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Background: Spinal anesthesia is the most popular regional anesthesia technique for lower limb and lower abdominal surgery. Bupivacaine 0.5% heavy is commonly used for intrathecal use. New long-acting local anesthetic agents such as ropivacaine have claimed benefits of reduced cardiac toxicity on overdose and more specific effects on sensory rather than motor nerve fibers. The use of intrathecal hyperbaric ropivacaine is not much studied. With this background, we studied intrathecal ropivacaine hyperbaric 0.75% against intrathecal bupivacaine hyperbaric 0.5% for lower abdominal and lower limb surgery. Aims and Objectives: To note the effectiveness of intrathecal ropivacaine and bupivacaine on characteristics of subarachnoid block such as sensory block, motor block, hemodynamic parameters, and complications if any. Materials and Methods: We randomized patients undergoing lower abdominal surgeries and lower limb orthopedic surgeries under spinal anesthesia into two groups so as to receive intrathecal either ropivacaine 0.75% hyperbaric (3 mL) or bupivacaine 0.5% hyperbaric (3mL) and noted study parameters. Results: Time of sensory block onset (P=0.0005), peak sensory level (P=0.0029), and onset of L1 bromage-3 motor block (P=1.27E--08) was significantly delayed in the ropivacaine group as compared to bupivacaine group. However, maximum sensory level achieved (T6), time required for two-segment sensory regressions (P=0.1162), and time of onset of pain (P=0.1162) were comparable in both groups. Conclusion: Intrathecal ropivacaine 0.75% hyperbaric produced slow onset sensory and motor block than 0.5% hyperbaric bupivacaine with comparable cephalic spread and duration of sensory block. [ABSTRACT FROM AUTHOR]

Introduction: The relevance of plasma cells in the allograft liver is of utmost importance and objective assessment of these infiltrates and correlation with other ancillary findings needs to be evaluated. Materials and Methods: Three hundred and sixty‑eight graft liver biopsies received in the department from 2012 to 2022 and 115 allograft liver biopsies with histopathological diagnosis of rejection were selected. Based on plasma cells percentage in the portal tracts, the biopsies were divided into three groups: Group 1 showing not more than an occasional plasma cell, Group 2 showing <10% plasma cells, and Group 3 showing >10% plasma cells. Rejection activity index (RAI), portal/lobular inflammation, interface activity, subendothelial inflammation (portal and central vein), duct damage/loss, presence of cholestasis, apoptosis, perivenulitis, necrosis, rosette along with serial liver function tests (LFTs), and patient status at 1 year of follow‑up were recorded and compared between the groups. Results: Plasma cell infiltrates were observed in 52.6% of the specimens, with the mean percentage of plasma cells in the infiltrates being 4.9. Increased plasma cell infiltrates were associated with higher RAI scores, marked duct damage, marked portal and central vein endotheliitis, marked portal inflammation, and presence of interface activity. Higher levels of transaminitis were recorded at the time of biopsy, but no significant association was observed in the fall of serial LFTs over a 2‑week period with the presence of plasma cells. Conclusion: Identifying plasma cell infiltrates in liver allografts can serve as a clue toward increased severity of rejection in liver allograft biopsies. Further studies with emphasis on correlation with the clinical outcome and response to treatment are needed to validate its utility as an objective tool. [ABSTRACT FROM AUTHOR]

Byline: Arjun. Prakashey, Hita. Mehta, Neha. Agrawal, Dharm. Sondagar Sir, Molluscum contagiosum (MC) is a common benign cutaneous viral infection caused by a poxvirus and is transmitted by skin-to-skin contact [...]

Calculus in the urethra of the female is very unusual. The patient remains asymptomatic or uncommonly presents with symptoms of dysuria, post-void urinary dribbling, and dyspareunia. If asymptomatic, it can be diagnosed incidentally on gynecological examination. Being hard in consistency, it may mimic metastatic lesion. We present a case of a female who presented to us for management of ovarian mass. On routine examination there was a hard mass in her vagina which was suspected to be a metastatic lesion. This mass on evaluation came out to be a urethral diverticulum with a large calculus. Very large urethral calculus are a very rare presentation in a female. [ABSTRACT FROM AUTHOR]

