Search

Introduction: India launched a national initiative named Health and Wellness Centres (HWCs) in 2018 to provide population‑based primary care including for the non‑communicable diseases (NCDs) in rural areas. The current study assesses whether operationalization of HWCs improved the detection of NCDs and increased the share of public sector facilities in providing NCD services. Methods: Two rounds of household surveys were conducted in rural Chhattisgarh in 2019 and 2022. With a focus on NCDs, the household survey covered a representative sample of individuals above the age of 30 years – 2760 individuals in 2019 and 2638 in 2022. Multi‑variate regression analysis was carried out to determine effects of HWCs on identification of NCDs and utilization of public sector services. Results: The population covered by HWCs had 25% greater chance of being identified with NCDs as compared to the population without HWCs (AOR = 1.25, P = 0.03). The NCD patients living in areas covered by HWCs had 70% greater chance of utilizing the public healthcare facilities (AOR = 1.70, P = 0.01). In the population covered by HWCs, the share of the public sector in NCD care increased from 41.2% in 2019 to 62.1% in 2022, whereas the share of informal private providers dropped from 23.5% in 2019 to 8.4% in 2022. Conclusion: The HWCs showed effectiveness in increasing detection of NCDs at the population level and bringing a larger share of NCD patients to utilize public sector services. They can prove to be a crucial architectural correction for improving primary care service delivery for NCDs and other population health needs in India. [ABSTRACT FROM AUTHOR]

Peptic ulcer disease (PUD) is the most common gastrointestinal condition in the world, with significant death and morbidity rates. The many adverse effects of antiulcer drugs now available on the market include hypersensitivity, arrhythmia, impotence, gynecomastia, haematological abnormalities, and renal disease. Traditional medicine accounts for a substantial part of primary healthcare worldwide. On the crude extract of Ficus racemosa, a number of qualitative and quantitative investigations were carried out in order to determine the presence of characteristic phytochemical components. The present research looked at different solvents' potential to cure ulcers. Leaf extract from Ficus racemosa Linn. in albino rats. To measure antiulcer activity, the ethanol-induced stomach ulcer, free and total acidity, and pylorus-ligated ulcer techniques were also applied. Using the soxhlet extraction technique, the leaves of Ficus racemosa were progressively extracted with petroleum ether (60–80 C), chloroform, ethyl acetate, Petroleum ether, ethanol, methanol, and water. They were evaluated for consistency in colour, phytochemical content, phytoconstituents such glycosides, saponins, and phytosterols, and yield percentage. Early studies on the different extracts revealed the presence of flavonoids, phenols, steroids, and terpenoids all in favourable results. The results of fractionation tests showed that the methanol fraction had the highest antiulcer effectiveness and the chloroform fraction had the lowest efficacy. Due to their antiulcer effect and safety profile, the leaves of Ficus racemosa may be a viable option for treating PUD in individuals. [ABSTRACT FROM AUTHOR]

Introduction: Bile is deemed a sterile fluid, with the presence of clinical conditions like cholelithiasis, cholecystitis, previous biliary interventions, biliary strictures, and so on, leading to bile stasis, and increases the chances of bacteriobilia. In this study, we recognize the bacterial spectrum of microorganisms isolated from bile samples, diagnostic parameters, and antibiotic sensitivity patterns. Methods: A retrospective observational study was carried out by compiling data from the hospital information system of a tertiary care center from 2021 to 2022 to evaluate biliary infections in patients who underwent surgical procedures related to the biliary tract and associated organs. Results: A total of 234 patients' bile samples were included in our study. The mean age of patients was 48.04 ± 14.74 years, with more patients below the age of 65 years among those with infected bile samples. One hundred and sixty-three (163/234, 69.66%) patients infected by 209 pathogenic microorganisms were recognized. The most common microorganism isolated was Escherichia coli (83/209, 39.71%), followed by Pseudomonas aeruginosa (37/209, 17.7%). Acinetobacter baumannii and Klebsiella pneumoniae isolate owed to more than 90% penicillin, extended-spectrum beta-lactamase, carbapenem, and fluoroquinolone resistance among all isolates. Length of hospital stay, malignant obstruction, and chronic kidney disease were identified as statistically significant risk factors that lead to the isolation of multi-drug-resistant isolates from bile culture. Conclusion: We recognized the spectrum of pathogens causing biliary tract infections at our center along with the antibiotic resistance pattern to guide and facilitate prompt and appropriate treatment by primary health care professionals and family medicine practitioners. [ABSTRACT FROM AUTHOR]

