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Targeted rapid degradation of bilirubin has the potential to thwart incipient bilirubin encephalopathy. We investigated a novel spinel-structured citrate-functionalized trimanganese tetroxide nanoparticle (C-MnSevere neonatal unconjugated hyperbilirubinemia (SNH) was induced in neonatal C57BL/6j mice model with phenylhydrazine (PHz) intoxication. Efficiency of the nanodrug on both in vivo bilirubin degradation and amelioration of bilirubin encephalopathy and associated neurobehavioral sequelae were evaluated.Single oral dose (0.25 mg kgThis study demonstrates the in vivo capacity of this novel nanodrug to reduce systemic and neural bilirubin load and reverse bilirubin-induced neurotoxicity. Further compilation of a drug-safety-dossier is warranted to translate this novel therapeutic chemopreventive approach to clinical settings.None of the current pharmacotherapeutics treat severe neonatal hyperbilirubinemia (SNH) to prevent risks of neurotoxicity. In this preclinical study, a newly investigated nano-formulation, citrate-functionalized Mn

The potentiality of Förster resonance energy transfer (FRET) for studying molecular interactions inside biological tissues with improved spatial (Angström) and temporal (picosecond) resolution is well established. On the other hand, the efficacy of diffuse reflectance spectroscopy (DRS) that uses optical radiation in order to determine physiological parameters including haemoglobin, and oxygen saturation is well known. Here we have made an attempt to combine diffuse reflectance spectroscopy (DRS) with picosecond-resolved FRET in order to show improvement in the exploration of molecular contacts in biological tissue models. We define the technique as ultrafast time-resolved diffuse reflectance spectroscopy (UTRDRS). The illuminated photon of the fluorophore from the surface of the tissue-mimicking layers carries the hidden information of the molecular contact. In order to investigate the validation of the Kubelka-Munk (KM) formulism for the developed UTRDRS technique in tissue phantoms, we have studied the propagation of incandescent and picosecond-laser light through several layers of cellulose membranes. While picosecond-resolved FRET in the diffuse reflected light confirms the hidden nano-contact (4.6 nm) of two different dye layers (8-anilino-1-naphthalenesulfonic acid and Nile blue), high-resolution optical microscopy on the cross-section of the layers reveals the proximity and contacts of the layers with limited spatial resolution (∼300 nm). We have also investigated two biologically relevant molecules, namely carboxyfluorescein and haemoglobin, in tissue phantom layers in order to show the efficacy of the UTRDRS technique. Overall, our studies based on UTRDRS in tissue mimicking layers may have potential applications in non-invasive biomedical diagnosis for patients suffering from skin diseases.

The pediatric sequential organ failure assessment (pSOFA) score has been recently validated from its adult version having included the six clinical and biochemical parameters of organ dysfunction (respiratory, coagulation, cardiovascular, neurological, hepatic, and renal) and adapting age-adjusted cutoffs. Our goal was to find out which among the pSOFA scores (recorded on admission, highest score, and the mean score i.e., pSOFA1, pSOFAh, and pSOFAm respectively) performed better to predict mortality among the patients admitted in our pediatric intensive care unit (PICU). This prospective observational study was conducted on 104 patients (1 month to 12 years of age) admitted in the eight bedded PICU of a tertiary care hospital in India who met the inclusion criteria. The highest values of serial pSOFA scores were recorded on every alternate day starting from the day of admission up to day 9. The mean and median values of the pSOFA1, pSOFAm, and pSOFAh were higher in the nonsurvivor group than in the survivors. The mean pSOFA (with a diagnostic accuracy of 92.3% at a mean cut-off value of 12.8) has outperformed the other two pSOFA scores. In this exploratory analysis, the pSOFAm is the best tool in predicting the mortality outcome of any critically ill child. The use of the pSOFA score at admission and the mean values helps the clinician to quantify the organ dysfunction, and it may be helpful for the clinicians to take steps for further management. It may be useful to communicate to the parents of the sick child for prognostication too. The pSOFA1 also reflects well on the early prognostication when multiple pSOFA scores are unavailable. In the resource constraint settings, one may rely on the pSOFA1 and the approximate pSOFAm value may be predicted from the pSOFA1 as pSOFAm=[(1.03 XpSOFA1) – 0.9] within limitations.

Normal sexual behavior brings pleasure to oneself and one's partner involves stimulation of the primary sex organs including coitus; it is devoid of inappropriate feelings of guilt or anxiety and is not compulsive. Sexual functioning is influenced by a number of factors, mental illness being one of them. Sexual dysfunction in patients with OCD has mostly been studied independently or in gender-specific studies. These studies have reported significant dysfunction in different areas of sexual functioning. The aim of this study is an attempt to assess & compare the presence, prevalence & types of sexual dysfunctions (SD) in OCD mostly coming from rural background in a Tertiary Government Hospital in West Bengal. Our study revealed Sexual dysfunction was in 53.33% of the subjects. Orgasmic dysfunction was the most frequent dysfunction 20.51% in females (N=8), followed by problems in desire15.38%. However since the data were collected from a specific population, the degree to which they represent the general population cannot be commented upon. Key word : OCD, Sexual Dysfunction