Simple Summary: The treatment for advanced and metastatic esophagogastric malignancies has historically required time-intensive multi-agent chemotherapy regimens, where patients spend time away from home to engage in therapy administrations and supportive care. With the addition of immunotherapies to the standard of care, the authors completed this study to estimate the time spent in health care across various systemic treatment regimens. The authors estimated the time toxicity, or the days spent in health care facilities, due to cancer diagnosis and treatment with immunotherapy- and chemotherapy-based treatment regimens for esophagogastric cancers. (1) Background: The purpose of this study was to evaluate the time toxicity, or time spent in health care, of immunotherapy- versus chemotherapy-based regimens for metastatic esophageal and gastric cancers. (2) Methods: A literature search was conducted, and 18 phase III clinical trials of immune checkpoint inhibitors were selected for analysis. Health care days were calculated based on the number of days associated with receiving therapy and the adverse events reported in the clinical trials. Both the number of health care days and the median overall survival were compared among chemotherapy-only, immunotherapy-only, and chemo-immunotherapy regimens across this cohort of drug registration trials. (3) Results: The estimated median number of health care days was 37 (range of 7–52) days, or 1.2 (range of 0.2–1.7) months, compared to a median survival of 10.2 months across these 18 studies. For the chemotherapy-only regimens, the median number of health care days was 39 (range of 21–51) days, and for chemo-immunotherapy, it was 39 (range of 30–52) days. The immunotherapy-only regimens had fewer days, a median of 28 (range of 24–41), p < 0.05, compared to the other two arms. (4) Conclusions: The chemo-immunotherapy regimens did not add time toxicity compared to chemotherapy alone. The immunotherapy-only regimens had lower time toxicity compared to chemotherapy alone. In the setting of decreased time toxicity and improved overall survival, further development of immunotherapy-based regimens could improve outcomes in advanced esophageal and gastric cancers. [ABSTRACT FROM AUTHOR]

New avenues for research have opened, which assess the influence of systemic disease on periodontium and vice versa. To find the correlation between polycystic ovary syndrome (PCOS) and periodontium by assessing clinical parameters [plaque index (PI), probing depth, periodontal disease index (PDI)] and the anthropological parameter [body mass index (BMI)] and to find the correlation between body mass index and periodontal disease index in subjects with and without PCOS. Sixty females comprising 30 with PCOS and 30 without PCOS were selected. Clinical, anthropological, and radiological assessment was done. Double blinding was incorporated. There was a statistically highly significant difference in mean age, mean PI, and mean PDI (P < 0.001) in PCOS group when compared to those without PCOS group by unpaired t-test for inter-group analysis. A statistically significant difference was found in mean probing depth and mean BMI (P < 0.05) in PCOS group when compared to those without PCOS group by unpaired t-test for inter-group analysis. No statistically significant correlation was found between mean PDI and mean BMI in PCOS and non-PCOS group subjects using Spearman's rank correlation. Women suffering from PCOS may be at a heightened risk for developing periodontal disease as our study re-establishes this association with respect to some periodontal parameters. With such a result, general practitioners/gynecologists can be encouraged to refer cases of PCOS to periodontists for early detection, prevention of periodontal disease, and maintenance of periodontal health. [ABSTRACT FROM AUTHOR]

Mature cystic teratoma is a benign ovarian tumor that usually presents in reproductive-age females. This tumor usually presents with pain abdomen, bloating, and a lump. Hereby, we describe a case of an ovarian dermoid presented with features of intestinal obstruction secondary to ileo-dermoid fistula formation. A 55-year-old postmenopausal female presented with lower abdominal pain, nausea, vomiting, and the feeling of a lump in the abdomen. On evaluation and imaging, it was diagnosed as a large ovarian dermoid (with malignant transformation) with multiple fistulous communications with ileal loops. The patient was managed by laparotomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy, bowel resection, and anastomosis. The patient was discharged in good condition. The rupture of malignant ovarian dermoid followed by enterodermoid fistula formation and intestinal obstruction is rare. Complete cytoreduction and bowel repair should be considered for optimal results. [ABSTRACT FROM AUTHOR]

Background Post–kala-azar dermal leishmaniasis (PKDL) is a dermal complication of visceral leishmaniasis. Oral miltefosine (MF) is the first-line treatment for PKDL patients in South Asia. This study assessed the safety and effectiveness of MF therapy after 12 months of follow-up to explore more precise data. Methods In this observational study, 300 confirmed PKDL patients were enrolled. MF with the usual dose was administered to all patients for 12 weeks and followed up for 1 year. Clinical evolution was recorded systematically by photographs at screening and at 12 weeks, 6 months, and 12 months after treatment onset. Definitive cure consisted of disappearance of skin lesions with a negative PCR at 12 weeks or with >70% of lesions, disappearing or fading at 12-month follow-up. Patients with reappearing clinical features and any positive diagnostics of PKDL during the follow-up were considered as nonresponsive. Results Among 300 patients, 286 (95.3%) completed 12 weeks of treatment. The per-protocol cure rate at 12 months was 97%, but 7 patients relapsed and 51 (17%) were lost to 12-month follow-up, resulting in a final cure rate of only 76%. Eye-related adverse events were noted in 11 (3.7%) patients and resolved in most (72.7%) within 12 months. Unfortunately, 3 patients had persistent partial vision loss. Mild to moderate gastrointestinal side effects were seen in 28% patients. Conclusions Moderate effectiveness of MF was observed in the present study. A significant number of patients developed ocular complications, and thus MF for treatment for PKDL should be suspended and replaced with a safer alternative regimen. [ABSTRACT FROM AUTHOR]

Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value <0.05 was considered statistically significant. Results: Domains "knowledge", "Professional Responsibility and Identity", and "Remembrance, awareness, and judgment" showed a statistically significant correlation with most tobacco cessation counseling behaviors. In addition, undergraduate education received in Tobacco Cessation counseling, and Continuing education received in Tobacco Cessation counseling had significantly impacted the practice of tobacco cessation counseling (p=0.02 and 0.04, respectively). Conclusion: This study suggests that "Knowledge", "Professional Responsibility and Identity" and "Remembrance, awareness, and judgment" are the potential determinants that could be used to design effective strategies to enhance tobacco counseling among dentists in India. [ABSTRACT FROM AUTHOR]

Factor VIII (FVIII) replacement and emicizumab are effective at preventing bleeds in patients with hemophilia A (HA). Though benefits of emicizumab among inhibitor patients with HA (PwHA) are well established, more real-world evidence among non-inhibitor patients is needed. Using a United States healthcare claims database, we compared billed annualized bleed rates (ABRb) and the total cost of care (TCC) before and after switching from FVIII prophylaxis to emicizumab among non-inhibitor male PwHA. Bayesian inferences were used to assess the difference in ABRb and TCC per patient per year (PPPY) pre- versus post-prophylaxis switch. We included 101 non-inhibitor male PwHA aged between 3 and 63 years old who switched from FVIII prophylaxis to emicizumab prophylaxis in 2018 or 2019. The ABRb increased from 0.52 to 0.62 (p = 0.83) after switch. The posterior probability of the mean ABRb increasing after the switch was 75.54%. The TCC PPPY increased from $517,143 to $627,005 (p < 0.0001) after switch and the posterior probability of mean costs increasing after the switch was 99.80%. Personalization of care through the identification of the most appropriate therapy for each patient can optimize clinical and economic outcomes. Future real-world evidence research could help establish the value of prophylactic options in targeted populations such as the non-inhibitor male PwHA. [ABSTRACT FROM AUTHOR]

Background Recent trials testing immune-checkpoint inhibitors in esophago-gastric malignancies have shown mixed results. We aim to assess key subgroups using the ASCO Net Health Benefit Score (NHBS) and ESMO Magnitude of Clinical Benefit Scale (MCBS). Materials and Methods A search for phase III trials of FDA-approved anti-PD-1 or anti-PD-L1 drugs in esophago-gastric cancer trials was identified using www.clinicaltrials.gov. These published studies were scored using the ASCO NHBS and ESMO MCBS. The ASCO NHBS scores were compared by primary site of cancer (esophageal vs gastric) and PD-L1 expression using the Mann-Whitney test and the ESMO-MCBS grading, by Fisher's Exact test. Results Fifteen of 45 clinical trials were included. Of them, 6 were primarily esophageal cancer trials, and 9 were primarily gastric cancer trials. Ten stratified their analysis based on PD-L1 expression. The ASCO NHBS score was higher (mean 40, range 20 to 56.6 vs. mean 12, range −1.1 to 18.4, P <.01) for esophageal cancer than gastric cancer. No difference was observed in survival and response endpoints between the 2 groups. Similarly, the ESMO MCBS scored higher for esophageal cancer group than gastric cancer (P <.05). Additionally, the scores were higher in those with high PD-L1 expression vs. low PD-L1 (mean 36, range 11.2-66.6 vs. mean 14, range −19.5 to 43.6, P <.05). Conclusion The ASCO NHB and ESMO scores were consistently higher among esophageal cancer trials than gastric cancer trials and in those with high PD-L1 expression than low expression. Histology and PD-L1 expression should be considered when discussing value of immunotherapy to patients. [ABSTRACT FROM AUTHOR]

The green, cost-effective and sustainable synthesis of nanomaterials has been a key concern of scientists and researchers. In this view, MNPs were prepared using a sapota plant leaf extract and the surface of the magnetite nanoparticles was engineered with unsaturated fatty acids. The first report on the effect of unsaturation on the size and magnetic properties of magnetite nanoparticles (MNPs), prepared by the co-precipitation method, has been studied by coating surfactants on MNPs based on their unsaturation from zero to three (lauric acid, oleic acid, linoleic acid, linolenic acid). The size effect and magnetic properties of MNPs coated with a surfactant have been studied in comparison with uncoated magnetite nanoparticles. After the surface modification of the magnetite particle, it is necessary to check whether the magnetic property has been restored or not. Therefore, the magnetic property was studied. The presence of a surfactant on the surface of MNPs was confirmed by Fourier-transform infrared spectroscopy (FTIR), which was later confirmed by scanning electron microscope (SEM) and thermogravimetric analysis (TGA). The atomic structure was studied by X-ray diffraction (XRD) and the size of uncoated and surfactant-coated MNPs was determined by transmission electron microscopy (TEM) and the Scherrer equation by following XRD data. The magnetization property was analyzed by a vibrating sample magnetometer (VSM) at 10, 100 and 300 K and both bared and surfactant-coated MNPs exhibited a superparamagnetic nature at room temperature. The saturation magnetization (Ms) study shows that MNPs coated with a surfactant have a lower saturation magnetization value in comparison to uncoated NPs, confirming surface layering. Because the magnetic fluid has been stabilized in the aqueous medium, the double-layer model is expected to prevail. [ABSTRACT FROM AUTHOR]

