Publications by authors named "Akanksha Singh"

124 Publications

Risk factors for mortality in critically ill infants with acute kidney injury: A resource-limited setting experience.

Ther Apher Dial 2021 Jul 22. Epub 2021 Jul 22.

Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

Infants with acute kidney injury (AKI) who are critically ill often will have multiorgan dysfunctions. Objective of the present study was to find out mortality, recovery of kidney function at discharge and at 3 months, and to determine risk factors for mortality. Fifty-two infants (24 newborns and 28 postneonatal) with AKI were included. Staging was done as per Kidney Disease Improving Global Outcomes classification. Patients were subjected to medical treatment and peritoneal dialysis (PD), wherever indicated. Kidney function tests were performed at admission, discharge, and at 3 months follow-up. Median age of neonates was 8 days and postneonatal infants were 4.5 months. Stage 1, 2, and 3 AKI were present in 14 (26.9%), 16 (30.7%), and 22 (42.3%) cases, respectively. PD was required in 22 (42.3%) infants, and significantly higher in postneonatal than in neonates (57.1% vs. 25%, p < 0.05). Significant recovery of kidney function occurred at discharge and cases had normal parameters at 3 months. Mortality was 17.3%. Patients had significantly higher risk of mortality, if they had metabolic acidosis (OR 13.22, CI 2.33-74.94, p = 0.002) and needed ventilation (OR 14.93, 95% CI 1.7-130.97, p = 0.006) and PD (OR 6.53, 95% CI 1.20-35.48, p = 0.026). In logistic regression analysis, fluid overload (p < 001), hypotension (p < 0.01), and higher PRISM-III score (p < 0.05) were found as significant risk factors for mortality. Medical management including PD led to good recovery of kidney function. Presence of fluid overload, hypotension, and higher PRISM-III score adversely affected the outcome.
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http://dx.doi.org/10.1111/1744-9987.13712DOI Listing
July 2021

Osteopetrosis and renal tubular acidosis: Answers.

Pediatr Nephrol 2021 Jul 12. Epub 2021 Jul 12.

Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

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http://dx.doi.org/10.1007/s00467-021-05185-7DOI Listing
July 2021

Osteopetrosis and renal tubular acidosis: Questions.

Pediatr Nephrol 2021 Jul 12. Epub 2021 Jul 12.

Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

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http://dx.doi.org/10.1007/s00467-021-05159-9DOI Listing
July 2021

Developing a "dry lab" activity using lower body negative pressure to teach physiology.

Adv Physiol Educ 2021 Sep;45(3):445-453

Department of Physiology, Autonomic Function Laboratory, All India Institute of Medical Sciences, New Delhi, India.

In this paper we assessed how lower body negative pressure (LBNP) can be used to teach students the physiological effects of central hypovolemia in the absence of the LBNP and/or a medical monitor using a "dry lab" activity using LBNP data that have been previously collected. This activity was performed using published LBNP papers, with which students could explore LBNP as an important tool to study physiological responses to central hypovolemia as well as consider issues in performing an LBNP experiment and interpreting experimental results. The activity was performed at the All India Institute of Medical Sciences, New Delhi, with 31 graduate students and 4 teachers of physiology. Both students and teachers were provided with a set of questionnaires that inquired about aspects related to the structure of the activity and how this activity integrated research and knowledge, as well as aspects related to motivation of the students and teachers to perform the activity. Our results from student and teacher surveys suggest that a "dry lab" activity using LBNP to teach physiology can be an important tool to expose students to the basics of systems physiology as well as to provide useful insights into how research is performed. Providing insight into research includes formulating a research question and then designing (including taking into account confounding variables), implementing, conducting, and interpreting research studies. Finally, developing such an activity using LBNP can also serve as a basis for developing research capacities and interests of students even early in their medical studies.
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http://dx.doi.org/10.1152/advan.00123.2020DOI Listing
September 2021

Perceptions of Endocrine Therapy in African-American Breast Cancer Survivors: Mixed Methods Study.

JMIR Form Res 2021 Jun 11;5(6):e23884. Epub 2021 Jun 11.

College of Nursing, University of South Carolina, Columbia, SC, United States.

Background: Although the incidence of breast cancer is lower in African-American women than in White women, African-American women have a decreased survival rate. The difference in survival rate may stem from poor endocrine therapy adherence, which increases breast cancer recurrence. Therefore, accessible and culturally sensitive interventions to increase endocrine therapy adherence are necessary.

Objective: The purpose of this concurrent convergent mixed methods study was to provide further data to guide the development of the proposed culturally sensitive mHealth app, STORY+ for African-American women with breast cancer.

Methods: We recruited 20 African-American women diagnosed with estrogen-positive breast cancer and currently prescribed endocrine therapy. We used a concurrent convergent data collection method to (1) assess the use of smartphones and computers related to health care and (2) identify foundational aspects to support endocrine therapy adherence for incorporation in a mobile health app.

Results: Overwhelmingly, the participants preferred using smartphones to using computers for health care. Communicating with health care providers and pharmacies was the most frequent health care use of smartphones, followed by exercise tracking, and accessing the patient portal. We identified 4 aspects of adherence to endocrine therapy and smartphone use for incorporation in app development. The factors that emerged from the integrated qualitative and quantitative data were (1) willingness to use, (2) side effects, (3) social connection, and (4) beliefs about endocrine therapy.

Conclusions: Further research is needed to develop a culturally sensitive app for African-American women with breast cancer to improve adherence to endocrine therapy. Our work strongly suggests that this population would use the app to connect with other African-American breast cancer survivors and manage endocrine therapy.
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http://dx.doi.org/10.2196/23884DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235283PMC
June 2021

Concentrations, transport characteristics, and health risks of PM-bound trace elements over a national park in central India.

J Environ Manage 2021 Sep 4;293:112904. Epub 2021 Jun 4.

