Search

Purpose: The purpose of our meta-analysis was to look at the impact of modified nutrition risk in the critically ill (mNUTRIC) on mortality in patients with critical illness. Materials and methods: Literature relevant to this meta-analysis was searched in PubMed, Web of Science, and Cochrane Library till 26 August 2023. Prospective or retrospective studies, patients >18 years of age, studies that reported on mortality and mNUTRIC (mNUTRIC cut-off score) were included. The QUIPS tool was used to evaluate the risk for bias in prognostic factors. Results: A total of 31 studies on mNUTRIC score, involving 13,271 patients were included. The summary area under the curve (sAUC) of 0.80 (95% CI: 0.76-0.83) illustrates the mNUTRIC score's strong discrimination. The pooled sensitivity was 0.79 (95% CI: 0.74-0.84) and pooled specificity was 0.68 (95% CI: 0.63-0.73). We found no discernible variation in the mNUTRIC's prediction accuracy among cut-off values of <5 and >5 in our subgroup analysis and sAUC values were 0.82 (95% CI: 0.78-0.85) and 0.78 (95% CI: 0.74-0.81), respectively. Conclusion: We observed that mNUTRIC can discriminate between critically ill individuals and predict their mortality. [ABSTRACT FROM AUTHOR]

Today, more than ever, the necessity for remote availability, independent of a client's location, is driving the popularity of remote systems. WiFi, Bluetooth, and GPRS are just a few of the wireless technologies that have facilitated the widespread availability of the internet on mobile phones, PDAs, laptops, and other portable electronic devices, and the ease with which users may exchange and sync data between them. MANET, or mobile ad hoc network, is one of the newer ways for nodes to connect because of its decentralized structure and self-configuring nature. Many different protocols control the MANET, and because of its dynamic topology, new problems have emerged in recent years. The black hole attacks put ad hoc networks at risk of data loss. These attacks trick the source into thinking it is sending data through the shortest path possible when, in reality, it is not. It's a cosmic black hole metaphor where everything vanishes. This research aims to investigate the implications of the Blackhole attack on the On-Demand Multicast Routing Protocol in a MANET and propose solutions to counteract it. MATLAB is used to test the efficacy of our strategy. In addition, the suggested method is evaluated using standard performance measures like packet delivery ratio, throughput, packet loss, etc. [ABSTRACT FROM AUTHOR]

A knowledge graph (KG) is a structured form of knowledge describing real‐world entities, properties and relationships as a graph. Question answering over knowledge graphs (KGQA) allows people to ask questions in natural language and extract answers from KG accurately and more quickly. The main task of a KGQA is to convert a natural language query to the corresponding structured query form like SPARQL. However, generating the precise SPARQL query from a question is challenging and highly error‐prone. Here we propose a question‐answering framework that uses KG to answer simple questions without using SPARQL. Question classification, dependency parsing, entity linking, BERT‐based relation finding and answer extraction constitute the main modules of the approach. We have used the DBpedia as the KG and tested the end‐to‐end system with a subset of QALD‐4, LC‐QuAD and SimpleQuestions datasets. Results show considerable improvement compared to other approaches in terms of F1‐score. [ABSTRACT FROM AUTHOR]

Background and Aims: Postoperative pain for patients having hip arthroplasty ranges from moderate to severe. Many regional anaesthesia procedures treat postoperative pain to improve functional ability and quality of life. Evidence comparing the analgesic effects of the pericapsular nerve group (PENG) block and fascia iliaca compartment block (FICB) remains unclear. The analgesic efficacies of PENG and FICB in hip arthroplasty were compared to determine which technique is associated with superior analgesia. Methods: The electronic databases (PubMed, Cochrane Library, Google Scholar and Web of Sciences) were searched for published randomised controlled trials (RCTs) till 5 April 2023 comparing PENG block vs. FICB following hip arthroplasty. The primary outcome was pain scores [numerical rating scale (NRS) or visual analogue scale (VAS)] between 0 and 10 at rest and during movement at 24 h. Secondary outcomes included pain scores at rest and during movement within 30 min, at 6 h and 12 h, time to first rescue analgesia and cumulative postoperative opioid use in 24 h. We assessed the risk of bias using the Cochrane Collaboration Risk-of-Bias 2 tool. Using Grading of Recommendations Assessment, Development, and Evaluation (GRADE), the certainty of the evidence was assessed. Subgroup analysis was performed to explore the source of heterogeneity. Results: We included 12 RCTs examining 644 patients. Pain scores at rest at 24 h (standardised mean differences (SMDs): 0.17; 95% confidence interval (CI): -0.90 to 1.23; P = 0.76, moderate certainty) and during movement at 24 h (SMD: -0.58, 95% CI: -1.53 to 0.38, P = 0.24, moderate certainty) were not different in both PENG block and FICB. Pain scores at rest and during movement within 30 min may be lower with PENG block than FICB. However, the pain score at rest and during movement at 6 h and the time to first rescue analgesia were not different between the two treatment arms. The mean opioid consumption in oral morphine equivalents (mg) in 24 h may be lower with PENG than FICB. Conclusion: We observed no difference between the PENG block and the FICB at 24 h for pain at rest and movement with a moderate degree of certainty. However, PENG block showed improved analgesia within 30 min at rest and during movement, and reduce postoperative opioid consumption in 24 h with moderate certainty of evidence. Further large-scale and high-quality RCTs are required to supplement the present findings. [ABSTRACT FROM AUTHOR]

Background: The incidence of postoperative nausea and vomiting (PONV) is quite high after laparoscopic surgeries. This study endeavors to compare the efficacy of the combination of palonosetron and dexamethasone with that of either drug alone in the prevention of PONV in patients undergoing laparoscopic surgeries. Methods: This randomized, parallel-group trial was done on ninety adults of American Society of Anesthesiologists Grade I and II patients aged 18–60 years undergoing laparoscopic surgeries under general anesthesia. The patients were randomly divided into three groups of thirty patients each. Group P (n = 30) received palonosetron 0.075 mg intravenously (iv), Group D (n = 30) received dexamethasone 8 mg iv and Group P + D (n = 30) received palonosetron 0.075 mg and dexamethasone 8 mg iv. The primary outcome was incidence of PONV in 24 h, and the secondary outcome was a number of rescue antiemetics required. To compare the proportions in the groups, unpaired t-test, Mann–Whitney U-test, Chi-square test, or Fisher's exact test was applied. Results: We found that the overall incidence of PONV was 46.7% in Group P, 50% in Group D, and 43.3% in Group P + D during the first 24 h. Rescue antiemetic was required in 27% of the patients in Group P and Group D compared to 23% of the patients in Group P + D and twice in 3% of the patients in Group P, 7% of the patients in Group D, and none in Group P + D which were not significant. Conclusions: The combination therapy of palonosetron plus dexamethasone did not significantly reduce the incidence of PONV when compared with either drug alone. [ABSTRACT FROM AUTHOR]

Background: Emergency authorization and approval were given for the coronavirus disease-19 (COVID-19) vaccines. The efficacy reported after phase III trials were 70.4% and 78% for Covishield and Covaxin, respectively. In this study, we aim to analyze the risk factors, which were associated with mortality in critically ill COVID-19-vaccinated patients admitted into intensive care unit (ICU). Materials and methods: This study was conducted from April 1, 2021 to December 31, 2021 across five centers in India. Patients who had received either one or two doses of any of the COVID vaccines and developed COVID-19 were included. The ICU mortality was a primary outcome. Results: A total of 174 patients with COVID-19 illness were included in the study. The mean age was 57 years standard deviation (SD 15). Acute physiology, age and chronic health evaluation (APACHE II) score and the sequential organ failure assessment (SOFA) score were 14 (8-24.5) and 6 (4-8), respectively. Multiple variable logistic regression showed patients who have received a single dose [odds ratio (OR): 2.89, confidence interval (CI): 1.18, 7.08], neutrophil:lymphocyte (NL) ratio (OR: 1.07, CI: 1.02,1.11), and SOFA score (OR: 1.18, CI: 1.03,1.36) were associated with higher mortality. Conclusion: The mortality in the vaccinated patients admitted to the ICU was 43.68% due to COVID illness. The mortality was lower in patients who had received two doses. [ABSTRACT FROM AUTHOR]

