A Suspended Nanogap Formed by Field-Induced Atomically Sharp Tips

A sub-nanometer scale suspended gap (nanogap) defined by electric field-induced atomically sharp metallic tips is presented. A strong local electric field (\u3e109 V=m) across micro/nanomachined tips facing each other causes the metal ion migration in the form of dendrite-like growth at the cathode. The nanogap is fully isolated from the substrate eliminating growth mechanisms that involve substrate interactions. The proposed mechanism of ion transportation is verified using real-time imaging of the metal ion transportation using an in situ biasing in transmission electron microscope (TEM). The configuration of the micro/nanomachined suspended tips allows nanostructure growth of a wide variety of materials including metals, metal-oxides, and polymers. VC 2012 American Institute of Physics

Assessment of thyroid and prolactin levels among the women with abnormal uterine bleeding

Background: Thyroid disorders are 10 times more common in women than men.1 Menstrual disturbances usually accompany clinical alterations in thyroid function and every clinician would have encountered altered menstrual pattern among women suffering from either hypo or hyper thyroidism. A high serum prolactin level can distrurb the follicular maturation and corpus luteum function, and leads to inhibition of normal pulsatile secretion of gonadotrophin-releasing hormone in hypothalamus resulting in anovulation. The aim of the study was to assess the thyroid and the prolactin levels among the women with abnormal uterine bleeding and to evaluate the association between them by comparing with normal females.Methods: A cross sectional study was conducted for a period of one year between Jan 2016 and December 2016 in our institution at the gynaecology OPD. Patients in the age group of 15 to 45 with the complaints of abnormal uterine bleeding and with the ultrasound findings showing normal uterus and ovary were included in the study. Hundred age and sex matched controls without any complaints of abnormal uterine bleeding in the age group of 15 – 45 years were also included in the study. Free T3, Free T4, TSH and prolactin estimation was done by chemiluminescent immunoassay for both the patients and the controls.Results: The mean TSH levels among the cases were much higher than that of the controls and the difference in the levels found to be statistically significant. Similarly, hyperprolactinemia was found in 18 cases when compared to 2 cases in controls and the mean prolactin levels were higher in cases. The serum prolactin levels and the serum TSH levels showed a perfect positive correlation which indicates that as the TSH level increases prolactin levels also increases with the R value >0.5.Conclusions: Early detection of hypothyroidism in such subjects saves the patient from recurrent curettage and at times hysterectomy. The financial implications of screening for prolactin/thyroid hormone abnormalities will have to be evaluated before a general recommendation can be made

Comparison of haematological parameters between alcoholics and non-alcoholics

Background: Alcohol being one of the most commonly used drug, whose consequences include changes of CBC. The main causes leading to changes of CBC (complete blood count) are: myelosuppression that is accompanying with slight reduction in all blood cells, blood loss from gastrointestinal tract, malnutrition etc. Alcoholics may suffer from moderate anemia, characterized by enlarged, structurally abnormal RBC’s; mildly reduced numbers of WBC’s, especially of neutrophils; and moderately to severely reduced numbers of platelets. The objective of the study was to study the haematological manifestation among alcoholics based on the quantity and duration of alcohol intake and compare them with non-alcoholics.Methods: A cross-sectional study was conducted for a period of one year in our medical college hospital in medicine OPD with the collaboration of department of pathology and bio-chemistry. The study was started after getting the approval from the institutional ethical committee. A total of 150 study subjects were included in the study in which 50 were non-alcoholics, 50 were moderate alcoholics (less than or equal to two drinks per day for men and less than or equal to one drink per day for women) and the remaining 50 were severe alcoholics (more than 7 drinks a week in women and more than 14 drinks in a week in men). Blood investigations such as CBC, prothrombin time, liver function test, renal function test, folic acid levels and vitamin B12 levels were measured and the levels were compared between alcoholics and non-alcoholics.Results: Mean RBC count, mean MCH, MCHC were normal among the non-alcoholic group and it started decreasing among moderate alcoholics and more so with severe alcoholics and a similar type of result was also seen with total count and platelet count and the difference was found to be statistically significant. LFT, RFT, prothrombin time and vitamin B12 levels were found to be high and folate levels were decreased among alcoholics group when compared to non-alcoholics and the difference was statistically significant.Conclusions: Detection of hematological changes in chronic alcoholics and giving psychiatric counseling and treatment for alcohol dependence will decrease the future complications like cirrhosis liver, cardiac and renal disease, cerebellar degeneration, neuropathy, pancreatitis, etc. and reduce the morbidity and mortality in alcoholics