Center for Research on Environment and Sustainable Technologies, Indian Indstitute of Science Education and Research Bhopal, India; Earth and Environmental Sciences, Indian Institute of Science Education and Research Bhopal, Bhauri, Bhopal, 462 066, India. Electronic address:

Fine particulate matter (PM) mass and its chemical constituents were measured over Van Vihar National Park (VVNP) in Bhopal, central India. Fine PM collected over two years onto Teflon filters using a Mini-Vol® sampler were analyzed for trace elements using an Energy Dispersive X-ray fluorescence (ED-XRF) spectrometer. The temporal behaviour, dry deposition fluxes and transport pathways of elements, in addition to their health risks were examined in this study. S, K, Si, Al, Ca, and Fe accounted for most of the PM-bound trace elements (~88% on average). Pronounced seasonality was observed for major elements (S, K, and Cl) and reconstructed soil (estimated as the sum of oxides of crustal elements, i.e., Si, Al, Ca, Fe, and Ti), with winter and post-monsoon season highs, potentially due to source strengths and favourable metrology during these seasons. The synoptic meteorology during these seasons favoured the fetch of particles from highly polluted regions such as the Indo-Gangetic Plain. The estimated average dry depositional flux of each element in this study was comparable to those measured/estimated for each of these species over other urban areas. The sum of the dry deposition flux for crustal elements (1301.9 ± 880.7 μg m d) was in agreement with global dust cycle models. Air-parcel trajectory cluster analysis revealed that S, K, and Cl were influenced by biomass and coal burning in predominantly in central, and northwestern India, while reconstructed soil was influenced by air masses from the Arabian and Thar deserts. Finally, human exposure risk assessment to carcinogens (As, Cr, Cd, Pb and Ni) and non-carcinogens (Cu, Zn, Mn, V, Hg, Se and Al) revealed that no significant risk was posed by these elements. The assessment in this study was a screening for severe adverse effects, rather than a speciated health assessment. Thus, over the study region, monitoring, health risk assessment and mitigation measures, where needed, must be enhanced to ensure that trace elements induced health effects continue to be within safe levels.
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http://dx.doi.org/10.1016/j.jenvman.2021.112904DOI Listing
September 2021

Comparison of Propofol and Ketofol on Transcranial Motor Evoked Potentials in Patients Undergoing Thoracolumbar Spine Surgery.

Asian Spine J 2021 May 20. Epub 2021 May 20.

Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India Study.

Study Design: This was a double-blind randomized study.

Purpose: The primary purpose was to compare the effects of propofol and ketofol on amplitudes and latencies of transcranial motor evoked potentials (TcMEPs) during thoracolumbar spine surgery. In addition, intraoperative hemodynamics and muscle power were compared.

Overview Of Literature: Propofol is commonly used during intraoperative TcMEP monitoring. However, propofol inhibits TcMEP amplitudes and causes hypotension in a dose-dependent fashion.

Methods: Amplitude and latency of TcMEPs were recorded bilaterally from the abductor pollicis brevis (APB) and abductor hallucis (AH) muscles in 38 adult American Society of Anesthesiologists I and II patients undergoing thoracolumbar spine surgery. Baseline recordings of TcMEPs in both groups were recorded under propofol infusion. Group X patients then received propofol and fentanyl (1 mcg/kg/hr), and group Y patients received ketofol and fentanyl (1 mcg/kg/hr). Bispectral index was maintained at 40-60 in both groups. Amplitude and latency were recorded at 30 minutes intervals for 2 hours.

Results: Propofol caused no significant changes in amplitude and latency in any muscle. In contrast, amplitude increased significantly at all time points in the bilateral APB muscles and 60, 90, and 120 minutes in the left AH muscle without changes in latency in response to ketofol. When the two groups were compared, ketofol induced significantly higher amplitudes at 60, 90, and 120 minutes in the (left) APB, at all time points in the (right) APB, and at 120 minutes in both AH muscles, compared with propofol. Blood pressures were lower and fluid and vasopressor requirements were higher in group X. Muscle power was similar between the two groups.

Conclusions: Ketofol facilitates TcMEP amplitudes without affecting latency. Use of ketofol resulted in a better and more stable hemodynamic profile than did use of propofol.
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http://dx.doi.org/10.31616/asj.2020.0562DOI Listing
May 2021

Predictive value of intraoperative D-wave and m-MEP neurophysiological monitoring in patients with preoperative motor deficits in immediate and late postoperative period.

J Craniovertebr Junction Spine 2021 Jan-Mar;12(1):26-32. Epub 2021 Mar 4.

Department of Neuroanaesthesia and Critical Care, All India Institute of Medical Sciences, New Delhi, India.

Background: Presence of preoperative motor deficits in patients poses a distinct challenge in monitoring the integrity of corticospinal tracts during spinal surgeries. The inconsistency of the motor-evoked potentials is such patients, limits its clinical utility. D-wave is a robust but less utilized technique for corticospinal tract monitoring. The comparative clinical value of these two techniques has not been evaluated in the patients with preoperative deficits.

Objectives: The objective of the study was to compare the predictive utility of myogenic Motor Evoked Potentials (m-MEP) and D-wave in terms of recordability and their sensitivity and specificity in predicting transient and permanent new motor deficits.

Materials And Methods: Thirty-one patients with preoperative motor deficit scheduled to undergo spinal surgery were included in the study. Intraoperative m-MEP and D-wave changes were identified and correlated with postoperative neurology in the immediate postoperative period and at the time of discharge.

Results: The mean preoperative motor power of the patient pool in left and right lower limb was 2.97 ± 1.56 and 3.32 ± 1.49, respectively. The recordability of m-MEPs and D-wave was observed to be 79.4% and 100%, respectively. The m-MEP predicted the motor deterioration in immediate postoperative period with 100% sensitivity and 80% specificity, while D-wave had 14% sensitivity and 100% specificity. At the time of discharge, m-MEPs' specificity reduced to 61%, while D-wave demonstrated 100% specificity.

