Silhouette of cardiac impairment in diabetic patients at a medical college in Rewa district

Background: The modern technology (TMT) had helped to detect cardiac impairment in diabetes patients relative to past. This study had attempted to use modern tools for detection of cardiac impairment in patients who attended OPD in a medical college of Rewa district. Objectives of the study was to evaluate cardiac dysfunction and factors associated with cardiac dysfunction (using values of TMT) in diabetic patients.Methods: A descriptive study was done with help of recording history of variables like smoking, alcohol, BMI, HBA1C value, cholesterol level and others. Chi square was done to assess test of significance.Results: Diastolic dysfunction was more in patients with diabetic complications than those without diabetic complications. Most patients having peripheral neuropathy, nephropathy and retinopathy had diastolic dysfunction. Patients had also shown high incidence of positivity to TMT. Half of the patients (50%) positive results for stress test were higher with cases who led a sedentary life style (13.64%). Most of patients (70%) had serum. cholesterol level less than 200 mg/dl but the positive results for stress test were higher in patients with Serum. cholesterol level 200 to 239 mg/dl.  Conclusions: The study could shower light on the conclusion that left ventricular diastolic dysfunction in type 2 diabetes mellitus patients is more relative to systolic dysfunction

Persistence in Cluster--Cluster Aggregation

Persistence is considered in diffusion--limited cluster--cluster aggregation, in one dimension and when the diffusion coefficient of a cluster depends on its size $s$ as $D(s) \sim s^\gamma$. The empty and filled site persistences are defined as the probabilities, that a site has been either empty or covered by a cluster all the time whereas the cluster persistence gives the probability of a cluster to remain intact. The filled site one is nonuniversal. The empty site and cluster persistences are found to be universal, as supported by analytical arguments and simulations. The empty site case decays algebraically with the exponent $\theta_E = 2/(2 - \gamma)$. The cluster persistence is related to the small $s$ behavior of the cluster size distribution and behaves also algebraically for $0 \le \gamma < 2$ while for $\gamma < 0$ the behavior is stretched exponential. In the scaling limit $t \to \infty$ and $K(t) \to \infty$ with $t/K(t)$ fixed the distribution of intervals of size $k$ between persistent regions scales as $n(k;t) = K^{-2} f(k/K)$, where $K(t) \sim t^\theta$ is the average interval size and $f(y) = e^{-y}$. For finite $t$ the scaling is poor for $k \ll t^z$, due to the insufficient separation of the two length scales: the distances between clusters, $t^z$, and that between persistent regions, $t^\theta$. For the size distribution of persistent regions the time and size dependences separate, the latter being independent of the diffusion exponent $\gamma$ but depending on the initial cluster size distribution.Comment: 14 pages, 12 figures, RevTeX, submitted to Phys. Rev.

Missing emissions from post-monsoon agricultural fires in northwestern India: regional limitations of MODIS burned area and active fire products

A rising source of outdoor emissions in northwestern India is crop residue burning, occurring after the monsoon (kharif) and winter (rabi) crop harvests. In particular, post-monsoon rice residue burning, which occurs annually from October to November and is linked to increasing mechanization, coincides with meteorological conditions that enhance short-term air quality degradation. Here we examine the Global Fire Emissions Database (GFED), whose bottom-up emissions are based on the 500-m burned area product, MCD64A1, derived from Moderate Resolution Imaging Spectroradiometer (MODIS) observations. Using a household survey from 2016, we find that MCD64A1 tends to underestimate burned area in many surveyed villages, leading to poor representation of small, scattered fires and consequent spatial biases in model results. To more accurately allocate such small fires and resolve sub-village heterogeneity, we use an experimental hybrid MODIS-Landsat method (ModL2T) to map burned area at 30-m spatial resolution, which results in 44 ± 21% higher burned area than MCD64A1 and up to 105 ± 52% increase in dry matter emissions over GFEDv4s. In our validation and assessments, we find that ModL2T performs better relative to MCD64A1 in terms of bias and omission error, but may introduce commission error due to conflation of burning with harvest and still underestimate burned area due to Landsat's coarse temporal resolution (every 16 days). We conclude that while MODIS and Landsat provide more than two decades worth of observations, their spatio-temporal resolution is too coarse to overcome several region-specific challenges: small median landholding size (1–3 ha), quick harvest-to-sowing turnover period, prevalence of partial burning, and increasing haziness. To further constrain agricultural fire emissions in northwestern India and improve model estimates of associated public health impacts, integration of finer resolution imagery, as well as better understanding of the spatial patterns in burn rates, burn practices, and fuel loading, is requisite

