A study of bone mineral density among people living with HIV in India and its correlation with CD4 count

Background: Data on the prevalence of osteoporosis in HIV patients in Asian population is scarce this study was done to find out the prevalence of osteoporosis in HIV infected patients and its correlation with CD4 counts.Methods: This cross- sectional study was conducted in NACO- ART center of tertiary care hospital. Total 115 HIV patients were included in this study which were divided into ART naive (n= 69) and patients taking ART (n= 46). We analysed BMD by DEXA in 115 HIV positive patients and 78 HIV negative age and sex matched controls. Correlation of BMD with a CD4 count and ART regimen was studied.Results: BMD was found to be low in HIV positive patients. T score in HIV positive patients was significantly lower (p<0.05) as compared to the HIV negative control group. The prevalence of osteopenia and osteoporosis in HIV positive patients was 50.4% and 29.6% respectively, as compared to 23.1% and 2.6% in HIV negative controls. BMD showed relation with CD4 count. We did not find any statistical difference between any ART regimen and BMD.Conclusions: The prevalence of osteopenia and osteoporosis in HIV infected cases was higher as compared to HIV negative controls and higher in ART group as compared to ART naïve group. Low BMD levels show correlation with low CD4 count. We recommend that HIV positive patients especially with advanced stage of disease, low CD4 count should be screened for low BMD by DEXA scan for osteoporosis and managed accordingl

Fabrication and Evaluation of Low Density Glass-Epoxy Composites for Microwave Absorption Applications

In the present work, fabrication and evaluation of low density glass – epoxy (LDGE) composites suitable for absorbing minimum 80 per cent of incident microwave energy in 8 GHz to 12 GHz (X-band) is reported. LDGE composites having different densities were fabricated using a novel method of partially replacing conventional S-glass fabric with low density glass (LDG) layers as the reinforcement materials. Flexural strength, inter laminar shear strength and impact strength of the prepared LDGE composites were evaluated and compared with conventional High density glass-epoxy (HDGE) composites to understand the changes in these properties due to replacement of S-glass fabrics with LDG layers. To convert LDGE structures to radar absorbing structures controlled quantities of milled carbon fibers were impregnated as these conducting milled carbon fibers can act as dielectric lossy materials which could absorb the incident microwave energy by interfacial polarisation. Electromagnetic properties namely loss tangent and reflection loss of carbon fiber impregnated LDGE composites were evaluated in 8 GHz -12 GHz frequency region and compared with HDGE composites. It was observed that both LDGE and HDGE composites have shown loss tangent values more than 1.1 and minimum 80 per cent absorption of incident microwave energy. Thus the results indicates that, LDGE composites can show EM properties on par with HDGE composites. Furthermore these LDGE composite could successfully withstand the low velocity impacts (4.5 m/s) with 50 J incident energy. Due to their ability to show good mechanical properties and light weight, LDGE composites can be used as a replacement for conventional HDGE composites to realise radar absorbing structures

Efficacy and safety of Tinospora cordifolia (Tc) as an add-on therapy in patients with type-2 diabetes

Background: Type 2 diabetes has become a global epidemic. Tinospora cordifolia is being used in the treatment of type 2 diabetes since ancient times. It is a common misconception that Ayurvedic medicines are always safe. In fact, they also pose serious health risks either in the form of adverse reactions or in the form of drug interactions. Hence this study was undertaken to study the efficacy and safety of Tc on human subjects.Methods: We recruited 40 type 2 diabetic patients who were on oral hypoglycaemic agents. These patients were then randomly divided into two groups, A and B. Patients in group A continued with their anti-diabetic medications while in group B Tc was given at a dose of 500 mg three times daily along with their conventional medications. The fasting and post prandial blood glucose levels, renal function tests and liver function tests were recorded at baseline, 3 months and 6 months.Results: During the course of study we observed a decrease in the fasting and post prandial blood glucose levels of the patients. No significant change was observed in the renal function tests and liver function tests and no other event of any adverse drug reactions were recorded.Conclusion: Tinospora cordifolia (Tc) is effective as an add-on therapy in patients with type-2 diabetes. There is no negative impact of Tc on the renal as well as liver function tests.