In 2018, the Government of Madhya Pradesh initiated the feasibility testing of integrating an algorithmic approach (assess, give, counsel, treat) to strengthen antenatal nutrition services in routine government-funded programmes coupled with a health system thinking approach to strengthen the health service delivery platform. Implementation phases included (1) an evidence review and stakeholder consultations (April 2018) and (2) a health systems strengthening preparedness phase (May–December 2018), including pilot testing in Vidisha district (January–December 2019) covering ∼54 100 pregnant women with 237 antenatal contact points through 241 government auxiliary nurse midwives/staff nurses. During 2020–21, feasibility testing was expanded to an additional 7 districts. We used programme registers of the Auxiliary Nurse Midwives Registers (2019–21) and National Family Health Survey data for 2016 and 2021 to show changes in the Vidisha district and 7 expansion districts. We compare the performance of Vidisha district with Ashok Nagar district, where no such intervention occurred. Comparing 2016 and 2021 data, the Vidisha district showed improvements in receipt of antenatal care in the first trimester (29 to 85%) and in four antenatal visits (17 to 54%). Using the difference-in-difference approach, a 42% net increase in first-trimester antenatal check-ups in Vidisha as compared to Ashok Nagar is observed. There was also an improvement in the maternal nutrition budget of the state from USD 8.5 million to USD 17.8 million during this period. The Vidisha initiative offers several lessons in time-effective workflow to deliver all constituents of nutrition services at various antenatal contact points through and via routine government health systems. Continued execution of the algorithm for screening, with longitudinal data on the management of all nutrition risks, will be critical to show its long-term impact on maternal morbidities and birth outcomes. [ABSTRACT FROM AUTHOR]

Background: A micellar-HPLC method was developed for the determination of oxaliplatin (OHP) and curcumin (CUR) employing a C18 column [4.6-250mm, particle size (dp) -5 mm] and diode array detector. Objective: A rapid, cost-effective, environmentally friendly, time-efficient, easy-to-handle, and safe method was developed. Methods: The conditions were optimized for the estimation of OHP and CUR: 0.15M sodium dodecyl sulfate (SDS) in 6% (v/v) pentanol buffered to pH 5.0 with a flow rate of 1.0 mL/min, injection volume of 20 mL, and detection at 325nm. Different analytical parameters, including linearity, accuracy, precision, robustness, specificity, LOD, and LOQ, were determined in compliance with the International Council on Harmonisation (ICH) guidelines. Results: The LOD (S/N-3) of OHP was 0.004 mg/mL and for CUR it was 0.005 mg/mL. The calibration curves for OHP and CUR were linear over the range 0.015-10 mg/mL (determination coefficient r2-0.9999) and 0.015-10 mg/mL (r2-0.9994), respectively. Conclusion: The drugs were eluted in <12min and the developed method was applicable for analyzing multiple samples per day. Moreover, it was determined to be robust and was used to quantify OHP and CUR in mice serum/blood. The method could pave the way for quantitative analysis of these drugs during the development of a pharmaceutical preparation for the treatment of colorectal cancer. Highlights: A simple, cost-effective, eco-friendly HPLC method was developed to simultaneously estimate oxaliplatin and curcumin. The developed method was validated as per the ICH guidelines. [ABSTRACT FROM AUTHOR]

Introduction: Commiphora wightii (Arn.) Bhandari (Guggul) is native to semi-arid to arid zones. Its oleoresin gum is used for both medicinal and non-medicinal applications. Reportedly, the species faces highdegree conservation threats. A network of Four Medicinal Plants Conservation Areas (MPCA) was carved out in Kachchh region- under financial support from National Medicinal Plants Board. The species also occurs in sanctuary and protected by default. It is considered important to assess genetic diversity of these conserved populations. Methods: A total of 38 accessions of Guggul leaves were collected from five study sites and the whole genomic DNA was extracted for each sample. Genetic study was carried out using ISSR technique. Scorable bands were obtained for 14 out of 40 primers tested. A total of 49 bands were obtained of which 20 were polymorphic in nature. UPGMA dendrograms were constructed for individual sites and also a collective dendrogram for all the study sites. Results: All the 8 accessions of Tharawada MPCA were observed to share a high similarity coefficient. Among rest of three sites, genetic diversity was seen to be narrow. The accessions obtained from NSWS displayed good diversity. These accessions were also noted to be distant to the populations captured in the MPCA sites. Conclusions: Established MPCA sites capture the available gene pool of Commiphora wightii of Kachchh region. Since NSWS populations are distant to rest of the region, it is suggested to create another site for this purpose. It is desirable to assess the genetic diversity in rest of the MPCA sites. [ABSTRACT FROM AUTHOR]

