Role of HbA1c and duration of diabetes in predicting mortality in patients of diabetic ketoacidosis in type II diabetes mellitus

Background: Previous studies have reported the presence of diabetes ketoacidosis in patients of type 2 diabetes mellitus (T2DM). India reported that up to 30% of hospitalized DKA cases result in inpatient death. Aims and objectives of the study was to study the role of HbA1c and duration of diabetes in outcome of patients of diabetic ketoacidosis in type 2 diabetes mellitus.Methods: Hundred T2DM patients having DKA admitted in the Department of Medicine, Gandhi Medical College and Hamidia Hospital, Bhopal, were included. Data on demography (age, sex and diabetes duration, random blood sugar (RBS) and glycated hemoglobin (HbA1c) were recorded for each patients. Outcome was also recorded and compared with duration of diabetes and HbA1c level.Results: DKA was more common in age group of51-55 years (21%) with mean age of 56.10±10.40 years. Male preponderance was observed. Mean duration of diabetes, hemoglobin, random blood sugar (RBS) and HbA1c were 7.28±3.81 years, 9.8±1.42 gm%, 351.72±22.32 mg/dl, and 7.14±0.10 respectively. Mortality was higher among the patients with longer duration of diabetes (23.1%; p=0.012) and higher HbA1c (25%, p>0.05).Conclusions: Duration of diabetes play a significant role in deciding mortality in T2DM patients with DKA however HbA1c has no role in that

Seismic collapse risk assessment and probabilistic sensitivity analysis of braced frames under near-fault earthquakes

2019 Spring.Includes bibliographical references.Special concentrically braced frames (SCBFs) are popular structural systems used in regions with high seismicity. For SCBFs located in regions close to earthquake faults, they may be subject to near-fault ground motions, often characterized by forward directivity pulse with long periods. These near-fault pulses could impose additional seismic demands on structures and increase the risk for structural collapse. Currently, there is limited research on the seismic collapse risk of SCBFs under near-fault earthquakes. To accurately assess the seismic collapse risk of structures under near-fault ground motions, the seismic hazards and the near-fault characteristics and the associated uncertainties need to be properly quantified. To this end, this research investigates the seismic collapse risk of SCBFs under near-fault earthquakes focusing on two typical SCBFs (i.e., SCBF with Chevron bracing and SCBF with Cross bracing). To assess the seismic collapse risk, a general simulation-based risk assessment framework is used. To quantify the large variability and uncertainty associated with the seismic hazard, stochastic ground motion (SGM) model is used where the near-fault pulse characteristics are explicitly incorporated. The uncertainties in the SGM model parameters (including the near-fault pulse characteristics) are addressed through appropriate selection of probability distribution functions (PDFs). To accurately predict the occurrence of collapse, numerical models capable of capturing the nonlinear and collapse behavior are established for the two braced frames and used in nonlinear time history analysis subject to the stochastic ground motion excitations. Stochastic simulation is used to propagate the uncertainties and evaluate the resulting multidimensional risk integral. Probabilistic sensitivity analysis is carried out to investigate the importance of each (or groups of) uncertain model parameters within the SGM including the near-fault pulse characteristics towards the seismic collapse risk of the two braced frames. The results indicate that near-fault ground motions could lead to significant increase in the seismic collapse risk of SCBFs and need to be properly considered when designing such structures

Comparing the degree of pelvic pain with the macroscopic features of endometriosis

Background: Endometriosis is considered as the chronic benign gynecologic disease which can cause chronic pelvic pain (CPP) and infertility. Endometriosis has affected almost 10% of the women of reproductive age.Methods: Thirty women diagnosed with endometriosis were studied. Pain intensity was assessed by visual analogue scale (VAS) and categorized as mild, moderate or severe accordingly. This was followed by laparoscopy/ laparotomy and staging of endometriosis which was done as per the American Society for Reproductive Medicine (ASRM) classification system. Corrective procedures were done simultaneously.Results: Mean age of women with endometriosis was 30±5.75 years. Majority had superficial implants (30%), 6.66% had deep implants and 6.66% had combination of superficial and deep implants. There was no significant difference between implants and severity of pain (p=0.069). There was a significant association between severity of pain with obliteration of POD. Significant association was seen between deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration and severity of pain.Conclusions: Severity of pain was significantly associated with deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration. However, no association was obtained between severities of pain with superficial implants