Background: Melasma is the most common cause of facial melanosis and presents with a complex therapeutic problem. Intralesional platelet-rich plasma (PRP) has shown promising results in hyperpigmentation, whereas alphaglucoside derivative of trihydroxy benzoic acid (THBG) is a newer molecule for the management of pigmentation. Aims and objective: To compare therapeutic effects of PRP and THBG in facial melasma, note any untoward side effects of therapy and evaluate dermoscope as a tool for therapeutic prognosis. Methods: A total of 60 patients were enrolled based on inclusion and exclusion criteria after due written informed consent. After clinical, dermoscopic, and Wood lamp examination with relevant blood investigations, group P was treated by three sittings of intralesional injection of PRP at monthly interval, whereas group B was subjected to local application of THBG twice a day. Intergroup as well as intragroup comparative analyses were performed by subjective scores and dermoscope. Results: The mean of difference between modified melasma area and severity index (mMASI) score at the end of the study (i.e., difference mMASI at 12 and 0 weeks) was 2.21 for group P and 0.18 for group B and on comparison, the Pvalue was <0.0001 which is considered statistically significant. The average %mMASI improvement in group P was 35.05%, whereas in group B, it was 3.18%. On analysis of other parameters, physician global assessment, patient global assessment, and melasma quality of life scale patients of group P showed higher and significant improvements in comparison with group B. Changes in dermoscopic parameters could be appreciated in patients with significant improvement only. Conclusion: There is mild-moderate improvement in melasma (average 35.05%) with PRP with no untoward side effects, whereas THBG did not show any promising result in the treatment of melasma in FT grade IV/V. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) is a significant cause of morbidity worldwide, especially in the low and middle-income countries like India and is found to be more common in the rural areas. Delays in diagnosis and initiation of treatment along with lower treatment adherence and completion rates have increased the morbidity and mortality of TB in the rural areas. The collation of information accumulated through the assessment of people's Knowledge, Attitude, and Practices (KAP) towards TB, helps in charting new health programs for the public, identifying lacunae, and devising interventions based on these lacunae which in turn will help us to achieve the vision of a "TB free India” by 2025. Aim: To find out KAP and any association amongst them regarding TB among the study subjects. Materials and Methods: This was a cross-sectional study conducted on patients attending Outpatient Department (OPD) at the Rural Health Training Centre (RHTC) attached to NCR Institute of Medical Sciences, Meerut, Uttar Pradesh, India, during January 2021 to April 2021. From a sample of 106 patients data of KAP regarding TB was collected via a structured questionnaire which was predesigned and pretested. Pearson’s Chi-square test was used to ascertain the association between subjects' KAP about TB. A p-value <0.05 was taken as the predictor of statistical significance. Results: Out of 106 patients, 72 (67.92%), 80 (75.47%) and 52 (49.06%) had adequate KAP respectively. Participants having adequate knowledge showed positive attitude and good practices and this association was found to be statistically significant. Conclusion: The study results reflect that having adequate knowledge of the disease transforms into good practices and a positive attitude towards a person suffering from the said disease as well as helps the people to have a positive frame of mind in case they themselves contract the disease. Health education and behaviour change communication hence needs to be scaled up in rural communities to prevent, detect and treat tuberculosis in order to achieve a TB free India. [ABSTRACT FROM AUTHOR]

Aim of the Study: The objective of this in-vitro study was to assess the screening capabilities of three endodontic sealers, namely the BioRoot RCS, the MTA Fillapex, and Sealapex (a calcium hydroxide-based sealer), and the gutta-percha cone by using a scanning electron microscopy to the dentine walls. The results from the research are presented here. Results: ZOE exhibited more gaps in the sealing materials evaluated with the least dental sealing performance, followed by the cervical third by the MTA Fillapex, the Sealapex, and the BioRoot RCS. The ZOE, followed by Sealapex, MTA Fillapex, and BioRoot RCS, exhibited inadequate dental wall sealing capacity in the middle of the third. The third apical ZOE exhibited more deficiencies in the formation of dental walls, followed by Sealapex, MTA Fillapex, and BioRoot RCS. Conclusion: Under the constraints of the investigation, it can be stated that for the bioceramic sealer, a minimal gap was seen, with RCS of BioRoot superior to Fillapex of MTA. In the middle third, Sealapex was better adapted to the calcium hydroxide-based sealant than the MTA Fillapex sealer. MTA Filllapex had lower gap development than Sealapex in cervical or apical thirds. [ABSTRACT FROM AUTHOR]