Topotecan (TPT) is a semi-synthetic, water-soluble derivative of camptothecin, which inhibits the action of topoisomerase I in the S-phase of the cell cycle leading to cell death. For the effective delivery of TPT to cancer cells, pH-sensitive sialic acid modified liposomes were developed. These liposomes were prepared by the thin-film hydration method using the active loading technique. Vesicle size, polydispersity index (PDI), zeta potential, and percentage entrapment efficiency were determined to be 167 ± 3.78 nm, 0.243, −8.39 mV, and 79.88 ± 1.67%, respectively. The pH-sensitive sialic acid (SA) conjugated liposomes enhanced the drug release at acidic pH 4 (92.33 ± 4.21%) as compared to physiological pH 7.4 (63.11 ± 4.51%). A Sulforhodamine B (SRB) cytotoxicity assay was performed in Murine sarcoma S180 cell lines and the GI50 value of free TPT, Lipo, P-Lipo, SA-P-Lipo, and Adriamycin (ADR) were determined to be 10.07 ± 0.15, 27.33 ± 1.01, 28.76 ± 0.87, 15.7 ± 0.45, and 11.5 ± 0.21 µg/mL, respectively. Results obtained from the apoptosis study revealed that cell death by a combination of early apoptosis and apoptosis caused by SA-P-Lipo was ∼24 fold higher than the control. These results demonstrated that pH-sensitive sialic acid conjugated liposomes will be a potential formulation for improving the antitumor efficacy of TPT. However, further research is necessitated to expedite its applicability in clinical regimen in order to ascertain its safety and efficacy. [ABSTRACT FROM AUTHOR]

Background: Curcumin has been extensively employed in the treatment of several diseases in traditional medicine, including cancer. The main obstacles that avert its approval as a therapeutic moiety are its low aqueous solubility and low in vivo bioavailability. Liposomes have been recognized as effective carrier systems owing to their ability to solubilize hydrophobic molecules and to change their pharmacokinetic attributes. This study was intended at developing Eudragit S 100 coated alginate beads bearing curcumin loaded liposomes for colonic delivery. Methods: The liposomes were prepared by the film casting method. The optimization of various formulation and process variables was done by Box-Behnken design using Design-Expert® Software. Three variables i.e.HSPC:Chol molar ratio (X1), curcumin concentration (X2), and sonication time (X3) were selected as independent variables and entrapment efficiency of curcumin, polydispersity index, and vesicle size were selected as dependent variables. Results: The optimized liposomes had an average particle size of 109. 8 ± 1.4 nm, polydispersity index 0.218 ± 1.2, zeta potential +19.30 ± 2.46 mV, and with entrapment efficiency 70.16 ± 1.6 %. These liposomes were entrapped in eudragit coated beads and these beads were characterized for their size, swelling index and in vitro drug release. The in vitro drug release depicted that no release was observed till 6 hrs and a sustained and significant drug release was noted after 6.5 hr. Conclusion: The stability studies indicated that liposomes were stable at 4°C depicting little aggregation of the vesicles. The research suggested that curcumin-loaded liposomes bearing eudragit coated calcium alginate beads can be effectively used for colonic delivery. [ABSTRACT FROM AUTHOR]

