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Abstract In this brief report, we present laser induced breakdown spectroscopy (LIBS) evidence of deuterium (D) production in a 3:1 urethane dimethacrylate (UDMA) and triethylene glycol dimethacrylate (TEGDMA) polymer doped with resonant gold nanorods, induced by intense, 40 fs laser pulses. The in situ recorded LIBS spectra revealed that the D/(2D + H) increased to 4–8% in the polymer samples in selected events. The extent of transmutation was found to linearly increase with the laser pulse energy (intensity) between 2 and 25 mJ (up to 3 × 1017W/cm2). The observed effect is attributed only to the field enhancing effects due to excited localized surface plasmons on the gold nanoparticles.

Objectives A number of regulatory and accrediting bodies require the reporting of critical results on a timely basis (immediately or within the time frame established by the laboratory) to “the responsible, licensed caregiver” as timely notification of critical laboratory results can pivotally affect patient outcome. The aim of the study was to decrease the turnaround time (TAT) of critical result notification along with assurance of notification to the concerned caregiver or clinicians. The objectives was 30% reduction in the critical value notification TAT and identify factors associated with delayed reporting and root cause analysis for these factors by application of quality tools. Materials and Methods The study was conducted at the Institute of Human Behavior and Allied Sciences, Delhi, a tertiary center teaching Hospital, from April 2019 to June 2021. A value streamed Process Map of critical alert was prepared. The incidents related to failure were presented through Pareto chart. The possible causes were analyzed through the fishbone model. The failure mode prioritization was executed with Failure Mode and Effect Analysis (FMEA). Through extensive brainstorming, appropriate and feasible corrective actions were implemented. The effectiveness of the implemented plan was analyzed by reassessing the TAT of critical alert and feedback received by clinical caregivers. Results After implementation of corrective action plan using quality tools for 3 months, the average critical alert TAT was reduced to 21 minutes from 30 minutes (30% reduction). The median critical alert TAT for ICU, emergency, and IPD were reduced to 3 minutes (IQR: 1–7). During the pilot project, 156 critical value data were sent for feedback with treatment plan but was received only for 88 patients (56%). Conclusion Comprehensive utilization of quality tools has a potential role in patient safety by reducing the critical alert TAT as well as establishing an effective communication between laboratory personnel and clinicians.

Background: Diabetes mellitus is emerging as a major health problem due to its serious complications. It is important to assess the various factors contributing to the occurrence of the diseases so that by limiting these factors the progression of the disease in patients can be controlled. Prediabetes is a state characterized by impaired fasting glucose or impaired glucose tolerance. Aims and Objective: The present study was undertaken to determine the risk factors for Type 2 diabetes mellitus (T2DM) among adults, prediabetic subjects were identified from first degree relatives of T2DMpatients. Materials and Methods: The present observational study was carried out at Department of Physiology, S.P. Medical College and Hospital in collaboration with diabetic research center P.B.M. hospital Bikaner (Rajasthan). Prediabetic subjects were identified from first degree relatives of T2DMpatients, enrolled in diabetic research center P.B.M. hospital Bikaner. Prediabetics (impaired fasting glucose) subjects were identified on the basis of fasting blood glucose 100–125 mg/dL and HbA1C (5.7–6.4%) as per American Diabetic Association (ADA) 2011 guidelines. Consecutive sampling was conducted till sample size satisfied during the period of study. Subjects of age group 20–74 years having FPG between 100 and 125 mg/dL, HbA1C between 5.7% and 6.4%, and gave informed written consent were included in study. Pre-structured performa was used to collect general information, sociodemographic information, baseline physical characteristics, personal habits, biochemical analysis, and for blood parameters. Results: Age, occupation, body mass index (BMI), diet, smoking, alcohol, truncal obesity, and family history of DM were significantly associated with prevalence of T2DM/prediabetes whereas gender and literacy were not. Conclusion: In the present study, it was observed that advanced age, occupational changes, BMI, substance abuse such as alcohol and smoking, truncal obesity, and family history of diabetes were highly associated risk factors for T2DM whereas literacy, gender, and central obesity showed no association with risk of T2DM.

Abstract Mutations in the Membrane-type frizzled related protein (Mfrp) gene results in an early-onset retinal degeneration associated with retinitis pigmentosa, microphthalmia, optic disc drusen and foveal schisis. In the current study, a previously characterized mouse model of human retinal degeneration carrying homozygous c.498_499insC mutations in Mfrp (Mfrp KI/KI) was used. Patients carrying this mutation have retinal degeneration at an early age. The model demonstrates subretinal deposits and develops early-onset photoreceptor degeneration. We observed large subretinal deposits in Mfrp KI/KI mice which were strongly CD68 positive and co-localized with autofluorescent spots. Single cell RNA sequencing of Mfrp KI/KI mice retinal microglia showed a significantly higher number of pan-macrophage marker Iba-1 and F4/80 positive cells with increased expression of activation marker (CD68) and lowered microglial homeostatic markers (TMEM119, P2ry13, P2ry13, Siglech) compared with wild type mice confirming microglial activation as observed in retinal immunostaining showing microglia activation in subretinal region. Trajectory analysis identified a small cluster of microglial cells with activation transcriptomic signatures that could represent a subretinal microglia population in Mfrp KI/KI mice expressing higher levels of APOE. We validated these findings using immunofluorescence staining of retinal cryosections and found a significantly higher number of subretinal Iba-1/ApoE positive microglia in Mfrp KI/KI mice with some subretinal microglia also expressing lowered levels of microglial homeostatic marker TMEM119, confirming microglial origin. In summary, we confirm that Mfrp KI/KI mice carrying the c.498_499insC mutation had a significantly higher population of activated microglia in their retina with distinct subsets of subretinal microglia. Further, studies are required to confirm whether the association of increased subretinal microglia in MfrpKI/KI mice are causal in degeneration.

Abstract The current study assessed the nematicidal and plant growth promoting potential of metabolites produced by Streptomyces hydrogenans strain DH-16 on morphological and physiological activities in 60 days old Solanum lycopersicum plants grown under Meloidogyne incognita stress. M. incognita infestation altered the levels of various photosynthetic pigments, various stress markers, enzymatic and non-enzymatic antioxidants in S. lycopersicum plants grown under in-vivo conditions. However, treatment with culture cells, supernatant and extract produced by S. hydrogenans strain DH-16 significantly reduced the number of galls in M. incognita infested plants when compared with untreated M. incognita infected plants. Moreover, the culture cells/ supernatant/ extract remarkably lowered the levels of stress markers (Hydrogen peroxide and Malondialdehyde) in infected plants and enhanced the activities of non-enzymatic antioxidants (glutathione, tocopherol) and enzymatic antioxidants (Catalase, Superoxide dismutase, Ascorbate peroxidase, Guaiacol peroxidase, Gluatathione-S-transferase and Polyphenol oxidase) in metabolites treated M. incognita infected plants. The enhanced level of different photosynthetic attributes were also evaluated by studying gas exchange parameters and different plant pigments. Moreover, an increment in the content of phenolic compounds such as total phenols, anthocyanin and flavonoids were also reflected in treated and nematode infested plants. The present study also evaluated the microscopic analysis depicting cell viability, nuclear damage and hydrogen peroxide localization in differently treated plants. The outcome of the present study therefore endorses the efficacy of DH-16 as a potential biocontrol agent that help plants in mitigating M. incognita stress.