Image processing fields, such as separating data from healthcare images, can benefit greatly from using deep learning algorithms. This can be extremely beneficial. For the treatment of someone with a brain tumour, discovering the tumour as soon as possible is critical. The patient's life expectancy would increase if the tumour was discovered sooner rather than later. Medical images typically lack contrast because of noise or because there aren't enough diffusive boundaries in the image. This is because of noise. In order to better understand tumours in medical image segmentation, MRI was used to diagnose the tumour, but it also played a beneficial role in clinical image analysis. Why did an MRI need to be done? This paper will examine how bad a brain tumour is using the hybrid deep learning algorithm, which is what this paper is about. Algorithms help us get the correct answer. Based on the direction of the images taken by MR, there will be a lot of information about how to divide up the pictures. In this way, three separate networks are trained to improve their segmentation results. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease-2019 (COVID-19) is prone to acute hypoxemic respiratory failure (AHRF). Because tracheal intubation is associated with a higher risk of death in these patients, AHRF employs high-flow nasal oxygen therapy (HFNOT). The goal of this study was to assess the effect of HFNOT on oxygenation status as well as different predictors of HFNOT failure. Methods: A prospective observational cohort study was conducted in COVID-positive critically ill adult patients (age >18 years) with AHRF, who were unable to maintain SpO2 >90% on a non-rebreathing face mask at an oxygen flow ≥15 L/minute. Respiratory variables (PaO2/FiO2, SpO2, and RR) before HFNOT (baseline) and then at 1 hour, 6 hours, 7th day, and 14th day after HFNOT application were recorded. Borg CR10 scale and visual analogue scale were used to evaluate the subjective sensation of dyspnea and comfort level, respectively. As needed, Student's t, Mann--Whitney U, or Wilcoxon signed-rank tests were performed. To find parameters linked to HFNOT failure, multivariate logistic regression and receiver-operating characteristic (ROC) analysis were employed. Results: A total of 114 patients were enrolled in the study, with an HFNOT failure rate of 29%. The median PaO2/FiO2 ratio at baseline (before the initiation of HFNOT) was 99.5 (80--110) which significantly increased at various time points (1 hour, 6 hours, 7th day, and 14th day) after HFNOT initiation in the successful group. Patients reported significant improvement in sensation of breathlessness [9 (8--10), 3 (2--4); p <0.001] as well as in comfort level [2 (1--2), 8 (4--9); p <0.001]. Multivariate logistic regression analysis, sequential organ failure assessment (SOFA) score >7, acute physiology and chronic health evaluation (APACHE) II score >20, admission P/F ratio <100, D-dimer >2 mg/L, IL-6 >40 pg/mL, random blood sugar (RBS) >250 mg/dL, and 6 hours ROX Index <3.5 were independent prognostic factors of HFNOT failure. Conclusion: The use of HFNOT significantly increased the oxygenation levels in COVID-19 patients with AHRF at various time periods after HFNOT beginning. Age, SOFA score, APACHE II score, ROX score, admission P/F ratio, IL-6, D-dimer, and RBS were independent prognostic factors of HFNOT failure in this cohort. [ABSTRACT FROM AUTHOR]

Summary For the sensor network, greedy forwarding is thought to be the best energy‐efficient routing method. There are two restrictions on greedy forwarding: a minimum local scenario and an intersection problem in which it is unable to locate an existing route. The proposed independent gradient forward (IGF) proves that the Euclidean equation used by greedy forwarding is less capable of dealing with the problems mentioned above. IGF considers each dimension independently to enhance the efficiency of greedy forwarding, sustaining its simplicity. It contributes to strengthening the suggested IGF's ability to manage holes and get around obstructions in the wireless sensor network. We have demonstrated that it travels a shorter potential path and avoids stuck nodes well in advance. It is more energy‐efficient since it can predict the void node and never visits a stalled node. We evaluated the suggested IGF's performance against other traditional boundary traversal‐based methods on both rare and dense networks. In comparison with other boundary traversal‐based algorithms, the simulation results indicate that it generates a 10% smaller route to bypass. The IGF average energy consumption increases slowly, rising by just 7% and 12.5% for dense and rare networks, respectively, with a fivefold increase in void size (from 100 to 500 m). [ABSTRACT FROM AUTHOR]

We report biochemical studies on two Cys residues mutation (Cys15Thr, Cys38Gly) nearest to the active site and three other amino acid substitution mutations expected to be the part of active site of Ld DLDH_Variant1. Our biochemical studies show that the replacement of Cys15 increases the K m for dihydrolipoamide (DLD) substrate by five folds and NAD+ by three fold indicating that this mutation affects the binding of DLD and NAD+ significantly. Cys38 was also mutated to 'Gly' which resulted in nine fold greater K m for NAD+ without affecting K m for DLD. However, even after these mutations (Cys15Thr and Cys38Gly), reduced enzyme activity suggests that both the 'Cys' residues are not involved in disulfide bond formation but affect the binding of substrates. The data hints towards the possibility of a different catalytic mechanism from the classical class I - pyridine nucleotide-disulfide oxidoreductase. Remaining other mutated residues Ala48Ile, Asp49Gly, and Ala54Ile showed an increase in two to three-folds K m value for NAD+, which means these residues are important for the binding of NAD+ to the enzyme. However, Ala48Ile and Asp49Gly mutations showed a decrease of K m for DLD. Apart from the mutational studies, localization of Ld DLDH_Variant2 of Ld DLDH was also analyzed. [ABSTRACT FROM AUTHOR]

Context: Shivering is one of the most commonly recognized complications of the central neuraxial blockade. For optimal perioperative care, control of postspinal anesthesia shivering is essential. Aims: The present study designed to compare the clinical efficacy, hemodynamic parameters, and side effects of nalbuphine and tramadol for control of postspinal anesthesia shivering. Settings and Design: This was a prospective, randomized, double-blind study. Materials and Methods: This study was conducted on 90 American Society of Anesthesiologists Physical Status I and II patients of either gender, aged between 18 and 60 years, who subsequently developed shivering grade 3 or 4, scheduled for different surgical procedures under spinal anesthesia. The patients were randomized into two groups of 45 patients each to receive either nalbuphine 0.06 mg.kg−1 (Group N) or tramadol 1 mg.kg−1 (Group T). Grade of shivering, onset of shivering, time interval for cessation of shivering, response rate at 5 and 30 min, rescue dose, hemodynamic parameters, and side effects were observed at scheduled intervals. Statistical Analysis Used: Independent t-test and Chi-square/Fisher's exact test were used to analyze the data. Results: The time taken for cessation of shivering was significantly less with nalbuphine in comparison with tramadol (P < 0.05). It was observed that the response time at 5 and 30 min and rescue dose requirement for control of shivering were not much difference (P > 0.05). Conclusions: Both nalbuphine and tramadol are effective; however, the time taken for cessation of shivering is significantly less with nalbuphine when compared to tramadol. Furthermore, tramadol causes significantly more nausea and vomiting; however, nalbuphine causes significantly more sedation. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease-2019 (COVID-19) in the last few months has disrupted the healthcare system globally. The objective of this study is to assess the impact of the COVID-19 pandemic on the psychological and emotional well-being of healthcare workers (HCWs). Materials and methods: We conducted an online, cross-sectional, multinational survey, assessing anxiety [using Generalized Anxiety Disorder (GAD) Scale: GAD-2 and GAD-7], depression (using Center for Epidemiologic Studies Depression Scale), and insomnia (using Insomnia Severity Index Scale), among HCWs across India, the Middle East, and North America. We used univariate and bivariate logistic regression to identify risk factors for psychological distress. Results: The prevalence of clinically significant anxiety, depression, and insomnia was 41.4%, 48.0%, and 31.3%, respectively. On bivariate logistic regression, lack of social or emotional support to HCWs was independently associated with anxiety [odds ratio (OR), 3.81 (2.84-3.90)], depression [OR, 6.29 (4.50-8.79)], and insomnia [OR, 3.79 (2.81-5.110]. Female gender and self-COVID-19 were independent risk factors for anxiety [OR, 3.71 (1.53-9.03) and 1.71 (1.23-2.38)] and depression [OR, 1.72 (1.27-2.31) and 1.62 (1.14-2.30)], respectively. Frontliners were independently associated with insomnia [OR, 1.68 (1.23-2.29)]. Conclusion: COVID-19 pandemic has a high prevalence of anxiety, depression, and insomnia among HCWs. Female gender, frontliners, self- COVID-19, and absence of social or emotional support are the independent risk factors for psychological distress. [ABSTRACT FROM AUTHOR]

