Hypersensitivity reaction with metformin: a case report

Metformin is a biguanide derivative widely used for treatment of diabetic patients. The most common toxic effects of metformin are gastrointestinal (anorexia, nausea, vomiting, abdominal discomfort and diarrhoea). As with other drugs, allergic reactions can occur with metformin also, but these are very rare. A case of hypersensitivity reaction with metformin was reported in adverse drug monitoring centre. A 59-year-old female, newly diagnosed case of diabetes mellitus II, started on metformin tablet 500 mg twice daily, developed purpuric skin lesions on her arms, legs and back few days after starting the drug. metformin was stopped and patient was put on glimepiride tablet. The lesions slowly started subsiding after stopping metformin

Computational predictions of weld structural integrity in hydrogen transport pipelines

We combine welding process modelling with deformation–diffusion–fracture (embrittlement) simulations to predict failures in hydrogen transport pipelines. The focus is on the structural integrity of seam welds, as these are often the locations most susceptible to damage in gas transport infrastructure. Finite element analyses are conducted to showcase the ability of the model to predict cracking in pipeline steels exposed to hydrogen-containing environments. The validated model is then employed to quantify critical H2 fracture pressures. The coupled, phase field-based simulations conducted provide insight into the role of existing defects, microstructural heterogeneity, and residual stresses. We find that under a combination of deleterious yet realistic conditions, the critical pressure at which fracture takes place can be as low as 15 MPa. These results bring new mechanistic insight into the viability of using the existing natural gas pipeline network to transport hydrogen, and the computational framework presented enables mapping the conditions under which this can be achieved safely

On the suitability of single-edge notch tension (SENT) testing for assessing hydrogen-assisted cracking susceptibility

Combined experiments and computational modelling are used to increase understanding of the suitability of the Single-Edge Notch Tension (SENT) test for assessing hydrogen embrittlement susceptibility. The SENT tests were designed to provide the mode I threshold stress intensity factor (Kth) for hydrogen-assisted cracking of a C110 steel in two corrosive environments. These were accompanied by hydrogen permeation experiments to relate the environments to the absorbed hydrogen concentrations. A coupled phase-field-based deformation–diffusion-fracture model is then employed to simulate the SENT tests, predicting Kth in good agreement with the experimental results and providing insights into the hydrogen absorption–diffusion–cracking interactions. The suitability of SENT testing and its optimal characteristics (e.g., test duration) are discussed in terms of the various simultaneous active time-dependent phenomena, triaxiality dependencies, and regimes of hydrogen embrittlement susceptibility

Are informal healthcare providers knowledgeable in tuberculosis care? A cross-sectional survey using vignettes in West Bengal, India.

Background: India accounts for one-quarter of the world's TB cases. Despite efforts to engage the private sector in India's National TB Elimination Program, informal healthcare providers (IPs), who serve as the first contact for a significant TB patients, remain grossly underutilised. However, considering the substantial evidence establishing IPs' role in patients' care pathway, it is essential to expand the evidence base regarding their knowledge in TB care. Methods: We conducted a cross-sectional study in the Birbhum district of West Bengal, India. The data were collected using the TB vignette among 331 IPs (165 trained and 166 untrained). The correct case management was defined following India's Technical and Operational Guidelines for TB Control. Results: Overall, IPs demonstrated a suboptimal level of knowledge in TB care. IPs exhibited the lowest knowledge in asking essential history questions (all four: 5.4% and at least two: 21.7%) compared with ordering sputum test (76.1%), making a correct diagnosis (83.3%) and appropriate referrals (100%). Nonetheless, a statistically significant difference in knowledge (in most domains of TB care) was observed between trained and untrained IPs. Conclusions: This study identifies gaps in IPs' knowledge in TB care. However, the observed significant difference between the trained and untrained groups indicates a positive impact of training in improving IPs' knowledge in TB care

Ongoing Exercise Intolerance Following COVID‐19: A Magnetic Resonance–Augmented Cardiopulmonary Exercise Test Study

Background: Ongoing exercise intolerance of unclear cause following COVID‐19 infection is well recognized but poorly understood. We investigated exercise capacity in patients previously hospitalized with COVID‐19 with and without self‐reported exercise intolerance using magnetic resonance–augmented cardiopulmonary exercise testing. / Methods and Results: Sixty subjects were enrolled in this single‐center prospective observational case‐control study, split into 3 equally sized groups: 2 groups of age‐, sex‐, and comorbidity‐matched previously hospitalized patients following COVID‐19 without clearly identifiable postviral complications and with either self‐reported reduced (COVIDreduced) or fully recovered (COVIDnormal) exercise capacity; a group of age‐ and sex‐matched healthy controls. The COVIDreducedgroup had the lowest peak workload (79W [Interquartile range (IQR), 65–100] versus controls 104W [IQR, 86–148]; P=0.01) and shortest exercise duration (13.3±2.8 minutes versus controls 16.6±3.5 minutes; P=0.008), with no differences in these parameters between COVIDnormal patients and controls. The COVIDreduced group had: (1) the lowest peak indexed oxygen uptake (14.9 mL/minper kg [IQR, 13.1–16.2]) versus controls (22.3 mL/min per kg [IQR, 16.9–27.6]; P=0.003) and COVIDnormal patients (19.1 mL/min per kg [IQR, 15.4–23.7]; P=0.04); (2) the lowest peak indexed cardiac output (4.7±1.2 L/min per m2) versus controls (6.0±1.2 L/min per m2; P=0.004) and COVIDnormal patients (5.7±1.5 L/min per m2; P=0.02), associated with lower indexed stroke volume (SVi:COVIDreduced 39±10 mL/min per m2 versus COVIDnormal 43±7 mL/min per m2 versus controls 48±10 mL/min per m2; P=0.02). There were no differences in peak tissue oxygen extraction or biventricular ejection fractions between groups. There were no associations between COVID‐19 illness severity and peak magnetic resonance–augmented cardiopulmonary exercise testing metrics. Peak indexed oxygen uptake, indexed cardiac output, and indexed stroke volume all correlated with duration from discharge to magnetic resonance–augmented cardiopulmonary exercise testing (P<0.05). / Conclusions: Magnetic resonance–augmented cardiopulmonary exercise testing suggests failure to augment stroke volume as a potential mechanism of exercise intolerance in previously hospitalized patients with COVID‐19. This is unrelated to disease severity and, reassuringly, improves with time from acute illness

