Search

Inherited Factor VII (FVII) deficiency is commonest among the rare bleeding disorders. A small number of patients present in infancy with severe bleeding, and many may remain asymptomatic but detected before surgery/invasive procedures. Genetic testing may be helpful in predictive testing/prenatal diagnosis in severe cases.Characterisation of clinical and genotypic spectrum of patients with inherited FVII deficiency.Retro-prospectively, 35 cases with prolonged prothrombin time and FVII activity (FVII:C)50 IU/dl were subjected to targeted resequencing. After in-silico analysis, variant/s were validated by Sanger sequencing in index cases and family members. Haplotype analysis was done for F7 polymorphisms.Severe FVII deficiency was found in 50% of patients (FVII:C ≤1 IU/dl), and 42.9% were asymptomatic. Clinical severity assessment revealed 17% severe, 17% moderate and 22.9% patients with mild bleeds. FVII levels ranged from .3 to 38 IU/dl. Molecular analysis revealed variants in 30/35 cases, of which 17 were homozygous, 10 were compound heterozygous and 3 were heterozygous. Twelve genetic variants were identified, one promoter variant c.-30AC; seven missense (c.215CG, c.244TC, c.253GC, c.904GA, c.961CT, c.1109GT, c.1211GA), two deletions (c.21delG, c.868_870delATC), and one each of nonsense c.634CT and splice-site variant c.316+1GA. Recurrent variants c.1109GT and c.215CG were found in 17 and 8 cases, 12 of the former cases were homozygous. They had the same haplotype, indicating the founder effect in North Indians.This is the largest cohort of FVII genotyping from India, confirming heterogeneity in terms of clinical manifestations, FVII activity and zygosity of the variants with a limited genotypic phenotypic correlation.

The aim of this study was to assess subject wise and tooth wise distribution and prevalence of traumatic injuries to the anterior teeth of 2- to 6-year-old children.A cross-sectional survey was performed. Primary maxillary and mandibular anterior teeth of 1,800 children aged between 2 years and 6 years, who attended 20 pre-schools in National Capital Region Delhi, India, were examined by a single examiner, and a questionnaire was filled in person by the parent/guardian. Andreasen's classification was used to classify the traumatic injuries. The Chi-square test was used to statistically analyze the variation in traumatic dental injuries (TDIs) with age and gender. Multiple logistic regression was used to determine the influence of independent variables on the occurrence of TDIs.The prevalence of TDIs was 17%. Significant and highly significant differences were found between boys and girls for cause and location of trauma (The prevalence of traumatic injuries to the anterior teeth in 2- to 6-year-old children in National Capital Region of Delhi, India, was 17%. There is a need to run educational programs to increase parents' awareness of the risks of dental trauma and emphasize preventive measures.Parents should be made aware of the widespread prevalence, risk factors, and consequences of trauma to primary dentition, so that they can seek appropriate care timely. The time elapsed between injury and dental care is of utmost importance.

Peanut stem rot caused by Athelia rolfsii is a serious soilborne disease worldwide and is becoming increasingly important in China. A total of 293 A. rolfsii isolates were collected from four representative peanut producing provinces in northern, central, and southern China. These isolates were assigned to 45 mycelial compatibility groups (MCGs) through pairing testing. The MCG diversity among isolates was greater in the southern sampled provinces compared with the northern provinces. A high level of genetic variability was found among the isolates from Guangdong Province in southern China. Variations were found in mycelial growth rate and sclerotial number, size, and dry weight of isolates sampled from places in different latitudes. Size and dry weight of sclerotia were positively correlated with latitude (P < 0.01), but the number of sclerotia was negatively correlated with latitude (P < 0.01). All tester isolates were pathogenic on peanut but varied in disease index. Inter-simple sequence repeat analysis and unweighted pair-group method with arithmetic average clustering resulted in three distinct clusters that were associated with the geographical location of the collection sites and sclerotial traits but were not associated with virulence of these isolates. These findings imply that genetic diversity, morphological traits, and virulence among A. rolfsii isolates varied in diverse geographical regions in China, and genetic diversity and sclerotial traits might be affected by latitude.

