To establish the reference range of glycated hemoglobin

Background: Diabetes mellitus (DM) has emerged as a major healthcare problem in India. There were an estimated 40 million persons with DM in India in 2007 and this number is predicted to rise to almost 70 million by 2025. It is estimated that every fifth person with diabetes will be an Indian. The objective of the present investigation was to establish the reference range for glycated hemoglobin (HbA1C) in healthy non-diabetic subjects in our hospital laboratory and compare it with the values reported by standard laboratories.Methods: The study was conducted in the Department of Biochemistry, MMIMSR, Mullana (Ambala, Haryana). Total number of subjects was 50 (25 males, 25 females), aged 30 to 70 years. 2 ml of blood was collected from antecubital vein under aseptic conditions from each subject and put in EDTA vials. Hemolysed blood was estimated by semiautoanalyzer for HbA1C.Results: In females, the levels were 6.50 ± 0.74 % while in males the levels were 6.27 ± 0.94 %. The overall range in females was 4.8 - 7.56 % while in males it was 4.2 to 7.56 %. The values were comparable (p>0.05) with those reported by standard laboratories, e.g. Dr. Lal PathLabs (<6%), Charak diagnostic (4.5-6.3%) and Mayo Clinic (6.5-7%). Conclusion: Our laboratory levels of HbA1C are comparable with the reference range of different laboratories and hence suitable to be used as cut-offs while interpreting the results of patients with DM.

Psoriatic Arthritis in the Eastern Part of Uttar Pradesh

Aim: This original research article aims to study Psoriatic Arthritis in the Eastern Part of Uttar Pradesh. Material &amp; Method: Two hundred twenty-eight patients of psoriasis regardless of age, sex, religion, occupation, attending the skin, and V. D. outpatients Department, B.R.D. Medical College, Gorakhpur for were taken because of the subject of this study. The bulk of patients belonged to the Eastern U.P. and adjoining areas of Bihar and Nepal. The clinical criteria for diagnosis of psoriasis were the presence of Erythematous and papulosquamous lesions with loosely adherent silvery-white scales. The auspitz's sign was demonstrated all told the cases. The detailed clinical history and examination were recorded with Tests for Rheumatoid factor and serum uric acid, Radiographs of both hands and feet, Radiographs of the lumbosacral Spine and both sacroiliac joints and Radiographs of affected joints (if any). Each patient was categorised into mild to severe psoriasis. Result: The total number of psoriatic arthritis cases was found, 26 of which male were 17 and female were 9. The maximum number of Arthritis cases, 18.5%, were seen with severe disease (PASI score &gt; 15) with higher occurrence in males. The maximum number of joints involved distal interphalangeal joint was 69.2 3%, and the minimum number of joints involved was significant joint 7.69%. Conclusion: Psoriasis care is unbalanced, with men being more likely to undergo specialist treatment than women, causing higher distal interphalangeal (D.I.P.) joint arthropathy

Role of traditional medicines as a challenge for Coronavirus (Covid-19)

The most countries in the World are facing the problem of disease caused by Noval coronavirus (covid-19) with symptoms of higher grade flu like symptoms or with no symptom. The infection is spreading through contact with the person suffered from coronavirus symptoms like sneezing, high fever, cough and ultimately blockade of respiratory system. Sometimes symptoms of diarrhea and dysentery were also detected at advanced stage of the disease. Till now any effective medicine or vaccine could not be developed for the prevention and getting relief. Only trial and error by applying some antimalarial drugs chloroquine hydroxide alongwith some other antiviral infections is used and up to 38% are being recovered in India as well as other countries. Under such circumstances strengthening immune system becomes only option for preventing from this viral disease and our traditional medicines are playing vital role for immunity strengthening. Accordingly, some herbs either singly or in combination form have been suggested as preventive measure for coronavirus through this communication

Enhancement and modulation of cosmic noise absorption in the afternoon sector at subauroral location ( L = 5) during the recovery phase of 17 March 2015 geomagnetic storm