Deferiprone (DFP) and deferasirox (DFX) are the most well-known, efficacious and safe chelators to reduce the serum ferritin (SF) level in multi transfused thalassemic children, although there are few reports available for assessing the efficacy between DFP and DFX. We compared the efficacy of DFP vs. DFX as iron chelating drugs in β-thalassemia major (β-TM) patients. Pediatric patients diagnosed to carry β-TM, aged between 2 and 10 years, were recruited. A suitable data collection form and questionnaire were used. Paired and unpaired t-tests were used to compare the safety and efficacy of the chelating drugs DFP and DFX. The mean SF level at the 12th month was found to be 3016.73 ± 670.04 ng/mL (p = 0.002) in the DFX-treated group, which was quite significant in contrast to DFP response, where the value was 3204.06 ± 690.15 ng/mL (p = 0.14). There is no statistically significant (p = 0.15) difference on relative changes of the left ventricular ejection fraction (LVEF), between these two groups. The adverse effects were transient and none of them required stoppage of therapy. Deferasirox is more effective when compared to DFP in reducing chelating drug-related complications and iron overload specially in multiple transfusion dependent β-TM patients.

The usual treatment for anemia and especially for anemia of inflammation (also called anemia of chronic disease) is supportive care with the target of improving the lifestyle of the patients. There is no effective medication to date for proper management. As the inflammation, erythropoiesis, and oxidative stress are the major concerns in this case, it inspired us to use a nano-erythropoietin stimulating agent (nano-ESA) made up of a nano-complex of manganese and citrate (Mn-citrate nano-complex), which has been hypothesized to have excellent antioxidant and anti-inflammatory mechanisms. Single oral dose of the nano-ESA efficiently prevented the onset of anemia as well as led to recovery from anemia in our phenylhydrazine (PHz)-intoxicated C57BL/6J mice model of anemia without any toxicological side effects. These preliminary findings may pave the way for an affordable and safe clinical use of the nano-ESA as a rapid recovery medication of anemia, especially anemia of inflammation.

The study was aimed to evaluate the performance of a newly developed non-invasive and non-contact bilirubin measurement device (AJO-Neo) as an alternative to the conventional invasive biochemical method of total serum bilirubin (TSB) estimation in preterm and term neonates suffering from hyperbilirubinemia associated with risk factors, and/or undergoing phototherapy. The safety and efficacy of the device were assessed in 1968 neonates with gestational ages ranging from 28 to 41 weeks and suffering from incidences of hyperbilirubinemia. Linear regression analysis showed a good correlation between AJO-Neo and the conventional method of TSB (Pearson’s coefficient, r = 0.79). The small bias (0.27 mg/dL) and limits of agreements (− 3.44 to 3.99 mg/dL) were within the range of clinical acceptance. The device was also precise in the measurement of bilirubin levels in all subgroups of the study. The receiver operator curve (ROC), that takes account of both sensitivity and specificity of a device showed high efficacy of the device (area under the curve, AUC = 0.83) in the detection of bilirubin. While monitoring the bilirubin level during phototherapy, the device indicated promising results showing good agreement with TSB. Specificities and sensitivities of the device indicated a much higher accuracy in neonates with associated risk factors for hyperbilirubinemia. Hence, the newly developed device (AJO-Neo) is reliable in measuring bilirubin level in preterm, and term neonates irrespective of gestational or postnatal age, sex, risk factors, feeding behavior or skin color.

Drug delivery to a target without adverse effects is one of the major criteria for clinical use. Herein, we have made an attempt to explore the delivery efficacy of SDS surfactant in a monomer and micellar stage during the delivery of the model drug, Toluidine Blue (TB) from the micellar cavity to DNA. Molecular recognition of pre-micellar SDS encapsulated TB with DNA occurs at a rate constant of k

Neonatal encephalopathy is a common entity encountered by treating physicians in any neonatal intensive care unit. Though hypoxic ischaemic encephalopathy is the most frequent cause in developing countries, metabolic causes should also be looked for in refractory neonatal seizures with sibling death and parental consanguinity. Early myoclonic infantile encephalopathy, considered under the broad spectrum of infantile encephalopathy, is a rare syndrome in infants with onset within 3 months of age. It is characterized by myoclonic seizures, features of encephalopathy and caused by underlying metabolic diseases, nonketotic hyperglycinemia being the most common cause. On contrary its close mimicker, Ohtahara syndrome or early infantile epileptic encephalopathy is most likely associated with structural neurological lesions. We report a 12-day term Indian male neonate, born of second degree consanguinity with multiple sibling death history, presented with refractory myoclonic seizures in spite of uneventful birth history. Myoclonic seizures, refractory to intravenous phenobarbitone, phenytoin and infusion Midazolam, persisted after ruling out hypoglycemia, dyselectrolytemia, and neonatal sepsis. EEG showed typical burst suppression pattern pointing towards diagnosis of early myoclonic infantile encephalopathy. Further metabolic causes were looked for but tandem mass spectrometry for dried blood sample was normal. Lastly, urinary GCMS revealed 5-oxoprolinuria, an autosomal recessive condition, characterized by acidosis, jaundice, and severe hemolytic anemia among neonates, primarily due to glutathione synthetase enzyme deficiency. In severe form of 5-oxoprolinuria, neurological complications in form of seizures, ataxia have been documented in earlier studies; however, its association with myoclonic encephalopathy is yet to be reported in the literature and this report may be the first of its kind.

