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Summary Hydroxycarbamide (HC) is the most widely used therapeutic for individuals with sickle cell disease (SCD, including sickle cell anemia and other forms of the disease). HC's clinical benefits are primarily associated with its ability to induce foetal haemoglobin (HbF); this limited view of HC's therapeutic potential may lead to its discontinuation when a modest amount of HbF is induced. A better understanding of the HbF‐independent effects of HC on genes and pathways relevant to SCD pathophysiology is therefore needed. In this study, we performed bulk RNA‐Seq on whole blood samples collected from a cohort of 25 paediatric patients with SCD to identify genes and pathways that are affected by treatment with HC. At the maximum tolerated dose (MTD) of HC, patients showed altered expression levels of several genes and biological pathways. Pathways related to haeme metabolism, interferon‐alpha response, and interferon‐gamma response were significantly downregulated at HC MTD relative to the matched pre‐HC samples. Pathways linked with IL2‐STAT5 signalling and TNFα signalling via NF‐Kβ were observed to be up‐regulated at HC MTD. These results illustrate the range of effects exerted by HC during therapy for SCD and pave the way for an improved understanding of the HbF induction‐independent benefits of HC. [ABSTRACT FROM AUTHOR]

The efficacy of teaching communication skills for breaking bad news in graduate-level counseling programs was examined. A structured model, PEWTER (Prepare, Evaluate, Warning, Telling, Emotional Response, Regrouping; Keefe-Cooperman and Nardi 2004), provides a method for this difficult task. Prior to training in using the model, students reported not feeling adequately trained or comfortable giving bad news. The PEWTER training undertaken was significantly related to students' increased feelings of preparedness and comfort. Breaking bad news is a universal experience across cultures and the structured protocol seems to offer value in helping counselors in training be better prepared for such a challenging task.

Groundwater in several parts of India is highly polluted with fluoride. Fluoride, although beneficial to humans in small quantities, causes dental fluorosis, brittle bones and stunted growth when consumed in larger quantities over a period of time. In the present investigation, Aluminum oxide (Al2O3) synthesized by gel combustion process was used as on adsorbent to remove fluoride from aqueous solution. The synthesized adsorbent was characterized by X-Ray Diffraction (XRD) and Scanning Electron Microscopy (SEM). The effects of pH, initial fluoride concentration and adsorbent dosage on adsorption were studied. Maximum fluoride adsorption on Al2O3 results at lower initial fluoride concentration (1 ppm), high adsorbent dosage (2.5 g/50 mL) and in acidic medium (2 pH). Statistically based experimental designs like Central Composite Design (CCD) and Box Behnken Method (BBM) were used to study the effect of variables on adsorption. The predicted and experimental values are in good agreement with regression coefficient more than 0.9. [ABSTRACT FROM AUTHOR]

Objectives: Diabetic macular edema results in irreversible loss of vision and is the major cause of visual morbidity in patients with Diabetes of adult onset. DCCT trial has linked this to poorer control and increased duration of DM. laser treatment in such cases is known to reduce visual impairment by 50% for a period of 5 years. The aim of this study is to evaluate the effect of laser on visual outcome in patients with clinically significant macular edema and also evaluate the effect of some factors like control of blood sugar, hypertension, nephropathy etc., Methods: Retrospective analysis of 165 eyes of patients with diabetic maculopathy who underwent laser as per the ETDRS (early treatment diabetic retinopathy study) protocol was made. All these patients underwent Visual Acuity check, slit lamp examination of anterior segment, IOP check and after dilatation detailed examination of macula with 78/90 d lens and areas of retinal thickening recorded and subjected to focal laser/grid laser depending upon whether the maculopathy was focal/diffuse. Patients were assessed for control of sugar and presence of hypertension/nephropathy or any other related systemic diseases. Patients were followed up for a minimum of 6 months to a maximum of 24 months. The visual acuity at the end of 3-4 months was taken as final visual acuity after laser., Results: 165 eyes of patients having CSME (clinically significant macular edema) were subjected to laser. 108 (64.54%) eyes underwent focal laser and the rest were given grid laser. 153 eyes underwent macular laser without PRP (Pan retinal photocoagulation) while rest had even PRP along with macular laser. 92 eyes (55.75%) totally, 39 eyes (59.1%) in controlled group and 26 eyes (56.5%) in the controlled group and 12 eyes (54.5%) in patients with hypertension had stable vision 3-4 months after laser. 44 eyes (26.7%) overall, 18 eyes (27.3%) in controlled group, 16 eyes (34.8%) in uncontrolled group and 7 eyes (31.8%) in hypertensive showed improvement of vision after laser., Conclusion: More than 50% of eyes of patients who underwent laser had stabilization of VA and >25% of eyes had improvement in VA. No correlation was found between outcome of laser and control of blood sugar and associated hypertension.