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Background: Alzheimer’s disease (AD) is the most common type of neurodegenerative dementia affecting people in their later years of life. The AD prevalence rate has significantly increased due to a lack of early detection technology and low therapeutic efficacy. Despite recent scientific advances, some aspects of AD pathological targets still require special attention. Certain traditionally consumed phytocompounds have been used for thousands of years to treat such pathologies. The standard extract of Gingko biloba (EGB761) is a combination of 13 macro phyto-compounds and various other micro phytocompounds that have shown greater therapeutic potential against the pathology of AD. Objective: Strong physiological evidence of cognitive health preservation has been observed in elderly people who keep an active lifestyle. According to some theories, consuming certain medicinal extracts helps build cognitive reserve. We outline the research employing EGB761 as a dual target for AD. Methods: This study investigates various inhibitory targets against AD using computational approaches such as molecular docking, network pharmacology, ADMET (full form), and bioactivity prediction of the selected compounds. Results: After interaction studies were done for all the phytoconstituents of EGB761, it was concluded that all four of the phytocompounds (kaempferol, isorhamnetin, quercetin, and ginkgotoxin) showed the maximum inhibitory activity against acetylcholinesterase (AChE) and GSK3β. Conclusion: The highly active phytocompounds of EGB761, especially quercetin, kaempferol, and isorhamnetin, have better activity against AChE and GSK3β than its reported synthetic drug, according to molecular docking and network pharmacology research. These compounds may act on multiple targets in the protein network of AD. The AChE theory was primarily responsible for EGB761’s therapeutic efficacy in treating AD.

Background: The aim of the present study was to determine the pattern of adverse drug reactions (ADRs) reported at ADR monitoring centre (AMC) in Punjab. Methods: This observational retrospective study was done in department of Pharmacology, GGS Medical College and Hospital, Faridkot from September 2020 to August 2021. A total of 148 ADRs were reported during the study period. Each ADR was analyzed for demographic data and characteristics of ADR. Assessment of causality, severity and preventability was done according to WHO UMC scale, modified Hartwig and Siegel scale and Modified Schumock and Thornton Preventability Scale respectively. Results: A total of 148 ADRs were reported from both outpatients and in patients of various departments. Most of the ADRs were found in males (55%) and patients of age group 31-45 years (33%). Majority of ADRs were reported from dermatology department (40%). Overall, 38% of ADRs were due to antimicrobial drugs. Most of the ADRs were reported as possible (57%), followed by probable (41%) as per WHO causality assessment. Most of the ADRs were moderate severity (83%). 97% of the ADRs were found to be definitely preventable type. Conclusions: We concluded that most of the ADRs were reported from antimicrobial drugs, so it is advisable to have close monitoring of the antimicrobial drug therapy to prevent ADRs in the patients. Although the majority of ADRs were moderate in nature but mostly were recovered. The study of ADRs in a particular institute using demographic patterns will contribute to patient safety by sensitizing the clinicians in that particular institute.

The present study examines whether overweight and obese are inter related with low-grade systemic inflammation as measured by serum hs-CRP concentration. The present observational, cross-sectional study is from the department of medicine, CSS Hospital, Subharti Medical College, Meerut, to evaluate the profile of patients who came for routine health check-ups from December 2020 to January 2022. The study comprised 150 patients divided into three groups normotensives, normoglycemic adults of the age group 20-70 years based on BMI as Normal BMI (18.5-22.9 kg/m2), overweight (23-24.9 kg/m2) and obese (BMI>25 kg/m2), according to Asian standards by WHO. The mean age among the study subjects was 49.38±12.62 years. Out of 150 subjects, 83 (55.33%) were males and 67 (44.67%) were females. Normal, overweight, and obesity were found among 34%, 29.33%, and 36.67% of the subjects respectively. Normal and high hs-CRP was reported in 46% and 54% of the subjects respectively. The mean hs-CRP among the study subjects was 6.07±4.23. Mean FBS (mg/dL), WC (cm), TC (mg/dL), TGL (mg/dL), and HDL (mg/dL) among the study subjects was 102.94±13.03, 88.2±13.36, 161.84±52.56, 133.18±64.48 and 34.73±17.44 respectively. Mean hs-CRP was found to be highest in obese subjects (10.09±3.67) followed by overweight (6.74±2.48) and normal subjects (2.32±1.11). When hs-CRP was compared among normal vs overweight, normal vs obese, and overweight vs obese using a t-test, a significant difference was found. Pearson correlation analysis revealed a positive correlation between BMI, FBS (mg/dL), WC (cm), TC/HDL (mg/dL), TGL (mg/dL), and hs-CRP i.e. with an increase in these mentioned parameters, hs-CRP value also increases. Conclusion: Obesity is a state of chronic inflammation that has a strong link to hs-CRP levels.