Urinary bladder cancer (UBC) is one of the most common cancers and has notoriously high risk of recurrence and mortality across the globe. Current clinical initial diagnostic approaches are either invasive or lacks sensitivity. In this study, an attempt has been made to invent a cost-effective, novel, portable diagnostic device based on the environmental sensitive fluorophores namely Nile Red (NR), Eosin Y (EY) and Rose Bengal (RB). They act as sensing agents for detecting volatile organic compounds (VOC) exclusively present in the urine sample of UBC patients and differentiate the UBC samples from the healthy control group. Upon exposure with a particular group of VOCs, a significant amount of increment in fluorescence intensities of NR, EY and RB were detected and recorded in our indigenously developed "NABIL" device. To check the performance of NABIL, the data collected from the device was compared with the conventional techniques by arranging a clinical trial with 21 healthy controls and 52 UBC patients. With the assistance of our analysis technique based on LabVIEW platform, very high sensitivity and accuracy from healthy controls have been achieved. For UBC patients, it shows impressive diagnostic results. In addition, depending on the sample processing mechanism, NABIL device can also reveal the grade of UBC and prognosis under treatment. Overall, this study contributes a novel, non-invasive, easy-to-use, inexpensive, real-time, accurate method for selectively UBC diagnosis, which can be useful for personalized care/diagnosis and postoperative surveillance, resulting in saving more lives.

Careful screening of bilirubin level in newborns is mandatory as per American Academy of Pediatrics (2004), to reduce incidents of kernicterus and acute bilirubin encephalopathy. Although, invasive capillary collection of blood and subsequent biochemical test is considered a gold standard for jaundice detection in neonates, transcutaneous bilirubin measurement using various non-invasive instruments is also used sporadically across the globe. The major aim of this study was to develop a non-invasive spectrometry-based technique for measurement of neonatal bilirubin level as an alternative of total serum bilirubin (TSB) test without limitations of other available bilirubinometers.The instrument comprises of a light source and a spectroscopic detector. A light beam from source incident on the neonatal nail plate through optical fibers. The retro reflected light is acquired using the detector. An indigenously developed software is used to acquire and analyze the optical signal and to calculate the bilirubin value. The instrument was calibrated and validated in reference to TSB on 1033 subjects.The result (r = 0.95 and P0.001) indicates a strong correlation between the bilirubin value obtained from our method and TSB. Time variant analysis of the subjects undergoing phototherapy provided a good correlation (r = 0.98). The repeatability test result shows the mean coefficient of variation is less than 5.0%.The indigenously developed non-invasive technique successfully detects the bilirubin level in newborns under various physiological conditions with high accuracy and precision.

Precise control of intracellular redox status, i.e., maintenance of physiological level of reactive oxygen species (ROS) for mediating normal cellular functions (oxidative eustress) while evading the excess ROS stress (distress) is central to the concept of redox medicine. In this regard, engineered nanoparticles with unique ROS generation, transition, or depletion functions have the potential to be the choice of redox therapeutics. However, it is always challenging to estimate whether ROS-induced intracellular events are beneficial or deleterious to the cell. Here, we propose the concept of redox buffering capacity as a therapeutic index of engineered nanomaterials. As a steady redox state is maintained for normal functioning cells, we hypothesize that the ability of a nanomaterial to preserve this homeostatic condition will dictate its therapeutic efficacy. Additionally, the redox buffering capacity is expected to provide information about the nanoparticle toxicity. Here, using citrate functionalized trimanganese tetroxide nanoparticles (C-Mn3O4 NPs) as a model nanosystem we explored its redox buffering capacity in erythrocytes. Furthermore, we went on to study the chronic toxic effect (if any) of this nanomaterial in animal model in order to co-relate with the experimentally estimated redox buffering capacity. This study could function as a framework for assessing the capability of a nanomaterial as redox medicine (whether maintains eustress or damages by creating distress), thus orienting its application and safety for clinical use.

Regular monitoring of electrolyte balance is essential for patients suffering from chronic kidney disease (CKD), particularly those undergoing dialysis. In the context of the recent COVID-19 pandemic, more severe forms of infection are observed in elderly individuals and patients having co-morbidities like CKD. The repeated blood tests for the monitoring of electrolyte balance predispose them not only to COVID-19 but also other to hospital-acquired infections (HAI). Therefore, a non-invasive method for easy detection of essential electrolyte (K+ and Na+) levels is urgently needed. In this study, we developed an optical emission spectroscopy-based non-invasive device for simultaneous monitoring of salivary Na+ and K+ levels in a fast and reliable way. The device consisted of a closed spark chamber, micro-spectrometer, high voltage spark generator, electronic circuits, optical fiber, and an indigenously developed software based on the LabVIEW platform. The optical emission originating from the biological sample (i.e., saliva) due to recombination of ions energized by impingement of electrons returning from high voltage spark provides necessary information about the concentration of electrolytes. A small-scale clinical trial on 30 healthy human subjects shows the potential of the indigenously developed device in determining salivary Na + and K+ concentration. The low-cost, portable, point-of-care device requires only 2 mL of sample, and can simultaneously measure 1.0–190.0 mM Na+, and 1.0–270.9 mM K+ . To our understanding, the present work will find its relevance in combating COVID-19 morbidities, along with regular CKD patient-care.

