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The groundwater of many developed and developing countries including India has reported excessive fluoride concentrations. Various technologies are being used to remove fluoride from water but still the problem has remained unsolved. Among the available different technologies, adsorption is one of the best methods due to its easy handling, high efficiency, and lower cost. Adsorption technique with the application of nanoadsorbents has become more efficient, as the adsorption capacity is found to increase significantly due to the large surface area provided by the nanoparticles. Since the last few years, nanomaterial-related technologies have gained much attention in the field of water treatment. The previous studies have discussed the possible mechanism for fluoride ion adsorption on nanoparticles. This chapter discusses the possibility of magnesium oxide nanoparticles as adsorbents for the removal of fluoride from wastewater. This chapter demonstrated the use of modified Hummers' method for synthesizing nano-magnesium oxide (n-MgO) and nanocomposites (n-MgO-coated GOs). The developed adsorbents were characterized using various methods such as FTIR, XRD, SEM-EDX, TEM, etc. The effect of various influencing parameters such as initial pH, initial fluoride concentration, adsorbent dosage, and contact time on fluoride adsorption using developed adsorbents was studied. This chapter demonstrated the efficient removal of fluoride ions from aqueous solution using n-MgO and nanocomposites.

A variety of industrial effluents causing detrimental effects have been posing serious environmental issues. Efforts have been taken to remove these effluents by using different conventional treatment processes; however, they possess some disadvantages. Nanoadsorbents have desirable characteristics such as uniform particle size, higher removal efficiency, environmental friendly, and selectivity, which are useful for higher pollutant removal. This study highlights the use of nanoadsorbents for effective removal of industrial removal. The factors responsible for adsorption efficiency—contact time, dosage, initial concentration, pH, temperature, ionic strength, and dissolved organic matter—have been discussed in detail. Different characterization techniques have been discussed in detail. Furthermore, different types of adsorption mechanisms such as π-π Interaction, electrostatic interaction, hydrophobic interaction, and hydrogen bonding have been elaborated to understand the adsorption of pollutants in detail. Finally, challenges in adsorption, conclusion, and future prospective related to the use of nanomaterials in pollution control have been elaborated.

BackgroundPlants have been used in alternative and traditional medicines for the cure of different types of diseases since ancient time. Secondary metabolites from natural sources play a crucial role in the treatment of various ailments. The present study carried out to investigate the phytochemical, antimitotic and cytotoxic activity of methanolic (95%) extracts ofMucuna pruriensseeds,Asteracantha longifoliaseeds andSphaeranthus indicusstems.ResultPhytochemical analysis was performed using qualitative test to confirm the presence of phytochemical such as flavonoids, terpenoids, amino acids, cardiac glycosides, saponins, steroids, tannins, phenols and carbohydrates. The antimitotic activity was screened by usingAllium ceparoot meristematic cells. Methotrexate (0.1 mg/mL) was used as a standard. The data was analyzed by using software GraphPad Prism, Version 6.0 (GraphPad Software Inc., San Diego, CA) with one-way ANOVA. A statistical difference ofp< 0.05 was considered significant in all cases.pvalueof M. pruriensseeds,A. longifoliaseeds andS. indicusstems calculatedp= 0.0001 for all plant extracts. Cytotoxic potential of all three plant extracts have been studied on breast cancer cell line MCF7 and lung cancer cell line A549.M. pruriensshowed mild cytotoxicity with IC50values 36.74 μg/mL on MCF7 and 39.42 μg/mL on A549 cell line.A. longifoliashowed better activity on MCF7 with IC50of 12.32 μg/mL and theS. indicusshowed the least activity on MCF7 with IC50of 185.56 μg/mL. TheA. longifoliashowed better activity on A549 with IC50of 16.53 μg/mL.ConclusionA. longifoliahas significant amount of nearly all phytochemicals as compared to other two plant extracts. It is found that all three plant extracts showed antimitotic activity havingpvalue less than 0.05. The cytotoxicity assay revealed that all plant extracts displayed inhibition of MCF7 and A549 cells lines.A. longifoliashowed better activity against MCF7 whileM. prurienspossessed mild cytotoxic effect against both MCF7 and A549 cell lines.

Microneedles (MNs) are tiny needle like structures used in drug delivery through layers of the skin. They are non-invasive and are associated with significantly less or no pain at the site of administration to the skin. MNs are excellent in delivering both small and large molecules to the subjects in need thereof. There exist several strategies for drug delivery using MNs, wherein each strategy has its pros and cons. Research in this domain lead to product development and commercialization for clinical use. Additionally, several MN-based products are undergoing clinical trials to evaluate its safety, efficacy, and tolerability. The present review begins by providing bird’s-eye view about the general characteristics of MNs followed by providing recent updates in the treatment of cancer using MNs. Particularly, we provide an overview of various aspects namely: anti-cancerous MNs that work based on sensor technology, MNs for treatment of breast cancer, skin carcinoma, prostate cancer, and MNs fabricated by additive manufacturing or 3 dimensional printing for treatment of cancer. Further, the review also provides limitations, safety concerns, and latest updates about the clinical trials on MNs for the treatment of cancer. Furthermore, we also provide a regulatory overview from the “United States Food and Drug Administration” about MNs.

ObjectiveTo investigate in situ decellularization of a large animal model of saccular aneurysm as a strategy for achieving aneurysmal growth and lasting inflammation.Methods18 New Zealand White rabbits were randomized 2:1 to receive endoluminal sodium dodecyl sulfate infusion (SDS, 1% solution, 45 min) following elastase or elastase-only treatment (control). All aneurysms were measured by digital subtraction angiography every 2 weeks. Every 2 weeks, three of the rabbits (two elastase + SDS, one control) underwent MRI, followed by contrast injection with myeloperoxidase (MPO)-sensing contrast agent. MRI was repeated 3 hours after contrast injection and the enhancement ratio (ER) was calculated. Following MRI, aneurysms were explanted and subjected to immunohistopathology.ResultsDuring follow-up MRI, the average ER for SDS-treated animals was 1.63±0.20, compared with 1.01±0.06 for controls (pConclusionsIn situ decellularization of a large animal model of saccular aneurysms reproduces features of unstable aneurysms, such as chronic inflammation (up to 12 weeks) and active aneurysm wall remodeling, leading to continued growth over 8 weeks.

