Statistical optimized production of Phytase from Hanseniaspora guilliermondii S1 and studies on purification, Homology modelling and growth promotion effect

This investigation was performed to obtain a promising phytase enzyme producing yeast. In this regard, the PSM was used to isolate the phytase-producing Hanseniaspora guilliermondii S1 (MG663578) from sugarcane juice. The SSF optimum conditions for phytase generation were optimized using (OVAT) one-variable-at-a-time strategy using both Box-Behnken design and shake flask method (g/100ml: 0.05 yeast extract, 0.15 Peptone, 0.05 malt extract 0.50 dextrose, pH 5.8 and 28ᵒC). The protein model developed was shown to be adequate for phytase production (91% accuracy), with the greatest phytase productivity in shake flask with substrate jack fruit seed powder being 395± 0.43 U/ml compared to 365U/ml for the BBD projected value. Crude Phytase was partially purified with a protein recovery of 43%, revealing a molecular weight of 120 kDa. It had an enzyme kinetic value of Km 3.3 mM and a Vmax of 19.1 mol/min. The 3D structure of PhyS1 amino acid sequences (PhyS1.B99990002) was simulated using Modeler 9.23, and the validated result revealed that 86.7% were in the favored region by Ramachandran plot. The SAVES server verified the 3D PDB file as satisfactory, and the model (in.pdb format) was uploaded in the PMDB database with the accession number ID: PM0082974. At the lab level, Hanseniaspora guilliermondii S1 (MG663578) producing phytase exhibited successful plant growth promotion activity in Ragi - CO 19 (Eleusine coracana L.) and Rice -Navarai - IR 64 (Oryza sativa L.). As a result, a phytase-based formulation for sustainable agriculture must be developed and tested on a large scale in diverse geographical areas of agricultural lands to determine its effect and potential on plant development.

Identification and physico-chemical characterization of microplastics in marine aerosols over the northeast Arabian Sea

Microplastics (MPs) in the atmosphere can undergo long-range transport from emission regions to pristine terrestrial and oceanic ecosystems. Due to their inherent toxic and hazardous characteristics, MPs pose serious risks to both human well-being and the equilibrium of ecosystem. The present study outlines the comprehensive characterization, spanning physical and chemical attributes of MPs associated with atmospheric aerosols. Total suspended particulates (TSPs) were collected on a quartz fibre filter by operating a high-volume sampler for 24 h during distinct years (March, 2016 and November, 2020) at a coastal location in the northeast Arabian Sea. Subsequent to the sampling, a series of techniques were applied including density separation. The assessment and scrutiny of the MPs was carried out using stereo-zoom microscopy with supplementary validation using advanced fluorescence microscopy for enhanced precision in identification. Our comparative assessment suggests peroxide treatment followed by density separation could be a robust procedure for the definitive identification and characterization of MPs in the atmosphere. Average total abundance of MPs was found to be 1.30 ± 0.14 n/m3 in 2016 and 1.46 ± 0.12 n/m3 in 2020 with fibres, fragments and films having similar relative contributions (41 %, 31 %, 28 % in 2016 and 40 %, 35 %, 25 % in 2020). Fibres were found to be dominant morphotype followed by fragments and films over the coastal region of the Arabian Sea. In order to unravel the detailed chemical nature of these MPs, spectral analysis using μ-FTIR was carried out. The outcome of the analysis showed prevailing polymers as polyvinyl chloride and polymethyl methacrylate (50545 %) as dominant polymers followed by polyester (15 %), styrene butyl methacrylate (11 %), and polyacetal (9 %). MPs present in the vicinity of the Arabian Sea have potential to supply nutrients and toxicants, consequently can contribute to the modulation of the surface water biogeochemical processes.

A randomized controlled study to compare first stick success with Instaflash technology: The FIRSST study

BACKGROUND

Peripheral intravenous catheters (PIVCs) are frequently used in clinical settings for intravenous access. Multiple attempts of PIVC insertions leads to patient discomfort, delay in treatment, associated complications, and extensive expenditure cost. Reduced number of attempts causes patient/nursing personnel satisfaction and expenditure costs. The present study evaluated performance efficacy of BD Venflon™ I with Instaflash needle technology (investigational device) as compared to the BD Venflon™ without Instaflash needle technology (control device).

METHODOLOGY

The PIVC insertions were randomized in the ratio 1:1 using either investigational or control device and were monitored for first stick success rate, ease of insertion, and patient satisfaction. Data was analyzed using R 4.0.3 and Microsoft Excel. Chi square test was used to establish association between two categorical variables.

RESULTS

In total, 1402 patients were analyzed for first attempt insertion success which showed 98.72% success rate in investigational device as compared to 88.87% success rate in case of the control device (p = 0.0004). Marginal differences were observed in ease of insertion in investigational (98.71%) and control devices (99%) signifying high satisfaction levels of nursing personnels. Positive responses were observed in investigational (98.01%) and control devices (99%) underlining satisfactory performances of overall patient experiences.

CONCLUSION

The present study showed that BD Venflon™ I with Instaflash needle technology enhanced first attempt insertion success rate along with marginal differences in its efficacy in comparison with the BD Venflon™ without Instaflash needle technology thus enhancing patient and nursing personnel satisfaction in turn making it a better alternative to be used in hospitals.

Cold atmospheric plasma mediated cell membrane permeation and gene delivery-empirical interventions and pertinence

