The continuum of liver injury with severity of dengue fever: A retrospective observational study

BACKGROUND

Dengue is a major international health concern prevalent in tropical and sub-tropical countries. There are a paucity of studies on the relationship of hepatic complications with inflammatory parameters in dengue infection.

METHODS

Single-centre observational study was conducted at the tertiary care centre in North India. Patients (>12 years) diagnosed with dengue infection between August and November 2021 were enrolled in the study. The frequency of hepatic derangements and their associations with inflammatory severity was analysed.

RESULTS

Based on the clinical symptoms, 170 patients were classified into three categories, namely, dengue fever, warning dengue and severe dengue. Higher incidence of liver dysfunction was observed in severe dengue patients with median values of aspartate aminotransferase (AST) (3051 U/L, p < 0.001), alanine aminotransferase (ALT) (1792 U/L, p = 0.009), alkaline phosphatase (172 U/L, p = 0.001), T.Bil (34.2 µmol/L, p < 0.001), albumin (30 g/L, <0.001), and gamma-glutamyl transferase (152 U/L, p < 0.001) along with inflammatory marker C-reactive protein (CRP) (43 mg/dL, p < 0.001) highly deranged, in comparison to patients with/without warning signs. Median levels of CRP were found to be positively and significantly correlated with the median levels of AST and ALT (p < 0.05, r = 0.99) in all three categories of dengue patients. Liver injury was noted in 107 (63%) of the cohort, and mixed type of liver injury involving both hepatocellular and cholestatic patterns was observed as the most common type of injury (n = 50, 29.4%). Liver injury correlated with the severity of dengue illness as about 85% of severe dengue patients had significant liver injury (p = 0.014).

CONCLUSION

In dengue patients, the association of the liver injury with inflammatory severity suggests that the mechanism of liver injury may be related to inflammatory response apart from the hepatotropic nature of the virus.

Enhanced photocatalytic and SERS performance of Ag nanoparticles functionalized MoS2 nanoflakes

We report the preparation of Ag nanoparticles functionalized MoS2 nanoflakes by using the chemical reduction method followed by the hydrothermal method. Field emission scanning electron microscopy and elemental mapping reveals the uniform functionalization of Ag nanoparticles with MoS2 nanoflakes. High density of Ag plasmonic nanoparticles onto MoS2 nanoflakes demonstrates tremendously improved charge separation behavior in Ag-MoS2 nanohybrids. Photodecomposition capability of plasmonic Ag-MoS2 nanohybrids was explored by the decomposition of industrial pollutant molecules, showing a direct correlation between the Ag content over the MoS2 surface with their photodecomposition ability. The SERS-based detection profiles of the plasmonic were investigated by the ultra-low detection of MB molecules. The Ag-MoS2 nanohybrids SERS substrate manifests the detection of MB molecules solution up to a concentration of 10-9 M with an enhancement factor of 107. In the current study, we proposed and elucidated the probable efficient charge transfer mechanism for improved photocatalytic behavior and SERS-based sensing performance.

Descriptive Epidemiology of Unintentional Childhood Injuries in India: An ICMR Taskforce Multisite Study

BACKGROUND

Children 0-14 years constitute about 31.4% of Indian population, among whom the magnitude and risk factors of childhood injuries have not been adequately studied.

OBJECTIVE

To study the prevalence of and assess the factors associated with unintentional injuries among children aged 6 month - 18 years in various regions.

METHODOLOGY

This multi-centric, cross-sectional, community-based study was conducted at 11 sites across India. States included were Gujarat, Karnataka, Madhya Pradesh, Punjab, Sikkim, Tamil Nadu, Uttarakhand, and West Bengal between March, 2018 and September, 2020. A total of 2341 urban and rural households from each site were selected based on probability proportionate to size. The World Health Organization (WHO) child injury questionnaire adapted to the Indian settings was used after validation. Information on injuries was collected for previous 12 months. Definitions for types (road traffic accidents, falls, burns, poisoning, drowning, animal-related injuries) and severity of injuries was adapted from the WHO study. Information was elicited from parents/primary caregivers. Data were collected electronically, and handled with a management information system.

