Hepatitis B Virus: Inactive carriers

Inactive carriers forms the largest group in chronic HBV infected patients. Around 300 million people are inactive carriers The inactive HBsAg carrier state is diagnosed by absence of HBeAg and presence of anti-HBe, undetectable or low levels of HBV DNA in PCR-based assays, repeatedly normal ALT levels, and minimal or no necroinflammation, slight fibrosis, or even normal histology on biopsy. Inactive cirrhosis may be present in patients who had active liver disease during the replicative phase of infection. The prognosis of the inactive HBsAg carrier state is usually benign. Long-term follow- up (up to 18 years) of these carriers has indicated that the vast majority show sustained biochemical remission and very low risk of cirrhosis or hepatocellular carcinoma (HCC). Rarely, patients, even noncirrhotics, may develop liver cancer during the inactive HBsAg carrier state. In addition, approximately 20 to 30% of persons in the inactive HBsAg carrier state may undergo spontaneous reactivation of hepatitis B during follow-up. Multiple episodes of reactivation or sustained reactivation can cause progressive hepatic damage and even hepatic decompensation. Introductio

A REVIEW ON THE PREVALENCE OF HYPERTENSION IN SIDE-LINED POPULATIONS; SLUM DWELLERS, SHIFT JOB WORKERS AND OCCUPATIONAL NOISE AFFECTED WORKERS: ATTRIBUTABLE TO LIFESTYLE AND ENVIRONMENTAL FACTOR

Hypertension is a condition that is characterized by the persistent raised blood pressure. It is not seen as a disease rather as a major risk factor that is solely responsible for different types of cardiovascular diseases such as heart failure, ischemic heart disease, and left ventricular hypertrophy. Although this condition cannot be cured, hypertension can be managed and prevented by adopting a healthy lifestyle that encompasses factors such as diet, physical exercise, reduced alcohol consumption, moderate sodium and potassium intake, and psychological factors. Apart from these, environmental factor like noise has also proved to be associated with the high blood pressure. Different prevalence studies have been conducted to find out the relationship between high blood pressure and different lifestyle factors. This article aims to review and emphasize the prevalence of high blood pressure in slum dwellers and at-risk workers who are shift job workers and occupational noise affected workers. Different research articles pertaining to different authors and countries have been reviewed to portray the concern of this condition. There is the need for proper recognition to these folks of people who are exposed to the precarious and high-risk style of living in the slum dwellers, shift job workers, and occupational noise affected workers. The distress in the physiological functioning of the body leading to hypertension has been found in the slum dwellers and at-risk workers; shift job workers and occupational noise affected workers that are again attributable to aforementioned lifestyle and environmental factor. The proper management of hypertension is extremely required to safeguard these unacknowledged groups of people

Antibiotics-related adverse drug reactions at a tertiary care hospital in North India

Background: Antibiotics are considered to be commonly used drugs in hospital setting due to higher prevalence of infectious diseases especially in India. So, the present study was conducted to assess the incidence of adverse drug reactions (ADRs) due to antibiotics and analyze for causality of adverse drug events reported.Methods: The present retrospective and observational, study was conducted in BPS GMC for women, Khanpur Kalan, Sonepat, Haryana which is a 500 bedded government medical hospital situated in rural area between March 2016 to February 2019 (i.e., 3 years). Patients of either sex or age who developed ADRs by any route were included in the study.Results: 300 (38.65%) cases were reported due to antibiotics out of total 776 ADR cases. 3% cases were serious. Adults (65%) were found to be most commonly affected by ADRs. Among antibiotics, cephalosporins and penicillins (15.98%) were the major culprit to cause adverse events followed by nitroimidazoles (15.2%) and antitubercular drugs and fluoro quinolones (13.16%). The most affected organ system was skin (49.33%) followed by the gastrointestinal system (33%). As per WHO scale of causality assessment, 33.33% and 67.67% reported cases were found to probably and possibly related to adverse events respectively.Conclusions: Antibiotics are most commonly prescribed drugs so its monitoring regarding ADRs may benefit the clinicians in early identification and management of ADRs so that quality of life of patient can be safeguarded at an earliest

