Dynamics of magnetization at infinite temperature in a Heisenberg spin chain

Understanding universal aspects of quantum dynamics is an unresolved problem in statistical mechanics. In particular, the spin dynamics of the one-dimensional Heisenberg model were conjectured as to belong to the Kardar-Parisi-Zhang (KPZ) universality class based on the scaling of the infinite-temperature spin-spin correlation function. In a chain of 46 superconducting qubits, we studied the probability distribution of the magnetization transferred across the chain's center, [Formula: see text]. The first two moments of [Formula: see text] show superdiffusive behavior, a hallmark of KPZ universality. However, the third and fourth moments ruled out the KPZ conjecture and allow for evaluating other theories. Our results highlight the importance of studying higher moments in determining dynamic universality classes and provide insights into universal behavior in quantum systems.

Interface engineering of heterogeneous NiMn layered double hydroxide/vertically aligned NiCo2S4 nanosheet as highly efficient hybrid electrocatalyst for overall seawater splitting

We report the fabrication of a heterogeneous catalyst through vertically aligned NiCo2S4/Ni3S2 nanosheet with encapsulation of ultrathin NiMn layered double hydroxide over self-standing nickel foam (NM/NCS/NS/NF) via two-step hydrothermal processes. Benefiting from more adequate catalytic active centres and copious interfacial charge transfer channels, NM/NCS/NS/NF electrode demonstrates superior bifunctional activity for oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) processes under alkaline fresh/simulated seawater electrolyte conditions. As a result, NM/NCS/NS/NF electrode requires the smallest overpotentials of 282 & 312 mV (OER) and 171 & 204 mV (HER) to attain current densities of 30 & 50 mA cm-2 respectively under alkaline simulated seawater electrolyte conditions. Besides, the presence of amorphous NiMn LDH layers over crystalline NiCo2S4/Ni3S2 catalyst stimulates surface adsorption of oxygen intermediate species, water dissociate ability on catalytic active centres, and mass transport with electron transfer at the interface. Further, the two-electrode configuration assisted electrolyser system delivers an efficient overall water splitting activity with minimum cell voltages of 1.54 V (in 1 M KOH) and 1.56 V (in 1 M KOH+0.5 M NaCl) at a current density of 10 mA cm-2. Besides, a fabricated electrolyser cell provides a more sustained water electrolysis process and robust durability for 20 h which displays NM/NCS/NS/NF electrode is a vibrant and potential candidate for realistic seawater electrolysis. Therefore, our proposed heterogeneous electrocatalyst could open up a new platform for developing efficient large-scale efficient seawater electrolysis.

Marine actinomycete Streptomyces variabilis S26 as a biocontrol agent for vibriosis in shrimp larval rearing systems

Indiscriminate use of antibiotics has led to the emergence of antibiotic-resistant microbes and the loss of natural flora in aquaculture systems necessitating the ban of many of these chemotherapeutants in aquaculture. Actinobacteria play a profound role in the biogeochemical cycling in the marine environment and represent the principal source of secondary metabolites with antimicrobial property. In the present study, 98 marine-derived actinomycete isolates were screened for antimicrobial activity against the common aquatic pathogens. A potent actinomycete isolate S26, identified as Streptomyces variabilis based on 16 S ribosomal RNA (rRNA) gene sequencing was then checked for the production of antibiotic in five different fermentation media and the one which showed maximum production was chosen for further study. Optimization of the fermentation medium for secondary metabolite production was carried out by response surface methodology (RSM) using DESIGN EXPERT. The analysis of variance (ANOVA) of the quadratic regression model demonstrated that the model was highly significant for the response concerned that is, antimicrobial activity as evident from the Fisher's F- test with a very low probability value [(P model>F) = 0.0001]. Of the 10 different solutions suggested by the software, the most suitable composition was found to be starch, 1.38%; soy powder, 0.88%; ammonium sulfate, 0.16% and salinity, 27.76‰. S. variabilis S26 cultured in the optimized production medium was applied in the Penaeus monodon larval rearing system and the total Vibrio count and survival rate were estimated. S. variabilis S26 treatment showed a significant reduction in vibrios and conferred better protection to P. monodon in culture system compared with control.

Social Factors Influencing Utilization of Old Age Homes by Elderly in Urban Area of South Chennai, Tamil Nadu

Background

Currently, most old age homes in India are completely occupied. Nowadays, nuclear families are more than joint families, and due to various factors such as urbanization, the elderly are deprived of essential care at home and are moved from their own homes to old-age homes. With the increasing geriatric population, this study explored the various social factors influencing the elderly to reside in old age homes.

Material and Methods

The study was conducted among 330 elderly in old age homes using simple random sampling. The study population included elderly above the age of 60 years and residing in old age homes, who were willing to participate. A pretested structured questionnaire with data on sociodemographic characteristics, family, financial support, and various other social factors was collected. Data were analyzed using SPSS.

Results

Among the respondents, 20.6% were supported by children financially and 18.5% had a pension. Almost 70% of the elderly were left unattended by friends and family. Care and support through means of calls, letters, and visits when analyzed showed that 27.3% were provided care and support through children and 33.6% were left unattended.

Conclusion

Family members, friends, and relatives should be encouraged to give regular visits and spend time with the elderly so that the bonding will have a positive effect on their mental health. Aging and geriatric health should be considered sensitively and should be made mandatory for schools and colleges to arrange visits to old age homes, thereby keeping the younger generation aware of the issues.

Tailoring epoxy coating with acetoxime derivative of zinc for advanced anticorrosive performance on mild steel: experimental and computational insights

CONTEXT

In this work, the corrosion inhibitive effect of acetoxime derivative of zinc chloride, (ZnCl2.2HON=C(CH3)2) (ZA), was investigated on mild steel in epoxy/polyamide coating. ZA was used to modify diglycidyl ether of bisphenol A (DGEBA) to yield novel anticorrosive coating (epoxy-ZA) with excellent barrier characteristic. The dispersal of ZA may lead to the formation of Zn-O-C and O-Zn-O linkages in the polymer framework which act as inorganic fillers producing a dense structure of hybrid coating. In electrochemical findings, electrochemical impedance spectroscopy (EIS) and Tafel polarization (TP) indicate higher protection efficiency for epoxy-ZA coatings (99.99 and 99.93 % for EIS and TP, respectively) as compared to others. Using surface analysis and electrochemical data, it was concluded that an inhibition synergy was developed when ZA was taken instead of acetoxime or zinc chloride (ZC) alone in the coating formulation.

METHODS

Fourier transform infrared (FT-IR) was used to investigate epoxy interaction with zinc compounds and scanning electron microscopy (SEM) was used to investigate morphology of the samples. To reinforce the experimental results, reactivity of crosslinked epoxy and epoxy-ZA coatings with metallic surface was also explored using density functional theory (DFT) with basis set B3LYP/6-311G(d,p) and molecular dynamics (MD) methods by using Forcite module. Modification of epoxy with ZA enhances its interaction with steel surface in dry as well as in wet conditions as indicated by the adhesion energy calculated by MD simulations.