Endometriosis refers to the extrauterine presence of hormonally active endometrial glands and stroma. This ectopic endometrial tissue exhibits cyclic bleeding, inflammation, fibrosis and leads to formation of adhesions. Endometriosis affects about 10% to 15% of women between 15 to 45 years of age. Clinical presentations vary from infertility, dysmenorrhoea, chronic pelvic pain, deep dyspareunia and even bleeding at external sites like the umbilicus. Besides involving fallopian tubes, bowel, liver, thorax, pericardium, pleura etc, the most commonly affected areas in the gastrointestinal tract are the descending colon, rectosigmoid, appendix, and ileo-caecum in descending order of frequency. This case series highlights some unusual presentations of endometriosis along with co-existence of other ovarian pathologies which are not frequently encountered in clinical practice. This series also highlights the role of preoperative radiology for an adequate clinical diagnosis and complete surgical excision.

Skin manifestations have always been alarming to the patient and often warrant complete clinical evaluation. A thorough understanding of relationship between gastrointestinal (GI) disorders and skin diseases can alert the clinician to an underlying occult GI disorder. The aim of the study was to review the cutaneous changes in patients with co-existent, often masked GI diseases and to observe the underlying pathophysiology of such lesions. This was a retrospective, record based observational study. The archived histopathology reports & medical records of patients over a period of 5 years were searched and all patients who underwent skin biopsy with co-existent GI diseases were included. Out of a total of 218 patients of GI diseases who had dermatological manifestations, only 44 were biopsied. Pruritis (n=175), koilonychia (n=52) and erythematous rash (n=35) were the most common clinical features. Psoriasis (n=4), vasculitis (n=4), Dermatitis Herpetiformis (n=3) and pyoderma gangrenosum (n=5) were often seen associated with benign GI diseases like Inflammatory Bowel Diseases, Chronic Liver Disease, Malabsorption syndrome etc. Sweets syndrome (n=2) and cutaneous metastatic nodules (n=3) were associated with underlying malignancy particularly of gall bladder and pancreas.

Introduction and Aim: Pregnancy is complicated by the hypertension disease known as pre-eclampsia. The development of hypertension to a level of 140/90 mmHg or greater in the presence of proteinuria after the 20th week of gestation characterises this condition, a multisystem disorder with an unclear cause. Uric acid and microalbuminuria were assessed in preeclamptic women (PW) and normal pregnant women (NPW). Materials and Methods: For the present study 120 women (60 NPW and 60 PW) were selected from the hospital at Mullana, Ambala, Haryana. The level of uric acid and microalbuminuria were estimated in all subjects. Results: Preeclamptic women had microalbuminuria levels that were substantially (p

Background: Adverse drug reactions are important causes of mortality and morbidity in the patients. Early detection, evaluation and monitoring of ADRs is essential to improve public health. Methods: This was an observational, non-interventional and retrospective study conducted at the ADR monitoring centre of a tertiary care hospital of North India. Suspected ADR forms reported over a period of 4 years involving at least one chemotherapeutic drug with at least one dose were analyzed. Results: A total of 261 chemotherapeutic drugs associated ADRs were analyzed. Out of these, maximum numbers of ADRs were reported by males (54%). Maximum reporting was done by Skin and VD department (37.93%). Causality assessment was probable in maximum number of cases (54%). Most common ADRs were skin rashes (21.46%), followed by jaundice, urticaria and fixed drug eruptions. Maximum ADRs were suspected to be caused by Anti tubercular drugs (31.42%) followed by anticancer drugs (14.56%). Conclusions: ADRs due to antibiotics and anticancer drugs is a significant health problem.

