Analytical performance of a coagulation monitoring system INRatio [point of care] for the determination of INR compared with an established laboratory method and its use in shortening patient treatment time in a tertiary care vascular surgery centre

BACKGROUND: Point of care (POC/ near patient) testing for measurement of the international normalized ratio (INR) is a technical advance with claims of increased utility and better patient outcomes. This has also been reported to be useful in inpatients to improve time to intervention. This study evaluated the accuracy and precision of the coagulation monitoring system (INRatio) for the determination of INR compared with an established laboratory method for reducing patient treatment time in the outpatient setting in vascular surgery. METHODS: A prospective case control design was used to study all patients on oral anticoagulation managed in the Vascular Surgery outpatient clinic. Patients with anemia, haemolysis or lupus anticoagulant positivity were excluded from the study. The POC test result was compared to the reference lab test to check for statistical and clinical correlation. Sample size was calculated based on published literature with a test sensitivity of 87.5%; precision 5% and desired confidence level 99%. RESULTS: There were 168 patients tested; 55% were male, the mean age was 45.4(Range 20-75). All patients tested were on anticoagulation with a target INR range of 2-3; 93% were under treatment for DVT and 7% for arterial disease. 60% of the study population was in the target INR range. Tests were done for statistical and clinical correlation. The INR range obtained by using the test machine was 0.8-7.5 (reference lab 0.8-10), mean INR was 2.22+/- 1.6 (test machine) compared to 2.46 +/- 1.3 (reference lab). The mean absolute difference was 0.79 +/- 0.92 and the mean relative difference was 8.1% +/- 1.03. Data was analyzed using a Bland-Altman plot yielding a mean of 0.738 (SD 0.92) Concordance between the tests was 75% with r2= 0.52 on linear regression. Using an error grid plot, excellent clinical correlation was seen in 63.8%. In 5.4% a major corrective action was needed but potentially missed if relying on the test machine. CONCLUSION: This test achieved only moderate statistical and clinical correlation. In the presence of a good reference lab, this POC test cannot replace the lab test and hence cannot be used in shortening patient treatment time. The accuracy of the machine is moderate therefore it has potential utility where access to a reference lab is difficult

Environmental Pursuits In Nanomaterial Systems Science With Indian Exemplars

The behavior and pattern of NPs of minerals in the evolutionary history of the earth vis – a –vis the environmental context are inquired into, with a riverine system as a model. The study of fractal dimensions of NPs of interest serves as an aid to obtain a comprehensive view of natural NPs in the model system. The present study combines inputs from work done on nanoparticles, derived from the Subanarekha River System and products of base metal mine effluents that are rich in NPs of minerals. The authors believe this study would help to establish certain universalities about NPs and provide an updated framework for understanding the current state of nanomineral science

A Study on Serum Pepsinogen I and Pepsinogen II levels and the Pepsinogen I/II ratio in Indian patients with Gastric Cancer

BACKGROUND: The aim of this study was to measure the serum pepsinogen I and II levels in gastric cancer patients at a tertiary care centre in South India and to study the serum pepsinogen I/II ratio in patients with gastric cancer. METHODS: Thirty three patients: 17 with gastric cancer and 16 normal controls were studied. Serum levels of pepsinogen I (PG I) and pepsinogen II (PG II) were measured by ELISA. RESULTS: The mean PG I levels for cancer patients and controls were 185.3 μg/l and 188.1 μg/l, respectively (P= not significant), the mean PG II levels were 21.2 μg/l and 12.7μg/l respectively (P=not significant). The PG I/II ratio however was 12 in cancer and25 in controls: the ratio was significantly lower in cancer patients (P< 0.05). CONCLUSION: The serum pepsinogen I/II ratio is modified significantly in gastric cancer

Characterizing Stress-Strain Behavior of Materials through Nanoindentation

Nanoindentation is a widely used state of the art facility to precisely and conveniently evaluate the mechanical properties of a wide group of materials. Along with the determination of elastic modulus and hardness of materials, this chapter particularly aims to explore the possibilities to assess the corresponding stress–strain characteristics of elastic–plastic materials and most importantly unique pseudoelastic materials. The suitability of continuous stiffness measurement (CSM) based nanoindenter systems along with the adaptability of the instrument without CSM for precisely evaluating the deformation behavior of specialized materials is discussed in details. In this regard, the roll of indenter tip geometry and size is greatly emphasized. The recent research in the field is reviewed thoroughly and the updated protocol generated is illustrated

Permanent Draft Genome Sequence of the French Bean Symbiont Rhizobium sp. Strain RSm-3 Isolated from the Eastern Himalayan Region of India

The genus Rhizobium contains many species able to form nitrogen-fixing nodules on plants of the legume family. Here, we report the 6.9-Mbp draft genome sequence of Rhizobium sp. strain RSm-3, with a G+C content of 61.4% and 6,511 candidate protein-coding genes

Detection of biomarker in breath: A step towards noninvasive diabetes monitoring

Along with more than two hundred volatile organic compounds (VOCs), acetone is also a normal constituent of breath of healthy individuals, albeit in the sub-ppm range, and its concentration increases in diabetic patients. Considering the importance of breath acetone as a biomarker of diabetes, some studies have already been made to measure breath acetone concentration (and correlate with blood sugar level) using GC-MS. There are a few reports of measuring breath acetone concentration using semiconductor sensor in the background of air (i.e. in the absence of VOCs present in normal breath and hence the question of selectivity remains in the real situation) and at a higher concentration (above 10 ppm). We report excellent sensitivity of sonochemically prepared nanosized gamma-Fe2O3 sensors towards sub-ppm acetone (pathological range) in the background of human breath. Our preliminary results should stimulate further research towards developing cheap, rugged and compact semiconductor sensors for noninvasive monitoring of diabetes

Salt Stress Tolerance in Casuarina glauca: Insights from the Branchlets Transcriptome

Climate change and the accelerated rate of population growth are imposing a progressive degradation of natural ecosystems worldwide. In this context, the use of pioneer trees represents a powerful approach to reverse the situation. Among others, N2-fixing actinorhizal trees constitute important elements of plant communities and have been successfully used in land reclamation at a global scale. In this study, we have analyzed the transcriptome of the photosynthetic organs of Casuarina glauca (branchlets) to unravel the molecular mechanisms underlying salt stress tolerance. For that, C. glauca plants supplied either with chemical nitrogen (KNO3 +) or nodulated by Frankia (NOD+) were exposed to a gradient of salt concentrations (200, 400, and 600 mM NaCl) and RNA-Seq was performed. An average of ca. 25 million clean reads was obtained for each group of plants, corresponding to 86,202 unigenes. The patterns of differentially expressed genes (DEGs) clearly separate two groups: (i) control- and 200 mM NaCl-treated plants, and (ii) 400 and 600 mM NaCltreated plants. Additionally, although the number of total transcripts was relatively high in both plant groups, the percentage of significant DEGs was very low, ranging from 6 (200 mM NaCl/NOD+) to 314 (600 mM NaCl/KNO3 +), mostly involving down-regulation. The vast majority of up-regulated genes was related to regulatory processes, reinforcing the hypothesis that some ecotypes of C. glauca have a strong stress-responsive system with an extensive set of constitutive defense mechanisms, complemented by a tight mechanism of transcriptional and post-transcriptional regulation. The results suggest that the robustness of the stress response system in C. glauca is regulated by a limited number of genes that tightly regulate detoxification and protein/enzyme stability, highlighting the complexity of the molecular interactions leading to salinity tolerance in this speciesinfo:eu-repo/semantics/publishedVersio