The discovery of human obesity-associated genes can reveal new mechanisms to target for weight loss therapy. Genetic studies of obese individuals and the analysis of rare genetic variants can identify novel obesity-associated genes. However, establishing a functional relationship between these candidate genes and adiposity remains a significant challenge. We uncovered a large number of rare homozygous gene variants by exome sequencing of severely obese children, including those from consanguineous families. By assessing the function of these genes in vivo in Drosophila, we identified 4 genes, not previously linked to human obesity, that regulate adiposity (itpr, dachsous, calpA, and sdk). Dachsous is a transmembrane protein upstream of the Hippo signalling pathway. We found that 3 further members of the Hippo pathway, fat, four-jointed, and hippo, also regulate adiposity and that they act in neurons, rather than in adipose tissue (fat body). Screening Hippo pathway genes in larger human cohorts revealed rare variants in TAOK2 associated with human obesity. Knockdown of Drosophila tao increased adiposity in vivo demonstrating the strength of our approach in predicting novel human obesity genes and signalling pathways and their site of action. This study set out to identify novel gene variants that may contribute to human obesity, by combining human exosome sequencing analyses with systematic functional screening in Drosophila. This identifies a number of novel obesity-associated genes which control adiposity in flies, and uncovers a potential role for the Hippo signaling pathway in obesity. [ABSTRACT FROM AUTHOR]

Introduction: Protein-Energy Malnutrition (PEM) and prevalence of under-weight children in India, is an important health concern. Aim: To evaluate the effect of Oral Nutritional Supplement (ONS) on growth, overall nutrient intake and frequency of illness in nutritionally at-risk Indian children. Materials and Methods: In this prospective, randomised, gender-stratified, controlled, parallel group, open label study, 216 children (aged 4-6 years with weight-for-age z-score between -2 and -1) were randomised (1:1) to receive either 45 g of ONS {Test product+Dietary advice (T+D)} or control group {Dietary advice only (D-only)} for three months. Primary endpoints included weight-for-age z-score and weight gain in terms of g/kg/day from baseline to three months. Secondary endpoints included change in height-for-age z-scores; frequency of illness, change in dietary nutrient intake and Protein/Energy (P/E) ratio from baseline through three months. Safety endpoint included Adverse Events (AEs). PROC MIXED was used to perform Repeated Measures Analysis Of Variance (RMANOVA) based on the changes in z-scores. The z-scores changes within the group from baseline to the end of three months End-of-Study (EOS) were compared using paired t-test. Results: At baseline, the mean (SD) weight-for-age z-scores were similar in both the groups {1.50 (0.309) and -1.49 (0.312) in T+D and D-only groups, respectively}. At the EOS, only T+D group showed significant mean (SD) change from baseline in weight-for-age z-score compared to the D-only group {0.59 (0.296), p<0.001 vs. 0.04 (0.267), p=0.0974}. Mean rate of weight gain (g/kg/day) was significantly higher in T+D group vs. D-only group (1.12 vs. 0.26, p<0.0001). At baseline, height-for-age z-scores were similar in both the groups {-1.36 (0.668) vs -1.37 (0.638) in T+D and D-only groups, respectively}. At EOS, the mean (SD) change from baseline in height-for-age z-score was -0.02 (0.198), p=0.2389 in T+D group and -0.15 (0.171), p<0.001 in the D-only group. However, the change was not proportionate to weight-for-age z-score. Total absolute number of illness episodes was less in T+D group vs. D-only group (9 vs. 13). Improvement in dietary nutrient intake (carbohydrate, fat, protein and energy) and P/E ratio was significantly higher (p<0.001) in T+D group vs. D-only group. Overall, 8.3% children in T+D group experienced at least one treatment-emergent AE. Conclusion: The ONS helps to improve growth, nutrient intake and reduces frequency of illness in nutritionally at-risk children. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus aureus (S. aureus) and its resistant form methicillin-resistant S. aureus (MRSA) is one of the most common nosocomial pathogens causing a wide range of infections in humans. The anterior nares are the main ecological niche for S. aureus. Nasal carriage of S. aureus acts as an important reservoir of infection among the colonised healthcare workers and they transmit the infection to the community. The aim of the present study was to estimate the nasal colonisation of S. aureus (with special reference to MRSA) in healthcare workers (doctors and nursing staff) and its antibiotic susceptibility pattern. Methods: A descriptive study was planned in the Department of Microbiology, JLN Medical College, Ajmer (Rajasthan, India) after due approval from the institutional ethics committee. A total of 170 healthcare workers of either sex aged between 18 to 60 years were screened for S. aureus. Identification was done using standard microbiological techniques, by studying their morphology, colony and biochemical characteristics. MRSA was detected by cefoxitin disc diffusion test, oxacillin disc diffusion test, minimum inhibitory concentration (MIC) of oxacillin by E-test and oxacillin screen agar test. The observations were described in proportions and Chisquared test was used to find independence. Statistical significance was considered at 5 %. Results: Among 170 samples, 159 (93.53 %) samples (50 doctors and 109 nursing staff) had staphylococci colonisation. Among these 159 isolates, 34 (21.38 %) were S. aureus. Further, 8 (5.03 %) S. aureus isolates were resistant to both cefoxitin and oxacillin and had oxacillin MIC values ≥ 4 µg/mL and were considered MRSA. All the MRSA were detected in the nursing staff (males: 5.50 %, females: 1.83 %). All S. aureus and MRSA isolates were found sensitive to linezolid, vancomycin and mupirocin (minimum inhibitory concentration ≤ 4 µg/mL). Conclusion: Screening and treatment of healthcare workers colonised with MRSA should be an important component of hospital infection control policy. These measures will prevent spread of infection to patients and the community and thereby reduce the morbidity, mortality and healthcare costs associated with nosocomial infections. [ABSTRACT FROM AUTHOR]

