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Conformity of dextrancoated fullerene C70 with L929 fibroblast cells. Colloids and Surfaces
No full textFullerene C70 with symmetric nanostructure and unique properties that open up leeway for both material science and healthcare applications. Poor water dispersity and limited knowledge about its associated toxicity hinders the biomedical scope of C70. These restraining factors need to be addressed. Dextran, natural and water-soluble polymer was used to improve the dispersity of C70 in water. Dextran coating on C70 successfully yielded stable dispersion of C70 in water with remarkable cytocompatibility with L929 fibroblast cells. The dextran-coated C70 was characterized using different characterization techniques such as fourier transformed-infrared spectroscopy (FT-IR), transition electron microscopy (TEM), dynamic light scattering (DLS) and zeta potential. The cell viability assays suggested that the L929 cells retained more than 80% cell viability after 24 h treatment with dextran-coated C70. The mitochontrial membrane potential of the treated cells were found to be uncompromised. Fluorescent imaging techniques done with the aim of evaluating the integrity of lysosomes detected no potential toxicity in L929 cells treated with dextran-coated C70. Actin filaments showed intact organelles when viewed using Rhodamine- phalloidin staining after 24 h post-treatment. DAPI staining also revealed the integrity of nucleus after exposure to dextran-coated C70. The calcein AM/PI flow cytometry analysis further confirmed that dextran-coated C70 kept cell viability of treated cells above 80% for all concentrations. The results points out the scope of dextran-coated C70 for various health care applications
Study of the predictors of rupture of a specific aneurysm in a patient diagnosed with multiple aneurysms - a prospective exploratory observational study
No full textCerebral aneurysms rupture leads to subarachnoid hemorrhage which leads to
significant morbidity and mortality.
The outcome after subarachnoid hemorrhage due to aneurysmal rupture is still
poor; mortality rates ranges from 40-50%, severe disability in 10-20% and only 40%
reach independent status1,2
. Contributing causes to mortality and morbidity is bleed,
rebleed, vasospasm and cerebral ischemia.
Thereby “prevention is better than cure” can be applied for cerebral aneurysms
if causative factors are known and will result in effective treatment of this patients.
Predictive factors for bleeding in aneurysm are studied well in literature series.
Multiple intracranial aneurysms occur in approximately one third (15–45%) of
patients presenting with Subarachnoid hemmorhage.
3,4,9 The exact mechanism of
intracranial aneurysm formation per se remains obscured; however, congenital and/or
acquired degenerative changes in the arterial wall have been implicated.5,6,7
The presence of multiple aneurysms is sometimes associated with poor
outcome because of the complex management issues that are involved and the higher
incidence of complications arising from both the hemorrhage and any treatment 6
.
It follows, therefore, that the identification of modifiable risk factors for
formation of multiple aneurysms is important and has implications both for the
prevention of SAH and a more detailed understanding of the pathogenesis of multiple
cerebral aneurysms. It is also important to know which aneurysm has bled so as to
deal with it at first.
Consideration of radiological and clinical parameters is necessary for the
assessment of the rupture. Many criteria on the basis of radiology i.e angiographic
studies has been taken into account such as shape, size, location . neck, aspect ratio,
etc have been evaluated in various studies. 6,7,8 Clinical assessment is also carried out in many studies for the same such as
age, gender, cigarette smoking, alcohol, familial, hypertension, collagen vascular
diseases, etc.3,4 ,5
Cerebrovascular disease risk factors such as hypertension, cigarette smoking,
and alcohol consumption have been shown to increase the risk of SAH and
spontaneous intracerebral hematoma.5
However, the role of these risk factors in the formation of multiple, as opposed
to single, aneurysms is less well defined. To have an insight of this factors
determining rupture of specific aneurysm we carried out a prospective exploratory
study of multiple aneurysm in our institute
Synthesis and Evaluation of Multifunctional Nanothiomatrices For an Efficient Antitumor Therapy
No full textAlcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
No full textBackground
Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.
Methods
Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.
Findings
Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week.
Interpretation
Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
Funding
Bill & Melinda Gates Foundation
GBD 2017 SDG Collaborators. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden.
No full textBackground
Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment.
Methods
We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator.
Findings
The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030.
