Evaluation of Flow Rate, pH, and Buffering Capacity of Saliva in Children with Caries, Fluorosis, and Caries with Fluorosis

Background

Saliva is one of the most important aids in the diagnosis of various oral diseases. Few physicochemical properties of saliva such as flow rate, pH, and buffering capacity often vary with the occurrence of dental caries, fluorosis, and other systemic conditions.

Purpose

The aim of the study was to evaluate the relationship between the salivary flow rate, pH, and buffering capacity in healthy children, children with caries, children with fluorosis, and children with both caries + fluorosis.

Materials and methods

The study population consisted of 144 children aged 7-14 years and were divided into four groups of 36 children each. Group I, 36 healthy children with no caries and fluorosis; group II, 36 children with caries (dmfs ≤ 10); group III, 36 children with fluorosis (moderate to severe); and group IV, 36 children with caries + fluorosis. Unstimulated saliva is collected from all the selected subjects and evaluated for the salivary flow rate, pH, and buffering capacity. The recorded data were tabulated and statistically analyzed using a paired t-test.

Results

The mean salivary flow rate and buffering capacity were found to be highest in group III when compared with all the other groups. The mean pH was greater in group I when compared with groups I, II, and III.

Conclusion

The physicochemical properties of saliva like pH, buffering capacity, and salivary flow rate alter with caries and fluorosis conditions. Hence, more clinical and laboratory studies are needed to determine the exact relationship between these physicochemical properties of saliva in dental caries and fluorosis.

How to cite this article

E RR, S S, M K, et al. Evaluation of Flow Rate, pH, and Buffering Capacity of Saliva in Children with Caries, Fluorosis, and Caries with Fluorosis. Int J Clin Pediatr Dent 2023;16(4):587-590.

Application of Indian Diabetic Risk Score (IDRS) and Community Based Assessment Checklist (CBAC) as Metabolic Syndrome prediction tools

BACKGROUND

Indian Diabetic Risk Score (IDRS) and Community Based Assessment Checklist (CBAC) are easy, inexpensive, and non-invasive tools that can be used to screen people for Metabolic Syndrome (Met S). The study aimed to explore the prediction abilities of IDRS and CBAC tools for Met S.

METHODS

All the people of age ≥30 years attending the selected rural health centers were screened for Met S. We used the International Diabetes Federation (IDF) criteria to diagnose the Met S. ROC curves were plotted by taking Met S as dependent variables, and IDRS and CBAC scores as independent/prediction variables. Sensitivity (SN), specificity (SP), Positive and Negative Predictive Value (PPV and NPV), Likelihood Ratio for positive and negative tests (LR+ and LR-), Accuracy, and Youden's index were calculated for different IDRS and CBAC scores cut-offs. Data were analyzed using SPSS v.23 and MedCalc v.20.111.

RESULTS

A total of 942 participants underwent the screening process. Out of them, 59 (6.4%, 95% CI: 4.90-8.12) were found to have Met S. Area Under the Curve (AUC) for IDRS in predicting Met S was 0.73 (95%CI: 0.67-0.79), with 76.3% (64.0%-85.3%) sensitivity and 54.6% (51.2%-57.8%) specificity at the cut-off of ≥60. For the CBAC score, AUC was 0.73 (95%CI: 0.66-0.79), with 84.7% (73.5%-91.7%) sensitivity and 48.8% (45.5%-52.1%) specificity at the cut-off of ≥4 (Youden's Index, 2.1). The AUCs of both parameters (IDRS and CBAC scores) were statistically significant. There was no significant difference (p = 0.833) in the AUCs of IDRS and CBAC [Difference between AUC = 0.00571].

CONCLUSION

The current study provides scientific evidence that both IDRS and CBAC have almost 73% prediction ability for Met S. Though CBAC holds relatively greater sensitivity (84.7%) than IDRS (76.3%), the difference in prediction abilities is not statistically significant. The prediction abilities of IDRS and CBAC found in this study are inadequate to qualify as Met S screening tools.

Ray tracing biometry in post radial keratotomy eye

OBJECTIVE

To report a case of post radial keratotomy (RK) cataract in a 55-year-old lady wherein biometry was done by ray-tracing method incorporated in scheimpflug topographer (Sirius + Scheimpflug Analyzer, CSO, Italy).