Introduction to Plasma Based Propulsion System: Hall Thrusters

Technically, there are two types of propulsion systems namely chemical and electric depending on the sources of the fuel. Electrostatic thrusters are used for launching small satellites in low earth orbit which are capable to provide thrust for long time intervals. These thrusters consume less fuel compared to chemical propulsion systems. Therefore for the cost reduction interests, space scientists are interested to develop thrusters based on electric propulsion technology. This chapter is intended to serve as a general overview of the technology of electric propulsion (EP) and its applications. Plasma based electric propulsion technology used for space missions with regard to the spacecraft station keeping, rephrasing and orbit topping applications. Typical thrusters have a lifespan of 10,000 h and produce thrust of 0.1–1 N. These devices have E→×B→ configurations which is used to confine electrons, increasing the electron residence time and allowing more ionization in the channel. Almost 2500 satellites have been launched into orbit till 2020. For example, the ESA SMART-1 mission (Small Mission for Advanced Research in Technology) used a Hall thruster to escape Earth orbit and reach the moon with a small satellite that weighed 367 kg. These satellites carrying small Hall thrusters for orbital corrections in space as thrust is needed to compensate for various ambient forces including atmospheric drag and radiation pressure. The chapter outlines the electric propulsion thruster systems and technologies and their shortcomings. Moreover, the current status of potential research to improve the electric propulsion systems for small satellite has been discussed

Influence of Altitude on Pulmonary Function

Variation in lung function at high altitude (HA) impacts the working capacity of individuals and may predispose body towards hypoxia induced illness. So, we investigated the changes in pulmonary function of healthy human male volunteers belonging to two different ethnicities i.e. Indian and Kyrgyz. Twenty, age and BMI matched, volunteers (Indian=10 and Kyrgyz=10) were recruited for the study. Measurement for pulmonary functions (FVC, FEV1, FEV1/FVC ratio, PEF, FEF 25-75%, MEF 25%, MEF 50%, MEF 75%, MVV) were performed on each individual at basal (800 m) and high altitude (4,111 m) on day 3,7,14 and 21. Results indicate that Kyrgyz has comparatively higher FVC, FEV1, PEF and MVV values and lower FEV1/FVC ratio upon altitude induction than those of Indian counterparts. Mid expiratory flow FEF25-75% was significantly increased in Kyrgyz upon altitude induction indicate more proficient lung emptying while only moderate increase at day 7 in Indian. MEF25% was significantly increased in Kyrgyz, while no change is observed in Indians at high altitude which indicates that 75% of lung emptying through small airways is better in Kyrgyz. MEF 50% and MEF 75% increased with altitude in both groups. For MVV, the maximum increase was ~17% in Indian at HA14 (p<0.01) and in Kyrgyz ~33% (p<0.001) at HA14 as compared to basal. Difference in lung function response observed, indicates that Kyrgyz has better pulmonary dynamics during altitude exposure as compared to Indian counterparts. The varied result observed may be due to different ethnic origin of the groups

Protocol for magnetic resonance imaging acquisition, quality assurance, and quality check for the Accelerator program for Discovery in Brain disorders using Stem cells

