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Byline: Pradeep. Venkatesh, Abhidnya. Surve, Rajkumar. Yadav Dear Editor, We thank the authors for reading our published work on 'Effect of short-term meditation training in central serous chorioretinopathy' and seeking [...]

Background: Low-pressure pneumoperitoneum (LPP) is an attempt to improve laparoscopic surgery. Lower pressure causes lesser inflammation and better hemodynamics. There is a lack of literature comparing inflammatory markers in LPP with deep NMB to standard pressure pneumoperitoneum (SPP) with moderate NMB in laparoscopic cholecystectomy. Methodology: This was a single institutional prospective randomized control trial. Participants included all patients undergoing laparoscopic cholecystectomy for symptomatic gall stone disease. Participants were divided into 2 groups group A and B. Group A—Low-pressure group in which pneumoperitoneum pressure was kept low (8–10 mmHg) with deep Neuromuscular blockade (NMB) and Group B—Normal pressure group (12–14 mmHg) with moderate NMB. A convenience sample size of 80 with 40 in each group was selected. Lab investigations like CBC, LFT, RFT and serum IL-1, IL-6, IL-17, TNF alpha levels were measured at base line and 24 h after surgery and compared using appropriate statistical tests. Other parameters like length of hospital stay, post-operative pain score, conversion rate (low-pressure to standard pressure), and complications were also compared. Results: Eighty participants were analysed with 40 in each group. Baseline characteristics and investigations were statistically similar. Difference (post-operative–pre-operative) of inflammatory markers were compared between both groups. Numerically there was a slightly higher rise in most of the inflammatory markers (TLC, ESR, CRP, IL-6, TNFα) in Group B compared to Group A but not statistically significant. Albumin showed significant fall (p< 0.001) in Group B compared to Group A. Post-operative pain was also significantly less (p< 0.001) in Group A compared to Group B at 6 h and 24 h. There were no differences in length of hospital stay and incidence of complications. There was no conversion from low-pressure to standard pressure. Conclusion: Laparoscopic cholecystectomy performed under low-pressure pneumoperitoneum with deep NMB may have lesser inflammation and lesser post-operative pain compared to standard pressure pneumoperitoneum with moderate NMB. Future studies with larger sample size need to be designed to support these findings.

In this study, the gold nanoparticles synthesized from chemical (CH-AuNPs) and green methodologies from Hibiscus rosa-sinensis(HRS) leaves extracts (HRS-Bio-AuNPs) and Trichoderma reesei(TR) fungal biomass (TR-Bio-AuNPs). The TR-Bio-AuNPs displayed an absorption peak at 527 nm, HRS-Bio-AuNPs at 525 nm. On the other hand, the CH-AuNPs displayed an absorption peak at 530 nm. The zeta potentials of −17.00 mV and −16.10 mV, respectively of the HRS-Bio-AuNPs and TR-Bio-AuNPs solutions had single peaks indicating the presence of repulsion between the synthesized NPs, whereas CH-AuNPs solutions possessed −19.10 mV zeta potential. Using a transmission electron microscope (TEM), the average size 42.48 nm, 22.60 nm and 16.33 nm was observed in CH-AgNPs, HRS-AuNPs, and TR-AuNPs respectively; they were evenly disseminated with no significant aggregation. Furthermore, assess the toxicity in percentage inhibition (% PI) as in vitro by applying toxtrak test against prebiotic and probiotic cultures and the % PI values of HRS-Bio-AuNPs (19.60%) and TR-Bio-AuNPs (15.76%) and CH-AuNPs (33.43%) were obtained and clearly demonstrate their non-toxic behavior treated against prebiotic and probiotic bacterial cultures. The effects of CH-AuNPs, HRS-Bio-AuNPs, and TR-Bio-AuNPs were also evaluated using an in vivo technique on Drosophilaegg laying capability (eggs/fly/day was 61.89, 62.79, and 63.19 respectively), emergence of flies from pupa (number of fly out of 100 pupa were obtained, 98.49, 99.09, and 99.59 respectively) and the life span (the survival rate of fly was 66, 69, and 70 days respectively). According to the data acquired, there were no significant differences were observed between any of the groups. Overall, we can say that TR-Bio-AuNPs made from fungus biomass have the best qualities, are safe, eco-friendly and have no adverse effects on prebiotic or probiotic bacterial cultures or the reproductive fitness-related traits of Drosophila melanogaster. The next possibility is HRS-Bio-AuNPs, followed by CH-AuNPs as the choices.

