Effect of diuretics on sodium, potassium and chloride levels- a cross sectional study

Background: Diuretics are one of the widely used class of drugs used in various cardiovascular and other disorders. However, they can cause various metabolic adverse effects, electrolyte imbalance being among important changes.Methods: A cross sectional study was conducted in which patients diagnosed with hypertension for at least one month were included. Over a period of 6 months patients were enrolled irrespective of whether they were taking diuretics or not. Demographic details, drug therapy and electrolyte levels were recorded in a proforma. Data was analyzed for difference in serum electrolyte levels between diuretic and nondiuretic groups as well as between different diuretic groups.Results: Out of total 177 participants, 71 were on diuretic therapy. There was significant difference in mean serum sodium (S. Na), potassium (S. K) and chlorine (S. Cl) levels between diuretic and nondiuretic groups (P<0.05). Hyponatremia, hypokalemia and hyperkalemia were observed. Thiazide diuretic group showed significantly greater hyponatremia compared to other diuretics (P=0.028). Hyperkalemia was observed in participants receiving K sparing diuretic or combination of loop and K sparing diuretics. Old age and number of comorbidities showed negative association with S. Na. Females had significantly more hyponatremia than male participants.Conclusions: The study confirms that diuretics cause various abnormalities in electrolytes namely Na and K levels. Old age, comorbidities and female sex are risk factors for hyponatremia

Managers vs. Students: New Approach in Analyzing Current Practices in Capital Structure Management Education

According to Graham and Harvey (2001), an immense gap exists between capital structure theories and practice. This paper argues that this can be partially explained by current educational practices by analyzing undergraduate students'perceptions of capital structure theories and the differences between their opinion and that of the current CEO's and managers. Educators mostly focus on one or maybe two most popular theories and students have much smaller knowledge about other theories. Secondly educational practices favor trade-off theory to asymmetric information based theories. The paper provides some suggestions regarding capital structure education and future research

Population Intermediate Outcomes of Diabetes Under Pay-for-Performance Incentives in England From 2004 to 2008

OBJECTIVE—To evaluate diabetes outcomes under a national “pay-for-performance” program

Enabling lightweight, high load aero-bearings

Environmental and commercial considerations are strongly driving research into weight saving in aircraft. In this research, innovative manufacturing processes were developed to produce lightweight titanium alloy bearings capable of withstanding high bearing pressures. This will enable the replacement of heavier conventional bearing materials with titanium alloy bearings of the same size thereby saving weight. Plasma processing and PVD coating techniques were refined and combined and a sound scientific understanding of the resulting novel processes developed to assure high performance, reliability and repeatability. These techniques were applied to test discs and small bearing (bush) samples, which were tested under progressively greater loads (pressures). FEA was also used to evaluate pressure distribution in a bush test assembly. The novel treatment has potential applications for many bearings and bearing surfaces throughout aircraft.peer-reviewe

A Novel Role for CCL3 (MIP-1α) in Myeloma-induced Bone Disease via Osteocalcin Downregulation and Inhibition of Osteoblast Function

Upregulation of cytokines and chemokines is a frequent finding in multiple myeloma (MM). CCL3 (also known as MIP-1α) is a pro-inflammatory chemokine whose levels in the MM microenvironment correlate with osteolytic lesions and tumor burden. CCL3 and its receptors, CCR1 and CCR5, contribute to the development of bone disease in MM by supporting tumor growth and regulating osteoclast (OC) differentiation. Here, we identify inhibition of osteoblast (OB) function as an additional pathogenic mechanism in CCL3-induced bone disease. MM-derived and exogenous CCL3 represses mineralization and osteocalcin production by primary human bone marrow stromal cells and HS27A cells. Our results suggest that CCL3 effects on OBs are mediated by ERK activation and subsequent downregulation of the osteogenic transcription factor osterix. CCR1 inhibition reduced ERK phosphorylation and restored both osterix and osteocalcin expression in the presence of CCL3. Finally, treating SCID-hu mice with a small molecule CCR1 inhibitor suggests an upregulation of osteocalcin expression along with OC downregulation. Our results show that CCL3, in addition to its known catabolic activity, reduces bone formation by inhibiting OB function and therefore contributes to OB/OC uncoupling in MM

