Study of Cardiac Dysfunction in Portal Hypertension: A Single-Center Experience From Eastern India

INTRODUCTION

Cardiac functional abnormalities are common in patients with cirrhosis of the liver. Nonetheless, the effect of portal hypertension and liver disorder on cardiac abnormalities is yet to be investigated. The current study evaluated the contribution of cirrhotic and non-cirrhotic portal hypertension as the potential cause of cardiac abnormalities.

METHODS

The present study was a cross-sectional observational study. After excluding known heart diseases, 128 patients with portal hypertension from different causes were enrolled in the study. Cardiac functional activity was assessed by electrocardiogram (ECG) and transthoracic echocardiography (TTE).  Results: This study included a total of 128 patients, out of which 24 had extrahepatic portal vein obstruction (EHPVO), four patients had Budd-Chiari syndrome and 100 had liver cirrhosis. Normal ventricular function was observed in patients with EHPVO and Budd-Chiari syndrome. Sixty-eight percent of cases had liver cirrhosis diastolic abnormalities. The mean QTc interval in patients with cirrhotic cardiomyopathy (CCM) was 0.49 ± 0.05 sec which was significantly increased when compared to patients without CCM with 0.432 ± 0.07 at p=0.0016. The Child Turcotte Pugh (CTP) score and MELD (Model for End-Stage Liver Disease) score in patients with CCM were significantly higher as compared to patients without CCM. All alcoholic cirrhotic and non-alcoholic cirrhotic patients had equal prevalence of diastolic dysfunction (p-value >0.05).

CONCLUSION

 Patients with Child class C or a high MELD score are associated with a higher prevalence rate of CCM while normal cardiac function was observed among patients having portal hypertension due to extrahepatic causes. We recommend cardiac evaluation by echocardiography in all cirrhotic patients. Institution of specific medical therapy and early referral for liver transplantation should be considered to improve survival in patients with decompensated cirrhosis.

Effective voltammetric tool for Nano-detection of triazine herbicide (1-Chloro-3-ethylamino-5-isopropylamino-2,4,6-triazine) by naphthalene derivative

The development and operation of a nanosensor for detecting the poisonous 1-chloro-3-ethylamino-5-isopropylamino-2,4,6-triazine (Atrazine) are described in this study for the first time. The carbon electrode (CE) surface was modified with cysteine-substituted naphthalene diimide to create this sensitive platform. The developed nanosensor (NDI-cys/GCE) was evaluated for its ability to sense Atrazine using differential pulse voltammetry and cyclic voltammetry. To achieve the best response from the target analyte, the effects of several parameters were examined to optimize the conditions. The cysteine-substituted naphthalene diimide significantly improved the signals of the Atrazine compared to bare GCE due to the synergistic activity of substituted naphthalene diimide and cysteine molecules. Under optimal conditions, atrazine detection limits at the (NDI-cys/GCE) were reported to be 94 nM with a linear range of 10-100 μM. The developed sensing platform also showed positive results when used to detect the atrazine herbicide in real tap water, wastewater, and milk samples. Furthermore, a reasonable recovery rate for real-time studies, repeatability, and stability revealed that the developed electrochemical platform could be used for sample analysis.

Removal of Pb ions using green Co3O4 nanoparticles: Simulation, modeling, adsorption, and biological studies

Chemical co-precipitation synthesized novel and green cobalt-oxide nanoparticles (Co₃O₄-NPs) utilizing cobalt nitrate as cobalt precursors. FTIR, Raman, scanning electron microscopy, UV visible, X-ray powder diffraction, and BET was used to analyze the surface characteristics, composition, and morphology, of the NPs. These green Co₃O₄-NPs were employed to remove Pb ions from simulated wastewater solutions at various pH, adsorbate, temperature, and dose concentrations. At dose 20 mg/L, pH 6.0, 20 mg/L (Pb(II) solution, 25 °C of temperature, and 45 min for equilibrium, nearly 99.44% of Pb ions were removed. To evaluate the kinetic data, four different kinetic equations were used. The data fit the Elovich rate equation better than the other three models. Thermodynamic and isothermal studies were also evaluated, and the maximum adsorption capacity of 450.45 mg/g was observed at 298.15 K. 0.1 M HNO_3, and 0.1 HCl were used to regenerate used Co₃O₄-NPs. Simulation results show the strong correlation of the Co atom in the Co₃O₄-NPs generates active delocalized surface states, which are energetically most favorable for heavy metal (Pb ions) adsorption and removal, supporting the experimental outcomes. In concluding remarks, green Co₃O₄-NPs can also be used as an adsorbent to remove Pb ions from wastewater bodies.