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an important cause of neonatal indirect hyperbilirubinemia or even kernicterus leading to long-term neurological sequelae specially in countries like India where G6PD deficiency is quite prevalent. Aims and Objectives: We have planned this study to know the prevalence of G6PD deficiency among cases of neonatal jaundice and also to evaluate the difference between G6PD deficient and normal neonates with indirect hyperbilirubinemia in terms of laboratory parameters and need of phototherapy or exchange transfusion. Materials and Methods: This observational and cross-sectional study was done for a period of 1 year in the SNCU and NICU of a district Medical College of West Bengal among 200 term neonates presented with indirect hyperbilirubinemia. Birth weight, sex, hemoglobin, G6PD level, serum bilirubin at admission, phototherapy duration, and need for exchange transfusion were recorded along with other necessary parameters. Results: We found G6PD deficiency in 24 neonates (12%) out of 200 cases of neonatal jaundice, 20 of whom were male. There is a statistically significant difference in hemoglobin and serum bilirubin level between two groups. Difference in early presentation of jaundice within 24–48 h (66.7% vs. 34.1%) and need of prolonged phototherapy 72–96 h (45.83% vs. 7.4%) between G6PD deficient and normal group were statistically significant. Difference in requirement of exchange transfusion is not statistically significant. Conclusion: Early screening for G6PD deficiency should be considered in every neonates of G6PD deficient endemic countries so that we can predict the natural course of the jaundice in those G6PD deficient neonate and prevent complication by early initiation of phototherapy or exchange transfusion.

Background: Family planning methods prevent pregnancy-related health risks for women. Aims and Objectives: This study was undertaken to assess knowledge, attitude, and practice of various family planning methods among postnatal women in a Medical College Hospital. Materials and Methods: A standard predesigned questionnaire was asked to randomly selected 300 postnatal women who delivered at F.M. Medical College and Hospital, Balasore, Odisha, India over a period of 1 year. Data on sociodemographic variables, knowledge regarding various family planning methods, source of information, utilization, and reason for its none use were analyzed. Results: Majority were between the age group of 20–30 years (81%). About 91% were aware of its use. About 82% were aware of its need. About 75% of the women gave history of prior use of birth spacing methods. Withdrawal, oral contraceptive pills (OCP) and barrier were mostly used methods in the past (i.e., 31%, 19%, and 9%, respectively). Child spacing was most common reason for use of family planning methods. Majority were aware of OCPs (79%) followed by sterilization (72%), barrier methods (71%), intrauterine contraceptive device (53%), withdrawal (31%), and injectable (23%). Social circle (54%) and health-care provider (35%) were major source of knowledge. Man reason for non-utilization of family planning methods was desire of child (42%), fear of side effects (17%), and husband and in-law opposition (16%). Conclusion: In spite of high contraceptive knowledge and awareness, the actual use of modern family planning method is not satisfactory in our study which suggests proper counseling and education are required to increase its usage.

Knowledge of the position of lung fissures is necessary for the appreciation of lobar anatomy and thus locating the bronchopulmonary segments. The study aimed to investigate the patterns of fissures and lobes of the lungs and their variations in Andhra Pradesh, India and to find their clinical implications and compare them with the previous studies. Methods: The patterns of lobes, fissures, and hilar anatomy of lungs and its variations of 47 lungs by dissection method of embalmed cadavers was performed in the Department of Anatomy, Narayana Medical College (Nellore, India). The specimens were macroscopically observed for gross morphology of fissures and lobes. Results. The study showed oblique fissure in 33 % (grade 1), 26 % (grade 2), 24 % (grade 3) and 14 % (grade 4) of right lungs and 27 % (grade 1), 31 % (grade 2), 12 % (grade 3) and 12 % (grade 4) of left lungs. The incomplete horizontal fissure was seen in 38 % of right-sided lungs (grade 1). 19 % of right lungs and 10 % of left lungs had accessory lung fissures. Conclusions. Awareness of the variations in the lobes and fissures of the lungs is important for radiologists while interpreting magnetic resonance imaging and computed tomography scans. Also, we believe that the data from the present study certainly adds an important reference in the medical literature to thoracic surgeons in performing pneumonectomy and segmental resection.

Introduction: Competitive swimming is one of the popular sports, where physical conditioning and skill have a large contribution in achieving high-level performances. In males, the second to fourth digit ratio (2D:4D) have lower values than females but the mean digit ratio remains the same with age. This ratio is considered to be a biomarker of the balance between Foetal Testosterone (FT) and Foetal Oestrogen in a nearly embryonic stage. Aim: To determine the correlation of 2D:4D ratio in swimming beginners. Materials and Methods: This cross-sectional pilot study was conducted in the swimming pool facility of Banaras Hindu University Varanasi, Uttar Pradesh, India from March 2019 to June 2019. A total of 118 (59 females and 59 males), swimming beginners participants having age between 18 to 27 years were selected and cross-sectional samples were taken for the study. Participants passed all the stages of swimming learning under a well-trained coach for six weeks. In the last week of swimming learning, final performance assessment tests were conducted. For which six minutes was given to each participant and the total distance covered during swimming was measured in meters. Body Mass Index (BMI) was calculated from measured height and weight. The left and right 2D:4D ratio, height and length of participants were recorded and analysed for correlation. The collected data were analysed using a Statistical Package for the Social Sciences (SPSS),16.0 version. Results: A total of 118 participants, 59 males and 59 females, with mean age of the male participants was 21.37±3.52 years and the mean age of the female participants was 20.64±2.63 years. The mean 2D:4D ratio of both right and left hand digits in both sexes was

Abstract Background With the continuous emergence of new SARS-CoV-2 variants that feature increased transmission and immune escape, there is an urgent demand for a better vaccine design that will provide broader neutralizing efficacy. Methods We report an mRNA-based vaccine using an engineered “hybrid” receptor binding domain (RBD) that contains all 16 point-mutations shown in the currently prevailing Omicron and Delta variants. Results A booster dose of hybrid vaccine in mice previously immunized with wild-type RBD vaccine induced high titers of broadly neutralizing antibodies against all tested SARS-CoV-2 variants of concern (VOCs). In naïve mice, hybrid vaccine generated strong Omicron-specific neutralizing antibodies as well as low but significant titers against other VOCs. Hybrid vaccine also elicited CD8+/IFN-γ+ T cell responses against a conserved T cell epitope present in wild type and all VOCs. Conclusions These results demonstrate that inclusion of different antigenic mutations from various SARS-CoV-2 variants is a feasible approach to develop cross-protective vaccines.

