Controlling the size distribution of nanoparticles through the use of physical boundaries during laser ablation in liquids

A simple, yet effective method of controlling the size and size distributions of nanoparticles produced as a result of laser ablation of target material is presented. The method employs the presence of physical boundaries on either sides of the ablation site. In order to demonstrate the potential of the method, experiments have been conducted with copper and titanium as the target materials that are placed in two different liquid media (water and isopropyl alcohol). The ablation of the target material immersed in the liquid medium has been carried out using an Nd:YAG laser. Significant differences in the size and size distributions are observed in the cases of nanoparticles produced with and without confining boundaries. It is seen that for any given liquid medium and the target material, the mean size of the nanoparticles obtained with the boundary-fitted target surface is consistently higher than that achieved in the case of open (flat) targets. The observed trend has been attributed to the plausible role(s) of the confining boundaries in prolonging the thermalisation time of the plasma plume. In order to ascertain that the observed differences in sizes of the nanoparticles produced with and without the presence of the physical barriers are predominantly because of the prolonged thermalisation of the plasma plume and not due to the possible formation of oxide layer, select experiments with gold as the target material in water have also been performed. The experiments also show that, irrespective of the liquid medium, the increase in the mean size of the copper-based nanoparticles due to the presence of physical boundaries is relatively higher than that observed in the case of titanium target material under similar experimental conditions.Comment: 24 pages, 9 figures, a part of this work has been published in Photonics Prague 2017, (Proc. SPIE 10603, Photonics, Devices, and Systems VII, 1060304) titled "A novel method for fabrication of size-controlled metallic nanoparticles

Omental infarction: A rare cause of acute abdomen

Omental infarction is an uncommon but important cause of acute abdominal pain, which frequently mimics other surgical presentations. Low incidence and non-specific presentation contribute to Omental infarction being misconstrued for appendicitis, peptic ulcer perforation, acute pancreatitis or mesenteric ischemia. Its etiology remains uncertain, predisposing factors include obesity, strenuous activity, trauma, and sometimes idiopathic. Its diagnosis has traditionally been one of exclusion, based on intraoperative and pathologic findings. Here, we report the case of idiopathic omental infarction in a 51-year-old male. We discuss the diagnosis of primary omental infarction as well as the role of conservative and surgical management

Tricks and tracks in resource recovery from wastewater using bio-electrochemical systems (BES): A systematic review on recent advancements and future directions

Rapid industrialization and ameliorated lifestyle have vividly contributed to the release of huge quantity of wastewater into the environment. On the other hand, wastewater is enriched with resources like nutrients, metals, and chemicals that possess greater economic value. As a result, resource recovery from wastewater promoted ‘wastewater to wealth’ notion, thereby fostering the circular economy approach. In the recent years, bio-electrochemical systems (BES) emerged as versatile technology for simultaneous wastewater treatment and resource recovery. While the technology offers numerous advantages, its widespread commercial application has been hindered by challenges in scaling up, economical aspects, operational aspects, etc. Over the past few years, substantial efforts have been made to enhance the efficiency of electrode materials, choice of biocatalysts and design improvisations of BES. These improvements have significantly increased the performance efficiency of BES. Nevertheless, further enhancements are still necessary for BES to become economically viable. This review provides a comprehensive over view of recent developments in BES, with a particular focus on their resource recovery applications. The article covers fundamental concepts, various BES types, and the mechanisms underlying electron transfer, with a specific focus on their role in resource recovery from wastewater. Furthermore, the article delves into the challenges of scaling up BES for practical applications and provides in-depth insights into real-world applications of BES technology. The future potential of integrating phototrophic options into BES is also discussed to further enhance resource recovery and the production of value-added products

Use of thiopurines in inflammatory bowel disease : an update

Inflammatory bowel disease (IBD), once considered a disease of the Western hemisphere, has emerged as a global disease. As the disease prevalence is on a steady rise, management of IBD has come under the spotlight. 5-Aminosalicylates, corticosteroids, immunosuppressive agents and biologics are the backbone of treatment of IBD. With the advent of biologics and small molecules, the need for surgery and hospitalization has decreased. However, economic viability and acceptability is an important determinant of local prescription patterns. Nearly one-third of the patients in West receive biologics as the first/initial therapy. The scenario is different in developing countries where biologics are used only in a small proportion of patients with IBD. Increased risk of reactivation of tuberculosis and high cost of the therapy are limitations to their use. Thiopurines hence become critical for optimal management of patients with IBD in these regions. However, approximately one-third of patients are intolerant or develop adverse effects with their use. This has led to suboptimal use of thiopurines in clinical practice. This review article discusses the clinical aspects of thiopurine use in patients with IBD with the aim of optimizing their use to full therapeutic potential.Peer reviewe