Conclusions: D-wave has a better recordability than m-MEPs in neurologically compromised patients. D-wave predicts development of long-term deficits with 100% specificity, while m-MEPs have a high sensitivity for transient neurological deficit. A combination of D-wave and m-MEP is recommended for monitoring the integrity of the corticospinal tract in patients with preoperative motor deficits.
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http://dx.doi.org/10.4103/jcvjs.JCVJS_76_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035592PMC
March 2021

The Efficiency of Plant Defense: Aphid Pest Pressure Does Not Alter Production of Food Rewards by Okra Plants in Ant Presence.

Front Plant Sci 2021 15;12:627570. Epub 2021 Mar 15.

Chair for Terrestrial Ecology, Department of Ecology and Ecosystem Management, Technische Universität München, Freising, Germany.

Pearl bodies are produced by some plant species as food reward for ants and in exchange, ants defend these plants against insect pests. Sap-sucking pests such as aphids also excrete honeydew as food reward for ants, leading to potential conflict where ants could preferentially defend either the plant or the aphid. How pest insects might influence plant pearl body production, is yet to be investigated. Okra is a widely consumed vegetable worldwide and is attacked by the ant-tended cotton aphid. The plants produce pearl bodies, which are predominantly found on the underside of the leaves and formed from epidermal cells. We conducted a set of field and greenhouse experiments to explore plant-aphid-ant interactions, their influence on pearl body production and resulting performance of okra plants, across okra varieties. We found that ants of genus, which are dominant in okra fields, preferred pearl bodies over aphid honeydew; although, their highest abundance was recorded in presence of both these food rewards, and on one okra variety. Removal of pearl bodies from the plants increased their production; however, plant growth and chlorophyll content were negatively associated with pearl body replenishment. Potentially to mitigate this resource cost, plants developed such a novel defense response because we found that aphid presence reduced pearl body production, but only when there were no ants. Finally, aphids negatively affected plant performance, but only at very high densities. As aphids also attract ants, plants may tolerate their presence at low densities to attract higher ant abundances. Our study highlights that plants can adapt their defense strategies in pest presence for efficient resource use. We suggest that understanding pearl body associated interactions in crop plants can assist in using such traits for pest management.
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http://dx.doi.org/10.3389/fpls.2021.627570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005652PMC
March 2021

Nanotechnology-based approaches applied to nutraceuticals.

Drug Deliv Transl Res 2021 Mar 18. Epub 2021 Mar 18.

Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India.

Nutraceuticals and food industries are opening to a tremendously upcoming technology in the field of "Nano science". A new prospect has been defined by nanotechnology by conferring modified properties of nanomaterials and its application in the development of nanoformulations, nutritional supplements and food industry. Nanomaterials reveal exclusive properties because of their small size and high surface/volume ratio; thus, they have a complete application in nutraceuticals and food sector. In the existent review article, we obligate to present a comprehensive outline of the application of nanomaterials in development of advanced nano-based nutraceuticals with enhanced bioavailability, solubility, improved encapsulation efficiency, increased stability, sustained and targeted drug delivery, protection against degradation and microbial contamination and with improved pharmacological activity. It also highlights the importance of nanomaterials as nanosensors/nano-bio sensors for encapsulating peptides, antibodies, enzymes, etc. and in the food packaging industry and its future application. Thus, the review aims to focus on the benefits and new dimensions provided by nanomaterials and nanotechnology in health sectors by improving treatment strategies and quality of life.
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http://dx.doi.org/10.1007/s13346-021-00960-3DOI Listing
March 2021

Deciphering the key mechanisms leading to alteration of lipid metabolism in Drosophila model of Huntington's disease.

Biochim Biophys Acta Mol Basis Dis 2021 Jul 17;1867(7):166127. Epub 2021 Mar 17.

Department of Zoology, University of Delhi, Delhi 110007, India. Electronic address:

Huntington's disease (HD) is an inherited, progressively debilitating disorder marked by prominent degeneration in striatal and cortical brain regions. HD is caused by (CAG) repeat expansion in huntingtin (HTT) gene that translates into a mutant form of the ubiquitously present Huntingtin (HTT) protein. Extensive metabolic dysfunction coexisting with overt neuropathies has been evidenced in clinical and experimental settings of HD. Body weight loss despite normal to high caloric intake remains a critical determinant of the disease progression and a challenge for therapeutic interventions. In the present study, we intended to monitor the cellular and molecular perturbations in Drosophila, caused by pan-neuronal expression of mHTT (mutant Huntingtin) protein. We found aberrant transcription profile of key lipolytic and lipogenic genes in whole-body of the fly with disease progression. Interestingly, fatbody undergoes extensive alteration of vital cellular processes and eventually surrenders to increased apoptotic cell death in terminal stage of the disease. Extensive mitochondrial dysfunction from early disease stage along with calcium derangement at terminal stage were observed in fatbody, which contribute to its deteriorating integrity. All the mechanisms were monitored progressively, at different disease stages, and many alterations were documented in the early stage itself. Our study hence provides insight into the mechanisms through which neuronal expression of mHTT might be inflicting the profound systemic effects, specifically on lipid metabolism, and may open new therapeutic avenues for alleviation of the multidimensional disease.
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http://dx.doi.org/10.1016/j.bbadis.2021.166127DOI Listing
July 2021

Effect of the Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (NIFTP) Nomenclature Revision on Indian Thyroid Fine-Needle Aspiration Practice.

Am J Clin Pathol 2021 Jul;156(2):320-327

Endocrine Surgery, King George's Medical University, Lucknow, India.

Objectives: To analyze risk of malignancy (ROM) in Bethesda categories (BCs) and the impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) reclassification on malignancy risk and surgical outcome.

Methods: In this retrospective study based on fine-needle aspiration samples with histologic follow-up, ROM was analyzed in BCs. Possible cases of NIFTP were reviewed, followed by the analysis of impact of this reclassification on ROM in BCs.