OBJECTIVE To study the safety profile of blind bronchial sampling in mechanically ventilated children. DESIGN Prospective interventional study. SETTING Tertiary level pediatric intensive care unit of a multispecialty hospital. PATIENTS Children aged 1 month to 16 years on mechanical ventilator for ≥48 h, were assessed by clinical pulmonary infection score for ventilator-associated pneumonia (VAP). INTERVENTIONS Blind bronchial sampling was performed following standard procedural guidelines. The hemodynamic, ventilation parameters, and arterial blood gases done before, and in next 24 h post procedure were recorded and compared. MEASUREMENTS AND MAIN RESULTS Among the 40 enrolled children, VAP was suspected at 5.8 ± 3.7 days post intubation with insignificant increase in median (IQR) PELOD score to 15 (11-23) from 13.5 (11-23) (P value 0.29). A statistically significant increase in mean blood pressure (75.5 ± 14.7 to 79.1 ± 14.2, P 0.04) and transient drop in SpO2 (98.2 ± 2.3 to 92.2 ± 9.2, P

In the present study, H. stevensii was cultivated on a semi-continuous mode in a laboratory scale bio-reactor using CO2(g) [15% (v/v)] as carbon source and thiosulfate (S2O32−) as an energy source for the total duration of three days. Approximately, 100% CO2(g) removal from gaseous phase was achieved. Leachate obtained was subjected to different downstream bio-processing strategies. Biomass harvesting using filtration and recovery of metabolites without cell disruption using solvent extraction from wet biomass was observed as the best downstream processing strategy. Qualitative analysis of products was carried out using gas chromatography and mass spectroscopy (GC–MS) and their results have indicated fatty alcohols (C8–C27) as primary metabolites. Fourier transform infrared spectroscopy (FTIR) analysis, approximate material balance and thermodynamic analysis have confirmed the intracellular assimilation of CO2(g) as HCO3− and its metabolization into fatty alcohols. Economic feasibility of the process has suggested that the developed downstream process has the capability to replace coconut oil based process for the production of fatty alcohols (C12–C14) and it can be utilized for the production of dodecanol as compared to the tetradecanol.

Background: Sickle cell disease (SCD) is major health problem in central India. This is a single centre study conducted to assess the health-related quality of life (HRQOL) in children and adolescent with homozygous (SS pattern) and heterozygous (AS pattern) SCD with respect to healthy children.Methods: This is a case control study conducted in a tertiary care hospital. Study group included total of 150 children and adolescents with SS pattern and AS pattern. HRQOL of the children in study group was compared with demographically matched 100 healthy children in comparison group. WHO-QOL BREF questionnaire was administered to both the groups to measure their HRQOL in various domains. Multivariable linear regression was used to account for socio-demographic factors influencing HRQOL.Results: The WHO-QOL BREF scores of children with SS pattern were significantly lower than those obtained in the AS pattern and healthy children (p

Constitutively activated signal transducer and activator of transcription 3 (STAT3) factor is an important therapeutic target in head and neck cancer (HNC). Despite early promising results, a reliable systemic delivery system for STAT3- targeted oligonucleotide (ODN) drugs is still needed for future clinical translation of anti-STAT3 therapies. We engineered and tested a novel ODN duplex/gold nanoparticle (AuNP)-based system carrying a therapeutic STAT3 decoy (STAT3d) payload. This strategy is two-pronged because of the additive STAT3 antagonism and radiosensitizing properties of AuNP. The specificity to head and neck cancer cell surface was imparted by using a nucleolin aptamer (NUAP) that was linked to AuNP for taking the advantage of an aberrant presentation of a nuclear protein nucleolin on the cell surface. STAT3d and nucleolin aptamer constructs were independently linked to AuNPs via Au-S bonds. The synthesized AuNP constructs (AuNP-NUAP-STAT3d) exhibited internalization in cells that was quantified by using radiolabeled STAT3d. AuNP-NUAP-STAT3d showed radiosensitizing effect in human HNC FaDu cell culture experiments that resulted in an increase of cell DNA damage as determined by measuring γ-H2AX phosphorylation levels by flow cytometry. The radiosensitization study also demonstrated that AuNP-NUAP-STAT3d as well as STAT3d alone resulted in the efficient inhibition of A431 cell proliferation. While FaDu cells did not show instant proliferation inhibition after incubating with AuNP-NUAP-STAT3d, the cell DNA damage in these cells showed nearly a 50% increase in AuNP-NUAP-STAT3d group after treating with radiation. Compared with anti-EGFR humanized antibody (Cetuximab), AuNP-NUAP-STAT3d system had an overall stronger radiosensitization effect in both A431 and FaDu cells.

Status Asthmaticus is a common reason for Emergency Room visits in children. Most of the asthma flares are successfully managed by use of β agonist and steroids. If these therapies fail to halt the progression of asthma, a number of medical therapies may be used to treat it. However, the data supporting the use of these therapies are conflicting. We present successful use of Extracorporeal Membrane Oxygenation and isoflurane in a child with Refractory Status Asthmaticus.

Background: Unintentional injuries are important cause for childhood mortality and long-term morbidity. Developing countries accounts for majority of the childhood deaths due to unintentional injuries. Methods: This was a retrospective descriptive study done at a tertiary care center. Data were obtained from the records of patients. Result: A total of 180 children presented to pediatric emergency during the study period with male-to-female ratio of 2.1:1. The injuries were more common in 1-5-year age group. The most common mechanism of injuries were fall (49.4%) and hit by object (11.1%). Most of the injuries occurred at home. Median duration of arrival to hospital was 60 minutes. Out of 180 children, 19 (10.5%) required hospital admission. Injuries over the head and face were significantly associated with hospital admissions (adjusted odds ratio: 6.45, 95% confidence interval: 1.96-21.93, p=0.002).Background: Unintentional injuries are important cause for childhood mortality and long-term morbidity. Developing countries accounts for majority of the childhood deaths due to unintentional injuries. Methods: This was a retrospective descriptive study done at a tertiary care center. Data were obtained from the records of patients. Result: A total of 180 children presented to pediatric emergency during the study period with male-to-female ratio of 2.1:1. The injuries were more common in 1-5-year age group. The most common mechanism of injuries were fall (49.4%) and hit by object (11.1%). Most of the injuries occurred at home. Median duration of arrival to hospital was 60 minutes. Out of 180 children, 19 (10.5%) required hospital admission. Injuries over the head and face were significantly associated with hospital admissions (adjusted odds ratio: 6.45, 95% confidence interval: 1.96-21.93, p=0.002). Conclusion: Pediatric injuries are common in India. Male children are at higher risk. Injuries over the head and face are associated with higher rates of hospitalization in children. Pediatric injuries are common in India. Male children are at higher risk. Injuries over the head and face are associated with higher rates of hospitalization in children.