Applicability of new sustainable and efficient green metal-based nanoparticles for removal of Cr(VI): Adsorption anti-microbial, and DFT studies

Artemisia absinthium leaves were utilized as a reducing agent for green synthesis of Zinc oxide nanoparticles (particle size 17 nm). Synthesized green-ZnO (g-ZnO) were characterized by SEM/EDX, FTIR, XRD, UV, and BET analyses and then further used as an adsorbent to remove Cr(VI) ions from simulated wastewater. Optimal pH, temperature and adsorbent dosage were determined through batch mode studies. High removal efficiency and adsorption capacity were observed at pH 4, 0.25 g L^-1 dosage, and 25 mg L^-1 concentration of Cr(VI). Experimental data were modelled with different adsorption kinetics (Elovich model, PFO, PSO, IDP model) and isotherms (Langmuir, Freundlich, and Temkin), and it was found the adsorption process was well fitted to Langmuir with an R² value greater than>0.99. Computational calculation showed that the g-ZnO nanoparticles became ∼14 times more dynamic with delocalized surface states making them a relevant platform to adsorb Cr with greater work function compatibility supporting the experimental findings. The Q_max adsorption capacity of g-ZnO was 315.46 mg g^-1 from Langmuir calculations. Thermodynamic calculations reveal that the Cr (VI) adsorption process was spontaneous and endothermic, with a positive ΔS value representing the disorder at the solid-solution interface during the adsorption. In addition, the present study has demonstrated that these g-ZnO nanoparticles show strong antibacterial activities against P. aeruginosa (MTCC 1688) and E. coli (MTCC 1687). Also, the novel g-ZnO adsorbent capacity to remove Cr(VI) from simulated water revealed that it could be reused at least six times with higher removal rates during regeneration experiments. The results obtained from adsorption and antimicrobial activities suggest that g-ZnO nanoparticles could be used effectively in real-time wastewater and agricultural safety applications.

Association of Vitamin D Level With Disease Severity and Quality of Life in Newly Diagnosed Patients of Ulcerative Colitis: A Cross-Sectional Analysis

Introduction

Ulcerative colitis is an immunologically mediated disorder affecting the gastrointestinal tract. Vitamin D3 has been shown to modulate many immunological diseases, but its role in ulcerative colitis is not well documented. This study was done to find out if levels of vitamin D are associated with the severity of disease and quality of life in ulcerative colitis patients.

Methods

This cross-sectional study consists of two parts. The first part consists of having a comparative assessment of baseline parameters of newly diagnosed ulcerative colitis patients and healthy controls. The 2nd part consists of an evaluation of the association of levels of vitamin D3 with disease severity and quality of life in ulcerative colitis. Independent predictors of disease severity and quality of life were assessed using multiple linear regression.

Results

Vitamin D levels were significantly lower in healthy controls compared to newly diagnosed ulcerative colitis patients. Median ulcerative colitis disease activity index score was significantly higher in the vitamin D deficient group compared with those who had normal vitamin D levels (p-0.001). Quality of life was also poor in the vitamin D deficient group compared to those with normal vitamin D levels (p-0.000). Vitamin D levels were found to be independent predictors of ulcerative colitis disease activity scores and health-related quality of life scores.

Conclusion

Vitamin D may have some immunomodulating properties, which might be associated with decreased ulcerative colitis disease activity index and better quality of life.

