A community-based knowledge, attitude and practices study of Accredited Social Health Activist functionaries in active case detection of Leprosy in Sitapur district of Uttar Pradesh

Background: Leprosy was eliminated at the global level in the year 2000. But regional disparities still exist. Some countries have not attained the elimination status and still reporting a good number of cases. The major burden of new cases was from India, Brazil and Indonesia. Early case detection and treatment is the key to achieve elimination. ASHA workers are involved in this campaign to make it successful. The objective of this study was to assess the knowledge of ASHA functionaries regarding leprosy disease and to analyze the field practices of ASHA functionaries during LCDC activity.Methods: The present study was a community based observational study which was conducted at field practice area of RHTC, Hind Institute of Medical Sciences from 6 November to 19 November 2017. All ASHA functionaries were interviewed using preformed semi-structured questionnaire. Data were stored in Microsoft excel XP and analyzed.Results: None (0%) of ASHA functionaries correctly knew the exact cause of leprosy. Only 10.2% knew mode of transmission, 89.8% knew sign and symptoms, 28.6% knew complications, 12.2% knew prevention of complications, only 10.2% knew exact meaning of MDT. Only 63.3% ASHAs had prior information about orientation training. Out of these only 26.5% completed the practical exercises. Local community remained uninformed about LCDC activity as IEC activities were very poor in all of the centers.Conclusions: In India ASHA workers are the main health functionaries for LCDC activity and in this study, we found that quality of orientation training was substandard as compared to GOI guidelines. So, every effort should be given to make orientation training successful

Serum metabolomic profiling in acute alcoholic hepatitis identifies multiple dysregulated pathways

Background and Objectives While animal studies have implicated derangements of global energy homeostasis in the pathogenesis of acute alcoholic hepatitis (AAH), the relevance of these findings to the development of human AAH remains unclear. Using global, unbiased serum metabolomics analysis, we sought to characterize alterations in metabolic pathways associated with severe AAH and identify potential biomarkers for disease prognosis. Methods This prospective, case-control study design included 25 patients with severe AAH and 25 ambulatory patients with alcoholic cirrhosis. Serum samples were collected within 24 hours of the index clinical encounter. Global, unbiased metabolomics profiling was performed. Patients were followed for 180 days after enrollment to determine survival. Results Levels of 234 biochemicals were altered in subjects with severe AAH. Random-forest analysis, principal component analysis, and integrated hierarchical clustering methods demonstrated that metabolomics profiles separated the two cohorts with 100% accuracy. Severe AAH was associated with enhanced triglyceride lipolysis, impaired mitochondrial fatty acid beta oxidation, and upregulated omega oxidation. Low levels of multiple lysolipids and related metabolites suggested decreased plasma membrane remodeling in severe AAH. While most measured bile acids were increased in severe AAH, low deoxycholate and glycodeoxycholate levels indicated intestinal dysbiosis. Several changes in substrate utilization for energy homeostasis were identified in severe AAH, including increased glucose consumption by the pentose phosphate pathway, altered tricarboxylic acid (TCA) cycle activity, and enhanced peptide catabolism. Finally, altered levels of small molecules related to glutathione metabolism and antioxidant vitamin depletion were observed in patients with severe AAH. Univariable logistic regression revealed 15 metabolites associated with 180-day survival in severe AAH. Conclusion Severe AAH is characterized by a distinct metabolic phenotype spanning multiple pathways. Metabolomics profiling revealed a panel of biomarkers for disease prognosis, and future studies are planned to validate these findings in larger cohorts of patients with severe AAH.This study was funded by Grant 5K08AA017622 from the National Institutes of Health and a University of Pittsburgh Medical Center Pilot Grant to JB. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

pH-Mediated Collective and Selective Solar Photocatalysis by a Series of Layered Aurivillius Perovskites