The present study demonstrates development of silver-yttrium oxide nanopcomposites (SYONs) and its use as novel adsorbent for efficient removal of Cu(II), Cr(VI)and multiple metal ions from waste water. The nanocomposite was synthesized using solution combustion synthesis method and characterized using standard technique viz. with X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), energy dispersive X-ray (EDX) spectroscopy, thermo gravimetric analysis (TGA), zeta potential and Fourier transform infrared spectroscopy (FTIR) analysis. The particles were elliptical in shape with the size predominantly ranging between 41 and 70 nm. A series of experiments was performed to study the effect of various parameters (contact time, concentration of metal ions, pH, adsorbent dose, temperature) on the metal ion removal potential of SYONs. The maximum adsorption capacity for Cu(II) and Cr(VI) was obtained as 773 ± 4.94 mg g−1 and 720 ± 8.48 mg g−1 respectively. The equilibrium time of contact for adsorption was found as 720 min and adsorption of Cu(II) and Cr(VI) was found maximum at pH = 6. Thermodynamic studies revealed that the adsorption of Cu(II) and Cr(VI) on SYONs surface was an endothermic process. The nanoadsorbent was successfully regenerated using acid treatment for consecutive cycles.

General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. The most common emergencies encountered in pediatric office practice are respiratory distress, dehydration, anaphylaxis, seizures and trauma. Assessment of children is sometimes difficult as the signs and symptoms might be subtle and not markedly expressed. Also, normal value of vital signs vary with age, thus their interpretation requires discrete knowledge of age appropriate values. Initial approach to a sick child involves formation of initial impression, doing primary assessment, proper history taking and classifying the condition into following categories: Respiratory distress, Respiratory failure, Compensated shock, Decompensated shock and Primary brain dysfunction. Initial management of any pediatric emergency involves assessment of airway, breathing and circulation and providing relevant adequate support. Majority of cardiac arrests in pediatric practice are secondary to progressive respiratory failure and thus, if intervened timely and effectively, will prevent fatal outcome. In a child with shock, compensated state can rapidly evolve to decompensated state, thus necessitating its early recognition and rapid intervention. Anaphylaxis should be suspected in any child with sudden onset of skin or mucosal symptoms along with respiratory, circulatory or gastro-intestinal involvement and adrenaline should be given by intra-muscular route.

Rickettsial infections are relatively less common in children, probably due to low index of suspicion and unavailability of diagnostic facilities. Scrub typhus is the predominant type of rickettsial illness identified in our country. Infections with other rickettsial species are rarely reported in Indian children. We report a case of a 3 year child with acute febrile illness with rash and multiorgan dysfunction. Weil Felix test was strongly positive for OX 19, with negative scrub typhus IgM antibody test, suggesting a murine typhus infection. There were few salient differences in clinical and laboratory parameters, compared to scrub. Treatment of rickettsial infections is inexpensive and highly effective especially in early course of the disease. Differential diagnosis of rickettsial infection should be kept in a child presenting with fever, rash and multisystem involvement and adding empirical doxycycline at admission may be considered.

PURPOSE: To develop multimodality imaging techniques for measuring epidermal growth factor receptor (EGFR) as a therapy-relevant and metastasis-associated molecular marker in triple-negative mammary adenocarcinoma metastases. MATERIALS AND METHODS: An orthotopic bone metastasis EGFR-positive, triple-negative breast cancer (TNBC) model in rats was used for bioluminescence imaging, SPECT/CT, PET/CT, and MRI with quantitative analysis of transcripts (n = 22 rats). Receptor-specific MRI of EGFR expression in vivo was performed by acquiring spin-echo T1-weighted images after sequential administration of a pair of anti-EGFR antigen binding fragments, F(ab’)(2), conjugated to either horseradish peroxidase or glucose oxidase, which have complementing activities, as well as paramagnetic (gadolinium[III]-mono-5-hydroxytryptamide of 2,2′,2′′-(10-(2,6-dioxotetrahydro-2H-pyran-3-yl)-1,4,7,10-tetraazacyclododecane-1,4,7-triyl)triacetic acid, or Gd-5HT-DOTAGA) or positron-emitting (gallium 68-5HT-DOTAGA) substrates for MRI and PET/CT imaging, respectively. EGFR expression was confirmed by quantitative reverse transcriptase polymerase chain reaction and immunohistochemical analyses to compare with image findings. RESULTS: After surgical intraarterial delivery of TNBC cells, rats developed tumors that diverged into either rapidly growing osteolytic or slow-growing nonosteolytic tumors. Both tumor types showed receptor-specific initial MRI signal enhancement (contrast-to-noise ratio) that was three to six times higher than that of normal bone marrow (29.4 vs 4.9; P < .01). Micro PET/CT imaging of EGFR expression demonstrated a high level of heterogeneity with regional uptake of the tracer, which corresponded to region-of-interest MRI signal intensity elevation (121.1 vs 93.3; P < .001). Analysis of metastases with corroboration of imaging results showed high levels of EGFR protein and messenger RNA, or mRNA, expression in the invasive tumor. CONCLUSION: Convergence of multimodal molecular receptor imaging enabled comprehensive assessment of EGFR overexpression in an orthotopic model of TNBC metastasis. Keywords: Animal Studies, Molecular Imaging-Cancer, MR-Contrast Agent, Radionuclide Studies, Skeletal-Appendicular, Metastases Supplemental material is available for this article. © RSNA, 2021

The present study demonstrates the integration between carbon dioxide [CO2 (g)] fixation process with the wastewater treatment and simultaneous production of value added products utilizing Halomonas stevensii (H. stevensii). Laboratory scale experiments were conducted in a bio-reactor (semi-continuous mode) for 6 days to evaluate the potential of H. stevensii towards biofixation of CO2 (g) [10% (v/v)] in deionized water with 100 mM thiosulphate, domestic wastewater with 100 mM thiosulphate and domestic wastewater. H. stevensii grown on domestic wastewater showed maximum biomass yield, maximum specific growth rate and biomass productivity of 5.31 g L−1, 1.19 d−1 and 3.24 g L−1 d−1, respectively which are comparable with the results obtained from two other culture medias. The possibility for the simultaneous removal of various nutrients and pollutant such as NO3–, NH4+, PO43-, COD and SO42– were also carried out. FTIR and GC-MS analysis of leachate confirmed the presence of fatty alcohols and long chain hydrocarbons in all the three culture medias. The GC-MS analysis of cell lysate and supernatant in all the three culture conditions is dominated by the presence of hydrocarbons and fatty alcohols. Techno-economic analysis of the present system was carried out by estimating the total operating cost per batch and per kg of biomass produced. The assessment indicated the feasibility for the use of domestic wastewater as culture media as a replacement of deionized water with thiosulphate ions.