We developed an integrated device composed of a single-probe Electroencephalogram (EEG) and Charge Coupled Device (CCD) based motion sensors for objective measurement of Attention-deficit Hyperactivity Disorder (ADHD). While the measurement of attention-deficit hyperactivity disorder (MAHD) relies on the EEG signal for the assessment of attention during a given structured task, the CCD sensor depicts the movement pattern of the subjects engaged in a continuous performance task. A statistical analysis of attention and movement patterns was performed, and the accuracy of completed tasks was analyzed using indigenously developed software. The device with the embedded software is intended to improve certainty with criterion E. We used the EEG signal from a single-channel dry sensor placed on the frontal lobe of the head of the subjects (3–5 year old pre-schoolers). During the performance of the task power for delta and beta, EEG waves from the subjects are found to be correlated with relaxation and attention/cognitive load conditions. While the relaxation condition of the subject hints at hyperactivity, a more direct CCD-based motion sensor is used to track the physical movement of the subject engaged in a continuous performance task. We used our indigenously developed software for statistical analysis to derive a scale for the objective assessment of ADHD. We also compared our scale with clinical ADHD evaluations and found a significant correlation between the objective assessment of the ADHD subjects and the clinician’s conventional evaluation. MAHD, the integrated device, is supposed to be an auxiliary tool to improve the accuracy of ADHD diagnosis by supporting greater criterion E certainty.

The current COVID-19 pandemic has increased the use of facial masks globally, which of late have registered their presence as a part of our civilization. The N95 mask is one of the most popular choices under the current situation. However, the available masks cannot provide breathing comfort for an extended period, which results in rebreathing of exhaled air that is CO2 rich, and which remains in the breathing space of the respirator. Furthermore, problems like moisture settlement on the covered area of the face due to the multiple layers of fabric-like material causes significant discomfort. Hence, the need for a mask with an air-purification activity is the need of the hour. The present innovation relates to the invention of a mask that is battery-powered or solar-operated and addresses the aforementioned problems. This mask not only regulates the airflow, which is beneficial to our body in every way, but also lowers the discomfort of sweating and heating. The effect of the addition of the self-developed active respirator to the commercially available masks on the inspired CO2 level, thermal comfort, and speech clarity has been demonstrated in this study. We have exhibited through in vitro experiments that the filtration capability of the active-respirator improvised mask, we call the Bose shield, does not deter from that of the standard N95 mask. To our understanding, the use of this novel mask can reduce the occurrence of CO2 rebreathing in respiratory protective devices and its impact on workers who inevitably wear them for a prolonged period of time.

BackgroundTargeted degradation of bilirubinin vivomay enable safer and more effective approach to manage incipient bilirubin encephalopathy consequent to severe neonatal hyperbilirubinemia (SNH). This report builds on the use of a spinel structured mixed-valence transition metal oxide (trimanganese tetroxide) nanoparticle duly functionalized with biocompatible ligand citrate (C-Mn3O4NP) having the ability to degrade bilirubin without photo-activation.MethodThe efficiency of C-Mn3O4NP inin vivodegradation of serum bilirubin and amelioration of severe bilirubin encephalopathy and associated neurobehavioral changes was evaluated in C57BL/6j animal model of SNH.ResultsOral single dose (0.25 mg kg-1body weight) of the NPs efficiently reduced serum bilirubin levels (both conjugated and unconjugated) in study mice. It prevents bilirubin-induced neurotoxicity with reduction of SNH as observed by neurobehavioral and movement studies of SNH-mice. Pharmacokinetic data suggests intestinal reabsorption of the NPs and explain sustainable action. Biodistribution, pharmacokinetics, and biocompatibility of the NPs were tested during sub-chronic exposure.ConclusionThus, we report preliminary studies that explore an affordable chemoprevention mechanism to acutely prevent or minimize bilirubin neurotoxicity in newborn infants.IMPACT STATEMENTDespite several attempts, no pharmaco-therapeutics are available for the treatment of severe neonatal hyperbilirubinemia (SNH) and associated neurotoxicity.Our newly developed nanodrug, citrate functionalized Mn3O4nanoparticles (C-Mn3O4NPs), can efficiently ameliorate SNH and associated neurotoxicity as investigated in preclinical rodent model.Chemoprevention effect of the nanodrug is found to be safe and sustainable.If successfully translated into clinical trials, C-Mn3O4NPs could become the first drug to treat SNH.