RESULTS

In the 25751 households studied, there were 31020 children aged 6 months-18 years. A total of 1452 children (66.1% males) had 1535 unintentional injuries (excluding minor injuries) had occurred in the preceding one year. The overall prevalence of unintentional injuries excluding minor injuries was 4.7% (95% CI: 4.4-4.9). The commonest type of injury was fall-related (842, 54.8%) and the least common was drowning (3, 0.2%). Injuries in the home environment accounted for more than 50% of cases.

CONCLUSIONS

The findings of the study provide inputs for developing a comprehensive child injury prevention policy in the country. Child safe school with age-appropriate measures, a safe home environment, and road safety measures for children should be a three-pronged approach in minimizing the number and the severity of child injuries both in urban and rural areas.

Bimetallic Ag-Au alloy nanocubes for SERS based sensitive detection of explosive molecules

We have fabricated Ag-Au alloy nanocubes using the galvanic replacement of silver nanocubes by aqueous HAuCl₄ and investigated their morphological, structural, compositional and optical properties. The inter-diffusion between silver and gold at 100 °C leads to the formation of Ag-Au alloy nanocubes with hollow interiors. A broad tuning of the surface plasmon resonance (SPR) wavelength from 624 nm to 920 nm is obtained with the varying volume of HAuCl₄. When excited at wavelength 785 nm, the bimetallic Ag-Au nanocubes with pinholes exhibit two-fold Raman intensity enhancement compared to pristine Ag nanocubes. The surface-enhanced Raman spectroscopy (SERS) substrate prepared with Ag-Au alloy nanocubes shows high-intensity enhancement factor of 1.9 × 10⁷ for 11.2 wt% Au content. The SERS-active Ag-Au alloy nanocubes substrates were exploited for the detection of two explosive molecules; p-nitrobenzoic acid (PNBA) and picric acid (PA). Remarkable detection sensitivity and ultra-low detection limit of 1.7 × 10^-14 M for PNBA and 4.1 × 10^-11 M for PA were obtained, demonstrating the very high SERS detection capabilities of the as-prepared substrate.

Pulsed photoacoustic and photothermal response of gold nanoparticles

Gold nanospheres and nanorods are promising agents for photoacoustic imaging and photothermal therapy. In this work, seed-mediated methods were optimized for the synthesis of gold nanosphere and nanorod collides of different sizes. Nanosecond pulse photoacoustic and photothermal analysis of these nanoparticles was carried out and compared with finite element simulation. The simulations were performed to quantify the size dependent photoacoustic signal enhancement for nanospheres and nanorods. The non-sphericity contribution of nanospheres was found to enhance the photoacoustic signal. Nanosecond pulse photoacoustic studies of nanorods of different aspect ratio were carried out. Nanorods of aspect ratio ∼4.8 were found to be the most efficient photoacoustic signal generators. Photoacoustic studies of nanorods at varying laser fluence were performed and threshold fluence of 5 mJ cm^-2 was observed. Nanorods exposed to nanosecond laser pulses underwent size and shape variations which were confirmed by optical absorbance and transmission electron microscopy measurements. Simulations of nanorods of different aspect ratio and diameter were performed to investigate the photoacoustic signal enhancement and photothermal stability. The miniature size nanorod with a diameter of 10 nm and aspect ratio of 5 was found to be most appropriate in terms of photoacoustic signal generation and photothermal stability.