Clustering is an unsupervised classification method used to group the objects of an unlabeled data set. The high dimensional data sets generally comprise of irrelevant and redundant features also along with the relevant features which deteriorate the clustering result. Therefore, feature selection is necessary to select a subset of relevant features as it improves discrimination ability of the original set of features which helps in improving the clustering result. Though many metaheuristics have been suggested to select subset of the relevant features in wrapper framework based on some criteria, most of them are marred by the three key issues. First, they require objects class information a priori which is unknown in unsupervised feature selection. Second, feature subset selection is devised on a single validity measure; hence, it produces a single best solution biased toward the cardinality of the feature subset. Third, they find difficulty in avoiding local optima owing to lack of balancing in exploration and exploitation in the feature search space. To deal with the first issue, we use unsupervised feature selection method where no class information is required. To address the second issue, we follow pareto-based approach to obtain diverse trade-off solutions by optimizing conceptually contradicting validity measures silhouette index (Sil) and feature cardinality (d). For the third issue, we introduce genetic crossover operator to improve diversity in a recent Newtonian law of gravity-based metaheuristic binary gravitational search algorithm (BGSA) in multi-objective optimization scenario; it is named as improved multi-objective BGSA for feature selection (IMBGSAFS). We use ten real-world data sets for comparison of the IMBGSAFS results with three multi-objective methods MBGSA, MOPSO, and NSGA-II in wrapper framework and the Pearson's linear correlation coefficient (FM-CC) as a multi-objective filter method. We employ four multi-objective quality measures convergence, diversity, coverage and ONVG. The obtained results show superiority of the IMBGSAFS over its competitors. An external clustering validity index F-measure also establish the above finding. As the decision maker picks only a single solution from the set of trade-off solutions, we employee the F-measure to select a final single solution from the external archive. The quality of final solution achieved by IMBGSAFS is superior over competitors in terms of clustering accuracy and/or smaller subset size. [ABSTRACT FROM AUTHOR]

Abstract Trypanothione based redox metabolism is unique to the Trypanosomatida family. Despite extensive studies on redox metabolism of Leishmania parasites, a prominent question of why Leishmania adopt this unique redox pathway remains elusive. We have episomally expressed human glutathione reductase (HuGR) in Leishmania donovani (LdGR+) and investigated its effect. LdGR+ strain has slower growth compared to the wild type (Ld) indicating decreased survival ability of the strain. Further, LdGR+ strain showed enhanced accumulation of intracellular reactive oxygen species (ROS) and more sensitivity to the anti-leishmanial drug, Miltefosine, inferring increased stress level. In contrast, the expression analyses of genes specific to redox metabolism were increased significantly in LdGR+ strain compared to wild type. Lower infectivity index of the LdGR+ strain substantiated the above findings and indicated that the expression of HuGR reduces the stress tolerance ability of the parasite. From molecular docking studies with HuGR, it was observed that oxidized trypanothione (TS2) binds much better than oxidized glutathione (GS2). These results also give us hints that the parasite is losing infectivity potential due to an overall increase in intracellular stress caused with the expression of HuGR, showcasing a possible role of evolutionary pressure on the Leishmania parasites posed by HuGR. Graphical abstract Unlabelled Image Highlights • Trypanothione based redox metabolism is present in Leishmania parasites. • Expression of glutathione reductase in Leishmania cells destabilises redox homeostasis. • Cell growth and viability were found to be reduced in Ld GR+ with increase in ROS levels. • Trypanothione shows better affinity to glutathione reductase. • Results hint evolutionary selection of TR over GR base redox system. [ABSTRACT FROM AUTHOR]

Calreticulin (CRT), a highly conserved ubiquitous eukaryotic protein with a molecular mass of 46 kDa, containing three domains (N, P, and C) is involved in promoting prolonged parasite-host relations. Brugia malayi Calreticulin (BmCRT) is involved in the establishment of parasite infection by suppression of C1q-mediated host immune response. Calcium plays important role in this immunomodulatory mechanism of BmCRT. In the present study binding of calcium with BmCRT region involved in this interaction was investigated and correlated with the accompanying changes in fluorescence, circular dichroism (CD) and UV absorption. The results obtained clearly indicated that BmCRT is a calcium binding protein and contains types two of Ca 2+ binding sites, one high affinity Ca 2+ binding site at P domain and another low affinity Ca 2+ binding site at C domain. Zinc also binds to additional sites that do not have appreciable affinity for the calcium. These studies have provided new knowledge that allows us to describe how the structure of BmCRT responds to interactions with calcium and zinc which is different from human CRT and also discuss how this mechanism help to complex formation with host C1q. [ABSTRACT FROM AUTHOR]

Coenzyme A acts as a necessary cofactor for many enzymes and is a part of many biochemical processes. One of the critical enzymes involved in Coenzyme A synthesis is Dephospho-coenzyme A-kinase (DPCK). In this study, we have used integrated computational and experimental approaches for promising inhibitors of DPCK using the natural products available in the ZINC database for anti-leishmanial drug development. The top hit compounds chosen after molecular docking were Veratramine, Azulene, Hupehenine, and Hederagenin. The free binding energy of Veratramine, Azulene, Hupehenine, and Hederagenin was estimated. Besides the favourable binding point, the ligands also showed good hydrogen bonding and other interactions with key residues of the enzyme's active site. The natural compounds were also experimentally investigated for their effect on the L. donovani promastigotes and murine macrophage (J774A.1). A good antileishmanial activity by the compounds on the promastigotes was observed as estimated by the MTT assay. The in-vitro experiments revealed that Hupehenine (IC 50 = 7.34 ± 0.37 μM) and Veratramine (IC 50 = 12.46 ± 2.28 μM) exhibited better inhibition than Hederagenin (IC 50 = 23.36 ± 0.54 μM) and Azulene (IC 50 = 24.42 ± 3.28 μM). This work has identified novel anti-leishmanial molecules possibly acting through the inhibition of DPCK. [ABSTRACT FROM AUTHOR]