Objective: To know the prevalence of a true middle mesial canal and isthmus in the mesial root of lower first and second molar teeth using cone beam computed tomography (CBCT) in an Indian population. Material and Methods: Two hundred fifty-six mandibular first and second molar teeth were evaluated from CBCT scans of 220 patients. Age, gender, presence of isthmuses and middle mesial canalsand number of root canals in the mesial root were doc- umented. Results: Of the 256 teeth studied, 38 (14.8%) of teeth were having true middle mesial canals. The prevalence of the middle mesial canal was 28% in first molar teeth and 7% in second molar teeth and the occurrence among the two teeth was statistical- ly non-significant (P = 0.83). No statistical difference was foundbetween the presence of middle mesial canal and age and gender. The frequency of isthmi in the mesial roots was 69.63% and the prevalence of isthmi was significant in patients between 20 to 30 years of age (P < 0.001). Conclusion: This study showed an increased rate of lower molar teeth with middle mesial canals or isthmi. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 as COVID-19 virus has affected the entire world and so to the cancer care and health-care facility. Cancer cervix is one of the common malignancies among women in developing and underdeveloped countries. Various challenges are being faced by patients and health-care providers to deliver optimal treatment under prescribed time frame. Faster delivery of whole treatment is desirable in the current pandemic. Overall treatment time in cancer cervix has prognostic value. Adoption of altered fractionation to delivered external beam radiation therapy could be a method for faster delivery of whole treatment. Altered fractionation such as hyperfractionation (HFX), hypofractionation, and accelerated fraction alone or with HFX has already been experimented for the past three decades. The total duration of treatment has been significantly reduced without addition of much toxicity. Few studies had also highlighted the feasibility of addition of chemotherapy to such fractionation schedule. However, prospective studies are still warranted to generate data to further support its use in the future. [ABSTRACT FROM AUTHOR]

Introduction: IgA nephropathy (IgAN) is the most common form of glomerulonephritis across the world. Oxford classification defines criteria and effects of endocapillary hypercellularity on E score but the reproducibility of the same is debatable. Hence, there is a need for an objective marker that could establish a gold standard in assessing endocapillary hypercellularity. Methods: Forty biopsies of proven IgAN were taken and grouped into two groups based on the presence or absence of endocapillary hypercellularity (n = 20 each). These biopsies were then stained by CD68 immune stain and the glomerular macrophages were quantified. Mean serum creatinine, presence of hypertension, degree of proteinuria and haematuria at the time of biopsy were also recorded and the correlation between these parameters and endocapillary hypercellularity was also studied. Results: Mean glomerular CD 68+ cell count was significantly higher in glomeruli showing endocapillary hypercellularity. Utilising the objective cutoff values of 0.6 CD68+ per glomerulus, more than 8 glomerular CD68+ cells in the entire biopsy and/or around 4 CD68+ cells in the most inflamed glomerulus, endocapillary hypercellularity can be predicted with a sensitivity of 70-80% and specificity of 70%. After regrouping the biopsies based on the cutoff values obtained from the receiver operating curve analysis the mean urine RBC count per high power field showed a significant correlation with endocapillary hypercellularity. Conclusion: Glomerular CD68+ macrophage count seems to be a promising approach in assessing endocapillary hypercellularity. Further studies with emphasis on correlation with the clinical outcome are needed to validate its utility as an objective tool. [ABSTRACT FROM AUTHOR]