Pulsed photoacoustic and photothermal response of gold nanoparticles

Gold nanospheres and nanorods are promising agents for photoacoustic imaging and photothermal therapy. In this work, seed-mediated methods were optimized for the synthesis of gold nanosphere and nanorod collides of different sizes. Nanosecond pulse photoacoustic and photothermal analysis of these nanoparticles was carried out and compared with finite element simulation. The simulations were performed to quantify the size dependent photoacoustic signal enhancement for nanospheres and nanorods. The non-sphericity contribution of nanospheres was found to enhance the photoacoustic signal. Nanosecond pulse photoacoustic studies of nanorods of different aspect ratio were carried out. Nanorods of aspect ratio ∼4.8 were found to be the most efficient photoacoustic signal generators. Photoacoustic studies of nanorods at varying laser fluence were performed and threshold fluence of 5 mJ cm^-2 was observed. Nanorods exposed to nanosecond laser pulses underwent size and shape variations which were confirmed by optical absorbance and transmission electron microscopy measurements. Simulations of nanorods of different aspect ratio and diameter were performed to investigate the photoacoustic signal enhancement and photothermal stability. The miniature size nanorod with a diameter of 10 nm and aspect ratio of 5 was found to be most appropriate in terms of photoacoustic signal generation and photothermal stability.

Evidence of oxygen defects mediated enhanced photocatalytic and antibacterial performance of ZnO nanorods

Defect engineered one-dimensional (1D) ZnO nanostructures have found great interest in diverse fields, including water detoxification and environmental remediation. In this article, we report a facile, low-temperature hydrothermal synthesis of defect enriched ZnO nanorods at different pH conditions. The dimension of all the synthesized ZnO nanostructures was restricted to 1D with changes only in their aspect ratios, unlike previous reports where change in morphology accompanies the effect of pH. With an increment in the pH value of the reaction mixture, oxygen defect concentration was controlled and confirmed using XPS and Raman spectroscopy. Considerable increase in optical light absorption and reduction in the bandgap, as inferred from the UV-vis study, corroborating the pH-dependent enrichment of defect states in 1D ZnO. Superior photosensitivity of oxygen defect rich ZnO nanorods was utilized to study their sunlight-induced photocatalytic and bactericidal activity towards its application in wastewater treatment. Within 4 h and 30 min of sunlight exposure (900 W/cm²), a 100% bacterial population (S.aureus, 10⁶ cells/m) killing and complete degradation of methylene blue dye (10μM) were achieved. Enhanced reactive oxidative species (ROS) formation due to the presence of additional oxygen defect states is ascribed to be the prime factor facilitating improved degradation efficiency. Additionally, during the optimization study, ZnO nanorods were found to be active against bacterial cells even in the absence of light opening avenues in antimicrobial food packaging and protective surface coatings.

Silver nanodendrites for ultralow detection of thiram based on surface-enhanced Raman spectroscopy

Metal nanostructures with highly branched morphologies are attractive due to their fascinating plasmonic properties which are related to their unique morphological features. In this work a simple fabrication methodology is used for fabrication of surface-enhanced Raman spectroscopy (SERS) substrates composed of branched silver nanostructures with dendritic morphology. The high Raman intensity enhancement factor of the order ∼10¹⁰ was achieved which allows the detection of ∼zeptomole thiram molecules by SERS substrates. The appearance of new bands at 344 cm^-1 and 1521 cm^-1 provides an evidence of contribution of chemical enhancement in SERS. The observed spectral changes in SERS spectrum originate from the adsorption of the analyte on the metal surface and provide an insight into molecule-metal interaction in SERS. The extreme sensitivity of SERS substrates is discussed in terms of the distinction between electromagnetic and chemical enhancement mechanisms. Moreover, the highly sensitive SERS substrates were used for simultaneous detection of Rhodamine B and thiram molecules from their mixture with different individual concentrations demonstrating detection capabilities for the identification of pesticides with dye molecules.

Rhodium nanocubes and nanotripods for highly sensitive ultraviolet surface-enhanced Raman spectroscopy