Semiconductor photocatalysis under natural sunlight is an emergent area in contemporary materials research, which has attracted considerable attention toward the development of catalysts for environmental remediation using solar energy. A series of five-layer Aurivillius-phase perovskites, Bi5ATi4FeO18 (A = Ca, Sr, and Pb), are synthesized for the first time. Rietveld refinements of the powder X-ray diffraction data indicated orthorhombic structure for the Aurivillius phases with Fe largely occupying the central octahedral layer, whereas the divalent cations (Ca, Sr, and Pb) are statistically distributed over the cubo-octahedral A-sites of the perovskite. The compounds with visible-light-absorbing ability (Eg ranging from ∼2.0 to 2.2 eV) not only exhibit excellent collective photocatalytic degradation of rhodamine B–methylene blue (MB) and rhodamine B–rhodamine 6G mixture at pH 2 but also show almost 100% photocatalytic selective degradation of MB from the rhodamine B–MB mixture at pH 11 under natural solar irradiation. The selectivity in the alkaline medium is believed to originate from the combined effect of the photocatalytic degradation of MB by the Aurivillius-phase perovskites and the photolysis of MB. Although a substantial decrease in MB adsorption from the mixed dye solution (MB + RhB) together with slower MB photolysis at the neutral pH makes the selective MB degradation sluggish, the compounds showed excellent photocatalytic degradation activity and chemical oxygen demand removal efficacy toward individual RhB (at pH 2) and MB (at pH 11) under sunlight irradiation. The catalysts are exceptionally stable and retain good crystallinity even after five successive cyclic runs without any noticeable loss of activity in both the acidic and alkaline media. The present work provides an important insight into the development of layered perovskite photocatalysts for collective degradation of multiple pollutants and selective removal of one or multiple pollutants from a mixture. The later idea may open up new possibilities for recovery/purification of useful chemical substances from the contaminated medium through selective photocatalysis

Serum metabolomic profiling in acute alcoholic hepatitis identifies multiple dysregulated pathways

Background and Objectives While animal studies have implicated derangements of global energy homeostasis in the pathogenesis of acute alcoholic hepatitis (AAH), the relevance of these findings to the development of human AAH remains unclear. Using global, unbiased serum metabolomics analysis, we sought to characterize alterations in metabolic pathways associated with severe AAH and identify potential biomarkers for disease prognosis. Methods This prospective, case-control study design included 25 patients with severe AAH and 25 ambulatory patients with alcoholic cirrhosis. Serum samples were collected within 24 hours of the index clinical encounter. Global, unbiased metabolomics profiling was performed. Patients were followed for 180 days after enrollment to determine survival. Results Levels of 234 biochemicals were altered in subjects with severe AAH. Random-forest analysis, principal component analysis, and integrated hierarchical clustering methods demonstrated that metabolomics profiles separated the two cohorts with 100% accuracy. Severe AAH was associated with enhanced triglyceride lipolysis, impaired mitochondrial fatty acid beta oxidation, and upregulated omega oxidation. Low levels of multiple lysolipids and related metabolites suggested decreased plasma membrane remodeling in severe AAH. While most measured bile acids were increased in severe AAH, low deoxycholate and glycodeoxycholate levels indicated intestinal dysbiosis. Several changes in substrate utilization for energy homeostasis were identified in severe AAH, including increased glucose consumption by the pentose phosphate pathway, altered tricarboxylic acid (TCA) cycle activity, and enhanced peptide catabolism. Finally, altered levels of small molecules related to glutathione metabolism and antioxidant vitamin depletion were observed in patients with severe AAH. Univariable logistic regression revealed 15 metabolites associated with 180-day survival in severe AAH. Conclusion Severe AAH is characterized by a distinct metabolic phenotype spanning multiple pathways. Metabolomics profiling revealed a panel of biomarkers for disease prognosis, and future studies are planned to validate these findings in larger cohorts of patients with severe AAH

Possibility of SARS-CoV-2 transmission from the breast milk of COVID-19 affected women patients to their infants: worries and strategies to counter it

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Serum levels of protein degradation products.

<p>Relative levels of serum protein degradation products, including acetylated amino acids, dipeptides, and urea cycle intermediates. Serum levels of each metabolite were compared using paired Welch's <i>t</i> tests, and <i>q</i> values were calculated to account for false discovery rates to correct for multiple comparisons.</p><p>Serum levels of protein degradation products.</p

Schematic representations of altered fatty acid omega-oxidation and lysolipid and phospholipid turnover in severe AAH.

<p>(A) Fatty acid omega-oxidation. (B) Lysolipid and phospholipid turnover.</p

Serum levels of significantly altered metabolites between AAH survivors and nonsurvivors.

<p>Relative levels of serum metabolites between survivors and nonsurvivors with severe AAH. Serum levels of each metabolite were compared using paired Welch's <i>t</i> tests, and <i>q</i> values were calculated to account for false discovery rates to correct for multiple comparisons. AA, amino acid; BCAA, branched-chain amino acid; FA, fatty acid. *Fold change Survivor vs. Non-survivor.</p><p>Serum levels of significantly altered metabolites between AAH survivors and nonsurvivors.</p