Delivery of genetic material to cells is an integral tool to analyze and reveal the genetic interventions in normal cellular processes and differentiation, disease development and for gene therapy. It has profound applications in pharmaceutical, agricultural, environmental and biotechnological sectors. The major methods relied for gene delivery or transfection requires either viral vectors or xenogenic carrier molecules, which renders probabilistic carcinogenic, immunogenic and toxic effects. A newly evolved physical method, Cold atmospheric plasma induced transfection neither needs vector nor carriers. The 4th state of matter 'Plasma' is a quasineutral ionized gas-containing ions, neutral atoms, electrons and reactive radical molecules; and possess electric and magnetic field, along with emanating photons and UV radiations. Plasma produced at atmospheric pressure conditions, and having room temperature is conferred as Low temperature plasma or Cold atmospheric plasma. Selective and controlled application of cold atmospheric plasma on tissues creates temporary, restorable pores on cell membranes that could be diligently manipulated for gene delivery. Research in this regard attained pace since 2016. Cold atmospheric plasma induces transfection by lipid peroxidation, electroporation, and clathrin dependent endocytosis in cell membranes, by virtue of its reactive radicals and electric field. Plasma formed reactive radicals, especially 'OH' penetrates to the cell membrane and cleaves the phosphate head group of membrane lipids, peroxidize and detaches fatty acid tails. This decreases membrane thickness, increases membrane fluidity and permeability. Simultaneously plasma formed ions, electrons and reactive radicals accumulate over cells, generating local electric field and neutralize the negative charge of cell membrane. This induces stress on cell membrane and disrupts its structural integrity, by infringing the dynamic equilibrium between surface tension, spatial repulsion and linear tension between the head groups of phospholipids, generating minute pores. Neutralization of membrane charge promote foreign, external plasmid and gene movement towards cells and its enhanced binding with ligands and receptors on cell membrane, instigating clathrin dependent endocytosis. In vitro and in vivo studies have successfully delivered plasmids, linear DNA, siRNA and miRNA to several established cell lines like, HeLa, PC12, CHL, HUVEC, Jurkat, MCF, SH-SY5Y, HT, B16F10, HaCaT, LP-1, etc., and live C57BL/6 and BALB/c mice, using cold atmospheric plasma. This review delineates the cell surface mechanism of plasma-induced transfection, critically summarizes the research progress in this context, plasma devices used, and the inimitable features of this method. Metabolic activity, cell function, and viability are not adversely affected by this process; moreover, the cell permeating plasma-formed reactive radicals are effectively defended by cellular antioxidant mechanisms like superoxide dismutase, glutathione reductase and cytokines, alleviating its toxicity. A deeper understanding on mechanism of plasma action on cells, its aftermath, and the research status in this field would provide a better insight on future avenues of research.

A Systematic Review and Network Meta-Analysis Assessing the Impact of Adding First Generation Non-Steroidal Anti-Androgens (NSAA) to LHRH Agonists (LHRHa) in Men Receiving Radiotherapy for Localized Prostate Cancer

PURPOSE/OBJECTIVE(S)

Randomized clinical trials consistently demonstrate that the addition of androgen deprivation therapy (ADT) to prostate radiation therapy improves overall survival (OS). However, there is substantial heterogeneity regarding the type of ADT: LHRHa alone, first generation NSAA alone (e.g., bicalutamide) or combination androgen blockade (CAB) with NSAA and LHRHa. There are no published randomized trials in localized disease that specifically compare the efficacy of NSAA to LHRHa, nor the utility of CAB over monotherapy ADT. We herein performed a systematic review and network meta-analysis to assess the impact of NSAA in relation to LHRHa in men receiving radiotherapy for localized prostate cancer.

MATERIALS/METHODS

We performed a systematic literature search in PubMed to identify clinical trials of patients with localized prostate cancer for which ADT duration was the primary randomization variable. Both definitive and salvage radiation trials were included. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated from data extracted from published survival curves. A network meta-analysis was performed to compare OS by ADT regimens. We defined NSAA toxicity as early discontinuation of any ADT agent due to side effects given the inconsistent reporting of specific related toxicity. A meta-regression was performed to assess association with NSAA toxicity, adjusted for study year, patient age, T stage, Gleason score and total ADT duration. NSAA duration was assessed as a continuous variable.

RESULTS

Of the 11 trials (8,169 patients) with OS data, the median duration of any ADT was 3 months (range 0-36 months) and the median duration of NSAA specifically was 3.5 months (range 0-24 months). There was no significant difference in OS between those treated with LHRHa (n = 369) vs. CAB (n = 4,792; HR 1.10, 95% CI 0.78-1.55). Among those receiving CAB, increased NSAA duration did not improve OS (versus 0 months; 1-6 months HR 1.41, 95% CI 0.94-2.13; 7-12 months HR 1.43, 95% CI 0.87-2.34) when controlling for total ADT duration. Of the 19 trials (15,067 patients) with toxicity data, patients on NSAA (n = 503) appeared more likely to discontinue treatment early compared to those receiving LHRHa (n = 902), though this was not statistically significant (odds ratio [OR] 4.20, 95% CI 0.16-109.19). A longer duration of NSAA did not adversely affect ADT compliance. Patients were more likely to discontinue ADT prematurely, regardless of type, if the planned duration was longer (OR 1.08, 95% CI 1.07-1.09).

CONCLUSION

We did not detect an overall survival benefit to adding NSAA to LHRHa, and NSAA appeared less well tolerated than LHRHa in men receiving radiation therapy for localized prostate cancer. These data suggest that providers should consider LHRHa without the addition of a NSAA as optimal when clinically appropriate.

Cellular temperature probing using optically trapped single upconversion luminescence

BACKGROUND

The thermally coupled energy states that contribute to the upconversion luminescence of rare earth element-doped nanoparticles have been the subject of intense research due to their potential nanoscale temperature probing. However, the inherent low quantum efficiency of these particles often limits their practical applications, and currently, surface passivation and incorporation of plasmonic particles are being explored to improve the inherent quantum efficiency of the particle. However, the role of these surface passivating layers and the attached plasmonic particles in the temperature sensitivity of upconverting nanoparticles while probing the intercellular temperature has not been investigated thus far, particularly at the single nanoparticle level.

RESULTS

The analysis of the study on the thermal sensitivity of oleate-free UCNP, UCNP@SiO₂, and UCNP@SiO₂@Au particles is carried out at a single particle level in a physiologically relevant temperature range (299 K-319 K) by optically trapping the particle. The thermal relative sensitivity of the as-prepared upconversion nanoparticle (UCNP) is found to be greater than that of UCNP@SiO₂ and UCNP@SiO₂@Au particles in an aqueous medium. An optically trapped single luminescence particle inside the cell is used to monitor the temperature inside the cell by measuring the luminescence from the thermally coupled states. The absolute sensitivity of optically trapped particles inside the biological cell increases with temperature, with a greater impact on the bare UCNP, which exhibits higher values for thermal sensitivity than UCNP@SiO₂ and UCNP@SiO₂@Au. The thermal sensitivity of the trapped particle inside the biological cell at 317 K indicates the thermal sensitivity of UCNP > UCNP@SiO₂@Au > UCNP@SiO₂ particles.

SIGNIFICANCE AND NOVELTY

Compared to bulk sample-based temperature probing, the present study demonstrates temperature measurement at the single particle level by optically trapping the particle and further explores the role of the passivating silica shell and the incorporation of plasmonic particles on thermal sensitivity. Furthermore, thermal sensitivity measurements inside a biological cell at the single particle level are investigated and illustrated that thermal sensitivity at a single particle is sensitive to the measuring environment.