We report the shape- and wavelength-dependent ultrasensitive label-free detection of adenine on rhodium cube- and tripod-star-like nanoparticles (Rh NPs) using ultraviolet surface-enhanced Raman scattering (UV-SERS). Rh NPs immobilized on a silane-treated glass substrate probed at near-resonant and non-resonant wavelengths served as the SERS platform for the highly reproducible, stable, and real-time detection of adsorbed adenine molecules in the femtomolar region. The sensitivity of SERS-active Rh NPs displaying LSPR in the UV region was exploited for the 266 nm (DUV), 325 nm (UV) and 532 nm (visible) Raman excitation wavelengths. With the 266 nm and 325 nm DUV-UV excitation lines, for the Rh tripod geometry near or pre-resonant excitation being closer to the analyte absorption band combined with the intrinsic UV-LSPR resonant energy produced a SERS enhancement factor as high as 105 and accelerated photoinduced degradations compared to 532 nm for our substrates. Computational results consistent with the experiment clearly demonstrated that the NP SERS enhancement was sensitive to both the intrinsic optical properties of Rh in the UV region and the excitation closer to the LSPR peak producing larger EM enhancements. The wavelength-dependent correlations between the optical properties of the shape-tailored Rh NPs and SERS enhancements envisage the merit and demerit of DUV-UV excitation over visible excitation for Raman measurements. The as-fabricated SERS substrate could also be efficiently recycled using O2 plasma for the detection of other biomolecules. The use of oxide-free transition metal Rh and DUV-UV excitation thereby extends the improved generality of the SERS technique for ultrasensitive bimolecular detection and for gaining a comprehensive understanding of UV-SERS-based applications.

Factors affecting seasonal changes in blood pressure in North India: A population based four-seasons study

Objective

There are no community based, longitudinal, intra individual epidemiological studies on effect of weather and season on blood pressure (BP). We evaluated the effect of season and temperature on prevalence and epidemiology of BP in tropical climate.

Methods and results

It was a longitudinal cross sectional survey of rural and urban subjects in their native surroundings. BP was measured in four different seasons in same subjects. A total of 978 subjects (452 rural and 521 urban) were included in the current analysis. Demographic characteristics such as age, gender, education, occupational based physical activity and body mass index (BMI) were recorded. Mean BP, both systolic and diastolic were significantly higher in winter season as compared to summer season. Mean difference between winter and summer was 9.01 (95% CI: 7.74–10.28, p < 0.001) in systolic BP and 5.61 (95% CI: 4.75–6.47, p < 0.001) in diastolic BP. This increase in BP was more marked in rural areas and elderly subjects. Prevalence of hypertension was significantly higher during winter (23.72%) than in summer (10.12%).

Conclusion

BP increases significantly during winter season as compared to summer season. Increase is more marked in rural areas and elderly subjects. Seasonal variation in BP should be taken into account while looking at prevalence of hypertension in epidemiological studies.

Trend in prevalence of coronary artery disease and risk factors over two decades in rural Punjab

OBJECTIVES

The burden of coronary artery disease (CAD) has increased in the last three decades in low-income and middle-income countries including India. CAD is responsible for 20% deaths in India. The burden of CAD has increased due to a higher prevalence of risk factors related to the changing lifestyle. We studied the change in prevalence of CAD and risk factors over 20 years in a rural area.

METHODS

A rural population of adults over the age of 30 years from three villages of Punjab was surveyed for the prevalence of CAD and its risk factors in 1994 and 2014 using similar research methodology. CAD was diagnosed by Epstein and clinical criteria. Blood pressure, anthropometry, ECG and biochemical analysis were carried out. The findings of two surveys were compared with a look at the change in the prevalence of CAD and its risk factors over 20 years.

RESULTS

The overall age standardised prevalence of CAD increased from 2.79% in 1994 to 4.06% (p<0.05) in 2014. There was a significant increase in the prevalence of several risk factors including sedentary lifestyle (8.2% vs 41.3%, p<0.001), hypertension (14.5% vs 26.5%, p<0.001), diabetes (4.7% vs 9.7%, p<0.001), obesity (16.6% vs 35.4, p<0.001) and hypercholesterolaemia (7% vs 9.6%, p 0.011). In contrast, cigarette smoking (8.9% vs 3%, p<0.001) and use of desi ghee (51.4% vs 28.5%, p<0.001) decreased.

CONCLUSIONS

In a rural population of Punjab, the prevalence of several CAD risk factors like sedentary lifestyle, hypertension, diabetes, obesity and hypercholesterolaemia increased over 20 years. These changes in risk factors were associated with a modest increase in prevalence of CAD.