METHOD

In our case, we performed intraocular lens (IOL) power calculation using a recent concept of ray tracing with scheimpflug topographer and compared with traditional methods available at American Society of Cataract and Refractive Surgery(ASCRS) website (www.ascrs.org) for eyes with prior RK. Phacoemulsification was performed and a monofocal + 24.5D IOL implanted in the capsular bag.

RESULT

Manifest refraction at six weeks postoperative period was + 1.0DS/-2.0DC × 75° with spherical equivalence of 0. On comparison of all the methods used to calculate IOL power, the absolute errors of ray tracing and Barrett true K were found to be the least, 0.14 and 0.18 respectively.

CONCLUSION

Ray tracing biometry with scheimpflug topographer seems to provide accurate IOL power in post RK eyes.

Survey on Diagnosing CORONA VIRUS from Radiography Chest X-ray Images Using Convolutional Neural Networks

Corona Virus continues to harms its effects on the people lives across the globe. The screening of infected persons has to be identified is a vital step because it is a fast and low-cost way. Certain above mentioned things can be recognized by chest X-ray images that plays a significant role and also used for examining in detection of CORONA VIRUS(COVID-19). Here radiological chest X-rays are easily available with low cost only. In this survey paper, Convolutional Neural Network(CNN) based solution that will benefit in detection of the Covid-19 positive patients using radiography chest X-Ray images. To test the efficiency of the solution, using data sets of publicly available X-Ray images of Corona virus positive cases and negative cases. Images of positive Corona Virus patients and pictures of healthy person images are divided into testing images and trainable images. The solution which are providing the good results with classification accuracy within the test set-up. Then GUI based application supports for medical examination areas. This GUI application can be used on any computer and performed by any medical examiner or technician to determine Corona Virus positive patients using radiography X-ray images. The result will be precisely obtaining the Covid-19 Patient analysis through the chest X-ray images and also results may be retrieve within a few seconds.

A study of the pattern of dermatoses in adolescent patients in South India

BACKGROUND

Adolescence describes the age group between 10 and 19 years. This is the transitional stage of physical and physiological human development generally occurring between puberty and adulthood. Hormonal changes occurring during puberty result in various physical and psychological changes, affecting their social relationship. At this stage, external appearance is of immense concern to them. As such, any dermatological condition can extremely affect their psychological status. This study was conducted to give an insight on the various dermatological conditions of the adolescent age groups and their incidence.

METHODS

Study design: Descriptive study - Cross-sectional study. Three hundred patients between the ages of 10 and 19 years, attending the tertiary care center in South India, were included in the study. A detailed history, clinical examination, and appropriate laboratory investigations were carried out.

RESULTS

Out of 300 patients, females (52.7%) more commonly presented with dermatoses than males (47.3%). Most of the 300 patients belonged to the age group of 17-19 years (50.33%). Infections/infestations (39%) were the most predominant dermatoses followed by acne (17.67%), eczema (9.67%), insect bite reactions (IBRs) (7%), keratinization disorders (6.67%), polymorphic light eruptions (PLEs) (4.33%), urticaria (4.33%), and pigmentary disorders (4.33%).

CONCLUSION

This study gives an insight of various dermatological conditions among the adolescent age groups. Females more commonly presented with dermatoses. The most common dermatoses were infections. Since very few studies regarding dermatoses in adolescents are available in the literature, this study is distinctive in this regard.

Efficacy and Safety of Eberconazole vs Sertaconazole in Localised Tinea Infection

BACKGROUND

Topical antifungals especially azole group of drugs are effective agents in the treatment of dermatophytoses producing 100% clinical and mycological cure. Each of them vary having specific characteristics to tackle several clinical challenges like high relapse rate, recurrences and quality of life.

AIMS AND OBJECTIVES

To compare the efficacy and safety of Eberconazole and Sertaconazole in tinea infection.

MATERIALS AND METHODS

This was a randomized, observer-blinded, parallel-group study conducted at a dermatology out-patient department (OPD) of tertiary care teaching hospital in Puducherry. 85 patients with tinea corporis and tinea cruris infections who visited the dermatology OPD were enrolled in this study. The treatment phase involved two groups receiving either Sertaconazole 2% cream or Eberconazole 1% applied topically twice daily for 4 weeks. At the end of treatment phase, there was a 'follow-up phase' at the end of 4 weeks, where the patients were assessed clinically and mycologically. The data were analyzed using descriptive statistics using MS Excel version 2019 and SPSS version 15 for Windows.