Urban-Rural Differences in Atherogenic Dyslipidaemia (URDAD Study): A Retrospective Report on Diabetic and Non-diabetic Subjects of Northern India

Diabetes and urbanization are major contributors to increased risk factors of cardiovascular diseases. Studying whether atherogenic dyslipidaemia increases with urbanization in type 2 diabetes mellitus is, therefore, important. The sample of the present study consisted of 400 subjects. They were categorized according to residential area and diabetes into four groups: urban diabetic group, urban non-diabetic control group (from a metropolitan city Delhi), rural non-diabetic diabetic group, and rural control group (from villages of Khanpur Kalan, Sonepat, Haryana). Differences in lipid levels and risk factors of emerging cardiovascular diseases between groups were evaluated with analysis of variance. Diabetic patients of both urban and rural areas had significantly higher total cholesterol (TC), triglycerides (TG), very low-density lipoproteins (VLDL), TC to high-density lipoprotein cholesterol (TC/HDL) ratio, TG to high\u2011density lipoprotein cholesterol (TG/HDL) ratio, and atherogenic index (AI) compared to respective controls (p&lt;0.05). The HDL concentrations in urban diabetics were significantly lower (p&lt;0.05) than in urban non-diabetic group and rural diabetic group. Comparison between urban and rural diabetic groups showed significantly higher atherogenic dyslipidaemia (AD) in the urban patient-group (p&lt;0.05). We evaluated significant relationships of diabetes and urbanization with AD by multiple regression analysis. Receiver operating curve (ROC) analysis showed high area under curve (AUC) for TG/HDL in urban diabetic group (0.776, p&lt;0.0001) and in rural diabetic group (0.692, p&lt;0.0001). It is concluded that diabetes was associated with higher AD parameters. Urbanization in diabetes is also associated with elevated levels of AD, indicating higher risk in urban population. This study suggests that TG/HDL may be particularly useful as atherogenic risk predictor in newly-diagnosed type 2 diabetic patients

Global nitrogen budgets in cereals: A 50-year assessment for maize, rice, and wheat production systems

Industrially produced N-fertilizer is essential to the production of cereals that supports current and projected human populations. We constructed a top-down global N budget for maize, rice, and wheat for a 50-year period (1961 to 2010). Cereals harvested a total of 1551 Tg of N, of which 48% was supplied through fertilizer-N and 4% came from net soil depletion. An estimated 48% (737 Tg) of crop N, equal to 29, 38, and 25 kg ha−1 yr−1 for maize, rice, and wheat, respectively, is contributed by sources other than fertilizer- or soil-N. Non-symbiotic N2 fixation appears to be the major source of this N, which is 370 Tg or 24% of total N in the crop, corresponding to 13, 22, and 13 kg ha−1 yr−1 for maize, rice, and wheat, respectively. Manure (217 Tg or 14%) and atmospheric deposition (96 Tg or 6%) are the other sources of N. Crop residues and seed contribute marginally. Our scaling-down approach to estimate the contribution of non-symbiotic N2 fixation is robust because it focuses on global quantities of N in sources and sinks that are easier to estimate, in contrast to estimating N losses per se, because losses are highly soil-, climate-, and crop-specific

Socio-economic assessement of farmers' vulnerability as water users subject to global change stressors in the hard rock area of southern India. The SHIVA ANR project