Abstract Cervical cancer is the most common gynaecological cancer and reaches an alarming stage. HPVs are considered the main causative agents for cervical cancer and other sexually transmitted infections across the globe. Currently, three prophylactic vaccines are available against HPV infections with no therapeutic values. Due to a lack of effective therapeutic and prophylactic measures, the HPV infection is spreading in an uncontrolled manner. Next-generation of vaccine is needed to have both prophylactic and therapeutic values against HPV. Here first time we have designed a multi-epitope chimeric vaccine using the most oncogenic strain HPV 16 and HPV 18 through an immunoinformatic approach. In this study, we have used the L1, E5, E6 and E7 oncoproteins from both HPV 16 and HPV 18 strains for epitope prediction. Our recombinant chimeric vaccine construct consists, selected helper and cytotoxic T cell epitopes. Our computational analysis suggests that this chimeric construct is highly stable, non-toxic and also capable of inducing both cell-mediated and humoral immune responses. Furthermore, in silico cloning of the multi-epitope chimeric vaccine construct was done and the stabilization of the vaccine construct is validated with molecular dynamics simulation studies. Finally, our results indicated that our construct could be used for an effective prophylactic and therapeutic vaccine against HPV.

Objective: The metabolic syndrome (MetS) may be responsible for occurrence of high frequency of cardiovascular disease in rheumatoid arthritis (RA) patients. An association between inflammatory activity of RA and MetS has also been speculated. This study was designed to see whether presence of MetS along with RA increases the severity of disease and to find the risk association of the disease severity markers of RA namely TNF-α, anti-CCP, RF, CRP and ESR with MetS. Methodology: 185 patients of RA (EULAR 2010) were recruited and assessed for MetS according to NCEP/ATP III criteria. Serum level of disease specific biomarkers of RA namely TNF-α, anti-CCP, RF, CRP and ESR were quantified in all patients and compared between RA with MetS and only RA patients. Cytokine TNF-α, anti-CCP, RF, and CRP were assayed through ELISA. Results: The prevalence of MetS among RA patients was 41.2%. The mean age of RA cases with MetS is significantly older (55.65yrs) with increased disease duration. The levels of TNF-α, anti-CCP, CRP and ESR along with EULAR & DAS score were significantly (p

Abstract Evidence suggests that there are social inequalities in multimorbidity, with a recent review indicating that area levels of deprivation are consistently associated with greater levels of multimorbidity. Definitions of multimorbidity, the most common of which is the co-occurrence of more than one long term condition, can include long term physical conditions, mental health conditions or both. The most commonly used measure of deprivation in England and Wales is the Index of Multiple Deprivation (IMD), an index of seven different deprivation domains. It is unclear which features of IMD may be mediating associations with multimorbidity. Thus, there may be associations because of the individual characteristics of those living in deprived areas, characteristics of the areas themselves or overlap in definitions. Data from over 25,000 participants (aged 16+) of Understanding Society (Wave 10, 1/2018–3/2020) were used to understand the most salient features of multimorbidity associated with IMD and whether physical or mental conditions are differentially associated with the seven domains of IMD. 24% of participants report multimorbidity. There is an increased prevalence of multimorbidity composed of only long-term physical conditions in the most deprived decile of deprivation (22%, 95% CI[19,25]) compared to the least deprived decile (16%, 95% CI[14,18]). Mental health symptoms but not reporting of conditions vary by decile of IMD. Associations with multimorbidity are limited to the health, income, education and employment domains of IMD. We conclude that multimorbidity represents a substantial population burden, particularly in the most deprived areas in England and Wales.

Highlights/Take-away message 1. The Chimpanzee Adenovirus-vectored Vaccine (ChAdOx1 nCoV-19 vaccine) has been widely used in Himalayan Country, Nepal and India. 2. Apart from other minor side effects, delayed thromboses in superficial vein have been reported after vaccination of ChAdOx1 nCoV-19 vaccine and they may be the consequences of vaccination though larger study is needed to verify them. 3. Superficial vein thrombosis (SVT) should be an additional adverse effect to be mentioned in the list of adverse events associated with ChAdOx1 nCoV-19, Covishield, vaccine. 4. The benefits of the vaccine in breaking the chain of COVID 19 spread are certainly greater than the risk of thromboses.

Abstract Carbapenemase-producing clinical isolates are becoming more common over the world, posing a severe public health danger, particularly in developing nations like India. Carbapenem-resistant Gram-negative bacterial (CR-GNB) infection has become a fast-expanding global threat with limited antibiotic choice and significant mortality. This study aimed to highlight the carbapenem-resistance among clinical isolates of hospital admitted patients in Bihar, India. A cross-sectional study was conducted with 101 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. All GNB isolates were tested for their antimicrobial susceptibility using Kirby-Bauer disc diffusion method. Double disc synergy test / modified Hodge test (DDST/MHT) were used to detect carbapenemase production by these isolates. Subsequently, these isolates were evaluated for carbapenem-resistance genes using whole-genome sequencing method. The overall percentage of carbapenem-resistance among GNB was (17/101) 16.8%. The genomic analysis of antimicrobial-resistance (AMR) demonstrates a significantly high prevalence of blaCTX-M followed by blaSHV, blaTEM, blaOXA, and blaNDM β-lactam or carbapenem resistance genes among clinical isolates of GNB. Co-occurrence of blaNDM with other beta-lactamase-encoding genes was found in 70.6% of carbapenemase-producing isolates. Our study highlights the mechanism of carbapenem-resistance to curb the overwhelming threat posed by the emergence of drug-resistance in India.

Background: Pregnancy and childbirth, especially in high-risk women, necessitate proper antenatal, intranatal, and immediate postpartum care. Early detection of complications and prompt referral to the higher level of care can reduce the associated adverse maternal outcomes. Aims and Objectives: The aim of the study was to evaluate the spectrum of pregnancy-related referrals to our hospitals and their outcomes. Materials and Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynecology, B.R.D Medical College, Gorakhpur, U.P, India, over a period of 1 year (October 2020–September 2021). All the referred cases of obstetric indications ≥28 weeks of gestation were analyzed for reasons of referral and their outcomes. Results: Obstetrics referral accounted for 31.15% of the total obstetrics admissions (1416/4545). The average age of study participants was 26.92 years and majority being primigravida. The major reasons for referring patient were hypertensive disorders of pregnancy (16.74%), previous cesarean section (12.78%), and severe anemia (7.70%). There were 70 maternal deaths leading to case fatality rate of 4.94% while 94.2% of patient were discharged healthy. Conclusion: Lack of knowledge, ignorance, and poor transport facilities are major contributors of poor pregnancy outcome. Timely and appropriate referral is crucial in improving maternal outcome. Improvement in the quality of Maternal Child Health care at Primary Health Centre, Community Health Centre level; regular training of health-care providers in emergency obstetrics care is required to curb unnecessary referrals and consequently in reducing fetomaternal morbidity and mortality.