Impact of microfiber pollution on aquatic biota: A critical analysis of effects and preventive measures

The widespread use of Personal protective equipments (PPEs) by the healthcare professionals and public due to Corona Virus Disease (COVID-19) pandemic has become a new source for MFs pollution. Mismanaged plastic wastes and random dispose of used surgical face mask end up in large aquatic bodies via small waterways and waste water treatment plants (WWTPs). Microplastics/Microfibres (MPs/MFs) have recently been reported in a variety of aquatic and terrestrial ecosystems, including water, deep sea sediments, air and soil. Natural components like UV radiation and temperature play a major role in weathering of surgical masks. High loads of MPs/MFs emitted into the aquatic environment are easily consumed by organism's habitat in such ecosystem by disrupting the food chain and causing chronic health problems in the organisms including humans. The aim of this review article is to shed light on these issues and compile the most recent information available regarding the deterioration of surgical face masks in the environment as well as other contaminants and their presence in various environments, particularly with regard to methods that make use of exposure models, biomarkers of exposure, and their limitations. Along with this, the study focuses on identifying gaps in current understanding and highlighting prospective research directions. The literature on surgical face mask pollution and its effects on the biological and physiological systems of various organisms and ecosystems is critically analysed in this review. It also raises awareness of how to properly dispose of used surgical face masks and other PPEs.

Efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty: a single-blinded randomized control trial

Background and aim

Chronic otitis media is defined as a chronic inflammation of the middle ear cleft producing irreversible pathological changes. The myringoplasty aims at the reconstruction of the tympanic membrane using a graft material. Autologous platelet-rich plasma can be used along with the graft to have a successful outcome. The aim of the study was to assess the efficacy of autologous platelet-rich plasma on graft uptake in myringoplasty.

Methods

This was a randomized controlled trial with a sample size of 76 patients. All patients were above 18 and below 55 years of age diagnosed with chronic suppurative otitis media and were planned for myringoplasty. The participants were randomly allotted to two groups by block randomization (block of 4). Intra-operatively, group I (n=38) received platelet-rich plasma–soaked gel foam and group II (n=38) was taken as the control group who received saline-soaked gel foam and examined by a blinded examiner at the end of 1st and 3rd months.

Results

The mean air-bone gap reduction post-operatively in the platelet-rich plasma group was 8.68 ± 4.8 (P value 0.034) and 6.05 ± 4.05 in the control group. The improvement in pure-tone average in the platelet-rich plasma group (P = 0.009) is more than that in the control group. The graft uptake was higher among the platelet-rich plasma group than the control group both at 1st and 3rd months (P value 0.049) which were statistically significant.

Conclusion

The present study concludes that the usage of platelet-rich plasma in the conventional myringoplasty technique has improved the success rate of graft uptake and reduced the graft migration.

Trial registration

Clinical Trials Registry-India (ICMR-NIMS) CTRI/2020/04/024416. Date of registration: 01/04/2020. Date of enrolment of the first participant to the trial: 06/04/2020. URL of the trial registry: http://www.ctri.nic.in.

Highlights

Usage of autologous platelet-rich plasma (PRP) in conventional myringoplasty in underlay technique.

Assessment of graft uptake, percentage of perforation closure, and the audiological outcome.

Significant mean reduction of ABG in the PRP group.

Significant improvement in PTA average in the PRP group.

Graft uptake and percentage of perforation closure were higher in the PRP group and the control group.

PRP is also beneficial in revision cases.

VS2 wrapped Si nanowires as core-shell heterostructure photocathode for highly efficient photoelectrochemical water reduction performance

Interfacing an electrocatalyst with photoactive semiconductor surfaces is an emerging strategy to enhance the photocathode performance for the solar water reduction reaction. Herein, a core-shell heterostructure photocathode consisting of vanadium disulfide (VS₂) as a 2D layered electrocatalyst directly deposited on silicon nanowire (Si NWs) surface is realized via single-step chemical vapor deposition towards efficient hydrogen evolution under solar irradiation. In an electrochemical study, 2D VS₂/Si NWs photocathode exhibits a saturated photocurrent density (17 mA cm^-2) with a maximal photoconversion efficiency of 10.8% at -0.53 V vs. RHE in neutral electrolyte condition (pH∼7). Under stimulated irradiation, the heterostructure photocathode produces a hydrogen gas evolution around 23 μmol cm^-2 h^-1 (at 0 V vs. RHE). Further, electrochemical impedance spectroscopy (EIS) analysis reveals that the high performance of the core-shell photocathode is associated with the generation of the high density of electron-hole pairs and the separation of photocarriers with an extended lifetime. Density functional theory calculations substantiate that core-shell photocathodes are active at very low Gibbs free energy (ΔG_H*) with abundant hydrogen evolution reaction (HER) active sulphur sites. The charge density difference plot with Bader analysis of heterostructure reveals the accumulation of electrons on the sulphur sites via modulating the electronic band structure near the interface. Thus, facilitates the barrier-free charge transport owing to the synergistic effect of Si NWs@2D-VS₂ core-shell hybrid photocatalyst for enhanced solar water reduction performance.

POS0755 SAFETY, TOLERABILITY, PHARMACOKINETICS, AND PHARMACODYNAMICS OF A SINGLE ORALLY ADMINISTERED DOSE OF ENPATORAN IN A PHASE I STUDY OF HEALTHY JAPANESE AND CAUCASIAN PARTICIPANTS

Background

Enpatoran, a novel, highly selective and potent dual toll-like receptor (TLR) 7 and TLR8 inhibitor, is in development for the treatment of autoimmune disorders including systemic and cutaneous lupus erythematosus. A first-in-human study in healthy participants has shown that enpatoran is well-tolerated and has a linear pharmacokinetic (PK) profile.

Objectives

To compare the PK parameters, safety, and tolerability of single ascending oral doses of enpatoran in a Phase I study in Japanese and Caucasian participants, and to explore a potential PK/pharmacodynamic (PD) relationship.

Methods

A single-centre, open-label, sequential dose group study enrolled healthy Japanese and Caucasian participants into three dose cohorts. Each Caucasian participant was matched by body weight (± 20%), height (± 15%) and sex to a Japanese participant. Participants received a single orally administered enpatoran dose of 100 mg, 200 mg, or 300 mg as a film-coated tablet under fasting conditions. PK parameters, (maximum plasma concentration [Cmax]; area under the plasma concentration–time curve (AUC) from time 0 to infinity [AUC0-inf]; AUC from time 0 to the last sampling time [AUC0-tlast]) determined using noncompartmental analysis, were estimated post-dose from Day 1–3. Safety was assessed from Day -1 to 8. PK (exposure) between the two ethnic groups was compared using an analysis of covariance (ANCOVA) model including ethnic group, natural log-transformed dose, and ethnic group by natural log dose interaction. Ex vivo secretion of cytokines (PD) under stimulated (using the TLR7/8 agonist, R848) and unstimulated conditions, was assessed pre- and post-dose. A panel of cytokines was analysed by multiplex immunoassay; IL-6 was considered the primary PD biomarker.