Evaluating the relationship between serum uric acid levels with Killip classification suggestive of left heart failure in acute myocardial infarction

Background: Present evidence shows that increased uric acid level is a negative prognostic factor in patients with moderate to severe heart failure. A study has highlighted a correlation between serum uric acid levels and Killip class in patients of acute myocardial infarction (AMI). Aim of this study the relationship between serum uric acid level and Killip classification in patients with AMI.Methods: Sixty patients with AMI were studied prospectively in Department of Medicine/ Department of Cardiology, JA Group of Hospitals between 2016-2018. Patients were grouped based on the Killip class. Age, sex, history of smoking, alcohol consumption, hypertension and diabetes were recorded. Serum uric acid level were measured on Day 1, 3 and 5, which was compared with Killip class.Results: Majority of the patients were males (65%) and had age between (28.3%) 51-60 years. No significant association was obtained between any risk factors of AMI and Killip’s class (p>0.05). Serum uric acid levels were significantly higher in Killip grade III (7.80±3.57) as compared to Killip’s grade II (6.64±2.88) and I (6.30±2.33) (p=0.014). Majority of the patients with Killip’s grades I and II, had uric acid level ≤7.0 mg/dl (n=18 and n=9 respectively) (p=0.040). Serum uric acid was equally distributed among different types of killip’s grades between patients who expired and survived. (p>0.05).Conclusions: Serum uric acid levels has been found to be well correlated with Killip classification in patients with AMI. Combination of Killip class and serum uric acid level after AMI is a good predictor of mortality after AMI

Atmospheric Sciences Perspectives on Integrated, Coordinated, Open, Networked (ICON) Science

Abstract: This collaborative article discusses the opportunities and challenges of adopting integrated, coordinated, open, and networked (ICON) principles in atmospheric sciences. From the global nature of the atmosphere, there has always been a need for atmospheric science to be an ICON science. With the help of evolving technology, it is possible to go further in implementing and spreading the ICON principles for productive global collaboration. In particular, technology transfer and applications could be approached with reproducibility in mind, and data‐sharing infrastructure could enable easier and better international collaboration. There are, however, various challenges in following the ICON principles in the acquisition, quality control, and maintenance of data, and the publication of results in a systematic way. Moreover, the extent of such issues varies geographically and hence poses different challenges to implementing ICON principles. In this commentary article, we briefly state our perspectives on the state of ICON, challenges we have met, and future opportunities. Furthermore, we describe how atmospheric science researchers have benefited from these collaborative multi‐dimensional approaches that fulfill the core goal of ICON

HTAP3 fires: towards a multi-model, multi-pollutant study of fire impacts

Open biomass burning has major impacts globally and regionally on atmospheric composition. Fire emissions include particulate matter, tropospheric ozone precursors, greenhouse gases, as well as persistent organic pollutants, mercury and other metals. Fire frequency, intensity, duration, and location are changing as the climate warms, and modelling these fires and their impacts is becoming more and more critical to inform climate adaptation and mitigation, as well as land management. Indeed, the air pollution from fires can reverse the progress made by emission controls on industry and transportation. At the same time, nearly all aspects of fire modelling – such as emissions, plume injection height, long-range transport, and plume chemistry – are highly uncertain. This paper outlines a multi-model, multi-pollutant, multi-regional study to improve the understanding of the uncertainties and variability in fire atmospheric science, models, and fires’ impacts, in addition to providing quantitative estimates of the air pollution and radiative impacts of biomass burning. Coordinated under the auspices of the Task Force on Hemispheric Transport of Air Pollution, the international atmospheric modelling and fire science communities are working towards the common goal of improving global fire modelling and using this multi-model experiment to provide estimates of fire pollution for impact studies. This paper outlines the research needs, opportunities, and options for the fire-focused multi-model experiments and provides guidance for these modelling experiments, outputs, and analysis that are to be pursued over the next 3 to 5 years. It proposes a plan for delivering specific products at key points over this period to meet important milestones relevant to science and policy audiences

