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Background: Transmission of infection has always been a concern for blood bank professionals and for practising physicians who prescribe blood and blood components for their patients. The rate of Transfusion transmitted infections in donated blood is one of the main indicators of blood safety which has to be monitored precisely. This paper provides a thorough study of blood safety indicators. To study the trends of infections that can be transmitted by blood such as HIV, Hepatitis B Virus, Hepatitis C Virus, Syphilis and Malaria among blood donors at a tertiary care Government Medical College blood bank in north India in the last 7 years. Material and Methods: This study was conducted retrospectively over a period of 7 years from August 2013 to January 2020. A total of 29,262 blood donors who donated blood during this period were tested for HIV, HBV, HCV, Syphilis and Malaria. Comparative analysis was done to study the trend of transfusion transmitted infection among these blood donors. Results: : Out of 29,262 blood unit tested a total of 86 cases of HIV, 840 cases of HBV, 163 cases of HCV,4 cases of syphilis and 13 cases of malaria were identified. Among the blood donors 0.294 % were reactive to HIV, 2.87% were reactive to HBsAg, 0.557 % were reactive to HCV. Whereas 0.0136 % were found to be positive for syphilis and 0.044 % were positive for malaria. Conclusion: Comparing various infections among repeat blood donor and first-time blood donor a retrospective data over a long period showed a trend in seroprevalance of HIV, HBsAg, HCV, Syphilis and malaria. The risk of transmission of these infections by blood transfusion remains high among first time donors. The results of the study reflect the prevalence of these infections in the apparently healthy population and warrant measures like effective donor retention and education policy and newer testing modality such as nucleic acid testing (NAT) to detect infection early and prevent residual risk of transmission.

The disposal of municipal solid waste (MSW) directly at landfills or open dump areas, without segregation and treatment, is a significant concern due to its hazardous contents of antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARGs), and metal resistance genes (MGEs). The released leachate from landfills greatly effects the soil physicochemical, biological, and groundwater properties associated with agricultural activity and human health. The abundance of ARB, ARGs, and MGEs have been reported worldwide, including MSW landfill sites, animal husbandry, wastewater, groundwater, soil, and aerosol. This review elucidates the occurrence and abundance of ARB, ARGs, and MRGs, which are regarded as emerging contaminants (ECs). Recently, ECs have received global attention because of their prevalence in leachate as a substantial threat to environmental and public health, including an economic burden for developing nations. The present review exclusively discusses the demands to develop a novel eco-friendly management strategy to combat these global issues. This review also gives an intrinsic discussion about the insights of different aspects of environmental and public health concerns caused due to massive leachate generation, the abundance of antibiotics resistance (AR), and the effects of released leachate on the various environmental reservoirs and human health. Furthermore, the current review throws light on the source and fate of different ECs of landfill leachate and their possible impact on the nearby environments (groundwater, surface water, and soil) affecting human health. The present review strongly suggests the demand for future research focuses on the advancement of the removal efficiency of contaminants with the improvement of relevant landfill management to reduce the potential effects of disposable waste. We propose the necessity of the identification and monitoring of potential environmental and human health risks associated with landfill leachate contaminants.

Background Depression is an important global public health problem due to its relatively high lifetime prevalence and significant disability caused by it. The present study was conducted to compare improvement in disability outcome by Amisulpride and Escitalopram among depression patients using WHO-Disability Assessment Schedule (WHO-DAS). Materials and Methods The study was conducted in depression patients for 1 year in the Department of Neuropsychiatry, Nepalgunj Medical College & Teaching Hospital. A total of 117 depression patients were divided into 2 groups. Group I (58 patients) received Amisulpride tablet at a dose of 50 mg/day and Group II (59 patients) were given Escitalopram at a dose of 10 mg/day. The patients were required to follow up at 4 weeks, 8 weeks and at 15 weeks. The efficacy of the drugs was calculated by Hamilton depression rating scale (HAM-D). The improvement in functional outcome was compared between the two groups by using WHO-Disability Assessment Schedule (WHO-DAS). Appropriate statistical tools using GraphPadInstat 3.0 were used for analysis. p value < 0.05 was considered significant. Results HAM-D score in group receiving Amisulpride at 0 and 15 weeks was 16.92±0.35 and 7.87±0.29 (p0.05). Gastrointestinal disturbances, sexual disturbances, amenorrhea, lactation, agitation and insomnia were the commonly encountered adverse drug reactions. Conclusion Both Amisulpride and Escitalopram showed improvement in WHO Disability Assessment Score (WHO-DAS) at the end of study period. But intergroup comparison showed no significant difference in the two groups. Journal of Nobel Medical College Vol.5(2) 2016; 37-42

