Strength Evaluation of Functionalized MWCNT-Reinforced Polymer Nanocomposites Synthesized Using a 3D Mixing Approach

The incorporation of carboxyl functionalized multi-walled carbon nanotube (MWCNT- COOH) into a polymethyl methacrylate (PMMA) has been investigated. The resultant tensile and flexural mechanical properties have been determined. In this paper, a novel synthesis process for a MWCNT-reinforced polymer nanocomposite is proposed. The proposed method significantly eliminates the most challenging issues of the nano-dispersed phase, including agglomeration and non-homogeneous mixing within a given matrix material, and also resolves the issues occurring in conventional mixing processes. The results of scanning electron microscopy support these claims. This 3D-mixing process is followed by an extrusion process, using a twin-screw extruder for pristine MWCNT, and a compression molding process for COOH-MWCNT, to prepare test specimens for experimentally determining the mechanical properties. The test specimens are fabricated using 0.1, 0.5, and 1.0 wt.% MWCNT, with a remaining PMMA phase. The testing is conducted according to ASTM D3039 and ASTM D7264 standards. Significant improvements of 25.41%, 35.85%, and 31.75% in tensile properties and 18.27%, 48%, and 33.33% in flexural properties for 0.1, 0.5, and 1.0 wt.% COOH-MWCNT in PMMA, respectively, compared to non-functionalized MWCNTs, were demonstrated. The highest strength was recorded for the nanocomposite with 0.5 wt.% f-MWCNT content, indicating the best doping effect at a lower concentration of f-MWCNT. The proposed CNT-PMMA nanocomposite may be found suitable for use as a scaffold material in the domain of bone tissue engineering research. This type of research possesses a high strength requirement, which may be fulfilled using MWCNT. Furthermore, this analysis also shows a significant amount of enhancement in flexural strength, which is clinically required for fabricating denture bases.This research was funded by a grant from the Romanian Ministry of Research, Innovation, and Digitalization, project number PFE 26/30.12.2021, PERFORM-CDI@UPT100—The increasing of the performance of the Polytechnic University of Timis, oara by strengthening the research, development, and technology transfer capacity in the field of “Energy, Environment and Climate Change” at the beginning of the second century of its existence, within Program 1—Development of the national system of Research and Development, Subprogram 1.2—Institutional Performance-Institutional Development Projects—Excellence Funding Projects in RDI, PNCDI III.info:eu-repo/semantics/publishedVersio

Ultrasound Guided versus Peripheral Nerve Stimulator Guided Transversus Abdominis Plane Block for Postoperative Analgesia in Patients undergoing Laparoscopic Cholecystectomy: A Randomised Clinical Study

Introduction: The Transversus Abdominis Plane (TAP) block is a relatively simple technique that provides analgesia that, as part of a multimodal analgesic treatment, may be useful in the prevention of postoperative pain. Ultrasound (USG) versus Peripheral Nerve Stimulator (PNS) guided TAP blocks are being frequently given postoperatively for pain these days in laparoscopic cholecystectomy. Aim: To assess the analgesic efficacy of USG guided and PNS guided transversus abdominis plane block in patients undergoing laparoscopic cholecystectomy. Materials and Methods: The randomised clinical study was conducted in the Department of Anaesthesiology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India, from March 2020 to June 2021. Total 90 adult patients were enrolled and randomly allocated into three groups. Group 1 (n=30) received bilateral USG guided TAP block with 20 mL of 0.375% ropivacaine along with standard postoperative analgesia regimen. Group 2 (n=30) received bilateral PNS guided TAP block with 20 mL 0.375% ropivacaine along with standard postoperative analgesia regimen. Group 3 (Control) (n=30) received standard postoperative analgesia regimen consisting of inj. paracetamol iv 1 gm (six hourly) and inj. diclofenac 75 mg i.v. (12 hourly). Each patient was assessed for VAS score, duration of analgesia, total analgesic consumption and patient satisfaction for 24 hours postoperatively. Results: The average mean VAS score in first 24 hrs was 2.04±0.80 in group 1, 2.10±0.70 in group 2 and 3.18±0.63 in group 3. The duration of analgesia was least in group 3 (5.8±2.31 hrs) followed by group 2 (9.67±2.47 hrs) and maximum in group 1 (11.87±2.97 hrs). The total tramadol requirement in first 24 hours postoperatively was 126.67±44.98 mg in group 1, 140±62.15 mg in group 2 and 226.67±63.97 mg in group 3. Conclusion: Postoperative analgesia with USG and PNS guided TAP block enables better pain control and less analgesic consumption. PNS guided TAP block is good alternative when compared with control for postoperative analgesia when USG machine is not available

Piloting Upfront Xpert MTB/RIF Testing on Various Specimens under Programmatic Conditions for Diagnosis of TB & DR-TB in Paediatric Population