Aim and objectives: To know the diagnostic yield of pleuroscopy (medical thoracoscopy) in cases of pleural effusions which remain undiagnosed after routine initial investigations. To notice the different gross pleuroscopic findings during the procedure. To observe various histopathological reports of pleural biopsy taken through medical thoracoscopy. To know the various complications of pleuroscopy in patients undergoing this procedure. Materials and methods: A total of 56 patients having undiagnosed pleural effusion were taken for study after informed written consent. All patients underwent medical thoracoscopy. The clinical, demographic, and radiological profile of patients was recorded. Gross pleuroscopic findings and histopathological reports of the pleural biopsy were noted. All patients were observed for any complications that occurred during or after the procedure. Result: Diagnostic yield of thoracoscopy in the present study was 91.07% (malignant pleural effusion 75% and tuberculous pleuritis 12.5%). Adenocarcinoma was the commonest malignancy in 60.71% of patients amongst malignant pleural effusion in the present study. Very few complications were recorded. The most common postprocedure complication was subcutaneous emphysema (12.5%) followed by pneumothorax (10.78%). Conclusion: Thoracoscopy gives excellent diagnostic yield in undiagnosed pleural effusion without major complications, and should be utilized wherever feasible.

Biotic stress is a critical factor limiting soybean growth and development. Soybean responses to biotic stresses such as insects, nematodes, and fungal, bacterial, and viral pathogens are governed by complex regulatory and defense mechanisms. Next-generation sequencing has availed research techniques and strategies in genomics and postgenomics. This review summarizes the available information on marker resources, quantitative trait loci, and marker trait associations involved in regulating biotic stress responses in soybean. We discuss the differential expression of related genes and proteins reported in different transcriptomics and proteomics studies and the role of signaling pathways and metabolites reported in metabolomic studies. Recent advances in omics technologies offer opportunities to reshape and improve biotic stress resistance in soybean by altering gene regulation and/or other regulatory networks. We recommend using ‘integrated omics’ to understand how soybean responds to different biotic stresses. We discuss the potential challenges of integrating multiomics for functional analysis of genes and their regulatory networks and the development of biotic stress-resistant cultivars. This review will help direct soybean breeding programs to develop resistance against different biotic stresses.

Nanomedicine has emerged as an area of research that has earned a lot of attention in the past decade along with frequent and sustained advancements leading to its extensive plethora of biomedical applications. Following the same, the drug carrier systems like gold nanoparticles (AuNPs) have become the success stories with many marketed formulations now and has proved to be a most suitable answer to the drug delivery concers due to their exclusive electrical and optical properties. They serve as one of the best surfaces to either adsorb, attach, or conjugate and exhibit remarkable optoelectronic, physicochemical, morphological and functional properties. In this study, Gabapentin (GBP) a known FDA approved anti-epileptic drug is selected for improving its pharmaceutical limitations and we have synthesized monodispersed AuNPs for GBP conjugation using citrate reduction method. Here the research group has modified AuNP surfaces with three different thiol moieties namely, Mercaptopropionic acid (3-MPA), 11-Mercaptoundecanoic acid (11-MUA) and the amino acid L-Cysteine (L-Cys) and then attached the GBP with these linkers. The synthesized GBP–AuNP nano-conjugate moieties were further characterized and tested for their in-vitro cytotoxicity, release kinetics and stability properties. The in-vitro release kinetics and cytotoxicity (MTT-Assay) analysis of the formulated GBP–AuNP nano-conjugates along with all the 3 types of linkers was carried out and after the data analysis for the same, it was observed that the GBP–AuNP nano-conjugate with L-Cys linker exhibited the sustained release pattern and non- significant cytotoxicity followed by MUA and MPA, respectively. Moreover, the assessment of GBP-AuNPs evaluated through the comprehensive release kinetics analysis, reinforced the GBP-thiol linkers as potentially more effective and competent than GBP alone. Furthermore, all the experimental data was validated by statistical method, and it can be concluded from the present study that the symmetrical monodispersed AuNPs formulation coated with stable functionalized thiol layer were synthesized with minimal cytotoxicity and can be further explored as an efficient drug delivery system for therapeutic application.