In order to prevent the overloading, the routing algorithm aids in building productive paths both within and between clusters. When sending information from the source IoT device to a base station, not all IoT devices are utilized in the path. We introduced an energy aware cluster-based routing in this paper, in which Improved Fuzzy C-means model plays a major role in clustering initially. Meanwhile, the clustering procedure considers the factors like energy and distance. Subsequent to the clustering process, optimal routing will be takes place by a new hybrid optimization algorithm named Custom Honey Badger and Coot Optimization (CHBCO) that combines the models like Honey badger optimization and Coot optimization model, respectively. For routing, the model considers the constraints like Energy as well as link quality. Also, this model establishes the fault tolerance method, which ensures that the network will continue to operate normally even in the situation of a CH failure. During this, the cluster members switch to another CH. The performance of proposed CHBCO based routing model is compared over existing models with respect to convergence rate, distance evaluation, energy, alive nodes, distance, normalized energy and link quality under five scenarios such as 100, 500, 1000, 1500, and 2000. Moreover, the proposed model obtained 56 alive nodes in the round 1500 for scenario 1(i.e node 100). Also in the round 1500, the CHBCO model obtain a minimum distance as 25 however the existing models achieve higher distance like EHO as 50, HHO as 70, COOT as 40, HBA as 60, MFO as 75, DCPSO as 150, and HGS as 85 for the node setup 1000. The proposed method achieve a better normalized energy as 0.29 in the 2000 round along with node setup 100, while the conventional models reach the lowest normalized energy. Moreover, the CHBCO method fine link quality values such as 0.96, 0.96, 0.95, 0.97, and 0.97 at the node setups of 100, 500, 1000, 1500, 2000 respectively.

Internet of Things (IoT) is a networking paradigm shift that aims to link almost everything on the world. Due to the limited form of smart devices, energy-efficient routing would be critical to their effective implementation. Clustering techniques divide a network's nodes into groups or clusters, each of which is led by a specified node known as the cluster head. Clustering methods have been presented in the area of Wireless Sensor Networks (WSN), while their application in IoT might solve comparable problems. By transferring a major portion of communication overhead to the cluster head, clustering would promote topology maintenance and energy efficient routing. Therefore, this article aims to establish a novel clustering model in IoT, in which the cluster head selection is performed via a proposed Sandpiper Optimization with Cycle Crossover Process (SOCCP) model. Moreover, this cluster head selection includes certain constraints including (i) Distance (ii) Energy (iii) security (based on the risk levels), and (iv) Cluster Radius, respectively. At first, the clustering is done by the Optimized Fuzzy C-Means (FCM) algorithm. Here, the determination of the cluster head and cluster radius is tuned optimally via an adopted SOCCP model. At the end, the results of the adopted technique are computed to extant based on various metrics including alive node analysis, risk analysis, distance analysis, cluster radius analysis, as well as normalized energy analysis, respectively.

The clinical course of COVID-19 has been complicated by secondary infections, including bacterial and fungal infections. The rapid rise in the incidence of invasive mucormycosis in these patients is very much concerning. COVID-19-associated mucormycosis was detected in huge numbers during the second wave of the COVID-19 pandemic in India, with several predisposing factors indicated in its pathogenesis. This study aimed to evaluate the epidemiology, predisposing factor, cumulative mortality and factors affecting outcomes among the coronavirus disease COVID-19-associated mucormycosis (CAM).A multicenter retrospective study across three tertiary health care centers in Southern part of India was conducted during April-June 2021.Among the 217 cases of CAM, mucormycosis affecting the nasal sinuses was the commonest, affecting 95 (44%) of the patients, orbital extension seen in 84 (38%), pulmonary (n = 25, 12%), gastrointestinal (n = 6, 3%), isolated cerebral (n = 2) and disseminated mucormycosis (n = 2). Diabetes mellitus, high-dose systemic steroids were the most common underlying disease among CAM patients. The mucormycosis-associated case-fatality at 6 weeks was 14%, cerebral or GI or disseminated mucormycosis had 9 times higher risk of death compared to other locations. Extensive surgical debridement along with sequential antifungal drug treatment improved the survival in mucormycosis patients.Judicious and appropriate management of the predisposing factor and factors affecting mortality associated with CAM with multi-disciplinary approach and timely surgical and medical management can be much helpful in achieving a successful outcome.