A variety of environmental stress stimuli have been linked to poor quality of life, tissue dysfunctions, and ailments including metabolic disorders, cognitive impairment, and accelerated aging. Oxidative, metal, and hypoxia stresses are largely associated with these phenotypes. Whereas drug development and disease therapeutics have advanced remarkably in last 3 decades, there are still limited options for stress management. Because the latter can effectively decrease the disease burden, we performed cell-based screening of antistress compounds by recruiting 3 chemical models of oxidative (paraquat), metal (cadmium nitrate), or hypoxia (cobalt chloride) stresses. The screening of 70 compounds for their ability to offer protection against oxidative, metal, and hypoxia stresses resulted in the selection of 5 compounds: Withaferin-A (Wi-A), methoxy Withaferin-A (mWi-A), Withanone (Wi-N), triethylene glycol (TEG), and Ashwagandha (Withania somnifera) leaf M2-DMSO extract (M2DM). Molecular assays revealed that whereas stress caused increase in (a) apoptosis, (b) reactive oxygen species accumulation coupled with mitochondrial depolarization, (c) DNA double-strand breaks, and (d) protein aggregation, low nontoxic doses of the selected compounds caused considerable protection. Furthermore, Wi-N, TEG, and their mixture-treated normal human fibroblasts (at young, mature, and senescent stages representing progressively increasing accumulation of stress) showed increase in proliferation. Taken together, these results suggested 3-way (oxidative, metal, and hypoxia) antistress potential of Wi-N and TEG that may be useful for management of environmental and old-age–related pathologies. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 25-year-old female with Ebstein's anomaly and bleeding vagina after amenorrhea. It discusses the physiological effects of her condition, treatment using hysterotomy, and pathophysiological aspects of the patient. Particular focus is given to the issues faced by pregnant women with hypothyroidism when given anaesthesia.

Grisel's syndrome is a nontraumatic subluxation of atlanto-axial joint which is associated with inflammatory conditions of head and neck and occurs primarily in children. Anesthetic management is such cases constitute a multitude of challenges, especially related to the airway management. We presented here a case of 16-year-old male child weighing 23 kg, came to our hospital for the treatment of torticollis who was previously treated with intravenous antibiotics for rhinopharyngitis and diagnosed as a case of Grisel's syndrome. The child was operated on for unilateral resection of sternocleidomastoid muscle under general anesthesia. This case report pertains to the successful airway and anesthetic management in the background of difficult airway. [ABSTRACT FROM AUTHOR]

Genotypic variability, heritability and genetic advance expressed as percentage of mean for yield and its component were studies in twenty five genotypes of french bean collected from different sources and maintained in the Department of Applied Plant Science (Horticulture) under the School for Bio-sciences and Biotechnology, Babasaheb Bhimrao Ambedkar University Vidya-Vihar, Rae Bareli, Road, Lucknow (U.P.) India, were evaluated for various quantitative and quality traits. The material showed wide range of variability for green pod yield per plant (91.50-248.09q/ha), green pod yield per plant (54.91-148.87g), plant height (34.47-128.21cm), germination percent (68.87-100) and protein (17.09-30.38). The genotypic and phenotypic variances were high for 100-seed weight (43.1 l-43.22g) and plant height (40.92-41,71g). Heritability was high for 100-seed weight (99.50%) and plant height (96.50%) whereas it was lowest for green pod breath (26.80cm), high heritability combined with high genetic advance expressed as percentage of mean for 100-seed weight (88.59%). plant height (82.72%) and green pod yield q/ha (54.01%). The characters like 100-seed weight, plant height, green pod yield/plot, green pod yield/plant and green pod yield (q/ha), showed high genotypic coefficient variation and phenotypic coefficient variation with genetic advance, indicating there by that selections based on phenotypic performance could be effective for improvement of these characters. [ABSTRACT FROM AUTHOR]

Maneb (MB) and paraquat (PQ) are environmental toxins that have been experimentally used to induce selective damage of dopaminergic neurons leading to the development of Parkinson's disease (PD). Although the mechanism of this selective neuronal toxicity in not fully understood, oxidative stress has been linked to the pathogenesis of PD. The present study investigates the mechanisms of neuroprotection elicited by Withania somnifera (Ws), a herb traditionally recognized by the Indian system of medicine, Ayurveda. An ethanolic root extract of Ws was co-treated with the MB-PQ induced mouse model of PD and was shown to significantly rescue canonical indicators of PD including compromised locomotor activity, reduced dopamine in the substantia nigra and various aspects of oxidative damage. In particular, Ws reduced the expression of iNOS, a measure of oxidative stress. Ws also significantly improved the MB + PQ mediated induction of a pro-apoptotic state by reducing Bax and inducing Bcl-2 protein expression, respectively. Finally, Ws reduced expression of the pro-inflammatory marker of astrocyte activation, GFAP. Altogether, the present study suggests that Ws treatment provides nigrostriatal dopaminergic neuroprotection against MB-PQ induced Parkinsonism by the modulation of oxidative stress and apoptotic machinery possibly accounting for the behavioural effects. [ABSTRACT FROM AUTHOR]

Highlights: [•] Neuroprotective role of Mucuna pruriens (Mp) was evaluated in Parkinson’s disease mouse model. [•] Tyrosine hydroxylase immunoreactivity was increased in Mp treated mice. [•] Activation of astrocytes was restored by Mp treated mice. [•] The efficiency of Mp treatment against PD is equal or greater than estrogen. [•] Mp could potentially be used as an anti-Parkinson drug. [ABSTRACT FROM AUTHOR]

Dear Editor, The original research entitled, "Epidemiology and outcome of trauma victims admitted in trauma centers of tertiary care hospitals - A multicentric study in India"[[1]] is a great piece of academic research which creates an elite snapshot of current trauma set up in the country and enumerates various epidemiological factors associated with negative outcome in such population of patients. Epidemiology and outcome of trauma victims admitted in trauma centers of tertiary care hospitals - A multicentric study in India: A comment Epidemiology and outcome of trauma victims admitted in trauma centers of tertiary care hospitals-A multicentric study in India. [Extracted from the article]

Highlights: [•] Role of Mucuna pruriens (Mp) in neuroprotection was investigated. [•] Antioxidant properties of Mp were validated in Parkinson’s disease (PD) mouse model. [•] Number of tyrosine hydroxylase positive neurons was increased in Mp treated mice. [•] The study suggests a promising role of Mp in treatment of PD and in drug development. [Copyright &y& Elsevier]

Parkinson's disease (PD) is a neurodegenerative disorder and these days a lot of emphasis is given on the treatment of this disease using herbal medicines. The present study evaluates the neuroprotective effect of Withania somnifera (Ws) root extract on Parkinsonian mice. The mice were divided into three groups; the first group served as control, the second group was given maneb (MB) and paraquat (PQ) and the last group was administered MB-PQ along with Ws root extract for 3, 6 and 9 weeks. The behavioral studies showed a significant improvement in the motor movement patterns and gripping ability of Ws root extract exposed Parkinsonian mice. Tyrosine hydroxylase (TH) immunostaining was reduced in the substantia nigra of MB-PQ exposed mice, while Ws co-exposure restored TH immunostaining significantly. Additionally, our results also demonstrate generation of oxidative stress in the nigrostriatal region of MB-PQ exposed mice. There was a marked decline in the level of catalase and a simultaneous increase in the level of nitrite and lipid peroxidation in Parkinsonian mice. Thus, the Ws root extract have shown to counteract the pro-oxidants and their associated oxidative stress in the PD model studied here. Our results clearly indicate the usefulness of Ws root extract in providing protection against MB-PQ induced nigrostriatal dopaminergic neurodegeneration and marked improvement in the behavioral, anatomical and the biochemical deformities. [ABSTRACT FROM AUTHOR]