Prospective evaluation of the diagnostic potential of LipL32 based latex agglutination test for Bovine leptospirosis

The Livestock Sector of India plays an important role in livelihood security and socioeconomic development of rural households. Leptospirosis is an important zoonotic disease responsible for septicaemia, interstitial nephritis, jaundice, abortion, reproductive problem in most of the animal species. Reproductive disturbances in bovine population is most often restricted to investigation of brucellosis, however apart from brucellosis, there are many undiagnosed diseases like leptospirosis that takes a toll in the reproductive anomalies of cattle and buffalo. Hence, the present study was elucidated to screen the seroprevalence of Leptospira in cattle and buffalo in various hamlets of North India using a user friendly screening test i.e. LipL32 latex agglutination test. The overall seropositivity was found to be 26.01% (230/884) in case of bovine in this study and the LipL32 LAT showed a profound sensitivity and specificity with level of 94.97% and 99.53% respectively.

A prospective study on incidence, risk factors, and validation of a risk score for post-infection irritable bowel syndrome in coastal eastern India

BACKGROUND AND AIM

Post-infection irritable bowel syndrome (PI-IBS) can occur following acute gastroenteritis (AGE). This study was designed to evaluate the incidence and risk factors of PI-IBS following AGE and to validate a PI-IBS risk score.

METHODS

This prospective study was performed between September 2014 and October 2016 on AGE patients by documenting their AGE severity and following up after 3 and 6 months to study the development of IBS (ROME III criteria). The risk score was calculated for all the subjects, and its discrimination ability was tested.

RESULTS

Out of 136 hospitalized AGE patients, 35 developed PI-IBS after 6 months. The factors associated with PI-IBS were younger age, longer duration of AGE, anxiety, depression, abdominal pain, bloody stool, vomiting, fever, family history of IBS, and positive stool culture (univariate analysis); however, on multivariate analysis, younger age (adjusted odds ratio [AOR] 0.5; p 0.03), prolonged duration of AGE (AOR 8.6; p 0.01), and abdominal cramps (AOR 2.1; p 0.02) were the independent factors influencing its occurrence. PI-IBS occurred even after infection with Vibrio cholerae. The PI-IBS risk score was significantly higher in patients who developed PI-IBS (72.4 ± 14.48 vs. 31.56 ± 20.4, p-value < 0.001); score > 50 had a sensitivity and specificity of 91.4% and 84.2%, respectively.

CONCLUSION

One fourth of AGE patients developed PI-IBS after 6 months. Factors influencing its development were younger age, long duration of AGE, and abdominal pain. The PI-IBS risk score had good predictive accuracy in our population.

Therapeutic management of trypanosomosis with ophthalmic involvement in a dog

The present report communicates a case of canine trypanosomosis with ophthalmic involvement, its diagnosis, hemato-biochemistry and therapeutic management in a 2 year old dog. The dog had history of bilateral corneal opacity and impaired vision since last 4 weeks. On the basis of history and clinical signs, a presumptive diagnosis of canine trypanosomosis was made followed by confirmation with Giemsa stained buffy coat smear examination. Therapeutic regimen was comprised of Diminazine aceturate @ 3.5 mg/kg deep IM for two occasions 24 h apart along with parenteral fluids, hematinics, NSAID and multivitamins which yielded favourable response by third day post-therapy. Haemato-biochemical parameters took nearly 14 days of time to return to near normal levels. Improvement with respect to corneal opacity took 6 weeks of time and the animal was followed up to 3 months without any recurrence.

Study of Methaemoglobin in Malaria Patients

To estimate the concentration of methemoglobin (MetHb) in malaria patients and correlate with severity of malaria infection. This prospective study included 30 untreated cases of malaria confirmed by Quantitative Buffy Coat (QBC) test and 30 age sex matched non-malarial cases taken as controls. All the patients underwent thorough clinical examination and routine biochemical investigation. Methemoglobin levels were estimated by spectrophotometric (co-oxymeter) method on day 1 and day 10 of diagnosis of all study group patients and correlated with clinical profile and severity. Out of 30 malaria patients 22 were males and eight were females. The clinical presentations in complicated malaria group (n = 21) were fever 21 (100 %), anemia 17 (80.95 %), renal failure 12 (52.38 %) and coma/convulsion 5 (23.8 %). The mean age of the study group was 41.66 years. Mean MetHb in complicated malaria on day 1 was 2.55 ± 1.75 % and day 10 was 10.69 ± 8.19 % (statistically significant). The overall mortality was 13 (43.33 %) among study group while 5 (16.66 %) was found among control group. Mean MetHb who died (n = 13) on day 1 was 3.144 ± 1.829 % and (n = 8) on day 10 it was 19.982 ± 8.406 %. Increase in level of methaemoglobin is detrimental to the body and is associated with increase in mortality. Routine MetHb estimation may be used as a prognostic indicator in the management of malaria patients. It is suggested that addition of drugs which reduce MetHb may be tried along with antimalarial drugs to decrease morbidity and mortality in malaria.