Results: The incidence of NIFTP was 6.9% among excised thyroid nodules and 16.8% among all resected neoplastic lesions. ROM for BCs I to VI was 37.5%, 9.6%, 40.0%, 46.5%, 88.8%, and 96.8%, respectively. Risk of neoplasia was 50.0%, 13.8%, 55.0%, 71.2%, 88.8%, and 96.8% respectively. When NIFTPs were considered nonmalignant lesions, ROM decreased by 6.3%, 4.3%, 20%, 19.1%, 22.5%, and 1.5% in each Bethesda category (I-VI), respectively. Inability to diagnose NIFTP preoperatively led to overtreatment in 16.2%.

Conclusions: Prevalence of NIFTP in Asian countries may be higher than expected. Substantial cases of NIFTP have a benign preoperative cytology; hence, cases of follicular adenoma and adenomatous colloid nodule should be included in the review. NIFTP reclassification has significantly reduced the ROM in indeterminate BCs, suggesting diagnostic lobectomy rather than total thyroidectomy. Countries should establish their own malignancy risk range and parameters.
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http://dx.doi.org/10.1093/ajcp/aqaa241DOI Listing
July 2021

Graphene nanoplatelets embedded polymer: An efficient endodontic material for root canal therapy.

Mater Sci Eng C Mater Biol Appl 2021 Feb 8;121:111864. Epub 2021 Jan 8.

CSIR-National Environmental Engineering Research Institute, Nehru Marg, Nagpur 440020, India. Electronic address:

The design and preparation of clinically relevant endodontic obturating material for root canal therapy is a great challenge. For the first time, we report a new polymer nanocomposite which was prepared by using reversible addition-fragmentation chain-transfer (RAFT) polymerization of methacrylic acid and methylene glycol dimethacrylate. The polymer was embedded with reduced graphene oxide nanoplatelets (rGO). These graphene nanoplatelets were embedded in the polymers (GNPs) have shown the tensile strength (27--36%) and the elongation at break 2.1 - 3.1% is quite similar to the commercial gutta percha (GP-C). Atomic force micrograph provided interesting information related to scattering of rGO flakes in GNPs and the surface of GNP contains crystalline spikes of height varied between 0.95 and 1.26 μm. These spikes improved the adhesion of GNPs to bio-interface. The GNPs were 95% more effective in inhibiting bacterial colonization without disturbing the nearby cell integrity compared to commercial GP. It was found that the GNPs after incubation of 24 h at 37 °C, the radius of the inhibition zone was 6.8 mm and 4.3 mm for E.coli and S. aureus, respectively indicating better effective antibacterial activity than the GP-C. This work offers biocompatible, better adhesive and antibacterial endodontic obturating material for future root canal therapy.
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http://dx.doi.org/10.1016/j.msec.2021.111864DOI Listing
February 2021

Standard-Volume Plasma Exchange Improves Outcomes in Patients With Acute Liver Failure: A Randomized Controlled Trial.

Clin Gastroenterol Hepatol 2021 Jan 29. Epub 2021 Jan 29.

Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India. Electronic address:

Background: High volume plasma-exchange (HVPE) improves survival in patients with acute liver failure (ALF), but apprehension regarding volume overload and worsening of cerebral edema remain.

Methods: In an open-label randomized controlled trial, 40 consecutive patients of ALF were randomized 1:1 to either standard medical treatment (SMT) or SMT with standard-volume plasma-exchange (SVPE). SVPE was performed using centrifugal apheresis [target volume of 1.5 to 2.0 plasma volumes per session] until desired response was achieved. Cerebral edema was assessed by brain imaging. Results were analyzed in an intention-to-treat analysis. Primary outcome was 21-day transplant-free survival. The levels of cytokines, damage-associated molecular patterns (DAMPs) and endotoxins were analyzed at baseline and day 5.

Results: ALF patients [aged 31.5 ± 12.2 years, 60% male, 78% viral, 83% hyperacute, 70% with SIRS were included. At day 5, SVPE [mean sessions 2.15 ± 1.42, median plasma volume replaced 5.049 L] compared to SMT alone, resulted in higher lactate clearance (p = .02), amelioration of SIRS (84% vs. 26%; P = .02), reduction in ammonia levels [(221.5 ± 96.9) vs.(439 ± 385.6) μg/dl, P = .02) and SOFA scores [9.9(±3.3) vs. 14.6(±4.8); P = .001]. There were no treatment related deaths. SVPE was associated with a higher 21-day transplant free-survival [75% vs. 45%; P = .04, HR 0.30, 95%CI 0.01-0.88]. A significant decrease in levels of pro-inflammatory cytokines and an increase in anti-inflammatory cytokines along with a decrease in endotoxin and DAMPs was seen with SVPE.

Conclusion: In ALF patients with cerebral edema, SVPE is safe and effective and improves survival possibly by a reduction in cytokine storm and ammonia. ClinicalTrial.gov (identifier: NCT02718079).
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http://dx.doi.org/10.1016/j.cgh.2021.01.036DOI Listing
January 2021

Integrated Digital Patient Education at the Bedside for Patients with Chronic Conditions: Observational Study.

JMIR Mhealth Uhealth 2020 12 22;8(12):e22947. Epub 2020 Dec 22.

Department of Medicine, School of Medicine, University of South Carolina, Columbia, SC, United States.

Background: Patient education delivered by a health care provider increases patients' understanding and adherence to medical instructions, which helps to improve patient health. Multiple challenges exist to delivering effective patient education to patients with multiple chronic conditions, including giving the necessary time, range, and types of learning materials, and assessing the level of understanding. To help overcome these challenges, it is important to study new electronic means to assist in patient education, such as the use of mobile devices, interactive media, 3-dimensional images, and multimedia educational content at the bedside.

Objective: The goal of this study was to address the need for blended learning strategies combining technical and workflow integration of digital patient education systems for patients with chronic conditions within and across the regular process of care. Studies are needed to evaluate the utility and benefits of these technologies for providers and patients alike.