RESULTS

The primary efficacy variables namely change in pruritus, erythema, induration, scaling and mycological cure significantly improved in both the groups, as compared to baseline (P < 0.001), in the treatment phase and follow-up phase. Intergroup comparison with respect to pruritus and scaling showed significant difference (P < 0.001), suggestive of better reduction of pruritus and scaling scores at 4 weeks with Sertaconazole when compared to Eberconazole.

CONCLUSIONS

Sertaconazole was better than Eberconazole in relieving signs and symptoms of dermatophytoses, especially pruritus, thereby improving patients' quality of life.

Effect of Digitalized Previsit Imagery on Behavior of Children in the Dental Operatory

Aim and objective

The present study was aimed to determine the impact of exposure to digitalized previsit imagery technique on the anticipatory dental anxiety levels of children.

Design

40 children, aged 4-8 years requiring noninvasive dental treatment were included in the study. Preintervention anxiety levels were assessed using Venham picture test (VPT) in the waiting room and randomly divided into two groups. The study group was exposed to the digitalized previsit imagery technique which included a customized cartoon video of dental operatory and the concerned pediatric dentist in his/her own voice through WhatsApp messenger. The other group was dealt with the conventional approach using verbal and nonverbal communication. Postintervention anxiety was assessed in both the groups and the difference was compared.

Result

A significant difference in anticipatory dental anxiety was found between the two groups (p<0.001) using SPSS software. There was no marked relation of age and sex with the reduction of anxiety levels after exposure to digitalized previsit imagery.

Conclusion

The idea of digitalizing previsit imagery can be a time saving approach which is helpful in managing anxious children before entering the dental operatory.

How to cite this article

Reddy RE, Merum K, Mudusu SP, et al. Effect of Digitalized Previsit Imagery on Behavior of Children in the Dental Operatory. Int J Clin Pediatr Dent 2021;14(S-2):S124-S130.

Design of a Pilot SOFC System for the Combined Production of Hydrogen and Electricity under Refueling Station Requirements

The objective of the current work is to support the design of a pilot hydrogen and electricity producing plant that uses natural gas (or biomethane) as raw material, as a transition option towards a 100% renewable transportation system. The plant, with a solid oxide fuel cell (SOFC) as principal technology, is intended to be the main unit of an electric vehicle station. The refueling station has to work at different operation periods characterized by the hydrogen demand and the electricity needed for supply and self-consumption. The same set of heat exchangers has to satisfy the heating and cooling needs of the different operation periods. In order to optimize the operating variables of the pilot plant and to provide the best heat exchanger network, the applied methodology follows a systematic procedure for multi-objective, i.e. maximum plant efficiency and minimum number of heat exchanger matches, and multi-period optimization. The solving strategy combines process flow modeling in steady state, superstructure-based mathematical programming and the use of an evolutionary-based algorithm for optimization. The results show that the plant can reach a daily weighted efficiency exceeding 60%, up to 80% when considering heat utilization.

Tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx: A study of 206 cases

INTRODUCTION

The nasal cavity, paranasal sinuses, and nasopharynx though in continuity form a complex system of upper respiratory tract; this region is endowed with a variety of elements such as epithelial, glandular, lymphoid, cartilage, and bone and is also exposed to a variety of infections, tumor-like and true neoplastic conditions.

AIMS AND OBJECTIVES

To find out the frequency of various tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx.

MATERIALS AND METHODS

The present study is an analysis of 206 tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx diagnosed during a period of 5 years.

RESULTS

The patients' age ranged from 14 months to 85 years. Benign lesions were predominant in the second and third decades, with 30 cases (68.1%) occurring in that age group. Malignancies occurred predominantly in the sixth and seventh decades with 28 (60.9%) cases in this age group. Benign lesions in the nasopharynx comprised 75% cases and malignancies 25%. Eighty-three (71.5%) tumor-like conditions occurred in the nose and antrochoanal region.

CONCLUSION

Angiofibroma was the most common benign tumor accounting for 25.55% of all neoplastic lesions. Squamous cell carcinoma was the most common malignancy at this site constituting 50% of all malignancies.

Histopathological analysis of meningioma and its variants: A study of fifty cases

BACKGROUND

The study was conducted to know the various histopathological variants of meningiomas, the age incidence and sex ratio.

MATERIALS AND METHODS

A retrospective and prospective analysis of all the samples sent for histopathology for 2 years during June 2013-May 2015 was done to diagnose meningioma and its variants. Cases were analyzed in detail about the complete clinical history, exact location, and clinical and radiological diagnosis. The majority of the cases were clinically and radiologically diagnosed as meningioma.

