Novel Biomarkers for the Diagnosis of Urinary Tract Infection—A Systematic Review

Urinary tract infections (UTIs) are associated with significant morbidity. We rely on clinical presentation, urinalysis, and urine culture to diagnose UTI. To differentiate between lower UTI and pyelonephritis, we depend on the clinical presentation. In the extremes of age and in immunocompromised individuals, clinical presentation is often atypical posing a challenge to diagnosis. In the elderly, the high prevalence of asymptomatic bacteriuria is another confounder. We conducted a search of publications to find novel biomarkers to diagnose UTI and to ascertain its severity. We searched PUBMED, MEDLINE and SCOPUS databases for studies pertaining to novel biomarkers and UTI. Two reviewers independently evaluated the methodology of the studies using the STARD (Standards for Reporting of Diagnostic Accuracy) criteria. We have identified procalcitonin as a biomarker to differentiate lower UTI from pyelonephritis in the pediatric age group. Elevated serum procalcitonin levels can result in early and aggressive treatment at the time of presentation. Interleukin 6 has also shown some promise in differentiating between lower UTI and pyelonephritis but needs further validation. Lastly, given the paucity of data in certain subgroups like diabetics, kidney transplant recipients, and individuals with spinal cord injury, further studies should be conducted in these populations to improve diagnostic criteria that will inform clinical management decisions

Does BCG vaccine prevent contract and severity of COVID-19 infection in India? A situational analysis

Background: The COVID-19 pandemic has created worldwide emergency with morbidities, mortality and panic. The BCG vaccine, usually given to prevent childhood tuberculosis, surfaced as an option as suggested by some ecological observations. However, some others studies could not establish and explain the protective effects of BCG vaccination against COVID-19 pandemic. India is one country with high BCG vaccination coverage and is among the countries with lowest COVID-19 case fatality rate. Aims and Objectives: We examine the relationship between the BCG coverage and COVID-19 burden in various states/UTs of India. Materials and methods: The information on BCG coverage and morbidity and mortality of COVID-19 was obtained from NFHS and www.covid19India.org respectively. Results: The analysis suggested very weak positive relationship of BCG coverage with cases and deaths due to COVID-19. Moderate positive relationship was observed between BCG coverage and COVID-19 case fatality rate even after adjusting for health system performance. Conclusion: The conclusion of the study is against the role of BCG vaccination in containing the COVID-19 pandemic. The positive correlation which is not significant may be spurious and affected by many confounding factors like co-morbid conditions, testing strategies, population level immunity for other viral infections etc. Hence, the states and UTs should not be complacent by the hypothesized role of BCG vaccine in COVID-19 control. Rather, they should continue with the principles of social distancing, contact tracing, treating and surveillance of COVID-19

Pattern of Tobacco Use and Perceived Risk of COVID-19 Following Tobacco Use among the COVID-19 Patients of a Tertiary Health Care Institution in Eastern India

Background: COVID-19 presented an unprecedented situation in which behavioural factors including tobacco use were believed to increase the risk of morbidity and mortality. The objective of the present study was to find the tobacco use pattern among the COVID-19 patients and the perceived risk of developing severe COVID-19 following tobacco use.Methods: This hospital-based, cross-sectional, analytical study was conducted among 300 COVID-19 patients at the All India Institute of Medical Sciences (AIIMS), Patna, India, during November and December 2020 using a semi-structured, pretested questionnaire. Descriptive and univariate analyses were performed using statistical software and the results were presented as proportion and percentage.Findings: About 27% and 16% of the COVID-19 patients were ever and current tobacco users, respectively. Quit attempts were found to have increased during the COVID-19 pandemic. A majority (65%) of current tobacco users had reduced their amount of tobacco use. Nearly 2 in every 3 patients perceived high risk of developing severe COVID-19 following tobacco use. Perceived risk was significantly higher among tobacco non-users, patients who were aware of the ill health effects of tobacco use, and patients who had noticed anti-tobacco messages or had been advised to quit tobacco. Among the current tobacco users, a significantly higher proportion of patients who perceived high risk of developing severe COVID-19 following tobacco use had made quit attempts or had reduced tobacco consumption during the pandemic (76.7% vs. 40%; P = 0.032).Conclusion: A high proportion of COVID-19 patients believed that tobacco use aggravated the COVID-19 condition. Increased quit attempts and reduction in tobacco consumption during this pandemic is a positive sign for tobacco contro

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

Removal of Heavy Metals from Industrial Effluent Using Bacteria

ABSTRACT Industrial development results in the generation of industrial effluents, and if untreated results in water, sediment and soil pollution. (Fakayode and Onianwa, 2002