Objective: The objective of the study was to evaluate the etiology of hospital-acquired hyponatremia (HAH) and its effects on morbidity and mortality in the Pediatric Intensive Care Unit (PICU) patients. Design: This study design was a prospective observational case–control study. Setting: this study was conducted at tertiary care PICU. Materials and Methods: All consecutive cases admitted with at least one measured serum sodium (PNa) value were evaluated. Those with normal admission PNa were followed till they develop hyponatremia (PNa < 35 mEq/L) 7 days or PICU discharge whichever was earlier. Results: During the study period, 123 (19.6%) cases developed HAH and 126 patients remained isonatremic (control group). The admission PNa 138.8 ± 3.03 mEq/L decreased to 132 ± 2.58 mEq/L (drop of 6.68 ± 3.39 mEq/L, P < 0.001) in HAH cases. The use of antidiuretic hormone (ADH)-stimulating drugs (odds ratio [OR]: 2.83, P = 0.01), postsurgical status (OR: 2.95, P = 0.006), and fluid intake ml/kg (OR: 1.0, P = 0.001) were found to be significant risk factors in HAH group on multivariate analysis. HAH cases had prolonged PICU stay (P = 0.000) and mechanical ventilation (P = 0.01), but no difference in the mortality when compared to controls. Conclusions: HAH is associated with increased fluid intake, presence of ADH-stimulating drugs or conditions, and postsurgical status and has an adverse effect on the outcome of PICU patients.

Introduction: Cardiovascular autonomic neuropathy (CAN) is a least understood complication of diabetes which is often underdiagnosed. It causes resting tachycardia, orthostatic hypotension, and exercise intolerance and is associated with higher cardiovascular mortality in diabetic patients. This stresses the need of early diagnosis of CAN to prevent higher mortality rates. Materials and Methods: Fifty cases of diabetes mellitus with no clinical evidence of cardiac disease were subjected to cardiac autonomic function (CAF) tests according to Ewing's criteria which included heart rate (HR) variability during deep breathing, Valsalva maneuver ratio, HR response on standing, blood pressure (BP) response to standing, and BP response to sustained handgrip to find the prevalence of CAN. Results: In this study, among 100 patients (50 case and 50 control), we found CAN in 52%. Out of which, parasympathetic neuropathy was seen in 52% of cases, and sympathetic neuropathy was seen in 26% of cases. CAF tests of HR variability during deep breathing, Valsalva maneuver ratio, HR response to standing, BP response to standing, and BP response to sustained handgrip found abnormal response in 68%, 40%, 52%, 12%, and 14%, respectively. Diabetic retinopathy and nephropathy were significantly associated with CAN (P = 0.0001, S). Conclusion: Prevalence of CAN among diabetics was 52%, and parasympathetic CAF tests are more sensitive for the detection of CAN than sympathetic CAF tests. Development of CAN in diabetic patients may lead to increased morbidity; thence, they should be routinely evaluated for CAN using these bedside tests.

The present study was aimed to isolate, Klebsiella pneumoniae from activated sludge. It was used to remove Zn 2+ from aqueous solution in batch and continuous modes. Batch study was conducted for 20–200 mg L −1 of initial Zn 2+ concentration to determine the optimum value of initial Zn 2+ concentration. Batch bioremediation studies were also performed to determine the optimum values of solution pH, minimal salt medium (MSM) dosage, macronutrients amount, aerobic & facultative anaerobic conditions, temperature and inoculum volume. The optimum solution pH for the growth of K. pneumoniae was found as 7 for the Zn 2+ bioremediation. The growth of K. pneumoniae was found optimum in aerobic condition and in the temperature range of 37–40 °C. In continuous mode, the removal of Zn 2+ from aqueous solution was investigated in a hybrid biofilter column packed with coal and compost as medium over a period of 60 days. K. pneumoniae was used as a potential metal removing agent. The maximum removal efficiency was obtained as 91.5% during phase II for 10 mL min −1 flow rate of Zn 2+ and 20 mg L −1 of Zn 2+ inlet concentration. Biofilter column was run under shock loading conditions for 14 days immediately after 60 days of operation which revealed the stable nature of the column with fluctuating inputs. Field emission scanning electron microscopy with electron dispersive X-ray (FESEM-EDX) analysis confirmed the presence of Zn 2+ and change in surface morphology after Zn 2+ sorption on the outer surface of K. pneumoniae .

The fixed-bed adsorption experiments are performed for the removal of copper [Cu(II)] and zinc [Zn(II)] by utilizing activated neem bark as an adsorbent. The present study demonstrated the effect of various parameters such as inlet concentration, adsorbent mass and inlet flowrate for the removal of Cu(II) and Zn(II) from aqueous solutions. Various kinetic parameters such as EBRT, stoichiometric capacity, breakthrough time, etc. are evaluated using the experimental data. Yoon–Nelson and Yan model available in the literature are also validated with the experimental data. The developed adsorbent is also tested for the simultaneous removal of multiple metal ions [Cr(VI), Cu(II), Zn(II), Pb(II), Ni(II) and Cd(II)] from the synthetically prepared pulp & paper industrial effluent.