Evaluating the Efficacy of Levonorgestrel Intrauterine System and Danazol for Relief of Postoperative Pain in Endometriosis

INTRODUCTION

Endometriosis is an oestrogen-dependent disorder, manifests during reproductive years and is associated with pain and infertility. There is considerable debate about the effectiveness of various interventions for pain relief.

AIM

To evaluate the efficacy of Levonorgestrel Intrauterine System (LNG-IUS) and Danazol in postoperative pain relief for patients with endometriosis.

MATERIALS AND METHODS

Hundred patients with diagnosis of endometriosis, who were treated laparoscopically, entered the study to receive either danazol (600 mg once daily) or LNG-IUS (inserted during immediate post operative period) postsurgery, for pain relief. Patients were analysed for pain relief according to VAS score and recurrence of disease using ultrasonography at third and sixth months of follow up.

RESULTS

There were 50% patients in stage IV of endometriosis. Majority of them presented with complaint of infertility (49%) and pelvic pain (43%). It was observed that LNG-IUS was significantly more effective in relieving pain compared to danazol (65.2% vs 38.0%, p<0.05). Recurrence rate was significantly lower in LNG-IUS users compared to other group.

CONCLUSION

LNG-IUS was found to be more effective in relieving pain compared to danazol.

Clinical spectrum and outcome of pulmonary nocardiosis: 5-year experience

Background:

Pulmonary nocardiosis is a rare but a life-threatening infection caused by Nocardia spp. The diagnosis is often missed and delayed resulting in delay in appropriate treatment and thus higher mortality.

Aim:

In this study, we aim to evaluate the clinical spectrum and outcome of patients with pulmonary nocardiosis.

Methods:

A retrospective, 5-year (2009–2014) review of demographic profile, risk factors, clinical manifestations, imaging findings, treatment, and outcome of patients with pulmonary nocardiosis admitted to a tertiary care hospital.

Results:

The median age of the study subjects was 54 years (range, 16–76) and majority of them (75%) were males. The risk factors for pulmonary nocardiosis identified in our study were long-term steroid use (55.6%), chronic lung disease (52.8%), diabetes (27.8%), and solid-organ transplantation (22.2%). All the patients were symptomatic, and the most common symptoms were cough (91.7%), fever (78%), and expectoration (72%). Almost two-third of the patients were initially misdiagnosed and the alternative diagnosis included pulmonary tuberculosis (n = 7), community-acquired pneumonia (n = 5), lung abscess (n = 4), invasive fungal infection (n = 3), lung cancer (n = 2), and Wegener's granulomatosis (n = 2). The most common radiographic features were consolidation (77.8%) and nodules (56%). The mortality rate for indoor patients was 33% despite treatment. Higher mortality rate was observed among those who had brain abscess (100.0%), HIV positivity (100%), need for mechanical ventilation (87.5%), solid-organ transplantation (50%), and elderly (age > 60 years) patients (43%).

Conclusion:

The diagnosis of pulmonary nocardiosis is often missed and delayed resulting in delay in appropriate treatment and thus high mortality. A lower threshold for diagnosing pulmonary nocardiosis needs to be exercised, in chest symptomatic patients with underlying chronic lung diseases or systemic immunosuppression, for the early diagnosis, and treatment of this uncommon but potentially lethal disease. Despite treatment mortality remains high, especially in those with brain abscess, HIV positivity, need for mechanical ventilation, solid-organ transplantation, and elderly.

Depression and anxiety among middle-aged women: A community-based study

Background:

Anxiety and depressive disorders constitute a substantial proportion of the global burden of disease and are projected to form the second most common cause of disability by 2020.

Objective:

To assess the level of depression and anxiety among middle age women and the possible factors behind it.

Materials and Methods:

A total of 180 women aged 40–60 years were selected by proportionate sampling technique. Age, education, marital status, socioeconomic status, age at marriage, age at menopause, weight and height were noted. Zung-self-rating scales were used for calculating levels of depression and anxiety in these women. The data were analyzed by using statistical software SPSS.

