Correlation of serum magnesium levels with renal parameters in patients with acute kidney injury

Background: Acute kidney injury is a common problem with various causes and consequences like electrolyte disturbances in the form of hypocalcaemia, hypokalemia, hyperkalemia depending on the phase. Hypomagnesaemia is one of the most common electrolyte disturbance found in hospitalized patients especially in the critically ill patients. Prevalence of hypomagnesemia varies from 11 to 65% in different studies. Hence, we decided to conduct a study to evaluate correlation of serum magnesium levels in AKI.Methods: A cross-sectional, hospital based time bound study was conducted between November 2016 and August 2018 with a sample of 100 patients aged 18-65 years and who had AKI were included and patients with diabetes mellitus, multi-organ dysfunction, obstructive uropathy and drug induced AKI were excluded from study. The decrease in magnesium <1.7 mg/L was defined as hypomagnesaemia. AKI was defined as per AKIN criteria. Day 1, day 3 and day 6 magnesium levels were measured.Results: Prevalence of hypomagnesaemia was 53%, 30% and 36% on day 1, day 3 and day 6 respectively. It was observed that there was a positive correlation between serum magnesium, and serum creatinine. Normomagnsemia and hypermagnesemia on day 1, 3 and 6 were significantly associated with recovery of AKI (p<0.001).Conclusions: The prevalence of hypomagnesemia was significantly higher in AKI patients and normal magnesium and hypermagnesium on day 1, 3 and day 6 was associated with recovery than non-recovery. Hypomagnesemia was associated more with non-recovery then recovery

SNODGRASS Procedure A Versatile Technique for Various Types of Hypospadias Repair

There are about 156 operations described forhypospadias. The sheer number of proceduresindicates that no single procedure is standardfor hypospadias. We report our series of 20patients operated for hypospadias by Snodgrassprocedure. The technical details of the proce-dure and post-operative management protocolis discussed

Enabling rapid and accurate construction of CCSD(T)-level potential energy surface of large molecules using molecular tailoring approach

The construction of the potential energy surface (PES) of even a medium-sized molecule employing correlated theory, such as CCSD(T), is an arduous task due to the high computational cost. In this Letter, we report the possibility of efficient construction of such a PES employing the molecular tailoring approach (MTA) on off-the-shelf hardware. The full calculation (FC) as well as MTA energies at CCSD(T)/aug-cc-pVTZ level for three test molecules, viz. acetylacetone, N-methyacetamide, and tropolone are reported. All the MTA energies are in excellent agreement with their FC counterparts (typical error being sub-millihartree) with a time advantage factor of 3 to 5. The energy barrier from the ground- to transition-state is accurately captured. Further, the accuracy and efficiency of the MTA method for estimating energy gradients at CCSD(T) level are demonstrated. This work brings out the possibility of the construction of PES for large molecules using MTA with the computational economy at a high level of theory and/or basis set

Knowledge, attitude and practices towards COVID-19 among people living with HIV in Pune, India: a cross-sectional study

Background: Studies on knowledge, attitude, and practices (KAP) are important for implementation of interventions. This cross-sectional study was conducted among HIV infected individuals attending antiretroviral therapy (ART) centre at Pune, India, to assess KAP towards COVID-19.Methods: The study conducted between June and December 2020 consisted of twelve, five and seven questions pertaining to knowledge, attitude, and practices respectively towards COVID-19. Frequencies and percentages of correct knowledge, attitude and practices were calculated. Overall knowledge scores were categorized into poor, moderate and good using class width equation.Results: Of the total 1175 participants enrolled, 649 (55.2%) were females. Mean age and CD4count of participants at study entry were 44 years (SD: 9.1) and 637 cells/mm3 (SD: 297) respectively. Overall, 400 (34.0%, 95% CI: 31.33-36.83), 612 (52.1%, 95% CI: 49.18-54.98) and 163 (13.9%, 95% CI: 11.95-15.98) participants had good, moderate and poor knowledge respectively regarding COVID-19. Illiterate participants had six times higher probability of having poor knowledge as compared to their counterparts (OR 5.70, 95% CI: 3.94-8.23; p<0.001). Majority of people living with (PLHIV) had correct attitude towards adherence to government prevention and control measures. Healthy preventive practices of social distancing (99.5%), wearing masks at public places (99.7%) and frequent washing hands with soap and water (98.7%) were followed by PLHIV.Conclusions: PLHIV have average knowledge, correct attitude towards adherence to government prevention and control measures, and appropriate practices towards prevention of COVID-19. Counselling sessions at ART centres should include information for improving knowledge related to COVID-19 especially targeting illiterate individuals.