Background: It is hypothesized that electrical vestibular stimulation may be an effective adjunctive therapy in the management of Temporomandibular disorder (TMD). Aims and Objectives: The aim of the present study is to assess the effectiveness of electrical vestibular nerve stimulation (VeNS) in the management of pain in patients with temporomandibular disorders. Materials and Methods: A total of 24 male and female participants newly diagnosed with TMD were recruited after obtaining the written informed consent. VeNS was administered for 4 weeks. Each daily session was for an hour (1 h), with three sessions being carried out each week. The pain was assessed using a numerical pain rating scale. The JFLS-8 is a short form for measuring global functional limitations of the jaw. The DASS-21 questionnaire is comprised of three self-reported scales to measure negative emotional states of depression, anxiety, and stress. Results: Age, height, weight and, BMI were not significantly different between the control and intervention groups (Table 1). There was a significant decrease in the pain score in the intervention group when compared with the control group (P

Abstract Objective Elizabethkingia meningoseptica is a multidrug resistance strain which primarily causes meningitis in neonates and immunocompromised patients. Being a nosocomial infection causing agent, less information is available in literature, specifically, about its genomic makeup and associated features. An attempt is made to study them through bioinformatics tools with respect to compositions, embedded periodicities, open reading frames, origin of replication, phylogeny, orthologous gene clusters analysis and pathways. Results Complete DNA and protein sequence pertaining to E. meningoseptica were thoroughly analyzed as part of the study. E. meningoseptica G4076 genome showed 7593 ORFs it is GC rich. Fourier based analysis showed the presence of typical three base periodicity at the genome level. Putative origin of replication has been identified. Phylogenetically, E. meningoseptica is relatively closer to E. anophelis compared to other Elizabethkingia species. A total of 2606 COGs were shared by all five Elizabethkingia species. Out of 3391 annotated proteins, we could identify 18 unique ones involved in metabolic pathway of E. meningoseptica and this can be an initiation point for drug designing and development. Our study is novel in the aspect in characterizing and analyzing the whole genome data of E. meningoseptica.

Abstract Objectives Tamoxifen is considered to be the most widely used adjuvant therapy for hormone receptor positive breast cancer in premenopausal women. However, it is reported that nearly 30% of patients receiving tamoxifen therapy have shown reduced or no benefits. This may be due to the high inter-individual variations in the CYP2D6 gene that is involved in tamoxifen metabolism. The CYP2D6*10 gene variant (rs1065852C>T) is reported to be commonly found in Asian and South Asian populations. The present study was undertaken to design a novel pharmacogenetic assay (Single step-Tetra Arms Polymerase Chain Reaction) for the identification of the CYP2D6*10 variant and implement the designed assay by genotyping a cohort of breast cancer patients. Results The novel assay was successfully designed, optimized and validated using Sanger sequencing. Blood samples from 70 patients were genotyped. The following bands were observed in the gel image: Control band at 454 bp; band for C allele at 195 bp; band for T allele at 300 bp. The genotype frequencies for the CYP2D6*10 (rs1065852C>T) variant were: CC-24.28% (17/70), CT-75.71% (53/70), TT-0% (0/70). The allele frequencies were: T-allele-37.86% and C-allele-62.14%.

Abstract In vertebrates dysregulation of the antioxidant defense system has a detrimental impact on male fertility and reproductive physiology. However, in insects, especially mosquitoes the importance of sperm quality has been poorly studied. Since long-term storage of healthy and viable sperm earmarks male reproductive competency, we tested whether the heme peroxidase, a member of antioxidant enzyme family proteins, and abundantly expressed in the testis, also influence male fertility in the mosquito An. stephensi. Here, we show that a heme peroxidase 12 (HPX12), is an important cellular factor to protect the sperms from oxidative stress, and maintains semen quality in the male mosquito reproductive organ. We demonstrate that knockdown of the HPX12 not only impairs the sperm parameters such as motility, viability but also causes a significant down-regulation of MAG expressing transcripts such as ASTEI02706, ASTEI00744, ASTEI10266, likely encoding putative Accessory gland proteins. Mating with HPX12 knockdown male mosquitoes, resulted in ~ 50% reduction in egg-laying, coupled with diminished larval hatchability of a gravid female mosquito. Our data further outlines that increased ROS in the HPX12 mRNA depleted mosquitoes is the ultimate cause of sperm disabilities both qualitatively as well as quantitatively. Our data provide evidence that testis expressing AsHPX12 is crucial for maintaining optimal homeostasis for storing and protecting healthy sperms in the male mosquito’s reproductive organs. Since, high reproductive capacity directly influences the mosquito population, manipulating male mosquito reproductive physiology could be an attractive tool to combat vector-borne diseases.

Abstract Hydroxyurea is an antimetabolite drug that induces fetal haemoglobin in sickle cell disease. However, its clinical usefulness in β-thalassaemia is unproven. We conducted a randomised, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of hydroxyurea in transfusion-dependent β-thalassaemia. Sixty patients were assigned 1:1 to oral hydroxyurea 10–20 mg/kg/day or placebo for 6 months by stratified block randomisation. Hydroxyurea treatment did not alter the blood transfusion volume overall. However, a significantly higher proportion of patients on hydroxyurea showed increases in fetal haemoglobin percentage (89% vs. 59%; p 1.5%), 44% of patients were identified as hydroxyurea-responders. Hydroxyurea-responders, required significantly lower blood volume (77 ± SD27ml/kg) compared to hydroxyurea-non-responders (108 ± SD24ml/kg; p

Abstract Cancers are immunologically heterogeneous. A range of immunotherapies target abnormal tumor immunity via different mechanisms of actions (MOAs), particularly various tumor-infiltrate leukocytes (TILs). We modeled loss of function (LOF) in four common anti-PD-1 antibody-responsive syngeneic tumors, MC38, Hepa1-6, CT-26 and EMT-6, by systematical depleting a series of TIL lineages to explore the mechanisms of tumor immunity and treatment. CD8+-T-cells, CD4+-T-cells, Treg, NK cells and macrophages were individually depleted through either direct administration of anti-marker antibodies/reagents or using DTR (diphtheria toxin receptor) knock-in mice, for some syngeneic tumors, where specific subsets were depleted following diphtheria toxin (DT) administration. These LOF experiments revealed distinctive intrinsic tumor immunity and thus different MOAs in their responses to anti-PD-1 antibody among different syngeneic tumors. Specifically, the intrinsic tumor immunity and the associated anti-PD-1 MOA were predominately driven by CD8+ cytotoxic TILs (CTL) in all syngeneic tumors, excluding Hepa1-6 where CD4+ Teff TILs played a key role. TIL-Treg also played a critical role in supporting tumor growth in all four syngeneic models as well as M2-macrophages. Pathway analysis using pharmacodynamic readouts of immuno-genomics and proteomics on MC38 and Hepa1-6 also revealed defined, but distinctive, immune pathways of activation and suppression between the two, closely associated with the efficacy and consistent with TIL-pharmacodynamic readouts. Understanding tumor immune-pathogenesis and treatment MOAs in the different syngeneic animal models, not only assists the selection of the right model for evaluating new immunotherapy of a given MOA, but also can potentially help to understand the potential disease mechanisms and strategize optimal immune-therapies in patients.