Comparison of antral follicle count, antimullerian hormone and day 2 follicle stimulating hormone as predictor of ovarian response and clinical pregnancy rate in patient with an abnormal ovarian reserve test

Background: Patients having abnormal ovarian reserve test are likely to have poor response to controlled ovarian stimulation (COS) in artificial reproduction technique, where large number of follicles is desirable. Although direct measurement of the primordial follicle pool is impossible, it has been shown that the number of antral follicles in the ovaries is proportionally related to the size of primordial follicle stock from which they were recruited. Therefore, the antral follicle count (AFC) is believed to represent the quantitative aspect of ovarian aging. The aim of the study was to To compare the  day two Antral follicle count, antimullerian hormone and  Follicle stimulating hormone levels as a predictor of ovarian response among the patients undergoing controlled ovarian stimulation using GnRH antagonist and its implications in clinical pregnancy rate.Methods: A prospective study was conducted in KJK Hospital Trivandrum on 119 patients having abnormal ovarian reserve test undergoing controlled ovarian stimulation (COS) with GnRH antagonist protocol from January 2010- December 2015. Patients AFC, AMH and FSH levels were measured and their association in predicting the ovarian reserve in terms of oocyte maturation, fertilization and embryo cleavage and their pregnancy rate.Results: AFC had the highest accuracy for predicting ovarian response in patient with abnormal ovarian reserve test and was statistically significant (number of oocyte aspirated p value <0.001) than AMH (p value 0.06) and FSH (p value 0.212) in predicting ovarian response. For prediction of poor ovarian response a model including AFC+AMH was found to be almost similar to that of (p value 0.001) using AFC alone. However AFC (p value 0.458), AMH (p value 0.267) and FSH (p value 0.486) did not predict pregnancy rate in patient with abnormal ovarian reserve test and it was statistically not significant.Conclusions: This study indicates that AFC is the most useful marker in predicting the ovarian response. Doing AFC assessment alone would be more cost effective for predicting the ovarian response in patients undergoing controlled ovarian stimulation with GnRH antagonist

A Novel Batch-Processing Method for Accurate Crystallographic Axis Alignment

A new method for the accurate alignment of lithographically-defined patterns to the crystallographic axes of substrates is presented. We provide a lower (worst-case) limit of the achievable high aspect ratio using anisotropic wet chemical silicon etch for deep trenches. The method uses the fact that the intensity of light reflected from two sets of gratings, one on the photomask and the other on the substrate, is a sharp function of their relative angular misalignment. By using pre-etched gratings on the substrate formed by wet anisotropic etching, alignment accuracies better than 50 millidegrees with respect to silicon crystallographic axes have been demonstrated. Two types of microstructures—trenches with an aspect ratio \u3e90:1 and silicon nanowires with widthsfacets—have been fabricated using i-line lithography to illustrate some applications of this alignment method. This all-optical method is readily applicable to industry-standard optical lithography and avoids the need for any individualized process steps, enabling cost-effective micro/nanostructure manufacturing

Incidence of dengue fever and its clinical profile during an outbreak in a rural area in Tamil Nadu