Background: Exposure of humans and animals to heavy metals is increasing day-by-day; thus, lead even today remains of significant public health concern. According to CDC, blood lead reference value (BLRV) ranges from 3.5 µg/dl to 5 μg/dl in adults. Recently, almost 2.6% decline in male fertility per year has been reported but the cause is not well established. Lead (Pb2+) affects the size of testis, semen quality, and secretory functions of prostate. But the molecular mechanism(s) of lead toxicity in sperm cells is not clear. Thus, present study was undertaken to evaluate the adverse effects of lead acetate at environmentally relevant exposure levels (0.5, 5, 10 and 20 ppm) on functional and molecular dynamics of spermatozoa of bucks following in vitro exposure for 15 min and 3 h. Results: Lead significantly decreased motility, viable count, and motion kinematic patterns of spermatozoa like curvilinear velocity, straight-line velocity, average path velocity, beat cross frequency and maximum amplitude of head lateral displacement even at 5 ppm concentration. Pb2+modulated intracellular cAMP and Ca2+levels in sperm cells through L-type calcium channels and induced spontaneous or premature acrosome reaction (AR) by increasing tyrosine phosphorylation of sperm proteins and downregulated mitochondrial transmembrane potential. Lead significantly increased DNA damage and apoptosis as well. Electron microscopy studies revealed Pb2+-induced deleterious effects on plasma membrane of head and acrosome including collapsed cristae in mitochondria. Conclusions: Pb2+not only mimics Ca2+but also affects cellular targets involved in generation of cAMP, mitochondrial transmembrane potential, and ionic exchange. Lead seems to interact with Ca2+channels because of charge similarity and probably enters the sperm cell through these channels and results in hyperpolarization. Our findings also indicate lead-induced TP and intracellular Ca2+release in spermatozoa which in turn may be responsible for premature acrosome exocytosis which is essential feature of capacitation for fertilization. Thus, lead seems to reduce the fertilizing capacity of spermatozoa even at 0.5 ppm concentrations. Graphical Abstract:

The presentation of the bronchogenic cyst is variable making preoperative diagnosis difficult. The majority are either asymptomatic or discovered incidentally. The most common presenting symptoms are cough, fever and dyspnoea. We discuss the case of a large bronchogenic cyst in the posterior mediastinum causing oesophageal compression and also impinging on the left atrium. The patient presented with dysphagia and back pain and was extensively investigated by various physicians before being diagnosed as having bronchogenic cyst. We concluded that the backache was due to stretching of nerves in the parietal pleura. This case demonstrates the need for detailed investigations prior to the treatment of patients with such symptom complex as a bronchogenic cyst may be the cause of such symptoms. Keywords: Mediastinal tumour | Cysts | Pain, Introduction Bronchogenic cyst though rare is the most common primary cyst of the mediastinum and accounts for 6.3% of primary mediastinal masses and 34% of the cysts. They originate as [...]

A Ni/NiO catalyst is reported for converting a phenolic compound, such as guaiacol, and cashew nut shell liquid (CNSL) into different hydrocarbons. High guaiacol conversion (80%) and higher cyclohexane selectivity (23%) over the Ni/NiO catalyst are reported in comparison to the other reported Ni-based catalysts at a temperature of 300 °C and 50 bar H2pressure. The CNSL hydrodeoxygenation (HDO) activity increased with the temperature and reached a maximum conversion (100%) at 300 °C. The high total acidic sites of Ni/NiO favored the high conversion (100%) with 15% cyclohexane selectivity, 30% phenol selectivity, and maximum selectivity for tetradecane (45%) in CNSL HDO. This is the first such report to the best of our knowledge. The Ni/NiO catalyst was characterized by X-ray diffraction (XRD), transmission electron microscopy, X-ray photoelectron spectroscopy, temperature-programmed desorption of ammonia, N2sorption, X-ray absorption near edge structure, and X-ray absorption fine structure (XAFS). The products were analyzed by Fourier transform infrared spectroscopy, proton nuclear magnetic resonance, gas chromatography, and gas chromatography–mass spectrometry. XRD analysis showed that NiO crystallinity decreased while Ni crystallinity increased after reduction. XAFS analysis confirmed that the metallic Ni nature increased after reduction, as indicated by a decrease in the Ni–Ni1Nibond distance from 2.596 Å for unreduced Ni/NiO to 2.519 Å (closer to that for the metallic Ni face-centered cubic phase) for the reduced sample, which would result in improved hydrogenation activity of the reduced catalyst. The spent Ni/NiO catalyst showed good stability without any phase change during the reaction and retained its original structure.