Results:

The level of syndromal depression and anxiety was found to be 86.7% and 88.9%, respectively. Most of the subjects had the moderate type of depression (49.5%) followed by mild (29.4%) and severe depression (7.8%). While in case of anxiety, most of the subjects (69.4%) had a mild form of anxiety and 17.8% had moderate anxiety level. A significant difference was observed in the level of depression with respect to marital status (P = 0.009) and in the level of anxiety with respect to age (P = 0.021) in the study subjects. On applying logistic regression, none of the factors studied were found to be significant variables for anxiety or depression in the study population.

Conclusion:

Depression and anxiety are prevalent among the middle-aged women in rural Punjab. Provision of mental health services in this group is essential.

Improved catalytic activity of laser generated bimetallic and trimetallic nanoparticles

We report synthesis of silver nanoparticles, bimetallic (Al2O3@Ag) nanoparticles and trimetallic (Al2O3@AgAu) nanoparticles by nanosecond pulse laser ablation (PLA) in deionized water. Two-step laser ablation methodologies were adopted for the synthesis of bi- and tri-metallic nanoparticles. In this method a silver or gold target was ablated in colloidal solution of γ-alumina nanoparticles prepared by PLA. The TEM image analysis of bimetallic and trimetallic particles reveals deposition of fine silver particles and Ag-Au alloy particles, respectively, on large alumina particles. The laser generated nanoparticles were tested for catalytic reduction of 4-nitrophenol to 4-aminophenol and showed excellent catalytic behaviour. The catalytic rate was greatly improved by incorporation of additional metal in silver nanoparticles. The catalytic efficiency of trimetallic Al2O3@AgAu for reduction of 4-nitrophenol to 4-aminophenol was remarkably enhanced and the catalytic reaction was completed in just 5 sec. Even at very low concentration, both Al2O3@Ag nanoparticles and Al2O3@AgAu nanoparticles showed improved rate of catalytic reduction than monometallic silver nanoparticles. Our results demonstrate that alumina particles in the solution not only provide the active sites for particle dispersion but also improve the catalytic activity.

Awareness and Perceptions of School Children about Female Feticide in Urban Ludhiana

BACKGROUND

Although the Indian girl child's position is precarious throughout the country, she remains the most vulnerable in Punjab.

OBJECTIVES

To assess the awareness and perceptions of school children regarding female feticide.

STUDY DESIGN

Crosssectional study.

MATERIALS AND METHODS

The study involved collection of information regarding knowledge and perception of school students about female feticide using multiple choice questionnaire. A total of 527 students between the age group of 11-18 years of various schools of district Ludhiana, Punjab were the study subjects. They had come to participate in the poster competition on organ donation (SAARC Transplant games), organized by Department of Community Medicine, D.M.C and H, Ludhiana.

RESULTS

Out of total 527 students, 97.9% were aware of female feticide. Main source of information was TV (56%), followed by newspaper (33%). Majority of the students (65.2 %) felt that discrimination between boys and girls is prevalent in the society. Regarding perception of school students for curbing this social evil, 37.8% school students were of the view that awareness among the masses is the solution to stop this practice, while 25% of the students responded that equal status to girls will stop this practice of female feticide.

CONCLUSIONS

The school students had optimum level of awareness about female feticide and almost all of them strongly felt that this harmful practice should be stopped altogether.

Scanning electron microscopic study of hazardous waste flakes of polyethylene terephthalate (PET) by aminolysis and ammonolysis

Polyethylene terephthalate (PET) waste flakes were degraded with aqueous methylamine and aqueous ammonia, respectively at room temperature in the presence and absence of quaternary ammonium salt as a catalyst for different periods of time. The aminolysed and ammonolysed PET samples were investigated for the surface morphology with the help of scanning electron micrograph (SEM). It shows that the semi-crystalline PET waste samples reduce to monodisperse rods before fully degradation to the end products. The presence of the catalyst provides site for degradation of PET waste and enhances the rate of degradation. The SEM shows early developments of fissures in comparison to the one in absence of quaternary ammonium salt used as catalyst.