Systems thinking as a paradigm shift for sustainability transformation

The Sustainable Development Goals (SDGs), adopted as reference and universal guidepost for transitioning to Sustainable Development by the United Nations in 2015 as part of the 2030 Agenda for Sustainable Development, are intended to be used as a set of interconnected goals and global targets for ‘Transforming our world’, as the 2030 Agenda is titled. This is a far more challenging task than business as usual; it requires systems thinking for understanding the conditions that generate and propagate sustainability challenges, moving away from the reductionist and anthropocentric thinking that created them in the first place. Taking a systems approach to addressing these challenges has been gaining currency with academics and policymakers alike, and here we make the case for holistic, integrated, and interdisciplinary thinking that challenges assumptions and worldviews, crucially based on public participation and engagement, to create the enabling conditions for sustainability to emerge. System transformations require interconnected changes to technologies, social practices, business models, regulations and societal norms, an intentional process designed to fundamentally alter the components and structures that cause the system to behave in its current unsustainable ways, a paradigm shift enabling the transition to sustainability

A recent trend of drug-nanoparticles in suspension for the application in drug delivery

Persistent development in nanomedicine has enabled successful nanosizing of most drug samples which, in turn, imparts remarkable properties to the drugs such as enhanced solubility and bioavailability for the applications in drug delivery In this context several review articles are available in scientific domain covering inorganic nanoparticles such as Au Ag, SPIONs Qdots, carbon nanotubes and graphene; however, this review covers the development of drug nanoparticles together with their possibilities and limitation from ..

Feto-maternal Outcome in Teenage Pregnancy

Background:According to WHO any pregnancy in which a girl is between 10-19 years of age at the time of delivery is defined as teenage pregnancy1.Teenage pregnancy have been associated with adverse pregnancy outcome specially maternal anemia, hypertensive disorder, placental abnormalities, PPH, UTI, low birth weight, small for gestational age, pre maturity and a high neonatal and post neonatal mortality14,15.Aims and Objectives:To study the prevalence, socio-demographic factors associated with teenage pregnancies at our institute, and to study the incidence of antenatal, intrapartum, postpartum complications, perinatal morbidity and mortality of mother and fetus, among teenage patients at our institute. Also, to study the incidence of MTPs and awareness and prevalence of contraceptive practices among teenage pregnancies.Material and Methods:This was a retrospective analytical study and the study was carried out at the Department of Obstetrics and Gynaecology of our institute during the period - February 2021 to February 2023.Result and Conclusion:The study was conducted to evaluate maternal and fetal outcome associated with teenage pregnancy. Our present study suggested the common complications associated with teenage pregnancy are anemia, hypertensive disorders of pregnancy, higher incidence of operative delivery, lactation related issues, pyscho-social issues because of age related immaturity and social taboopre-term labour, low birth weight, still birth. There is substantial increased maternal and fetal morbidity and mortality associated with teenage pregnancy

Individualised and complex experiences of integrative cancer support care: combining qualitative and quantitative data

Objectives: The widespread use of complementary therapies alongside biomedical treatment by people with cancer is not supported by evidence from clinical trials. We aimed to use combined qualitative and quantitative data to describe and measure individualised experiences and outcomes. Materials and methods In three integrative cancer support centres (two breast cancer only) in the UK, consecutive patients completed the individualised outcome questionnaire Measure Yourself Concerns and Wellbeing (MYCaW) before and after treatment. MYCaW collects quantitative data (seven-point scales) and written qualitative data and the qualitative data were analysed using published categories. Results: Seven hundred eighty-two participants, 92% female, mean age 51 years, nominated a wide range of concerns. Psychological and emotional concerns predominated. At follow-up, the mean change (improvement) in scores (n = 588) were: concern 1, 2.06 (95% CI 1.92–2.20); concern 2, 1.74 (95% CI 1.60–1.90); and well-being, 0.64 (95% CI 0.52–0.75). The most common responses to ‘what has been the most important aspect for you?’ were ‘receiving complementary therapies on an individual or group basis’ (26.2%); ‘support and understanding received from therapists’ (17.1%) and ‘time spent with other patients at the centres’ (16.1%). Positive (61.5%) and negative (38.5%) descriptions of ‘other things affecting your health’ correlated with larger and smaller improvement in concerns and well-being, respectively. Conclusions: In a multicentre evaluation, the MYCaW questionnaire provides rich data about patient experience, changes over time and perceptions of what was important to each individual with cancer within that experience. It is unlikely that meaningful evaluations of this complex intervention could be carried out by quantitative methods alone