India accounts for one-fifth of the global TB incidence. While the exact burden of childhood TB is not known, TB remains one of the leading causes of childhood mortality in India. Bacteriological confirmation of TB in children is challenging due to difficulty in obtaining quality specimens, in the absence of which diagnosis is largely based on clinical judgement. While testing multiple specimens can potentially contribute to higher proportion of laboratory confirmed paediatric TB cases, lack of high sensitivity tests adds to the diagnostic challenge. We describe here our experiences in piloting upfront Xpert MTB/RIF testing, for diagnosis of TB in paediatric population in respiratory and extra pulmonary specimens, as recently recommended by WHO.Xpert MTB/RIF testing was offered to all paediatric (0-14 years) presumptive TB cases (both pulmonary and extra-pulmonary) seeking care at public and private health facilities in the project areas covering 4 cities of India.Under this pilot project, 8,370 paediatric presumptive TB & presumptive DR-TB cases were tested between April and-November 2014. Overall, 9,149 specimens were tested, of which 4,445 (48.6%) were non-sputum specimens. Xpert MTB/RIF gave 9,083 (99.2%, CI 99.0-99.4) valid results. Of the 8,143 presumptive TB cases enrolled, 517 (6.3%, CI 5.8-6.9) were bacteriologically confirmed. TB detection rates were two fold higher with Xpert MTB/RIF as compared to smear microscopy. Further, a total of 60 rifampicin resistant TB cases were detected, of which 38 were detected among 512 presumptive TB cases while 22 were detected amongst 227 presumptive DR-TB cases tested under the project.Xpert MTB/RIF with advantages of quick turnaround testing-time, high proportion of interpretable results and feasibility of rapid rollout, substantially improved the diagnosis of bacteriologically confirmed TB in children, while simultaneously detecting rifampicin resistance

Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95$7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95$43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and$37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

To compare the sensory and motor blockade produced by caudal Bupivacaine and Ropivacaine in pediatric patients

Background & Method: The aim of the study is to compare the sensory and motor blockade produced by caudal Bupivacaine and Ropivacaine in pediatric patients. Patients were randomly allocated to 1 of the 2 groups (n = 25) by using a random number table, to receive caudal block with either Inj Bupivacaine (0.25%) 1ml/kg (Group I) or Inj. Ropivacaine (0.25%) 1ml/kg (Group II). Result: The mean age distribution in Group Bupivacaine and Group Ropivacaine were almost the same without any significant difference. Heart rate and systolic arterial pressures measured at specific time intervals showed no significant difference. Conclusion: Present study was designed to compare the effect of bupivacaine versus ropivacaine used in caudal block in pediatric patients, in a prospective randomized controlled study. Mean motor score at different time intervals postoperatively was more for ropivacaine group but Heart rate and systolic arterial pressures measured at specific time intervals were similar

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Not AvailableGroundnut (Arachis hypogaea L.) is a major oilseed and cash crop of Asia and Africa. Fungal diseases, grey weevils and termites are consistent major pests in arid region inflicting damage to the groundnut production. It is not feasible to identify all the pests precisely and adopt several management practices simultaneously to protect the crop in curative mode. Therefore, an integrated biointensive prophylaxis collegial module encompassing varietal tolerance, soil amendment, biocontrol agents and the minimal prophylactic use of pesticides is developed to promote sustainable agriculture and economic benefit for the farmers of arid region. This Integrated Pest Management module in prophylaxis mode proved to be the most effective in reducing the disease and insect pests in two groundnut cultivars HNG-10 and Girnar-2 with enhanced pod yields by 29.35% and 26.35%, respectively.Not Availabl

SIMULTANEOUS ESTIMATION OF RABEPRAZOLE SODIUM AND ACECLOFENAC COMBINED CAPSULE DOSAGE FORM AS PER ICH GUIDELINE BY UV SPECTROSCOPIC METHODS

The present work aimed to develop and validate spectrophotometric methods for simultaneous estimation of rabeprazole sodium and aceclofenac in a pure and capsule dosage form. A simple, sensitive, spectrophotometric method in UV region has been developed for the simultaneous estimation of Rabeprazole sodium and Aceclofenac in bulk and semi dosage form (Capsule). Standard solution of Rabeprazole sodium shows maximum absorbance at 283 nm and Aceclofenac shows maximum absorbance at 276 nm. Beer’s Lamberts law is obeyed in concentration range 10-60 µg/ml for Rabeprazole with regression, slope and intercept of 0.991, 0.0918 and 0 respectively while for, Beer’s Aceclofenac Lambert law is obeyed in concentration range 10-60 µg/ml with regression, slope and intercept having 0.9984, 0.2069 and 0.0253 respectively. Method was validated for linearity, range, accuracy, precision, recovery studies and interference study of mixture. All these parameters showed the adaptability of the method for the quality control analysis of the drug in bulk and in combination formulations. Keywords: Rabeprazole sodium, Aceclofenac, Simultaneous equations, absorbance interference stud

SARS-CoV-2 / COVID-19 and its Transmission, Prevention, Treatment and Control - An Update

Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Virus-2 (SARSCoV-2), pandemic has caused huge panic, havoc and global threats worldwide. The origin of this virus has been linked to animals, intermediate host is still to be identified, and studies are being carried out that how it got transmitted to humans and acquired rapid human-to-human transmission. Within a short time period of only 05 months, SARS-CoV-2 has spread to 213 countries, and till 28th May, 2020,\ud nearly 5.8 million confirmed cases have been reported while taking lives of 0.36 million persons. Seeing the current situation of rapid increase in COVID-19 cases daily in many countries, this seems to be the deadliest pandemic after the 1918 Spanish Flu. There is currently no specific effective treatment for COVID-19 and also in absence of vaccine the radical cure of the disease is far away. Researchers are pacing high to design and develop effective vaccines, drugs and therapeutics to counter COVID-19, however such efforts, clinical trials, necessary approvals and then to reach the level of bulk production of many millions of doses may still take much time. Prevention and control of COVID-19 outbreaks requires an evidence-based, multi-factorial and effective mitigation strategy to be adopted. The current review discusses on the research advancements, challenges and opportunities in COVID 19 management with a focus on its transmission, prevention, treatment and control