The association of the fibrinolytic markers with deep vein thrombosis (DVT) is still a matter of debate. The present study aimed to investigate the association between fibrinolytic markers and DVT. This observational study recruited 52 adult cases with lower limb DVT and 52 healthy adult volunteers as controls. The quantitative determination of plasminogen activator inhibitor-1 (PAI-1), plasminogen, thrombin activable fibrinolysis inhibitor (TAFI), tissue plasminogen activator (tPA) and α2-antiplasmin (α2-AP) was performed by ELISA. TAFI, plasminogen and t-PA were significantly higher in cases than controls and PAI-1 was significantly lower in cases than controls. In addition, TAFI, plasminogen and t-PA levels were significantly increased in unprovoked and idiopathic DVT cases than controls. The present study suggests that the fibrinolytic markers tested in patients with a remote history of DVT are different than in individuals with no history of DVT and, with further study, may prove useful as screening assays for DVT risk.

Climate change across the globe has an impact on the occurrence, prevalence, and severity of plant diseases. About 30% of yield losses in major crops are due to plant diseases; emerging diseases are likely to worsen the sustainable production in the coming years. Plant diseases have led to increased hunger and mass migration of human populations in the past, thus a serious threat to global food security. Equipping the modern varieties/hybrids with enhanced genetic resistance is the most economic, sustainable and environmentally friendly solution. Plant geneticists have done tremendous work in identifying stable resistance in primary genepools and many times other than primary genepools to breed resistant varieties in different major crops. Over the last two decades, the availability of crop and pathogen genomes due to advances in next generation sequencing technologies improved our understanding of trait genetics using different approaches. Genome-wide association studies have been effectively used to identify candidate genes and map loci associated with different diseases in crop plants. In this review, we highlight successful examples for the discovery of resistance genes to many important diseases. In addition, major developments in association studies, statistical models and bioinformatic tools that improve the power, resolution and the efficiency of identifying marker-trait associations. Overall this review provides comprehensive insights into the two decades of advances in GWAS studies and discusses the challenges and opportunities this research area provides for breeding resistant varieties.

Background: Pharmacological therapies of proven efficacy in corona virus disease 2019 are still lacking with no proven antiviral treatment. Impaired type I interferon activity may be responsible for severe disease in COVID-19 patient. We performed prospective, observational, open-label study to evaluate the efficacy and safety of a single dose of Pegylated IFN-α2b in addition to Remdesivir with moderate to severe COVID-19 cases. Aim: The aim of this study is to assess the role of synergistic effect of Remdesivir and Pegylated Interferon alfa 2 Beta in moderate to severe COIVID-19 disease. Materials and Methods: 24 subjects with moderate to severe covid disease are included. Subjects were given PEG IFN-α2b (1 μg/kg subcutaneous [SC] injection, single dose) plus Remdesivir and other standard treatment protocol (MoHFW).We observed oxygen saturation and respiratory rate at discharge and duration of hospital stay and the impact of comorbidities on the same. Results: In the study at admission mean SpO2 was 90.25 ± 2.454% and at discharge was 95.13 ± 1.872%.At admission mean RR was 23.00 ± 2.670 bpm and at discharge was 18.71 ± 1.546 bpm. Mean duration of illness was 7.88 ± 2.112 days. Mean HRCT score was 12.21 ± 2.889.Mean days of recovery was 7.29 ± 3.329 days. There was no significant change in o2 saturation respiratory rate and duration of illness with respect to co morbidities. Conclusions: This study provides evidence for the potential use of a single dose of 1 μg/kg PEG IFN-α2b in the treatment of moderate COVID-19 disease. The significant improvement in clinical status is likely due to faster viral reduction. Further confirmatory studies are required to support the data observed in this study.