Ulcer is one of the most common diseases affecting throughout the world population. The allopathic treatment of ulcer adversely affects the health by causing harmful side effects. Currently, many herbal plants and secondary metabolites have been used for the ulcer treatment. In the present review, many herbal plants and their parts (root, rhizome, bark, leaves and fruits) have been listed in the table are currently being used for ulcer treatment. These metabolites are responsible for ulcer-neutralization or anti-inflammatory properties. In silico study, plant metabolites showed interaction between protodioscin (secondary metabolites of Asparagus racemosus) and interferon-γ (virulent factor of gastric ulcer) during molecular docking. All the residues of interferon-γ exhibited hydrophobic interactions with plant metabolites. These interactions helps in understanding the plant secondary metabolites vis a vis will open a new door in the research field of new drug discovery and designing for the ulcer treatment.

Background: Time since death (TSD) is an important parameter to the forensic expert. Only a fewer studies are available in the literature to determine the relationship between vitreous K + concentration and TSD especially among injury (trauma) cases and thus information on the same is patchy and scanty. Objective: To determine the relationship between changes in vitreous K + concentration with increasing TSD among injury (trauma) cases. An additional objective was to derive a formula for determining TSD from changes in levels of vitreous K + in the study subjects. Materials and Methods: In this study, autopsy cases brought to the mortuary of Department of Forensic Medicine and Toxicology of a tertiary care center, were the subjected for collection of vitreous humor for determination of vitreous potassium. Data of 55 such cases where autopsy confirmed the cause of death as injury (trauma), were included in this study. Determination of potassium level in the collected sample was done using ion-selective electrode method (Biolyte 2000 auto analyzer). Results: A linear relationship was observed between vitreous potassium concentration and TSD in both the eyes. External factors like seasonal variations and temperature, gender difference and age had no appreciable effect on the concentration of vitreous potassium in either eye. In this study, the linear regression equations obtained from potassium concentration (y) verses time (x) for the two groups among injury (trauma) cases were as follows: For right eye: Regression line (y) = −5.040 (x) = +1.989, for left eye: Regression line (y) = −5.223 (x) = +2.005. The potassium levels are found to increase up to 40 h after death. Conclusion: The study highlighted the usefulness of relationship between vitreous potassium concentration and TSD in both the eyes. The formula calculated from the current study could prove to be more appropriate as it is based on a more recent study and more reliable tests.

Effect of embedding multiwalled carbon nanotubes (MWCNTs) on low velocity impact response of quasi-isotropic asymmetric laminate of plain woven carbon fabric/epoxy was investigated. Laminates were embedded with 0 wt.%, 2 wt.%, and 5 wt.% MWCNTs to improve impact resistance. Impact in laminates was conducted according to ASTM D7136 standard at an impact energy of 94.14 J corresponding to the impact velocity of 6 m/sec. Energy-time response, force-time response, and pyramidal damage area of laminates doped with varying weight percentage (wt.%) of MWCNTs were quantified and compared with laminate without MWCNTs. Absorbed impact energy increases by 13.53% on doping of 2 wt.% MWCNTs, whereas it decreases by 10.49% on doping 5 wt.% MWCNTs. Damage area is reduced on doping 2 wt.% MWCNTs in laminate.

Highlights: [•] Patients with refractory seizures were assessed with diffusion tensor tractography. [•] We evaluated 33 patients of, lesional and non-lesional, refractory epilepsy. [•] Diffusion changes were detected both ipsilateral and contralateral to the lesion. [•] Microstructural changes were also observed in patients with normal imaging. [•] Our findings may help in epilepsy surgery planning and prognostication. [ABSTRACT FROM AUTHOR]