Results

The study included 36 male participants (18 Japanese and 18 Caucasian) with a mean (± SD) age of 35.1 (± 10.8) years and mean (± SD) body mass index of 23.1 (± 2.1) kg/m2. Each dose group included six Japanese and six Caucasian participants. The geometric mean enpatoran plasma exposure parameters (Cmax, AUC0-inf, and AUC0-tlast) were consistent between the two ethnic groups for each dose level (Table 1) and indicated dose proportionality. ANCOVA modeling demonstrated comparable exposure between the two groups (geometric least square mean ratio [Japanese/Caucasian;90% CI] of Cmax: 0.9409 [0.7855–1.1270]; AUC0-inf: 0.8959 [0.7497–1.0704] and AUC0-tlast: 0.8963 [0.7511–1.0695]). Treatment-emergent adverse events (TEAEs) were observed in six Japanese (n = 0, 100 mg; n = 3, 200 mg; n = 3, 300 mg) and four Caucasian (n = 1, 100 mg; n = 0, 200 mg; n = 3, 300 mg) participants. There we no serious TEAEs; most were mild and not dose dependent. Treatment-related TEAEs were mild diarrhoea, mild flatulence, and moderate headache. There were no deaths, withdrawals, or early terminations due to TEAEs. Administering enpatoran effectively reduced ex vivo stimulated cytokine release, with maximal inhibition observed at 2 hours post-dose (IL-6: mean ≥99%). High inhibition levels were sustained through 24 hours in a dose-dependent manner (IL-6: mean ~76–97%). The pattern of cytokine release inhibition was consistent across doses and ethnic groups.

Table 1.

PK parameters in Japanese and Caucasian participants at the three enpatoran dose levels

Parameter100 mg200 mg300 mgJapaneseCaucasianJapaneseCaucasianJapaneseCaucasianN = 6N = 6N = 6N = 6N = 6N = 6Cmax139175260245486490(ng/mL)AUC0-inf7749481910185028403330(h*ng/mL)AUC0-tlast7589311880183028103270(h*ng/mL)

All values are Geometric mean.

Cmax, maximum plasma concentration AUC0-inf, area under the plasma concentration–time curve (AUC) from time 0 to infinity; AUC0-tlast, AUC from time 0 to the last sampling time.

Conclusion

There were no relevant ethnic differences in PK, PD, and safety between healthy Japanese and Caucasian participants across a range of single oral enpatoran doses, thus supporting the inclusion of Asian participants in future global Phase II studies.

Acknowledgements

We would like to thank those who took part in the study. This study was sponsored by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945), who funded medical writing support by Bioscript Stirling Ltd.

Disclosure of Interests

Sathej Gopalakrishnan Shareholder of: Merck Healthcare KGaA, Employee of: Merck Healthcare KGaA, Axel Krebs-Brown Employee of: Merck Healthcare KGaA, Marco Nogueira Filho Employee of: Merck Healthcare KGaA, Yoshihiro Kuroki Employee of: Merck Biopharma Co., Ltd., Angelika Bachmann Employee of: Merck Healthcare KGaA, Andreas Becker Shareholder of: Merck Healthcare KGaA, Employee of: Merck Healthcare KGaA, Frank Schippers Employee of: Merck Healthcare KGaA, Markus Fluck Shareholder of: Merck Healthcare KGaA, Employee of: Merck Healthcare KGaA, Özkan Yalkinoglu Employee of: Merck Healthcare KGaA, Lena Klopp-Schulze Employee of: Merck Healthcare KGaA

Operator Scaling Dimensions and Multifractality at Measurement-Induced Transitions

Repeated local measurements of quantum many-body systems can induce a phase transition in their entanglement structure. These measurement-induced phase transitions (MIPTs) have been studied for various types of dynamics, yet most cases yield quantitatively similar critical exponents, making it unclear how many distinct universality classes are present. Here, we probe the properties of the conformal field theories governing these MIPTs using a numerical transfer-matrix method, which allows us to extract the effective central charge, as well as the first few low-lying scaling dimensions of operators at these critical points for (1+1)-dimensional systems. Our results provide convincing evidence that the generic and Clifford MIPTs for qubits lie in different universality classes and that both are distinct from the percolation transition for qudits in the limit of large on-site Hilbert space dimension. For the generic case, we find strong evidence of multifractal scaling of correlation functions at the critical point, reflected in a continuous spectrum of scaling dimensions.

Dietary Habits and Obesity among Adolescent School Children: A Case Control Study in an Urban Area of Kancheepuram District

BACKGROUND

Obesity is an important public health problem and is on the rise among adolescents in developed and developing nations. This case-control study was done to assess the dietary risk factors associated with obesity among school children of the adolescent age group.

MATERIALS AND METHODS

This study was done among age-matched 110 cases and 110 controls who were adolescent children between ages 10 and 17 years. Data were collected using a pretested, structured, interviewer-administered questionnaire and was analyzed using descriptive and analytical statistics.

RESULTS

About 52.7% of children belonged to the age group 13-15 years. Adequate fruits intake was reported by 42.7% of obese adolescents and 60% of nonobese adolescents. Adequate intake of vegetables was noted in 20.9% of cases and 24.5% of controls. The risk factors which were found to be statistically associated with adolescent obesity were increased fast food intake, sweets consumption, inadequate fruit intake, and the liberty given by the parents in purchasing snacks.

CONCLUSIONS

Since adolescent obesity is rising at an alarming rate, the dietary determinants of obesity need to be addressed at the level of schools, families, and community. School health services should include education on healthy food habits and regular monitoring of the health status of children. Parents need to be aware on the significance of balanced diet, avoidance of junk foods, and ensure adequate intake of fruits and vegetables for their children to prevent early onset of noncommunicable diseases.

Elastic and viscoelastic flexural wave motion in woodpecker-beak-inspired structures

This paper comprehensively investigates elastic and viscoelastic flexural wave propagation in structures that are inspired by the unique suture configurations present in a woodpecker's beak, in order to understand their ability to attenuate velocity amplitudes and wave speeds. Waveguides characterized by sinusoidal depth variations, both plain and variously graded along the length, mimicking the suture geometry, are considered in this work. Elastic and viscoelastic wave propagation analyses, along with prior static and free vibration studies, are carried out using a novel superconvergent finite element formulation. In elastic wave propagation analysis, firstly the attenuation characteristics are appraised in relation to the high amplitude and frequency waves of three different plain waveguides with differing depth profile orientations. This prompted us to next consider waveguides of hybrid configurations derived from them. Further, waveguides with lengthwise graded sinusoidal segments, as observed in nature, are studied for better wave attenuation properties compared to plain waveguides. This is followed by viscoelastic wave propagation analysis. Regarding the important role of the suture geometry, which is the focus of this work, the results from the elastic analyses revealed the nature of the reduction in wave speeds and amplitudes, both qualitatively and quantitatively, in such waveguides, and their dependence on the orientation and magnitude of the sinusoidal depth variation. Some waveguide configurations with remarkable wave attenuation characteristics, in terms of both wave speeds and amplitudes, are presented, along with their implications regarding impact mitigation applications.

POS1054 UPADACITINIB PHARMACOKINETICS AND EXPOSURE-RESPONSE RELATIONSHIPS FOR EFFICACY AND SAFETY IN PSORIATIC ARTHRITIS – ANALYSES OF THE PHASE 3 SELECT-PsA STUDIES

Background:

Upadacitinib (UPA) is an oral, reversible, JAK inhibitor approved for the treatment of rheumatoid arthritis (RA). The efficacy and safety profile of UPA in psoriatic arthritis (PsA) has been established in the SELECT-PsA program which includes two global Phase 3 studies.

Objectives:

These analyses characterize UPA pharmacokinetics and exposure-response relationships for efficacy and safety endpoints using data from the SELECT-PsA studies.