RESULTS

Of 50 cases which were diagnosed as meningiomas, 21 were meningothelial variant, 15 were psammomatous, 8 were fibroblastic, 4 were transitional, and 1 case each of anaplastic and atypical variant. The most common age group was between 41 and 50 years. The youngest age group was 16 years and oldest was 70. The male:female ratio was 1:1.5.

CONCLUSION

The majority of the meningiomas have been observed between 41 and 50 years. Their proper recognition is therefore important to allow appropriate treatment. Histopathological study plays a major role by which we can diagnose the lesion. Meningiomas typically develop in middle-aged individuals and occur more frequently in women than men. These lesions may also occur in children.

Augmentation of bacterial homeostasis by regulating in situ buffer capacity: Significance of total dissolved salts over acidogenic metabolism

During anaerobic fermentation, consequent accumulation of acidic fermented products leads to the failure of pH homeostasis. The present study aimed to comprehend the changes in buffering capacity with addition of sodium salts of hydroxide, bicarbonate and phosphate. The results showed notable augmentation in buffer capacity and cumulative hydrogen production (CHP) compared to control. The influential factor is the amount of undissociated volatile fatty acids released that affected the cell metabolism and consequently biohydrogen generation. It is inferred that among the tested salts, sodium bicarbonate has substantial buffering capacity (β, 0.035± mol) ensuing maximum CHP (468± mL). Besides, bioelectrochemical analysis revealed variations in redox currents that aligned with biohydrogen production. The study provides valuable information on the role of inorganic dissolved salts that would be required to regulate H₂ generation and acidogenesis in the aspects of acid-gas phase system.

Erythema Necroticans - A Case Report

Erythema Nodosum Leprosum (ENL) is characterized by evanescent, erythematous, painful raised nodules which fade within 48-72 hours. Necrotic and ulcerative forms are rare presentations of severe ENL. A 27 year old male patient presented with multiple erythematous nodules on trunk and extremities associated with high grade fever, joint pain and pedal edema. Patient developed ulceration of nodules associated with pain and burning sensation over another 3 days. Slit smear showed clumps of granular bacilli. Biopsy showed superficial dermis showing edema with dense focal perivascular infiltrate of lymphocytes, macrophages and few scattered neutrophils. Fite-Faraco stain was negative. Patient was diagnosed as a case of erythema necroticans and started on oral steroids and thalidomide. The histological findings illustrate the need to consider leprosy diagnosis in necrotizing vasculitis even when Virchow's cells are not found in the infiltrate. Thalidomide is the drug of choice in such cases. This patient showed a marked response to the drug with healing of all ulcers within 2 weeks of starting thalidomide.

Spectrum of cervical lesions observed in 500 cases: Carcinoma cervix the leading cause of death in females

INTRODUCTION

The present study was done to know the various histopathological variants in cervical lesions, to know the age incidence and to know the preventive measures and early detection of cervical cancer.

MATERIALS AND METHODS

This is a retrospective and prospective study done on all the hysterectomy specimens and on punch biopsy samples sent for histopathology. We studied a total of 500 cases for a period of 3 years.

RESULTS

Out of the 500 cases, 395 cases were non-neoplastic and 105 cases were neoplastic lesions. Chronic cervicitis was the most common non-neoplastic lesion and large cell non-keratinizing squamous cell carcinoma was the most common malignant lesion.

CONCLUSION

The main aim of presenting this study is to highlight the various histopthological variants, age incidence and to educate about the preventive measures and early detection of cervical cancer.

The Role of ORAI1 in the Odontogenic Differentiation of Human Dental Pulp Stem Cells

Pulp capping, or placing dental materials directly onto the vital pulp tissues of affected teeth, is a dental procedure that aims to regenerate reparative dentin. Several pulp capping materials are clinically being used, and calcium ion (Ca(2+)) released from these materials is known to mediate reparative dentin formation. ORAI1 is an essential pore subunit of store-operated Ca(2+) entry (SOCE), which is a major Ca(2+) influx pathway in most nonexcitable cells. Here, we evaluated the role of ORAI1 in mediating the odontogenic differentiation and mineralization of dental pulp stem cells (DPSCs). During the odontogenic differentiation of DPSCs, the expression of ORAI1 increased in a time-dependent manner. DPSCs knocked down with ORAI1 shRNA (DPSC/ORAI1sh) or overexpressed with dominant negative mutant ORAI1(E106Q) (DPSC/E106Q) exhibited the inhibition of Ca(2+) influx and suppression of odontogenic differentiation and mineralization as demonstrated by alkaline phosphatase (ALP) activity/staining as well as alizarin red S staining when compared with DPSCs of their respective control groups (DPSC/CTLsh and DPSC/CTL). The gene expression for odontogenic differentiation markers such as osteocalcin, bone sialoprotein, and dentin matrix protein 1 (DMP1) was also suppressed. When DPSC/CTL or DPSC/E106Q cells were subcutaneously transplanted into nude mice, DPSC/CTL cells induced mineralized tissue formation with significant increases in ALP and DMP1 staining in vivo, whereas DPSC/E106Q cells did not. Collectively, our data showed that ORAI1 plays critical roles in the odontogenic differentiation and mineralization of DPSCs by regulating Ca(2+) influx and that ORAI1 may be a therapeutic target to enhance reparative dentin formation.

Algal biocathode for in situ terminal electron acceptor (TEA) production: synergetic association of bacteria-microalgae metabolism for the functioning of biofuel cell

Replacement of energy intensive mechanical aeration with sustainable oxygenic photosynthesis by microalgae at cathode was studied in dual-chambered microbial fuel cell (MFC). The synergistic association between bacterial fermentation at anode and the oxygenic photosynthesis of microalgae at cathode facilitated good power output as well as treatment efficiency. However, MFC operation during spring showed higher bioelectrogenic activity (57.0 mW/m(2)) over summer (1.1 mW/m(2)) due to the higher oxygenic photosynthetic activity of microalgae and respective dissolved oxygen (DO) levels. This can be attributed to RuBisCO inactivation under high temperatures and light intensity of summer, which prevented rich algal biomass growth as well as their photosynthetic activity. Unlike abiotic cathode, the algal cathode potential increased with operation time due to the algal biomass growth during spring but was negligible during summer. The catalytic currents on voltammetric signatures and the bioprocess parameters also corroborated well with the observed power output.

Cysticercosis: The day to day public health problem and the various sites affected by it - A one year study

Introduction:

The present study is done to highlight the various regions in the body affected by cysticercosis and to educate the people about the personal hygiene and prevention of the parasite.

Materials and Methods:

This is a study done on patients who were referred for swelling in the body, which were diagnosed as cysticercosis in one of their differential diagnosis clinically.

Results:

During the 1 year study (from October 2011 to September 2012) we diagnosed seven cases of cysticercosis involving the various sites in the body. Our cases highlight the rare presentation of cysticercus infestation as cause of treatablelymphadenopathy.

Conclusions:

Cysticercosis should be included in the differential diagnosis of cervical swellings especially in endemic regions. Timely diagnosis and intervention help in preventing fatal complications.

Knowledge attitude and practice of pesticide use among agricultural workers in Puducherry, South India

OBJECTIVES

To study the level of knowledge and practice related to pesticides and their adverse effects among agricultural workers.

MATERIALS AND METHODS

A cross sectional study among 100 randomly selected agricultural workers, using or ever used pesticide within last one year was conducted in Puducherry, South India. The questionnaire was adapted from WHO field surveys of 'Exposure to Pesticides Standard Protocol' and similar studies. Data were collected by face to face interview.

RESULTS

All the participants were male with mean age of 54.3 yrs. While 70% of respondents perceived pesticide spraying affects a person's health, only 40% were aware that it affects the environment. Two thirds of the respondents (62%) were aware that pesticide enters the body through nose and affects lungs. Awareness on other modes of entry was less. Majority (76%) of them was aware of training programs conducted by government agriculture department on pest management. About 42% of farmers had good knowledge regarding pesticide. Between 40% and 70% of respondents were not using any protective equipments during pesticide spraying. Around 68% of farmers indiscriminately disposed empty containers while 48% buried the leftover pesticides. Significant association (p < 0.05) was observed between knowledge of the farmers and their practices related to pesticides.

CONCLUSION

Overall awareness of agricultural workers on pesticide was inadequate. Improper disposal of pesticides and its container can produce harm to the environment. The findings of the study emphasize the need to educate agricultural workers regarding safe and adequate use of pesticides to prevent health and environmental hazards.

