Carotid artery intima media thickness in relation with atherosclerotic risk factors in patients with newly diagnosed type 2 diabetes mellitus in a rural tertiary care hospital in central India

Background: Vascular complications of atherosclerosis are major causes of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). The aim of the study was to study the correlation between carotid artery intima media thickness (CIMT) and risk factors for atherosclerosis and atherosclerotic vascular events in newly diagnosed type 2 diabetes mellitus patients with an objective to determine the predictive value of CIMT as an indicator of early atherosclerosis.Methods: The predictive value of CIMT as well as various atherosclerotic risk factors including ankle brachial index (ABI) were determined as an indicator of early atherosclerosis. Data were presented in form of percentage and proportions. Qualitative variables were tested using Chi square test and the p values were calculated between the groups having CIMT less than and more than 0.9 mm. p values of ≤0.05 were considered statistically significant. Averages were expressed between groups as mean ±standard deviation or as percentage. Multivariate analysis was done using the multiple linear regression model.Results: The study showed that though age, smoking and dyslipidemia did not show any association with CIMT; hypertension, ABI, glycosylated hemoglobin and urine albumin excretion rate had positive correlation with CIMT with statistically significant association between ABI and CIMT.Conclusions: Assessment of CIMT by B mode ultrasound is a relatively inexpensive means of measuring subclinical atherosclerosis. Present study showed that CIMT is significantly higher in those type 2 diabetic patients who had atherosclerotic events than in those type 2 diabetic patients who had only risk factors for atherosclerosis

Research Support Services: An Analysis of top Science and Technology Institutions

Purpose – This research article aims to find out the different types of research support services provided by the top fifty libraries listed under science and technology institutions category in the QS ranking 2022. The analysis results will provide an in-depth view of the research support services offered by these institutions and will be helpful to libraries everywhere in designing their research support service. Design/methodology/approach – The top 50 institutions listed in the 2022 QS World University Rankings in the category of science and technology were taken. Out of them, 44 libraries were selected on the basis of research support services provided by them. The available research support services were investigated using the website analysis of these institutions. The data so obtained are filtered, categorised, analysed and visualised to get results. Findings – With regard to research and data-intensive research, research support service has emerged as one of the most important services offered by academic institutions in the sciences and technologies category. Research data management (39, 88.63%), research guides (40, 90.90%), research consultation (42, 95.45%), research tools recommendation (36, 81.81%), scholarly publishing/communication (39, 88.63%), open access (37, 84.09%) and training and workshop (36, 81.81%) are the most common types of research support services. The leading three countries are the USA (29.54 per cent), the UK (11.36 per cent) and Australia (9.09 per cent). Most of the institutions under the QS top 50 ranking are from the USA. Originality/value – This report conducts a thorough study of research support services offered by academic libraries at world-class science and technology institutions. The results will aid science and technology academic libraries in enhancing their research support services, which will, in turn, aid researchers in their efforts and advance scientific discovery. Also, the article will assist other institutions in planning their research support services

Indian common krait envenomation presenting as fulminant myocarditis and coma: a case report

Fulminant myocarditis is an unusual manifestation of cardiotoxicity with severe elapid snake envenoming and is meagrely reported with snake bite due to Indian common krait. We report a 12-year-old boy who was admitted in complete locked-in state and hemodynamic instability after severe neurotoxic snake envenoming by Bungarus caeruleus (Indian common krait). His hospital course was complicated with recurrent episodes of sustained ventricular tachycardia requiring defibrillation; and cardiogenic shock requiring inotropes, vasopressors and intraaortic balloon counterpulsation. Severe heart failure features secondary to fulminant toxic myocarditis persisted even after full neurological recovery requiring prolonged standard medical heart failure therapy. Patient subsequently achieved full clinical recovery and regained normal left ventricular systolic function. We also reviewed the literature on cardiac manifestations, possible mechanisms and treatment of patients with cardiotoxicity due to elapid snake bites. The importance of anticipating severe cardiovascular complications is highlighted to help formulate appropriate therapeutic strategy

Pancreatoblastoma with multiple peritoneal metastases: a rare entity with atypical presentation and review of literature

Pancreatoblastoma is a rare primary pancreatic neoplasm that predominantly effects young children and characterized by unique clinical features. Its biological behavior is aggressive with frequent local invasion and metastases. Only hundred cases have been reported in medical literature and its radiological features have been infrequently studied. We report the sonographic, contrast enhanced computed tomography findings of pancreatoblastoma in a 3 year old boy

Fabrication of superhydrophobic surfaces by laser surface texturing and autoxidation

The creation of superhydrophobic surfaces (SHS) has received exceptional thought from the entire research community due to its notable application in varied fields such as anti-icing, self-cleaning, drag reduction, anti-bacterial, and oil-water separation. The super­hy­drophobic (SH) conditions for a surface can be attained through the consolidation of a low surface energy surface with appropriate micro/nano-surface roughness through texturing. Motivated by the SH nature of lotus leaf and petal effect, microstructures have been prepared in this work on a metal surface by a fiber laser marking machine at 35 W. The textured surfaces with a different pitch to diameter (p/d) ratio (2.0-0.70) have been turned into hydrophobic and finally SH, after storing in an ambient environment for a few days due to oxide layer deposition on the textured surface. In this study, the maximum contact angle achieved by textured geometry after 30 days of auto-oxidation was 158.6 o. Further, test results showed that the fabricated surfaces have a high potential to maintain their SH nature even after the harsh condition of applications

Tropical endomyocardial fibrosis: an overview

Tropical endomyocardial fibrosis is the commonest form of endemic restrictive cardiomyopathy that affects mainly children and adolescents, and is geographically restricted to some poor areas in the tropical and subtropical regions of the world such as Africa, Latin America and Asia including southern districts of India especially in the coastal belt of Kerala state. Sub-endocardial fibrosis affecting the apices and the inflow tracts of the right or left ventricle, or both; and varying degree of atrioventricular valve regurgitation defines the disease. Chronic systemic venous hypertension and severe pulmonary hypertension are characteristic features of right ventricular and Left ventricular endomyocardial fibrosis respectively. Due to lack of resources for research in the disease endemic areas, the exact epidemiology, etiology and pathogenesis remain unknown, and the natural history is incompletely understood. Various infections and toxic factors were postulated regarding its etiology. During the last few years, incidence of the disease has decreased considerably because of the significant improvement in the living standards of the people with the corresponding decline in the childhood malnutrition, infections, worm infestations and associated eosinophilia. It is a condition with high morbidity and mortality, for which no effective therapy is available. However, surgical management improves the natural history of this disease to some extent. We have conducted a systematic review of the most intriguing aspects of epidemiology, natural history, clinical picture and management of endomyocardial fibrosis, proposing new ways to increase research into this challenging and neglected cardiovascular disease. We relied primarily on articles in the MEDLINE database with either ‘‘endomyocardial fibrosis’’ or ‘‘endomyocardial sclerosis’’ in the title.

Neurocysticercosis with initial clinical presentation of acute cysticercal meningitis coexisting with anterior chamber intraocular cysticercosis: a case report from a rural institute in India

Acute cysticercal meningitis coexisting with intraocular cysticercosis is an extremely infrequent clinical presentation of neurocysticercosis. We report a 26 year old male, who presented with signs and symptoms of acute eosinophilic cysticercal meningitis with intraocular cysticercosis in the anterior chamber of left eye. Diagnosis was confirmed with demonstration of cerebrospinal fluid (CSF) eosinophilia, cysticercus specific IgG antibodies by CSF ELISA, sterile bacterial, mycobacterial and fungal CSF cultures, cystic lesions containing characteristic scolices consistent with neurocysticercosis on neuroimaging and histopathological demonstration of cysticercus cellulosae larva viscoexpressed from the eye. The importance of having high index of clinical suspicion highlighted along with need of examining cerebrospinal fluid with Wright-Giemsa stain so as not to miss cerebrospinal fluid eosinophilia and diagnosis of this extremely under-reported clinical entity, when there is concurrent presence of brain and other extracerebral lesions consistent with cysticercosis

Echocardiographic assessment of the impact of cardiovascular risk factors on left ventricular systolic function in patients with acute myocardial infarction

Background: Objectives of current study were to determine the magnitude of left ventricular systolic dysfunction in patients with acute myocardial infarction in the rural sub-population of Uttar Pradesh in India and to evaluate the impact of cardiovascular risk factors on the risk of impairment of left ventricular systolic function. Methods: One hundred and fifty seven consecutive patients with first acute myocardial infarction were enrolled into the study. Most patients were male (73.2%) and the mean age of presentation was 52.7 years. Two dimensional echocardiography was utilized to assess conventional parameters such as Left Ventricular End-Diastolic Diameter (LVEDD), Left Ventricular End-Systolic Diameter (LVESD), LV End-Diastolic Volume (LVEDV), LV End-Systolic Volume (LVESV) and Left Ventricular Ejection Fraction (LVEF). The LV volumes (end-systolic and end-diastolic) and LVEF were calculated from the conventional apical two-and four-chamber images using the biplane Simpson’s technique. LV systolic function was considered depressed when LVEF was less than 45%. The chi-square test was used in the statistical analysis to compare proportions and a logistic regression model was used to assess the independent effect of the each variable.Results:The study projects a high proportion (42.7% of the patient population) of left ventricular systolic dysfunction in patients with Acute Myocardial Infarction (AMI). No association was found between gender or age and LV systolic dysfunction. The proportion of patients with diabetes mellitus was higher in the sub-group of patients with impaired LV systolic function (45.2% vs. 30.2%, P = 0.01); the proportion of patients with history of current or past smoking was also higher in the sub-group of patients with impaired LV systolic function (48.9% vs. 34.2%, P = 0.03). On the other hand, hypertension and dyslipidemia were not associated with impaired LVEF. After adjustment of other variables, diabetes and smoking were associated with a significantly higher risk of LV systolic dysfunction (diabetes: OR = 3.73; 95% CI = 1.25-11.16; smoking: OR = 3.8; 95% CI = 1.37-11.05).Conclusion:Since the proportion of patients with LV systolic dysfunction in patients with AMI remains relatively high, LV systolic function variables such as LVEF and LVESV should be echocardiographically evaluated in all patients with AMI. Since the post-infarction LV systolic function remains the single most important determinant of survival, treatment of AMI patients should be aimed at limitation of infarct size and prevention of ventricular dilation. Moreover, cardiovascular risk factors such as diabetes mellitus and smoking have a significant impact on the likelihood of impairment of LV systolic function in patients with AMI and hence could influence long-term prognosis.

Pattern, Management, and Outcome of Poisoning in a Tertiary Care Hospital

Introduction: Poisoning is a significant global public health problem. The appropriate management of poisoning at emergency needs accurate assessment and immediate treatment. The immense chance for better outcomes occurs with early diagnosis and treatment. This study was conducted to assess pattern, management, and outcome of poisoning in tertiary care hospital. Methods: An observational cross-sectional study was conducted in which records of patients with a diagnosis of poisoning over a period of four years were reviewed. Results: A total of 138 patients were included in the study. A majority (63%) of them were females. Most (67.4%) were managed by general or supportive measure only. Gastric lavage was done in 60% of total patients while 52.9% patients received activated charcoal. Pralidoxime and atropine was received by 51.1% of patients treated with specific antidote. All the antidotes were administered through intravenous route. Regarding outcome, 89.9% were completely recovered. Suicidal poisoning was significantly higher in married as compared to unmarried patients (p = 0.029). Similarly, there was a significant relationship between occupation of the patients and manner of poisoning (p = 0.003). Outcome of treatment had a significant association with the manner of poisoning (p < 0.001). Further analysis revealed that the patients who expired in the hospital were more likely to ingest poison accidentally. Conclusion: Suicidal poisoning is common and females are more susceptible. Insecticide and rodenticide are the commonly ingested poisons. Treatment outcome of poisoning cases is generally favorable