International audienceDemand for vulnerability assessments is growing in policy-making circles, to support the choice of appropriate measures and policies to reduce the vulnerability of water users and resources. Through the SHIVA ANR project, we are seeking a method to assess and map the vulnerability of farmers in southern India to both climate and socioeconomic changes, and secondly, to assess the costs and benefits associated with trends farmers' vulnerability in the medium and long-term. The project is focusing on southern India 's hard rock area, as in the geological context, both surface and ground water resources are naturally limited. We are also focusing on farming populations as these are the main water users in the area and rely exclusively on groundwater. The area covers southern India's semi-arid zone, where the rainfall gradient ranges from 600 mm to 1100 mm. Vulnerability is expected to vary according to local climatic conditions but also the socioeconomic characteristics of farming households. The SHIVA research team has been divided into six thematic groups in order to address the different scientific issues : downscaling the regional climate scenario, farm area projections, vulnerability assessments and quantification, vulnerability mapping, hydrological modelling and upscaling, and vulnerability impact assessements. Our approach is multidisciplinary to cater for for numerous inherent themes, and integrated to cater for vulnerability as a dynamic and multidimensional concept. The project 's first results after 10 months of research are presented below

Rapid assessment of facilitators and barriers related to the acceptance, challenges and community perception of daily regimen for treating tuberculosis in India

Introduction: The Revised National Tuberculosis Control Program (RNTCP) is the largest tuberculosis (TB) control program in the world based on Directly Observed Treatment Short-Course (DOTS) strategy. Globally, most countries have been using a daily regimen and in India a shift towards a daily regimen for TB treatment has already begun. The daily strategy is known to improve program coverage along with compliance. Such strategic shifts have both management and operational implications. We undertook a rapid assessment to understand the facilitators and barriers in adopting the daily regimen for TB treatment in three Indian states. Methods: In-depth interviews were planned across six districts of three purposively selected states of Maharashtra, Bihar and Sikkim, among health system personnel at various levels to identify their perspectives on adoption of a daily regimen for TB. These districts were sampled on the basis of TB notification rates. Thematic analysis of the qualitative data was undertaken. Results: 62 respondents were interviewed from these 6 districts. During the analysis, it was observed that an easily accessible, patient-centred and personalized outreach is an enabling factor for adherence to treatment. Lack of transportation facilities, out-of-pocket expenses and loss of wages for accessing DOTS at institutions are major identified barriers for treatment adherence at individual level. At program level, lack of trained service providers, poor administration of treatment protocols and inadequate supervision by health care providers and program managers are key factors that influence program outcomes. Conclusion: A major observation that emerged from the interviews is that the key to achieve a relapse-free cure is ensuring that a patient receives all doses of the prescribed treatment regimen. However, switching to a daily regimen makes adherence difficult and thus new strategies are needed for its implementation at patient and health provider levels. Most stakeholders appreciate the reasons for switching to a daily regimen. The stakeholders recognised the efforts of the Ministry of Health & Family Welfare (MoHFW) in spearheading the program. Strategies like the 99 DOTS call-centre approach may also further ensure treatment adherence

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Sweeten PAMPs: Role of sugar complexed PAMPs in innate immunity and vaccine biology

Innate sensors play a critical role in the early innate immune responses to invading pathogens through sensing of diverse biochemical signatures also known as pathogen associated molecular patterns (PAMPs). These biochemical signatures primarily consist of a major family of biomolecules such as proteins, lipids, nitrogen bases, and sugar and its complexes, which are distinct from host molecules and exclusively expressed in pathogens and essential to their survival. The family of sensors known as pattern recognition receptors (PRRs) are germ-line encoded, evolutionarily conserved molecules and consist of Toll-like receptors (TLRs), RIG-I-like receptors (RLRs), NOD-like receptors (NLRs), C-type lectin-like receptors (CLRs), and DNA sensors. Sensing of PAMP by PRR initiates the cascade of signaling leading to the activation of transcription factors, such as NF-κB and interferon regulatory factors (IRFs), resulting in a variety of cellular responses, including the production of interferons (IFNs) and pro-inflammatory cytokines. In this review, we discuss sensing of different types of glycosylated PAMPs such as -glucan (a polymeric sugar) or lipopolysaccharides, nucleic acid, and so on (sugar complex PAMPs) by different families of sensors, its role in pathogenesis, and its application in development of potential vaccine and vaccine adjuvants