Methods: A mixed-methods approach was employed including survey administration to 178 patients after they received digital patient education in person with a health care provider, and qualitative interviews with 16 nurse educators who used the mobile digital health education technology to deliver instruction to patients. Patient survey data were analyzed using chi-square statistical tests. Qualitative interviews were analyzed for user acceptance and perceived value themes.

Results: Patients who were counseled using a blended digital health education approach reported improved understanding of educational content (P=.034) and chronic health conditions (P<.001), were more motivated to care for themselves at home (P<.001), were more likely to say that they felt capable of making health care decisions with their doctors (P<.001) and on their own (P=.001), and were more likely to report their intention to follow their doctor's instructions (P<.001) than were patients whose education was not computer-based. Nurse educators felt that the digital education system and content enhanced their education efforts and could be easily integrated into the outpatient clinical workflow.

Conclusions: Patient education for individuals with chronic conditions may be more effective than traditional formats when provided in blended digital formats supervised by a health care provider.
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http://dx.doi.org/10.2196/22947DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785403PMC
December 2020

Zingiber zerumbet L. essential oil-based chitosan nanoemulsion as an efficient green preservative against fungi and aflatoxin B contamination.

J Food Sci 2021 Jan 13;86(1):149-160. Epub 2020 Dec 13.

Laboratory of Herbal Pesticides, Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India.

The present study envisages the potential application of chitosan-coated Zingiber zerumbet essential oil nanoemulsion (ZEO-CsNE) as green antimicrobial preservative against Aspergillus flavus, aflatoxin B (AFB ), and lipid peroxidation of stored functional foods. GC-MS analysis of ZEO exhibited the abundance of cis-geraniol (15.53%) as the major component. ZEO-CsNE showed biphasic release profile during in vitro release study conducted for 10 days. The ZEO-CsNE inhibited the growth of A. flavus (strain AF-LHP-SH1) and AFB production at 1.0 and 0.8 µL/mL, respectively. Interestingly, considerable reduction in ergosterol biosynthesis followed by enhanced leakage of vital cellular contents and methylglyoxal inhibition represents novel antifungal and antiaflatoxigenic mechanism of action, respectively. Further, ZEO-CsNE inhibited lipid peroxidation and AFB production in postharvest Salvia hispanica seeds during in situ trial and presented favorable safety profile (median lethal dose [LD ] = 29,114 µL/kg) for male mice. Based on overall observations, ZEO-CsNE could be recommended as a green antimicrobial substitute of synthetic preservatives for in vitro and in situ protection of functional food samples. PRACTICAL APPLICATION: Food industries are facing enormous amount of burden coming from fungal and aflatoxin contamination that can cause severe adverse effects to humans. Essential oils (EOs) are well known for their food preservative efficacy; however, some limitations such as oxidative instability in open system may limit their application directly into food system. The encapsulation of the EOs into polymeric matrix could provide a barrier that will protect the EOs from degradation. This research could provide a basis for utilization of EO after encapsulation into chitosan nanoemulsion for industrial-scale application for preservation of stored functional foods from fungal and aflatoxin contamination.
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http://dx.doi.org/10.1111/1750-3841.15545DOI Listing
January 2021

Discriminatory alteration of carbohydrate homeostasis by gold nanoparticles ingestion in .

Toxicol Ind Health 2020 Oct 17;36(10):769-778. Epub 2020 Aug 17.

Department of Zoology, 28742University of Delhi, Delhi, India.

With the extensive usage of gold nanoparticles (AuNPs) in various industrial sectors and biomedical applications, evaluation of their possible effects on human health becomes imperative. Therefore, the present study was aimed toward assessing the dose-dependent impact of AuNPs ingestion on metabolic homeostasis using as a model system. We found that larval ingestion of higher dose of AuNPs significantly reduced body weight. Further analysis of the crucial energy reservoir showed selective alteration in carbohydrate levels without any change in the lipid and protein levels. Transcriptional downregulation of glycogen synthase further supported impaired glycogen metabolism in flies supplemented with higher dose of AuNPs. Additionally, ingestion of higher dose of AuNPs in larvae results in significantly increased levels of reactive oxygen species (ROS) in the peripheral tissues, suggestive of stress condition. Our findings clearly imply that supplementing higher doses of AuNPs at an early developmental stage can potentially cause weight loss, impair glycogen metabolism, and elevate ROS production. Therefore, determination of a biologically effective dose is critical for the safety of mankind and vulnerable populations at the workplace.
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http://dx.doi.org/10.1177/0748233720947211DOI Listing
October 2020

Anti-atherogenic effect of Nepitrin-7-O-glucoside: A flavonoid isolated from Nepeta hindostana via acting on PPAR - α receptor.

Steroids 2021 01 21;165:108770. Epub 2020 Nov 21.

Prin. K. M. Kundnani College of Pharmacy, Rambhau Salgaonkar Marg, Cuffe Parade, Mumbai, Maharashtra 400005, India.

Atherogenic dyslipidemia is a condition and responsible for the induction of major cardiovascular diseases. Traditionally, Nepeta hindostana a medicinal plant commonly used as cardioprotective in Indo-Pak regions has gained importance because of its therapeutic active flavonoid Nepitrin-7-O-glucoside. Flavonoid-glycosides are steroids having the ability to exert specific, decisive action on the cardiac muscle. In the present research work flavonoid, Nepitrin-7-O-glucoside was isolated from methanolic extract via chromatographic techniques. The structure was elucidated and confirmed by different spectral techniques like Mass and H NMR spectrometry. Various preclinical atherosclerosis parameters such as lipid levels, SGOT/SGPT, body weight, histology of aorta and heart were estimated and beneficial effect of Nepitrin in high-fat diet (HFD) induced atherosclerosis for six weeks were observed. Outcomes of the preclinical results showed and proved that Nepitrin significantly improved dyslipidemia at an effective dose of 50 mg/kg as compared with HFD control and Simvastatin. Molecular docking showed significant binding affinity towards the target PPAR-α receptor (PDB: 2P54). Further the docked ligands with PDB: 2P54 were exposed to molecular dynamics studies to confirm the dynamic behaviour of PPAR-α receptor. Outcomes of the results of the in-vivo study and molecular dynamics study were in correlation with each-others. Further, it can be concluded that Nepitrin has a potent antiatherogenic agent and act by reducing the lipid levels via acting on PPAR-α receptor and regenerating the damaged cells.
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http://dx.doi.org/10.1016/j.steroids.2020.108770DOI Listing
January 2021

Genome-Wide Association Analysis for Phosphorus Use Efficiency Traits in Mungbean ( L. Wilczek) Using Genotyping by Sequencing Approach.