Objective: To compare the detection rate of root canal orifices of maxillary first molar by various techniques in the Indian population. Material and Methods: A total of 50 maxillary 1st molar cases were selected and sequentially divided into four groups: Group I: Naked eye; Group II: Surgical loupe; Group III: Surgical operating microscope; and Group IV: Fluorescein sodium dye. After access opening, the number of root canal orifices was detected in all cases with these methods. Results: By naked eye and surgical loupe, a total of 171 root canal orifices were detected, by a surgical operating microscope, 176, and by fluorescein sodium dye, 177 root canal orifices were detected. The detection rate of root canal orifices is as follows: Group I (96.61%) = Group II (96.61%) < Group III (99.44%) < Group IV (100%) and detection rate of MB-2 canal orifices Group I (40%) = Group II (40%) < Group III (50%) < Group IV (52%). No significant difference in the number of canal orifices detected could be seen for any of the comparisons. No significant difference was observed between the naked eye and surgical loupe techniques. Although the surgical operating microscope detected more root canal orifices, it did not have a significantly higher detection than the other two techniques. Conclusion: No significant difference was seen among various methods. However, the use of a surgical operating microscope and fluorescein sodium dye increased the detection rate of root canal orifices. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of commonly used smokeless tobacco forms on oral health at habitual placement sites of smokeless tobacco compared to non-placement sites among the North Indian population. Material and Methods: This cross-sectional study was conducted among 542 individuals using smokeless tobacco recruited from the outpatient wing of the Dental College. Subjects completed a questionnaire and received an oral examination. Periodontal pocket depth, gingival index, plaque index, gingival recession, and oral mucosal changes were assessed. Kendal's Tau test, paired t-test, and chi-square test were carried out to compare different variables among placement and non-placement sites. Results: Most of the subjects were male, reporting an average of 11.26 years of SLT use. Clinical inflammation of gingiva was significantly greater (p=0.01) at placement-sites (1.64 ± 0.53) of SLT in comparison to non-placement-sites (1.40 ± 0.41). The difference in the GR and PPD at placement and non-placement-sites was also statistically significant with p=0.002 and p=0.001, respectively. Clinically, the majority of subjects had mucosal changes at the placement sites, and a statistically significant association (p=0.034) was observed between the duration of the use of smokeless tobacco and the mucosal changes. Conclusion: Smokeless tobacco use predisposes to increased risk of periodontal diseases and oral mucosal changes at the placement sites in an individual due to the local irritant effect. [ABSTRACT FROM AUTHOR]

Crop brassicas include three diploid [ Brassica rapa (AA; 2 n = 2 x = 16), B. nigra (BB; 2 n = 2 x = 18), and B. oleracea (CC; 2 n = 2 x = 20)] and three derived allotetraploid species. It is difficult to distinguish Brassica chromosomes as they are small and morphologically similar. We aimed to develop a genome-sequence based cytogenetic toolkit for reproducible identification of Brassica chromosomes and their structural variations. A bioinformatic pipeline was used to extract repeat-free sequences from the whole genome assembly of B. rapa. Identified sequences were subsequently used to develop four c. 47-mer oligonucleotide libraries comprising 27,100, 11,084, 9,291, and 16,312 oligonucleotides. We selected these oligonucleotides after removing repeats from 18 identified sites (500–1,000 kb) with 1,997–5,420 oligonucleotides localized at each site in B. rapa. For one set of probes, a new method for amplification or immortalization of the library is described. oligonucleotide probes produced specific and reproducible in situ hybridization patterns for all chromosomes belonging to A, B, C, and R (Raphanus sativu s) genomes. The probes were able to identify structural changes between the genomes, including translocations, fusions, and deletions. Furthermore, the probes were able to identify a structural translocation between a pak choi and turnip cultivar of B. rapa. Overall, the comparative chromosomal mapping helps understand the role of chromosome structural changes during genome evolution and speciation in the family Brassicaceae. The probes can also be used to identify chromosomes in aneuploids such as addition lines used for gene mapping, and to track transfer of chromosomes in hybridization and breeding programs. [ABSTRACT FROM AUTHOR]

Postmenopausal bleeding is one of the common presenting complaints in the gynecological outpatient department. The common causes of which are atrophic endometritis, vaginitis, estrogen therapy, cancer endometrium, and cancer cervix. Hereby, we present a rare case of a 65-year-old female presented with postmenopausal bleeding who had history of trauma 1 year back with pelvic bone fracture. The cause of postmenopausal bleeding, in this case, is abnormal bony protrusion secondary to malunited pelvic fracture causing laceration of the right lateral vaginal wall. The case was managed by local osteotomy and vaginal wall repair. [ABSTRACT FROM AUTHOR]

Even as the field of microbiome research has made huge strides in mapping microbial community composition in a variety of environments and organisms, explaining the phenotypic influences on the host by microbial taxa—both known and unknown—and their specific functions still remain major challenges. A pressing need is the ability to assign specific functions in terms of enzymes and small molecules to specific taxa or groups of taxa in the community. This knowledge will be crucial for advancing personalized therapies based on the targeted modulation of microbes or metabolites that have predictable outcomes to benefit the human host. This perspective article advocates for the combined use of standards-free metabolomics and activity-based protein profiling strategies to address this gap in functional knowledge in microbiome research via the identification of novel biomolecules and the attribution of their production to specific microbial taxa. [ABSTRACT FROM AUTHOR]