Introduction: Sleep is vital for mental and physical health of an individual. Duration of sleep influences the metabolism and regulates body weight. Objective: To assess the cross-sectional association of sleep duration with body mass index (BMI) and waist-hip ratio in Malaysian students. Methods: Eighty-nine Malaysian students of both genders, and with a mean (standard deviation) age of 21.2 (0.9) years were included. Institutional Ethics Committee clearance was obtained prior to the start of study. The subjects were interviewed regarding the average hours of sleep/day, their self-reported sleep duration was categorized as < 6hour/day (short sleep duration), 6-7hour/day and > 7hour/day. Their height (in meters), weight (in kilograms), waist and hip circumference (in centimetre) were measured. BMI and waist-hip ratio were calculated using appropriate formulas and expressed as mean (standard deviation). The duration of sleep was compared with BMI and waist-hip ratio using one way ANOVA. Results: No statistical significance was observed when sleep duration was associated with BMI (p=0.65) and waist-hip ratio (p=0.95). Duration of sleep did not affect BMI and waist hip ratio in the Malaysian students in our study. The age and healthy lifestyle of the subjects in this study may have been a reason for no significant influence of short sleep duration on the BMI and waist-hip ratio. Conclusion: No association was found between sleep duration with BMI and waist hip ratio in the Malaysian students. [ABSTRACT FROM AUTHOR]

• LDBPK_252400 is a novel, safe and protective vaccine against VL in murine model. • Protection in vaccinated mice correlated with antigen specific IFN-γ expressing CD4+/CD8+T cells. • Antigen-mediated humoral immunity associated with high antigen specific IgG2/IgG1 responses in vaccinated mice. • LDBPK_252400 vaccination drives robust expansion of TNF-α, IFN-γ, IL-12 and IL-10 cytokines. Visceral leishmaniasis (VL) is a potentially fatal parasitic disease causing high morbidity and mortality in developing countries. Vaccination is considered the most effective and powerful tool for blocking transmission and control of diseases. However, no vaccine is available so far in the market for humans. In the present study, we characterized the hypothetical protein LDBPK_252400 of Leishmania donovani (LdHyP) and explored its prophylactic behavior as a potential vaccine candidate against VL. We found reduced hepato-splenomegaly along with more than 50% parasite reduction in spleen and liver after vaccination in mice. Protection in vaccinated mice after the antigen challenge correlated with the stimulation of antigen specific IFN-γ expressing CD4+T cell (~4.6 fold) and CD8+T cells (~2.1 fold) in vaccinated mice in compared to infected mice, even after 2–3 months of immunization. Importantly, antigen-mediated humoral immunity correlated with high antigen specific IgG2/IgG1 responses in vaccinated mice. In vitro re-stimulation of splenocytes with LdHyP enhances the expression of TNF-α, IFN-γ, IL-12 and IL-10 cytokines along with lower IL-4 cytokine and IL-10/IFN-γ ratio in vaccinated mice. Importantly, we observed ~3.5 fold high NO production through activated macrophages validates antigen mediated cellular immunity induction, which is critical in controlling infection progression. These findings suggest that immunization with LdHyP mount a very robust immunity (from IL-10 towards TFN-γ mediated responses) against L. donovani infection and could be explored further as a putative vaccine candidate against VL. [ABSTRACT FROM AUTHOR]

Aim: The aim was to examine the outcomes of pregnant women admitted to intensive care unit with coronavirus disease-2019 (COVID-19) infection during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in India. The primary outcome of the study was maternal mortality at day 30. The secondary outcomes were the intensive care unit (ICU) and hospital length of stay, fetal mortality and preterm delivery. Materials and methods: This was a retrospective multicentric cohort study. Ethical clearance was obtained. All pregnant women of the 15--45- year age admitted to ICUs with SARS-CoV-2 infection during 1st March 2020 to 31st October, 2021 were included. Results: Data were collected from nine centers and for 211 obstetric patients admitted to the ICU with a confirmed diagnosis of COVID-19. They were divided in to two groups as per their SpO2 (saturation of peripheral oxygen) level at admission on room air, that is, normal SpO2 group (SpO2 > 90%) and low SpO2 group (SpO2 < 90%). The mean age was (30.06 ± 4.25) years and the gestational age was 36 ± 8 weeks. The maternal mortality rate was10.53%. The rate of fetal death and preterm delivery was 7.17 and 28.22%, respectively. The average ICU and hospital length of stay (LOS) were 6.35 ± 8.56 and 6.78 ± 6.04 days, respectively. The maternal mortality (6.21 vs 43.48%, p < 0.001), preterm delivery (26.55 vs 52.17%, p = 0.011) and fetal death (5.08 vs 26.09%, p = 0.003) were significantly higher in the low SpO2 group. Conclusion: The overall maternal mortality among critically ill pregnant women affected with COVID-19 infection was 10.53%. The rate of preterm birth and fetal death were 28.22 and 7.17%, respectively. These adverse maternal and fetal outcomes were significantly higher in those admitted with low SpO2 (<90%) at admission compared with those with normal SpO2. [ABSTRACT FROM AUTHOR]

Background and Aims: Sepsis-induced immunosuppression appears to be reversible with immunomodulatory drugs. Mycobacterium indicus pranii (MIP) stimulates the Th1 type of immune response. This systematic review and meta-analysis of randomised controlled trials (RCTs) was aimed to find out if MIP is effective at improving clinical outcomes in sepsis patients. Methods: The databases (PubMed, Google Scholar, Web of Science, and Cochrane Library), along with preprint servers until June 2023, were searched. The methodology was evaluated using the 'Cochrane Collaboration risk of bias-2 tool' for RCT. The study included patients more than 18 years of age with sepsis within 48 h of first organ dysfunction. The primary outcome was 28-day mortality, and secondary outcomes were the length of stay in the intensive care unit (ICU), days on vasopressor support, ventilator-associated pneumonia (VAP), secondary infections, catheter-related bloodstream infections (CRBSI), and the delta sequential organ failure assessment (SOFA) score. Results: The meta-analysis included two studies with 252 participants. In a pooled analysis, mortality in the MIP group was 43% lower than in the control (RR: 0.57, 95%CI: 0.33–1); however, this difference was statistically not significant. We observed the days on a vasopressor day (standardised mean difference [SMD]: 0.38; 95%CI: −1.20 to 0.44), length of ICU stay (SMD: 0.46; 95%CI: −1.44 to 0.51), secondary infection (RR: 0.75; 95%CI: 0.19–3.01), VAP (RR: 0.6; 95%CI: 0.28–1.56), CRBSI (RR: 0.97, 95%CI: 0.14–6.98), delta SOFA score (SMD: 0.88, 95%CI: −1.66 to − 0.10) between the two groups. Conclusions: Our findings observed preliminary evidence in the trends for a positive association of MIP with better outcomes in sepsis patients. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding questions from undergraduate students about the taste pathway in neuroanatomy and neurophysiology.