The present research was aimed to develop thiolated polyacrylic acid (TPA) based microspheres (MSPs) containing famotidine (FX) and clarithromycin (CLX). TPA was synthesised from polyacrylic acid and l-cysteine in the presence of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDAC). The prepared TPA was characterised using FT-IR (Fourier transform-infra red), 1H-NMR (proton nuclear magnetic resonance) spectroscopy, P-XRD (powder X ray diffraction) method, and zeta potential. The analytical tools have supported the formation of TPA. The thiolated microspheres were prepared by emulsion solvent evaporation method using 0.75% w/v polymer concentration and stirring at 400 rpm for 8 hr. The average particle size and zeta potential of optimised formulation was found to be 25.2 ± 1.87 μm and –26.68 mV, respectively. The entrapment efficiency of the optimised formulation was obtained 67.20% for FX and 70.20% for CLX. The developed microspheres were swelled only in 4 h from 0.5 to 0.9. The in vitro mucoadhesive study and in vitro drug release studies demonstrated that microspheres showed mucoadhesive property. In in vitro drug release studies, the release of FX and CLX were observed to be 58.68% and 60.48%, respectively from microspheres in 8 h. The thiolated microspheres showed higher adhesion time (7.0 ± 0.8 h) in comparison to the plain microspheres (2.6 ± 0.4 h). The prepared TPA based mucoadhesive microspheres can be utilised as carriers for the treatment of peptic ulcer caused by Helicobacter pylori which will offer enhanced residence time for the rational drug combination in the gastric region. [ABSTRACT FROM AUTHOR]

Context: Insulinoma needs accurate preoperative localization for minimally invasive surgery. Exendin‐4‐based imaging has shown promising results. Objective: To evaluate performance parameters of exendin‐4‐based imaging in insulinoma localization and compare with other imaging modalities. Design: Retrospective cross‐sectional study. Patients: We report 14 patients with endogenous hyperinsulinemic hypoglycaemia (EHH) managed at our centre; in whom, the final diagnosis was insulinoma (n = 11), Munchausen syndrome (MS) (n = 2) and inconclusive (n = 1). Retrospective reporting of CECT, 68Ga‐DOTATATE PET/CT and 68Ga‐NODAGA‐exendin‐4‐PET/CT was done. With per‐lesion analysis, performance parameters were calculated for the histopathological diagnosis of insulinoma. Main Outcome Measures: True positive (TP), false positive (FP), false negative (FN), true negative (TN), sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) for insulinoma localization. Results: In our cohort, 12 histopathologically proven insulinoma lesions [(TP): 11 primary lesions, 1 metastasis] were detected in 11 patients, whereas two patients had MS (TN). Sn and PPV were 75% and 100%, 33.3% and 80% and 83.3% and 71.4% for CECT, 68Ga‐DOTATATE PET/CT and 68Ga‑NODAGA‑exendin‑4‐PET/CT, respectively. With exendin‐4‐based imaging, FP uptake in normal pancreatic tissue and FN results in the pancreatic tail lesion was seen. In one patient, TN result suggested the correct diagnosis of MS. Conclusion: 68Ga‑NODAGA‑exendin‑4‐PET/CT has higher sensitivity than 68Ga‐DOTATATE PET/CT and CECT for insulinoma localization. FP uptake in normal pancreas and FN result in tail lesions are limitations of currently utilized exendin‐4‐based imaging. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the pathogenic role of a few benign variants and h ypomorphic pathogenic variants in SRD5A2. Design and methods: We retrospectively analyzed phenotypes and genotypes in 23 Ind ian patients with genetically proven steroid 5α-reductase 2 (SRD5A2) deficiency. The interactions of the SRD5A2 enzymes resulting due to the most common benign variant (p.Val89Leu), the most common (hypomorphi c) pathogenic variant (p.Arg246Gln) and the double variants (p.Val89Leu and p.Arg246Gln) in SRD5A2 were compared with that of the wild type (WT) enzyme by molecular dynamics (MD) simulation. Results: The majority (n = 19, 82.61%) of patients presented for atypical genitalia and had male gender identity (16/20). Including the two novel ones (p.Leu83Pro, p.Ala28Leufs*103), a total of nine different pathogenic variants were observed. p.Arg246Gln was the most common pathogenic variant (n = 12). Homozygous p.Arg246Gln (n = 9) variant was associated with milder undervirilization (Sinnecker score of ≤3a: 8/9 vs 6/14, P = 0.04) and had concurrent homozygous p.Val89Leu in all patients. Interestingly, asymptomatic fathers of two index patients were homozygous for p.Arg246Gln which questioned the pathogenicity of the variation as a sole f actor. Unlike all symptomatic homozygous p.Arg246Gln patients who were also homozygous for p.Val89Leu, asymptomatic homozygous p.Arg246Gln fathers were heterozygous for p.Val89Leu. On MD simulation SRD5A2 p.Val89Leu -Testeosterone (T) and SRD5A2 p.Arg246Gln-T complexes, but not SRD5A2 p.Val89Leu and p.Arg246Gln-T complex, demonstrated close interaction between NADPH and T as that of SRD5A2 WT-T. Conclusions: p.Arg246Gln may not be pathogenic as a sole variation even in the homozygous state; additional contribution of homozygous p.Val89Leu variant may be essential for the pathogenicity of p.Arg246Gln in SRD5A2. [ABSTRACT FROM AUTHOR]