In the past decades, AI was not playing a pivotal role in technology. But now, artificial intelligence is a key part of the revolution of technology. AI has become a powerful tool in recent years, enabling machines to think and act like humans. AI helps in developing a better approach to teaching students (i.e., adaptive learning where a computer algorithm identifies the rate of learning of a student and adapts itself so that the student learns efficiently). The aim of implementing AI in education is not to replace tutors, but to assist them in understanding the potential and limitations of each student individually. This chapter will cover the introduction, existing applications, and new applications of artificial intelligence in higher education. The prime focus of the chapter will be on the approaches to different product developments and their implementation using artificial intelligence in the education sector. It provides a brief idea of how the existing applications solve the problems in higher education and new approaches to make higher education more efficient.

Peanut stem rot caused by

Primary Biliary Cholangitis (PBC) is a debilitating autoimmune disorder involving intrahepatic biliary ducts. It is characterized by chronic inflammation followed by fibrous obliteration of biliary ducts. This condition is rarely associated with pericardial effusion. The association of pericarditis and PBC is rare and identifies the existence of extensive systemic inflammation. In the literature, only 5 cases of this association are reported. As a specific systemic syndrome, this association should be evaluated and its prognostic consequences should be analyzed in depth. We report a case of life-threatening pericardial effusion progressing to tamponade with pericarditis in a 38-year-old female patient with PBC.

Fracture and embolization of peripheral intravenous cannula is very rare. Although endovascular retrieval is the standard of care for most of the embolized intravascular devices, endovascular management of embolized peripheral intravenous cannula is technically difficult due to its radiolucent nature and it is not described previously in the literature. We describe the clinical presentation, imaging findings, and endovascular management in a middle aged male who had fractured peripheral intravenous cannula which was embolized into the pulmonary artery branch. Technical nuances associated with retrieval of this radiolucent little plastic tube have been discussed.

BACKGROUND: Early detection of comorbidities, severe patients with SARS-COV-2 and helpfuldiagnostic tools is very important for individual treatment and helps us in assessing the outcome ofmoderate to severe patients. METHOD: In our study we have included 108 patients with RT-PCRpositive for SARS COV-2 and the samples for D-dimer, Sr. LDH and Sr.ferritin were sent andanalyzed. RESULTS: the effect of D-dimer, serum LDH and serum ferritin individually andcombinedly showed in our study there was no significant difference between D-dimer and theoutcome however there was a significant p-value of

The experiment was done to evaluate the performance of forty genotypes of tomato in the experimental farm of college of horticulture, Department of vegetable science, Sri Konda Laxman Telangana State Horticultural University, Rajendranagar, Hyderabad, Telangana, during Kharif, 2017-18. Among the genotypes used for evaluation the genotype LA-3667 was the superior for yield and yield contributing characters i.e. fruit yield per plant (2.28 kg) and yield per hectare (85.96 tonnes). The genotype EC-313466 was found to be early as observed from the character days to first flowering (21.26 days) and days to 50% flowering (29 days). The genotype EC-631349 was significantly superior for plant height (191.56 cm), number of primary branches (9.83), number of fruits per plant (323.00) and ascorbic acid (59.43mg/100g). The accession EC-514013 was found to be superior for TSS (8.16 0Brix). Highest beta carotene content was found in Money maker (2.63mg/100g). The check variety Arka Meghali was found to be superior for lycopene content (6.12mg/100g) followed by Marutham (5.51mg/100g) and AVTO-1314 (4.97mg/100g).