Twenty three genotypes of basmati representing the broad spectrum of variation were assessed for ten yield attributing characters and ten quality characters using principal component analysis and cluster analysis. Principal component analysis identified five principal components with eigen values more than one for four components which contributed 90.40 per cent of the cumulative variance. The genotypes were grouped into six clusters by using cluster analysis. Cluster II was the largest, consisting of six genotypes followed by five genotypes each in clusters III, IV and V, two genotypes each in clusters I and VI. The results indicated that there was some degree of similarity of genotypes clustered together on the basis of their origin. However, the pattern of distribution of some genotypes from different eco-geographical regions was found random, indicating that geographical diversity and genetic diversity were not related. The maximum intra cluster distance was observed for the cluster III. The highest genetic divergence was observed between the clusters IV and III exhibiting wide diversity. Among different traits, plant height, days to 50% flowering, spikelets per panicle, KLAC and amylose content had maximum contribution towards total divergence may be used as selection parameters in segregating generations. Judicious selection of genotypes from the clusters may be used as potential donors for future hybridization programmes to develop varieties and hybrids of high yield without much compromise on quality. [ABSTRACT FROM AUTHOR]

This paper presents a non-dominated sorting based multi-objective artificial bee colony algorithm NSABC to solve multi-objective optimization problems. It is an extension of the artificial bee colony algorithm ABC, which is a single objective optimization algorithm, to the multi-objective optimization domain. It uses a novel approach in the employee bee phase to steer the solutions to simultaneously achieve both the orthogonal goals in the multi-objective optimization – convergence and diversity. The onlooker bee phase is similar to the ABC except for the fitness computation to exploit the promising solutions whereas there is no change in the scout bee phase, which is used to get rid of bad solutions and add diversity in the swarm by introducing random solutions. Along with a novel way of exploring new solutions, it uses non-dominated sorting and crowding distance, inspired by the NSGA-II, to maintain the best and diverse solutions in the swarm. It is tested on the 10 two-objective and three-objective unconstrained benchmark problems of varying nature and complexities from the CEC09 suite of test problems and is found better than or commensurable to thirteen state-of-the-art significant multi-objective optimization algorithms as well as other multi-objective variants of the ABC. Further, it is tested on the nine real-life data clustering problems considered from the UCI machine learning repository and proved itself better in comparison to the NSGA-II, MOVGA, and a recent multi-objective variant of the ABC named MOABC. Thus, it is observed that the NSABC is comparatively a simple, light, and powerful algorithm to solve multi-objective problems. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of levonorgestrel-releasing intrauterine system (LNG-IUS) on heavy menstrual bleeding in perimenopausal women. Methods: This was a prospective, observational clinical study conducted on 42 perimenopausal women with heavy menstrual bleeding who met the study eligibility criteria. LNG-IUS was inserted in the postmenstrual phase following baseline evaluation. The patients were followed up at the 4, 12, and 24 weeks. Pictorial blood assessment chart (PBAC) score, hemoglobin and serum ferritin levels, and endometrial thickness were assessed before insertion and during the follow-up visits. Results: Two patients (4.8%) were lost to follow-up, three patients (7.1%) opted for hysterectomy, two women (4.8%) experienced spontaneous expulsion and 35 (83.3%) women continued the usage. Menstrual blood loss assessed using the median PBAC score (interquartile range) significantly reduced (P < 0.001) from the pre-insertion level of 280 (246-306) to 124 (60-200) at 4 weeks to 45 (34-76) at 12 weeks and further to 32 (20-50) at the end of 24 weeks. Simultaneously, a significant (P < 0.001) improvement in the mean hemoglobin and serum ferritin levels and a significant (P < 0.001) decrease in endometrial thickness were observed. The most common side effect was spotting (50.0%) and vaginal discharge (38.1%). Conclusions: LNG-IUS causes a remarkable reduction in menstrual blood loss and marked improvement in dysmenorrhea. It also reduces anemia by improving the hemoglobin and ferritin levels. Thus, it can serve as an effective treatment option for heavy menstrual bleeding in perimenopausal women and prevent the need for a hysterectomy. [ABSTRACT FROM AUTHOR]

Background: Thrombocytopenia may result from mechanisms such as marrow hypoplasia, increased destruction of platelets, and splenic sequestration. The gold standard method for discriminating the causes of thrombocytopenia is bone marrow examination, but it is invasive and expensive. Therefore, an alternative method should be introduced as a first-line diagnostic procedure. Of late, the automated blood cell analyzer has made it possible to assess the cause of thrombocytopenia through various machine-derived parameters, known as platelet indices, which include the mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), which are provided as a part of routine complete blood count. Objectives: The objectives of the present study are to study the variation and effectiveness of platelet indices in establishing the etiology of thrombocytopenia. Method: An observational, prospective, and comparative study was conducted on 134 patients with thrombocytopenia, and 67 cases were taken as the normal group. The study group was classified into two groups: hypo-productive and hyper-destructive. Platelet indices were recorded and compared in the two groups along with the normal group. Results: The mean platelet count (10^3 µL) in the normal, hypo-productive, and hyper-destructive groups was 232.03 ± 74.84, 73.00 ± 36.52, and 68.28 ± 38.24, respectively. The MPV and mean PCT in the normal, hypo-productive, and hyper-destructive groups were 9.46 ± 1.68fL, 8.99 ± 1.49fL, and 11.35 ± 1.35fL and 0.22 ± 0.06%, 0.07 ± 0.04%, and 0.08 ± 0.05%, respectively. The mean PDW in the normal, hypo-productive, and hyper-destructive groups was 15.66 ± 1.76fL, 17.63 ± 1.01fL, and 18.32 ± 1.10fL, respectively. Conclusion: In the present study, platelet indices such as MPV, PCT, and PDW are higher in the hyper-destructive group and may discriminate hyper-destructive from hypo-productive causes of thrombocytopenia. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 has emerged as a global pandemic causing millions of critical cases and deaths. Early identification of at-risk patients is crucial for planning triage and treatment strategies. Methods and findings: We performed this systematic review and meta-analysis to determine the pooled prognostic significance of procalcitonin in predicting mortality and severity in patients with COVID-19 using a robust methodology and clear clinical implications. Design: We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane Handbook for Systematic Reviews of Interventions guidelines. We included thirty-two prospective and retrospective cohort studies involving 13,154 patients. Results: The diagnostic odds ratio of procalcitonin for predicting mortality were estimated to be 11 (95% CI: 7 to 17) with sensitivity, specificity, and summary area under the curveof 0.83 (95% CI: 0.70 to 0.91), 0.69 (95% CI: 0.58 to 0.79), and 0.83 (95% CI: 0.79 to 0.86) respectively. While for identifying severe cases of COVID-19, the odds ratio was 8.0 (95% CI 5.0 to 12.0) with sensitivity, specificity, and summary area under the curve of 0.73 (95% CI 0.67 to 0.78), 0.74 (0.66 to 0.81), and 0.78 (95% CI 0.74 to 0.82) respectively. Conclusion: Procalcitonin has good discriminatory power for predicting mortality and disease severity in COVID-19 patients. Therefore, procalcitonin measurement may help identify potentially severe cases and thus decrease mortality by offering early aggressive treatment. [ABSTRACT FROM AUTHOR]

Objective: Due to the lack of resources for culture and antibiotic susceptibility testing in most underdeveloped countries, puerperal sepsis is treated empirically with a wide range of antibiotics. Empirical treatment, on the other hand, does not ensure treatment effectiveness and may even contribute to antibiotic resistance. So, we studied cases of puerperal sepsis, its socio-demographic factors, bacterial isolates, and antibiotic sensitivity in a tertiary health center. Material and Methods: This was a cross-sectional study conducted at the obstetrics and gynecology department of a tertiary health center in India from April 2019 to September 2020. During this time, all patients with sepsis who met the criteria for inclusion were included. After granting an informed written consent, the subjects were registered on a pre-designed proforma. Results: There were 2,049 obstetrical admissions throughout this period, with 106 (5.1%) of these having puerperal sepsis. The majority of these women (58.7%) were between the ages of 21 and 30, were multiparous (96.5%), and unbooked. Fever 104 (98.1%) was the most prevalent clinical characteristic, whereas wound gape was the most common consequence (47.1%). Klebsiella aerogens was the most common organism found in various cultures. Many organisms were shown to be multidrug-resistant and sensitive to gentamycin and amikacin. Conclusion: Klebsiella aerogens wasthe most common cause of puerperal sepsis in this investigation. Because the causal agents of puerperal sepsis and their antibiotic sensitivity patterns change over time, positive blood culture and antibiotic susceptibility of the isolates are the best guides for selecting the optimum antimicrobial therapy for treating sepsis. [ABSTRACT FROM AUTHOR]

