Efficacy of topical recombinant epidermal growth factor as compared to Povidone Iodine on chronic diabeic foot ulcers

Background: Diabetic foot ulcer is a common surgical complication in patient of diabetes mellitus. It is the most frequent reason for hospitalization for patients with diabetes. Still the ideal material for dressing is not known.  This study has been conducted to compare the efficacy of topical application of Povidone- Iodine with recombinant epidermal growth factor in  chronic diabetic foot ulcers of size 5 to 10 cm2. Methods: Diabetic foot ulcers which were non-healing for more than 3 months were  randomized into two groups of 30 each. Clinical examination of the ulcer and limb was  done. Ischemic ulcers, ulcers with gangrene or associated osteomyelitis were excluded. One group  had received Povidone iodine  (Betadine 10% solution) soaked dressing while other group was dressed with  Recombinant Epidermal Growth Factor gel (Eugraf 150 mcg gel) dressing  twice weekly for 12 weeks. At the end of twelve weeks ulcers were assessed for healing. Results:There were total 60 cases from Jan 2014 till Dec 2014. Age range from 45 to 70 yrs (mean age 55 yrs). There were 45 males and 15 females (M: F:  3:1).  The ulcers were developed  most commonly in foot in 48 patients ( 80%) followed by  in lower leg around ankle in 06 patients ( 10%)  and in 10 % of cases involved foot and leg both.  Six (20%) patients on Povidone- Iodine dressing group showed complete wound healing while 23 (76%) patients on recombinant epidermal growth factor dressing group showed complete wound healing. Dressing with recombinant epidermal growth factor is the more effective than Povidone iodine dressing (P<. 001). Average healing time for complete healing for completely healed ulcers was 11 weeks in  Povidone-Iodine Dressing and 8 weeks in Recombinant epidermal growth factor  dressing group. Conclusion: Recombinant epidermal growth factor dressing is the significantly effective dressing in comparison to Povidone-Iodine in diabetic foot  non healing ulcers of size 5 to 10 cm in size. Average time of complete healing of diabetic foot  non healing ulcers is less with topical application of Recombinant epidermal growth factor  soaked dressing as compared to Povidone – Iodine dressings

Evidence of robust 2D transport and Efros-Shklovskii variable range hopping in disordered topological insulator (Bi2Se3) nanowires

We report the experimental observation of variable range hopping conduction in focused-ion-beam (FIB) fabricated ultra-narrow nanowires of topological insulator (Bi2Se3). The value of the exponent in the hopping equation was extracted as ~ 1/2 for different widths of nanowires, which is the proof of the presence of Efros-Shklovskii hopping transport mechanism in a strongly disordered system. High localization lengths (0.5nm, 20nm) were calculated for the devices. A careful analysis of the temperature dependent fluctuations present in the magnetoresistance curves, using the standard Universal Conductance Fluctuation theory, indicates the presence of 2D topological surface states. Also, the surface state contribution to the conductance was found very close to one conductance quantum. We believe that our experimental findings shed light on the understanding of quantum transport in disordered topological insulator based nanostructures.Comment: 14pages, 4 figure

NMR elucidation of early folding hierarchy in HIV-1 protease

Folding studies on proteases by the conventional hydrogen exchange experiments are severely hampered because of interference from the autolytic reaction in the interpretation of the exchange data. We report here NMR identification of the hierarchy of early conformational transitions (folding propensities) in HIV-1 protease by systematic monitoring of the changes in the state of the protein as it is subjected to different degrees of denaturation by guanidine hydrochloride. Secondary chemical shifts, HN-Hα coupling constants, 1H-15N nuclear Overhauser effects, and 15N transverse relaxation parameters have been used to report on the residual structural propensities, motional restrictions, conformational transitions, etc., and the data suggest that even under the strongest denaturing conditions (6 m guanidine) hydrophobic clusters as well as different native and non-native secondary structural elements are transiently formed. These constitute the folding nuclei, which include residues spanning the active site, the hinge region, and the dimerization domain. Interestingly, the proline residues influence the structural propensities, and the small amino acids, Gly and Ala, enhance the flexibility of the protein. On reducing the denaturing conditions, partially folded forms appear. The residues showing high folding propensities are contiguous along the sequence at many locations or are in close proximity on the native protein structure, suggesting a certain degree of local cooperativity in the conformational transitions. The dimerization domain, the flaps, and their hinges seem to exhibit the highest folding propensities. The data suggest that even the early folding events may involve many states near the surface of the folding funnel

Septic complications in perforation peritonitis: microflora and search for therapia sterilisans Magna