Introduction: Anaemia during pregnancy is a major public health problem throughout the world, particularly the developing countries. Maternal anaemia affects the major macronutrients contents of breast milk. Aim: To analyse the major nutrients and components of transitional milk in anaemic mothers and healthy non anaemic mothers. Materials and Methods: This was an observational crosssectional study conducted from January 2018 to June 2019 for a period of 18 months, included 180 lactating mothers who were divided into two groups: Anaemic {Haemoglobin (Hb) 11 gm/dL) based on their antenatal haemoglobin status. Anaemic group patients were further subdivided according to severity as recommended by the Indian Council of Medical Research. Breast milk samples (15-20 mL) were collected from postpartum patients on day 4 to 14. The sample was collected in the morning 1 hour after the previous breastfeeding and instilled into a milk analyser and compared the following major components (fat, lactose, protein) in both the groups. The data was coded in Microsoft excel sheet and was analysed by using Statistical Package for the Social Sciences (SPSS) version 24.0 software. Analysis of the component of transitional milk was done. Results: There were 90 cases in each group, with total 180 lactating mothers. The mean age of the anaemic group was 26.18±2.89 and non anaemic group was 26.03±3.43 (p-value= 0.792) were statistically similar. The mean parity of both the group (p-value=0.039) were significant. Study shows that anaemia grossly affects the protein and lactose content of the breast milk but there is no significant change in fat content. In severe anaemia, there was significant difference present in all the 3 components, fat, protein, and lactose (p-value=0.012, p-value=0.051, p-value=0.001 respectively). Conclusion: Maternal anaemia particularly of severe type adversely affects all the macronutrients of breast milk in terms of protein, fat, and lactose.

Abstract In this work, aspect ratio of various intercalation doped MLGNR interconnects are optimized using a numerical approach to achieve improved performance and reliability. A numerical optimization method is presented to estimate optimized aspect ratio considering combined effects of performance, noise and reliability metrics for any arbitrary nano interconnect system. This approach is cost effective and will be extremely useful to industry for selection of aspect ratio of interconnects as it is a non-SPICE method and reduces fabrication iterations for achieving desired performance and reliability. Our numerical method suggests that by minimizing the figure of merit (i.e. Noise Delay Power Product / Breakdown Power $$P_{BD}$$ P BD ratio), aspect ratio of FeCl3 doped MLGNR interconnect is optimized at 0.987, 0.61 and 0.579 for local, intermediate and global level, respectively at 7 nm node. Comparing the optimized performance metrics in this work with the estimated metrics at prescribed aspect ratio by IRDS roadmap, delay, noise delay product (NDP), power delay product (PDP), $$PDP/ P_{BD}$$ P D P / P BD ratio and figure of merit are improved by ( $$\sim$$ ∼ 2% and $$\sim$$ ∼ 25%), ( $$\sim$$ ∼ 44% and $$\sim$$ ∼ 50%), ( $$\sim$$ ∼ 9% and $$\sim$$ ∼ 48%), ( $$\sim$$ ∼ 6% and $$\sim$$ ∼ 48%) and ( $$\sim$$ ∼ 49% and $$\sim$$ ∼ 68%) for 10 $$\mu$$ μ m and 1 mm long Fecl3 doped MLGNR interconnect, respectively at 7 nm node. Increase in contact resistance leads to significant decrease in performance and increase in optimized aspect ratio of local Fecl3 doped MLGNR interconnect. Scaling down from 10 to 7 nm node results in increase of optimized aspect ratio in all levels of interconnects. Even though the performance of MLGNR degrades with scaling down but when compared to copper, the performance improves with technology scaling. Finally, this study provides circuit designers a detailed guideline for selecting an optimized aspect ratio for achieving better performance, power efficiency and reliability in doped MLGNR interconnects.

Healthcare systems deal with disease prevention, early detection, diagnosis, investigation, and timely, affordable, and safe treatment. For the delivery of services in the health sector, communication is the key to linking the service provider and the patients. Mobile technology in the recent past has rendered various platforms of communications for the healthcare system. Thus, in health, mobile technology has greatly contributed to time management and cost reduction for healthcare at every level including hospital visits to individual appointments with doctors, hence the convenience. With advancements in mobile technologies and the growing number of mobile users, newer opportunities have opened up for the use of mobiles for patient care. Emerging information and communication technologies with the help of the Internet of Things (IoT) have been instrumental in integrating different domains of the health sector with mobile technology. Thus, the technology may have the potential to become powerful medical tools to support the health sector at all levels of care. In this review, the concept, applications, and advantages of mobile technology for health and the present pandemic have been discussed. It also discusses mobile health technology, as a support system for convenient and safer healthcare for public health, and the opportunities to improve its applications for unseen future health crises.

Background: With ever-increasing digitization, the internet has intertwined into the daily lives of users to a large extent. It holds tremendous educational benefits to college students; however, its excessive usage can lead to addiction and even psychological morbidities. Objectives: To determine the prevalence of internet addiction and its association with various factors including depression, anxiety, and stress. Materials and Methods: A cross-sectional study was conducted among undergraduate students of two professional colleges, i.e., medical and engineering colleges in the Jammu region. A pre-tested, semi-structured questionnaire was used to elicit the information regarding socio-demographic and personal details of students. Young's internet addiction scale was used to assess internet addiction, whereas the DASS 42 scale was used to measure depression, anxiety, and stress. Data thus collected were analyzed using the PSPP software. Results: A total of 480 students constituted the study population. The prevalence of internet addiction was found to be 78.7%, with a significantly higher prevalence seen among the male students in comparison to females (P < 0.005). A significantly positive correlation of internet addiction was found with depression, anxiety, and stress. Conclusions: Internet addiction is significantly associated with psychopathology among the respondents. In this context, there is an urgent need to develop effective strategies for the prevention of internet addiction by promoting awareness among the students.

While tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease among children, its first presentation in the third decade of life just after successful pregnancy outcome is extremely rare. In fact, survival of both child and mother having uncorrected TOF after noninstitutional delivery is unheard of. Herein, authors report a case of previously undiagnosed TOF associated with other midline congenital abnormalities, that is, nasal dermoid cyst and cleft palate, who presented for the first time with postpartum hemorrhage after an unsupervised home birth. To the best of our knowledge, this unique association has never been described before.