Front Plant Sci 2020 29;11:537766. Epub 2020 Oct 29.

Division of Crop Science, Indian Council of Agricultural Research, New Delhi, India.

Mungbean ( L. Wilczek) is an annual grain legume crop affected by low availability of phosphorus. Phosphorus deficiency mainly affects the growth and development of plants along with changes in root morphology and increase in root-to-shoot ratio. Deciphering the genetic basis of phosphorus use efficiency (PUE) traits can benefit our understanding of mungbean tolerance to low-phosphorus condition. To address this issue, 144 diverse mungbean genotypes were evaluated for 12 PUE traits under hydroponics with optimum- and low-phosphorus levels. The broad sense heritability of traits ranged from 0.63 to 0.92 and 0.58 to 0.92 under optimum- and low-phosphorus conditions, respectively. This study, reports for the first time such a large number of genome wide Single nucleotide polymorphisms (SNPs) (76,160) in mungbean. Further, genome wide association study was conducted using 55,634 SNPs obtained by genotyping-by-sequencing method. The results indicated that total 136 SNPs shared by both GLM and MLM models were associated with tested PUE traits under different phosphorus regimes. We have identified SNPs with highest value (-log()) for some traits like, TLA and RDW with value (-log()) of more than 6.0 at LP/OP and OP condition. We have identified nine SNPs (three for TLA and six for RDW trait) which was found to be present in chromosomes 8, 4, and 7. One SNP present in gene contains zinc finger CCCH domain. In total, 71 protein coding genes were identified, of which 13 genes were found to be putative candidate genes controlling PUE by regulating nutrient uptake and root architectural development pathways in mungbean. Moreover, we identified three potential candidate genes , , and with missense SNPs in coding sequence region, which results in significant variation in protein structure at tertiary level. The identified SNPs and candidate genes provide the essential information for genetic studies and marker-assisted breeding program for improving low-phosphorus tolerance in mungbean.
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http://dx.doi.org/10.3389/fpls.2020.537766DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658405PMC
October 2020

Enhancing early detection of neurological and developmental disorders and provision of intervention in low-resource settings in Uttar Pradesh, India: study protocol of the G.A.N.E.S.H. programme.

BMJ Open 2020 11 3;10(11):e037335. Epub 2020 Nov 3.

Division of Phoniatrics, Research Unit iDN (Interdisciplinary Developmental Neuroscience), Medical University of Graz, Graz, Austria.

Introduction: Around 9% of India's children under six are diagnosed with neurodevelopmental disorders. Low-resource, rural communities often lack programmes for early identification and intervention. The Prechtl General Movement Assessment (GMA) is regarded as the best clinical tool to predict cerebral palsy in infants <5 months. In addition, children with developmental delay, intellectual disabilities, late detected genetic disorders or autism spectrum disorder show abnormal general movements (GMs) during infancy. General Movement Assessment in Neonates for Early Identification and Intervention, Social Support and Health Awareness (G.A.N.E.S.H.) aims to (1) provide evidence as to whether community health workers can support the identification of infants at high-risk for neurological and developmental disorders and disabilities, (2) monitor further development in those infants and (3) initiate early and targeted intervention procedures.

Methods: This 3-year observational cohort study will comprise at least 2000 infants born across four districts of Uttar Pradesh, India. Community health workers, certified for GMA, video record and assess the infants' GMs twice, that is, within 2 months after birth and at 3-5 months. In case of abnormal GMs and/or reduced MOSs, infants are further examined by a paediatrician and a neurologist. If necessary, early intervention strategies (treatment as usual) are introduced. After paediatric and neurodevelopmental assessments at 12-24 months, outcomes are categorised as normal or neurological/developmental disorders. Research objective (1): to relate the GMA to the outcome at 12-24 months. Research objective (2): to investigate the impact of predefined exposures. Research objective (3): to evaluate the interscorer agreement of GMA.

Ethics And Dissemination: G.A.N.E.S.H. received ethics approval from the Indian Government Chief Medical Officers of Varanasi and Mirzapur and from the Ramakrishna Mission Home of Service in Varanasi. GMA is a worldwide used diagnostic tool, approved by the Ethics Committee of the Medical University of Graz, Austria (27-388 ex 14/15). Apart from peer-reviewed publications, we are planning to deploy G.A.N.E.S.H. in other vulnerable settings.
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http://dx.doi.org/10.1136/bmjopen-2020-037335DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640505PMC
November 2020

Combating silver nanoparticle-mediated toxicity in Drosophila melanogaster with curcumin.

J Appl Toxicol 2021 Aug 4;41(8):1188-1199. Epub 2020 Nov 4.

Department of Zoology, University of Delhi, Delhi, India.