Objective: This study was conducted to determine the etiology, anatomical site of perforation and the suitable empirical antibiotic in our region which decreases the bacterial load effectively and to decrease the morbidity associated with infectious complications in patients with peritonitis secondary to gut perforation. Methods: This study was a prospective study conducted for a period of one year. Patients who were fulfilled the inclusion criteria with peritonitis due to gut perforations and operated in our institute were included in this study. Data regarding patient demography, associated co-morbidities and relevant history were recorded. Duration of hospitalization, wound infection, wound dehiscence, anastomotic leak, re do surgeries and number of patients died after surgery were documented. Antimicrobial susceptibility testing was done by Kirby-Bauer disk diffusion method. Antibiotics were changed as per clinical progress of the patient and as per culture and sensitivity report. Results: Perforations were mostly ileal (38%) followed by duodenal (29%).Common etiology being peptic ulcer disease (38.7%) and typhoid fever (22.5%). Peptic ulcer perforations were managed by Graham patch omentopexy in 24 (38.6 %) cases, small bowel perforations by only stoma in 18 (29 %), primary repair 6 (9.6 %) cases and resection and anastomosis done in 8 (12.9%) who presented with multiple small bowel perforation. Appendicectomy was done in 6 (9.6%) cases.Sensitivity to Cefaperazone was about 66 % in E. Coli isolates while 75% for Ceftazidime while for Klebsiella 60% and 80% resperctively. Meropenam was sensitive in all the isolates of Staphyloccus, Streptococcus, Pseudomonas and Proteus while cefaperazone was sensitive only in 50 % of the cases. Piperacillin + Tazobactum were sensitive in all the isolates of Stryptococcus, Pseudomonas and Proteus. The sensitivity of Amoxicillin+ Clavulinic acid, Ceftriaxone, Aminoglycosides and Fluoroquinolones were very low. Conclusion: Most common organisms cultured from peritoneal fluid were E. coli and Klebsiella. Piperacillin + Tazobactum and Carbepenam were sensitive in most of the isolates and might be started in patients with perforation peritonitis as a empirical antibiotic therap

Extrinsic Pseudocapacitive NiSe/rGO/g-C3N4 Nanocomposite for High-Performance Hybrid Supercapacitors

Battery-type materials with ultrahigh energy density show great potential for hybrid supercapacitors (HSCs). In this work, we have developed a nickel selenide (NiSe)/reduced graphene oxide (rGO)/graphitic carbon nitride (g-C3N4) ternary composite as a promising positive electrode for hybrid supercapacitors (HSCs). The extended π-conjugated planar layers of g-C3N4 promote strong interconnectivity with rGO, which further enhances surface area, surface free energy, and efficient electron/ionic path. Additionally, it establishes clear ion diffusion pathways, serving as ion reservoirs during charge and discharge and facilitating efficient redox reactions. As a result, the NiSe/g-C3N4/rGO nanocomposite electrode displayed a specific capacity of 412.6 mA h g-1 at 1 A g-1. Later, the HSC device was assembled using the nanocomposite as the positive electrode and activated carbon as the negative electrode, which delivered an energy density of 65.2 Wh kg-1 at a power density of 750 W kg-1. Notably, the HSC device maintained excellent cyclic stability, preserving 93.3% of its initial performance and Coulombic efficiency of 86.6% for 10,000 charge-discharge cycles at 5 A g-1. These findings underscore the potential utility of NiSe/g-C3N4/rGO as a versatile and effective electrode material for the strategic development of HSC devices.</p

Interface Engineering of Nickel Selenide and Graphene Nanocomposite for Hybrid Supercapacitor

Nickel selenide is an emerging electrode material for high‐performance hybrid supercapacitors; however, poor electrical conductivity and sluggish ion kinetics limit its application. Herein, a unique architecture by decorating NiSe nanoparticles on reduced graphene oxides (rGO) is developed. The synergistic effect of NiSe and rGO facilitated by the optimized addition of rGO results in significant improvement in the electrochemical performance. The physicochemical characterizations suggest that the enhancement can be attributed to increased interfacial interaction and access to the electrochemically active sites. The NiSe/rGO hybrid delivers a specific capacity of 351 mAh g−1 at 1 A g−1, which is significantly higher than that for bare NiSe. Later, the hybrid supercapacitor based on NiSe/rGO hybrid as positive and activated carbon as negative electrode delivers a maximum energy density of 49.6 Wh kg−1 at a power density of 748.37 W kg−1. In addition, the device shows good cyclic stability of 83.3% over 5000 cycles. Thus, an innovative approach to the development of high‐performance hybrid supercapacitors is offered

Effect of Oleylamine on the Surface Chemistry, Morphology, Electronic Structure, and Magnetic Properties of Cobalt Ferrite Nanoparticles