Background: Breast and cervical cancers are the two leading causes of cancer-specific mortality and morbidity amongst Indian women. Screening methods are cost-effective. However, the uptake of screening methods in India is very low. Knowledge and attitude of healthcare professionals (HCPs) play an important role in reducing the mortality related to cancer. Materials and Methods: This study aimed to assess the knowledge and utilisation of screening methods for cervical and breast cancer and to elaborate barriers for non-utilisation amongst female HCPs, both doctors and nurses. A cross-sectional study was carried out from April to July 2017 in a tertiary healthcare hospital of eastern India amongst 200 female HCPs using a pre-designed, pre-tested, self-administered questionnaire. Data were analysed using the Statistical Package for the Social Sciences version 20.0. Statistical tests such as proportion and mean were calculated and the Chi-square test was used as a test of significance for categorical variables. Results: Clinical breast examination and mammography were practiced by only 26.5% and 7% of respondents, respectively. Only seven doctors and one nurse had ever undergone Pap smear. More than 90% of respondents knew risk factors, signs and symptoms and the availability of screening tools for the detection of cervical and breast carcinoma. Conclusions: The utilisation of breast and cervical cancer screening was unsatisfactory despite having good knowledge of the preventable cancers and screening methods amongst HCPs. There is a need for attitudinal change amongst HCPs by continuous sensitisation programmes.

Background: Improving the quality of life of the geriatric population along with maintaining their health and promoting social participation still poses a major public health challenge in the twenty-first century. Hence, we planned to measure the quality of life (QOL) in each domain namely physical, psychological, social, and environmental using the world health organization quality of life brief version (WHO QOL-BREF) questionnaire and to assess the predictors of QOL among the elderly population. Methodology: A community-based cross-sectional study was conducted in Ormanjhi, Ranchi, Jharkhand for a period of 6 months. The study was carried out among 206 geriatric populations fulfilling the eligibility criteria. The data collected were entered in MS Excel and analyzed using SPSS version 20. The QOL scores were expressed in terms of mean and standard deviation, and the difference between mean scores was tested by using student t-test/analysis of variance (ANOVA). The predictor associated with QOL was done by multiple linear regression analysis. P value less than 0.05 was considered statistically significant. Results: A total of 206 geriatric people fulfilling the study criteria were enrolled during the study. The majority of the people were of the age between 60 and69 years (71.8%). Most of them 202 (98.1%) resided in rural areas, 108 (52.4%) of them were illiterate by education, and nearly half 102 (49.5%) depended on pension for livelihood. Nontribal ethnicity, backward category, illiteracy, low socio-economic status, nuclear family, elderly person having no own source of income, currently living alone, person having more co-morbidity, and less activities of daily living (ADL) score were significantly associated with low QOL score. Conclusion: Overall QOL was good to excellent in Ranchi, Jharkhand. We concluded that QOL is affected by many different factors.

Background: Viral diseases continue to emerge as a threat to mankind and are a serious concern to public health. The latest lethal SARS-CoV-2 or COVID-19 is a highly contagious disease, which propagated quickly across the globe. Similar to other influenza-like viral infections, symptoms such as fever, dry cough, myalgia, arthralgia, headache, diarrhea, dyspnea, and fatigue were reported among COVID-19 patients. Evidence suggests that the oral cavity is affected by this virus either directly or indirectly. Aim: The aim of this observational study was to determine the oral manifestations among COVID-19 patients. Materials and Methods: A cross-sectional, questionnaire-based study was carried out among COVID-19 recovered patients. A sample of 100 subjects, diagnosed as mild and moderate cases of COVID-19 disease were selected based on inclusion and exclusion criteria. Results: The study comprised an almost equal number of male (51%) and female (49%) participants and among them, 48% belong to the health professional group. A total of 54% of subjects were aged above 35 years and 46% below 35 years. Oral manifestations among study subjects during and after the disease illness included xerostomia being the commonest symptom (44%), followed by swallowing difficulty (16%), mouth ulcerations (10%), chewing problem (7%), gum bleeding (6%), and burning sensation (4%). Conclusion: Xerostomia, frequent aphthous ulcers, swallowing difficulty, and burning mouth were the most frequently encountered symptoms in study subjects during the disease and post recovery. Early identification of oral symptoms in COVID-19 recovered or suspected cases can help a dentist or a general physician to diagnose high-risk groups, mitigate transmission, and promote overall health.

Background: Heavy menstrual bleeding (HMB) poses threat to the quality of life among women. To prevent HMB, the levonorgestrel-releasing intrauterine system (LNG-IUS) is a well-known nonsurgical, long-performing, and alternative method. Objectives: The objective of this study was to determine the efficacy of LNG-IUS in women with HMB through an analytical observational study. Materials and Methods: This study was performed among 60 patients who visited the gynecology and obstetrics outpatient department (OPD) at the Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital (IPGMER and SSKMH), Kolkata, West Bengal, India from May 2019 to April 2020 due to HMB. The mean demographic and clinical profiles were evaluated, and comparative analysis was performed for hemoglobin (Hb), spotting, pain, and endometrial thickness on day 0 and follow-up 3 months, 6 months, and 12 months. Results: The mean age of patients was 37.77 ± 4.58 years was obtained. The Hb level was significantly (P < .001) increased, whereas pictorial blood loss assessment chart (PBAC) score, endometrial thickness, spotting, and pain were significantly (P < .01 and P < .001) reduced. The majority of patients had pallor, but the rates of spontaneous expulsion and hysterectomy were observed lower after using LNG-IUS among studied patients. Conclusion: the usage of LNG-IUS is potential in the treatment of HMB in women, which may lead to a better quality of life. This can be the alternative to hysterectomy and oral pills for long-term use. It is suggested in a future study with larger sample size and multicentric approach to minimize hospital biasness.

Introduction: Isoniazid (H) is one of the most important first-line antituberculosis drugs used for the treatment of active tuberculosis (TB) and latent TB infection (LTBI) with high bactericidal activity and a good safety profile. The emergence of TB strains resistant to isoniazid threatens to reduce the effectiveness of TB treatment. Specific INH resistance allele is more frequently associated with resistance to other drugs. Aim and Objectives: To analyze the prevalence of mutations in genes associated with isoniazid resistance and to explore the association of specific mutations conferring other drugs resistance. Material and Methods: This is a prospective study done from October 2018 to July 2020 in the Department of Pulmonary Medicine, Guntur Medical College, Govt. Fever Hospital, Guntur. A total of 369 sputum-positive isoniazid-resistant pulmonary TB cases were included in the study and subjected to line probe assay (LPA). Results: The prevalence of InhA and KatG gene mutation is 63.14% and 36.85%, respectively. InhA gene is associated with fifampicin mutation in 7.72%, fluoroquinolone (FQ) in 6%, and second-line injectables (SLI) in 1.71% cases. KatG gene is associated with rifampicin mutation in 13.23%, FQ in 7.35%, and SLI in 1.47% cases. Conclusion: InhA gene is the most common gene pattern observed in isoniazid-resistant cases and associated equivalently with other drug resistance patterns such as KatG indicating the recent change in the level of resistance of InhA-resistant strains.