Avian Influenza (H5N1) Virus of Clade 2.3.2 in Domestic Poultry in India

South Asia has experienced regular outbreaks of H5N1 avian influenza virus since its first detection in India and Pakistan in February, 2006. Till 2009, the outbreaks in this region were due to clade 2.2 H5N1 virus. In 2010, Nepal reported the first outbreak of clade 2.3.2 virus in South Asia. In February 2011, two outbreaks of H5N1 virus were reported in the State of Tripura in India. The antigenic and genetic analyses of seven H5N1 viruses isolated during these outbreaks were carried out. Antigenic analysis confirmed 64 to 256-fold reduction in cross reactivity compared with clade 2.2 viruses. The intravenous pathogenicity index of the isolates ranged from 2.80–2.95 indicating high pathogenicity to chickens. Sequencing of all the eight gene-segments of seven H5N1 viruses isolated in these outbreaks was carried out. The predicted amino acid sequence analysis revealed high pathogenicity to chickens and susceptibility to the antivirals, amantadine and oseltamivir. Phylogenetic analyses indicated that these viruses belong to clade 2.3.2.1 and were distinct to the clade 2.3.2.1 viruses isolated in Nepal. Identification of new clade 2.3.2 H5N1 viruses in South Asia is reminiscent of the introduction of clade 2.2 viruses in this region in 2006/7. It is now important to monitor whether the clade 2.3.2.1 is replacing clade 2.2 in this region or co-circulating with it. Continued co-circulation of various subclades of the H5N1 virus which are more adapted to land based poultry in a highly populated region such as South Asia increases the risk of evolution of pandemic H5N1 strains

Policy of foreign direct investment liberalisation in India: implications for retail sector

This study has analysed the impact of liberalisation of Indian economy and FDI policy on the retail sector since its implementation in the 1990s. It also further analyses sub-categories by investigating its impact on the unorganised retail sector and the flow of FDI in single-brand retail and multi-brand retail sectors. A comprehensive and critical review of the existing evidence on the subject was carried out, and descriptive statistical analysis of data from 1991 to 2013 was performed which leads to conclude that the policy of FDI liberalisation has proved to provide diversification and sustainable development to the Indian economy and specifically retail sector which is considered to be one of the significant pillars of economy. Furthermore, for continuous growth of the economy, it seems vital to encourage more investment in other sectors by liberalising the restrictive policies

A Care Process Model to Deliver 177Lu-Dotatate Peptide Receptor Radionuclide Therapy for Patients With Neuroendocrine Tumors

Purpose: To develop a care process model for the delivery of peptide receptor radionuclide therapy (PRRT) with lutetium-177 (177Lu)-Dotatate for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs).Methods: A multidisciplinary, structured PRRT process model was established. Over the last 9 months, meetings were held bi-weekly to discuss the logistics of clinical trials. Meetings are still held regularly at the Mayo Clinic Florida to discuss plans regarding commercially available PRRT treatments. The process model has evolved as we have treated patients on both clinical trials and commercial treatments.Results: An effective process model was formulated. We had 5 patients on our Expanded Access Program (EAP) clinical trial. Our ability to be a part of the EAP allowed us to understand the mechanics of how to treat these patients, and what was involved before it became commercially available. Since commercial availability of the 177Lu-Dotatate, more than 50 treatments (&gt;20 patients) have already been completed, with several new patients getting started on treatment every week. Our nuclear medicine department receives continual requests to schedule new patients for PRRT. This can be attributed to our streamlined approach in delivering PRRT to our patients.Conclusion: A thorough procedural approach was formulated to provide patients with PRRT. Experiences and challenges led to refinement, which has allowed the process to advance. This development could lead to better patient outcomes, treatment efficiency, and a reference standard for other institutions trying to develop this at their location