Background: In Southeast Asian countries, dengue is the major cause of pediatric morbidity and mortality and in that India reports the maximum number of cases. The annual incidence of dengue in India ranges from 8 to 33 million cases per year and an increased risk of dengue virus infection in children older than 5 years of age have been documented. Aim: The main objective of this study was to assess the incidence of dengue among the fever cases and to assess the clinical profile of various types of dengue fever and also to assess the predictive variables for the severity of dengue and their clinical outcomes. Methodology: A prospective longitudinal study was conducted at a pediatric hospital in a rural area of Tamil Nadu for a period of 6 months. A total of 325 patients were included in the study based on the study period and the inclusion criteria. For all the cases that were having a fever, basic blood investigations which includes hemoglobin, total count, and platelet count were performed along with peripheral smear study for malaria, dengue card test, and liver function test. Further, dengue positive patients were grouped into non-severe and severe dengue fever based on the operational definition formulated by the WHO. Results: The overall incidence of dengue among all the patients with fever was 71.3% among which 83.6% were non-severe dengue and the remaining 13.6% of the patients had severe dengue. Clinical signs such as palmar erythema, splenomegaly, and bleeding manifestations were more common in severe dengue patients than that of non-severe dengue, and this difference was found to be statistically significant. Hemoglobin and platelet count was found to be much lower among the patients with severe dengue along with raised liver enzymes (serum glutamic-oxaloacetic transaminase and serum glutamic pyruvic transaminase) than that of the non-severe dengue, and the difference was found to be statistically significant. Majority of the patients with severe dengue received crystalloid and few patients received blood products whereas only very few with non-severe dengue received crystalloids, and none of the patients in this group received blood products. Conclusion: Health-care personnel of all levels must be made aware of the clinical signs and symptoms of all dengue types. Early recognition, precise assessment and appropriate treatment with the help of the WHO revised classification and management guidelines would reduce the mortality due to dengue fever

Validity of diffusion-weighted magnetic resonance imaging in the evaluation of acute pyelonephritis in comparison with contrast-enhanced computed tomography

Purpose: Applications of diffusion-weighted magnetic resonance imaging outside the brain have gained increasing importance in recent years, and recent studies have shown the usage of diffusion-weighted (DW) imaging in diagnosing pyelonephritis based on renal cortical and medullary apparent diffusion coefficient (ADC) values. The aim of this study was to assess the validity of DW magnetic resonance (MR) imaging in comparison with contrast-enhanced computed tomography (CECT) in diagnosing pyelonephritis. Material and methods: A cross-sectional observational study was conducted for a period of six months in a tertiary hospital in Coimbatore. All patients with clinical and laboratory diagnosis of acute pyelonephritis, who were referred for radiological imaging (CECT), were taken into the study. Out of 112 patients with a clinical and laboratorial diagnosis of acute pyelonephritis (APN), who underwent both DW MR and CECT, diagnosis of APN was made in 100 patients based on CECT, while in 12 cases the investigation (CECT) was negative. Finally, these 100 patients were included in the study. The validity of DW MR imaging in diagnosing APN was assessed by deriving sensitivity, specificity, and positive and negative predictive value in comparison with CECT findings. Results: The validity report of DW MR imaging in the detection of APN showed a very high sensitivity (96-100%) and specificity (86-90%) and very low false positives (6-10%) and negatives (< 5%), and it also showed that in the areas of affected renal parenchyma ADC values were consistently lower compared to unaffected renal parenchyma. Conclusion: Based on the generated hypothesis, DW MR imaging of the kidneys seems to be highly sensitive and specific for the detection of focal or diffuse infections within the kidney in comparison with CECT