Methods:

The SELECT-PsA program enrolled patients with prior inadequate response (IR) or intolerance to ≥1 non-bDMARD1 (N=1705) and prior IR or intolerance to ≥1 bDMARD2 (N=642). Data from both trials was integrated for patients receiving placebo (PBO), UPA 15mg once daily (QD) and UPA 30mg QD; adalimumab data was excluded from this analysis. UPA pharmacokinetics were characterized in PsA patients using Bayesian population pharmacokinetics analyses and utilizing prior information from analyses in healthy subjects and RA patients. Exposure-response analyses were conducted using logistic regression to characterize the relationships between upadacitinib average plasma concentration during a dosing interval (Cavg) and the percentage of patients achieving ACR20/50/70 at Weeks 12 and 24, static Investigator Global Assessment of psoriasis (sIGA) of 0 or 1 (clear or almost clear) and at least a 2-point improvement from baseline, and PASI75 at Weeks 16 and 24 or experiencing selected clinically relevant safety events through week 24.

Results:

Analyses were conducted using data from 1694 subjects (for pharmacokinetics) and 1916 subjects (for exposure-response analyses). UPA model-estimated plasma exposures in subjects with PsA who received 15mg and 30mg QD doses were comparable to previously estimated exposures in subjects with RA. Body weight and methotrexate use had no clinically relevant effects on UPA exposures. There was a statistically significant relationship between UPA Cavg and the percentage of subjects who achieved Week 12 ACR50/70, Week 16 sIGA 0/1, and Week 24 sIGA 0/1 (Figure 1). No statistically significant exposure-response relationship was observed for Week 12 ACR20, Week 16 PASI75, or Week 24 ACR20/50/70 or PASI75, indicating that the 15mg QD exposures are approximately at the plateau of response for these endpoints. No statistically significant relationships were observed between upadacitinib Cavg and the percentage of subjects experiencing pneumonia, herpes zoster, hemoglobin < 8 g/dL, Grade ≥3 lymphopenia, Grade ≥3 neutropenia. There was a shallow but statistically significant exposure-response relationships with the occurrence of serious infections and decrease in hemoglobin from baseline (>2 g/dL and >2 g/dL in combination with hemoglobin < lower limit for normal).

Figure 1.

Observed and Model Predicted Efficacy Responses at Week 12 (for ACR50/70) or at Weeks 16 and Week 24 (for sIGA 0/1) Versus Upadacitinib Plasma Exposures

Conclusion:

Exposure-response analyses demonstrated that plasma exposures associated with UPA 15 mg QD achieves robust efficacy in subjects with PsA with limited effects on the evaluated safety endpoints. UPA plasma exposures associated with UPA 15 and 30mg QD are predicted to provide similar ACR responses by week 24 while a small additional efficacy benefit with UPA 30mg is predicted for the achievement sIGA 0/1.

References:

[1]van Vollenhoven R, et al. Monotherapy with Upadacitinib in MTX-naïve Patients with Rheumatoid Arthritis: Results at 48 Weeks from the SELECT-EARLY Study. 2019 EULAR; THU0197

[2]Fleischmann R, et al. Safety and Effectiveness of Upadacitinib or Adalimumab in Patients with Rheumatoid Arthritis: Results at 48 weeks from the SELECT-COMPARE Study. 2019 EULAR; FRI0147

Disclosure of Interests:

Elena Muensterman Shareholder of: AbbVie, Employee of: AbbVie, Benjamin Engelhardt Shareholder of: AbbVie, Employee of: AbbVie, Sathej Gopalakrishnan Shareholder of: AbbVie, Employee of: AbbVie, Jaclyn Anderson Shareholder of: AbbVie, Employee of: AbbVie, Mohamed-Eslam Mohamed Shareholder of: AbbVie, Employee of: AbbVie.

Knowledge, attitude, and health seeking behavior on leprosy among urban adults in Kancheepuram district of Tamil Nadu: A Community-based cross-sectional study

Introduction:

Although various measures are taken to create awareness about the epidemiological features of leprosy and encourage health-seeking behavior, they have seldom been able to tackle the high incidence of new leprosy cases in India.

Objective:

To determine Leprosy-related knowledge, attitude, and health seeking behavior among the urban population in Kancheepuram district of Tamil Nadu.

Materials and Methods:

This community-based cross-sectional study was conducted among a sample size of 640 people above 18 years of age residing in the study area, selected by multistage random sampling. A structured pretested questionnaire was used for data collection, and the data analysis was done using SPSS version 22.

Results:

Among the study participants, 54.7% of the participants had adequate knowledge and 23.3% had favorable attitude towards leprosy. With regard to knowledge, 66% of the participants believe that leprosy is a serious disease, and 71.2% of them were aware of transmission of leprosy from person to person. With regard to attitude, 57.7% were afraid of being diagnosed with leprosy, and 57% felt compassion and desire to help those diagnosed with leprosy. With regard to health-seeking behavior, around 83% preferred treatment from government hospitals and allopathic treatment. Male sex, occupation, education, and marital status were found to be having statistically significant association with knowledge, while the latter two were found to be associated with favorable attitude towards leprosy.

Conclusion:

Unfavorable attitude and inadequate knowledge regarding leprosy was found among the study participants. Behavior change communication programs have to be enhanced at community level to improve the knowledge and attitude regarding leprosy among the population.

Rice Blast Lesions: an Unexplored Phyllosphere Microhabitat for Novel Antagonistic Bacterial Species Against Magnaporthe oryzae

Dark brown necrotic lesions caused by Magnaporthe oryzae on rice foliage is a contrasting microhabitat for leaf-colonizing microbiome as compared with the surrounding healthy chlorophyll-rich tissues. We explored culturable bacterial communities of blast lesions by adopting microbiological tools for isolating effective biocontrol bacterial strains against M. oryzae. 16S rRNA gene sequencing-based molecular identification revealed a total of 17 bacterial species belonging to Achromobacter (2), Comamonas (1), Curtobacterium (1), Enterobacter (1), Leclercia (2), Microbacterium (1), Pantoea (3), Sphingobacterium (1), and Stenotrophomonas (5) found colonizing the lesion. Over 50% of the bacterial isolates were able to suppress the mycelial growth of M. oryzae either by secretory or volatile metabolites. Volatiles released by Achromobacter sp., Curtobacterium luteum, Microbacterium oleivorans, Pantoea ananatis, Stenotrophomonas maltophilia, and Stenotrophomonas sp., and were found to be fungicidal while others showed fungistatic action. In planta pathogen challenged evaluation trial revealed the biocontrol potential of Stenotrophomonas sp. and Microbacterium oleivorans that showed over 60% blast severity suppression on the rice leaf. The lesion-associated bacterial isolates were found to trigger expression of defense genes such as OsCEBiP, OsCERK1, OsEDS1, and OsPAD4 indicating their capability to elicit innate defense in rice against blast disease. The investigation culminated in the identification of potential biocontrol agents for the management of rice blast disease.