Sequestration of single heavy metal contaminant from industrial wastewater using pure bacterial strains has received much attention. However, application of a bacterial consortium in multiple metals sequestration is scarce. The present study was aimed to develop a consortium from three bacterial strains for the simultaneous sequestration of ternary metal ions (Cr6+, Cu2+ and Zn2+) from aqueous solution. Kinetic studies showed that the individual strain, Pseudomonas taiwanensis; Acinetobacter guillouiae and Klebsiella pneumoniae were able to remove Cr6+, Cu2+ and Zn2+ respectively. These bacterial strains were utilized to develop an indigenous consortium based on metal removal affinities and positive interferences between them. Consortium showed improved performance over individual strains for the removal of single as well as simultaneous removal of three metal ions. Fourier transform infrared (FTIR) spectral analysis showed the possible involvement of carboxyl, amino, hydroxyl, methyl, phosphate and sulphonate groups in metal ions sequestration. Consortium exhibits greater adaptability in ternary metal ions mixture which indicates its robust growth mechanism over individual bacterial strains.

Orodispersible Thin Films (OTFs) are the most innovative and patient-centered novel drug delivery systems. Many Pharmaceutical companies and academic experts across the world are already in the process of exploring the true potential of these films in delivering drugs not only from synthetic sources but also from the natural sources. The beauty of this unique drug delivery system is that they don't need water for consumption, as we see with consumption of conventional dosage forms (tablets, capsules), by the subjects. Additionally, these delivery systems are excellent in gaining patient compliance in general and particularly in pediatric and geriatric patient population. The present review provides insight into the history of OTFs, definitions, types of classification, mandatory characteristics, formulation aspects, manufacturing and evaluation methodologies, stability, approvals by regulatory authorities (CDSCO of India), key players in the domain, notable patent battle and future market potential.

PURPOSE. Developing and testing of microbicides for pre-exposure prophylaxis and post-exposure protection from HIV are on the list of major HIV/AIDS research priorities. To improve solubility and bioavailability of highly potent anti-retroviral drugs, we explored the use of a nanoparticle (NP) for formulating a combination of two water-insoluble HIV inhibitors. METHODS. The combination of a non-nucleoside HIV reverse transcriptase inhibitor (NNRTI), Efavirenz (EFV), and an inhibitor of HIV integrase, Elvitegravir (ELV) was stabilized with a graft copolymer of methoxypolyethylene glycol-polylysine with a hydrophobic core (HC) composed of fatty acids (HC-PGC). Formulations were tested in TZM-bl cells infected either with wild-type HIV-1(IIIB), or drug-resistant HIV-1 strains. In vivo testing of double-labeled NP formulations was performed in female rats after a topical intravaginal administration using SPECT/CT imaging and fluorescence microscopy. RESULTS. We observed a formation of stable 23–30 nm NP with very low cytotoxicity when EFV and ELV were combined with HC-PGC at a 1:10 weight ratio. For NP containing ELV and EFV (at 1:1 by weight) we observed a remarkable improvement of EC50 of EFV by 20 times in the case of A17 strain. In vivo imaging and biodistribution showed in vivo presence of NP components at 24 and 48h after administration, respectively. CONCLUSIONS. Insoluble orthogonal inhibitors of HIV-1 life cycle may be formulated into the non-aggregating ultrasmall NP which are highly efficient against NNRTI-resistant HIV-1 variant.

Enzymatic activity sensing in fluorescence lifetime (FLT) mode with “self-quenched” macromolecular near-infrared (NIR) sensors is a highly promising strategy for in vivo imaging of proteolysis. However, the mechanisms of FLT changes in such substrate-based NIR sensors have not yet been studied. We synthesized two types of sensors by linking the near-infrared fluorophore IRDye 800CW to macromolecular graft copolymers of methoxy polyethylene glycol and polylysine (MPEG-gPLL) with varying degrees of MPEGylation and studied their fragmentation induced by trypsin, elastase, plasmin and cathepsins (B,S,L,K). We determined that the efficiency of such NIR sensors in FLT mode depends on sensor composition. While MPEG-gPLL with a high degree of MPEGylation showed rapid (τ1/2=0.1–0.2 min) FLT increase (Δτ=0.25 ns) upon model proteinase-mediated hydrolysis in vivo, lower MPEGylation density resulted in no such FLT increase. Temperature-dependence of fluorescence de-quenching of NIR sensors pointed to a mixed dynamic/static-quenching mode of MPEG-gPLL-linked fluorophores. We further demonstrated that although the bulk of sensor-linked fluorophores were de-quenched due to the elimination of static quenching, proteolysis-mediated deletion of a fraction of short (8–10kD) negatively charged fragments of highly MPEGylated NIR sensor is the most likely event leading to a rapid FLT increase phenomenon in quenched NIR sensors. Therefore, the optimization of “built-in” dynamic quenching elements of macromolecular NIR sensors is a potential avenue for improving their response in FLT mode.

In the present study, a strategy to obtain the optimum parameters for the removal of metal ions from wastewater is developed. A generalized model is proposed which can be used to represent the dependence of the dependent parameter on the independent parameters. Here, the experimental data from various studies available in the literature are utilized for the development of the model. The experimental data are normalized on the basis of their maximum value considered among all the experiments in the study. The normalized data are further non-linearly regressed to a fourth-order polynomial using Microsoft Excel 2007 to obtain the model equation. The model equation is developed indicating the dependence of dependent parameter (adsorption capacity) on the independent parameters (initial metal concentration, pH, contact time and adsorbent dosage). The proposed generalized equation is validated using various experimental results from the literature and the parameters of the model equation are being estimated. The modeled equation is later being optimized by applying a specific optimization technique (differential evolution). A code of differential evolution is being developed using the platform of MATLAB 7 for the optimization of the models.

Present study deals with the development of a nano-porous adsorbent using neem bark for the simultaneous removal of Cu(II), Cr(VI) and Zn(II). The developed adsorbent is characterized using SEM, EDS and TGA. The effect of initial metal concentration, contact time, adsorbent dosage, temperature and pH are studied to see the performance of nANB for the metal ions removal. Various isotherm, kinetic and mass transfer models are validated with the experimental data and corresponding parameters are estimated. The maximum adsorption capacity of the developed adsorbent for Cu(II) and Zn(II) adsorption are found to be 21.23 and 11.904 mg g−1, respectively. The optimum parameter values for contact time, adsorbent dosage, temperature and pH are obtained as 48 h, 6 g L−1, 35 °C and 1.2, respectively, from the experimental results of Cu(II) and Zn(II) removal using nANB. The performance of nANB on the industrial effluent is evaluated by performing equilibrium batch experiments for the simultaneous removal of Cu(II), Cr(VI) and Zn(II) from an aqueous solution. The overall adsorption capacity of the nANB for the removal of multiple metal ions at 200 mg L−1 of each is obtained as 38.95 mg g−1 which is more than double for that obtained for individual metal ions.

