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The role of extracorporeal therapies for poisoning is expanding in the present days with technological advances and increased awareness among physicians attending critically ill patients both intensivists and nephrologists. In this regard we present our experience on hemoperfusion in poisonings over a period of 5 years. A total of 6 patients were treated with hemoperfusion during this period with majority of them were due to antiepileptic drugs (phenytoin, phenobarbitone, carbamazepine) followed by paraquat (a weedicide).The age range is from 19-59 years with a mean age of 31.3 years and male: female ratio of 1:1. Coming to the clinical presentation, 3 of them presented with unconsciousness, one with altered sensorium and two of them with vomiting associated with oliguria and breathlessness. Five of the six (83.3%) required ventilatory support during the hospital stay. The total number of hemoperfusion sessions required was 10, with an average of 1.6 sessions per patient. The average number of hemodialysis sessions required was 2.3 sessions per patient. Only one patient developed procedure related complication of thrombocytopenia related oral bleeding which subsided with supportive therapy and no further hemoperfusion. Four out of six patients (66.6 %) recovered while 33.4 % expired and both the patients who expired consumed paraquat poisoning. In conclusion hemoperfusion has a significant role in the management of certain poisonings which would reduce the morbidity and mortality associated with these poisonings.

Nickel oxide NiO nano particle is synthesized by Ultrasound assisted one pot method and thus synthesized nano NiO is mixed with polyvinyl alcohol PVA to prepare the PVANiO nanocomposite. The influence of the composition on the structural modification on the composite is evaluated. The particle size and morphology of NiO nano material is confirmed by HRTEM. The structure and properties of the PVANiO nanocomposite material are characterized by FTIR, XRD, UV–Visible spectroscopy, DSC, TGA, and HRTEM. The synthesized PVA nanocomposite underwent hydrolytic oxidation reaction assisted by the effect of nanosized NiO. © 2010 Wiley Periodicals, Inc. J Appl Polym Sci, 2010 [ABSTRACT FROM AUTHOR]

Purpose Artificial intelligence (AI) has rapidly gained popularity with the growth of ChatGPT (OpenAI, San Francisco, USA) and other large-language model chatbots, and these programs have tremendous potential to impact medicine. One important area of consequence in medicine and public health is that patients may use these programs in search of answers to medical questions. Despite the increased utilization of AI chatbots by the public, there is little research to assess the reliability of ChatGPT and alternative programs when queried for medical information. This study seeks to elucidate the accuracy and readability of AI chatbots in answering patient questions regarding urology. As vasectomy is one of the most common urologic procedures, this study investigates AI-generated responses to frequently asked vasectomy-related questions. For this study, five popular and free-to-access AI platforms were utilized to undertake this investigation. Methods Fifteen vasectomy-related questions were individually queried to five AI chatbots from November-December 2023: ChatGPT (OpenAI, San Francisco, USA), Bard (Google Inc., Mountainview, USA) Bing (Microsoft, Redmond, USA) Perplexity (Perplexity AI Inc., San Francisco, USA), and Claude (Anthropic, San Francisco, USA). Responses from each platform were graded by two attending urologists, two urology research faculty, and one urological resident physician using a Likert (1-6) scale: (1-completely inaccurate, 6-completely accurate) based on comparison to existing American Urological Association guidelines. Flesch-Kincaid Grade levels (FKGL) and Flesch Reading Ease scores (FRES) (1-100) were calculated for each response. To assess differences in Likert, FRES, and FKGL, Kruskal-Wallis tests were performed using GraphPad Prism V10.1.0 (GraphPad, San Diego, USA) with Alpha set at 0.05. Results Analysis shows that ChatGPT provided the most accurate responses across the five AI chatbots with an average score of 5.04 on the Likert scale. Subsequently, Microsoft Bing (4.91), Anthropic Claude (4.65), Google Bard (4.43), and Perplexity (4.41) followed. All five chatbots were found to score, on average, higher than 4.41 corresponding to a score of at least "somewhat accurate." Google Bard received the highest Flesch Reading Ease score (49.67) and lowest Grade level (10.1) when compared to the other chatbots. Anthropic Claude scored 46.7 on the FRES and 10.55 on the FKGL. Microsoft Bing scored 45.57 on the FRES and 11.56 on the FKGL. Perplexity scored 36.4 on the FRES and 13.29 on the FKGL. ChatGPT had the lowest FRES of 30.4 and highest FKGL of 14.2. Conclusion This study investigates the use of AI in medicine, specifically urology, and it helps to determine whether large-language model chatbots can be reliable sources of freely available medical information. All five AI chatbots on average were able to achieve at least "somewhat accurate" on a 6-point Likert scale. In terms of readability, all five AI chatbots on average had Flesch Reading Ease scores of less than 50 and were higher than a 10th-grade level. In this small-scale study, there were several significant differences identified between the readability scores of each AI chatbot. However, there were no significant differences found among their accuracies. Thus, our study suggests that major AI chatbots may perform similarly in their ability to be correct but differ in their ease of being comprehended by the general public., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Carlson et al.)