The present study has focused on the intense production of cosmic noise absorption (CNA) at Maitri, Antarctica (L = 5; CGM −62°S, 55°E) during the early recovery phase of the largest storm of the current solar cycle commenced on 17 March 2015 St. Patrick's Day. The enhancement of CNA during 15–18 UT (14–17 magnetic local time (MLT); MLT = UT − 1 at Maitri) was as large as the CNA enhancement occurred during the main phase of the storm. During this time the CNA pattern also exhibits oscillation in the Pc5 (2–7 mHz) range and is in simultaneity with geomagnetic pulsations in the same frequency range. We observed the amplitude of CNA pulsation is well correlated with the level of CNA production. High-amplitude Pc5 oscillations were observed in the vicinity of auroral oval near Maitri. Absence of electromagnetic ion cyclotron (EMIC) waves is marked suggesting the possible role of VLF waves in precipitation. The reason for the intense CNA production is found to be the precipitation caused mainly by hiss-driven subrelativistic electrons. The CNA enhancement event is located well inside the dusk plasmaspheric bulge region as suggested by Tsurutani et al. (2015). Signature of enhanced eastward electrojet at Maitri during 14–17 MLT could be an additional factor for such large CNA. In order to establish the cause and effect relationship between the geomagnetic and CNA oscillations at Maitri, transfer entropy method has been used, which confirmed the modulation of CNA by geomagnetic pulsations

Cooling rate effects on the structure of 45S5 bioglass: Insights from experiments and simulations

Due to its ability to bond with living tissues upon dissolution, 45S5 bioglass and related compositions materials are extensively used for the replacement, regeneration, and repair of hard tissues in the human body. However, the details of its atomic structure remain debated. This is partially due to the non-equilibrium nature of glasses, as their non-crystalline structure is highly dependent on their thermal history, namely, the cooling rate used during quenching. Herein, combining molecular dynamics (MD) simulations with cooling rates ranging over several orders of magnitude and experimental studies using nuclear magnetic resonance (NMR), we investigate the structure of the nominal 45S5 bioglass composition. These results suggest that the MD simulation results when extrapolated to experimental cooling rates can provide a reasonable estimate of the structure of 45S5 bioglass. Finally, based on these results, we suggest the propensity of the phosphate group to form isolated orthophosphate species. Overall, these results reconcile the simulation and experimental results on the structure of 45S5 bioglass, and particularly on the speciation of the phosphate group, which may be key in controlling the bioactivity of 45S5 bioglass

Cost-effectiveness of therapeutic use of safety-engineered syringes in healthcare facilities in India

Background: Globally, 16 billion injections are administered each year of which 95% are for curative care. India contributes 25–30% of the global injection load. Over 63% of these injections are reportedly unsafe or deemed unnecessary. Objectives: To assess the incremental cost per quality-adjusted life-year (QALY) gained with the introduction of safety-engineered syringes (SES) as compared to disposable syringes for therapeutic care in India. Methods: A decision tree was used to compute the volume of needle-stick injuries (NSIs) and reuse episodes among healthcare professionals and the patient population. Subsequently, three separate Markov models were used to compute lifetime costs and QALYs for individuals infected with hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Three SES were evaluated—reuse prevention syringe (RUP), sharp injury prevention (SIP) syringe, and syringes with features of both RUP and SIP. A lifetime study horizon starting from a base year of 2017 was considered appropriate to cover all costs and consequences comprehensively. A systematic review was undertaken to assess the SES effects in terms of reduction in NSIs and reuse episodes. These were then modelled in terms of reduction in transmission of blood-borne infections, life-years and QALYs gained. Future costs and consequences were discounted at the rate of 3%. Incremental cost per QALY gained was computed to assess the cost-effectiveness. A probabilistic sensitivity analysis was undertaken to account for parameter uncertainties. Results: The introduction of RUP, SIP and RUP + SIP syringes in India is estimated to incur an incremental cost of Indian National Rupee (INR) 61,028 (US$939), INR 7,768,215 (US$119,511) and INR 196,135 (US$3017) per QALY gained, respectively. A total of 96,296 HBV, 44,082 HCV and 5632 HIV deaths are estimated to be averted due to RUP in 20 years. RUP has an 84% probability to be cost-effective at a threshold of per capita gross domestic product (GDP). The RUP syringe can become cost saving at a unit price of INR 1.9. Similarly, SIP and RUP + SIP syringes can be cost-effective at a unit price of less than INR 1.2 and INR 5.9, respectively. Conclusion: RUP syringes are estimated to be cost-effective in the Indian context. SIP and RUP + SIP syringes are not cost-effective at the current unit prices. Efforts should be made to bring down the price of SES to improve its cost-effectiveness

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe