Indian Diabetes Risk Score (IDRS) as a strong predictor of diabetes mellitus: A cross sectional study among urban population of Jhalawar, Rajasthan

Introduction: The patients with Type 2 diabetes Mellitus may often remain asymptomatic for a longer period of time. The Indian Diabetes Risk Score (IDRS), a simple screening tool for prediction of undiagnosed diabetes. Objective: Validation of IDRS with standard test for type 2 diabetes among urban population of Jhalawar, Rajasthan. Material and Methods: A Community based Cross-sectional study was carried out in urban field practice area of Department of Community Medicine, Jhalawar Medical College, Jhalawar, Rajasthan. The study was conducted using a two-stage sampling design. A predesigned, pretested proforma and Indian Diabetes Risk Score (IDRS) sheet was used to collect data from the study participants. The IDRS is based on four parameters: age, family history of diabetes, waist circumference and physical inactivity. Data was collected using the World Health Organization stepwise approach to surveillance (STEPS). Results: Among 450 participants, 12.7% participants were in low risk, 59.1% were in moderate risk and 28.2% were in high risk of developing diabetes according to IDRS score. IDRS score of ?60 turned out to be the best cut point for identifying undiagnosed diabetes with sensitivity 92.3% and specificity 82.6%. Positive Predictive value and Negative Predictive value were 47.3% and 98.5% respectively. Conclusion: Association of IDRS was found significant with diabetes. IDRS score of ?60 turned out to be the best cut point for identifying undiagnosed diabetes. IDRS is found valid screening tool for early detection of Diabetes

Development of iron oxide/activated carbon nanoparticle composite for the removal of Cr(VI), Cu(II) and Cd(II) ions from aqueous solution

Iron oxide (Fe3O4) and iron oxide/activated carbon (Fe3O4/AC) were fabricated by co-precipitation method for the removal of Cr(VI), Cu(II) and Cd(II) ions from aqueous solution in batch mode. These nanoparticles were characterized by BET, FTIR, XRD, SEM/TEM and VSM. The optimum conditions for the removal of ions were pH = 2 for Cr(VI) and 6 for Cu(II) and Cd (II), initial metal ion concentration = 50 mg L-1, nanoparticle dose = 50 mg/10 mL, temperature = 25 +/- 1 degrees C, shaking speed = 180 rpm and contact time = 3 h. The equilibrium data of ions sorption were well described by Langmuir, Freundlich, Redlich-Peterson and Intraparticle Diffusion model. The R-2 values obtained by Langmuir model were highest by Fe3O4/AC for Cr(VI) = 0.9994, Cu(II) = 0.9998 and Cd(II) = 0.9750. The temperature dependent study in the range of 288-328 K confirmed that the adsorption process was endothermic in nature. Desorption studies with 0.1M HCl stated that these nanoparticles can be regenerated effectively and can be used after four adsorption-desorption cycles without any mass loss.Peer reviewe

A study of dengue and hepatopathy

Background: Dengue is a major international health concern that is prevalent in tropical and sub-tropical countries. It is 2nd most common arthropod borne disease in India. There are certain clinical features that are associated with Dengue in addition of the classical features. Previously organ impairment has been only considered under set up of severe disease. On the recent years, several studies have suggested the possibility of early involvement of the liver in dengue. Further due to its atypical presentation often dengue missed out as a differential diagnosis.Methods: A total of 50 patients were selected to be a part of study after applying inclusion and exclusion criteria. Only those patients were included in the study who had classical features of dengue- fever with chills, body ache, headache, rash, bleeding manifestations and thrombocytopenia and had a positive ELISA test i.e. IgM antibodies against dengue virus. Patients who had malaria and enteric fever were excluded from the study. All patients were subjected to a detailed history and a thorough clinical examination. A complete blood count, liver function tests, renal function tests, chest X-ray and USG abdomen were also done.Results: An analysis of 50 patients suffering from dengue showed liver dysfunction was present in all patients. Vomiting was an important symptom present upto 70% of patients. SGOT levels were higher than SGPT levels. Hepatosplenomegaly and ascitis were also present in significant number of patients. An analysis of these patients revealed that patients typically demonstrate high grade fever, body ache, rash, thrombocytopenia and bleeding tendency, there were other features such as liver dysfunction including a preferential rise of SGOT, hepatosplenomegaly, ascitis, pleural effusion and leucopoenia.Conclusions: This study showed that dengue fever was seen in the third decade and that AST and ALT levels were raised in the majority of these patients. It was also found that AST levels were more than ALT levels. So, AST and ALT can be a useful early marker to assess the severity of the disease which can thus lead to early recognition of high risk cases. The presence of raised liver enzymes in all patients, ascitis, hepatosplenomegaly, elevation of SGOT more than SGPT, should be kept in mind when evaluating patients with suspected dengue

A questionnaire-based study on knowledge and attitude towards counterfeit medication among the doctors in tertiary care hospital