Status of lipid peroxidation and plasma iron level in bronchial asthmatic patients

Low antioxidant levels and oxidative stress due to airway inflammation may be determinant of asthma severity. The study was conducted to find the extent of lipid peroxidation and change in the levels of plasma iron in asthmatic patients with severity of disease. Study included 155 asthmatic and 156 healthy volunteers of the age groups 18-45 of either sex. Asthmatic patients were grouped into mild, moderate and severe groups on the basis of Forced Expiratory Volume in first second percent (FEV1%). Level of plasma malondialdhyde (MDA) was used as index of lipid peroxidation. A significant increase (P<0.01) in plasma MDA and plasma iron levels was found in asthmatic subjects as compared to controls. There was maximum increase in plasma MDA and iron levels in moderate asthmatic group. A positive correlation between plasma MDA and iron (r = +0.3) has been found in asthmatic patients. An increased plasma iron levels in asthmatics may contribute to aggravate lipid peroxidation.

Nanostructuring of InP surface by low-energy ion beam irradiation

The InP nanodots of size 55 to 100 nm and height 25 to 30 nm have been synthesized by low-energy Ar+-ion irradiation with different ion energies. Sizes and size distributions of the dots strongly depend on growth conditions. Rapid thermal annealed (RTA) of the patterned surface shows cluster formation for annealing temperature 400 degrees C and above. Raman investigations reveal optical phonon softening due to correlation length shortening and broadening of the optical modes from the patterned surface. The softening is due to confinement of phonons in embedded nanocrystallites within the patterned surface along with surface nanodots, and broadening is attributed to their size distributions, which increases with increase in ion energy. The lattice damage recovery is observed from the patterned surface subjected to RTA, which exhibits upward shift of the LO and TO phonons due to the presence of complex interfacial stress, associated with the removal of crystal defects with RTA.

Impact of bed side communication with fathers on their anxiety about newborn

This study assessed the impact of bedside communication with fathers (N = 100) on their anxiety about sick neonates admitted in SCNU. The control group consisted of fathers of 100 sick babies communicated outside the unit. Anxiety was measured in both the groups on day 1 (at admission) and day 7, by using 5 point Likert Scale. At the time of admission there was no difference in the level of anxiety between the study group and controls (p >0.05; Mann Whitney test). There was a statistically significant difference (p <0.01; Mann Whitney test) in the level of anxiety between the study and control group at 7 days. When compared within the group, the anxiety in the fathers of study group was significantly less (p <0.01) at 7 days than at admission. In the control group there was no such significant difference. To conclude, bed side communication with fathers of admitted neonates reduces their anxiety significantly.

Perinatal mortality in rural Punjab--a population-based study

The results of a population-based case-control study are reported to examine the factors affecting perinatal mortality in rural Punjab, during the period 1991-1996. There were 91 perinatal deaths in 2424 of the pregnant women registered. The perinatal mortality rate was 34.57/1000 and the stillbirth rate was 30.94/1000. Odds ratio, 95 per cent confidence interval, prevalence and population attributable risk percent were calculated for the various risk factors; of the risk factors studied, material weight less than 40 kg, height less than 152 cm, body mass index < 20, illiteracy, a birth to conception interval less than 100 weeks, prematurity, late registration and home delivery were found to be significant on univariate analysis. When subjected to multiple logistic regression, the full model identified the significance of all the risk factors except late registration. However on the final model, only prematurity and short birth-interval were found to be significant. The highest population attributable risk, 35.16 per cent, was observed for prematurity.

The Spectrum and clinical correlates of electrodiagnostic abnormalities in acute organophosphorus poisoning : a study of 55 patients