Management of Unilateral Multiple Impacted Molars- An Interdisciplinary Approach of a Rare Clinical Case

Impaction of first, second and third molars at once comprise a rare clinical scenario with diverse therapeutic approaches and possess a great challenge for the dentist. Early detection of the eruption disturbances helps to manage and produce optimal outcomes. Here, the authors reported a case of 17-year-old male patient who reported with the chief complaint of pain in his lower left back tooth region with difficulty in mouth opening and chewing that revealed impacted mandibular left first, second and third molar on radiographic investigation. A proper decision making is required to satisfy the patient and also get an effective result. As the patient had severe pain in the left side of the jaw near the angle of the mandible, surgical removal of the impacted molars was planned and performed using extra oral submandibular approach. Following the removal of the teeth, implants were placed in the extracted site supported by bone graft material and fixed orthodontic appliance therapy was carried out to correct the supra- erupted upper molars on the left side and arch expansion screw with upper Hawley’s appliance was given to expand the maxillary arch to aid in appropriate occlusion. Restoration of the implant was done after one year of orthodontic treatment using ceramic crowns. The combined surgical, orthodontic and periodontal interdisciplinary approach helped the patient to gain proper occlusion and satisfactory masticatory function.

Asymptotically Exact Theory for Nonlinear Spectroscopy of Random Quantum Magnets

We study nonlinear response in quantum spin systems near infinite-randomness critical points. Nonlinear dynamical probes, such as two-dimensional (2D) coherent spectroscopy, can diagnose the nearly localized character of excitations in such systems. We present exact results for nonlinear response in the 1D random transverse-field Ising model, from which we extract information about critical behavior that is absent in linear response. Our analysis yields exact scaling forms for the distribution functions of relaxation times that result from realistic channels for dissipation in random magnets. We argue that our results capture the scaling of relaxation times and nonlinear response in generic random quantum magnets in any spatial dimension.

Alcohol consumption in India- An epidemiological review

One of the most important products of global addiction demand is an alcoholic beverage. In developing countries like India, alcohol consumption tends to be a major problem because of the various socio-cultural practices across the nation, different alcohol policies and practices across the various states, lack of awareness of alcohol-related problems among the community, false mass media propaganda about alcohol use, various alcohol drinking patterns among the alcohol consumers and the emergence of social drinking as a habit because of the widespread urbanisation across the country. Stringent alcohol policies are needed across the various states to reduce alcohol consumption, and alcohol consumers have to be educated about the various harmful effects of alcohol consumption and the effects it can have on their mind, body and soul. This review article focuses on the burden of alcohol consumption in context with its various harmful effects on the mind and body with a note on the alcohol policies in the country.

Reproductive health status of rural married women in Tamil Nadu: A descriptive cross-sectional study

Introduction:

Reproductive health of women is of special concern, especially during their reproductive years where the reproductive morbidity is very high, especially in countries like India.

Aims:

This study was carried out to find the reproductive health status of rural married women and identify those suffering from reproductive morbidity to provide appropriate guidance and treatment.

Methodology:

This community-based cross-sectional descriptive study was carried among rural married women above 18 years of age in the field practice areas of a medical college. By simple random sampling method, the required sample size of 650 was identified. Data collected by female investigators using a pretested structured questionnaire was analyzed using SPSS version 22.

Results:

Most of the study participants were in the age group of 21–40 years. About 32% of married women delivered by cesarean section and exclusive breastfeeding was followed by 88.9% of the mothers. Around 78% of the participants used contraceptive methods and the major reason given was for economic reasons (48%). About 67% of study participants suffered from one or more gynecological problems such as menorrhagia, lower abdominal pain, dysmenorrhea, and abnormal vaginal discharge. UTI (14%) and RTI (11.6%) were the most commonly diagnosed gynecological morbidity. Pallor was present in 45.5% of the study participants and 6.9% had clinical goiter.

Conclusion:

High prevalence of gynecological morbidity in this study shows that there is a dire need to plan and implement health education and awareness creation programs to complement the existing programs targeting women.

Pattern of alcohol consumption and its associated morbidity among alcohol consumers in an urban area of Tamil Nadu

Introduction:

In India, though the prevalence of alcohol consumption is low, nearly half of the alcoholic consumers fall into the category of hazardous drinking. There have been rapid changes in the trends and pattern of alcohol use in India.

Aims:

The study was carried to find out the pattern of alcohol consumption, associated morbidities, and its association with related factors in an urban area of Tamil Nadu.

Materials and Methods:

This is a descriptive cross-sectional study done among adult males >18 years of age in Kancheepuram district Tamil Nadu. Among the 400 study participants selected by simple random sampling, 156 were found to be alcohol consumers. A pre-tested structured questionnaire and Alcohol Use Disorders Identification Test (AUDIT) was used to identify the pattern of alcohol consumption and the associated health morbidities. Data analysis was done using SPSS version 22.

Results:

It was found that 67% of alcohol consumers had a problematic drinking pattern with 52.5% having a hazardous/harmful drinking pattern and 14.7% were found to be dependent alcoholics. The associated factors of problem drinking among the alcohol consumers were illiteracy, having a history of tobacco use, being unmarried/divorced and consuming alcohol in wine shops. The health morbidities that were found to be associated with alcohol consumption were hypertension, gastritis/peptic ulcer disease, and psychiatric illnesses.

Conclusion:

More than half of the alcohol consumers had a problematic drinking pattern, which is an alarming public health problem. All the current drinkers in a community have to be screened for problematic drinking pattern and it has to be supplemented with referral services, health promotion, behavioral change communication to the alcohol consumer, and his family members.

Epidemiology of alcohol consumption in an urban area of Kancheepuram district, Tamil Nadu

Introduction

In India, the ever increasing production, promotion, distribution, and the easy availability and accessibility of alcohol together with the changing values in the society have resulted in alcohol consumption becoming one of the major public health problems.

Aims

The study was undertaken to find out the prevalence of alcohol consumption and its epidemiological determinants in an urban area of Kancheepuram district, Tamil Nadu.

Methodology

This descriptive cross-sectional study was done among adult males above 18 years of age in Anakaputhur area of Kancheepuram district, Tamil Nadu. Simple random sampling method was used to select the study participants to reach the required sample size of 400. Pretested structured questionnaire was used as study tool to collect data regarding alcohol consumption practices. Data were analyzed using SPSS version 22.

Results

The prevalence of alcohol consumption among the study participants was found to be 39%. The major determinants of alcohol consumption which were found to be statistically significant were age less than 45 years, those belonging to a nuclear family, those who consume tobacco, consumption of alcohol by family members, those who did not receive advice regarding harmful effects of alcohol from family members, those having stigma of being a nondrinker among friends/peers and those having awareness of health problems caused due to alcohol consumption.

Conclusion

This study shows that it is high time we change the approach of educating the public about the effects of alcohol consumption by intensive behavioral change continuum activities at a younger age group, coupled with encouraging refusal skills to overcome peer pressure.

Health-seeking behaviour among antenatal and postnatal rural women in Kancheepuram District of Tamil Nadu: A cross-sectional Study

Introduction:

Maternal morbidity and mortality is still a major public health challenge. Lack of proper birth plan and delay in identification of pregnancy complications is one of the major causes of maternal morbidities and deaths, especially in the rural areas.

Aim:

The study was conducted with the aim to evaluate the health-seeking behaviour for obstetric care services among the antenatal and postnatal mothers in a rural area of Tamil Nadu.

Materials and Methods:

This descriptive cross-sectional study was done among antenatal and postnatal mothers registered in the Rural Health Training Centre, in Sripuram area of Kancheepuram district, Tamil Nadu during 2017. About 150 antenatal and 150 postnatal mothers were selected by simple random sampling method. A pre-tested structured questionnaire was used to collect relevant data which was analysed using the SPSS version 22.