Micronutrients enrichment in the staple food crops is an utmost breeding goal to alleviate „hidden hunger?. A set of forty eight maize (Zea mays L.) genotypes were evaluated for kernel iron (Fe), Zinc (Zn) and carotenoid concentration (β-carotene). The results revealed significant genetic variation among maize genotypes for Fe with values ranging from 22.59-41.03 mg/kg and a mean of 31.92 mg/kg. Whereas CM145 recorded highest kernel iron concentration (41.03 mg/kg) followed by CML193 (40.70 mg/kg) and KI-29 (39.75 mg/kg). For kernel Zn, range varied from 19.38-32.59 mg/kg with a mean of 24.80 mg/kg. The inbred CML169 recorded highest kernel Zn concentration (32.59 mg/kg) followed by CML193 (32.13 mg/kg) and CM152 (32.12 mg/kg). For kernel carotenoid range observed from 10.72-27.61 µg/g with a mean of 19.51 µg/g. The inbred CML162 recorded highest carotenoid concentration (27.09 µg/g) followed by Jaisinghpur Local (27.61 µg/g), BAJIM-06-01 (27.01 µg/g), Rato Makki2 (26.85 µg/g), LM-19-07 (26.57 µg/g) and BAJIM-08-26 (26.28 µg/g). These genotypes were identified as promising genotypes. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA) is a well-known plasticizer and xenoestrogen that is responsible for many acquired reproductive difficulties, especially in men. Despite the prevalence of BPA in society, the mechanism behind reproductive deficits remains elusive. The present study investigates the mode of BPA's action by evaluating its effect on the expression of inducible nitric oxide synthase (iNOS) and steriodogenic acute regulatoryprotein (StAR) in male mice testis. Swiss albino mice were treated with a range BPA concentrations of 0.5, 50 and 100 μg/kg body weight/day intraperitoneally for 60 days. Several markers of oxidative stress and male fertility were investigated. Nitrite levels, malondialdehyde levels and testicular injury scores were elevated whereas the sperm count, serum testosterone levels and catalase activity were reduced in the BPA groups. Mechanistically, an increase in iNOS expression was observed in the testis whereas the expression of the StAR was down regulated in the BPA treated mouse. These results suggest that BPA induces oxidative stress by altering the expression of iNOS, which consequently leads to the down regulation of StAR expression in the testis of male mouse. [ABSTRACT FROM AUTHOR]

Anemia is the most common haematological disorder in pregnancy. Anemia increases maternal morbidity and mortality. It is a condition that can be diagnosed and treated during antenatal period, preventing the serious complications of anemia during pregnancy and labour. Aims: This study investigated the prevalence of types of anemia during pregnancy and fetomaternal outcomes among pregnant women. Study Design: This was a cross-sectional study that enrolled 1100 pregnant women who were in the third trimester of pregnancy with haemoglobin level <11.0 gm/dl between March 2019 and August 2020. Methods and Material: Participants were selected by consecutive sampling and baseline data were collected by using a predesigned and pretested structured questionnaire. Data Analysis: Data were entered and analysed by using SPSS version 20. Results: The prevalence of anemia in third-trimester pregnancy in this study was 91.05%. Iron deficiency anemia was most common (69.18%) among pregnant women followed by megaloblastic anemia (2.5%). Most of pregnant women (45.90%) were mildly anemic. Mean ± SD of haematological parameters among the anemic pregnant women during third trimester of pregnancy were haemoglobin (8.08±2.24 gm/dl), haematocrit (28.92±7.78%), mean corpuscular volume (MCV) (93.02±11.32fl), mean corpuscular haemoglobin (MCH) (26.03±2.90 pg), mean corpuscular haemoglobin concentration(MCHC) (27.99 ± 2.01 gm/dl), RBC count (3.05 ± 0.67million/mm3). Most common maternal complications due to anemia in pregnancy was preterm labour (30%). Fetal outcome in the form of an alive term, most commonly seen in mild anemia (34.7%), fetal complications like Preterm alive (11.3%), preterm intrauterine fetal death (IUFD) (2.7%) most commonly associated with severe anemia. Conclusion: The present study concludes that the prevalence of anemia among pregnant women in third trimester of pregnancy was 91.05% which is a serious public health problem. Proper counselling to the patients and their family members regarding cause of anemia, effect of anemia and complications of anemia. So, that such preventable condition can be prevented. [ABSTRACT FROM AUTHOR]

Background: Combined spinal and epidural anesthesia (CSEA) is commonly performed by double space technique (DST) and single space segment technique (SST) or needle-through-needle technique (NNT). Aims and Objectives: We designed a double-blind randomized controlled study to compare the effect of the double-space technique with that of the single-space technique on time required by the procedure, the number of attempts, and a level of sensory, side effects and cost-effectiveness. Materials and Methods: Patients undergoing elective lower abdominal and lower limb surgeries under regional anesthesia were randomized to receive CSEA with either the double-space technique (double group, n = 30) or the single-space technique (single group, n = 30). In the single group, the procedure was performed at the L3-4 interspace using the needle-through-needle technique. In the double group, an epidural catheter was inserted at the L1–2 interspace, and dural puncture was performed at the L3–4 interspace. Results: The single space (needle-through-needle) technique for CSE takes less time, less number of spinal punctures. There was no difference between the two groups in terms of side effects. Sensory level at T10 on 5 min in group I was 90% and group II was 100% whereas at T8 it was 10% in group I; sensory level at T10, T8 and T6 on 10 min. in group I were 53.3%, 43.3% and 3.3% respectively whereas in group II were 80%, 16.7% and 3.3% respectively; sensory level at T10, T8, T6 and T4 on 15 min. in group I were 6.7%, 43.3%, 50% and 0% respectively whereas in group II were 23.3%, 50%, 23.3% and 3.3% respectively; and sensory level at T4, T6 and T8 on 20 min. in group I were 0%, 73.3% and 26.7% respectively whereas in group II were 16.7%, 33.3% and 50% respectively. Conclusions: Single-space (needle-through-needle) CSEA takes less time, less number of spinal punctures and results in improved patient satisfaction. There were no differences in intraoperative variables between the DST and SST for CSEA. [ABSTRACT FROM AUTHOR]

This article discusses a case study of a 13-year-old male child with post-traumatic cervical epidural haematoma. The child presented with neck pain, weakness, and numbness in both upper limbs following a fall while playing. The patient underwent decompressive laminectomy and evacuation of the epidural haematoma under general anesthesia. The article highlights the concerns regarding positioning, airway management, pain management, and maintaining spinal perfusion pressure. The perioperative period was uneventful, and the patient was discharged with improved upper limb power. [Extracted from the article]