Custom-designed 3D printed feed spacers and TFN membranes with MIL-101(Fe) for water recovery by forward osmosis

ABSTRACTIn this work, a dual-pronged approach- (i) novel thin-film nanocomposite polyether sulfone (PES) membrane with MIL-101 (Fe) and (ii) 3D printed spacers were explored to enhance water recovery by forward osmosis. The concentration of PES, pore former, draw solution, and MIL-101(Fe) was optimized for maximum pure water flux (PWF) and minimum specific reverse solute flux (SRSF). The best membrane exhibited a PWF of 7.52 Lm^-2h^-1 and an SRSF of 0.33 ± 0.03 gL^-1 using 1.5 M NaCl. The M₂₂ membrane with the diamond-type spacer demonstrated a PWF of 2.53 Lm^-2h^-1 and SRF of 0.75 gL^-1. The novel spacer design imparted significant turbulence to the feed flow and a lower foulant resistance of 1.3 m^-1 as compared to the ladder type (1.5 m^-1) or commercial spacer (1.7 m^-1). This arrangement could recover 19% pure water within 12 h of operation (98% oil rejection) with a ∼ 94% flux recovery after water wash.

Geochemical tracing of synoptic scale modern dust transport over the Northeast Arabian Sea during the southwest monsoon

During the Southwest monsoon (SWM), aeolian dust is mainly supplied via wet deposition over the north-eastern Arabian Sea (NEAS). To understand their impact on the biogeochemistry of the Arabian Sea, it is important to identify their sources and characteristics. In this context, wet deposit particulate (WDP) samples were collected at a coastal station (Goa; 15.4° N, 73.8° E) in the NEAS during the SWM for three years. These samples were used to characterize and identify mineral dust sources using mineralogical, elemental, and isotopic (Sr and Nd) signatures. The WDP samples were classified as Beginning of Monsoon (BM, June samples), Mid Monsoon (MM, July-August samples) and End of Monsoon (EM, September samples). Clay mineralogical composition indicate high palygorskite content during BM, which subsequently found to decrease in MM, and almost negligible in EM. However, smectite is highest during MM, with moderate presence of palygorskite during this period. The considerable variation in the relative percentages of clay minerals suggests significant temporal variability in dust sources which is further corroborated by the radiogenic isotopic composition. A strong seasonality in the isotopic composition is observed with ⁸⁷Sr/⁸⁶Sr ratio being relatively less radiogenic during MM than the BM and highly radiogenic at the EM. Whereas Ɛ_Nd values show an opposite trend to ⁸⁷Sr/⁸⁶Sr ratios throughout the monsoon, with more radiogenic Ɛ_Nd in the MM, and less radiogenic at the EM. End member mixing plot indicate dominant contribution of dust from the Arabian Peninsula (ARB) and Northeast African (NEA) sources during BM and MM, while a shift towards the Thar desert and Southwest Asian (SWA) sources at the EM. Trace elements associated with different sources were quantified and suggest high Fe concentration is associated with NEA dust sources, despite of ARB is the major supplier of aeolian dust to the Arabian Sea.

Optically trapped SiO2@Au particle-dye hybrid-based SERS detection of Hg2+ ions

The selective ultra-sensitive detection of a very low concentration of analyte in a liquid environment using surface-enhanced Raman spectroscopy (SERS) is a challenging task owing to the poor reproducibility of the Raman signals arising from the nonstationary nature of the substrate. However, plasmonic metal particle-incorporated microparticles can be effectively 3-D arrested in a liquid environment that can serve as a stable SERS substrate by employing an optical trapping force. Herein, we demonstrate a 3-D optically trapped Au-attached SiO₂ microparticle as an efficient SERS substrate that can detect 512 pM for Rhodamine6G and 6.8 pM for crystal violet. Further, the substrate allows the simultaneous detection of multiple analytes. By utilizing the Raman signal from Rhodamine 6G as the probe beam, the selective detection of Hg²⁺ ions as low as 100 pM is demonstrated.

Assessment of aeolian dust concentration, elemental composition, and their wet and dry deposition fluxes over the Northeast Arabian Sea

Atmospheric aerosol over the Arabian Sea is significantly impacted by the long-range transported mineral dust from the surrounding continents. This transported mineral dust is hypothesized and tested during several studies to see the impacts on the surface ocean biogeochemical processes and subsequently to the Carbon cycle. It is, thus important to quantify dust contributions and their fluxes to the Arabian Sea. Here we assess temporal variability of dust concentration, their elemental characteristics as well as quantify their dry and wet deposition fluxes over the North-eastern Arabian Sea. The dust concentrations were found to vary from 59 to 132 µg m^-3 which accounts for 50% to 90% of total mass during dusty days. However, its contribution during pre and post dust storms ranges between 6% and 60%. Relatively higher dust dry deposition flux of 28 ± 7 mg m^-2 day^-1 (range: 20-44) is estimated for dusty days compared to pre and post dusty days (range: 0.4-22 mg m^-2 day^-1). In contrast to dry deposition fluxes, significantly higher fluxes are estimated from wet deposition, averaging around 240 ± 220 mg m^-2 day^-1. These values are five times higher than those reported from cruise samples collected over the Arabian Sea. The contribution of dust to aerosol mass is further ascertained using elemental composition, wherein a significant correlation was observed between Fe and Al (r² = 0.77) for samples collected during the dusty period, highlighting their similar crustal sources. Our estimation of dust flux over this region has implications for the supply of nutrients associated with natural dust to the surface water of the Arabian Sea.Implications: The Arabian Sea, one of the productive oceanic regions among the global oceans, has been identified as a perennial source of atmospheric CO₂. This basin is heavily impacted by atmospheric dust deposition/inputs owing to its geographical location being surrounded by arid and semi-arid regions. It has been hypothesized that aeolian dust plays a significant role in modulating surface water biogeochemical processes including primary productivity, in the Arabian Sea. Furthermore, modelling studies have highlighted on the role of dust (containing Fe) in fueling and enhancing primary productivity in the Arabian Sea. However, quantification of dust deposition fluxes (wet and dry) on seasonal time scale is missing in the literature. This paper aims to partially fulfil this research gap by providing a long-term data of wet and dry deposition fluxes over the northeastern Arabian Sea. We have also discussed their seasonal variability and factors affecting this flux. Thus, this study will be valuable contribution to the aeolian research community and have significant implication toward the role of aeolian deposition to the surface water biogeochemical processes in the Arabian Sea.

Luminescence studies of a Li2 Ca1-x SiO4 :xSm3+ phosphor for the generation of white light under NUV-excited phosphor converting LEDs

In this paper, we present new aspects of Sm³⁺ -doped pure Li₂ CaSiO₄ as a suitable candidate for white light emitting diode (WLED) applications. The samples were mainly prepared using a conventional modified solid-state synthesis technique. The structural studies were done using X-ray diffraction and Rietveld refinement. Instruments such as a scanning electron microscope (SEM) were used to obtain information about the morphology of the as-prepared samples. Photoluminescence (PL) analysis of phosphor samples for variable concentrations of doping ions with variable excitations were presented. When doped with Sm³⁺ in host Li₂ CaSiO₄ it emitted intense blue, green and red emissions and a more intense red emission peak (605 nm) under 408 nm excitation (near-UV-blue). Our study shows that the as-prepared phosphor may be useful for optical devices and mainly for WLEDs. The corresponding transitions of doping ions and concentration quenching effect were studied in detail. The 1931 Commission Internationale de l'Eclairage (x, y) chromaticity coordinates showed the distribution of spectral regions calculated from PL emission spectra and this was found (0.63, 0.36) in the red region, so the phosphor may be useful for near-UV-blue excited WLED applications.

Economic analysis of a hybrid intelligent optimization-based renewable energy system using smart grids

Renewable energy has seen a substantial increase in deployment as an alternative to traditional power sources. However, two fundamental constraints exist that preclude widespread adoption: the availability of the generated power and the expense of the equipment. One of the most critical difficulties with this sort of hybrid system is to appropriately design the Hybrid Renewable Energy System (HRES) elements so that they fulfill all load requirements while requiring the least amount of investment and running expenditures. This research proposes a novel technique for evaluating the optimal smart grid linking Hybrid Renewable Energy (Solar photovoltaic and wind) with battery, to increase profitability, dependability, and feasibility. A multiobjective function is suggested and constructed to be optimized utilizing two optimization algorithms: Enhanced Particle Swarm Optimization (EPSO) and Harris Hawks Optimization (HHO) algorithm with Fuzzy-Extreme Learning Machine (ELM). The primary goal for the HRES is to operate optimally to reduce the cost of energy generat ion through hourly day-ahead. Here, the Fuzzy-ELM is utilized to predict the required load of the smart grid-connected system and hybrid EPSO-HHO, which are introduced to solve the problem of HRES economic analysis. Finally, the suggested EPSO-EHO method is implemented in the MATLAB software, and its performance comparison is made with other existing methods such as PSO, WOA, and HHO. The simulation result shows that the cost of the newly suggested EPSO-HHO technique-based Hybrid Renewable Energy System is less than PSO, WOA, and HHO by 4.89 %, 4.51 %, and 4.05 %, respectively.

Two-factor-based RSA key generation from fingerprint biometrics and password for secure communication

In an asymmetric-key cryptosystem, the secure storage of private keys is a challenging task. This paper proposes a novel approach for generating the same public and private key pair on a need basis. Hence, the need for secure storage of the private key is done away with. The proposed approach for generating the key pair is based on two factors: fingerprint biometrics and password. A stable binary string is generated from the distances among pairs of minutiae points in a fingerprint using a gray code-based method. Experiments show that gray code representation significantly reduces the number of inconsistencies between the generated bit strings from two instances of the same fingerprint as against the binary code representation. Hence, the Reed–Solomon error correction code successfully corrects errors due to variations in multiple instances of the same fingerprint to induce stability in the generated string. Hash of the stable string generated from the fingerprint and the string generated from hashed password are XORed to derive a stable seed value. The proposed approach uses this seed value to generate two large prime numbers. These prime numbers are used to generate the public and private key pair using the RSA key generation method. This seed value ensures the generation of the same key pair every time. The experimental results show that the proposed approach can ensure a stable generation of the key. It is not required to store either the fingerprint template or the password. Moreover, the generated private key is also not stored. It can be regenerated on a need basis.

Antioxidant Activities and Hepatoprotective Potential of Ethanol Leaf Extract of Justicia quinqueangularis against Selected Hepatotoxins Induced Hepatotoxicity in Albino Wistar Rats

Background: The objective of this research was to see whether the ethanolic extract of Justicia quinqueangularis leaves had antioxidant and hepatoprotective properties against paracetamol (PCT), ethanol (ETN), and isoniazid and rifampicin (IR)-induced hepatotoxicity in Albino Wistar rats. Methods: The leaves of Justicia quinqueangularis were dried in the shade at room temperature, pulverised, and extracted by soxhlet using ethanol. Quantitative phytochemical experiments were carried out as a first step. The ethanol extract's hepatoprotective activity was evaluated in Albino Wistar rats. PCT (3 g/kg), ETN (5 g/kg), and IR (100 mg/kg) reduced the levels of serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alkaline phosphatase (ALP) and bilirubin, which are all biochemical indicators of liver injury. Both hepatotoxin-treated and untreated group of animals determined for their antioxidant levels. SGOT, SGPT, ALP, bilirubin, antioxidant function of DPPH (2,2-diphenyl-1-picrylhydrazyl), hydrogen peroxide (H2O2), lipid peroxidation methods, hydroxyl radicals, and nitric oxide scavenging activities were among the biochemical and histopathological tests performed. Results: The altered levels of biochemical markers were restored to near normal levels in a dose-dependent fashion after treatment with J. quinqueangularis ethanol leaf extract (100 mg / kg, 200 mg / kg, and 400 mg / kg body weight). Conclusion: The findings of the current research indicated that the ethanol leaf extract of J. quinqueangularis had potent antioxidant and hepatoprotective properties against standard drug.

Evaluation of Hepatoprotective and Antioxidant Activity of Ethanolic Extract of Artabotrys zeylanicus Stem against Various Hepatotoxins Induced Hepatotoxicity in Albino Wister Rats

The objective of the present study was to investigate the antioxidant and hepatoprotective activity of ethanolic stem extract of Artabotrys zeylanicus against paracetamol (PCT), Ethanol (ETN) and Isoniazid and Rifampicin (IR) induced hepatotoxicity in Albino wister rats. Methodology: The material was dried in shade, they were powdered and extracted with ethanol. Preliminary Phytochemical tests were done. The hepatoprotective activity of the ethanol extract was assessed in Albino wister rats. PCT (3 g/kg), ETN (5 gm/kg) and IR (100 mg/kg) has enhanced the levels of various biochemical markers of hepatic damage like Serum Glutamic Oxaloacetic Trasaminase (SGOT), Serum Glutamic pyruvic transaminase (SGPT), Alkaline phosphatise (ALP), bilirubin. Antioxidant levels were tested in all the Hepatotoxins treated and untreated groups. Results: The various biochemical and Histopathological investigations done were Serum Glutamic Oxaloacetic Trasaminase (SGOT), Serum Glutamic pyruvic transaminase (SGPT), Alkaline phosphatise (ALP), Bilirubin, antioxidant activity by 1,1-diphenyl 2-picryl hydrazyl (DPPH), Nitro Blue Tetrazolium (NBT), Hyderogen peroxide (H2O2), lipid perioxidation, hyderoxil radical and nitric oxide. Treatment of ethanolic extract of stem of A. zeylanicus (100mg/kg, 200mg/kg and 400mg/kg body weight) has brought back the altered levels of biochemical markers to the near normal levels in the dose dependent manner. Ethanolic extract of A. zeylanicus were observed to inhibit oxidant stress with the maximum value of 71% and 62% at the concentration of 100 µg/mL. The crude ethanolic extract of A. zeylanicus had a calculated IC50 value of 62.2 and 63.25 μg/mL, which is nearly similar to the calculated IC50 value of the known antioxidant, ascorbic acid, ie 65.3 μg/mL. While the rats treated with AZ extract (100, 200 and 400 mg/kg) which were shown as reduction/absence of inflammatory cells, vascular congestion, cellular degeneration, necrosis and vacuoles. In contrast, the lower doses (100 mg/kg) of ethanolic extract of AZ stem shown low protection than at higher dose 400 mg/kg. Conclusion: Our findings suggested that A. zeylanicus ethanol stem extract possessed a potent antioxidant and hepatoprotective activity.

Tool Wear and Temperatures Analysis While Machining Ti-6Al-4V in MQCL-MIST Environment

Sustainable machining of titanium alloys have deficiency of studies on the built-up edges over the cutting tools and temperature correlation in minimum quantity cooling lubrication (MQCL) environment. Researchers focused on experimentation in dry, wet, and MQL (minimum quantity lubrication) conditions to analyze surface finish, cutting forces, and metal removal rates. This work focuses on the study of cutting parameters effects on temperatures and tool wear analysis by consideration of individual response and their optimality basing on signal-to-noise ratios. Efficacy of process parameters on wear of tool and temperatures requires a comprehensive understanding. An elaborated tool wear analysis is carried based on the microscopic flank wear investigations. Machining of Ti-6Al-4V alloy is carried in the environment of MQCL in form of mist using semi-synthetic fluid. Correlation study of tool wear with regard to temperatures is analyzed and regression models generated on tool wear and cutting temperatures individually showed 83% of goodness-of-fit and correlation regression is 85%.

Evaluation of bactericidal and virucidal activity of novel disinfectant Aaride AGT-1 compared to other commercially available disinfectants against hospital-acquired infections (HAIs)

Hand hygiene is the topmost crucial procedure to prevent hospital-acquired infections. Choosing an effective hand disinfectant is necessary in enforcing good hand hygiene practice especially in hospital settings. The aim of the study was to investigate the efficacy of Aaride AGT-1 as a hand disinfectant for the inhibition of pathogenic microorganisms' transmission among both patients and personnel in the health care system compared to other commercially available disinfectants. In the present study, a new hand disinfectant Aaride AGT-1 was tested against several bacterial and viral pathogens to evaluate its antimicrobial activity profile. The results revealed that Aaride AGT-1 displayed the highest antibacterial activity against five pathogenic bacteria including MRSA when compared to other commercially available hand sanitizers. Aaride AGT-1 showed the lowest percentage needed to inhibit the growth of bacterial pathogens. In addition, results obtained from time killing assay revealed that Aaride AGT-1 demonstrated the best killing kinetics, by eradicating the bacterial cells rapidly within 0.5 min with 6 log reduction (>99.99% killing). Also, Aaride AGT1 was able to reduce 100% plaque formed by three viruses namely HSV-1, HSV-2 and EV-71. In conclusion, Aaride AGT-1 is capable of killing wide-spectrum of pathogens including bacteria and viruses compared to other common disinfectants used in hospital settings. Aaride AGT-1's ability to kill both bacteria and viruses contributes as valuable addition to the hand disinfection portfolio.

Geochemical characterization of modern aeolian dust over the Northeastern Arabian Sea: Implication for dust transport in the Arabian Sea

The Arabian Sea, one of the most biologically productive oceanic regions, receive significant amount of nutrients through aeolian dust deposition which have potential to modulate surface water biogeochemical processes. Identification of dust sources is important to assess role of dust deposition to surface water biogeochemistry. Here we report geochemical characteristics (major elements and trace metals composition, clay mineralogy and radiogenic isotopes of Sr and Nd) of aeolian dust, derived from dust storms in Middle East and South West Asia, to decipher its sources and possible transport pathways over the Arabian Sea. Twelve bulk aerosol samples were collected, during dusty period, at a coastal station (Goa; 15.4^o N, 73.8^o E) located in the Northeastern Arabian Sea, spanning over three years in different seasons. A preliminary estimation of sources for dust storms was done using satellite imagery and air mass back trajectory analyses. Major element and trace metal compositions of storm derived dust samples indicate insignificant contribution from anthropogenic sources. Illite and chlorite are major clay minerals found in all dust samples, however, high palygorskite content were observed for dust sourced from the Arabian Peninsula. A more uniform Sr-Nd signature is found for those derived from Arabia, however, highly variable Sr-Nd isotope signatures were observed for those derived from the South West Asia (Iran and Makran coast). The reported comprehensive data set on geochemical characteristics of mineral dust, is the first attempt that provides important information to understand present and past dust emission and deposition over the Arabian Sea.

Epitope variances demonstrated by Blastocystis sp. ST3 symptomatic and asymptomatic isolates

Blastocystis sp. is an enteric protozoan parasite of humans and many animals. Blastocystis sp. subtype 3 (ST3) proves to be the highest frequency case in most populations around the world and it is further distinguished into symptomatic and asymptomatic isolates based on the clinical symptoms exhibited by infected individuals. Phenotypic and genotypic studies implicate the distinctiveness of this parasite which may describe its pathogenesis. However, the antigenic distinctiveness which describes the antibody mediated cell lysis of this parasite has not been explored. This study was aimed to identify the cross-reactivity and cytotoxicity effect between three isolates of symptomatic and asymptomatic Blastocystis sp. ST3 respectively. Antigen specificity and diversity of this parasite was performed by coculturing sera (10-fold dilution) obtained from mice immunised with Blastocystis sp. symptomatic and asymptomatic antigens and the respective Blastocystis sp. ST3 live cells through complement dependant cell cytotoxicity (CDC) assay. The results obtained has shown that, the sera (at 10-fold diluted concentration) from symptomatic and asymptomatic solubilised antigen immunised mice were able to specifically lyse the respective live parasites with an average percentage of 82% and 86% respectively. There were almost 50% crossreactivity observed between the three isolates of Blastocystis sp. ST3 from symptomatic and asymptomatic group proving high antigen diversity or rather low antigen specificity within the same group. However, there was only 17% cross-reactivity observed between the mice sera and parasitic cells of different groups (symptomatic vs asymptomatic isolates) suggesting high specificity between these two groups. We, for the first time have proven that through CDC analysis there were epitopes dissimilarities between Blastocystis sp. ST3 symptomatic and asymptomatic isolates which may allow the parasite to set up diverse immune modulations such as imbalanced Th1/Th2 responses in an infected host.

Effect of processing delay on bifurcation delay in a network of slow-fast oscillators

Bifurcation delay or slow passage effect occurs in dynamical systems with slow-fast time-varying parameters. In this work, we report the impact of processing delay on bifurcation delay in a network of locally coupled slow-fast systems with self-feedback delay. We report that the network exhibits coexisting coherent (synchronized) and incoherent (desynchronized) states among the oscillators as a function of various parameters like self-feedback delay, processing delay, and amplitude of the external current. In particular, we show the decrease of the synchronized region (control of synchronization) for (i) a fixed value of processing delay with varying self-feedback delay and (ii) fixed self-feedback delay with increasing processing delay. In contrast, we observe the increase of the synchronized region (control of desynchronization) for fixed processing delay and self-feedback delay while varying the amplitude of the external current. Finally, we have also analyzed the effect of processing delay on bifurcation delay with the presence of noise and we report that the inhomogeneity in the additional noise does not affect the asymmetry in a bifurcation delay.

Genotoxic effects of tobacco use in residents of hilly areas and foot hills of Western Ghats, Southern India

Smoking and smokeless tobacco consumption is a significant risk factor that provokes genetic alterations. The present investigation was to evaluate the biomarkers of genotoxicity including micronucleus (MN), chromosome aberrations (CA) and DNA strand breaks among tobacco consumers and control individuals residing in hilly areas of Western Ghats, Tamilnadu, South India. This study included 268 tobacco consumers with equal number of controls. The tobacco consumers were divided into Group I (<10 years of tobacco consumption with an age range from 15 to 35 years) and group II (>10 years consumption above 35 years of age). Chromosome aberration (CA) and comet assay were performed using blood and micronucleus assay from exfoliated buccal epithelial cells obtained from tobacco consumers and controls. Elevated levels of CA were found in group II (Chromatid type: 2.39 ± 1.13 and chromosome type: 1.44 ± 1.24) exposed subjects, high micronucleus and DNA damage (TL:4.48 ± 1.24 and TM:3.40 ± 1.58) levels were significantly (p < 0.05) observed in both smoking and smokeless tobacco consumers when comparison with group I and controls. This study also observed a lack of awareness among the tobacco consumers about the harmful health effects of tobacco. Tobacco consumption contributes to the significant alteration in genetic materials. In addition, a high rate of spontaneous abortion was also seen in the studied population.

A mid-treatment break and reassessment maintains tumor control and reduces toxicity in patients with hepatocellular carcinoma treated with stereotactic body radiation therapy

BACKGROUND AND PURPOSE

Patients with hepatocellular carcinoma (HCC) commonly have underlying liver dysfunction with variable tolerance to liver stereotactic body radiation therapy (SBRT). We hypothesized that insertion of a 1-month mid-treatment break would allow us to adapt treatment to the individual patient response, thereby reducing toxicity without compromising local control (LC).

MATERIALS AND METHODS

We analyzed HCC patients receiving 3-5 fraction SBRT at our institution from 2005 to 2017. Over this time, patients were offered enrollment on prospective trials assessing individualized adaptive SBRT. Based on normal tissue complication probability and modeling of changes in liver function following a 1-month treatment break between fractions 3 and 4, patients could receive a total of 3 or 5 fractions. Patients not on trial received 3 or 5 fractions without a break. Toxicity was defined as a ≥2 point rise in Child-Pugh (CP) score within 6 months of SBRT.

RESULTS

178 patients were treated with SBRT to 263 HCCs. Median follow-up was 23 months. 86 treatments had a 1-month break. 1-Year LC was 95.4%; this was not different between patients treated with or without a break (p = 0.14). Controlling for tumor size and dose a break was not associated with inferior LC (HR: 0.58, 95%CI: 0.1-3.34, p = 0.54). 54 patients experienced a ≥2 point rise in CP score. Controlling for the number of prior liver directed therapies and mean liver dose, a treatment break reduced the odds of toxicity (OR: 0.42, 95% CI: 0.17-1.03, p = 0.06).

CONCLUSION

A one-month mid-treatment break and reassessment may reduce the odds of treatment related toxicity without compromising LC.

First Measurement of Near-Threshold J/ψ Exclusive Photoproduction off the Proton

We report on the measurement of the γp→J/ψp cross section from E_{γ}=11.8  GeV down to the threshold at 8.2 GeV using a tagged photon beam with the GlueX experiment. We find that the total cross section falls toward the threshold less steeply than expected from two-gluon exchange models. The differential cross section dσ/dt has an exponential slope of 1.67±0.39  GeV^{-2} at 10.7 GeV average energy. The LHCb pentaquark candidates P_{c}^{+} can be produced in the s channel of this reaction. We see no evidence for them and set model-dependent upper limits on their branching fractions B(P_{c}^{+}→J/ψp) and cross sections σ(γp→P_{c}^{+})×B(P_{c}^{+}→J/ψp).

Immunogenic and antigenic heterogeneity of Blastocystis sp. subtype 3 from symptomatic and asymptomatic individuals

Blastocystis sp. subtype 3 (ST3) has been implicated previously to be phenotypically heterogeneous between isolates from symptomatic and asymptomatic persons in previous studies. The aim of this study is to identify the immunogenic and antigenic heterogeneity among three different isolates of Blastocystis sp. ST3 isolated from asymptomatic and symptomatic individuals. Immunogenic and antigenic profile of ST3 isolates was assessed through splenocyte proliferation, cytokine assessment and antibody measurements. The total IgG antibody responses in mice immunised with symptomatic (0.736±0.033) and asymptomatic (0.426±0.025) of ST3 Blastocystis sp. were significantly higher compared to the controls respectively. High secretions of IgG antibody mixture of IgG1/IgG2a antibodies were detected in sera of mice immunised with symptomatic and asymptomatic solubilised Blastocystis sp. Antigen (Blastocystis-Ag). Predominant IgG1 production was detected higher in mice injected with Blastocystis sp. ST 3 from asymptomatic individuals (0.148±0.016) (P<0.05) whereas predominant IgG2a production was detected higher in mice injected with the same subtype but from the symptomatic individuals (0.355±0.021). This data was supported by the production of significantly higher Th1 (IFNγ and IL-2) response (393.56±49.21) and (628.89±31.06) respectively in symptomatic isolates compared to Th2 (IL-4 and IL-10) response (93±7.85) and (103.22±11.33) in asymptomatic isolates after in-vitro stimulations. Splenocyte stimulation index (SI) was detected higher in symptomatic Blastocystis-Ag group. This study is the first to demonstrate antigenic and immunogenic heterogeneity among ST3 symptomatic and asymptomatic Blastocystis-Ag with symptomatic isolates being highly immunogenic and antigenic. No significant variations among the three isolates of asymptomatic and symptomatic groups. The study supports the suggestion from previous study that surface variations between symptomatic and asymptomatic isolates as well their distinct phenotypic variation despite being the same subtype may have caused the differences in the distinct immune responses.

Synthesis and Spectral Studies of Iron(III), Ruthenium(III) and Rhodium(III) Complexes with New Tetraaza Macrocyclic Ligands

Complexes of iron(III), ruthenium(III) and rhodium(III) with three new tetraaza macrocyclic ligands, oxo4bzo3[14]triene-N4[TBTAC14Tone], oxo4bzo2[14]diene-N4[DBTAC14Tone] and oxo4bzo2[15]diene-N4[DBTAC15Tone] have been prepared and characterised. The complexes are found to have the formulae [FeLCl2]Cl. 2H2O, [RuLCl2]Cl. 3H2O and [RhLCl2]Cl. 2H2O. The cations adopt a trans-dichloro configuration with the six-coordinated trivalent metal ions in a pseudo-octahedral geometry.

Rational use of intravenous polymyxin B and colistin: A review

Polymyxin B and colistin (polymyxin E) were introduced in clinical practice to treat Gram-negative infections in 1950s but their parenteral use waned in 1970s due to toxicity concerns. Resurgence of polymyxins use in Malaysia began approximately in 2009 due to a lack of treatment options for MDR Gram negative superbugs such as Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. However, limited experience and a lack of widespread availability of up-to-date dosing guidelines could potentially result in incorrect use of these last resort antibiotics by managing doctors. The recent report of polymyxin resistant strains is also a cause of concern. Herein, we discuss the importance of preserving the efficacy of polymyxins in hospitals, the similarities and differences between polymyxin B and colistin, issues pertaining to current use of polymxyins and strategies to improve polymyxins' prescription. Polymyxins should only be used to treat significant infections, in optimum doses and if possible, in combination with other antibiotics.

Bifurcation delay in a network of locally coupled slow-fast systems

We study the evolution of bifurcation delay in a network of locally coupled slow-fast systems. Our study reveals that a tiny perturbation even in a single node causes asymmetry in bifurcation delay. We investigate the evolution of bifurcation delay as a function of various parameters, such as feedback coupling strength, amplitude of external force, frequency of external force, and delay coupling strength. We show that a traveling wave is generated as the result of introducing local parameter mismatch, and the bifurcation delay shows a dip in the spatial profile. We believe that these spatiotemporal patterns in bifurcation delay shed light on the dynamics of neuronal networks.

A novel green approach for reduction of free standing graphene oxide: electrical and electronic structural investigations

Ion beam irradiation technique has been proposed, for efficient, fast and eco-friendly reduction of graphene oxide (GO), as an alternative to the conventional methods. 5 MeV, Au⁺ ion beam has been used to reduce the free standing GO flake. Both electronic and nuclear energy loss mechanisms of the irradiation process play a major role in removal of oxygen moieties and recovery of graphene network. Atomic resolution scanning tunnelling microscopy analysis of the irradiated GO flake shows the characteristic honeycomb structure of graphene. X-ray absorption near edge structure analysis at C K-edge reveals that the features of the irradiated GO flake resemble the few layer graphene. Resonant Rutherford backscattering spectrometry analysis evidenced an enhanced C/O ratio of ∼23 in the irradiated GO. In situ sheet resistance measurements exhibit a sharp decrease of resistance (few 100 s of Ω) at a fluence of 6.5 × 10¹⁴ ions cm^-2. Photoluminescence spectroscopic analysis of irradiated GO shows a sharp blue emission, while pristine GO exhibits a broad emission in the visible-near IR region. Region selective reduction, tunable electrical and optical properties by controlling C/O ratio makes ion irradiation as a versatile tool for the green reduction of GO for diverse applications.

Impact of pH on the viability and morphology of Blastocystis isolates

Blastocystis sp. is ubiquitous in avian, mammalian and human hosts and propagates in either neutral or slightly alkaline conditions within the host's gastro-intestinal tract. Of the few previous studies on this enteric protozoan parasite in feline and canine hosts, prevalence values have been shown to range between 0 to 70.8%. In view of the close association between humans, and canine and feline hosts as companion animals, faecal samples of 180 Felis catus and 82 Canis lupus, collected from Penang and Kuala Lumpur, Malaysia, were initially screened by in vitro cultivation followed by molecular characterization. No positive isolates were identified in culture but in 12 feline samples DNA barcoding detected a zoonotic subtype Blastocystis ST1 for the first time. Consequently, avian and human isolates, which had previously been successfully cultured, were used to investigate the impact of pH on the viability and morphology of Blastocystis sp. The use of Trypan blue showed that the number of viable cells increased when exposed to pH 4 and a significant increase in viability occurred in pH values of 5 to 7. Development of Blastocystis cells in both isolates was suppressed in media less than pH 5 followed by the disappearance of viable cells from avian isolates in more acidic media below pH 4. Morphologically at pH 4 cells from avian isolates were less rounded, and with wrinkled / shrunken surfaces, than the more normal rounded cells from human isolates. On the other hand, at values below pH 3, no viable cells in human isolates were visible. The present findings therefore confirm that gastro-intestinal pH is an important determinant of Blastocystis viability and consequently influences the epidemiology of infection within avian, mammalian and human hosts.

Genetic diversity of rodent Blastocystis sp. from Peninsular Malaysia

Rodents are ubiquitous zoonotic vectors for many human pathogens including Blastocystis sp. In this study, we examined the prevalence and subtypes of Blastocystis sp. in rodents captured from Peninsular Malaysia. A total of 293 rodents predominantly brown rat (Rattus norvegicus) (290 of 293, 99.0%) and house shrew (Suncus murinus) (3 of 293, 1.0 %), were captured in the vicinity of popular eateries in two cities (Kuala Lumpur and Ipoh) in Peninsular Malaysia. In vitro cultivation method showed presence of Blastocystis sp. in approximately half (133 of 290, 45.9%) of the brown rats tested. Among the 47 Blastocystis isolates subtyped using partial small subunit ribosomal RNA gene analysis, ST4 was the most abundant (43 of 47, 91.5%) followed by ST1 (2 of 47, 4.3%), ST5 (1 of 47, 2.1%) and ST7 (1 of 47, 2.1%). Our findings highlighted the importance of rodents as a source of Blastocystis sp. infection in Malaysia and showed the high prevalence of ST4 within the rodent population infected with Blastocystis sp.