In recent years, the biofiltration technique has gained significant importance for the removal of toxic organic compounds. However, very limited studies on biofiltration were carried out for the removal of divalent copper [Cu(II)] from aqueous solution using indigenous packing material. There are no reports in the literature that deal with the performance evaluation and kinetic modeling of the biofilter column for the removal of Cu(II). In the present study, a lab- scale biofilter column was fabricated and packed with a mixture of compost and coal as a packing material. The seeding of the column was done using an indigenous bacterial strain Acinetobacter guillouiae . The removal of divalent copper [Cu(II)] was investigated in this column for a period of 55 days. The maximum removal efficiency of 97.5% was achieved during phase II for Cu(II) inlet concentration of 20 mg L −1 . During shock loading, maximum removal efficiency obtained was 87% for initial Cu(II) concentration 28.5–30 mg L −1 . The Michaelis–Menten kinetic constants obtained were 0.2 mg L −1 min −1 and 13.03 mg L −1 . It was found that the Ottengraf model with zero-order diffusion-limitation fits the experimental data quite well for phase II, III and V.

Continuous adsorption experiments are carried out in a fixed-bed to evaluate the performance of a newly developed low-cost adsorbent (activated neem bark, ANB) for the removal of Cr(VI) along with other metal ions (Cu & Zn) from aqueous solutions. The effect of initial Cr(VI) concentration, mass of adsorbent and flow rate on the breakthrough curve are studied. It is observed that as there is an increase in the initial concentration of Cr(VI) from 50 to 100 mg L −1 , the mass of the adsorbent from 25 to 175 g, and flow rate from 5 to 15 mg L −1 , the breakthrough time decreases from 24.78 to 13.875 h, increase from 9.25 to 111.66 h and decrease from 35.09 to 8.26 h, respectively. The effect on the performance of the ANB for Cr(VI) adsorption is also studied in the presence of Cu and Zn. The breakthrough time is achieved earlier in the presence of Cu and Zn in the feed stream. The fixedbed adsorption process parameters such as saturation loading capacity, breakthrough time, total percentage removal of Cr(VI), the fraction of unused bed length, adsorption exhaustion rate and empty bed residence time are calculated for different experimental runs. The experimental results are likewise applied to the Yoon‐Nelson and the Yan kinetic models. The kinetic parameters for both the models are calculated and reported in this study.

Introduction: Depression and Metabolic syndrome both are the two major public health issues. The depressive patients are at higher risk for Cardiovascular Disease (CVD). The use of antidepressant medication has been linked to CVD. Major depression is associated with activation of the inflammatory response. Aim: To investigate the presence of metabolic syndrome, cardiovascular risk and inflammatory marker levels in depressed patients and compare it with healthy population without depression. Materials and Methods: Cross-sectional analysis was undertaken on 94 patients with the diagnosed depressive disorder from Department of Psychiatry, Sawai Man Singh Medical College Jaipur, Rajasthan, India and 50 healthy controls from the general population. The Body Mass Index (BMI), waist circumference, blood sugar, lipid parameters and high sensitive C-Reactive Protein (hs-CRP) were measured in both groups. Depressive symptoms were measured using MontgomeryAsberg Depression Rating Scale (MADRS), antidepressant medication use {Selective Serotonin Reuptake Inhibitor (SSRI)} was also reported. Metabolic syndrome prevalence was assessed based on International Diabetes Federation (IDF) guidelines. Results: The depressive subjects showed statistically significant increased blood glucose (p=0.007), and decreased High Density Lipoprotein Cholesterol (HDLC) (p=0.001) values. There were statistically significant increased hs-CRP values (3.30±2.61 mg/L) in users of SSRI antidepressant medication compared to healthy controls (1.96±0.70 mg/L). The prevalence of metabolic syndrome in depressed patients was 42.36%. Conclusion: Depressive patients are at higher risk for CVD due to a high prevalence of metabolic syndrome. These patients should be regularly monitored for CVD risk factors.

The published online version contains an inadvertent error. On page 8, under the heading “Approach to a Child with Trauma” there is a box with “Primary Survey & Resuscitation”.

Congenital central hypoventilation syndrome (CCHS) is characterized by shallow breathing during sleep due to negligible ventilatory sensitivity to hypercarbia and hypoxemia. It is diagnosed using a genetic test for PHOX2B mutation, which is not easily available. Neurally adjusted ventilatory assist (NAVA) is a spontaneous ventilatory mode that was designed basically for better adapting the ventilator to the patient by using electrical activity of diaphragm (EAdi) signals. We report a case of a 6-month-old infant who presented with recurrent apneas, where differential decrease in EAdi discharges during sleep using NAVA served as an early clue to the diagnosis of CCHS. Definitive diagnosis was later confirmed by genetic testing. How to cite this article Rauf A, Gupta D, Sachdev A, Gupta N, Gupta S, Kumar P, et al. Neurally Adjusted Ventilatory Assist: An Early Clue to Diagnosis of Congenital Central Hypoventilation Syndrome. IJCCM 2019;23(11):536–537.

Objective: In recent years, there has been an increase in the use of noninvasive positive pressure ventilation (NIPPV) and high-flow nasal cannula (HFNC) in children with increased work of breathing due to acute bronchiolitis. However, there are only limited studies comparing the efficacy of these two interventions. This study was done to compare efficacy and patients' comfort while receiving HFNC and NIPPV for acute bronchiolitis. Materials and Methods: Children admitted with the first episode of acute bronchiolitis with respiratory distress (modified Wood's Clinical Asthma Score >3) were randomized to receive NIPPV and HFNC. FiO2was titrated to achieve a SpO2of ≥94%. If the child was agitated and had a COMFORT B score of ≥17, dexmedetomidine infusion was started. The protocol lasted for at least 24 h or till the respiratory support was required as decided by the treating physician. Outcome parameters measured were failure of intervention and patient comfort (using COMFORT B scores). Social science system version SPSS 17.0 was used for statistical testing.P < 0.05 was taken to indicate a significant difference for all statistical tests. Results: Twenty-five cases were enrolled in each study group. Failure of therapy was noted in 11 (44%) patients in the HFNC group and 6 (24%) in the NIPPV group (P = 0.18). COMFORT B score was significantly better in the HFNC group as compared to the NIPPV group (NIPPV12 vs. HFNC 8;P < 0.001). A number of cases requiring sedation and duration of sedation (dexmedetomidine) were more in the NIPPV group as compared to the HFNC group (22 vs. 10, P = 0.02, and 31.2 vs. 20.6 h, P = 0.04). Conclusion: This study suggests that possibly HFNC and NIPPV are equally efficient in the treatment of moderate-to-severe bronchiolitis. HFNC is more comfortable for bronchiolitis patients in comparison to NIPPV.