Background: The effect of perineural versus intravenous (i.v.) dexamethasone (4 mg) when added to levobupivacaine as an adjuvant has not been well studied. Aims: This study was conducted to compare the analgesic efficacy of perineural and i.v. dexamethasone as an adjuvant to levobupivacaine in infraclavicular brachial plexus (ICBP) block. Settings and Design: This was a prospective, randomized, double-blind study. Materials and Methods: This study was conducted on 68 patients with the ultrasound-guided ICBP block, randomly allocated into two groups (34 each). Four patients had failed block (2 in each group) that was excluded from the study. Group A received 25 mL of levobupivacaine 0.5% and 1 mL of normal saline for the block and i.v. dexamethasone 4 mg. Group B received 25 mL of levobupivacaine 0.5% with 4 mg of perineural dexamethasone for the block. Postoperative vitals and different block characteristics were assessed. Statistical Analysis Used: Student's independent sample t-test and Chi-square test were used for statistical analysis. Results: The duration of motor block and analgesia in Group A was 1245.94 ± 153.22 min and 1310.16 ± 151.68 min, respectively. However, in Group B, the duration of motor block and analgesia was 1768.13 ± 309.86 min and 1743.59 ± 231.39 min, respectively, which was more when compared to Group A (P < 0.001). The Visual Analog Scale score of ≥3 in Group A was 37% and in Group B was 9% (P = 0.008). Four cases had delayed regression of motor block in the perineural group. Conclusions: Perineural dexamethasone significantly prolonged the duration of motor block promoted by levobupivacaine in infraclavicular brachial plexus block, reduced pain intensity and rescue analgesia needs in the postoperative period when compared with the intravenous dexamethasone. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to compare the analgesic efficacy of intrathecal fentanyl with ultrasound-guided transversus abdominis plane (TAP) block after lower segment cesarean section. The objectives of the study were to compare the effects of subarachnoid fentanyl versus TAP block with respect to duration of postoperative analgesia, time for first analgesic request, total analgesic consumption in 24 h, time to first breastfeed and Apgar score at 1 and 5 min. Materials and Methods: Sixty-two patients undergoing elective or emergency cesarean delivery were recruited for the study in a prospective, randomized, single-blind manner. The patients were randomly allocated to either intrathecal fentanyl group (Group F) or TAP block group (Group T) after determining the eligibility criteria. Group F patients received subarachnoid block with 10 mg of 0.5% bupivacaine heavy with 25 mcg of fentanyl. Group T patients received subarachnoid block with 10 mg of 0.5% bupivacaine heavy prior to surgery and at the end of surgery, they received TAP block with 0.25% bupivacaine 20 mL on each side. Results: Group T had significantly longer time for the first analgesic request (7.65 ± 1.23 h) than group F (4.10 ± 0.32 h). The total analgesic consumption in 24 h was significantly less in Group T (1.0 ± 0) than Group F (2.13 ± 0.34). The Visual Analogue Scale scores at rest and on movement were significantly less in Group T than Group F at all-time points. The Apgar score at 1 and 5 min and time to first breast feed were comparable between the two groups. The incidence of side effects was less in Group T. Conclusion: This study indicated that ultrasound-guided TAP block has a better analgesic as well as safety profile compared to intrathecal fentanyl for cesarean delivery. [ABSTRACT FROM AUTHOR]

Leishmania protozoans are the causative agent of leishmaniasis, a neglected tropical disease consisting of three major clinical forms: visceral leishmaniasis (VL), cutaneous leishmaniasis, and mucocutaneous leishmaniasis. VL is caused by Leishmania donovani in East Africa and the Indian subcontinent and by Leishmania infantum in Europe, North Africa, and Latin America, and causes an estimated 60,000 deaths per year. Trypanothione reductase (TR) is considered to be one of the best targets to find new drugs against leishmaniasis. This enzyme is fundamental for parasite survival in the human host since it reduces trypanothione, a molecule used by the tryparedoxin/tryparedoxin peroxidase system of Leishmania to neutralize the hydrogen peroxide produced by host macrophages during infection. Recently, we solved the X-ray structure of TR in complex with the diaryl sulfide compound RDS 777 (6-(sec-butoxy)-2-((3-chlorophenyl)thio)pyrimidin-4-amine), which impairs the parasite defense against the reactive oxygen species by inhibiting TR with high efficiency. The compound binds to the catalytic site and engages in hydrogen bonds the residues more involved in the catalysis, namely Glu466′, Cys57 and Cys52, thereby inhibiting the trypanothione binding. On the basis of the RDS 777–TR complex, we synthesized structurally related diaryl sulfide analogs as TR inhibitors able to compete for trypanothione binding to the enzyme and to kill the promastigote in the micromolar range. One of the most active among these compounds (RDS 562) was able to reduce the trypanothione concentration in cell of about 33% via TR inhibition. RDS 562 inhibits selectively Leishmania TR, while it does not inhibit the human homolog glutathione reductase. [ABSTRACT FROM AUTHOR]

Modified directed self-learning sessions in physiology with prereading assignments and Pecha Kucha talks: perceptions of students. Adv Physiol Educ 42: 26 –31, 2018; doi: 10.1152/advan.00048.2017.—The present study reports perceptions of first-year undergraduate medical students (n 120), regarding modified directed self-learning (DSL) sessions in physiology. Students were provided with prereading assignments (faculty developed PowerPoint slides containing diagrams with incomplete labeling/ flowcharts with missing steps) pertaining to the DSL topic 1 wk before the scheduled small-group DSL presentations. During DSL presentation sessions, which were facilitated by teachers, a few students individually presented learning objectives in the specified topic. Apart from that, students discussed answers for the questions in the prereading assignment. Students were also given an opportunity to use technology to support DSL, by way of involving them in Pecha Kucha (PK) talks. The impact of the modified DSL method was determined by requesting students to respond to a validated questionnaire. Frequency analysis of the responses revealed that 60% of students were positive about the modified DSL sessions improving their DSL, presentation, collaborative learning, and information retrieving skills. Students agreed that PK talks helped them to learn how to organize content (65%), present concise information (65.8%), and apply creativity (72.5%). Even though small in number, there were comments that the prereading assignments were useful for learning. The present study revealed that, even though students actively participated in modified DSL sessions, their perceptions on satisfaction and usefulness of the same toward achievement of various skills were not encouraging. The study generated significant results, which implies that undergraduate medical students should be oriented on the relevance of active learning strategies in their future studies. [ABSTRACT FROM AUTHOR]

Pancreatic heterotopia is defined as pancreatic tissue outside the boundary of pancreas that lacks an anatomic and vascular connection to it. Till today, no case of pancreatic heterotopia along with tubercular ileitis has been reported. We report one such case that presented in our institution. [ABSTRACT FROM AUTHOR]

Desi cotton Gossypium arboreum has wide adaptability under rainfed situation and also high degree of resistance to biotic and abiotic stresses. Present investigation total sixty GMS based desi cotton F1 hybrids along with complete set of nighteen parents and one checks were evaluated for variability, heritability and genetic advance in different yield and yield contributing traits. The treatment, i.e. mean sum of squares due to genotypes revealed significant differences for all characters studied, that revealing the presence of high genetic variability among the genotypes. The estimates of GCV were lower than the respective PCV; it means that the apparent variation is not only due to genotypes but also due to the influence of environmental factors on the expression of the traits studied. Characters like seed cotton yield/plant, No. of bolls plant-1 and gossypol content showed high GCV, PCV, heritability coupled with high genetic advance as percent of mean, suggesting that selection for the improvement of these characters may be rewarding. High heritability estimates coupled with high expected genetic advance as percent mean were observed for the traits like, seed cotton yield plant-1, No. of bolls plant-1 and gossypol content, that indicating presence of additive gene effects in its inheritance and such characters could be improved by selection. Low heritability estimates with expected low genetic advance were observed for the traits like Lint index, boll weight boll-1 and seed index that also indicates greater role of non-additive gene action in their inheritance suggesting heterosis breeding could be useful for improving these traits. [ABSTRACT FROM AUTHOR]

Pycnodysostosis (the Toulouse-Lautrec syndrome) is a rare autosomal-recessive disorder of osteoclast dysfunction. This disorder was first described by Maroteaux and Lamy in 1962. We describe anaesthetic management of a 35-year-old female having pyknodysostosis with fracture shaft left femur with anticipated difficult intubation. Therefore, spinal anesthesia was planned for her fracture fixation.The intra- and postoperative period remains uneventful. [ABSTRACT FROM AUTHOR]