Extensor mechanism of knee plays important role in successful long term functional outcome after total knee arthroplasty (TKA). Any injury to extensor mechanism during or after surgery can cause functional disability which can be devastating for patients. Patellar tendon injuries are not very common after TKA. The author reported a rare case of patellar tendon mid-substance tear after TKA, which was successfully managed by reconstruction using grafts without any implant.

The use of 2, 4-D dimethylamine is expanding as a result of the rise in glyphosate and paraquat resistance in weeds [1]. Instances of 2,4D dimethylamine intoxication have been on the rise. This herbicide exhibits a range of dose-dependent harmful mechanisms, including cell membrane destruction, disruption of acetyl coenzyme A metabolism, and oxidative phosphorylation uncoupling [2]. The neurological system, heart, lungs, liver, muscles, and endocrine system may all be affected by toxic effects [3]. Results in male cases are fatal [2,4]. The usefulness of alkaline diuresis as a life-saving treatment for 2,4-D dimethylamine poisoning with severe symptoms is discussed in this paper. 2, 4-D dimethylamine intoxication can be fatal if not treated promptly. There is no particular antidote and alkaline diuresis shows good result in the patient who present with severe intoxication of 2, 4-D dimethylamine.

A case of pregnancy associated with neurotoxic snake bite presenting with Neuropathic symptoms and systemic envenomation complicated by disseminated intravascular bleeding is uncommon. We present a case of 22-year-old Primigravida at 32 weeks gestation with snake bite on left-hand, with left-hand swelling, nasal bleeding and neuropathic signs. At presentation, there was pallor, tachycardia, hypotension, a gravid uterus with a single live fetus, & regular fetal heart rate. Primi Gravida with venomous snake bite with Neuropathy with disseminated intravascular Coagulation was diagnosed. Conservative management with Anti Snake Venom instituted led to survival of both mother and continuation of pregnancy.

The migrant community often lacks health care access due to poor health knowledge. Epistemology deals with the nature and scope of knowledge. Epistemology links the migrant community to health system with adequate knowledge to accept the health seeking behavior in lifestyle. Objective: To assess thesalutogenic health promotion model in primary health care for the migrant population. Methods: A qualitative analysis in the migrant community was conducted in a family with an antenatal case as the index case. The epistemological salutogenic health model of General Resistance Resources (GRR) and Sense of Coherence (SOC) was applied. A health promotion model was devised in accordance to the GRR and SOC. A health system intervention was also planned to improve health indicators. Results: The family had a better approach towards heath and preparedness towards the institutional delivery of the child. The children were immunized with appropriate documentation. The success story of the family turned the migrant community to act as a social support group for positive health. There were improvements in the health indicators of the urban slum improved. Conclusion: Usingepistemology aspects and salutogenic health promotion model bridged the gaps in the health system with the migrant community. The migrant community are often ignorant towards their health but with appropriate health promotion models their health needs can be addressed.

Background: The spread of coronavirus can be greatly reduced by the usage of face coverings, as corona virus is mainly spread through droplets when people talk, cough or sneeze, and through airborne transmission. N95 respirator mask is a protective device which is used to filter out the airborne particles with a very high efficiency, which is approximately up to 95%. The use of N95 mask in India has increased by a very high proportion due to the on-going coronavirus pandemic. Objectives: The constant use of N95 respirators by the personnel on duty for about six hours or more may influence the respiratory gases, volumes and capacities.