Nanoscale materials display unique physical and chemical properties that enable their assimilation into a variety of industrial and consumer products. Amongst the widely used nanomaterials, silver nanoparticles (AgNPs) have gained tremendous recognition for various applications, owing to their extraordinary plasmonic and bactericidal properties. Despite of the extensive usage of AgNPs in various sectors, its impact on human health remains ambiguous. Several studies have established that higher doses of AgNPs are detrimental to organismal health. In order to attain the best from these versatile nanoparticles, a recent advent of green nanotechnology, that is, employment of metal nanoparticles synthesized using plant extracts, has emerged. Here, using Drosophila as a model system, we tested if adding curcumin, a biologically active polyphenolic compound present in turmeric, having multitudes of therapeutic properties, could mitigate AgNP-mediated biotoxicity. We found that co-administration of AgNPs with curcumin in the fly food could alleviate several harmful effects evoked by AgNPs ingestion in Drosophila model. Addition of curcumin superseded reduction in feeding, pupation, eclosion, pigmentation, and fertility caused by AgNPs ingestion. Interestingly, impairment in ovary development observed in flies reared on AgNPs-supplemented food was also partially restored by co-administration of AgNPs with curcumin. Furthermore, substantial alleviation of reactive oxygen species level and cell death was observed in larval tissues upon co-supplementation of AgNPs with curcumin. We therefore propose that curcumin, when administered with AgNPs, can abrogate the toxic manifestations of AgNPs ingestion and hence can be incorporated in various consumer products encompassing it.
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http://dx.doi.org/10.1002/jat.4103DOI Listing
August 2021

The great masquerader: Hemophagocytic lymphohistiocytosis secondary to cytomegalovirus infection in an immunocompetent young man.

J Family Med Prim Care 2020 Jul 30;9(7):3762-3765. Epub 2020 Jul 30.

Department of Medicine, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Hemophagocytic lymphohistiocytosis (HLH) is a rare, poorly recognized and underdiagnosed syndrome of excessive immune activation, which is rapidly fatal. HLH can occur as a familial or secondary disorder. Secondary HLH is most commonly associated with infections, malignancies, or autoimmune diseases. It primarily affects patients with a compromised immune system and rarely presents in immunocompetent individuals. Acute cytomegalovirus (CMV) associated HLH in the immunocompetent individual is extremely rare and only documented in five case reports till date. We, hereby, report a case of 18 years old young immunocompetent man who was diagnosed to have HLH secondary to CMV infection.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_274_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567245PMC
July 2020

H-FABP: A beacon of hope for prediabetic heart disease.

J Family Med Prim Care 2020 Jul 30;9(7):3421-3428. Epub 2020 Jul 30.

Department of Medicine, PGIMER, Dr. RMLH, New Delhi, India.

Background: Prediabetes is increasingly being studied in the context of its association with cardiovascular disease (CVD). Besides raised HbA1c and sugar levels, the major underlying defect seems to be insulin resistance (IR). Subclinical atherosclerosis, measured by high sensitivity C reactive protein (hsCRP) and carotid artery intima media thickness (CIMT) underlies the pathogenesis of CVD in prediabetes. Heart-type fatty acid binding protein (H-FABP), a novel cardiac biomarker also might have a role in predictin prediabetic heart disease.

Aims: The aim of the study is to compare serum levels of H-FABP in prediabetics and controls and correlate them with the atherosclerotic markers, hsCRP and CIMT.

Setting And Design: 50 prediabetic patients and 50 age, sex and BMI matched controls were employed in the case control study. Serum F & PPBS, (HbA1c), fasting insulin levels were measured in cases and controls. Serum H-FABP was measured in both cases and controls. All cases and controls were subjected to bilateral CIMT measurements and Serum hsCRP levels. The values were compared between both the groups and subjected to appropriate statistical analysis.

Statistical Analysis Used: Categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± SD and median. Normality of data was tested by Kolmogorov-Smirnov test. If the normality was rejected then non parametric test was used. Quantitative variables were compared using Independent t test/Mann-Whitney Test (when the data sets were not normally distributed) between the two groups. Qualitative variables were correlated using Chi-Square test/Fisher's Exact test. Spearman rank correlation coefficient was used to find out the correlation of various parameters with each other. Univariate linear regression was used to find out the cause and effect relationship between various parameters. A <0.05 was considered statistically significant. The data analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0.

Results: The mean serum levels of H-FABP among cases and controls were 6.38± 2.76ng/ml and 3.24 ± 2.47 ng/ml respectively ( <0.0001). Mean CIMT was found to be higher in prediabetics (0.59 ± 0.11 mm ) compared to controls (0.45 ± 0.07mm) (<0.0001). Serum hsCRP levels were also statistically higher in prediabetics (5.75± 4.16 mg/l) then that of controls (1.86± 1.67 mg/l) ( <0.0001). The correlations of the two variables, hsCRP and CIMT with H-FABP were both strongly positive ( = 0.687) & ( = 0.779) respectively [both cases ( < 0.0001)].

Conclusion: The novel cardiac biomarker H-FAPB might be a good predictor of cardiovascular risks in prediabetics.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_296_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567222PMC
July 2020

Youth in Foster Care and the Reasonable and Prudent Parenting Standard.

Child Maltreat 2021 Aug 30;26(3):302-312. Epub 2020 Sep 30.

College of Social Work, 384654University of South Carolina, Hamilton College, Columbia, SC, USA.

Children in foster care face disproportionate rates of biopsychosocial challenges but social and extracurricular activities (SEAs) may support their healthy development. The Reasonable and Prudent Parenting Standard (RPPS), a 2014 federal policy, aims to increase access to these opportunities for children in foster care. Analyses of statutes from 50 US states and the District of Columbia (n = 51) revealed similarities and differences in state-level RPPS policy implementation. Building on these findings, researchers conducted semi-structured retrospective telephone interviews with foster parents across one southeastern state (n = 20) to identify local retrospective perspectives on RPPS implementation. Using thematic inductive coding two unique themes emerged about SEAs prior to RPPS: 1) negative social impacts and 2) complicated activity approval processes. Three unique themes emerged after RPPS: 1) empowerment, 2) implementation disparities and 3) resource recommendations. Policy implications include the need to support foster parents by increasing resources (funding, transportation, access), clarifying liability and clarifying motivation expectations.
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http://dx.doi.org/10.1177/1077559520957748DOI Listing
August 2021

Amebic Meningoencephalitis Mimicking Tubercular Meningitis.

Indian J Pediatr 2021 Aug 8;88(8):845-846. Epub 2020 Sep 8.