The present investigation was aimed to isolate banana starch (BS), synthesis of banana starch tartrate (BST), characterization, and application as a novel disintegrant in telmisartan tablets. Starch tartrate was synthesized by the esterification process by the treatment of tartaric acid on the backbone of the BS. Synthesized BST was found to be fine, slightly free-flowing and crystalline powder. The synthesized BST was subjected to Scanning Electron Microscopy (SEM) and micrometric evaluation. Flow properties of BS and BST were determined as an angle of repose, bulk density, tapped density, Carr's index, Hausner's ratio, etc. BST exhibited good swelling properties and showed no gelling at 100°C but it was transformed into a clear solution. Fourier transform infrared spectra (FTIR) did not show the presence of any significant interaction between BST and Telmisartan(T). The direct compression technique was employed in formulating telmisartan tablets using BST sodium starch glycolate and crospovidone as a disintegrant. Tablets were comparatively evaluated for weight variation, thickness, hardness, friability, and disintegration. The tablets formulated using BS and BST passed prescribed evaluation tests for weight variation, friability, hardness, and thickness. The tablets formulated using BST as disintegrant gave optimum disintegration compared to those tablets containing sodium starch glycolate and crospovidone sodium super disintegrants. Evaluations indicated that synthesized BST shows qualitatively and quantitatively good disintegration characteristics in comparison to super disintegrants in telmisartan tablet formulation. These results suggest that the synthes ized BST could be used as a novel semi-synthetic disintegrant in dispersible tablet formulations. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is the third most common cancer existing across the globe. It begins with the formation of polyps leading to the development of metastasis, especially in advanced stage patients, who necessitate intensive chemotherapy that usually results in a poor response and high morbidity owing to multidrug resistance and severe untoward effects to the non-cancerous cells. Advancements in the targeted drug delivery permit the targeting of tumor cells without affecting the non-tumor cells. Various nanocarriers such as liposomes, polymeric nanoparticles, carbon nanotubes, micelles, and nanogels, etc. are being developed and explored for effective delivery of cytotoxic drugs to the target site thereby enhancing the drug distribution and bioavailability, simultaneously subduing the side effects. Moreover, immunotherapy for CRC is being explored for last few decades. Few clinical trials have even potentially benefited patients suffering from CRC, still immunotherapy persists merely an experimental alternative. Assessment of the ongoing and completed trials is to be warranted for effective treatment of CRC. Scientists are paying efforts to develop novel carrier systems that may enhance the targeting potential of low therapeutic index chemo- and immune-therapeutics. Several preclinical studies have revealed the superior efficacy of nanotherapy in CRC as compared to conventional approaches. Clinical trials are being recruited to ascertain the safety and efficacy of CRC therapies. The present review discourses in a nutshell the molecular interventions including the genetics, signaling pathways involved in CRC, and advances in various strategies explored for the treatment of CRC with a special emphasis on nanocarriers based drug targeting. [ABSTRACT FROM AUTHOR]

Skin is the largest external organ in the human body but its use for therapeutic purposes has been minimal. Stratum corneum residing on the uppermost layer of the skin provides a tough barrier to transport the drugs across the skin. Very small group of drugs sharing Lipinski properties, i.e. drugs having molecular weight not larger than 500 Da, having high lipophilicity and optimum polarity are fortunate enough to be used on skin therapeutics. But, at a time where modern therapeutics is slowly shifting from use of small molecular drugs towards the use of macromolecular therapeutic agents such as peptides, proteins and nucleotides in origin, skin therapeutics need to be evolved accordingly to cater the delivery of these agents. Physical technologies like iontophoresis, laser ablation, micro-needles and ultrasound, etc. have been introduced to enhance skin permeability. But their success is limited due to their complex working mechanisms and involvement of certain irreversible skin damage in some or other way. This review therefore explores the delivery strategies for transport of mainly peptide and protein drugs that do not involve any injuries (non-invasive) to the skin termed as passive delivery techniques. Chemical enhancers, nanocarriers, certain biological peptides and miscellaneous approaches like prodrugs are also thoroughly reviewed for their applications in protein delivery. [ABSTRACT FROM AUTHOR]