Results:

Only 21% of the study participants had adequate knowledge regarding the danger signs of pregnancy and the major determinants were maternal literacy and adequate prenatal care. Regarding the health-seeking behaviour, 62.3% of them preferred primary health centres as preferred place of delivery, 87.3% of them had received adequate prenatal care and it was found to have statistically significant association with adequate gestational weight gain, exclusive breastfeeding, proper weaning practices and consumption of iron and folic acid supplements.

Conclusion:

The study shows the need to provide health education regarding the danger signs of pregnancy and importance of adequate prenatal care to all pregnant women and expectant mothers, to make them aware of when and how to seek medical care, which in turn could reduce the overall maternal morbidity and mortality.

Intestinal parasitic infestations and anemia among urban female school children in Kancheepuram district, Tamil Nadu

INTRODUCTION

In India, intestinal parasitic infection and anemia remain the most important cause of morbidity especially among the adolescent school children due to lack of awareness of personal hygiene practices, leading to intestinal parasite infections which could in turn lead to anemia.

AIM

This study was conducted with the aim to find out the prevalence of intestinal parasitic infection and anemia among adolescent female school children in an urban area of Tamil Nadu.

MATERIALS AND METHOD

This descriptive cross-sectional study was done among adolescent female school children in Anakaputhur area of Kancheepuram district. Three schools were selected randomly from a total of eight schools in the study area. Universal sampling was applied in each school, and a total of 250 willing children participated in the study. Early morning stool specimen was collected for microscopic examination and hemoglobin estimation was done. A pretested structured questionnaire was used to collect relevant data which were analyzed using SPSS version 22.

RESULTS

The prevalence of intestinal parasitic infection was found to be 36% with Entamoeba histolytica being the commonly isolated organism (23.2%) followed by Giardia intestinalis (5.2%), Hookworm (4.4%), and Ascaris lumbricoides (3.2%). The prevalence of anemia among them was found to be 84.8% with mild, moderate, and severe anemia being 12.8%, 46.8%, and 25.2%, respectively. Statistically significant association was found between intestinal parasitic infection and open field defecation, inadequate hand washing practices, and anemia.

CONCLUSION

The study reveals high prevalence of anemia and intestinal parasitic infection among female school children. Preventive measures such as periodic deworming and health education about nutritional balanced diet, iron supplements, and personal hygiene practices have to be given to both the parents and their children to prevent and reduce disease burden.

Comparison of laryngeal morbidities with modified reinforced silicone tube intubation guided over a bougie vs. a guidewire: novel assessment with voice analysis

Semi-rigid flexible introducer-guided tracheal intubation is associated with pharyngolaryngeal morbidities. We compared the practice of railroading a newly described modified reinforced silicone tracheal tube with a built-in guide channel in its wall over a non-kinking guidewire with railroading the same tube over a disposable bougie, with respect to pharyngolaryngeal morbidities. One hundred and twenty-four ASA 1 and 2 adults were randomly assigned to undergo bougie-guided (n = 62) or wire-guided (n = 62) intubation under general anaesthesia. All patients were assessed for postoperative pharyngolaryngeal complaints. In addition, voice parameters (fundamental frequency, shimmer, jitter and harmonic noise ratio) with vowels 'a' and 'i' were analysed pre-operatively and 24 h postoperatively. The success of first-attempt intubation and the associated haemodynamic response were also recorded. A higher incidence of pharyngolaryngeal complaints was seen in the bougie group, 48.3%, 95%CI (35.9-60.9%) when compared with wire-guided group 28.3%, 95%CI (18.0-40.6%), p = 0.01. Postoperatively, all the voice parameters were significantly more affected when compared with their pre-operative value in the bougie-guided group (p < 0.05) but not in the wire-guided group. The success of first-attempt intubation was similar in both groups. Wire-guided orotracheal intubation was associated with a lower incidence of pharyngolaryngeal complaints and effect on voice when compared with bougie-guided intubation.

Determinants of acute respiratory infections among under five children in a rural area of Tamil Nadu, India

Introduction:

Acute respiratory infection (ARI) is an infection of the respiratory tract. It may interfere with normal breathing of the individual and is communicable in nature. There are several modifiable risk factors that predispose younger age group of children to ARI. The aim of this study is to evaluate the risk factors that contribute to occurrence of ARI among the under 5 children.

Methods:

This community based cross sectional study was carried out among 380 rural under five children in Kancheepuram district, by systematic random sampling method. A pretested structured questionnaire was used for data collection that was analyzed using SPSS software version 16. The analytical statistics such as Chi – square test, Odds Ratio, and Confidence Interval were used to determine the association of ARI with its determinants.

Results:

In this study, the prevalence of ARI among under five children was 41.6%. The prevalence of ARI was predominant among boys (50.6%) and those residing in semi pucca and kutcha type of house (50.3%) with poor ventilation (61.3%), history of parental smoking (57%), respiratory infection among family members (51.1%) children who did not cry immediately after birth because of any complication (60.9%), and malnourished children (66.4%). These factors contributed to increased prevalence of ARI with a statistically significant association with a P value < 0.05.

Conclusion:

The high prevalence of ARI in this study was contributed by multiple factors. The primary care physician can play a vital role to create awareness on hazards because of exposure to the various contributing factors by lifestyle modifications, good nutrition, and healthy and safe environment.

Evaluation of inter-arm difference in blood pressure as predictor of vascular diseases among urban adults in Kancheepuram District of Tamil Nadu

Introduction:

An “Inter-Arm Difference” (IAD) in blood pressure (BP) is defined as a variation in systolic BP of >10 mmHg. Various studies conducted in different population show that there are wide variations in the prevalence of IAD, which ranges from 5% to 46%. The aim of this study is to evaluate the prevalence of IAD in BP among adults and its association with risk factors.

Methods:

This community-based cross-sectional study was carried out among urban adults in Kancheepuram district. The study sample size of 1634 was calculated, and simple random sampling method was used. Data analysis was performed using SPSS software version 16. Prevalence of IAD in BP was calculated using percentages, and statistical significance was tested to look for an association.

Results:

This study shows that 26.2% were at moderate risk for vascular events with IAD in systolic BP of 10–15 mmHg and 17.3% were at high risk with IAD >15 mmHg. About 14.2% had diastolic BP difference of 10–15 mmHg indicative of moderate risk and 6.1% had a difference of >15 mmHg indicative of high risk for vascular events. The statistical significant association was found between IAD in systolic BP and risk factors such as hypertension, smoking, alcoholism, and between IAD in diastolic BP with overweight/obesity (P < 0.05).

Conclusion:

This study outcome shows that the prevalence of IAD in BP is on the higher side. Hence, specific guidelines should be brought in to practice for measuring BP in both arms to detect IAD in every health-care settings.

Progress of health care in rural India: a critical review of National Rural Health Mission

National rural health mission (NRHM) was initiated in the year 2005 in eleventh five year plan, with the objective of providing quality health care services to the rural population. The mission brought out salient strategies by involving various sectors and forging partnerships with various organizations to unify health and family welfare services into a single window. Though the mission strived for a sustainable health care system, it did not envisage certain challenges in implementation. The public health system in India could take off from the foundations laid by the NRHM to overcome these challenges, in order to achieve various goals of health and development and put India on the road map of healthful development. The objective of this review article is to critically evaluate the implementation of national rural health mission and highlight its success and to make recommendations on the future health care planning and implementation in achieving universal health coverage for the rural India. NRHM has been a mammoth effort by the Union Government to build the public health infrastructure of the nation. The mission deserves its credit for empowering the rural India in health care, especially in States with poor health related indicators. NRHM has been a pioneer in reiterating the need for community participation, coupled with intersectoral convergence, to bring about a paradigm shift in the indicators, which has been reasonably achieved in most of the States. Taking forward the foundations laid by the NRHM, it is essential for the forthcoming policies and plans to focus on capacity building, not only on the infrastructure and technical aspects, but also on streamlining the health workforce, which is crucial to sustaining the public health infrastructure. The public health system in India should take off from the foundations laid by the NRHM. There is an imminent need to focus on forging a sustainable public private partnership, which will deliver quality services, and not compromise on the principles and identity of the public health system of the country, in its pursuit to achieve universal health coverage and sustainable development goals.