Glanzmann thrombasthenia (GT) is an autosomal recessive platelet function disorder characterized by mucocutaneous bleeding as the most common clinical phenotype. Patients with GT have normal platelet counts, platelet morphology but reduced platelet aggregation in response to various agonists. Homozygosity or compound heterozygosity for variants in the ITGA2B/ITGB3 genes is the genetic basis for GT. Establishing a molecular diagnosis is definitive and is important for predictive testing. Using multi-gene panels is an accurate, faster, and cost-effective mode as compared to Sanger sequencing in large genes. We used a targeted resequencing based approach to identify pathogenic variants in eight cases in seven families. These variants were validated using Sanger sequencing in patients as well as family members and were predicted probably pathogenic using in-silico prediction tools. The variants include three missense (3/7 = 43%) (ITGA2B:c.1028 T > C, ITGA2B:c.1186G > A, ITGB3:c.1388G > C), two deletions (ITGA2B:c.559delG, ITGA2B:c.3092delT), one duplication (ITGA2B:c.1424_1427dupAGGT) and nonsense variant (ITGA2B:c.2578C > T, p.Gln860Ter). Except for one case which was compound heterozygous, the rest of the cases were homozygous. We found two novel variants that are reported for the first time in GT. The targeted resequencing based approach revealed varied genetic variants in North Indian patients, including two novels ones. The high yield of our panel indicates its suitability for usage in larger cohorts for the genetic diagnosis of GT patients. This approach is cost-effective and less cumbersome as compared to Sanger sequencing for these large size genes with multiple exons. The information so obtained is helpful in prenatal testing, carrier analysis, and genetic counseling.

Solar Photovoltaic (PV) technology is an upcoming technology for harnessing solar power. The performances of the PV modules are affected by incident solar radiation and mainly due to the rise in surface temperature in the hot environmental conditions. To manage the PV module temperature, passive cooling technology is adopted in this work. The integration of phase change materials (PCMs) as a thermal regulating medium into the PV module’s rear surface is intended. Two inorganic hydrated salts, Sodium Carbonate Decahydrate (SCD) -Na2CO3.10H2O and Magnesium Sulfate Heptahydrate (MSH) – MgSO4.7H2O are used to form the binary eutectic PCM. The binary eutectic PCM was integrated on the backside of the 25 W polycrystalline silicon PV module and tested for temperature regulation under the outdoor conditions of Kovilpatti (9°10′0′′N, 77°52′0′′E), Tamil Nadu, south India. The thermophysical properties of the eutectic PCM, including the latent heat of fusion and, temperature of phase change were estimated using Differential Scanning Calorimeter (DSC). The melting and freezing point of the 70:30 SCD-MSH eutectic mixture was 35.6 °C and 31.1 °C, respectively, with a latent heat value of 230.5 J/g. The PV-PCM system showed an instantaneous temperature reduction up to 7°C with an increase of 1.21% in the daily average efficiency. An increase in the daily DC power output by 12.5% than the reference PV module is observed in the PV-PCM system.

Emphysema sequentially leads to the loss of gas exchanging surface and an abnormal shape of the diaphragm generating dyspnea refractory to standard medical therapy. Lung volume reduction surgery (LVRS) is a surgical treatment option for patients with severe emphysema whose symptoms are uncontrolled on standard therapy. Bronchoscopic LVR (bLVR) is a process by which lung volume reduction is achieved in a minimally invasive manner using bronchoscopy-guided insertion of valves, coils, sealants, or by thermal vapour ablation like techniques. These therapies have developed over the last few years and have variable results in patients. We have summarized the current evidence available on each of these methods in this review.