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

A study to evaluate the shifting trend of antimicrobial resistance

Introduction: Pus is an important clinical specimen received in Microbiology laboratory for aerobic culture and sensitivity. The pace of development of drug resistance in bacterial isolates far exceeds the rate of newer drug discoveries highlighting the importance of conducting periodic studies to determine their antibiogram.Aim:This study was conducted to evaluate the shifting trend of  antimicrobial resistance in various pus isolates.Materials and Methods: Pus samples from different departments of Patna Medical College and Hospital, Patnawere collected using aseptic technique for 6 months duration and were processed in the laboratory immediately using standard microbiological procedures. Identification of bacteria was carried out with motility testing, Gram staining and biochemical reactions. The antibiotic sensitivity testing of all isolates was performed by Kirby Bauer’s disc diffusion method on Muller Hinton agar and interpreted as per CLSI guidelines. Results: Analysis of 119 pus samples showed 93.27% culture positivity (M:F=1.48:1.00) with Surgical wards(32.43%) being the major contributor. Pseudomonas(29.73%) was the most common organism followed by Staphylococcus aureus(22.52%).Gram positive cocci were susceptible to Linezolid(94.87%), Vancomycin(92.31%) and Imipenem(92.31%) whereas Gram negative bacilli were susceptible to Imipenem(87.10%), Piperacillin(61.29%) and Gentamicin(48.39%). Conclusion:The changing trends of antimicrobial susceptibility in bacterial isolates from paus can serve as a useful tool for physicians to start empirical treatment of patients at the earliest according to the geographical areas and emerging multi- resistant bacteria. Keywords: Antibiogram, Imipenem, Pseudomonas, Pus, Staphylococcus aureus.      &nbsp

Assessment of KAP Score for Biomedical Waste Management

Background: Bio Medical Waste Management works for effective reduction of waste volume, proper collection,  segregation, transport and economical disposal of waste to prevent harm resulting from it, retrieve reusable materials.Aim: The aim of this study was to know the Knowledge, attitude, practices about BMW among Outdoor Assistants, Staff Nurses and Lab technicians. Methods: Total 147 subjects were selected randomly, a structured valid questionnaire of Bio Medical Waste related framed by us were disturbed to them. The respondents were asked to return the questionnaire immediately after answering. All the results were entered into spread excel sheet and analyzed. Results were expressed as number, percentages.Results: Lab Technicians  answered better than Outdoor Attendants and Staff Nurses towards KAP of Bio Medical Waste management. Out of 54 Lab Technicians, 88.8% gave correct answers to knowledge questionnaire, 79.6% and 74% responded well to attitude and practice questionnaire. Out of 147 participants, 14.2% of Outdoor Attendants, 21.7% of Staff Nurses, 32.6% of Lab Technicians gave correct answers to knowledge questionnaire. Conclusion: It was observed that higher education and clinical rounds are needed for paramedical staffs to increase the knowledge of bio medical waste management activities. Also very important to Create awareness and enough cognizant regarding bio medical waste management to paramedics who are going to manage bio medical waste in near future

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Comparative evaluation different laboratory methods for detection of methicillin resistant staphylococcus aureus

Background: MRSA is any strain of Staphylococcus aureus that has developed resistance to beta-lactamase antibiotics  which include Penicillin and Cephalosporins. With the increasing prevalence of MRSA infections, it has become important to have an ideal method of detection. other than the molecular/MIC so that it can be carried out even in the remote areas. Aim: To compare the three conventional methods namely oxacillin screen agar, cefoxitin disk diffusion and oxacillin disk diffusion for the detection of MRSA, with the gold standard MIC determination. Materials and Methods: This study was conducted at Department of Microbiology, at Patna Medical College and Hospital, Patna from March 2020 to September 2020. 75 strains of Staphylococcus aureus  were included in the study, confirmed by slide and tube coagulase tests. Oxacillin screen agar: By direct colony suspension method, any growth considered as resistant to methicillin. Oxacillin disk diffusion:After performing the test, a Zone of inhibition< 13, the strain is resistant. Cefoxitin disk diffusion:A 30 microg disk was used zone of inhibition < 20 is resistant. Minimum inhibitory concentration determination: Agar dilution method was used to determine the Minimum Inhibitory Concentration (MIC). Organisms with MIC of 4 and above were considered as MRSA and those with MIC below 4 were considered MSSA. Results: The results as obtained by all the three methods were observed to be the same. Out of the 75 strains of Staphylococcus aureus, all the methods detected 19 MSSA (25%) and 56 (75%) MRSA. All the three methods showed 100 percent sensitivity and specificity. Conclusion: Since all the tests showed 100 percent sensitivity and specificity we recommend that any two of the methods be used combined for accuracy and reliability. Keywords: MRSA; MIC; Oxacillin; Cefoxitin