Background: Tuberculosis (TB) depicts heterogeneous spatial patterns with geographical aggregation of TB cases due to either ongoing person-to-person transmission or reactivation of latent infection in a community sharing risk factor. In this regard, we aimed to assess the spatiotemporal aggregation of drug-resistant TB (DR-TB) patients notified to the national TB program (NTP) from 2015 to 2018 in selected districts of Karnataka, South India., Methods: This was a cross-sectional study among DR-TB patients notified from Dakshina Kannada, Udupi, and Chikamagalur districts of the state of Karnataka. Clinico-demographic details were extracted from treatment cards. The registered addresses of the patients were geocoded (latitude and longitude) using Google Earth. Using the QGIS software, spot map, heat maps and grid maps 25 km 2 with more than the expected count of DR-TB patients were constructed., Results: Of the total 507 patients studied, 376 (74%) were males and the mean (standard deviation) age of the study participants was 41.4 (13.9) years. From 2015 to 2018, the number of patients increased from 85 to 209 per year, the area of aggregation in square kilometers increased from 113.6 to 205.7, and the number of rectangular grids with more than the expected DR-TB patients (> 1) increased from 12 to 47., Conclusions: The increase in the number of DR-TB patients, area of aggregation, and grids with more than the expected count is a cause for concern. The NTP can use routine programmatic data to develop maps to identify areas of aggregation of disease for targeted TB control activities., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2020.)

Background and the Purpose of the Study: The combination of angiotensin II receptor antagonists and HMG CoA reductase inhibitors have shown to confer renoprotection.The purpose of this study was to find out the renoprotective effects of telmisartan and atorvastatin in combination and in monotherapy of Streptozotocin (STZ) induced diabetic nephropathy in rats., Methods: Diabetes was induced by i.p injection of STZ to rats, after 18 hrs of fasting. Diabetic rats were randomly grouped and treated with telmisartan and atorvastatin in combination as well as monotherapy for 30 days. The serum and urine glucose, creatinine and serum triglyceride, cholesterol, albumin and micro-albumin and blood urea nitrogen, total protein and histological analyses of the left kidney were performed at the end of the study., Results: By the end of the study, the combination showed significant (P < 0.05) improvement in urine glucose, serum cholesterol, serum and urine creatinine, blood urea nitrogen, total protein, serum albumin, micro-albuminuria levels in comparison to monotherapy. However, this combination didn't show significant changes on serum glucose and triglyceride levels. Kidney pathological injury was attenuated by the combination as compared to the diabetic group., Conclusion: The present study document that, telmisartan and atorvastatin combination have better renoprotective effects but not with individual drug when compared to the diabetic group. The combination also attenuated the progression of diabetic nephropathy by slowing the proteinuria and microalbuminuria and these effects were confirmed by histopathological analysis.

Melioidosis has recently gained the status of an emerging disease in India. Multidrug-resistant (MDR) Gram-negative bacteria, however, are already responsible for treatment failure and mortality. In addition, pandrug-resistant (PDR) Gram-negative bacteria have emerged as a new threat to modern medicine. The treatment, clinical follow up, and outcome of 25 patients with melioidosis and 46 patients with MDR non-fermenters (Pseudomonas aeruginosa and Acinetobacter spp.) infection were documented during the period 2005 2007. Pandrug resistance status of the MDR strains was evaluated with the minimum inhibitory concentration breakpoint of colistin. Skin and soft-tissue involvement (16%), liver abscess (16%) and bone and joint involvement (16%) were the most common presentations of melioidosis in diabetic patients. The presence of septicaemia (44%) and major organ failure (48%) resulted in death. Relapse was seen in patients with inappropriate treatment. Clinical cure was observed in five cases infected with PDR strains; colistin was used in only one case. Comorbid conditions may have contributed to the high fatality (82.7%). More awareness among clinicians and laboratory staff, and environmental investigations of soil are required for accurate diagnosis and prompt treatment of melioidosis. For MDR strains, colistin is the 'last resort' and should be used with caution; resistance should be monitored both globally and locally.

Enzymes of glutathione metabolism and GSH content in copper-treated Scenedesmus bijugatus cells and the synthesis of metal-binding peptides are reported in this investigation. Progressive depletion of GSH content in the cells was observed with increasing concentrations of copper. There was an increase in the protein thiol content while the non-protein thiol content decreased. There was an initial elevation and later decrease in the hydrogen peroxide level in the cells. Copper stress increased the activities of gamma-glutamylcysteine synthetase, GSH S-transferase and GSH-peroxidase and decreased the activity of GSSG-reductase. These results suggest that copper alters the equilibrium between synthesis and utilization of GSH either due to its antioxidant role or by serving as a precursor in the synthesis of phytochelatins.