Non-Fermi Glasses: Localized Descendants of Fractionalized Metals

Non-Fermi liquids are metals that cannot be adiabatically deformed into free fermion states. We argue for the existence of "non-Fermi glasses," phases of interacting disordered fermions that are fully many-body localized (MBL), yet cannot be deformed into an Anderson insulator without an eigenstate phase transition. We explore the properties of such non-Fermi glasses, focusing on a specific solvable example. At high temperature, non-Fermi glasses have qualitatively similar spectral features to Anderson insulators. We identify a diagnostic based on ratios of correlators that sharply distinguishes between the two phases even at infinite temperature. Our results and diagnostic should generically apply to the high-temperature behavior of MBL descendants of fractionalized phases.

The Need for Patient Follow-up Strategies to Confirm Diabetes Mellitus in Large Scale Opportunistic Screening

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. Type 2 (non-insulin dependent) Diabetes mellitus is one of the preventable non communicable disease resulting in increased morbidity and mortality in developing countries like India. It is characterized by disorders of insulin action and/or insulin secretion. Number of people with Type 2 Diabetes is growing rapidly worldwide with economic development, ageing populations, increasing urbanisation, dietary changes, reduced physical activity and lifestyle changes. The global prevalence of diabetes is 9%, while in India it is 8.63% and in Tamil Nadu it is 10.4%. National and State programmes on Diabetes control are implemented to combat the disease burden. A detailed review of the programme modules, operational guidelines and visit to health facilities were done to understand the implementation process related to control of Diabetes mellitus. As part of these programmes, opportunistic screening is implemented for target population. Though these programmes are unique, there are few lacunae identified which are missing opportunities and time consuming. There are no strategies so far in such programmes to make the screened positive cases to undergo confirmatory tests. Since screening is only opportunistic, the screened positive cases can be subjected to undergo confirmatory tests by different methods. The specified roles and responsibilities of health staffs at various levels to ensure follow up should also be framed and followed. The objective of this article is to review the existing strategies and to suggest the need for follow up pathways to be adopted from the first contact level to the level of final confirmation for better compliance.

Exploring plant growth-promotion actinomycetes from vermicompost and rhizosphere soil for yield enhancement in chickpea

The main objective of the present study was to isolate and characterize actinomycetes for their plant growth-promotion in chickpea. A total of 89 actinomycetes were screened for their antagonism against fungal pathogens of chickpea by dual culture and metabolite production assays. Four most promising actinomycetes were evaluated for their physiological and plant growth-promotion properties under in vitro and in vivo conditions. All the isolates exhibited good growth at temperatures from 20 °C to 40 °C, pH range of 7–11 and NaCl concentrations up to 8%. These were also found highly tolerant to Bavistin, slightly tolerant to Thiram and Captan (except VAI-7 and VAI-40) but susceptible to Benlate and Ridomil at field application levels and were found to produce siderophore, cellulase, lipase, protease, chitinase (except VAI-40), hydrocyanic acid (except VAI-7 and VAI-40), indole acetic acid and β-1,3-glucanase. When the four actinomycetes were evaluated for their plant growth-promotion properties under field conditions on chickpea, all exhibited increase in nodule number, shoot weight and yield. The actinomycetes treated plots enhanced total N, available P and organic C over the un-inoculated control. The scanning electron microscope studies exhibited extensive colonization by actinomycetes on the root surface of chickpea. The expression profiles for indole acetic acid, siderophore and β-1,3-glucanase genes exhibited up-regulation for all three traits and in all four isolates. The actinomycetes were identified as Streptomyces but different species in the 16S rDNA analysis. It was concluded that the selected actinomycetes have good plant growth-promotion and biocontrol potentials on chickpea.

Effect of plant growth-promoting Streptomyces sp. on growth promotion and grain yield in chickpea (Cicer arietinum L)

The physiological and molecular responses of six strains of Streptomyces sp. (CAI-13, CAI-85, CAI-93, CAI-140, CAI-155 and KAI-180), with their proven potential for plant growth-promotion (PGP) in rice were studied to understand the mechanisms causing the beneficial effects. In this investigation, those six strains were evaluated for their PGP capabilities in chickpea in the 2012-13 and 2013-14 post-rainy seasons. All of the Streptomyces sp. strains exhibited enhanced nodule number, nodule weight, root weight and shoot weight at 30 days after sowing (DAS) and pod number, pod weight, leaf area, leaf weight and stem weight at 60 DAS in both seasons over the un-inoculated control. At chickpea crop maturity, the Streptomyces strains had enhanced stover yield, grain yield, total dry matter, pod weight, seed number and seed weight in both seasons over the un-inoculated control. In the rhizosphere, at crop maturity, the Streptomyces strains also significantly enhanced soil biological and mineral nutrient traits including microbial biomass carbon, dehydrogenase activity, total nitrogen, available phosphorous and organic carbon in both seasons over the un-inoculated control. Of the six strains of Streptomyces sp., CAI-85, CAI-93 and KAI-180 were found superior to CAI-155, CAI-140 and CAI-13, in terms of their effects on root and shoot development, nodule formation and crop productivity. Scanning electron microscopy micrographs had revealed the success in colonization of the chickpea roots by all six strains. This investigation further confirms the broad-spectrum of PGP activities by the selected Streptomyces sp.

Midline upper lip sinus: a case report and review of literature

PURPOSE

A multitude of developmental anomalies has been reported in the head and neck, especially on the face; however, cases of upper lip sinuses and fistulas have hardly been reported.

METHOD

A 10-year-old girl presented with a recurrently discharging upper lip sinus. After adequate presurgical workup, excision of the lesion resulted in a clinical cure.

RESULT

Literature review suggests a number of theories for the origin of the upper lip sinus; however, none have proven to be conclusive.

CONCLUSION

Upper lip sinus formations are rare developmental events, and the pathogenesis of these lesions still needs further evaluation.

Adolescent health: present status and its related programmes in India. Are we in the right direction?

Adolescence is a phase of rapid growth and development during which physical, physiological and behavioural changes occur. They constitute more than 1.2 billion worldwide, and about 21% of Indian population. Morbidity and mortality occurring in this age group is mostly due to preventable causes. Young and growing children have poor knowledge and lack of awareness about physical and psychological changes that occurs during adolescence and the ill health affecting them. Existing Adolescent health programmes focus on rendering services like immunization, health education for sexual and reproductive health, nutritional education and supplementation, anemia control measures and counseling. Adolescent health programmes are fragmentary at present and there is no comprehensive programme addressing all the needs of adolescents. Access and availability of health care services are severely limited. Lack of accurate information, absence of proper guidance, parent's ignorance, lack of skills and insufficient services from health care delivery system are the major barriers. Interventions should focus on providing psychological and mental health services and behaviour change communication towards leading a healthy lifestyle, restricting advertisement related to junk food products, awareness creation about reproductive and sexual health, educating parents to prevent early marriage, teenage pregnancy and to counsel their children on nutrition and reproductive health. Universal coverage of Adolescent friendly clinics is highly recommended. To be cost effective, all health services addressing adolescent should come under single programme. This review is intended to create awareness among the stakeholders about the importance of strengthening adolescent health services in order to meet their felt needs.