Acetabular fractures: an analysis on clinical outcomes of surgical treatment

Background: Acetabulum fractures are among the most serious injuries treated by orthopedic surgeons. People of all ages are vulnerable to these injuries. ORIF is considered the right treatment method for acetabular fractures. Patients who underwent this treatment had a good result. For the general orthopedic surgeon the treatment for displaced acetabular fracture is a challenging task. The aim of the study was to evaluate the functional outcome of surgically treated acetabular fractures.Methods: A prospective longitudinal study was undertaken in our hospital during the period of June 2011–June 2015. A total number of 32 patients were included in the study. All patients with the history of fall and pain in the pelvic region were examined clinically and radiologically by doing an X-ray of plain AP view of the pelvis as well as CT-scan. Fractures that were displaced by more than 5 mm with concomitant disruption of the bony continuity of the acetabular dome were treated surgically. The follow-up schedule was 3, 6 and 12 months post-operatively and subsequently at two years when the operative outcome had been finalized and final evaluation of fracture healing and functional outcome was performed.Results: Radiologic evaluation showed 88.5% of excellent or good results and 12.5% of fair or poor results, while clinical evaluation showed 90.6% of excellent or good results and 9.4% of fair or poor results. The clinical evaluation was done for the patients based on the D’Aubigne-Postel criterion. . Based on this criterion 90% of the patients had shown good to excellent results and for the remaining 10% of the patients it was between poor and fair.Conclusions: In acetabular fractures open reduction and internal fixation was consistent with better anatomical reduction and functional outcome provided when it is carried out by an experienced surgeon and intervened within the first few days following the injury.

COVID-19 deaths in people with intellectual disability in the UK and Ireland: descriptive study.

BACKGROUND: Rapid spread of coronavirus disease 2019 (COVID-19) has affected people with intellectual disability disproportionately. Existing data does not provide enough information to understand factors associated with increased deaths in those with intellectual disability. Establishing who is at high risk is important in developing prevention strategies, given risk factors or comorbidities in people with intellectual disability may be different to those in the general population. AIMS: To identify comorbidities, demographic and clinical factors of those individuals with intellectual disability who have died from COVID-19. METHOD: An observational descriptive case series looking at deaths because of COVID-19 in people with intellectual disability was conducted. Along with established risk factors observed in the general population, possible specific risk factors and comorbidities in people with intellectual disability for deaths related to COVID-19 were examined. Comparisons between mild and moderate-to-profound intellectual disability subcohorts were undertaken. RESULTS: Data on 66 deaths in individuals with intellectual disability were analysed. This group was younger (mean age 64 years) compared with the age of death in the general population because of COVID-19. High rates of moderate-to-profound intellectual disability (n = 43), epilepsy (n = 29), mental illness (n = 29), dysphagia (n = 23), Down syndrome (n = 20) and dementia (n = 15) were observed. CONCLUSIONS: This is the first study exploring associations between possible risk factors and comorbidities found in COVID-19 deaths in people with intellectual disability. Our data provides insight into possible factors for deaths in people with intellectual disability. Some of the factors varied between the mild and moderate-to-profound intellectual disability groups. This highlights an urgent need for further systemic inquiry and study of the possible cumulative impact of these factors and comorbidities given the possibility of COVID-19 resurgence

DNA-dependent protein kinase: Epigenetic alterations and the role in genomic stability of cancer

DNA-dependent protein kinase (DNA-PK), a member of phosphatidylinositol-kinase family, is a key protein in mammalian DNA double-strand break (DSB) repair that helps to maintain genomic integrity. DNA-PK also plays a central role in immune cell development and protects telomerase during cellular aging. Epigenetic deregulation due to endogenous and exogenous factors may affect the normal function of DNA-PK, which in turn could impair DNA repair and contribute to genomic instability. Recent studies implicate a role for epigenetics in the regulation of DNA-PK expression in normal and cancer cells, which may impact cancer progression and metastasis as well as provide opportunities for treatment and use of DNA-PK as a novel cancer biomarker. In addition, several small molecules and biological agents have been recently identified that can inhibit DNA-PK function or expression, and thus hold promise for cancer treatments. This review discusses the impact of epigenetic alterations and the expression of DNA-PK in relation to the DNA repair mechanisms with a focus on its differential levels in normal and cancer cells