Microaerophilic microenvironment at biocathode enhances electrogenesis with simultaneous synthesis of polyhydroxyalkanoates (PHA) in bioelectrochemical system (BES)

Microaerophilic microenvironment at biocathode was evaluated for electrogenesis along with the polyhydroxyalkanoates (PHA) accumulation in bio-electrochemical system (BES). The electrogenic activity (512 mV; 15.2 mW/m(2)) was extended for longer periods (144 h) which might be attributed to the lowering of losses due to the controlled microbial metabolism. Growth limiting stress at cathode due to lower oxygen levels and its effective utilization by the protons and electrons coming from anode, might have diverted the microbial metabolism towards PHA synthesis instead of oxidation. PHA accumulation (19% of dry cell weight (DCW)) was observed with higher hydroxy butyrate (HB) (89%) concentration at 48 th h in the cathodic biocatalyst and was re-utilized by the end of experiment. Bio-electro kinetics studied through voltammetry and Tafel analysis further supported the observed electrogenesis in microaerophilic reduction microenvironment, in terms of redox catalytic currents, Tafel slopes, exchange current densities and polarization resistance.

Influence of terminal electron acceptor availability to the anodic oxidation on the electrogenic activity of microbial fuel cell (MFC)

The electrogenic activity of microbial fuel cell (MFC) with the function of anode placement from the terminal electron acceptor (TEA) was evaluated. Shorter anode distances from TEA showed higher electrogenesis due to the feasibility of higher electron acceptance as well as their discharge towards TEA. Substrate degradation was also higher at shorter anode placements from TEA due to the optimum substrate availability to the anodic biofilm. Bio-electro kinetics showed significant variation in the catalytic currents and exchange current densities with the function of anode placement indicating its role in electron acceptance and their transfer to the cathode. Anode placement of 3cm showed higher electrogenesis (406.38mW/m(2)) and substrate degradation (63.12%) along with significantly reduced polarization (6.72Ω) and charge transfer resistances compared to other anodic placements. The spacing between electrodes is crucial in accepting electrons as well as their discharge towards TEA which ultimately governs the power generation efficacy.

Change in electrogenic activity of the microbial fuel cell (MFC) with the function of biocathode microenvironment as terminal electron accepting condition: influence on overpotentials and bio-electro kinetics

Influence of biocathode microenvironment as terminal electron accepting process (TEAP) on the electrogenic activity of the microbial fuel cell (MFC)/bio-electrochemical system (BES) was evaluated in concurrence with the internal losses and bio-electro kinetics. Aerobic metabolism as TEAP showed power output (37.5 ± 2.7 mW/m(2)) for extended time (240 h) over abiotic (42.5 ± 1.5 mW/m(2)) electron accepting process. On the contrary, anaerobic metabolism as TEAP showed negligible power output in spite of increased retention time due to the absence of electron acceptor. Presence of strong electron acceptor conditions in aerobic metabolism facilitated gradual and stable reduction of electrons which helped to overcome the activation over potential and other potential losses. Voltammetric and amperometric analysis witnessed higher and sustainable electron discharge against the aerobic metabolism at cathode. Bio-electro kinetic analysis also showed lower Tafel slope and electron transfer co-efficient indicating the positive impact of aerobic metabolism at cathode in decreasing the internal losses.

Endocrine disruptive estrogens role in electron transfer: bio-electrochemical remediation with microbial mediated electrogenesis

Bioremediation of selected endocrine disrupting compounds (EDCs)/estrogens viz. estriol (E3) and ethynylestradiol (EE2) was evaluated in bio-electrochemical treatment (BET) system with simultaneous power generation. Estrogens supplementation along with wastewater documented enhanced electrogenic activity indicating their function in electron transfer between biocatalyst and anode as electron shuttler. EE2 addition showed more positive impact on the electrogenic activity compared to E3 supplementation. Higher estrogen concentration showed inhibitory effect on the BET performance. Poising potential during start up phase showed a marginal influence on the power output. The electrons generated during substrate degradation might have been utilized for the EDCs break down. Fuel cell behavior and anodic oxidation potential supported the observed electrogenic activity with the function of estrogens removal. Voltammetric profiles, dehydrogenase and phosphatase enzyme activities were also found to be in agreement with the power generation, electron discharge and estrogens removal.