Background Deliberate self-poisoning (DSP) is one of the leading causes of mortality and morbidity, with rodenticides being common compounds used by many victims. However, comprehensive data regarding the spectrum and outcome of rodenticide poisoning is scant. Method This retrospective study was conducted in the Emergency Department (ED) of a large tertiary care hospital in South India between January 2017 and December 2018. All patients with deliberate consumption of rodenticides were included in the analysis. Results During the study period, 1802 patients presented with DSP, among which 145 (8%) consumed rodenticide compounds. The mean (SD) age was 27.9 (10.7) years. Young adults (16–30 years) comprised 73% (106/145) of the study population. The majority (87%) were triaged as priority 2, while 10% were triaged as priority 1. Common rodenticide compounds consumed were yellow phosphorous (57%: 82/145), coumarins (12%: 17/145), zinc phosphide (19%: 27/145), and aluminum phosphide (1%: 1/145). A significant proportion of patients (18.6%) were under the influence of alcohol. Among the 73 males, 25 (34.2%) gave a history of co-consumption of alcohol. There was a history of previous DSP attempts in 6%. The majority (68%) of the patients were discharged alive from the hospital, and the in-hospital mortality rate was 9%. Age >30 years (adjusted OR: 2.2; 95% CI: 1.00–5.05; p value: 0.04) was an independent predictor of poor outcome. Conclusion Rodenticide compound consumption for DSP is prevalent in young adults and is associated with significant mortality, especially with yellow phosphorous poisoning. The current trend in our country of the increasing use of highly fatal phosphorous compounds over the innocuous coumarin derivatives is a cause of grave concern.

Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Research reported in this publication was supported by the Bill & Melinda Gates Foundation. S Afzal acknowledges the support for intellectual contributions to this manuscript by the Department of Community Medicine and Epidemiology at King Edward Medical University, Lahore, Pakistan. T Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. L Belo acknowledges support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. D Bennett is supported by the UK Medical Research Council Population Health Research Unit at the University of Oxford (Oxford, UK). M Carvalho acknowledges support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. L Castro-de-Araujo was funded by the Medical Research Council (UK), Grant no. MR/T03355X/1 and by the National Institute of Mental Health Grant no. R01MH128911. FJ Elgar is supported by the Canada Research Chairs program. F Greaves acknowledges support from the NIHR Applied Research Collaboration for NW London. V K Gupta acknowledges funding support from the National Health and Medical Research Council (NHMRC), Australia. VB Gupta acknowledges funding support from the National Health and Medical Research Council (NHMRC), Australia. C Herteliu is partially supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. C Herteliu is partially supported by a grant from the Romanian Ministry of Research Innovation and Digitalization, MCID, project number ID-585-CTR-42-PFE-2021. S Hussain was supported by the Operational Programme Research, Development and Education –Project, Postdoc2MUNI “(No. CZ.02.2.69/0.0/0.0/18_053/0016952). S M S Islam is funded by the National Health and Medical Research Council and received funding from the National Heart Foundation of Australia. The Serbian part of this GBD-related contribution has been co-financed through Grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. M Kivimaki was supported by the Wellcome Trust (221854/Z/20/Z), the UK Medical Research Council (MR/S011676/1), the US National Institute on Aging (R01AG056477), and the Academy of Finland (350426). K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. B Lacey acknowledges support from the UK Biobank, funded largely by the UK Medical Research Council and Wellcome. S Lorkowski acknowledges institutional support from the Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig (Germany; German Federal Ministry of Education and Research; grant agreement number 01EA1808A). G Lucchetti received a productivity scholarship from the Brazilian National Council for Scientific and Technological Development — CNPq (Level 1D). J McGrath was supported by the Danish National Research Foundation (Niels Bohr Professor). J McGrath is employed by the Queensland Centre for Mental Health Research (Australia), which receives support from the Queensland Health Department. C Parry acknowleges the South African Medical Research Council. A Peden is supported by a National Health and Medical Research Council Emerging Leadership Fellowship (Grant ID: APP2009306). M R Phillips was supported in part by the Global Alliance for Chronic Diseases - National Natural Science Foundation of China (NSFC. No. 81761128031). M Pinheiro acknowledges FCT for funding through program DL 57/2016 – Norma transitória. A Rahman acknowledges the support from the Data Science Research Unit in Charles Sturt University (Bathurst, NSW, Australia). U Saeed would like to acknowledge the International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan. A M Samy acknowledges support from Ain Shams University (Cairo, Egypt) and the Egyptian Fulbright Mission Program. N Senthil Kumar acknowledges the DBT, New Delhi sponsored Advanced State Level Biotech Hub (BT/NER/143/SP44475/2021), Mizoram University (Aizawl, Mizoram, India) for facilitating this work. F Sha is supported by the Shenzhen Science and Technology Program (Grant No. KQTD20190929172835662). A Shetty acknowledges Kasturba Medical College (Mangalore, India) and Manipal Academy of Higher Education (Manipal, India) for all the academic support. R Shrestha acknowledges a career development award from the National Institutes of Health (K01DA051346). D Silva was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brazil (CAPES)-Finance Code 001 and is supported in part by CNPq - Brazil (309589/2021-5). D Sleet acknowledges partial support from Veritas Management Group, Inc and The Bizzell Group, LLC. S Trias-Llimós acknowledges research funding from the Juan de la Cierva-Formación program of the Spanish Ministry of Science and Innovation (FJC-2019-039314-I). Sí