This study investigates the waste cardboard (WCB) fungal pretreatment (Oligoporus placenta and Tremetes hirsuta) under monoculture and mixed culture and then composting for 35 d after mixing with cow dung in different ratios. Fungal pretreatment caused significant reduction in cellulose (28.3-35.8%), hemicellulose (61.4-68.4%), lignin (67.5-69.3%) content in WCB. Pretreated WCB showed better rates of decrement in total organic carbon (26.02-47.92%), carbon-to-nitrogen ratio (19.4-23.5), and lignocellulose contents, as well as incensement in total nitrogen (40.48-63.31%), total potassium (51.92-73.91%), germination index (88.5-102.0%), and elemental (Cu, Fe, Zn, Cr, and Mn) levels. Dehydrogenases (142-210 µg g -1 h -1 ), and β-galactosidase (210-256 µg g -1 h -1 ) activities indicates high microbial-mediated mineralization in setups. Results suggested that WCB could be used as a valuable substrate for valuable-added compost preparation after pretreating with a consortium of white-rot fungi., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Introduction: Structural imaging of the brain does not demonstrate any changes in a vast majority of patients with vitamin B12 deficiency, even in advanced stages. In this study, we aimed to assess and correlate the functional integrity of the brain fiber tracts using diffusion tensor tractography with neuropsychological examination in patients with vitamin B12 deficiency., Methods: The study was conducted at two tertiary care centers. Thirty-two patients with vitamin B12 deficiency were enrolled and subjected to diffusion tensor tractography, as an extension of diffusion tensor imaging, and neuropsychological assessment. Tests of significance were done to detect changes, pre- and post-vitamin B12 supplementation in the diffusivity parameters (fractional anisotropy and mean diffusivity) and the neuropsychological test scores., Results: Statistically significant changes were observed in the diffusivity parameters and the neuropsychological test scores between the controls and the patients with vitamin B12deficiency in the pre- and post-treatment phases., Conclusions: This is the first study to evaluate the diffusion tensor tractography (DTT) parameters in the light of clinical neuropsychological assessment in patients with vitamin B12 deficiency. Utilization of DTT parameters may antedate structural changes and may quantify the neurocognitive deficits.

Background & Aims: Mammillary body atrophy in alcoholic liver disease usually indicates thiamine deficiency. The purpose of this study was to explore the relationship among blood thiamine, mammillary bodies, major fiber bundle fractional anisotropy, and volume changes with diffusion tensor tractography in patients with acute and acute-on-chronic liver failure of non-alcoholic etiology., Methods: Blood thiamine, mammillary bodies, fiber bundle fractional anisotropy and volume of major fiber tracts were quantified from acute and acute-on-chronic liver failure patients and compared with healthy controls. In 7 acute liver failure patients, follow-up study was done after clinical recovery at 5 weeks., Results: Blood thiamine, mammillary bodies and fornix volume, and fornix fiber bundle fractional anisotropy were significantly decreased as compared to controls. Blood thiamine showed significant positive correlation with mammillary bodies' volume only. On follow-up study, acute liver failure patients showed significant reversibility only in blood thiamine level and mammillary bodies' volume., Conclusions: Mammillary bodies' volume changes are primarily a consequence of thiamine deficiency, which may secondarily result in microstructural changes in the fornix. These observable changes are known to be specific and may be reversible with restoration of blood thiamine level. These imaging changes may be used as imaging biomarker of thiamine deficiency in these patients in future., (Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Introduction: The purpose of the present study was to identify the true prevalence of hemorrhage in the abscess using T2*-weighted angiography (SWAN) imaging and to study its influence on diffusion tensor imaging (DTI) metrics., Methods: Fifteen patients of brain abscess underwent conventional, SWAN, and DT imaging on a 3-T MRI followed by its confirmation with histology. DTI metrics were quantified by region-of-interest analysis on hemorrhagic and non-hemorrhagic regions of the abscess wall. Prussian blue staining was performed on excised abscess walls to confirm hemorrhage on histology., Results: Eleven of 15 patients showed evidence of hemorrhage on both Prussian blue staining as well as SWAN imaging. Fractional anisotropy (FA) and linear anisotropy (CL) values were significantly higher, while spherical anisotropy was significantly lower in hemorrhagic compared to non-hemorrhagic regions of the abscess wall., Conclusion: Hemorrhage in the abscess wall is a common feature and may not always indicate neoplasm. The presence of intracellular iron in addition to concentrically laid collagen fibers may have synergistic effect on FA and CL values in the abscess wall. Inclusion of SWAN to MRI protocol will define the true prevalence of hemorrhage in brain abscess.