Enhanced wastewater treatment efficiency through microbially catalyzed oxidation and reduction: synergistic effect of biocathode microenvironment

Microbially catalyzed treatment of wastewater was evaluated in both the anode and cathode chambers in dual chambered microbial fuel cell (MFC) under varying biocathode microenvironment. MFC operation with aerobic biocathode showed significant increment in both TDS (cathode, 90.2±1%; anode, 39.7±0.5%) and substrate (cathode, 98.07±0.06%; anode, 96.2±0.3%) removal compared to anaerobic biocathode and abiotic cathode operations (COD, 80.25±0.3%; TDS, 30.5±1.2%). Microbially catalyzed reduction of protons and electrons at cathode will be higher during aerobic biocathode operation which leads to gradual substrate removal resulting in stable bio-potential for longer periods facilitating salts removal. Bio-electro catalytic behavior showed higher exchange current density during aerobic biocathode operation resulting in induced electrochemical oxidation which supports the enhanced treatment. Anaerobic biocathode operation depicted relatively less TDS removal (anode, 16.35%; cathode, 16.04%) in both the chambers in spite of good substrate degradation (anode, 84%; cathode, 87.39%). Both the chambers during anaerobic biocathode operation competed as electron donors resulting in negligible bio-potential development.

Monilethrix: one step more on the ladder of cytogenetics

Monilethrix is one of the hair shaft abnormalities with increased fragility of hair. Here we describe a ten-year-old girl with a history of hair loss and breakage of hair since three months of age, associated with keratosis pilaris along with an abnormal microscopic finding of a hair shaft. A cytogenetic study of the patient showed an unexpectedly high degree of Acrocentric association.

Validation of a functional screening instrument for dementia in an elderly sri lankan population: comparison of modified bristol and blessed activities of daily living scales

Background

Cognitive tests have been used in population surveys as first stage screens for dementia but are biased by education. However functional ability scales are less biased by education than the cognitive scale and thus can be used in screening for dementia.

Objective

To validate Activities of Daily Living (ADL) scale appropriate for use in assessing the presence of dementia in an elderly population living in care homes in Sri Lanka.

Method

Sinhalese version of the modified Bristol and Blessed scale was administered to subjects aged 55 years and above residing in 14 randomly selected elders' homes. Receiver Operating Characteristic (ROC) was used to determine the cut-off scores of both the scales.

Results

Based on the ROC analysis, optimal cut off score of the modified Bristol scale was 20 with a sensitivity of 100%, specificity of 74.2% and the area under the curve 0.933(95% CI: 0.871-0.995) while the optimal cut off score of the modified Blessed scale was 10.5 with a sensitivity of 100%, specificity of 71% and the area under the curve 0.892 (95% CI: 0.816-0.967).

Conclusion

The findings confirm that both the scales can be used in screening for dementia in the elderly living in care homes in Sri Lanka.

Validation of the Geriatric Depression Scale for an elderly Sri Lankan clinic population

BACKGROUND

Geriatric Depression Scale (GDS) has not been validated for the elderly population in Sri Lanka.

AIM

To translate, validate, and examine the effectiveness of GDS and to suggest the optimal cut-off scores for elderly Sri Lankans attending a psychogeriatric clinic.

MATERIALS AND METHODS

The Sinhalese translation of GDS (GDS-S) was administered to people aged 55 years and above, attending a psychogeriatric outpatient clinic. The diagnostic performance of the instrument was compared against the ICD 10 diagnosis of a consultant psychiatrist, which was considered the 'gold standard'. Receiver operating characteristic (ROC) analysis was carried out to compare the diagnostic performance of the GDS-S. Optimal cut-off scores for depression and sensitivity and the specificity of the instrument was determined.

RESULTS

A total of 60 subjects formed the final sample (male/female=16/44) of which 30 were depressed, while 30 were age- and sex-matched controls. The optimal cut-off score for GDS-S was 8 for differentiating non-depressed from mildly depressed, while the cut-off score for moderate depression was 10. Sensitivity and specificity of GDS-S was 73.3% for differentiating depressed from non-depressed.

CONCLUSION

GDS is culturally acceptable, easy to use, sensitive, and a valid instrument to diagnose depression and to differentiate mild from moderate depression in an elderly Sri Lankan clinic population.