Jugular foramen schwannomas (JFS) are rare benign tumors located in the jugular foramen. They can present with various symptoms depending on the extent of involvement of the tumor such as hearing loss, tinnitus, headache, and ataxia. Surgical resection has been considered as the primary treatment option for JFS. Stereotactic radiosurgery (SRS) offers an equally good treatment in patients with small and residual tumors after surgery with the advantage of being non-invasive with minimal complication rates. Herein, we present a rare case of JFS treated by SRS in our institution.

The present study was focused to analyse and evaluate potential targets of NADPH Oxidase (NOX) at varying sub-units and co-relating their interactions with apocynin to identify appropreiate mechanism of inhibition for NOX by applying specific facets of computational biology . Active site molecular docking analysis was carried for apocynin against various subunits of NOX and comparatively analysise the binding affinity profiles which were obtained when apocynin was docked with p47phox complete subunit of NOX and all the other subunits.

Background Racism is a longstanding driver of health inequities. Although medical education is a potential solution to address racism in health care, best practices remain unknown. Objective We sought to evaluate the impact of participation in a curriculum addressing racism on pediatric residents' racial biases and empathy. Methods A pre-post survey study was conducted in 2 urban, university-based, midsized pediatric residency programs between July 2019 and June 2020. The curriculum sessions included Self-Reflection on Implicit Bias, Historical Trauma, and Structural Racism. All sessions were paired with empathy and perspective-taking exercises and were conducted in small groups to facilitate reflective discussion. Wilcoxon signed rank tests were used to assess changes in racial bias and empathy. Linear regression was used to assess the effect of resident characteristics on racial bias and empathy. Results Ninety of 111 residents receiving the curriculum completed pre-surveys (81.1%), and among those, 65 completed post-surveys (72.2%). Among participants with baseline pro-White bias, there was a statistically significant shift (0.46 to 0.36, P=.02) toward no preference. Among participants with a baseline pro-Black bias, there was a statistically significant shift (-0.38 to -0.21, P=.02), toward no preference. Among participants with baseline pro-White explicit bias, there was a statistically significant shift (0.54 to 0.30, P Conclusions Participation in a longitudinal discussion-based curriculum addressing racism modestly reduced pediatric residents' racial preferences with minimal effects on empathy scales.