Sterility mosaic disease (SMD) is a major problem for pigeonpea production in the Indian subcontinent. A comprehensive and systematic survey was carried out to determine the incidence of pigeonpea sterility mosaic disease (SMD) and variability among disease causing agents in Andhra Pradesh, Karnataka, Tamil Nadu and Telangana states of southern India during the 2017 rainy season. The results indicate a huge variation in SMD incidence ranging from 0 to 47.50% among the surveyed states and also within the states. Further, the phylogenetic analysis of the RNA-3 sequence of disease causing two viral agents such as PPSMV-I and PPSMV-II exhibited considerable variability among seven different geographical strains representing four states in southern India. RNA-3 sequence of PPSMV-I of Bengaluru, Tirupathi, Vamban, and Coimbatore isolates clustered together, while Gulbarga isolate distinctly separated out. Similarly, a RNA-3 sequence of PPSMV-II of Vamban isolate was separated out from the rest of the cluster. There is a separate existence of PPSMV-II alone alongside mixed infection of PPSMV-I and PPSMV-II in southern India. The samples from Patancheru location were positive for PPSMV-I and PPSMV-II, whereas one sample from Bengaluru and four samples from Coimbatore location were found positive for PPSMV-II only and the rest of the samples were positive for both the viruses. None of the sample was positive for PPSMV-I alone. Overall our study provides evidence of variability in SMD causing agents which is critical in developing precise diagnostic tools and stable management strategies in pigeonpea.

Background Blood services are facing shortage of blood all over the world. Demand for blood is rising day by day and current blood donation is insufficient to meet the demand. Objectives: To assess college going student’s knowledge regarding voluntary, non-remunerated blood donation. Study design: cross-sectional study. Participants: five hundred students above the age of 18 years who qualify for blood donation & Five hundred students of similar age group who were not participating in blood donation were also recruited after taking their consent. Sampling: Only those participants who gave consent to participate in the study were enrolled.Statistical Analysis: Study period: from March to September 2013.Results: Assessment of the level of knowledge among blood donor participant revealed that 36 (7.2%) participant had excellent knowledge, 222(44.4%) had good knowledge, 152 (30.4%) had average knowledge, 90 (18%) had poor knowledge. No participants among blood donor students had very poor level of knowledge. Among non-blood donor participants 93 (18.6%) had good level of knowledge, 108 (21.6%) had average level of knowledge, 166 (33.2%) had poor level of knowledge, 133 (26.6%) had very poor level of knowledge.Conclusion: Data analysis revealed that there was significant difference in the knowledge level among the donors and non-blood donor participants.

Background The gold standard for diagnosing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is microbiological confirmation by reverse transcriptase-polymerase chain reaction (RT-PCR)1 most commonly done using oropharyngeal (OP) and nasopharyngeal swabs (NP). But in suspected cases, where these samples are false-negative, bronchoalveolar lavage (BAL) may prove diagnostic. Objectives Hence, the diagnostic yield of BAL for detection of SARS-CoV-2 in cases of non-diagnostic upper respiratory tract samples is reviewed. Methods Databases such as MEDLINE, Scopus, and Google Scholar were searched using a systematic search strategy. The current study has been in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and has been registered with the International Prospective Registry of Systematic Reviews (CRD42020224088). Results 911 records were identified at initial database extraction, of which 317 duplicates were removed and, 596 records were screened for inclusion eligibility. We included total 19 studies in the systematic review, and 17 were included in metanalysis. The pooled estimate of SARS-CoV-2 positivity in BAL was 11% (95%CI: 0.01–0.24). A sensitivity analysis also showed that the results appear to be robust and minimal risk of bias amongst the studies. Conclusion The current study demonstrates that BAL can be used to diagnose additional cases primary disease and superadded infections in patients with severe COVID-19 lower respiratory tract infection.

A nonsmoker young Asian man presented with a large right pleural effusion. He had no signs of acute infection but was living in a tuberculosis-endemic region. Initial investigations, including thoracentesis and pleural fluid analysis, did not lead to a diagnosis. The patient underwent medical thoracoscopy, which showed extensive malignant pleural involvement. Histological analysis of pleural biopsies revealed metastases from lung adenocarcinoma, with rearrangement of the anaplastic lymphoma kinase (ALK) gene. The patient was started on crizotinib, a multitarget tyrosine kinase inhibitor. Pleurodesis by talc poudrage was successfully performed. This chapter addresses the role of medical thoracoscopy in undiagnosed exudative pleural effusions. Rigid and semirigid instruments are compared, and their relative advantages and disadvantages are discussed. The macroscopic appearances of pleural malignancy are described. The different methods of chemical and mechanical pleurodesis are also discussed.