Roadmap on chalcogenide photonics

Alloys of sulfur, selenium and tellurium, often referred to as chalcogenide semiconductors, offer a highly versatile, compositionally-controllable material platform for a variety of passive and active photonic applications. They are optically nonlinear, photoconductive materials with wide transmission windows that present various high- and low-index dielectric, low-epsilon and plasmonic properties across ultra-violet, visible and infrared frequencies, in addition to an, non-volatile, electrically/optically induced switching capability between phase states with markedly different electromagnetic properties. This roadmap collection presents an in-depth account of the critical role that chalcogenide semiconductors play within various traditional and emerging photonic technology platforms. The potential of this field going forward is demonstrated by presenting context and outlook on selected socio-economically important research streams utilizing chalcogenide semiconductors. To this end, this roadmap encompasses selected topics that range from systematic design of material properties and switching kinetics to device-level nanostructuring and integration within various photonic system architectures

Anxiety and depression among caregivers of the children with thalassemia, attending at Thalassemia Control Unit of a Rural Tertiary Care Medical College, Darjeeling, West Bengal

Background of Study: Caregivers of the children with thalassemia often experienced a life with varied degree of anxiety and depression due the chronic illness like of their children. Mothers as the main caregivers for most of the thalassemic children suffers with different forms of psychological problems. Objectives: The aim of this study was to assess the levels of anxiety and depression of the caregivers of children with Thalassemia and also to find out sociodemographic factors associated with their anxiety and depression. Materials and Methods: Descriptive cross-sectional study conducted in Thalassemia Control Unit (TCU) of North Bengal Medical College (NBMC) from December 2018 to April 2019. Complete enumeration method was used to include 136 caregivers of children (≤12 years) with thalassemia. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) was used to assess the levels of anxiety and depression. Collected data were entered into MS-Excel and analyzed by using SPSS software program, version 22.0. Results: Mean age of caregivers was 34.3 (SD ± 1.4 years). Most of caregivers were female (89%) and had educational qualification up to primary school (45.6%). Majority (70.6%) of the caregivers were the mothers of the children. Most of the study participants (54.4%) had moderate depression followed by 30.1% with mild mood disturbances. Majority (69.9%) of the study participants had mild anxiety and 30.1% moderate anxiety. The median (IQR) of BDI score was 21(23–18) and median (IQR) of BAI score was 20(22–18). Conclusions: Early counseling, psychotherapy, appropriate treatment should be prioritized. Social support, community involvement with their full participation should be emphasized

The mediating role of emotion regulation in the emotional complexity and subjective well-being relationship

Introduction Emotional complexity involves greater emotional awareness and understanding and associates strongly with adaptive emo-tion regulation. Similarly, regulation of emotion is vital for achieving, restoring, and sustaining subjective well-being. The present study, therefore, tested the mediatory role of emotion regulatory processes in the relationship between emotional complexity and subjective well-being. Participants and procedure A total of 285 participants completed self-report measures of emotional complexity, emotion regulation, positive/negative affect, and life satisfaction, and the data were analyzed using correlations and structural equation modelling. Results Findings indicated that individuals high in emotional complexity experience greater subjective well-being. Moreover, the results revealed that reappraisal mediated the relationship of emotion differentiation with positive affect and life satisfac-tion whereas suppression mediated the relationship between the range of emotions and life satisfaction. Conclusions These findings underscore the significance of emotion regulation in mediating the relationship between emotional complexi-ty and subjective well-being

Acceptance of Millets in Aspects of Nutritional Profiles, Health and Environmental Benefits

Millets are one of the oldest crops known to humans. Millets are small-seeded grasses belonging to the botanical family Poaceae. In Ayurvedic classics they are named as Kshudra dhanya. Common Millets available in India are Sorghum, Pearl Millet, Finger Millet, Foxtail Millet, Barnyard Millet, Kodo Millet, Little Millet, Proso Millet. Millets are good for the environment as they are the carbon neutral crops and also minimum fertilizers as well as pesticides are used for their cultivation. Millets are the most dependable crops to small farmers due to their short crop rotation characteristic and they are the resilient and climate adaptable crops in dry, hot and drought environments. Millets have significant role in traditional diets of different regions throughout the India. Millets are rich sources of nutrients like carbohydrate, protein, good-quality fat, dietary fibre and have sufficient amounts of minerals like calcium, potassium, magnesium, iron, manganese, zinc and B complex vitamins. Hence, millets may be an excellent choice of food for fortification of under nutrition or combating malnutrition and exerting health-promoting benefits and also they play efficient role in body immune system. Millets are rich with phytochemicals, hence millet have health promoting effects specifically anti-diabetic, anti-obesity and anti-hyperlipidaemic and also show therapeutic effects due to their anti-inflammatory and anti-oxidative properties. Phytochemicals and the dietary fibre of millets can hinder the absorption of minerals and different food processing methods are commonly used to eliminate the anti-nutritional factors of millets