Prevalence of gastrointestinal parasites in bovines in and around Junagadh (Gujarat)

Coprological examination of 416 bovine faecal samples revealed the presence of parasitic stages of Toxocara vitulorum, strongyles, Strongyloides spp., Fasciola spp., amphistomes, coccidia (Eimeria spp. and Cryptosporidium spp.) and Buxtonella sulcata. About 42 % (n = 302) faecal samples from cattle and 36 % (n = 114) samples from buffaloes were positive for gastrointestinal (GI) parasitic infections. Both cattle (14.57 %) and buffalo (15.79 %) had the highest incidence of Buxtonella sulcata, respectively. The overall incidence of GI parasitic infections in young animals (below 1 year) was higher followed by older (more than 5 years) and adult animals (1-5 years) and the difference was statistically significant (p < 0.05). Non descriptive breeds of bovines showed more parasitic infections than pure breeds, the difference being statistically non-significant (p > 0.05). Season wise GI parasitic infections were recorded to be non-significantly (p > 0.05) higher in monsoon (48.38 %) followed by summer (39 %) and winter (34.61 %) in cattle. There was no significant variation of GI infections in buffaloes in relation to season though highest prevalence was documented in monsoon (44.89 %) followed by winter (35.71 %) and summer (24.32 %). Similarly, sex wise females recorded higher infection rates than males in bovines and the difference being statistically non-significant (p > 0.05).

Theileriasis in crossbred cows and its therapeutic management: first report from Lushai hill district of Mizoram

To know the prevalence of theileriosis infection, haemato-biochemical alteration and efficacy of Oxytetracycline in combination with Diaminazene aceturate injection against theileriosis in Lushai hill district of Mizoram; fifty five cross bred cattle were screened during July, 2013 to November, 2013. The prevalence of tropical theileriosis was 9.09 % based on blood smear examination. Clinical features of the disease were manifested by high rise of body temperature 104.8 ± 1.2 °F, lymphadenopathy, inability to walk, anorexia, listlessness, moderate anaemia, nasal discharge, edema of eye and corneal opacity. There were marked decline (P < 0.01) in the haemoglobin 5.28 ± 1.81 gm/dl, total erythrocytic count 2.14 ± 0.7 × 10(6)/ul, packed cell volume 18.10 ± 0.8 % and total leukocyte count 6.95 ± 1.05 × 10(3)/ul, respectively. Erythrocyte sedimentation rate was significantly increased (P < 0.01) up to 104.5 ± 12.4 mm/1st hour. The percentage of neutrophils increased 62.75 ± 2.77 and lymphocytes decreased drastically 28.69 ± 1.45 as compared with un-infected cross bred cattle. Clinically infected cattle with Theileria annulata had significantly low levels of total proteins and albumin, (P < 0.05) but AST, total, direct and indirect bilirubin, BUN, creatinine levels and Ck-MB activity were significantly high (P < 0.05). Oxytetracycline in combination with Diaminazene aceturate was found effective against T. annulata and could control fever and temperature returns to normalcy by 7th day post treatment along with some haemato-biochemical profiles. In brief, the study revealed that tropical theileriosis was prevalent in Lushai hill district of Mizoram especially among cross breed cattle and had effect on hepatic, renal and cardiac function which can be effectively controlled by Oxytetracycline and Diaminazene aceturate injection.

Extraction of nickel by microbial reduction of lateritic chromite overburden of Sukinda, India

Microbial extraction of nickel from lateritic chromite overburden (COB), Sukinda by Acidithiobacillus ferrooxidans has been investigated in this work. In anoxic environment, A. ferrooxidans reduced the ferric iron in goethite [Fe(O)OH] mineral of COB by using elemental sulphur as electron donor. Nickel embedded in the complex goethite matrix of COB was successfully recovered by cumulative action of sulphuric acid, generated by oxidation of elemental sulphur and reduction of ferric iron in goethite matrix by A. ferrooxidans. Forty one percent of the nickel present in COB was extracted in a 3 L scale bioreactor (pH of 1.8 ± 0.05, temperature of 28 ± 2°C) maintained in anoxic environment. In contrast, only 11% of the nickel present in COB was extracted with continuous supply of air to the bioreactor keeping all the parameters unchanged. Kinetics study of anoxic microbial processing of COB revealed that the chemical reaction rate control model fits to the rate of nickel dissolution (R(2)=0.975).