Introduction: Selective Serotonin Reuptake Inhibitors (SSRIs) are recommended as first-line anti-depressants in Major Depressive Disorder (MDD) because of their relatively benign safety profile. Hyponatremia is under reported and notorious adverse effect of SSRIs shown by few Randomised Clinical Trials (RCTs). There are only few published studies of SSRIs on serum sodium level in human and animal model. Aim: To determine SSRI induced hyponatremia in human and its correlation with age. Materials and Methods: The clinical part is a prospective cohort study whereas second part is experimental study involving animals. In clinical part-Patients of either sex, aged above 18 years, attending the Out-Patient Department (OPD) of Psychiatry of a tertiary hospital and diagnosed as MDD Diagnostic and Statistical Manual (DSM) V with the help of a senior psychiatrist, were screened and recruited in the study after satisfying the inclusion and exclusion criteria by consecutive sampling. Patients were prescribed fluoxetine (n=90), sertraline (n=55), paroxetine (n=30) and escitalopram (n=25). Parameters recorded (serum sodium) at baseline, 4th week, 8th week and 12th week. Symptoms due to hyponatremia and Adverse Drug Reactions (ADR) were also checked. Multiple group comparison at different visits for sodium level was done using one-way ANOVA and repeated measures ANOVA test and relationship of blood sodium level with age were estimated with bivariate correlation. Animal experiment was done in Pharmacology Department, animals were randomised into 5 groups control, fluoxetine, sertraline, paroxetine and escitalopram (n=6). Blood sodium checked at baseline, 2nd week and 4th week. Kruskal Wallis test and Friedman’s test done to detect changes in sodium level in follow-up period. Results: Mean age ranged between 40-50 years with equal gender distribution. Both within group and between group analysis revealed significant difference in blood sodium level (p-value< 0.0001). Hyponatremia was strongly correlated with age (correlation coefficient >-0.783). Most participants (184 out of 200) developed asymptomatic hyponatremia. Two among sertraline developed seizure leading to discontinuation to therapy. About 72 (38.09%) ADRs belonged to probable, mostly belonging to fluoxetine and sertraline group, developement of hyponatremia was 9 days (median) from starting SSRI. In animal part within group analysis revealed significant change of sodium from baseline in all drug treated animals (p-value

Background: The study was conducted to assess the prevalence of sexual dysfunction among alcoholicmale and extent of sexual dysfunction and quality of life among alcohol dependant male with or withoutsexual dysfunction.Study design: Cross sectional study involving newly diagnosed 50 alcohol dependant male patients attendedPsychiatry out patient department.Result: Study showed significant relationship between occupation, level of education and socio-economicclass with total quality of life score. 76% of alcohol dependant males have sexual dysfunction. Alcoholdependant males without sexual dysfunction + SE (51.906+ .865) compared to alcohol dependent male withsexual dysfunction (40.977 + .473) which is statistically significant.Conclusion: The study highlighted high rates of sexual dysfunction along with lower total quality of lifescore in the alcohol dependant group.

Objective : Schizophrenia is a serious disease characterized by impairment in the perception or expression of reality, leading to occupational and social dysfunction. The use of antipsychotic medication is now universal in the first-line treatment of schizophrenia. This study was undertaken to compare the efficacy of asenapine with a standard atypical antipsychotic, olanzapine in treating this disease. Methods It was designed as a single blind, randomized, controlled, parallel group, single centre Phase IV trial of a newer atypical antipsychotic, asenapine versus existing standard atypical antipsychotic, olanzapine. Total 80 subjects were enrolled as per eligibility criteria.Each recruited subject received daily treatment with the trial medication (Olanzapine 10 mg or Asenapine 10 mg daily) for duration of 12 weeks. BPRS, CGI-S, CGI-I, Laboratory parameters and compliance was assessed and analyzed. Continuous variables were compared by t test and non-parametric data was analyzed by Mann-Whitney U test and Wilcoxon signed rank test. Likely categorical variables were analyzed by chi-square test or Fisher's exact test, as appropriate. Results The duration of schizophrenia at presentation was comparable in both the treatment groups. There was significant reduction of BPRS score between any two visits of each treatment groups. The decline in CGI-S and CGI-I scores was statistically significant (p < 0.001) when compared between visits of any of the both treatment arms. Adherence to treatment was excellent for all patients. Conclusion Newer atypical antipsychotic asenapine is more effective than standard olanzapine in reducing the symptoms of schizophrenia in this study and further larger studies are to be done.

To determine efficacy of Point-of-care Quality improvement (POCQI) in early initiation (within 30 minutes) of emergency treatment among sick neonates. Quality improvement project over a period of twenty weeks. Special Newborn Care Unit (SNCU) of a tertiary care center of Eastern India. All consecutive sick neonates (≥ 28 wk gestation) who presented at triage during morning shift (8 am to 2 pm). We used a stepwise Plan-do-study-act (PDSA) approach to initiate treatment within 30 min of receiving sick newborns. After baseline phase of one month, a quality improvement (QI) team was formed and conducted three PDSA cycles (PDSA I, PDSA II and PDSA III) of 10 d each, followed by a post-intervention phase over 3 months. Percentage of sick babies getting early emergency management at SNCU triage. 309 neonates were enrolled in the study (56 in baseline phase, 88 in implementation phase and 212 in post-intervention phase). Demographic characteristics including birthweight and gestational age were comparable among baseline and post intervention cohorts. During implementation phase, successful early initiation of management was noted among 47%, 69% and 80% neonates following PDSA I, PDSA II and PDSA III, respectively. In comparison to baseline phase, the percentage of neonates receiving treatment within 30 minutes of arrival at triage increased from 20% to 76% (P