Hyperammonemia and inflammation are major contributing factors in the development of cerebral edema (CE) in acute liver failure (ALF). Aim of this study was to look for the relationship between proinflammatory cytokines with diffusion tensor imaging (DTI) derived metrics and (1)H-MR spectroscopy ((1)H-MRS) derived Glutamate/Glutamine (Glx). Fourteen patients with ALF and 14 age/sex matched controls were included in this study. All subjects had undergone clinical, biochemical, MR imaging and (1)H-MRS studies. Serum proinflammatory cytokines (IL-6 and TNF-α), blood ammonia level and Glx were computed for independent t-test and Pearson correlation. Serum proinflammatory cytokines, blood ammonia level and brain Glx were significantly increased in ALF patients as compared to controls. Blood ammonia level and Glx showed significant positive correlation with proinflammatory cytokines. Spectroscopy voxel derived spherical anisotropy (CS) showed positive correlation with Glx while mean diffusivity (MD) showed negative correlation. Proinflammatory cytokines showed positive correlation with CS and negative correlation with MD in various brain regions including spectroscopy voxel. Significant correlation of Glx, CS and MD with proinflammatory cytokines suggests that both DTI derived metrics and (1)H-MRS measure the synergistic effect of hyperammonemia and proinflammatory cytokines and may be used as non-invasive tools for understanding the pathogenesis of CE in ALF.

Introduction: It is not always possible to differentiate infective from neoplastic brain lesions with conventional MR imaging. In this study, we assessed the utility of various perfusion indices in the differentiation of infective from neoplastic brain lesions., Methods: A total of 103 patients with infective brain lesions (group I, n=26) and neoplastic brain lesions (high-grade glioma, HGG, group II, n=52; low-grade glioma, LGG, group III, n=25) underwent dynamic contrast-enhanced MR imaging. The perfusion indices, including relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), transfer coefficient (k(trans)) and leakage (v(e)), were calculated and their degree of correlation with immunohistologically obtained microvessel density (MVD) and vascular endothelial growth factor (VEGF) determined. The rCBV was corrected for the leakage effect. Discriminant analysis for rCBV, rCBF, k(trans) and v(e) was performed to predict the group membership of each case and post hoc analysis was performed to look for group differences., Results: The rCBV, rCBF, k(trans), v(e), MVD and VEGF were significantly different (P<0.001) between the three groups. Discriminant analysis showed that rCBV predicted 73.1% of the infective lesions, 84.6% of the HGG and 72.0% of the LGG. The rCBF classified 86.5% of the HGG, 80.0% of the LGG and 65.4% of the infective lesions. The k(trans) discriminated 98.1% of the HGG, 76.0% of the LGG and 88.5% of the infective lesions correctly. The v(e) classified 98.1% of the HGG, 76.0% of the LGG and 84.6% the infective lesions. The rCBV was correlated significantly with MVD and VEGF, while the correlation between k(trans) and MVD was not significant., Conclusion: Physiological perfusion indices such as k(trans) and v(e) appear to be useful in differentiating infective from neoplastic brain lesions. Adding these indices to the current imaging protocol is likely to improve tissue characterization of these focal brain mass lesions.

Purpose: The aim of this study was to ascertain whether diffusion tensor imaging (DTI) metrics fractional anisotropy (FA), mean diffusivity (MD), linear case (CL), planar case (CP), spherical case (CS)-can characterize a threshold dose and temporal evolution of changes in normal-appearing white matter (NAWM) of adults with low-grade gliomas (LGGs) treated with radiation therapy (RT)., Methods and Materials: Conventional and DTI imaging were performed before RT in 5 patients and subsequently, on average, at 3 months (n = 5), 8 months (n = 3), and 14 months (n = 5) following RT for a total of 18 examinations. Isodose distribution at 5-Gy intervals were visualized in all the slices of fluid attenuated inversion recovery (FLAIR) and the corresponding DTI images without diffusion sensitization (b0DTI). The latter were exported for relative quantitative analysis., Results: Compared to pre-RT values, FA and CL decreased, whereas CS increased at 3 and 8 months and recovered partially at 14 months for the dose bins >55 Gy and 50-55 Gy. For the 45 50 Gy bin, the FA and CL decreased with an increase in CS at 3 months; no further change was seen at 8 or 14 months. For the >55 Gy and 50-55 Gy bins, CP decreased and MD increased at 3 months and returned to baseline at 8 months following RT., Conclusion: Radiation-induced changes in NAWM can be detected at 3 months after RT, with changes in FA, CL, and CS (but not CP or MD) values seen at a threshold dose of 45-50 Gy. A partial recovery was evident by 14 months to regions that received doses of 50-55 Gy and >55 Gy, thus providing an objective measure of radiation effect on NAWM.