Context: Microsponge is a novel approach for targeting the drug to the colon for the management of colon ailments such as inflammatory bowel disease. Objective: Prednisolone loaded microsponges (PLMs) were prepared and coated with Eudragit S 100 (ES) and evaluated for colon-specific drug delivery. Materials and methods: PLMs were prepared using quasi emulsion solvent diffusion technique using ethyl cellulose, triethylcitrate (1% v/v, plasticizer) and polyvinyl alcohol (Mol. Wt. 72 kDa, emulsifying agent). The developed microsponges were compressed into tablets via direct compression technique using sodium carboxymethyl cellulose (Na CMC) and magnesium stearate as super-disintegrant and lubricant, respectively. The tablets were then coated with ES to provide protection against harsh gastric environment and manifest colon-specific drug release. Results: PLMs were found to be nano-porous spherical microstructures with size around 35 µm and 86% drug encapsulation efficiency. Finally, they were compressed into tablets which were coated with Eudragit S 100 In vitro drug release from ES coated tablets was carried out at various simulated gastrointestinal fluids i.e. 1 hr in SGF (pH 1.2), 2 to 3 h in SIF (pH 4.6), 4-5 h in SIF (pH 6.8), and 6-24 h in SCF (pH 7.4) and the results showed the biphasic release pattern indicating prolonged release for about 24 h. Discussion and conclusion:In vitro drug release studies revealed that drug starts releasing after 5 h by the time PLMs may enter into the proximal colon. Hence maximum amount of drug could be released in the colon that may result in reduction in dose and dose frequency as well as side effects of drug as observed with the conventional dosage form of prednisolone. [ABSTRACT FROM AUTHOR]

Over the past few decades, applications of ultrasound (US) in drug delivery have been documented widely for local and site-specific release of bioactives in a controlled manner, after acceptable use in mild physical therapy for tendinitis and bursitis, and for high-energy applications in fibroid ablation, cataract removal, bone fracture healing, etc. US is a non-invasive, efficient, targetable and controllable technique. Drug delivery can be enhanced by applying directed US in terms of targeting and intracellular uptake. US cannot only provide local hyperthermia but can also enhance local extravasations and permeability of the cell membrane for delivery of cell-impermeable and poorly permeable drugs. It is also found to increase the anticancer efficacy of drug against solid tumors by facilitating uniform drug delivery throughout the tumor mass. This review summarizes the mechanism of US; various drug delivery systems like microbubbles, liposomes, and micelles; and biological manifestations employed for improving treatment of cancer, i.e., hyperthermia and enhanced extravasation. Safety issues are also discussed for better therapeutic outcomes of US-assisted drug delivery to tumors. This review can be a beneficial asset to the scientists looking at non-invasive techniques (externally guided) for improving the anticancer potential of drug delivery systems. [ABSTRACT FROM AUTHOR]