The potentiality of nano-enzymes in therapeutic use has directed contemporary research to develop a substitute for natural enzymes, which are suffering from several disadvantages including low stability, high cost, and difficulty in storage. However, inherent toxicity, inefficiency in the physiological milieu, and incompatibility to function in cellular enzyme networks limit the therapeutic use of nanozymes in living systems. Here, we have shown that citrate functionalized manganese-based biocompatible nanoscale material (C-Mn3O4 NP) efficiently mimics glutathione peroxidase enzyme in the physiological milieu and easily incorporates into the cellular multienzyme cascade for H2O2 scavenging. A detailed computational study reveals the mechanism of the nanozyme action. We further established the in vivo therapeutic efficacy of C-Mn3O4 nanozyme in a preclinical animal model of Huntington’s disease, a prevalent progressive neurodegenerative disorder, which has no effective medication till date.SUMMARYAlthough, nano-enzymes have shown lots of promises in the management of several diseases, two major concerns limit their clinical translation. Apart from the inherent toxicity of the constituent materials (e.g., cerium, vanadium, gold, etc.), activities of contemporary nanozymes are often inhibited in physiological milieu. Furthermore, most of them are incapable of incorporation into the cellular metabolic networks for functioning in tandem and parallel with natural enzymes, a major criteria for potential therapeutics.Here, we have shown that citrate-functionalized spherical Mn3O4 nanoparticles can efficiently mimic glutathione peroxidase (GPX) enzyme without the limitations of contemporary nanozymes, and effectively manage neurodegenerative Huntington’s disease in preclinical animal model. The choice of the material in the nanozyme lies on the fact that Mn is an essential micronutrient for mammals, and the stabilizing ligand citrate helps the nanoparticles to cross the blood-brain-barrier to reach brain. We have shown that the nanozyme can easily be incorporated in cellular antioxidant enzyme cascade. The specificity and efficacy of the nanozyme in the cascade was significantly higher compared to other reported nanozymes. We have justified our experimental findings with a detailed computational study. Understanding the mode of operation and management of Huntington’s disease in preclinical animal trial using a biocompatible (non-toxic) nanozyme as a part of the metabolic network may uncover a new paradigm in nanozyme based therapeutic strategy.

Background: Being in the age of technological advancement, the human mind is under constant risk of being engulfed by social media leading to pathological internet use. Cyberworld serves as a buffer under stress by means of satisfying various needs of an individual in the form of entertainment, access to information, gaining recognition and maintaining relationships. Conversely, the morbid preoccupation of the internet was found to be averted by positive coping resilience and sense of self-efficacy under stressful condition. Objectives: To observe the pattern of internet use in medical students and to explore any possible relationship of internet use with stressful life event and resilience level. Materials and Methods: The study sample was drawn from medical undergraduates using semistructured questionnaire consisting of demographic profile, details of various aspects of internet use, internet addiction test questionnaire (IAT), resilience scale and student stress scale (SSS). Results: Almost all of the participants (n = 98) used the internet and social media. Mean age of the sample was 20.41 (±1.64) years, 64.3% were male and 35.7% female. On IAT, 80.6% students were moderate users, and 19.4% were problem users. IAT negatively correlated with resilience (r = −0.272, P = 0.007), whereas positively correlated with SSS total score (r = 0.330, P = 0.001) and total number of stressful life events (r = 0.335, P = 0.001). 30.6% of the students stated that a major life event had influenced their internet usage. In the linear regression model, life event appeared as a significant predictor of IAT score. Conclusion: Medical students acknowledge the role of the internet in surviving the enormous stress level brought on by various life events. At the same time, stressful life events could predict IA.

Background: The occurrence of stress and stress related anxiety and depression in medical personnel are being increasingly reported in literature. The perceived stress scale (PSS) is the most widely used psychological instrument for measuring the perception of stress. It is needed to assess perceived stress in our population using appropriately translated version of PSS. The objectives of study were to prepare a Bengali version of PSS-10 and to establish its psychometric properties in the study population. Materials and Methods: The study was conducted in a teaching hospital among medical students and interns ( N=37). The translated Bengali version and the original English version of PSS-10 were separately handed over to the individual subjects. The scores were compared across different subgroups and psychometric properties of the translated version were assessed using SPSS 16. Results: Internal consistency of PSS English (α=0.79) and Bengali (α=0.80) was satisfactory. Intra-rater reliability was adequate (κ>0.5) for most of the items, but showed an inadequate value (κ

Background: Adequate sexual expression is an essential part of many human relationships, and may enhance quality of life and provide a sense of physical, psychological, and social well-being. Epidemiological and clinical studies show that depression is associated with impairments of sexual function and satisfaction, even in untreated patients. Most antidepressant drugs have adverse effects on sexual function, but accurate identification of the incidence of treatment-emergent dysfunction has proved troublesome. However, few investigators have reported the base rate for disturbances in sexual desire, arousal, and orgasm or ejaculation in patients with major depressive disorder (MDD) prior to antidepressant treatment. The purpose of this study is to define the frequency of sexual dysfunction (SD) in 60 patients with MDD and examine the relationship between SD and quality of life enjoyment and satisfaction variables. Materials and Methods: A consecutive series of 24 male and 36 female MDD patients diagnosed by SCID-DSM IV assessment completed a series of psychometric measures including a Sexual Function Questionnaire-Arizona Sexual Experience Scale (ASEX) which asked about change in sexual interest and function as well as quality of life of life enjoyment using QLESQ-SF. Results: Over 33.33% of men and 42% of women reported decreased sexual interest. Reduced levels of arousal were more common in both men and women (8-22%) than ejaculatory or orgasm difficulties (11-16%). In women, SDs were more than males. Quality of life was more impaired in sample with SDs than those without dysfunction showing significant impact of SD on quality of life. Limitation and Conclusion: Although limited by a relatively small sample of drug-free patients with MDD, and by the absence of a non-depressed comparison sample, these results emphasize the importance of factors beyond specific drug effects in the assessment of SD in drug naive-depressed patients.