Angiolipomas are uncommon benign vascular adipocytic mesenchymal tumors and generally present as painful subcutaneous nodules in the extremities and trunk. Chest wall is a rare site for angiolipoma. We describe a case of a giant retromammary angiolipoma that presented clinically as an apparent large breast lump. This tumor was surgically excised after preoperative angioembolization. Latter was carried out to reduce intraoperative bleeding and facilitate the excision. We recommend keeping benign tumors such as angiolipomas in differential when dealing with apparent breast/chest wall lumps. We also advocate preoperative angioembolization in select cases while excising large angiolipomas to decrease perioperative blood loss.

Introduction: COVID-19 has caused unprecedented disruption to the medical education process and the health care system worldwide. It has also affected clinical training and forced medical colleges to switch over to the online mode of teaching. This study aimed to learn about the experience and perception of undergraduate students regarding online learning and to study the advantage and disadvantages of online learning. Method: This was a cross-section study conducted among the undergraduate students of government medical colleges of Jharkhand. A validated electronic questionnaire was sent to students of all five government medical colleges in the google form. Response from 501 students was received and analyzed using SPSS software. Result: Only 30% of students were satisfied with the frequency, organization content, and preparedness of class. More than half of students were not satisfied with the preparedness, content, and frequency of online classes. Among various teaching methods, live online lectures were most common, and they were also preferred by the majority of students. Most of the students wanted a regular face-to-face classroom or hybrid teaching after the COVID-19 pandemic. Conclusion: The majority of the medical students preferred face-to-face teaching methods over online teaching methods. Lack of interpersonal interaction and poor infrastructure for online might be the reason for this. However, a hybrid method of learning can be included as a part of the medical curriculum that helps in better learning of medical students.

Background: Vascular endothelial growth factor (VEGF) stimulates angiogenesis, increases vascular permeability and seems to correlate to aggressiveness of tumors. Thyroid cancer has been found to have higher levels of VEGF expression. Thyroid stimulating hormone (TSH) is the most important thyroid hormone, yet few researches have been done on its relationship with VEGF. Aim: To study the clinical and demographic profile of thyroid lesions (benign and malignant) and to explored the relationship between VEGF expression (using immunochemistry) and serum TSH level. Methods: This prospective, observational study includes 61 patients of thyroid lesions who underwent partial, hemi, subtotal or total thyroidectomy as the primary treatment from June 2014 and July 2016. Tissue specimens of thyroid lesions for immunohistochemistry study of VEGF expression were done. Serum TSH was done using Chemiluminiscence technique and correlated to VEGF expression. Results: The mean age of patient was 36.26 ± 11.53 years (range 20-50 years) with female preponderance. Swelling was the most common presenting symptom. Of 61 patients, 37 (60.65%) patients were benign and 24 (39.35%) were malignant thyroid lesions. The mean TSH level in benign group was 1.92 ± 0.94 mIU/liter and malignant group was 2.73 ± 1.74 mIU/liter which was statistically significant (P = 0.023). VEGF expression was strongly positive (3+) in 26 (42.62%) patients and negative/equivocal (1+ & 2+) in 35 (57.38%) patients. In benign group, 10 (27.0%) patients were strongly positive for VEGF whereas in malignant group, 16 (66.7%) patients were strongly positive for VEGF showed significant association (P = 0.002). On comparing TSH level of benign, malignant and total patients separately with VEGF expression, significant association were also observed (P < 0.001, P = 0.004 and P < 0.001, respectively). Conclusion: VEGF was strongly expressed in malignant thyroid lesions which are having high serum concentration of serum TSH level. Serum TSH levels reveal a significant correlation with VEGF expression.

Background: Sleep is vital for every aspect of human life. Inadequate sleep has a massive negative impact on health and work. There is very limited information about the impact of COVID-19 on the sleep disturbance of health-care workers. In our current study, we aim to find answers to certain questions about the impact of the COVID-19 pandemic on sleep patterns on nurses working in COVID care area. Methods: A cross-sectional study was conducted on 305 health-care workers who were purposively enrolled for this study. The study was conducted at the Postgraduate Institute of Medical Education and Research, Chandigarh, India, from April to June 2021. An e-survey method was used to collect data. A questionnaire including sociodemographic characteristics, queries about sleep disturbances, and the patient health questionnaire-9 scale to assess anxiety among participants are among the research tools. Results: Mean age of health-care workers was 26.3 years (SD = 6.3). Most of them were women (81%) with a bachelor's degree in nursing (62%), nursing interns (46%), and married (71%). The majority of nurses (85%) were not infected with COVID and were given suitable personal protective equipment (46%) in the hospital. The majority of participants (45%) got 6–8 h of sleep per night did not receive any sleep therapy (90%). The most of participants (42%) reported that they did not enjoy performing activities and were under moderate stress (15.4). Conclusion: Health-care workers are struggling to cope with the COVID-19 pandemic with limited and almost hackneyed resources. Healthy sleep is everyone's right. The current situation of the pandemic has a great impact on the psychological health of frontline health-care workers by affecting their professional performance.

Background: The women who have been pregnant more than four times are fewer than 18or over 35-years-old, or have at least one medical issue before or during pregnancy, the pregnancy is considered high-risk. Increased maternal and foetal mortality and morbidity are linked to these risk factors. MTP in itself is a blind and risky procedure and performing it in High Risk Pregnancy (HRP) is a challenge for obstetrics and gynecology personnel. When performed with all pre, intra and post-op precautions, results are good and patient-friendly. Aims and Objectives: Aims of the study were to calculate the number, high-risk factors, method used, and its outcome of MTP in HRP. Materials and Methods: The present study was a retrospective observational study done at QMH, KGMU, Lucknow performed on subjects admitted for MTP from January 2018 to December 2018. Total admitted patients seeking MTP were 450 out of which 93 belonged to High-Risk Group who underwent surgical and medical abortion accordingly. All precautions and norms defined by Govt. of India were taken care of. Cases were evaluated on the basis of high-risk factors- Age, parity, obstetrical and medical illnesses, and interval since last delivery. Results: Out of 93 high-risk cases, 88 cases were of 1st trimester and 5 were of 2nd trimester abortion. Six cases required suction evacuation while seven cases were managed medically using medical abortion kit. Contraception was given to all subjects according to their needs. Seventy-one women were of more than 35 yrs, while two were teenagers. 21 women were grand multipara. Women of obstetrical risk were 17 while the rest were having medical illnesses. Conclusion: This study concludes that there are a large number of high-risk groups for MTP again showing unmet need and lack of specialized counseling of HR patients according to their mental and physical condition. Early recognition of pregnancy and timely intervention can be lifesaving in these women and proper contraceptive counseling is required to prevent future pregnancies.