Department of Microbiology Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

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http://dx.doi.org/10.1007/s12098-020-03476-9DOI Listing
August 2021

The impact of anthropogenic organic and inorganic pollutants on the Hasdeo River Water Quality in Korba Region, Chhattisgarh, India.

Bioinformation 2020 30;16(4):332-340. Epub 2020 Apr 30.

School of Life Sciences, Department of Botany, Guru Ghasidas Vishwavidyalaya, Bilaspur-495009, Chhattisgarh, India.

In the name of development, industries discharge their wastewater, which contains different Metallic species and massive organic load into the next-door river system. In this study, we assess the impact of organic and inorganic contaminations on Hasdeo River at Korba region, which is fifth critically polluted city in India. Hear, a new approach for water quality indexing like Water quality index (WQI), Heavy metal pollution index (HPI) and metal index (MI) has been proposed to represent pollution due to heavy metals in river system. The sample's pollution parameters and heavy metals contamination is exceed from BIS or WHO standards of drinking water (all p<0.05). WQI shows that the entire water samples are not suitable for drinking and aquatic life but they are safe only for irrigation. HPI and MI calculation revels that more than 95% sampling sites are critically polluted with heavy metals. Thus, a high level of industrialization deterioration of river water quality is recorded for adequate action.
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http://dx.doi.org/10.6026/97320630016332DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392093PMC
April 2020

Active Bicomponent Nanoparticle Assembly with Temporal, Microstructural, and Functional Control.

Chemistry 2021 Jan 17;27(2):705-711. Epub 2020 Nov 17.

Supramolecular Chemistry Laboratory, School of Advanced Materials (SAMat) and New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bangalore, 560064, India.

Transient supramolecular self-assembly has evolved as a tool to create temporally programmable smart materials. Yet, so far single-component self-assembly has been mostly explored. In contrast, multicomponent self-assembly provides an opportunity to create unique nanostructures exhibiting complex functional outcomes, newer and different than individual components. Even two-component can result in multiple organizations, such as self-sorted domains or co-assembled heterostructures, can occur, thus making it highly complex to predict and reversibly modulate these microstructures. In this study, we attempted to create active bicomponent nanoparticle assemblies of orthogonally pH-responsive-group-functionalized gold and cadmium selenide nanoparticles with temporal microstructural control on their composition (self-sorted or co-assembly) in order to harvest their emergent transient photocatalytic activity by coupling to temporal changes in pH. Moving towards multicomponent systems can deliver next level control in terms of structural and functional outcomes of supramolecular systems.
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http://dx.doi.org/10.1002/chem.202003415DOI Listing
January 2021

Yellow Mosaic Disease (YMD) of Mungbean ( (L.) Wilczek): Current Status and Management Opportunities.

Front Plant Sci 2020 24;11:918. Epub 2020 Jun 24.

World Vegetable Center, South Asia, ICRISAT Campus, Patancheru, Hyderabad, India.

Globally, yellow mosaic disease (YMD) remains a major constraint of mungbean production, and management of this deadly disease is still the biggest challenge. Thus, finding ways to manage YMD including development of varieties possessing resistance against mungbean yellow mosaic virus (MYMV) and mungbean yellow mosaic India virus (MYMIV) is a research priority for mungbean crop. Characterization of YMD resistance using various advanced molecular and biochemical approaches during plant-virus interactions has unfolded a comprehensive network of pathogen survival, disease severity, and the response of plants to pathogen attack, including mechanisms of YMD resistance in mungbean. The biggest challenge in YMD management is the effective utilization of an array of information gained so far, in an integrated manner for the development of genotypes having durable resistance against yellow mosaic virus (YMV) infection. In this backdrop, this review summarizes the role of various begomoviruses, its genomic components, and vector whiteflies, including cryptic species in the YMD expression. Also, information about the genetics of YMD in both mungbean and blackgram crops is comprehensively presented, as both the species are crossable, and same viral strains are also found affecting these crops. Also, implications of various management strategies including the use of resistance sources, the primary source of inoculums and vector management, wide-hybridization, mutation breeding, marker-assisted selection (MAS), and pathogen-derived resistance (PDR) are thoroughly discussed. Finally, the prospects of employing various powerful emerging tools like translational genomics, and gene editing using CRISPR/Cas9 are also highlighted to complete the YMD management perspective in mungbean.
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http://dx.doi.org/10.3389/fpls.2020.00918DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327115PMC
June 2020

Nanoencapsulated Cerv. ex Lag. essential oil as potential antifungal and antiaflatoxigenic agent against deterioration of stored functional foods.

J Food Sci Technol 2020 Aug 4;57(8):2863-2876. Epub 2020 Mar 4.

Laboratory of Herbal Pesticides, Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005 India.

In vitro antifungal activity of the essential oil from (MCEO) with possible mode of action was evaluated against (AF-LHP-SH1) and 15 other storage molds for controlling postharvest deterioration of stored functional food samples. The chemical profiling of MCEO as done through GC-MS analysis revealed caryophyllene (19.15%) as the major component. The MCEO showed broad spectrum fungitoxicity and completely inhibited the growth of all tested molds and aflatoxin B (AFB) production by AF-LHP-SH1 at 1.40 and 1.20 µL/mL, respectively. Plasma membrane damage and methylglyoxal inhibition was confirmed as the possible antifungal and antiaflatoxigenic mode of action of MCEO. MCEO exhibited remarkable antioxidant activity with IC value 2.24 μL/mL as determined through DPPH assay and did not cause adverse effect on seed germination. In addition, the MCEO was encapsulated into chitosan nanoparticle, characterized (SEM, FTIR, XRD) and assessed for their potential against inhibition of growth and AFB production. MCEO after encapsulation exhibited enhanced efficacy inhibiting fungal growth and AFB production by AF-LHP-SH1 at 0.6 and 0.5 µL/mL, respectively. Encapsulated MCEO may be recommended as novel preservative to extend the shelf life of stored functional food samples.
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http://dx.doi.org/10.1007/s13197-020-04318-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316916PMC
August 2020
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