Rats with Postinfarction Heart Failure: Effects of Propranolol Therapy on Intracellular Calcium Regulation and Left Ventricular Function

Patients with heart failure may live longer if they receive chronic treatment with beta-adrenergic blocking medications. Unresolved are the mechanisms underlying the beneficial effects and if they may be applied to ischemic heart failure. Rats (n = 28) underwent echocardiographic-Doppler exams one and six weeks following a simulated operation or myocardial infarction (MI). After the first echocardiography, rats were randomized to either no therapy or 500 mg/l of propranolol in their drinking water. The noninfected left ventricular (LV) papillary muscles were used to record isometric contractions and intracellular Ca transients simultaneously.Untreated MI rats had a restrictive LV diastolic filling pattern, decreased systolic function (13% ± 2%), and significant LV dilatation (10.6 ± 0.4 mm vs. 8.9 ± 0.3 mm, MI vs. control). The LV chamber diameters of the propranolol-treated MI rats were 10.6 ± 0.5 mm, and systolic performance (13% ± 2%). Higher LV end-diastolic pressures (27 ± 2 mmHg vs. 20 ± 3 mmHg) and a more constrained LV diastolic filling pattern (increased ratio of early to late filling velocities and faster E wave deceleration rate) were seen in the propranolol-treated animals. Papillary muscle contractility in untreated MI rats was lower (1.6 ± 0.3 g mm²). Furthermore, the inotropic response to isoproterenol was attenuated, and Ca transients were extended. During isoproterenol stimulation, beta-adrenergic blocking administration had no effect on force development (1.6 ± 0.3 g mm²) or the length of Ca transients.Rats with postinfarction heart failure receiving chronic propranolol treatment did not have improvements in systolic function or LV remodeling. Propranolol exacerbated LV diastolic pressures and filling patterns. Additionally, there was no discernible improvement in intracellular contractility following treatment, Calcium control, or beta-adrenergic sensitivity in the myocardium that is not infarcted)

Air pollution and climate change impact on forest ecosystems in Asian region – a review

Forests are complex ecosystems comprising various trophic levels responsible for carrying out various biogeochemical processes and providing ecosystem services. However, forests in Asia are doubly challenged by climate change and air pollution. The rapidly changing air quality, with increasing concentration of greenhouse gases (GHGs), trace gases, volatile organic compounds (VOCs), and ozone (O3) also causes global warming leading to climate change, thus jointly creating a challenging condition for the forest ecosystem. The impact on forest ecosystems of the two anthropogenic stressors, viz., climate change and air pollution, requires global attention. These two stressors have been widely studied separately but their combined impact on the forest ecosystem has not been studied extensively, particularly in the Asian region. In this review article, we attempt to explore the importance of interlinking air pollution and climate change impact on Asian forests, by studying the decline of different forest types as a background and markers of forest ecosystem degradation. Our main aim is to understand and summarise the past and ongoing research in this area and to facilitate researchers and policymakers to upgrade their research, policies, and management strategies in the area of integration of air pollution and climate change impact on forest ecosystems in the Asian region

Design of Dugout Type Farm Pond at the Farm of Chhattisgarh Engineering College, Durg Chhattisgarh

To increase food security in a drought-prone area, the water harvesting, capture and storage of rainwater are technologies proven for uses during dry periods. Erosion control and groundwater revive are extra favorable circumstances of water harvesting techniques that contribute to agricultural development and resource conservation. The contour map of the study area is used to select the location for the creation of the farm pond. Clay loam is found in soil texture analysis. For clay loam soil, the study area with a depth of 3.5 m and a side slope of 1.5:1 may be suitable. The available rainfall was computed for 75% probability by using empirical formula is found to 1.41483 ha-m. The tube well draft was calculated to be 0.8640 ha-m. The capacity of the designed farm pond is 0.6639 ha-m. The proposed pond facilitated total supplemental irrigation of 8.5 cm depth to an area of 6.5 ha paddy