•Gold nanoparticles deposited on mesoporous titania with isolated Si sites was synthesized.•Au/Ti0.72Si0.28O2catalyst exhibited superior activity for photocatalytic reduction of CO2into CH3OH.•The effects of Si sites on enhancing photocatalytic activity of TiO2were shown.

Although splenic artery aneurysm (SAA) is the commonest visceral and third most common intra abdominal aneurysm after aorta and iliac artery, aneurysm of splenic artery along with aneurysm of splenic vein with arteriovenous (a-v) fistula communication between them is a rare entity. Most are <3 cm in diameter. Giant true SAAs are rare and very few lesions >10 cm have been reported. We hereby report a case of an 18 cm x 15 cm size splenic artery and vein aneurysm with a-v fistula in an adult female nulliparous woman who presented with progressively enlarging pulsatile mass in the left upper abdomen with long-standing intractable pancytopenia and splenomegaly. Diagnosis was established by CT (computed tomogram) angiogram and laboratory tests. Laparotomy demonstrated huge well-defined aneurysm of splenic artery and vein with splenic a-v fistula, extending in all except the right lower and inferior quadrants of the abdomen along with splenomegaly. Aneurysmectomy with splenectomy was done.

The present work illustrates the promising intervention of smart diagnostics devices through artificial intelligence (AI) and mechanobiological approaches in health care practices. The artificial intelligence and mechanobiological approaches in diagnostics widen the scope for point of care techniques for the timely revealing of diseases by understanding the biomechanical properties of the tissue of interest. Smart diagnostic device senses the physical parameters due to change in mechanical, biological, and luidic properties of the cells and to control these changes, supply the necessary drugs immediately using AI techniques. The latest techniques like sweat diagnostics to measure the overall health, Photoplethysmography (PPG) for real-time monitoring of pulse waveform by capturing the reflected signal due to blood pulsation), Micro-electromechanical systems (MEMS) and Nano-electromechanical systems (NEMS) smart devices to detect disease at its early stage, lab-on-chip and organ-on-chip technologies, Ambulatory Circadian Monitoring device (ACM), a wrist-worn device for Parkinson’s disease have been discussed. The recent and futuristic smart diagnostics tool/techniques like emotion recognition by applying machine learning algorithms, atomic force microscopy that measures the fibrinogen and erythrocytes binding force, smartphone-based retinal image analyser system, image-based computational modeling for various neurological disorders, cardiovascular diseases, tuberculosis, predicting and preventing of Zika virus, optimal drugs and doses for HIV using AI, etc. have been reviewed. The objective of this review is to examine smart diagnostics devices based on artificial intelligence and mechanobiological approaches, with their medical applications in healthcare. This review determines that smart diagnostics devices have potential applications in healthcare, but more research work will be essential for prospective accomplishments of this technology.

Railway transport dynamics cause rails in general to experience a time varying rolling contact load to add shear strain to that from traction and normal strain from the axle loads. These loading conditions together with the frictional heat at the contact interface alters the microstructure in the near-surface region of the rails and wheels. This paper presents the hardness and microstructural study of used Indian rail steel to expose the influence of load parameter active at the interface. Samples are prepared from the rail section taken from Dhanbad railway division. The hardness variation along the rail head cross-section and metallurgical variations of the test sample are presented. Microstructural examinations reveal existence of micro cracks near to the rail surface favouring formation of wear debris. Also, the presence of the pro-eutectoid ferrite and cementite phase at the grain boundaries of the pearlitic rail material is observed. The fatigue cracks are found to initiate across the grain boundaries containing the pro-eutectoid ferrite phase. This study will help to develop a better understanding of rolling contact fatigue (RCF) crack initiation and wear debris formation mechanisms on the rails. Thus, these results can be used to improve rail maintenance planning and risk assessments.