As the number of diagnostic and therapeutic applications utilizing gold nanoparticles (AuNPs) increases, so does the need for AuNPs that are stable in vivo, biocompatible, and suitable for bioconjugation. We investigated a strategy for AuNP stabilization that uses methoxypolyethylene glycol-graft-poly(l-lysine) copolymer (MPEG-gPLL) bearing free amino groups as a stabilizing molecule. MPEG-gPLL injected into water solutions of HAuCl4 with or without trisodium citrate resulted in spherical (Zav = 36 nm), monodisperse (PDI = 0.27), weakly positively charged nanoparticles (AuNP3) with electron-dense cores (diameter: 10.4 ± 2.5 nm) and surface amino groups that were amenable to covalent modification. The AuNP3 were stable against aggregation in the presence of phosphate and serum proteins and remained dispersed after their uptake into endosomes. MPEG-gPLL-stabilized AuNP3 exhibited high uptake and very low toxicity in human endothelial cells, but showed a high dose-dependent toxicity in epithelioid cancer cells. Highly stable radioactive labeling of AuNP3 with (99m)Tc allowed imaging of AuNP3 biodistribution and revealed dose-dependent long circulation in the blood. The minor fraction of AuGNP3 was found in major organs and at sites of experimentally induced inflammation. Gold analysis showed evidence of a partial degradation of the MPEG-gPLL layer in AuNP3 particles accumulated in major organs. Radiofrequency-mediated heating of AuNP3 solutions showed that AuNP3 exhibited heating behavior consistent with 10 nm core nanoparticles. We conclude that PEG-pPLL coating of AuNPs confers "stealth" properties that enable these particles to exist in vivo in a nonaggregating, biocompatible state making them suitable for potential use in biomedical applications such as noninvasive radiofrequency cancer therapy.

An aerobic mixed culture collected in the form of activated sludge was enriched for Cr(VI) reduction. An indigenous microorganism was isolated from the enriched aerobic mixed culture and identified as Pseudomonas taiwanensis. Bioremediation studies were carried out for treating Cr(VI)-contaminated wastewater using the indigenous microorganism. The kinetic studies were carried out for initial Cr(VI) concentrations ranging from 20 to 200 mg L−1. The maximum consumption of Cr(VI) obtained was 108.3 mg L−1 for an initial Cr(VI) concentration of 150 mg L−1 at a solution pH of 7.0. The effect of nutrient dosage and pH were studied to get their optimum values. The same isolated bacterial strain was also used to treat Cr(VI)-contaminated industrial wastewater collected from a local plating industry. Various growth kinetic models, such as Monod, Powell, Haldane, Luong, and Edward models, were fitted with the obtained experimental data. The obtained results for different growth kinetic models indicate that ...

Water pollution is a major concern for the Government of India and other countries in recent years which arise due to the rapid industrialization. This rapid industrialization is leading to an ever-increasing use of various toxic chemicals. Most of the toxic chemicals contain heavy metals such as As, Cr, Cd, Cu, Zn, Fe, and Ni which are considered as hazardous pollutants. Disposal of these pollutants in the water streams causes serious environmental problems. Adsorption is an economic and comparatively effective process for the removal of heavy metals from wastewater streams. To achieve large surface area for adsorption, small size particle with high porosity are required to be developed. Today's era is focusing towards nanotechnology which is leading towards the use of nano-size materials. The demand for large adsorption capacity can only be met by nanoparticles as adsorbents. To reduce their concentration in drinking water, different Nanosized Metal Oxides (NMOs) were tested as adsorbents. The copper (II) oxide nanoparticles, in the present study, were prepared by precipitation method and characterised by SEM, XRD and FTIR techniques. The as synthesised nanooxide was found to have crystallite size in the range of 10–30 nm and the shape was found to be spherical. Systematic adsorption experiments were undertaken for the following two process parameters i.e., time of contact for different initial concentration and variation of adsorbent dosage to find out the efficiency of copper (II) oxide nanoparticles towards adsorption of zinc. The adsorption capacity as well as removal efficiency of zinc using Cu(II)O were calculated.

This research demonstrates the solution combustion synthesis (SCS) of silver nanoparticles combined with yttrium oxide (Ag-Y2O3) using urea as a fuel material. The morphology, composition and crystallinity of nanocomposite were confirmed using standard techniques. Due to the doping of yttrium oxide, the synthesized nanocomposites were found to be thermally stable, asymmetrical, and well distributed without any aggregation with an average particle size of 65 ± 3 nm and surface area of 18.05 m2 g−1. The applicability of synthesized nanocomposite for multiple heavy metal removal from aqueous solutions was tested by performing batch experiments. Applicability of Langmuir isotherm confirmed the monolayer adsorption of Cu(II) and Cr(VI) on nanocomposite. The maximum adsorption capacity of nanocomposite obtained using the Langmuir isotherm was 815 mg g-1 and 867.85 mg g-1 for Cu(II) and Cr(VI) adsorption respectively. It’s noteworthy that the observed maximum adsorption capacity is ˜300% higher as compared to other adsorbents reported in the literature. The ΔH° value confirmed the physical adsorption of both these metal ions on nanocomposite. The synthesized nanocomposite also showed excellent ability for simultaneous removal of multiple metal ions from the synthetically prepared textile industry wastewater. Negligible reduction in the percent removal of Cu(II) (98.5 to 93%) and Cr(VI) (98.3 to 95.1%) was observed in four subsequent adsorption-desorption cycles. Finally, the environmental toxicity of the synthesized nanocomposite was assessed by determining its antibacterial and antifungal activity against selected beneficial microbial species which indicated the risk free and safe disposal of the used nanocomposite.