The influence of oleylamine (OLA) concentration on the crystallography, morphology, surface chemistry, chemical bonding, and magnetic properties of solvothermal synthesized CoFe2O4 (CFO) nanoparticles (NPs) has been thoroughly investigated. Varying OLA concentration (0.01–0.1 M) resulted in the formation of cubic spinel-structured CoFe2O4 NPs in the size-range of 20–14 (±1) nm. The Fourier transform spectroscopic analyses performed confirmed the OLA binding to the CFO NPs. The thermogravimetric measurements revealed monolayer and multilayer coating of OLA on CFO NPs, which were further supported by the small-angle X-ray scattering measurements. The magnetic measurements indicated that the maximum saturation (MS) and remanent (Mr) magnetization decreased with increasing OLA concentration. The ratio of maximum dipolar field (Hdip), coercivity (HC), and exchanged bias field (Hex) (at 10 K) to the average crystallite size (Dxrd), i.e., (Hdip/Dxrd), (HC/Dxrd), and (Hex/Dxrd), increased linearly with OLA concentration, indicating that OLA concurrently controls the particle size and interparticle interaction among the CFO NPs. The results and analyses demonstrate that the OLA-mediated synthesis allowed for modification of the structural and magnetic properties of CFO NPs, which could readily find potential application in electronics and biomedicine

Ultrasonography of the neck in patients with obstructive sleep apnea

IntroductionIn resource-limited settings, obstructive sleep apnea (OSA) often goes undiagnosed as polysomnography (PSG) is expensive, time-consuming, and not readily available. Imaging studies of upper airway have been tried as alternatives to PSG to screen for OSA. However, racial differences in upper airway anatomy preclude generalizability of such studies. We sought to test the hypothesis that ultrasonography (USG), an inexpensive, readily available tool to study soft tissue structures of the upper airway, would have predictive value for OSA in South Asian people.MethodsAdult patients with sleep-related complaints suspicious for OSA were taken for overnight PSG. After the PSG, consecutive patients with and without&nbsp;OSA were studied with submental ultrasonography to measure tongue base thickness (TBT) and lateral pharyngeal wall thickness (LPWT).ResultsAmong 50 patients with OSA and 25 controls, mean age was 43.9&nbsp;± 11.4 years, and 39 were men.&nbsp;Patients with OSA had higher TBT (6.77 ± 0.63&nbsp;cm vs 6.34 ± 0.54&nbsp;cm, P value = 0.004) and higher LPWT (2.47 ± 0.60&nbsp;cm vs 2.12 ± 0.26&nbsp;cm, P value = 0.006) compared to patients without OSA. On multivariate analysis, TBT, LPWT, and neck circumference were identified as independent factors associated with OSA. These variables could identify patients with severe OSA with a sensitivity of 72% and a specificity of 76%.ConclusionPatients with OSA have higher tongue base thickness and lateral pharyngeal wall thickness proportionate to the severity of the disease, independent of BMI and neck circumference. These findings suggest that sub-mental ultrasonography may be useful to identify patients with severe OSA in resource-limited settings

Unusual magnetic ordering transitions in nanoscale biphasic LuFeO 3 : the role of the ortho–hexa phase ratio and the local structure

Understanding nanoscale ferromagnetism is becoming increasingly important in view of our enhanced ability to control growth and morphological features of complex nano-systems and their potential translation into emergent high density magnetic device technologies. In this work, we have examined the combined consequences of the magneto-crystalline anisotropy, shape anisotropy, intrinsic phase coexistence, and surface induced self-strain and related anisotropy on the magnetism and magnetic transitions in the case of nanoparticles (NPs) and nanofibers (NFs) of the intriguing multiferroic LuFeO3. We find that the two systems exhibit remarkable differences in the magnetic transitions as well as the value of the canted antiferromagnetic moment by virtue of significant differences in the relative hexagonal (h) and orthorhombic (o) phase contents with the h : o phase contribution in NPs (NFs) being 25 : 75 (77 : 23). In the case of NFs with a major hexagonal component, the bifurcation of ZFC and FC magnetization curves is seen to occur above room temperature with a transition seen at about 150 K, a feature reflecting in-plane (a and b) antiferromagnetic order. In the case of NPs with a dominant o-phase, a weak ferromagnetic (canted antiferromagnetic) signal is noted from 300 K (maximum measurement temperature) down to about 274 K, at which point the antiferromagnetic susceptibility feature is seen. Below 223 K a reentrant ferromagnetic order is seen down to 153 K, at which point a bifurcation is noted between FC and ZFC curves. After subtracting the major component of the field dependent linear moment, the weak ferromagnetic (canted) moment at 300 K is almost 2 orders higher in the case of NFs than NPs. A detailed analysis of phase constitution, local structure and lattice-distortions is performed using X-ray diffraction, Raman spectroscopy, and synchrotron-based X-ray absorption near edge structure (XANES) spectroscopy. The potential significance of the interfaces in influencing the canting via gradient spin order distribution is emphasized