Image based Search Engine for Online Shopping

This paper presents a method based on principle of content based image retrieval for online shopping based on color, HSV aiming at efficient retrieval of images from the large database for online shopping specially for fashion shopping. Here, HSV modeling is used for creating our application with a huge image database, which compares image source with the destination components. In this paper, a technique is used for finding items by image search, which is convenient for buyers in order to allow them to see the products. The reason for using image search for items instead of text searches is that item searching by keywords or text has some issues such as errors in search items, expansion in search and inaccuracy in search results. This paper is an attempt to help users to choose the best options among many products and decide exactly what they want with the fast and easy search by image retrieval. This technology is providing a new search mode, searching by image, which will help buyers for finding the same or similar image retrieval in the database store. The image searching results have been made customers buy products quickly. This feature is implemented to identify and extract features of prominent object present in an image. Using different statistical measures, similarity measures are calculated and evaluated. Image retrieval based on color is a trivial task. Identifying objects of prominence in an image and retrieving image with similar features is a complex task. Finding prominent object in an image is difficult in a background image and is the challenging task in retrieving images. We calculated and change the region of interest in order to increase speed of operation as well as accuracy by masking the background content. The Implementation results proved that proposed method is effective in recalling the images of same pattern or texture

Exploring the therapeutic mechanisms of Cassia glauca in diabetes mellitus through network pharmacology, molecular docking and molecular dynamics

Cassia glauca is reported as anti-diabetic medicinal plant and is also used as an ethnomedicine. However, its mode of action as an anti-diabetic agent has not been clearly elucidated. Hence, the present study investigated the probable mechanism of action of C. glauca to manage diabetes mellitus via network pharmacology and molecular docking and simulations studies. The reported bioactives from C. glauca were retrieved from an open-source database, i.e. ChEBI, and their targets were predicted using SwissTargetPrediction. The proteins involved in the pathogenesis of diabetes were identified from the therapeutic target database. The targets involved in diabetes were enriched in STRING, and the pathways involved in diabetes were identified concerning the KEGG. Cytoscape was used to construct the network among bioactives, proteins, and probably regulated pathways, which were analyzed based on edge count. Similarly, molecular docking was performed using the Glide module of the Schrodinger suite against majorly targeted proteins with their respective ligands. Additionally, the drug-likeness score and ADMET profile of the individual bioactives were predicted using MolSoft and admetSAR2.0 respectively. The stability of these complexes were further studied via molecular dynamics simulations and binding energy calculations. Twenty-three bio-actives were retrieved from the ChEBI database in which cassiarin B was predicted to modulate the highest number of proteins involved in diabetes mellitus. Similarly, GO analysis identified the PI3K-Akt signaling pathway to be primarily regulated by modulating the highest number of gene. Likewise, aldose reductase (AKR1B1) was majorly targeted via the bioactives of C. glauca. Similarly, docking study revealed methyl-3,5-di-O-caffeoylquinate (docking score −9.209) to possess the highest binding affinity with AKR1B1. Additionally, drug-likeness prediction identified cassiaoccidentalin B to possess the highest drug-likeness score, i.e. 0.84. The molecular dynamics simulations and the MMGBSA indicate high stability and greater binding energy for the methyl-3,5-di-O-caffeoylquinate (ΔGbind = −40.33 ± 6.69 kcal mol−1) with AKR1B1, thus complementing results from other experiments. The study identified cassiarin B, cassiaoccidentalin B, and cinnamtannin A2 as lead hits for the anti-diabetic activity of C. glauca. Further, the PI3K-Akt and AKR1B1 were traced as majorly modulated pathway and target, respectively

Seroepidemiology of pandemic influenza A (H1N1) 2009 virus infections in Pune, India