Electrodiagnostic findings in 55 patients with acute organophosphorus intoxication have been correlated with clinical severity. Patients were assigned 3 grades of intoxication, depending upon the clinical severity of poisoning, muscarinic and nicotinic manifestations, ventilatory failure and altered sensorium. Repetitive responses upon single supramaximal stimulation of the median motor nerve were noted in all three grades of intoxication. In mild intoxication (grade I), low frequency repetitive nerve stimulation (< 3 Hz) produced no change in the amplitudes of the successive compound muscle action potentials. High frequency repetitive nerve stimulation (30 Hz and 50 Hz) resulted in either incremental responses (18 out of 29 cases), decremental responses (5 out of 29 cases) or decremental - incremental responses (6 out of 29 cases). Thirty five electrodiagnostic evaluations were performed in patients with overt neuromuscular weakness but not requiring mechanical ventilation (grade 2). Decremental responses were noted in only 3 instances at low frequency (< 3 Hz) repetitive nerve stimulation and in 34 out of 35 cases with high rates of stimulation. Patients who required mechanical ventilation had decremental responses at high (30 and 50 Hz) (12 out of 12 cases) as well as low rates (3 and 5 Hz) (7 out of 12 cases) of repetitive nerve stimulation. Serial electrodiagnostic evaluations, which were done in 12 patients, revealed that neuromuscular transmission abnormalities were either mild or absent within 24 hours in 9 patients. A deterioration in the neuromuscular transmission studies was noted during subsequent examinations performed, 1- 4 days later in these 9 patients. Electrodiagnostic testing is highly sensitive for establishing a diagnosisof organophosphorus poisoning and correlates well with clinical findings and the severity of poisoning. It may, however be normal in the early stages of intoxication.

An anterolateral approach to the hip joint

I describe an anterolateral approach to the hip joint. The intermuscular plane is between the gluteus medius and tensor fascia lata. The anterior one third of gluteus medius and the insertion of gluteus minimus are stripped from the anterior aspect of the greater trochanter to raise a flap in a way that facilitates reattachment. The vastus lateralis muscle is left undisturbed. This simple and relatively quick approach provides sufficient anatomic orientation and exposure to allow the surgeon to perform total hip arthroplasty, with minimal dissection and without excessive retraction. There is no danger of injury to the superior gluteal nerve or its branches. This has been used in 178 patients for primary total hip replacement. The strength of the hip abductor muscles was unimpaired and there were no complications attributable to the approach in 128 patients reviewed after at least 6 months.

The role of secondary sex ratios in the declining sex ratio of India

The sex ratio in India has been gradually declining since the beginning of this century during the intercensus period of 1981-91, this ratio declined from 933 to 929. In the past the difference in sex ratios was wholly attributed to higher mortality amongst the females. However date for the years 1990-92 on secondary sex ratios i.e. sex ratio at birth presented in this paper suggest that the difference in sex ratio can also be attributed to a statistically significant higher number of males being born most probably as a result of selective abortion of female fetuses.

Diagnostic and prognostic significance of lactate dehydrogenase in cerebrospinal fluid in patients of meningitis

Activity of lactate dehydrogenase was measured in cerebrospinal fluid in 60 cases of meningitis (35 pyogenic, 18 tuberculous and 7 viral). Thirty age and sex matched healthy controls were taken to find out its diagnostic and prognostic significance in meningitis. The cerebrospinal fluid lactate dehydrogenase activity was significantly higher (p < 0.001) in cases of pyogenic meningitis and tuberculous meningitis as compared to the control group. The maximum elevation was seen on the 1st day in all types of meningitis but the activity declined significantly thereafter in patients of pyogenic meningitis who recovered without complications. However, in 2 cases of pyogenic meningitis and 5 cases of tuberculous meningitis who survived with complications, the lactate dehydrogenase activity on subsequent estimations increased serially. Further, the basal lactate dehydrogenase activity in 9 cases of pyogenic meningitis (who expired) was higher than those who survived without complications. The basal lactate dehydrogenase activity in pyogenic meningitis was significantly higher (p < 0.05) as compared to tuberculous meningitis and viral meningitis patients (p < 0.02) in this study.

Sleep pattern and night awakening in healthy infants

Sleep pattern and night-awakening were studied in 500 healthy infants by a semistructured interview method. A total of 92.2% infants shared bed with their mothers, 6.8% with grand parents and 1% with fathers. Paternal participation at bedtime was observed to be insignificant. Infants of non-working mothers and families with vegetarian habits slept significantly more as compared to the working mothers and families with non-vegetarian habits. Night-time awakening was reported in 96% of the infants. If a child is functioning well in other areas of life, parents can be assured that the problem is not of serious concern and unnecessary medication of infants should be avoided.