Accumulation of few heavy metals in sewage sludges, soils and plants of Coimbatore, Tamil Nadu (India)

A study was carried out in Coimbatore district of Tamil Nadu (India) to assess the distribution pattern of heavy metals in the soils and plants irrigated with sewage effluent/sludge. About 69 soil samples (surface and subsurface), 65 plant samples as well as 34-sewage sludge samples were collected from various tehsils of Coimbatore. Six tehsils in Coimbatore have been identified and categorized into two groups--Class I City (densely populated tehsils) and Class II city (thinly populated tehsils). The available micronutrients like Fe, Mn, Zn and Cu; heavy metals: Cr, Cd, Ni, and Pb were within the safe limits. However, the total Cr and Cd concentrations were relatively higher in the sludge samples collected from Coimbatore and Tiruppur tehsils compared to other tehsils, while for Ni, the sequence was in the order Coimbatore > Tiruppur > Palladam > Pollachi > Avinashi > Mettupalayam and for Pb, Coimbatore > Mettupalayam > Palladam > Tiruppur > Avinashi > Pollachi. Soil analysis results indicated that heavy metal concentration recorded higher level in soils of Class I city (densely populated tehsils) compared to Class II city (thinly populated tehsils). The plant samples analyzed had also registered higher concentration of total Cd, Ni and Pb, which were classified under toxic, excessive and below excessive level, respectively. Correlation analysis revealed that iron (Fe), zinc (Zn), copper (Cu), cadmium (Cd) and lead (Pb) were significantly negatively correlated with pH of soil. EC had a significant positive correlation with available iron (Fe), zinc (Zn), cadmium (Cd) and lead (Pb). A significant positive correlation of Fe, Mn, Zn, Cu, Cd and Pb was also registered with OC. Among the plant samples collected, it was evident that heavy metal concentrations were recorded higher in grass spp followed by Amaranthus spp. It was inferred from the study that soils samples had higher levels of heavy metals even though the values recorded were below the critical value/toxic limit. However, long-term and indiscriminate application of untreated (raw) sewage sludge and/or letting of sewage effluent directly to agricultural field without prior treatment may result in accumulation of toxic metals in surface and subsurface soils and subsequent biotransfer (bioaccumlation) into the food chain, it may further lead to toxicity not only to plants and animals but also to consumers of the harvested crops.

Oxidant/antioxidant balance, minerals status and apoptosis in peripheral blood of dogs naturally infected with Dirofilaria immitis

The present study was aimed to examine lipid peroxides, antioxidants, zinc, copper, iron panels and apoptosis in peripheral blood of dogs with clinical dirofilariosis. In comparison to healthy control, erythrocytic lipid peroxides level and superoxide dismutase activity were significantly (P<0.01) higher in diseased dogs. However, level of reduced glutathione and activities of glutathione peroxidase, glutathione-S-transferase and catalase were significantly (P<0.01) lower in diseased dogs. Blood zinc, copper and iron levels in dogs with dirofilariosis were significantly (P<0.01) lower than the healthy control. The percent apoptotic peripheral leukocytes were significantly higher in dogs with dirofilariosis in comparison with healthy control. From the present study, it is concluded that significant alterations in oxidant/antioxidant balance, mineral status and rate of apoptosis in peripheral blood may be implicated in the pathogenesis of clinical canine dirofilariosis.

Low awareness of cardiovascular disease risk among low-income African-American women

Focus groups were conducted with low-income African-American women in six different community settings in Northern California to assess their awareness of and concern for cardiovascular disease (CVD). These women had low awareness of the prevalence of CVD, attributed CVD to stress and low socioeconomic status, saw the media as an important source of health-related knowledge, and saw a need for more community awareness on CVD among African-American people.