Positive anodic poised potential regulates microbial fuel cell performance with the function of open and closed circuitry

Positive influence of poised potential on microbial fuel cell (MFC) performance was observed with increase in the applied potential up to 600 mV and decreased thereafter. Higher power output (79.33 mW/m(2)) was observed at 600 mV poised potential under open circuit operation (OC). Closed circuit operation (CC) showed almost negligible power output due to continuous electron discharge against an external load (100 Omega). However, CC operation resulted in the higher substrate (chemical oxygen demand (COD)) degradation [61.23% (control); 70.46% (OC; 600 mV); 74.15% (CC; 600 mV)] and total dissolved solids (TDS) removal [29.17% (control); 43.75% (OC; 600 mV); 72.92% (CC; 600 mV)] efficiencies compared to OC. Electron discharge and energy conversion efficiency was also observed to be higher with 600 mV poised potential. Poising potential showed additional redox couples (-0.29+/-0.05 mV) on cyclic voltammetry. Application of poised potential during startup phase will help to enrich electrochemically active consortia on anode resulting in improved performance of MFC.

Insight into the dehydrogenase catalyzed redox reactions and electron discharge pattern during fermentative hydrogen production

Dehydrogenase (DH) activity associated with bio-electrochemical behavior was analyzed for the first time to understand the redox reactions involved in fermentative hydrogen (H(2)) production process in concurrence with proton (H(+)) shuttling and electron (e(-)) discharge (ED) pattern. DH facilitates the availability of H(+) through redox reactions to make H(2). We have designed a comprehensive experimental study to evaluate the DH activity (H(+) shuttling) and ED to understand the biochemical process with the function of pH (5, 6, 7 and 8) and metabolic microenvironment [anaerobic, anoxic and aerobic (control)]. DH activity was observed to be higher during anaerobic operation suggesting the higher availability of H(+) and e(-) due to the inter-conversion of metabolites and the same was reflected in the voltammetry analysis. Higher H(2) production under anaerobic operation corroborated well with these findings. The DH activity associated with H(+) shuttling and ED was also correlated with the substrate degradation pattern.

Knowledge, attitudes and practices with respect to risk factors for otitis media in a rural South Indian community

OBJECTIVES

(a) To study knowledge, attitudes and practices with respect to risk factors of otitis media in a rural South Indian Community where the prevalence of otitis media is high. (b) To discover the association between parental education, socioeconomic status (SES) and family type (nuclear or joint) with knowledge, attitudes and practices regarding risk factors for otitis media.

METHODS

Using a cluster sampling design, the caregivers of 150 children attending daycare were interviewed to note knowledge, attitudes and practices with respect to risk factors for otitis media. Data on level of education of the caregiver, house type (an indicator of SES) and type of family structure were noted. A questionnaire was administered to collect all the relevant data. Statistical analysis of the data obtained was performed to note frequencies. Correlations between sociodemographic parameters and knowledge, attitudes and practices were studied using Chi-square test of proportions.

RESULTS

Over 50% of the population showed knowledge deficits with regard to the various risk factors for otitis media. Caregivers from nuclear families were slightly less knowledgeable regarding lack of immunization and household smoke as risk factors for the disease. There was no correlation between any of the sociodemographic factors and attitudes. However, educated mothers were more likely than illiterate mothers to clean their children's ears of wax on a regular basis with the belief that it would prevent ear disease (p=0.05). Treatment practices in the community were more or less uniform in that earache was either disregarded (26.4%) or treated with home remedies (67.2%) by most caregivers, while a doctor's opinion was often sought for ear discharge (50%). Parents of higher SES were more likely to use home remedies than those of lower SES (p=0.008).

CONCLUSIONS

Sociodemographic factors as well as poor knowledge and attitudes and unhealthy practices with respect to risk factors of otitis media contribute to the high prevalence of otitis media in this rural South Indian community. Health education regarding risk factors and provision of accessible health care is essential to reduce the disease burden.

Norms for the Mini-Mental State Examination from a sample of Sri Lankan older people

OBJECTIVE

To derive norms for the Mini Mental State Examination (MMSE) based on age, gender and level of formal education among the elderly in Sri Lanka.

METHOD

A validated Sinhalese version of the MMSE was administered to people aged 55 years and above residing in 14 randomly selected elders' homes. Effects of age, gender and level of formal education on MMSE scores were compared using multiple linear regression analysis.

RESULTS

A total of 446 subjects [male/female = 136/320] formed the final sample. Level of education and gender exerted a significant influence on MMSE scores, but not age. The median and 10th percentile scores on the Sinhalese MMSE for the education groups were as follows: education <5 years = 19 and 12; education >5 years = 24 and 16, respectively.

CONCLUSION

The findings confirm the influence of level of education on MMSE scores among the elderly living in care homes in Sri Lanka, and suggest that education stratified cut-off scores should be used while screening for cognitive impairment in this population.