<p>Abstract</p> <p>Background</p> <p>In India, Pune was one of the badly affected cities during the influenza A (H1N1) 2009 pandemic. We undertook serosurveys among the risk groups and general population to determine the extent of pandemic influenza A (H1N1) 2009 virus infections.</p> <p>Methods</p> <p>Pre-pandemic sera from the archives, collected during January 2005 to March 2009, were assayed for the determination of baseline seropositivity. Serosurveys were undertaken among the risk groups such as hospital staff, general practitioners, school children and staff and general population between 15^thAugust and 11^thDecember 2009. In addition, the PCR-confirmed pandemic influenza A (H1N1) 2009 cases and their household contacts were also investigated. Haemagglutination-inhibition (HI) assays were performed using turkey red blood cells employing standard protocols. A titre of ≥1:40 was considered seropositive.</p> <p>Results</p> <p>Only 2 (0.9%) of the 222 pre-pandemic sera were positive. The test-retest reliability of HI assay in 101 sera was 98% for pandemic H1N1, 93.1% for seasonal H1N1 and 94% for seasonal H3N2. The sera from 48 (73.8%) of 65 PCR-confirmed pandemic H1N1 cases in 2009 were positive. Seropositivity among general practitioners increased from 4.9% in August to 9.4% in November and 15.1% in December. Among hospital staff, seropositivity increased from 2.8% in August to 12% in November. Seropositivity among the schools increased from 2% in August to 10.7% in September. The seropositivity among students (25%) was higher than the school staff in September. In a general population survey in October 2009, seropositivity was higher in children (9.1%) than adults (4.3%). The 15-19 years age group showed the highest seropositivity of 20.3%. Seropositivity of seasonal H3N2 (55.3%) and H1N1 (26.4%) was higher than pandemic H1N1 (5.7%) (n = 2328). In households of 74 PCR-confirmed pandemic H1N1 cases, 25.6% contacts were seropositive. Almost 90% pandemic H1N1 infections were asymptomatic or mild. Considering a titre cut off of 1:10, seropositivity was 1.5-3 times as compared to 1:40.</p> <p>Conclusions</p> <p>Pandemic influenza A (H1N1) 2009 virus infection was widespread in all sections of community. However, infection was significantly higher in school children and general practitioners. Hospital staff had the lowest infections suggesting the efficacy of infection-control measures.</p

Temporal pathways of change in two randomized controlled trials for depression and harmful drinking in Goa, India

BACKGROUND: The current study explored the temporal pathways of change within two treatments, the Healthy Activity Program (HAP) for depression and the Counselling for Alcohol Problems (CAP) Program for harmful drinking. METHODS: The study took place in the context of two parallel randomized controlled trials in Goa, India. N = 50 random participants who met a priori criteria were selected from each treatment trial and examined for potential direct and mediational pathways. In HAP, we examined the predictive roles of therapy quality and patient-reported activation, assessing whether activation mediated the effects of therapy quality on depression (Patient Health Questionnaire-9) outcomes. In CAP, we examined the predictive roles of therapy quality and patient change- and counter-change-talk, assessing whether change- or counter-change-talk mediated the effects of therapy quality on daily alcohol consumption. RESULTS: In HAP, therapy quality (both general and treatment-specific skills) was associated with patient activation; patient activation but not therapy quality significantly predicted depression outcomes, and patient activation mediated the effects of higher general skills on subsequent clinical outcomes [a × b = -2.555, 95% confidence interval (CI) -5.811 to -0.142]. In CAP, higher treatment-specific skills, but not general skills, were directly associated with drinking outcomes, and reduced levels of counter-change talk both independently predicted, and mediated the effects of higher general skills on, reduced alcohol consumption (a × b = -24.515, 95% CI -41.190 to -11.060). Change talk did not predict alcohol consumption and was not correlated with counter-change talk. CONCLUSION: These findings suggest that therapy quality in early sessions operated through increased patient activation and reduced counter-change talk to reduce depression and harmful drinking respectively

Health care professionals' perspectives on screening and management of gestational diabetes mellitus in public hospitals of South India - a qualitative study.

BACKGROUND: Women developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM are essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. METHODS: We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using the grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. RESULTS: Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to their natal homes during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol. CONCLUSION: There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India