Byline: K. Pavitra, K. Shubrata One of the chief concerns of human sciences has been to understand how people think, how they construe meaning and make interpretations. Indian dance forms, Bharatanatyam in particular have always been closely linked to both physical and psychic spheres. The functionalists have understood art as an elaborate mechanism for defining social relationships, sustaining social rules, strengthening social values and forwarding doctrines. [sup][1] Dance movements in and of themselves, communicate effectively and cognitively the values, beliefs, attitudes and learned behavior, a community shares. [sup][2] They also contribute to the dynamic and overcharging phenomenon of culture. Thus, psyche-physique, culture and dance forms are all closely linked. Spencer [sup][3] reviews the recurrent themes emerging from writings on the subject. The first theme treats dance as a safety valve that releases pent-up emotions, tensions and drives. The second theme deals with the educational role of dance and transmission of sentiments. Dance may be seen as a cast or mold which shapes children into culturally conforming adults. Dance among Samoan children separates the adept from the in adept, preparing them respectively for success or failure in adulthood. It initiates grace, proficiency and confidence in skilled and keen children while the clumsy and incapable are rebuked and discouraged. [sup][4] The third theme views dance as transmitting and maintaining culturally desirable sentiments that underlie orderly social existence of society and promote solidarity. The fourth theme bespeaks of dance as a cumulative process in which collective passion rises as dancers lose themselves in the dance becoming absorbed in the unified community and being transported to a state of elation. The fifth theme emphasizes the element of competition in dance demonstrated in the work of Rappaport. [sup][5] The sixth theme tells of dance as a ritual drama lifting the people out of their structural routine into the realm of spiritual beings. The seventh theme regards dancing as a shared activity with non-verbal mode of communication and invites exploration of patterns of dance movements to discern concealed meaning. Emotions are construed as cultural acquisitions which are determined by the circumstances and concepts of a particular culture as well as, or rather much more than, by the functions of biology, more specifically neurology. [sup][6] The major postulates of a general theory of emotions, [sup][7] are (1) the concept of emotion is applicable to all evolutionary levels and applies to animals as well as to humans. (2) With an evolutionary history behind them, emotions have evoked forms of expression in different species. (3) Emotions are adaptive in helping organisms deal with key issues posed by the environment. (4) Despite different forms of expression of emotions in diverse species, there are certain identifiable common elements or prototype patterns. (5) There are a small number of basic, primary or prototype emotions. (6) All other emotions are mixed/derivative states i.e., they occur as combinations, mixtures or compounds of the primary emotions. (7) Primary emotions are hypothetical constructs or idealized states the properties and characteristics of which can be inferred. (8) Primary emotions can be computerized in terms of polar opposites. (9) All emotions vary in their degree of similarity to one another. (10) Each emotion can exist in varying degrees of intensity or levels of arousal. Emotions are being increasingly recognized as central to cultural meaning system, relationships and communication. Since children must be motivated to act in concordance with cultural values, it is important to incorporate, (1) meanings of the particular emotion words and the place of emotions in the structure and functioning of the self. (2) Developmental theories regarding the origin and the emergence of abilities in the child to feel and behave in an emotional manner of an adult, (3) beliefs about the relationship between emotions and personality types, in works of ethno psychology. …

Background: Diabetes mellitus (DM) is a frequently encountered chronic metabolic disease with various complications throughout its course, which causes severe restriction and disability in an individual′s life. It has been well documented that the incidence of depression is higher in diabetic patients and co-morbid depression causes further deterioration in the quality of life in diabetic patients. Aims: To study the prevalence of depression and its impact on quality of life in patients with type II DM. Settings and Design: Single centre, cross-sectional, single interview. Materials and Methods: Total 195 type II DM patients are included in this study. To diagnose Depressive Episode Structured Clinical Interview for DSM IV Axis-1 Disorders, Research Version patient edition was applied. All patients were evaluated with a semi-structured socio-demographic proforma to assess socio-demographic characteristics, Hamilton Rating Scale for Depression (HAM-D) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) SF (Short Form) to measure the quality of life. Results: Among them, 46.15% (N=90; males: 41, females: 49) met the DSM-IV diagnostic criteria for major depressive episodes. Among the depressed group, majority were (36.7%) moderately depressed. QLESQ-SF total and each item scores were significantly lower in the depressed group than in the non-depressed group. Both the HAM-D scores and HbA1c level have significant negative correlations with QLESQ-SF total scores. Conclusion: Our study demonstrates that the presence of depression in type II DM further deteriorates the quality of life of the patients. Therefore, treating depression would have a beneficial effect on the quality of life.