Objective: The Accelerator program for Discovery in Brain disorders using Stem cells (ADBS) is a longitudinal study on five cohorts of patients with major psychiatric disorders from genetically high-risk families, their unaffected first-degree relatives, and healthy subjects. We describe the ADBS protocols for acquisition, quality assurance (QA), and quality check (QC) for multimodal magnetic resonance brain imaging studies. Methods: We describe the acquisition and QC protocols for structural, functional, and diffusion images. For QA, we acquire proton density and functional images on phantoms, along with repeated scans on human volunteer. We describe the analysis of phantom data and test–retest reliability of volumetric and diffusion measures. Results: Analysis of acquired phantom data shows linearity of proton density signal with increasing proton fraction, and an overall stability of various spatial and temporal QA measures. Examination of dice coefficient and statistical analyses of coefficient of variation in test–retest data on the human volunteer showed consistency of volumetric and diffusivity measures at whole-brain, regional, and voxel-level. Conclusion: The described acquisition and QA–QC procedures can yield consistent and reliable quantitative measures. It is expected that this longitudinal neuroimaging dataset will, upon its release, serve the scientific community well and pave the way for interesting discoveries

RAPID DETECTION OF MULTI DRUG RESISTANCE AMONG MULTI DRUG RESISTANT TUBERCULOSIS SUSPECTS USING LINE PROBE ASSAY

Objective: GenoType MTBDRplus line probe assay (LPA) is developed for performing drug susceptibility testing (DST) for Rifampicin (RIF) and isoniazid in sputum specimens from smear-positive pulmonary tuberculosis (TB) patients and revised national TB control Programme (RNTCP) has endorsed LPA for the diagnosis of multi drug resistant TB (MDR-TB). This study was conducted to assess the potential utility of LPA for MDR-TB patient management.Methods: MDR-TB suspects under RNTCP PMDT criteria C referred from different districts in Delhi state were included in the study January 2013 toDecember 2014. Sputum specimens found acid-fast bacilli positive by fluorescent microscopy were processed for LPA.Results: Out of 3062 specimens, 2055 (67.1%) MDR-TB suspects were read as positive and specimens from 1007 (32.9%) suspects were read as negative in sputum smear microscopy. Out of 2019 specimens valid LPA results, 1427 were found to be pan-sensitive, 280 were MDR-TB, 40 were RIF monoresistant, 183 were Isoniazid (INH) monoresistant, and 89 specimens were found negative for Mycobacterium tuberculosis.Conclusion: Routine use of LPA can substantially reduce the time to diagnosis of RIF and/or INH-resistant TB and can hence potentially enable earlier commencement of appropriate drug therapy and thereby facilitate prevention of further transmission of drug resistant strains.Keywords: Multi drug resistant tuberculosis, Line probe assay, Rifampicin, Isoniazid

Utility of Serum Neopterin and Serum IL-2 Receptor Levels to Predict Absolute CD4 T Lymphocyte Count in HIV Infected Cases

A prospective study was carried out to evaluate the efficacy of serum neopterin and soluble IL-2 receptor (sIL-2R) concentrations in comparison to CD4 count to study the progression of HIV disease and monitor response to ART in HIV cases. One hundred newly diagnosed HIV seropositive subjects were recruited. CD4 counts were determined by FACS system. Serum neopterin and sIL-2R levels were measured using enzyme immunoassay. In our study, levels of neopterin and sIL-2R were significantly higher in subjects with CD4 <200 cells/μL (with S. neopterin levels of >25.1 nmol/L and sIL-2R levels of >47.1 pM as cutoff values for CD4 <200 cells/μL) compared to those in subjects with CD4 >200 cells/μL at baseline which indicate that these markers can be utilized for initiation of ART in HIV cases. The levels of these markers decreased significantly after initiation of ART. In patients with CD4 >200 cells/μL, these markers are helpful in predicting disease progression

Studies of Terahertz Sources and Their Applications

The contributed chapter discuss the applications of terahertz radiations and its generation mechanism through laser plasma interactions. The methods of generation of terahertz radiations from plasma wake field acceleration, higher harmonic generation and the laser beat wave plasma frequency are reviewed. The nonlinear current density oscillate the plasma at beat wave frequency under the effect of ponderomotive force and excite the terahertz radiation at beat wave frequency. The current state of the arts of the methods of generation has been incorporated. The mathematical expression of ponderomotive force has been derived under the influence of gradient of laser fields. In additions, the future challenge and their overcomes are also been discussed