

Crystalline Silicon-on-Sapphire (SOS) films were implanted with boron (B$^+$) and phosphorous (P$^+$) ions. Different samples, prepared by varying the ion dose in the range $10^{14}$ to 5 x $10^{15}$ and ion energy in the range 150-350 keV, were investigated by the Raman spectroscopy, photoluminescence (PL) spectroscopy and glancing angle x-ray diffraction (GAXRD). The Raman results from dose dependent B$^+$ implanted samples show red-shifted and asymmetrically broadened Raman line-shape for B$^+$ dose greater than $10^{14}$ ions cm$^{-2}$. The asymmetry and red shift in the Raman line-shape is explained in terms of quantum confinement of phonons in silicon nanostructures formed as a result of ion implantation. PL spectra shows size dependent visible luminescence at $\sim$ 1.9 eV at room temperature, which confirms the presence of silicon nanostructures. Raman studies on P$^+$ implanted samples were also done as a function of ion energy. The Raman results show an amorphous top SOS surface for sample implanted with 150 keV P$^+$ ions of dose 5 x $10^{15}$ ions cm$^{-2}$. The nanostructures are formed when the P$^+$ energy is increased to 350 keV by keeping the ion dose fixed. The GAXRD results show consistency with the Raman results.Comment: 9 Pages, 6 Figures and 1 Table, \LaTex format To appear in SILICON(SPRINGER