Insulin resistance (IR) is a condition of impaired response of cells towards insulin. It is marked by excessive blood glucose, dysregulated insulin signalling, altered pathways, damaged pancreatic β-cells, metabolic disorders, etc. Chronic hyperglycemic conditions leads to type 2 diabetes mellitus (T2DM) which causes excess generation of highly reactive free radicals, causing oxidative stress, further leading to development and progression of complications like vascular dysfunction, damaged cellular proteins, and DNA. One of the causes for IR is dysregulation of protein tyrosine phosphatase 1B (PTP1B). Advancements in drug therapeutics have helped people manage IR by regulating PTP1B, however have been reported to cause side effects. Therefore, there is a growing interest on usage of phytochemical constituents having IR therapeutic properties and aiding to minimize these complications. Medicinal plants have not been utilized to their full potential as a therapeutic drug due to lack of knowledge of their active and effective chemical constituents, mode of action, regulation of IR parameters, and dosage of administration. This review highlights phytochemical constituents present in medicinal plants or spices, their potential effectiveness on proteins (PTP1B) regulating IR, and reported possible mechanism of action studied on in vitro models. The study gives current knowledge and future recommendations on the above aspects and is expected to be beneficial in developing herbal drug using these phytochemical constituents, either alone or in combination, for medication of IR and diabetes.

Study was carried out in Punjab Agricultural University, Ludhiana, Punjab to analyse the impact of vegetable nutritional garden on the nutritional intake and socio- economic status of selected beneficiaries of District Moga, Punjab, India. Survey conducted to assess the impact of DST Project from 82 beneficiaries across the two blocks i.e. Village Khosapando and Niddhawala, Village Dagaru and Churchak from November- December, 2019 and again August-September, 2021, through a structured questionnaire developed by the Department of Food and Nutrition. The data pertaining to general profile, dietary habits, socio-economic status of the beneficiaries. The dietary diversity questionnaire include 12 groups of food like Cereals, Pulses, Green leafy vegetables, Roots, Tubers, Fruits, Vegetables, Milk and Milk products, Egg, Fat, Sugar, Meat and Miscellaneous. The information on respondent’s food consumption was collected using (24-hour recall).The results have shown that, there was difference in the nutritional uptake of beneficiaries during the intervention period and before the intervention of project. Under this project, area under vegetable cultivation has increased significantly in all selected villages over period 2019-2022 i.e. area under vegetable production in Village Khosa Pando, Dagru, Chuharchak and Nidhanwala increased by 91.6,100, 93.9, 94.2 percent. Moreover, per capita income of farmers having landholding of 0.5 to 1 acre and 0.1 to 0.5 acre has increased by 180 and 62 percent respectively. Furthermore, the consumption of green and leafy vegetables, roots and tubers, and other vegetables by intervention household increased drastically from 61.4, 48, 54 to 97.6, 95.0 and 88.1 respectively after establishing vegetable nutrition gardens.

COVID-19 pandemic has been a global challenge to all the nations and has really affected the sense of normalcy in the lives of People. It has been a sense of awakening that has made people realize the role of immunotherapy in fighting against such situations. It has been observed that the strong gut-associated lymphoid tissue (GALT) which accounts as a dominant role in the immunity has a very important role to play in strengthening the immune system. Dysbiosis could be a major cause of many health disorders and immune suppressants diseases. It was strongly observed that patients with compromised immune system badly affected in COVID-19. In this review, we are trying to find out the association between functional foods such as Probiotics, Prebiotics, and various other Nutraceuticals in strengthening the immune system and its potential benefit to act as preventive medicine in curbing down incidence or management of COVID-19.