Objectives: Lead is one of the most toxic heavy metal prevalent in the environment, which affects almost all major organs including heart, brain, intestines, kidneys as well as reproductive organs. It has been known that serum iron deficiency is associated with increased serum lead levels as lead is a particularly pernicious element to iron metabolism. Lead is also known to freely cross the placenta too; hence, this study was planned to determine any association between antenatal iron deficiency anemia (IDA), raised blood lead levels (BPb), and adverse pregnancy outcomes. Materials and Methods: This was an observational study done on 99 antenatal women with IDA and 41 nonanemic antenatal women. Lead levels were assessed in these 140 antenatal women and they were followed for adverse pregnancy outcomes. Chi-square test was used to find a difference in quantitative variables and Pearson's correlation test was used to assess association between BPb and hemoglobin levels. Results: We found that in 11 out of 99 (11.11%) women with IDA, BPb levels were high as compared to high BPb levels in only 1 out of 41 (2.4%) women without IDA and the high BPb levels ranged from 4 μg/dl–16.9 μg/dl with a mean BPb of 8.1 μg/dl. The difference in BPb among anemic and nonanemic antenatal women was significant (P < 0.05) and there was a negative dose effect relationship between BPb levels and hemoglobin levels. This difference in antenatal outcomes among women with and without high BPb levels was also significant with increased incidence of pre-eclampsia, FGR, and preterm deliveries in women with raised BPb levels. The incidence of NICU admission was also higher in the neonates of mothers with high BPb levels. Conclusions: We propose screening of high-risk women based on their social, occupational, environmental, and personal factors, with serum lead levels in the preconception period itself. All public and personal measures must be taken to reduce lead consumption and exposure in the preconception and antenatal period. [ABSTRACT FROM AUTHOR]

The human gut is colonized by trillions of bacteria as well as other microorganisms, collectively referred to as the "gut microflora." This microflora plays an important role in metabolism as well as immunity, and alterations in its normal composition and pattern of colonization can disturb the development and functioning of the immune system, predisposing the individual to several diseases. Neonates acquire their gut microflora from the mother as well as the surroundings, and as the infant grows, the gut microflora undergoes several changes, ultimately acquiring an adult-like composition. Characterization of the gut microflora of healthy infants is important to protect infants from infectious diseases. Furthermore, formulation of prebiotics and probiotics for boosting infant immunity in a specific population also requires prior knowledge of the normal gut microflora in a healthy infant in that population. To this end, several studies have been performed on Western infants; however, the gut microflora of Indian infants is as yet insufficiently studied. Moreover, there has been no comparative analysis of the development and characteristics of the infant gut microflora between the two populations. In this review, we discuss the development and maturation of the infant gut microflora and its effect on immunity, as well as the factors affecting the patterns of colonization. In addition, we compare the patterns of colonization of gut microflora between Western and Indian infants based on the available literature in an attempt to identify the extent of similarity or difference between the two populations. [ABSTRACT FROM AUTHOR]

The enzyme methyl-coenzyme M reductase (MCR) plays an important role in mediating global levels of methane by catalyzing a reversible reaction that leads to the production or consumption of this potent greenhouse gas in methanogenic and methanotrophic archaea. In methanogenic archaea, the alpha subunit of MCR (McrA) typically contains four to six posttranslationally modified amino acids near the active site. Recent studies have identified enzymes performing two of these modifications (thioglycine and 5-[S]-methylarginine), yet little is known about the formation and function of the remaining posttranslationally modified residues. Here, we provide in vivo evidence that a dedicated S-adenosylmethionine-dependent methyltransferase encoded by a gene we designated methylcysteine modification (mcmA) is responsible for formation of S-methylcysteine in Methanosarcina acetivorans McrA. Phenotypic analysis of mutants incapable of cysteine methylation suggests that the S-methylcysteine residue might play a role in adaption to mesophilic conditions. To examine the interactions between the S-methylcysteine residue and the previously characterized thioglycine, 5-(S)-methylarginine modifications, we generated M. acetivorans mutants lacking the three known modification genes in all possible combinations. Phenotypic analyses revealed complex, physiologically relevant interactions between the modified residues, which alter the thermal stability of MCR in a combinatorial fashion that is not readily predictable from the phenotypes of single mutants. High-resolution crystal structures of inactive MCR lacking the modified amino acids were indistinguishable from the fully modified enzyme, suggesting that interactions between the posttranslationally modified residues do not exert a major influence on the static structure of the enzyme but rather serve to fine-tune the activity and efficiency of MCR. The unusual post-translational modifications of the enzyme methyl-coenzyme M reductase have no major impact on the static structure of the enzyme, but instead serve to fine-tune its activity and efficiency of catalysis. [ABSTRACT FROM AUTHOR]