Background: Counterfeit drugs are a global problem and suffered almost all developing and developed countries worldwide. In India, it is a major problem which results life threatening issues as well as financial loss on health system. So, we conducted a cross sectional questionnaire-based study on knowledge and exposure to counterfeit drugs of doctors at SHKM Govt. Medical College, Nuh, Haryana, India.Methods: A structured questionnaire was distributed to 100 registered doctors. The questionnaire was based on knowledge, attitude and its consequence on the heath system by the practices of counterfeit medication.Results: There were Twenty questionnaires excluded from the study due to incomplete information. Only 57.77% (46/80) subjects having the knowledge of questionnaire correct meaning of counterfeit drug. However, almost 90% (72/80) subjects were aware about its dangerous effects. More than 50% of the subjects have suggested that modern technology is capable to control counterfeiting of the medicine.Conclusions: Counterfeit drugs create a people health hazard and waste to consumer income. The proper knowledge, awareness and modern technological approaches are the devices may helpful in diminution of counterfeit medication practices.

Syntheses, spectral, thermal and pH-metric studies on bivalent metal ion complexes of N,N’-bis(3-carboxy-1-oxo-z-prop-2-elenyl)ethylenediamine

A novel carboxyamide ligand has been synthesized using maleic anhydride and ethylenediamine. Co(II), Ni(II), Cu(II) and Pd(II) complexes of the ligand, i.e., N,N’-bis(3-carboxy-1-oxo-z-prop-2-elenyl)ethylenediamine [H2L] have been prepared and characterized by elemental analyses,  IR, electronic, 1H NMR, EPR spectral and thermal studies. It is revealed by IR and 1H NMR spectral studies that the ligand coordinated to the metal ions through deprotonated carboxylate oxygen and non-deprotonated amide nitrogen in all the complexes. It is suggested by electronic spectral and magnetic moment studies that N2O2 coordination is around each metal center with a strong field square planar chromophore. All the complexes have been studied by TGA and DTA studies done simultaneously. The complex formation between ligand and metal ions [Mn(II), Co(II), Ni(II), Cu(II) and Zn(II)] has also been studied pH metrically in 75% aqueous DMF solution at 298 K in 0.1 M NaClO4. The probable structures of the complexes have also been proposed

Safe practices for legitimate medical use of opioids: a study of trends in opioids prescription over a decade

Background: An unwavering availability of opioids is crucial for effective pain and palliative care and for managing opioid dependence. This study aims to study the pattern of morphine consumption and the use of safety protocols for prescribing opioids in a tertiary cancer hospital in India. Patients and methods: We studied the medical and pharmacy records retrospectively, to investigate the pattern of oral Morphine consumption and distribution from 2008 to 2020. Results: The number of new cancer patients visiting the hospital, the number of re-visits of these patients, and inpatient admissions to palliative care service increased unswervingly from 2008 to 2019 with a sharp fall in 2020 owing to the COVID pandemic. Annual oral morphine consumption showed a steady increase from 4.89 kgs in 2008 to 11.53 kgs in 2019 with a fall to 5.68 kgs in 2020. However, the trend for oral morphine dispensed per patient per visit showed a mild increase from 1.1 gram in 2008 to 2.06 grams in 2012, followed by a gradual decline to 0.89 grams in 2020. Opioid diversion incidence was found to be zero. Conclusions: Comprehensive interventions alongside safety protocols for prescriptions of opioids and effective integration of palliative care can help prevent opioid use disorders

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Enhancing Abiotic Stress Tolerance in Cereals Through Breeding and Transgenic Interventions

The success of plant breeding in the 20th century led to new cultivars that, to date, have provided enough food for an increasing world population (Conway and Toenniessen 1999; Mifflin 2000). The results of the Green Revolution-led in the 1960s by Henry M. Beachell andNormanE. Dotlaug—resulted in a dramatic increase in rice and wheal grain yields (Milford and Runge 2007; Ortiz et al. 2007). However, abiotic stresses and climate change are becoming increasingly serious threats to crop production worldwide at a time when food staple supply will need to be significantly higher to meet the demand of the growing human population. Water scarcity (Rockstrom et al. 2007], salinity (Rengasamy 2006). and low soil fertility (Sanchez and Swaminathan 2005) rank among the moat important abiotic stresses worldwide. Similarly, increased climatic disturbances due to global warming are causing the major stresses that necessitate crop improvements to safeguard grain supply, particularly in the developing world (Kumar 2006). Hence, genetic enhancement of cereal crops with respect to abiotic stress tolerance will be essential far ensuring grain yields in water-limited, increasingly hotter agricultural zones, particularly If these conditions combine with poor and saline soils, conditions that prevail in parts of the developing world. Crop breeding for adaptation to abiotic stress-prone environments remains a challenging task, not least because of the complexity of the stress-adaptive mechanisms in plants and particularly cereal crops, which are the staple of most of the world's population (Reynolds et al. 2005}

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation