Complication profile in a cochlear implantation- surgical audit in a large study population of low socio-economic status in a developing country

OBJECTIVES

To audit surgical complications and their management in cochlear implant (CI) recipients in a tertiary care referral otorhinolaryngology center in South India.

MATERIALS AND METHODS

Hospital data on 1,250 CI surgeries performed from June 2013 to December 2020 was reviewed. This is an analytical study with data collected from medical records. The demographic details, complications, management protocols and relevant literature were reviewed. Patients were divided into the following five age groups: 0-3 years, 3-6 years, 6-13 years, 13-18 years and above 18 years. Complications were divided into major and minor and complication occurrence was divided into peri-operative, early post-operative, and late post-operative, and the results were analyzed.

RESULTS

The overall major complication rate was 9.04% (including 6.0% due to device failure). If the device failure rate was excluded, the major complication rate was 3.04%. The minor complication rate was 6%.

DISCUSSION

CI is the gold standard in the management of patients with severe to profound hearing loss with minimal benefit from conventional hearing aids. Experienced tertiary care CI referral and teaching centers manage complicated implantation cases. Such centers typically audit their surgical complications, providing important reference data for young implant surgeons and newer centers.

CONCLUSION

Although not bereft of complications, the list of complications and its prevalence is sufficiently low to warrant the advocacy of CI worldwide, including developing countries with low socio-economic status.

Anti-dengue Potential of Mangiferin: Intricate Network of Dengue to Human Genes

Dengue fever has become one of the deadliest infectious diseases and requires the development of effective antiviral therapies. It is caused by members of the Flaviviridae family, which also cause various infections in humans, including dengue fever, tick-borne encephalitis, West Nile fever, and yellow fever. In addition, since 2019, dengue-endemic regions have been grappling with the public health and socio-economic impact of the ongoing coronavirus disease 19. Co-infections of coronavirus and dengue fever cause serious health complications for people who also have difficulty managing them. To identify the potentials of mangiferin, a molecular docking with various dengue virus proteins was performed. In addition, to understand the gene interactions between human and dengue genes, Cytoscape was used in this research. The Kyoto Encyclopedia of Genes and Genomes software was used to find the paths of Flaviviridae. The Kyoto Encyclopedia of Genes and Genomes and the Reactome Pathway Library were used to understand the biochemical processes involved. The present results show that mangiferin shows efficient docking scores and that it has good binding affinities with all docked proteins. The exact biological functions of type I interferon, such as interferon-α and interferon-β, were also shown in detail through the enrichment analysis of the signaling pathway. According to the docking results, it was concluded that mangiferin could be an effective drug against the complications of dengue virus 1, dengue virus 3, and non-structural protein 5. In addition, computational biological studies lead to the discovery of a new antiviral bioactive molecule and also to a deeper understanding of viral replication in the human body. Ultimately, the current research will be an important resource for those looking to use mangiferin as an anti-dengue drug.

Traditional uses, phytochemistry and pharmacology of Bauhinia racemosa Lam.: a comprehensive review

Background

Bauhinia racemosa is not familiarly known in Asian countries due to its limited existence and lack of medicinal information. It is commonly used as a medicine, ornamental plant, fence plant, and fodder for livestock since ancient times. It is also used as a landfill tree to avoid soil erosion of the forest.

Main body

In South India, people cultivate this plant in their premises in order to protect themselves from the effects of thunder. In this review, the various research prospects of this plant have been analyzed and are summarized. The aim of this review is to provide the traditional uses, phytochemicals and pharmacological activities of B. racemosa, and to highlight the current pharmacological developments of this medicinal plant.

Conclusions

The B. racemosa has immense therapeutic potential for treating diseases with both traditional and pharmacological applications. But many traditional uses of B. racemosa have not been validated by current investigations in the aspects of pharmaceutical. Until now, research on phyto-constituents from B. racemosa has not been done in an extensive way. Hence, the identified phytochemicals of B. racemosa should also be subjected to pharmacological studies to illuminate the biological mechanisms of these unreported secondary metabolites for the prevention of diseases or microbial infections and other health disorders of human and animal races.

Study of Permissible Flow Rate and Mixing Efficiency of the Micromixer Devices

This paper deals with design, simulation, fabrication, analysis of mixing efficiency and thin film bonding stability of the micromixer devices with different flow rates used for lab on chip applications. The objective of the present study is to achieve complete mixing with low flow rate and less pressure drop in low cost polymer microfluidic devices. This paper emphasis the design, simulation and fabrication of straight channel micromixer, serpentine channel micromixer with and without quadrant shaped grooves to study the mixing behavior by the effect of structural dimensions of the microfluidic channel at different flow rates. The designed micromixers were tested with varying rates of flow such as 1, 10, 25, 50, 75 and 100 µL/min.

Distribution of heavy metals and associated human health risk in mine, agricultural and roadside soils at the largest chromite mine of India

This study accessed the levels of Cd, Cr, Fe, Mn, Ni, Pb and Zn concentration in soils of different locations (mine, roadside, agricultural and control sites) of Sukinda chromite mine (the India's largest Chromite mine and listed among the world's ten most polluted regions). Geo-accumulation (I_geo) index indicates that the mine, agricultural and roadside soils are 'heavily to extremely contaminated' due to Cr, Ni, Pb and Cd, hence human residing/working in this region can have health hazards due to contaminated soil via different exposure pathways. The concentration of heavy metals (mg/kg) in mine site vary between 52.35 and 244.8 (Cr⁶⁺), 12,030.2 and 31,818.6 (Cr³⁺), 5460.4 and 8866.0 (Ni), 70.02 and 208.6 (Pb), 0.95 and 5.3 (Cd), 209.1 and 360.4 (Mn), 21,531.8 and 28,847 (Fe) and 221 and 349.3 (Zn). Fe, Cr⁶⁺, Cr³⁺ and Ni concentration in soil follows an order of mine site > road sites > agricultural lands > control forest sites. Principal component analysis and hierarchical cluster analysis indicate Cd, Cr, Fe, Ni and Pb as major pollutants in the region. Cancer Risk is 'high' in both adult (5.38E-04) and children (4.45E-04) in mining sites and 'low' to 'very low' in agricultural and road side soils. The hazard index for all the heavy metals in a mining areas is varied from 2.9 to 5.2 in adult and 2.8-5.1 in children, indicating 'high' to 'very high' non-cancer risk due to significant contribution of Ni, Pb and Cr⁶⁺ concentration (73, 11 and 10%, respectively).

Numerical Modeling and Parametric Optimization of Micromixer for Low Diffusivity Fluids

This paper deals with the design, analysis and optimization of micro-mixer for fluids having very low diffusivity (in the order of 10−12m2/s) to be used in Lab on Chip (LOC) for medical diagnosis. As flow is laminar and the cross-sectional area is in microscale, the viscous forces are strong causing the fluids to be transported in streamline with minimum diffusion. The main objective in designing a micro mixer is to achieve complete mixing with minimum channel length and pressure drop. In this work a passive micro mixer with two inlets and one outlet (Y shaped passive micro mixer) with obstacles in various shapes and sizes is modelled, to study the effect of mixing. After a CFD analysis, Analysis of variance (ANOVA) of 3Kdesign with 3 parameters as well as a 2Kdesign with 4 parameters was performed to study the effect of parameters on mixing index (mixing length) and pressure loss. There is a negative correlation between the response obtained for mixing length and pressure loss while varying the parameters. This makes it difficult to predict the optimum configuration. Taguchi method is used to obtain an optimum configuration to overcome this negative correlatiozn.

Dosimetric Validation of Volumetric Modulated Arc Therapy with Three 6MV Beam-Matched Linear Accelerators

Background:

To avoid inconvenience to patients due to linear accelerator down time in busy radio-therapy departments, treatment plans can be switched between linear accelerators provided that all exhibit the same same dosimetric characteristics. In other words linear accelerators should be beam-matched.

Aim:

The aim of this study was to evaluate the clinical significance of beam-matching using VMAT plans.

Materials and Methods:

Dosimetric data with a 6MV beam from am Clinac 2100CD were taken as baseline values and other two units, a 2300CD and a Unique Performance, were factory tuned in accordance. An analysis of PDD data was performed for different field sizes to evaluate energy matching. Beam profiles for field sizes of 10×10 cm² and 40 × 40 cm² at depths of 1.5 cm and 10 cm were analyzed. The relative output factor and MLC dosimetric properties were compared with each machine to determine variability among the different models. Thirty patients from our database were selected, ten each for head and neck, thorax and pelvis sites. VMAT plans were created in the Eclipse treatment planning system for a Clinac 2100 CD for reference. and verification plans were created for each to compare point dose measurements.

Results:

The TPR 20/10 for 10 × 10 cm² was well matched, showing no energy differences. Deviation of all point dose measurements fell within ±3%. Planar dose maps all showed greater than 95% of points with a passed area γ-value less than 1.

Conclusion:

Our study evaluation of beam matching with treatment planning modeling showed good agreement fior 6 MV beams across all three linear accelerators used in our clinical environment.

Dosimetric Validation of Volumetric Modulated Arc Therapy (VMAT) Using AAPM TG-119 Benchmark Plans in an Upgraded CLINAC 2100CD for Flattening Filter Free (FFF) Photon Beams

Background:

Recently we have upgraded our Varian Clinac 2100CD with a 6MV FFF beam, this upgrade being the first of its kind in our country. Even though the dosimetric characteristics of FFF beams have been reported both in experimental and Monte Carlo studies, application in planning and delivery is complex. The aim of this study was to validate the commissioning of upgraded FFF beams dosimetrically using AAPM TG-119 bench mark plans for VMAT and to make a comparison with IMRT plans for both flattened filtered and FFF beams.

Materials and Methods:

AAPM TG-119 proposes a set of test clinical cases for testing the accuracy of IMRT planning and delivery systems. For these clinical cases we generated four treatment plans using IMRT FF, IMRT FFF, VMAT FF and VMAT FFF on a Varian Clinac 2100CD machine equipped with a millennium 120 MLC in Eclipse treatment planning system. Dose prescription and planning objectives were set according to the TG-119 goals and plans were scored based on planning objectives. Plans were compared using dose coverage, the conformity index and the homogeneity index. Point doses were measured at points recommended by TG-119 using a CC13 ion chamber. Planar dosimetry was accomplished using Imatrix and gamma evaluation was conducted using Omnipro IMRT software.

Results:

Dose distributions of FFF beam based plans were comparable to FF plans for both IMRT and VMAT. Our planning results matched TG-119 planning results. Measured point doses were within ±2% of planned doses and planar dosimetry gamma values were <1 for >95% of data points for all plans.

Conclusion:

We found a reduction of 40% treatment time for FFF against FF beams for sliding window IMRT. Upgraded FFF beams were in good agreement with TG-119 benchmark plans and goals.

Electrospun protein nanofibers in healthcare: A review

Electrospun nanofibers are being utilized for a wide range of healthcare applications. A plethora of natural and synthetic polymers are exploited for their ability to be electrospun and replace the complex habitat provided by the extracellular matrix for the cells. The fabrication of nanofibers can be tuned to act as a multicarrier system to deliver drugs, growth factors and health supplements etc. in a sustained manner. Owing to its pliability, nanofibers reached its heights in tissue engineering and drug delivery applications. This review mainly focuses on various standardized parameters and optimized blending ratios for animal and plant proteins to yield fine, continuous nanofibers for effective utilization in various healthcare applications.

Fast Matrix Multiplication with Big Sparse Data

Big Data becameabuzz word nowadays due to the evolution of huge volumes of data beyond peta bytes. This article focuses on matrix multiplication with big sparse data. The proposed FASTsparse MULalgorithm outperforms the state-of-the-art big matrix multiplication approaches in sparse data scenario.

Ram's Horn Nail - Giant Onychomatricoma Treated by Complete Surgical Excision- A Rare Case Report

Giant onychomatricoma is a rare fibroepithelial nail matrix tumor with only two previous reports in literature, from Mexico. An 80-year-old female patient presented with a progressively painless mass in the left great toe nail, following trauma, of 2 years duration. On examination there was a single, hard, immobile mass of size 4 × 3 × 2 cm with proximal hyperpigmentation of the left great toe nail. The mass was totally excised and a punch biopsy of nail matrix was taken. Histopathology revealed hyperkeratosis, acanthosis, multiple channels lined by flattened epithelium and fibrocollagenous tissue in horizontal orientation in deeper layers. The patient had no recurrence after 1 month. We report this case for its rare and distinct clinical presentation, characteristic histopathology and easy surgical treatment.

Fabrication of electrospun zein nanofibers for the sustained delivery of siRNA

In this study, zein nanofibers based siRNA delivery system has been attempted for the first time. Here, the amphiphilic property of zein and the size advantage of nanofibers have been brought together in developing an ideal delivery system for siRNA. The morphological analysis of the GAPDH-siRNA loaded zein nanofibers revealed the proper encapsulation of the siRNA in the polymeric matrix. The loading efficiency of this delivery system was found to be 58.57±2.4% (w/w). The agarose gel analysis revealed that the zein nanofibers preserved the integrity of siRNA for a longer period even at the room temperature. The in vitro release studies not only depicted the sustaining potential of the zein nanofibers but also ensured the release of sufficient quantity of siRNA required to induce the gene silencing effect. The amphiphilic property of zein supported the cell attachment and thereby facilitated the transfection of siRNA into the cells. qRT-PCR analysis confirmed the potential of the developed system in inducing the desired gene silencing effect. Thus, electrospun zein nanofibers have been successfully employed for the delivery of siRNA which has a great therapeutic potential.

Design and development of a topical dosage form for the convenient delivery of electrospun drug loaded nanofibers

Nanofibers dispersed in gel facilitated the convenient administration of drug loaded nanofibers.

Impact of Si4+ Ions Doping on the Electrochemical Cycling Performance of NiTiO3 as Anodes for Li-Lon Batteries

Pristine and Si4+ doped NiTiO3 are successfully synthesized by molten salt method and electrochemically characterized for its use as an anode material for Li-ion batteries. The X-ray diffraction (XRD) results enumerates that the lattice parameter and the cell volume decreases upon the addition of Si4+ due to its smaller ionic radius. The presence of Si4+ in NiTiO3 structure was also confirmed using FTIR analysis, which showed the stretching vibrations of Si-O at -1008 cm(-1). The SEM images reveal that the NiTiO3 particles are in micrometer range and the size of the particle is found to be decrease after Si4+ addition. The electrical studies infers an enhancement in the conductivity from 4.4 x 10(-7) S x cm(-1) to 1.7 x 10(-6) S x cm(-1) on dopant addition. The initial discharge capacity of NiTiO3 is found to be 1257 mA h g(-1) and there is a capacity fading on consecutive cycles. NiTi0.9Si0.1O3 enhances the cyclic performances and a constant capacity around 400 mA h g(-1) is maintained, a very good reversibility with almost 100% efficiency is observed elucidating the fact that almost all the Li ions intercalated are successfully de-intercalated during the discharge process.

Lanthanum loaded CuO nanoparticles: synthesis and characterization of a recyclable catalyst for the synthesis of 1,4-disubstituted 1,2,3-triazoles and propargylamines

A click and three component A³ coupling reactions were achieved by lanthanum loaded CuO NPs under ultrasonication. 1,4-Disubstituted 1,2,3-triazoles and propargylamines were synthesized in a short reaction time with high regioselectivity and yields.

Metal oxide coated lithium cobalt fluorophosphate cathode materials for lithium secondary batteries--effect of aging and temperature

Lithium cobalt fluorophosphate (Li2CoPO4F) is a promising 5 V class cathode material for lithium secondary batteries. In this study, surface coating with ZrO2 improved the electrochemical activity of Li2CoPO4F with a maximum discharge capacity of 144 mA h g(-1). The effectiveness of ZrO2 coating was evaluated using aging analysis with a commercial electrolyte, i.e., 1 M LiPF6 in EC:DMC (1:1, v/v). The metal ion dissolution was reduced to 1/8th of that observed in the non-coated Li2CoPO4F. It was found that the thin coating layer had less or no contribution to the additional resistance for the cell, both at an open circuit potential and at a fully charged state; hence, the capacity of the cell was retained over cycling. Elevated temperature aging did not affect the intrinsic property of the coated Li2CoPO4F, as observed from the complete anodic and cathodic peaks from cyclic voltammetry studies after 30 days of storage at 50 degrees C. An increase in impedance was observed for aged cells, which could be due to the thick SEI layer formed during storage. The ZrO2 coating over Li2CoPO4F was crucial for the improved performance of electrode active material at higher operating potentials of up to 5.2 V.

Selective interactions of zein microspheres with different class of drugs: an in vitro and in silico analysis

In this study, we have evaluated the interactions of zein microspheres with different class of drugs (hydrophobic, hydrophilic, and amphiphilic) using in vitro and in silico analysis. Zein microspheres loaded with aceclofenac, metformin, and promethazine has been developed by solvent evaporation technique and analyzed for its compatibility. The physical characterization depicted the proper encapsulation of hydrophobic drug in the microspheres. The in vitro release study revealed the sustaining ability of the microspheres in the following order: hydrophobic > hydrophilic > amphiphilic. In silico analysis also confirmed the better binding affinity and greater interactions of hydrophobic drug with zein. The above results revealed that zein is more suitable for hydrophobic drugs in the development of sustained drug delivery systems using solvent evaporation technique. The study therefore envisages a scope for identifying the most suitable polymer for a sustained drug delivery system in accordance with the nature of the drug.

Aluminum based sulfide solid lithium ionic conductors for all solid state batteries

The present work focuses on the synthesis of lithium ionic conductors based on a Li2S-Al2S3-GeS-P2S5 system due to the high ionic conductivity exhibited by the constituents of this system. Mechanical milling for a short duration and a single step heat treatment at a moderate temperature of 550 °C resulted in crystalline powders with high lithium ionic conductivity at room temperature that are comparable to the organic liquid electrolytes. The effect of various aluminum to germanium ratios was studied. Among the samples containing Al : Ge, the ratio of 30 : 70 was found to show high ionic conductivities of 1.7 × 10(-3) S cm(-1) at 25 °C and ∼ 6 × 10(-3) S cm(-1) at 100 °C equivalent. The activation energy of this material was significantly less (Ea = 17 kJ mol(-1)), which can be considered to be the best value among solid electrolytes. The electrochemical stability was analyzed using cyclic voltammetry between -0.3 and 5.0 V and it was found that the voltammetric profile was smooth without any additional current response, due to electrolyte decomposition, or any other side reaction, except a pair of lithium deposition and stripping peaks.

Alumina coating on 5 V lithium cobalt fluorophosphate cathode material for lithium secondary batteries – synthesis and electrochemical properties

The high voltage cathode material, Li₂CoPO₄F was successfully synthesized and coated with various amounts of Al₂O₃ for enhanced electrochemical performance.

Solvent and catalyst free route to 3-indolyl glycoconjugates: synthesis of sugar tethered isoxazolines and isoxazoles from 3-indolyl nitroalkanes

An expedient, solvent and catalyst free strategy for the synthesis of sugar based bis(indolyl)methanes and indolyl nitroalkanes has been developed. Further, the nitroalkanes were converted to novel isoxazolines and isoxazoles by nitrile oxides cycloaddition.

A high performance hybrid capacitor with Li2CoPO4F cathode and activated carbon anode

For the first time, we report the possibility of utilizing Li2CoPO4F as a novel cathode material for hybrid capacitor applications. Li2CoPO4F powders were prepared by a conventional two-step solid state method. A hybrid cell was fabricated using Li2CoPO4F as the cathode along with activated carbon (AC) as the anode in 1 M LiPF6 dissolved in 1 : 1 EC/DMC electrolyte and its electrochemical properties were examined by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS) and constant current charge-discharge (C-D) techniques. The Li2CoPO4F/AC cell is capable of delivering a discharge capacitance of 42 F g(-1) at 150 mA g(-1) current density within 0-3 V region having excellent coulombic efficiency of over 99% even after 1000 cycles. Furthermore, the Li2CoPO4F/AC cell exhibited excellent rate performance with an energy density of ~24 W h kg(-1) at 1100 mA g(-1) current and maintained about 92% of its initial value even after 30,000 C-D cycles. Electrochemical impedance spectroscopy was conducted to corroborate the results that were obtained and described.

Bioanalytical method development, validation and quantification of dorsomorphin in rat plasma by LC-MS/MS

The present investigation describes the development and validation of a sensitive liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method for the estimation of dorsomorphin in rat plasma. A sensitive LC-MS/MS method was developed using multiple reaction monitoring mode, with the transition of m/z (Q1/Q3) 400.2/289.3 for dorsomorphin and m/z (Q1/Q3) 306.2/236.3 for zaleplon. Chromatographic separation was achieved on a reverse phase Agilent XDB C18 column (100 × 4.6 mm, 5 µm). The mobile phase consisted of acetonitrile and 5 mm ammonium acetate buffer (pH 6.0) 90:10 v/v, at a flow rate of 0.8 mL/min. The effluence was ionized in positive ion mode by electrospray ionization (ESI) and quantitated by mass spectrometry. The retention times of dorsomorphin and internal standard were found to be 2.13 and 1.13 min, respectively. Mean extraction recovery of dorsomorphin and internal standard in rat plasma was above 80%. Dorsomorphin calibration curve in rat plasma was linear (r(2) ≥ 0.99) ranging from 0.005 to 10 µg/mL. Inter-day and intra-day precision and accuracy were found to be within 85-115% (coefficient of variation). This method was successfully applied for evaluation of the oral pharmacokinetic profile of dorsomorphin in male Wistar rats.

Silymarin prevents benzo(a)pyrene-induced toxicity in Wistar rats by modulating xenobiotic-metabolizing enzymes

Benzo(a)pyrene (B(a)P), which is commonly used as an indicator species for polycyclic aromatic hydrocarbon (PAH) contamination, has a large number of hazardous consequences on human health. In the presence of the enzyme cytochrome-P-450 1A1 (CYP1A1), it undergoes metabolic activation to form reactive intermediates that are capable of inducing mutagenic, cytotoxic, teratogenic and carcinogenic effects in various species and tissues. Research within the last few years has shown that flavonoids exhibit chemopreventive effect against these toxins. In the present study, the protective effect of silymarin (a flavonoid) against B(a)P-induced toxicity was monitored in Wistar rats by evaluating the levels of hepatic phase I (CYP1A1), phase II enzymes (glutathione-S-transferase, epoxide hydroxylases, uridinediphosphate glucuronosyltransferases, NAD(P)H: quinone oxidoreductase 1, sulfotransferases), cellular antioxidant enzyme heme oxygenase and total glutathione. The results reveal that silymarin possesses substantial protective effect against B(a)P-induced damages by inhibiting phase I detoxification enzyme CYP1A1 and modulating phase II conjugating enzymes, which were confirmed by histopathological analysis. Overall, the inhibition of CYP1A1 and the modulation of phase II enzymes may provide, in part, the molecular basis for the effect of silymarin against B(a)P.