Interpretation
The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
Funding
Bill & Melinda Gates Foundation
Outcomes of Post Closed Mitral Valvotomy Mitral Valve Replacement- A retrospective cohort study
No full textPreclinical evaluation of hydrogel sealed fluropassivated indigenous vascular prosthesis
No full textBackground & objectives: Polyethylene terephthalate (PET) graft, designed and developed at our
institute for vascular reconstruction, is porous to promote optimal incorporation and neointima
formation, requiring pre-clotting or biomodification by sealing the pores before implantation. The
objective of this study was to characterize, test and perform preclinical evaluation of hydrogel
(alginate dialdehyde cross-linked gelatin) sealed fluoropassivated PET vascular prosthesis in pig model,
so as to avoid pre-clotting, for its safety and efficacy before employing the indigenous and less expensive
graft for clinical use.
Methods: Hydrogel sealed, fluoropassivated PET vascular prosthesis were tested for haemocompatibility
and toxicity followed by small animal toxicology tests and in vivo experiments in pigs receiving
implantation at thoracic aorta. All 33 animals received test as well as control grafts with a plan for
phased explantation at 2, 12 and 26 weeks. All animals underwent completion angiogram at the end of
procedure as well as before graft explantation.
Results: Haemocompatibility tests for haemolysis and toxicity tests showed no adverse events in tested
mice and rabbits. Completion angiogram showed intact anastamosis and patent graft in each animal
in post-operative period and at explantation. Gross and histopathological examination showed wellencapsulated
grafts, clean glistening neointima and no evidence of thrombus in both test and control
grafts.
Interpretation & conclusions: Hydrogel sealed, fluoropassivated PET vascular prosthesis was found
non-toxic, haemocompatible and remained patent in in vivo studies at planned intervals
Effect of combined visual-auditory-sensory stimulation in hemineglect syndrome following right hemispheric ischemic strokes: a randomized controlled trial
No full textPreparation of hydroxyapatite porous scaffolds from a coral like synthetic inorganic precusrsor for use as a bone graft substitute and a drug delivery vehicle
No full textA novel surfactant free hydrothermal method was developed for the preparation of large hydroxyapatite scaffolds. Synthetic calcium carbonate (calcite) was used as the starting material which when mixed with an inorganic setting solution containing phosphoric acid and sodium hydroxide forms the porous precursor body with pore size 20-700 μm. The porous precursor body was then hydrothermally converted to hydroxyapatite scaffolds when treated in basic phosphate solution of pH 10.5 at 150 °C and 15 bar pressure maintaining the structural stability and integrity. X-ray diffraction and the Fourier transform infrared spectroscopy confirmed that the developed material consist of single phase crystalline hydroxyapatite. Surface morphology and microstructures were studied using scanning electron microscopy and porosity was evaluated by micro CT analysis. The cell material interactions evaluated by cell viability assays and live cell staining methods confirmed the cell compatibility. The drug release study at physiological pH implied that the developed materials could be promising in sustained long-term release. The results emerged have shown that the hydrothermal conversion of inorganic coral-like precursor is effective to produce porous bioactive hydroxyapatite scaffolds for bone regeneration as well as drug delivery vehicles for the treatment of infectious bone diseases such as osteomyelitis
Medical Application of Engineered Nanoparticles
No full textNanoparticles (NPs) are the particles that exist on a nanometer scale i.e. at least one dimension must be below 100 nm. Due to
smaller size, they are highly reactive and show exceptional physical, chemical and optical properties compared to the bulk materials.
These remarkable properties make them attractive candidate in various medical applications. Nowadays Nano medicine is a widely
developing branch of science which deals with nanoparticle application in medical field. This review highlight the importance of
engineered nanoparticles (ENPs) in various medical applications such as drug delivery, antimicrobial agents, photothermal therapy,
magnetic hyperthermia, contrast agents in various imaging techniques and biosensors. Currently many NPs are under investigation
for drug and gene delivery. Silver, quantum dots (QDs), nano-TiO2 etc. are used as biofilm therapeutic agents. ENPs like QDs act as
theranostic agent i.e. they act as both diagnostic as well as therapeutic agent. ENPs have significant role in imaging techniques like
MRI, CT scan etc. The risks related with the application of ENPs in various medical applications are not explored much and hence
safety evaluation is mandatory before its clinical application