Standard treatment guidelines in primary healthcare practice

In India, healthcare delivery is implemented at primary, secondary and tertiary levels. Of these, primary health care is the essential health care and is the first point of care for the public across the country. The primary health care system caters to nearly 70% of the population by treating about 90% of the common and locally prevailing problems. One of the integral elements of primary health care is provision of essential medicines, which should be available at all times in adequate amounts in appropriate dosage forms and at an affordable cost. It has an important bearing on the medical, economical and social outcomes of the healthcare delivery system. This situation mandates the need for rational use of medicines by standardizing the treatment of commonly occurring illness at the primary health care level. Standard Treatment Guidelines (STGs) have been in vogue in India only since recent times and is gaining popularity among practitioners. STGs have many advantages for the patients, healthcare providers, drug manufacturers and marketing agencies, and above all, the policy makers and the legislative system of the country. The drawback in STGs lies in the difficulties in implementation on a large scale. With due efforts to prioritize the health needs, comprehensive coverage of national health programs involving all the stakeholders including professional organizations, undergraduate medical curriculum planners and medical practitioners, STGs can be implemented effectively and thereby we can ensure a quality health care at the primary care level at an affordable cost as part of the now redefined Universal Health Coverage. This article is intended as a guide to understand the concept of STGs, prepared with the aim of capacity building for medical professionals in rationally treating patients in their day-to-day clinical practice.

Study of morbidity profile of a rural population in Tamil Nadu

OBJECTIVE

To identify the reported morbidity profile of people according to age, gender and organ system affected using International Classification of Diseases (ICD) coding, in a demographically defined area in Tamil Nadu in order to identify their health care needs and to plan appropriate interventions strategies.

MATERIALS AND METHODS

This is a-cross sectional study using a convenience sample of 12308 persons sceened from the 41 panchayat units of the Kattankulathur block, comprising 90 villages with a population of about 2,00,890, over a period of one year. Diagnosis made were coded using ICD 10 version and data collected was analysed by appropriate statistical methods to explain the distribution of morbidity profile among the study population.

RESULT

Out of total, 38.1% screened were males and 61.9% were females. Underfives were 5.3%, school going children 43.3%, adults 39.2% and elderly 12.3%. Majority had illness affecting respiratory system (20%), 'symptoms and signs' (19%), musculo-skeletal system (16.1%) and digestive system(11.9%). 'Symptoms and signs' classification, is a group of conditions which is of nonspecific diseases, signs, symptoms, abnormal findings and complaints, apart from the system specific conditions diagnosed properly and not elsewhere classified, More males were affeced with respiratory, digestive and illnesses with 'symptoms and signs' while more women were affected with musculo-skeletal problems. Only 9.7 % of patients reported with non-communicable diseases. Among them, 55 % women and 42.3 % men had osteoarthritis and 15.7 % women and 21.3 % men had cataract. About 15.8 % women and 18.1 % men had hypertension and other heart diseases while 9.7 % women and 8.4 % men had diabetes and 10.0 % men and 3.9 % women had chronic respiratory diseases.

CONCLUSION

School going children and adults have higher levels of morbidity when compared to elderly and under five children. More females reported with illness but morbidity was found to be higher among males. The burden of illness increased with age. Acute ailments were responsible for high morbidity among children, while chronic ailments caused high morbidity among the elderly.

Community medicine teaching and evaluation: scope of betterment

There have been rapid and extensive changes in the way assessment is conducted in medical education. Assessment brings about standardization of the manner in which the syllabus is to be implemented and also gives guidelines regarding the teaching pattern, especially when the student is going to rotate through various departments in a medical college. Community Medicine is an important branch of medicine concerned with the health of populations. Existing forms of assessment of community medicine education mainly consists of internal [formative] assessment and final (summative) examination. Advantages of the present system is the similarity of the methods used for internal assessments and final examinations and is relatively easily done since only the knowledge application and recall ability of the student in theory and practical are assessed. Disadvantages in the current evaluation system are neglecting the assessment of psychomotor, affective and communication skills. Evaluation systems can be improved by implementing techniques to assess psychomotor skills, presentation and communication skills, organizational skills and the student's ability to work in a team. Regular feedback from students should be taken periodically for the betterment of Community Medicine education. This article is meant to sensitise the academic experts in medical education to plan better need based methods of assessment in the subject of Community Medicine, in relation to the new MCI 2012 Regulations, in order to make it a better learning experience for the students.

Many-body localization in dipolar systems

Systems of strongly interacting dipoles offer an attractive platform to study many-body localized phases, owing to their long coherence times and strong interactions. We explore conditions under which such localized phases persist in the presence of power-law interactions and supplement our analytic treatment with numerical evidence of localized states in one dimension. We propose and analyze several experimental systems that can be used to observe and probe such states, including ultracold polar molecules and solid-state magnetic spin impurities.

Control of cell migration direction by inducing cell shape asymmetry with patterned topography

In this study, we explored the concept of introducing asymmetry to cell shapes by patterned cell culture substrates, and investigated the consequence of this induced asymmetry to cell migration behaviors. Three patterns, named "Squares", "Grating", and "Arcs" were fabricated, representing different levels of rotational asymmetry. Using time-lapse imaging, we systematically compared the motility and directionality of mouse osteoblastic cells MC3T3-E1 cultured on these patterns. Cells were found to move progressively faster on "Arcs" than on "Grating", and cells on "Squares" were the slowest, suggesting that cell motility correlates with the level of rotational asymmetry of the repeating units of the pattern. Among these three patterns, on the "Arcs" pattern, the least symmetrical one, cells not only moved with the highest velocity but also the strongest directional persistence. Although this enhanced motility was not associated with the detected number of focal adhesion sites in the cells, the pattern asymmetry was reflected in the asymmetrical cell spreading. Cells on the "Arcs" pattern consistently displayed larger cytoplasmic protrusion on one side of the cell. This asymmetry in cell shape determined the direction and speed of cell migration. These observations suggest that topographical patterns that enhance the imbalance between the leading and trailing fronts of adherent cells will increase cell speed and control movement directions. Our discovery shows that complex cell behaviors such as the direction of cell movement are influenced by simple geometrical principles, which can be utilized as the design foundation for platforms that guide and sort cultured cells.

Interferometric probes of many-body localization

We propose a method for detecting many-body localization (MBL) in disordered spin systems. The method involves pulsed coherent spin manipulations that probe the dephasing of a given spin due to its entanglement with a set of distant spins. It allows one to distinguish the MBL phase from a noninteracting localized phase and a delocalized phase. In particular, we show that for a properly chosen pulse sequence the MBL phase exhibits a characteristic power-law decay reflecting its slow growth of entanglement. We find that this power-law decay is robust with respect to thermal and disorder averaging, provide numerical simulations supporting our results, and discuss possible experimental realizations in solid-state and cold-atom systems.