Bio-Vitrimers for Sustainable Circular Bio-Economy

The aim to achieve sustainable development goals (SDG) and cut CO2-emission is forcing researchers to develop bio-based materials over conventional polymers. Since most of the established bio-based polymeric materials demonstrate prominent sustainability, however, performance, cost, and durability limit their utilization in real-time applications. Additionally, a sustainable circular bioeconomy (CE) ensures SDGs deliver material production, where it ceases the linear approach from production to waste. Simultaneously, sustainable circular bio-economy promoted materials should exhibit the prominent properties to involve and substitute conventional materials. These interceptions can be resolved through state-of-the-art bio-vitrimeric materials that display durability/mechanical properties such as thermosets and processability/malleability such as thermoplastics. This article emphasizes the current need for vitrimers based on bio-derived chemicals; as well as to summarize the developed bio-based vitrimers (including reprocessing, recycling and self-healing properties) and their requirements for a sustainable circular economy in future prospects

A Prospective Study of Routine Screening of Hypothyroidism in Antenatal Patients and their Outcome with Levothyroxine Treatment

Introduction: Pregnancy with hypothyroidism is associated with significant maternal, fetal and neonatal complications. Early diagnosis and treatment can effectively reduce such complications. Aim: To find out the complications that can be prevented or reduced in severity in adequately treated hypothyroid pregnant women. Materials and Methods: Pregnant women attending obstetrics’ OPD upto 20 weeks were screened with serum Thyroid Stimulating Hormone (TSH) and free Thyroxine FT4. Those having Subclinical Hypothyroidism (SCH), Overt Hypothyroidism (OH) and pre pregnant women with hypothyroid were treated with levothyroxine as per consulting with endocrine unit. They were followed up till delivery and any adverse outcomes were documented such as Pregnancy Induced Hypertension (PIH), Pre Eclamptic Toxemia (PET), Abruption, Preterm Premature Rupture Of Membranes (PPROM), Low Birth Weight (LBW), oligohydramnios, Gestational Diabetes Mellitus (GDM), abortion, Intra Uterine Death (IUD), mode of delivery and Neonatal Intensive Care Unit (NICU) admission were compared with similar complications documented among normal pregnant women excluding the treated hypothyroid during a period of one year study. Untreated or late trimester diagnosed hypothyroidism were excluded from study group. Results: Incidence of PIH, GDM, Oligohydramnios, PPROM, NICU admissions and caesarean section were higher among hypothyroid pregnant women though adequately treated than the control pregnant women. But incidence of LBW baby is less and no one had developed PET, Eclampsia or abruption among treated group. Comparing between SCH and OH incidence of PIH is almost equal in both while association of GDM is more in OH. A p-value for PIH, GDM, Oligohydramnios, PPROM developed in hypothyroid pregnant ladies which were calculated by Yates corrected Chi-Square and Fisher’s-exact test from open epic version 3.03a. A p-value is significant (<0.001) for PIH, GDM, PPROM and oligohydramnios but insignificant for LBW. Conclusion: Severe form of PIH (PET and Eclampsia), IUD and Abruptio placentae can be prevented in adequately treated pregnant hypothyroid women and all pregnant women with SCH and OH must screen for GDM even if there is no other risk factors for GDM

Thrombogenic responses from electrocured tissue adhesives

Electrocured tissue adhesives offer a new route towards addressing unmet surgical challenges in tissue fixation. We have recently developed an electrocuring adhesive (aka Voltaglue) by grafting carbene precursors on polyamidoamine (PAMAM) G5 dendrimers. The cationic adhesive can be cured through low-voltage activation and exhibits voltage and time dependent crosslinking, allowing some control over material and adhesive properties. Herein, we have evaluated the platelet adhesion and activation of the bioadhesives electrocured with applied voltages of 5V and 10V. The electrocured bioadhesives exhibited platelet resistant properties that was dependent on voltage magnitude.MOE (Min. of Education, S’pore)Published versio

Deep Learning Approach to Nailfold Capillaroscopy Based Diabetes Mellitus Detection

Diabetes mellitus is a commonly occurring chronic metabolic disorder which has affected almost 400 million people around the world. It can lead to vascular structure alterations and various renal, cardiovascular, and neurologicalcomplications claiming several lives. Since diabetes mellitus results is vascular structure changes, NailfoldCapillaroscopy(NFC) based approach can be employed for the detection of diabetes. NFC is an inexpensive, non-invasive method which involves acquisition of images of capillaries in the nail bed region using a USB digital microscope. Qualitative parameters of the capillaries such as tortuosity, hemorrhages, angiogenesis, elongated capillariesand quantitative parameters like length, width and mean capillary density are considered for diabetes detection. About 600 capillary images of healthy and diabetic subjects were collected and further data augmentation was performed to increase this to 1018 images dataset. This paper focuses on using NFC to obtain capillary images and employdeep learning-based object detection algorithm to localize these capillary loops on the nailbed and differentiate them into five classes namely, normal, wide, elongated, tortuosity and hemorrhages. This classification is of prominent significance to medical practitioners as this helps in gauging the severity and progressionof the disorder