Chest trauma is one of the important causes of mortality and morbidity in pediatric trauma patients. The complexity, magnitude, and type of lung injury make it extremely challenging to provide optimal oxygenation and ventilation while protecting the lung from further injury due to mechanical ventilation. Independent lung ventilation is used sporadically in these patients who do not respond to these conventional ventilatory strategies using double-lumen endotracheal tubes, bronchial blocker balloons, etc. However, this equipment may not be easily available in developing countries, especially for pediatric patients. Here, we present a case of severe chest trauma with pulmonary contusion, flail chest, and bronchopleural fistula, who did not respond to conventional lung protective strategies. She was successfully managed with bronchoscopy-guided unilateral placement of conventional endotracheal tube followed by single lung ventilation leading to resolution of a chest injury.

In the present study, a mathematical model for the hydromagnetic non-Newtonian biofluid flow in the non-Darcy porous medium with Joule effect is proposed. A uniform magnetic field acts perpendicularly to the porous surface. The governing nonlinear partial differential equations are transformed into linear ones which are solved numerically by applying the explicit finite difference method. The effects of various parameters, like Reynolds number and hydro-magnetic, Forchheimer, and Darcian parameters, Prandtl, Eckert, and Schmidt numbers, on the velocity, temperature, and concentration are presented graphically. The results of the study can find applications in surgical operations, industrial material processing, and various heat transfer processes.

we propose a storage and retrieval approach of reusable software components based on UML diagram, metadata repository and neural network. If we search the repository on the basis of attributes of MDL file descriptions, the search result would be better and thus giving higher precision, as compared to keyword based search, then apply neural network to searching results of reusable software component for optimizing the searching results. The proposed approach is tested on various reusable software component datasets containing purely continuous or purely categorical or a mix of both types of attributes. Many features used in the analysis of reusable software component. In this paper reusable software component classified using feed forward back propagation Neural Network. One thousand sets of reusable software component obtained by software reusable techniques. The dataset consist of twenty eight features which represent the input layer to the FNN. The FNN will classify the reusable software component into type4, type3, type2 and type1 reusable software component. The sensitivity, specificity and accuracy were found to be equal 99.64%, 98.54% and 98.80% respectively. It can be concluded that FNN gives fast and accurate classification and it works as promising tool for optimizing the searching results of reusable software component. The overall accuracy of optimizing searching results of the proposed system is 96.50%. Thus, this approach is suitable for automated real time reusable software storing and searching. General Terms Software reuse, software component, Metadata, component retrieval, Component based engineering, Use Case Diagram, Class Diagram, MDL file.

Thermal-diffusion and diffusion-thermo effects on unsteady MHD mixed convection flow past an infinite vertical porous plate in the presence of chemical reaction, heat source and Joule effect have been studied numerically. A uniform magnetic field acts perpendicular to the porous surface. The governing non-linear partial differential equations have been transformed in to linear partial differential equations, which are solved numerically by applying explicit finite difference method. The effects of various parameters on the velocity, temperature, concentration, Nusselt number, Sherwood number and skin friction coefficient have been examined with the help of graphs and tables.

Methemoglobinemia can be congenital or acquired. Acquired methemoglobinemia occurs as a result of ingestion of some substances such as toluene, nitrates. Patient presents with cyanosis which is not explainable by the respiratory or cardiac cause. Most frequently used drug in treatment is methylene blue. We report a case of a patient with severe acquired methemoglobinemia in 14 months old baby, due to ingestion of toluene. He was cyanosed which was refractory to oxygen therapy and without any cardiac and respiratory disease. He had persistent high levels of methemoglobin, despite giving multiple doses of methylene blue and exchange transfusion. Finally, methemoglobin levels were controlled by automated RBC exchange transfusion and intralipid infusion.

Objectives: In this paper, we have evaluated the effectiveness of classification of Electroencephalogram (EEG) signals using the correlation between channels as a method of features selection. Methods/Statistical Analysis: First data is broken sample wise, then correlation coefficient between channel pair for each sample is calculated. After that mean of the correlation coefficient of all channel pair for each class over all samples is calculated and in a similar manner, standard deviation from the mean is also calculated. For feature selection we have plotted a pair of the Gaussian curves between channels of two separate classes and choose those channels which give us lower misclassified area as features. Then these features are used for training purpose of Support Vector Machine (SVM). Findings: Most of the previous researches follow either signal processing approach or machine learning approach while we emphasized upon the nature of the signal propagation amongst the neurons. The basic idea behind the feature selection is taken from the way the signals propagate from one neuron to the other. In our work we assume that EEG signals follow the normal distribution and verify the fact using chi-square test. On applying SVM the accuracy of classification on testing data confirms that correlation among channels can be used for feature selection. Application/Improvements: The results can be improved by improving the pre-processing of EEG signals. It can be used to develop a Brain Computer Interaction (BCI) system.

Duplication of the urethra is a complex and rarely seen congenital anomaly with three anatomic variants: epispadiac (dorsal), hypospadiac (ventral), and Y-type. We report here a case of hypospadiac duplication of anterior urethra with dorsal blind ending urethra in a 9-year-old boy who presented with complaint of passing urine from the ventral aspect of penis.

Benzophenone-uracil (BPU) scaffold-derived candidate compounds are efficient non-nucleoside reverse transcriptase inhibitors (NNRTI) with extremely low solubility in water. We proposed to use hydrophobic core (methoxypolyethylene glycol-polylysine) graft copolymer (HC-PGC) technology for stabilizing nanoparticle-based formulations of BPU NNRTI in water. Co-lyophilization of NNRTI/HC-PGC mixtures resulted in dry powders that could be easily reconstituted with the formation of 150–250 nm stable nanoparticles (NP). The NP and HC-PGC were non-toxic in experiments with TZM-bl reporter cells. Nanoparticles containing selected efficient candidate Z107 NNRTI preserved the ability to inhibit HIV-1 reverse transcriptase polymerase activities with no appreciable change of EC50. The formulation with HC-PGC bearing residues of oleic acid resulted in nanoparticles that were nearly identical in anti-HIV-1 potency when compared to Z107 solutions in DMSO (EC50 = 7.5 ± 3.8 vs. 8.2 ± 5.1 nM). Therefore, hydrophobic core macromolecular stabilizers form nanoparticles with insoluble NNRTI while preserving the antiviral activity of the drug cargo.