Introduction: Although few studies have demonstrated utility of 18 F- fluoro-2-deoxy-d-glucose positron emission tomography/computerised tomography (18 F-FDG PET/CT) in benign pheochromocytoma/paragangliomas (PCC/PGLs), there limited data on factors predicting the FDG uptake in PCC/PGL.Methods: The study was conducted at a tertiary health care centre. In addition to the routine investigations, all patients (n = 96) with PCC/PGL were evaluated with 18 F-FDGPET/CT and majority (n = 78) underwent 131 I-metaiodobenzyl guanidine (131 I-MIBG) scintigraphy. Forty-three patients also underwent testing for germline mutations in five PCC/PGL susceptibility genes (VHL, RET, SDHB, SDHC and SDHD) and all patients were evaluated clinically for neurofibromatosis-1.Results: The study included 96 patients with PCC/PGL(82 benign and 14 malignant). FDGSUVmax was significantly higher for malignant than benign PCC/PGL(P = 0.009) and for extra-adrenal PGL than adrenal PCC (P = 0.017). In subgroup analysis, metanephrine-secreting PCC and non-secretory PCC had significantly lower FDG SUVmax than normetanephrine-secreting PCC (P = 0.017, P = 0.038 respectively), normetanephrine-secreting-sympathetic PGL (P = 0.008, P = 0.019 respectively) and non-secretory sympathetic PGL (P = 0.003, P = 0.009 respectively). Patients with mutations in cluster 1 genes (n = 14) had significantly higher FDG SUVmax than those with mutations in cluster 2 genes (n = 4) (P = 0.04). Sensitivities of 131 I-MIBG and 18 F-FDG PET/CTwere 77.78% and 100% for cluster 1 genes-related PCC/PGL whereas they were 100% and 50% for cluster 2 genes-related PCC/PGL, respectively. Multivariate regression analysis of mutation positive patients identified genetic status as the only independent predictor of FDG SUVmax.Conclusion: The study suggests that the underlying genetic status determines FDG uptake in PCC/PGL and not location, secretory status or malignancy. [ABSTRACT FROM AUTHOR]

BASF is the world's leading chemical company. The case study is about making BASF (India) into a learning organization. BASF introduced a new competency and performance management framework aiming at changing not only the process but also the way employees think, feel, and act. BASF also had a structured talent development process that identified and developed high potential talent. BASF realized that it was important to challenge the assumptions held by individuals in the organization and create a more open culture. Thus BASF launched the 360 degree initiative for business and functional heads and their senior team. BASF worked on Strategy 2025 and used the bottom-up approach unlike what BASF did in the past. BASF strongly believed that one can learn a lot from others through regular interactions and common goals. BASF realized that learning is a continuous journey with its own challenges. BASF is committed to surge ahead on this path and to continuously innovate and learn in order to provide sustainable solutions and remain a market leader and most important be an admired organization. [ABSTRACT FROM PUBLISHER]

Hemodynamic derangements have been reported after surgery involving upper cervical spine. Similar observations, however, are rare during a lumbar spine surgery. We share our experience in a patient who had 2 episodes of bradycardia leading to transient asystole while undergoing lumbar discectomy for prolapsed intervertebral disc. The risk of life-threatening hemodynamic disturbances during seemingly uncomplicated surgery in prone position has been emphasized. [ABSTRACT FROM AUTHOR]

We present experimental investigation on critical phenomena in Cu2OSeO3 by analyzing the critical behavior of magnetization using a new method. This is necessary as a crossover from 3D Ising to 3D Heisenberg has been observed in Cu2OSeO3. The proposed method is applicable to explore the physics for a wide range of materials showing trivial or nontrivial critical behavior on two sides of the transition. A magnetic phase diagram has been constructed from the critical analysis. Multiple critical points due to multiple phases and transition between them have been observed in the phase diagram of Cu2OSeO3. [ABSTRACT FROM AUTHOR]

Fungal keratitis (FK) is treated by topical natamycin (Nat) which is an effective antifungal agent. However, it has numerous therapeutic limitations i.e. toxicity, tolerance, need of frequent dosing and patient incompliance. The aim of the present study was to develop Nat loaded trimethyl chitosan (TMC) coated mucoadhesive cationic niosomes (Muc-Cat-Nios) for prolonged and effective delivery to eyes. Niosomes were prepared using thin film hydration method and optimized using a Box-Behnken design (BBD) with the help of Design-Expert® Software. Three independent variables were considered: amount of Span 60 (X 1), amount of Cholesterol [Chol(X 2)] and TMC concentration (X 3). The encapsulation efficiency (R1: EE%), vesicle size (R2: VS) and Zeta potential (R3: ZP) were selected as dependent variables or responses. The optimized Nios displayed spherical shape, 1034.14 nm vesicle size and 81.76% EE. Nat loaded niosomes were incubated with TMC to get mucoadhesive cationic vesicular system. Uncoated and TMC coated niosomes were characterized for mucoadhesive properties, in vitro drug release, rheological behaviour, and ex vivo permeation studies. Cationic Nios showed greater mucoadhesive potential that provided drug release for a long period of time. The promising outcomes suggest that natamycin delivery using cationic mucoadhesive niosomes could be employed for the effective treatment of fungal keratitis. [ABSTRACT FROM AUTHOR]