Objective: To assess the efficacy and outcomes of percutaneous ablative therapies for hepatocellular carcinoma (HCC) in the caudate lobe. Methods: Patients within Milan criteria, who underwent thermal ablation (RFA/MWA) for HCC were analyzed. Based on the inclusion-criteria, patients were categorized in two groups. Group-1 (caudate-lobe HCC) and Group-2 (non-caudate-lobe HCC). Both the groups were analyzed for technical success (TS), local tumor progression (LTP), disease-free survival (DFS), and overall survival (OS) were compared between both the groups. Predictive factors for LTP, DFS, or OS in the study cohort were analyzed using appropriate statistical analyses. Results: Twenty-one patients qualified to be in Group-1 while 130 patients fulfilled the criteria for Group-2. TS of 90.5 and 97.7% was seen after the first session of ablation for Group-1 and group-2 respectively, while a TS of 95.2% (Group-1) and 100% (Group-2) was achieved after second session. The right-intercostal-approach was used in 66.7% (n = 14) and the anterior-epigastric-approach was used in 33.3% (n = 7) of patients having caudate-lobe HCC. Procedure-related complications in both the groups were comparable. Although, statistically insignificant, LTP in the Group-1 (19.5%, n = 4) was twice that of non-caudate lobe HCC (8.5%, n = 11). The cumulative DFS rate was better in Group-2 while OS in both groups were comparable. Multivariate analysis showed: tumor size and ablative margin of 5 mm being independent predictors of LTP after percutaneous-ablation of caudate-lobe HCC. Conclusion: Ablative therapies for HCC in caudate lobe is feasible and safe with comparable LTP and OS to non-caudate lobe HCC. Tumor size >2 cm and lack of 5 mm ablative margin are independent predictors of LTP. Advances in knowledge: 1. Percutaneous ablation of caudate lobe HCC is feasible using anterior epigastric approach or right intercostal approach. 2. These approaches may allow a safe and effective ablation of caudate lobe HCC with results comparable to non-caudate HCC ablation.

Data augmentation is an important method for evaluating the robustness of and enhancing the diversity of training data for natural language processing (NLP) models. In this paper, we present NL-Augmenter, a new participatory Python-based natural language (NL) augmentation framework which supports the creation of transformations (modifications to the data) and filters (data splits according to specific features). We describe the framework and an initial set of 117 transformations and 23 filters for a variety of NL tasks annotated with noisy descriptive tags. The transformations incorporate noise, intentional and accidental human mistakes, socio-linguistic variation, semantically-valid style, syntax changes, as well as artificial constructs that are unambiguous to humans. We demonstrate the efficacy of NL-Augmenter by using its transformations to analyze the robustness of popular language models. We find different models to be differently challenged on different tasks, with quasi-systematic score decreases. The infrastructure, datacards, and robustness evaluation results are publicly available on GitHub for the benefit of researchers working on paraphrase generation, robustness analysis, and low-resource NLP. El aumento de datos es un método importante para evaluar la solidez y mejorar la diversidad del entrenamiento datos para modelos de procesamiento de lenguaje natural (NLP). इस लेख में, हम एनएल-ऑगमेंटर का प्रस्ताव करते हैं - एक नया भागी- दारी पूर्वक, पायथन में बनाया गया, लैंग्वेज (एनएल) ऑग्मेंटेशन फ्रेमवर्क जो ट्रांसफॉर्मेशन (डेटा में बदलाव करना) और फीलटर (फीचर्स के अनुसार डेटा का भाग करना) के नीरमान का समर्थन करता है।. 我们描述了NL-Augmenter框架及其初步包含的117种转换和23个过滤器，并 大致标注分类了一系列可适配的自然语言任务. این دگرگونی ها شامل نویز، اشتباهات عمدی و تصادفی انسانی، تنوع اجتماعی-زبانی، سبک معنایی معتبر، تغییرات نحوی و همچنین ساختارهای مصنوعی است که برای انسان ها مبهم است. NL-Augmenterpa allin kaynintam qawachiyku, tikrakuyninku- nata servichikuspayku, chaywanmi qawariyku modelos de lenguaje popular nisqapa allin takyasqa kayninta. Kami menemukan model yang berbeda ditantang secara berbeda pada tugas yang berbeda, dengan penurunan skor kuasi-sistematis. Infrastruktur, kartu data, dan hasil evaluasi ketahanan dipublikasikan tersedia secara gratis di GitHub untuk kepentingan para peneliti yang mengerjakan pembuatan parafrase, analisis ketahanan, dan NLP sumber daya rendah.