Current status of Blastocystis in cockroaches

There are few reports on Blastocystis spp. infections in invertebrate hosts namely, cockroaches. Due to their close proximity to humans especially to their dwellings prompted this study as these organisms could possibly play a role in human transmission. A total of 151 cockroaches consisted predominantly of nymph and adult stages were captured from several types of dwellings in the state of Perak and Selangor, Malaysia. Approximately half (40.4%) of the cockroach intestinal contents screened were positive and were found associated to two main factors, host-stage and types of dwellings. The granular and vacuolated forms were the most common cell form found in the in vitro cultures and were morphologically similar to B. hominis. However, the surface coat observed was thick with an electron lucent area observed in the central vacuole. The isolates grew in room temperature but optimal growth was observed at a 24ºC similar to the reptilian Blastocystis with a high number of cells were recovered. Using the DNA barcoding method, two isolates were identified as ST3 (allele 56), one isolate was consider as the new subtype with close relation to allele 114.

Morphological and molecular detection of Blastocystis in wildlife from Tioman Island, Malaysia

Blastocystis infection is widely reported in wildlife, livestocks and in non-human primates however, occurrence in Malaysian wildlife is scarce. A wildlife survey on Tioman Island captured six water monitor lizard (Varanus salvator), four mouse-deer (Tragulus sp.) and one Malayan porcupine (Hystrix brachyura) based on convenience sampling. Intestinal contents from each animal were subjected to in vitro cultivation method using Jones medium supplemented with 10% horse serum. Low prevalence of infections was detected with only 1/6 (16.7%) water monitor lizard and 1/4 (25%) mouse-deer infected. The vacuolated form was the most common cell form found in both cultures with similar morphology to B. hominis. However, the monitor lizard isolate propagated well in the laboratory for several months using Jones medium while mouse-deer isolate could not be maintained for more than a week. The reptilian isolates grew optimally at a lower temperature of 24ºC compared to 37ºC for the mouse-deer isolate. Using the DNA barcoding method, both isolates were confirmed to be Blastocystis sp. Sequence obtained from a monitor lizard isolate has 94% sequence identity to B. lapemi, an isolate recovered from a reptile sea-snake whereas a mouse-deer isolate has 99% sequence identitical to B. hominis HJ01-7. The phylogenetic tree revealed that the monitor lizard isolate were positioned within the herptiles clade (clade VIII) while the mouse deer isolate located at the homoithermal clade (clade IV). The present paper is the first report on the presence as well as genetic characteristics of Blastocystis in wildlife captured from Tioman Island, Pahang.

Control of bifurcation-delay of slow passage effect by delayed self-feedback

The slow passage effect in a dynamical system generally induces a delay in bifurcation that imposes an uncertainty in the prediction of the dynamical behaviors around the bifurcation point. In this paper, we investigate the influence of linear time-delayed self-feedback on the slow passage through the delayed Hopf and pitchfork bifurcations in a parametrically driven nonlinear oscillator. We perform linear stability analysis to derive the Hopf bifurcation point and its stability as a function of self-feedback time delay. Interestingly, the bifurcation-delay associated with Hopf bifurcation behaves differently in two different edges. In the leading edge of the modulating signal, it decreases with increasing self-feedback delay, whereas in the trailing edge, it behaves in an opposite manner. We also show that the linear time-delayed self-feedback can reduce bifurcation-delay in pitchfork bifurcation. These results are illustrated numerically and corroborated experimentally. We also propose a mechanistic explanation of the observed behaviors. In addition, we show that our observations are robust in the presence of noise. We believe that this study of interplay of two time delays of different origins will shed light on the control of bifurcation-delay and improve our knowledge of time-delayed systems.

A Cross-Sectional Study of Quality of Life among Subjects with Epilepsy Attending a Tertiary Care Hospital

INTRODUCTION

Epilepsy is a chronic disorder associated with profound physical and psychological consequences leading to impaired quality of life (QoL). Evaluation of the QoL among epileptics would throw light on various factors that impair or affect the QoL in such a population.

AIM

To study the QoL among epileptic patients attending outpatient departments of a tertiary care hospital and to identify various factors that affect the QoL in such a population.

MATERIALS AND METHODS

A cross-sectional observational questionnaire based study, including patients with epilepsy, who were on antiepileptic drugs, on follow-up for minimum one year, aged more than 18years, both sexes and who were seizure free in the previous 24hours. The World Health Organisation Quality of Life (WHOQOL-BREF) questionnaire was administered to those included in the study. The data was analysed using Statistical Package for Social Sciences (SPSS) version 20 and statistical tests like t-test for independent variables and Analysis of Variance (ANOVA) were used to compare the QoL scores.

RESULTS

Of the 98 subjects 61.2% were males, majority were educated upto high school level and most of them were employed in unskilled labour. The mean total QOL score was 53.9 (15.8). There was a significant lower mean total QOL score among people with low educational status and poor seizure control.

CONCLUSION

Epilepsy is a syndrome associated with chronic drug use and regular long term follow-ups to hospitals. These treatment and disease associated problems affects the QOL of the subjects significantly in various squares of life. We found that a lower education and having seizure in the recent past affected the QOL scores.

Tenofovir-induced nephrotoxicity: A retrospective cohort study

BACKGROUND

Tenofovir (TDF) has been associated with renal function deterioration, but local data regarding the incidence and risk factors for this adverse event were lacking.

OBJECTIVES

To determine the incidence of nephrotoxicity in HIV-infected patients on tenofovir-based regimens and to evaluate risk factors involved in tenofovir-associated renal function decline.

METHODS

This is a single-centre retrospective cohort study of 440 HIV-infected adults who were started on tenofovirbased antiretroviral regimens. Data were extracted from electronic medical and pharmacy records.

RESULTS

A decline in eGFR of 25% or more was seen in 67 patients (15.2%) with an estimated incidence rate of 12 per 100 person-years. Among all 440 subjects, 22 discontinued TDF-based therapy due to renal complication. From multivariate analysis, the odds of developing >25% decrease in eGFR with tenofovir-containing regimen was three times higher for patients with baseline moderate renal impairment (HR 3.19; 95% CI, 1.43-7.12; p=0.005) and 14 times higher for patients with baseline severe renal impairment (HR 14.2; 95% CI, 11.20-170.7; p=0.036) as compared to those without pre-existing renal insufficiency. Age above 50 years and CD4 cell count of less than 50 were significantly associated with >25% decrement in eGFR.

CONCLUSION

The incidence rate of tenofovir-related renal dysfunction was found to be 12 per 100 person-years. Preexisting renal impairment, age 50 and above, and CD4 cell count below 50 as were predictors for renal function decline. Given that the use of tenofovir is escalating in Malaysia, increased awareness about this adverse event is essential.