Bardet-Biedl syndrome (BBS) is an autosomal recessive disorder with multisystem affection. Cardiac Involvement, when present is usually in the form of congenital heart disease. However, valvular involvement due to acquired heart disease is extremely unusual. Herein, a 10-year-old boy of Bardet-Biedl syndrome is reported who presented with multiple rheumatic valvular regurgitation.

Dengue is the most important mosquito-borne viral disease in the world and is caused by four distinct viruses (type 1 to 4) that are closely related antigenically. Infection by dengue virus may be asymptomatic or may lead to undifferentiated fever, dengue fever or dengue haemorrhagic fever. Recent observations indicate that the clinical profile of dengue is changing and the neurological complications are being reported more frequently. The neurological features includeheadache, seizures, neck stiffness, depressed sensorium, behavioural disorders, delirium, paralysis and cranial nerve palsies. Such neurological symptoms in dengue fever wereattributed to cerebral oedema, haemorrhage, haemoconcentration due to increasing vascular permeability, coagulopathy and release of toxic substances. Cerebral oedema, encephalitis-like changes (oedema and scattered focal lesions), intracranial haemorrhages as well as selective involvement of bilateral hippocampus in dengue infection have been reported previously on selective neuro-imaging but thalamic involvement is rare. We here report a case of a typical presentation of encephalopathy with left sided complete hemiplegia due to thalamic involvement in dengue infection.

Aims: To study the presence of personality disorder in cases of deliberate self harm (DSH) in young (15-24 years) and elderly (45-74 years) and compare. Materials and Methods: Deliberate self harm cases admitted in Medical and surgical departments and cases attending psychiatry department of R.G. Kar Medical College, Kolkata were studied. For diagnosis of personality disorder ICD 10 International Personality Disorder Examination (IPDE) questionnaire was used. Results: Percentage of elderly patients having personality disorder (64%) was higher compared to young DSH patients (58.5%). In young group, most common disorder was emotionally unstable personality disorder (28.6%) and in elderly group most common was anankastic type of personality disorder (36%). Schizoid, dissocial, histrionic, and anxious-avoidant personality disorders were found in small percentages of cases. Conclusion: Among DSH patients, the most common personality disorder found in young age was Emotionally unstable (Impulsive and Borderline) personality disorder, but most common personality disorder found in elderly patients was Anankastic personality disorder.

Two children presented with massive generalised enlargement of abdomen simulating ascites. Common medical causes being excluded. They were treated with antituberculous drugs without any response until the radiological features suggested and surgical exploration proved the condition to be omental cyst.

Byline: A. Ghosh, Asim. Mallick The burden of psychiatric morbidity is ever increasing, cutting across regional, socio-economic and cultural barriers. The global burden of disease due to neuropsychiatric disorders was measured to be 6.8% world wide in 1990. This is projected to increase to 15% by the year 2020. Psychiatric disorders account for 5 of the 10 leading causes of disability across the world.[sup] [1] Presenting Some Aspects of Mental Health in India Population - 1081.2 million Population per sq km - 328.9 Population under 15-32.1% Population over 60-7.1% Urban population -28.7% Men per 100 women -105 Mental-health disorders account for nearly a sixth of all related disorders. Yet we have just 0.4 psychiatrists and 0.02 psychologists per 100,000 people and 0.25 mental health beds per 10,000 population. Depression, child abuse, domestic violence, adjustment disorders are on the rise; so is the rate of suicide. The suicide rate in India in the early eighties used to be 6 per 1,00,000 per year. More than a decade later, the rate is 11 per 1,00,000 per year. The highest rate of suicide is prevalent among the younger age groups - between 18 and 29 years.[sup] [2] Despite such high rates of mortality and morbidity associated with psychiatric disorders, the psychiatrist to population ratio in India is very low. Besides, not all patients with psychiatric disorders or symptoms consult the psychiatrist. The findings of the ICMR-collaborated effort in Bangalore. Hyderabad and Vellore showed that an overwhelming majority of patients with neurosis, depression, alcohol-related problems, sexual problems and psychosomatic disorders seek advice from general physicians and not from the psychiatrists (ICMR, 1982). Studies have also revealed that nearly two-thirds of all persons who commit suicide contact their family physicians in the month preceding the event. Physicians being aware about psychiatric symptomatalogy therefore, can prevent many untimely deaths. Patients from all disciplines of Medicine or Surgery may develop psychiatric complications at any point of time. Delirum, one of the commonest psychiatric diagnoses, is present in nearly 10% of emergency department patients and 40% of all terminally ill patients. Nearly 53% of all patients of chronic renal failure have been shown to have definite psychiatric disturbances. Deafness lasting more than six years is associated with a higher incidence of paranoid schizophrenia. Depression is an independent risk factor for coronary heart diseases and an indicator of poor prognosis in post myocardial infraction patients. Psychooncology is one of the expanding facets of oncology research in India and abroad. Apart from postpartum psychosis, which is a psychiatric emergency, maternal anxiety and depression are definitely known to influence developmental quotient (DQ) of infants, their weight gain and over all morbidity. …