Abstract Eastern countries are a major source of medicinal plants, which set up a rich source of ethnopharmacologically known medicines used in the treatment of various diseases. These traditional medicines have been known as complementary, alternative, or nonconventional therapy across globe for ages. Tuberculosis (TB) poses a huge global burden and leads to maximum number of deaths due to an infectious agent. Treatment of TB using Directly Observed Treatment Short‐course (DOTS) therapy comprises multiple antibiotics is quite lengthy and causes serious side‐effects in different organs. The length of the TB treatment leads to withdrawal from the patients, which paves the way for the emergence of drug resistance in the bacterial population. These concerns related to therapy need serious and immediate interventions. Traditional medicines using phytochemicals has shown to provide tremendous potential in TB treatment, mainly in the eradication of Mycobacterium tuberculosis (M.tb), increasing natural immunity, and managing the side effects of anti‐TB drugs. This review describes the antituberculosis potential of selected ethnopharmacologically important phytochemicals as potential immune‐modulator and as an adjunct‐therapy in TB. This review will be a useful reference for researchers working on ethnopharmacology and will open the door for the discovery of novel agents as an adjunct‐therapy to tuberculosis.

Background: Dermatophytes are keratinophilic and keratinolytic fungi which are responsible for dermatophytosis. There are three genera of dermatophytes; Trichophyton, Microsporum and Epidermophyton. As they have affinity to keratin rich tissue, they produce dermal inflammatory response, intense itching and cosmetically poor appearance. The varied clinical presentation of tinea results in delay in diagnosis, poor compliance in follow up of cases, and consequently spread of infection in the community has rekindled interest in rapid identification of species. Materials and Methods: A hospital based cross sectional study was carried out in the department of Microbiology, Nobel medical college from January 2019 to December 2019. Clinically suspected 200 cases of dermatophytosis attending Out Patient Department were studied. Isolation and identification was done by various tests like macroscopic, microscopic and biochemical tests. Results: Out of 200 specimens, 138 (69%) were skin scraping, 42 (21%) were nail clipping and 20 (10%) were hair stubs. Highest incidence was seen in the age group 21-40 years with 115 (57.5%) cases followed by 41-60 years 46 (23%) cases. In our study male preponderance of 158 (79%) and female of 42 (21%) were seen. Tinea corporis was found to be the commonest clinical type with 96 (48%) cases followed by tinea unguinum, 42 (21%), Tinea cruris 10 (11.36%), Tinea capitis 5 (5.68%), Tinea faciei 4 (4.54%), Tinea pedis 2 (2.27%). Among the fungal isolates Trichophyton rubrum (67.04%) was the most common etiological agent followed by Trichophyton mentagrophytes (13.63%), Epidermophyton 10 (11.36%), Trichophyton violaceum 4 (4.54%) and Epidermophyton floccosum 3 (3.4%). Conclusion: The most common clinical presentation was tinea corporis followed by tinea unguinum. T. rubrum was the most common etiological agent of dermatophytosis

Introduction: Vaccine wastage is an expected component of any immunisation program. Wastage is defined as “loss by use, decay, erosion or leakage or through wastefulness”. Vaccine wastage in unopened vial is mostly attributed by cold chain and stock management problem. Vaccine wastage in opened vial is mostly due to discarding of remaining dose at the end of the session, not being able to draw the number of doses in a vial, submergence of opened vials in water and poor vaccine administration practices. Aim: To assess the vaccine wastage in an immunisation clinic of a tertiary care centre in western Odisha, India. Materials and Methods: A record based descriptive cross-sectional study was carried out at Immunisation Clinic, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Odisha, India. The information regarding children and pregnant women vaccinated were retrieved from immunisation register for the study period 1st October 2019 to 30th September 2020. Vaccine wastage rate at the immunisation clinic was calculated by taking into account the number of doses of vaccines wasted divided by the total number of the doses of vaccines issued multiplied by 100. Results: Vaccine wastage rate and wastage factor was found to be highest in case of Measles-Rubella (MR) vaccine (wastage rate 65% and wastage factor 2.85) and lowest in Hepatitis B vaccine (wastage rate 1.67% and wastage factor 1.01). Wastage rate for 10 dose vial was 28.37% followed by 19.72% for 25 dose vial and 10.11% for 20 dose vial. Wastage rate and wastage factor was found to be higher in lyophilised vaccines when compared to liquid vaccines and the difference was statistically significant. Wastage rate and wastage factor was found to be higher for oral vaccines when compared to injectable vaccines and the difference was statistically significant. Conclusion: It was seen that in case of MR vaccine (supplied as 10 dose/vial), vaccine wastage was more as it didn’t follow open vial policy and less number of beneficiary came for MR vaccine per immunisation session. The vaccine wastage can be reduced in lyophilised vaccines if they are supplied in less doses per vial.

Abstract Cellular senescence is a stable cell cycle arrest that normal cells undergo after a finite number of divisions, in response to a variety of intrinsic and extrinsic stimuli. Although senescence is largely established and maintained by the p53/p21WAF1/CIP1 and pRB/p16INK4A tumour suppressor pathways, the downstream targets responsible for the stability of the growth arrest are not known. We have employed a stable senescence bypass assay in conditionally immortalised human breast fibroblasts (CL3EcoR) to investigate the role of the DREAM complex and its associated components in senescence. DREAM is a multi-subunit complex comprised of the MuvB core, containing LIN9, LIN37, LIN52, LIN54, and RBBP4, that when bound to p130, an RB1 like protein, and E2F4 inhibits cell cycle-dependent gene expression thereby arresting cell division. Phosphorylation of LIN52 at Serine 28 is required for DREAM assembly. Re-entry into the cell cycle upon phosphorylation of p130 leads to disruption of the DREAM complex and the MuvB core, associating initially to B-MYB and later to FOXM1 to form MMB and MMB-FOXM1 complexes respectively. Here we report that simultaneous expression of MMB-FOXM1 complex components efficiently bypasses senescence with LIN52, B-MYB, and FOXM1 as the crucial components. Moreover, bypass of senescence requires non-phosphorylated LIN52 that disrupts the DREAM complex, thereby indicating a central role for assembly of the DREAM complex in senescence.

Introduction: Small blue round cell tumours are heterogeneous group of neoplasms characterised by small, round and relatively undifferentiated cells. These tumours pose a great challenge to the histopathologist for definite diagnosis and Immunohistochemistry (IHC) plays an important role in the further evaluation of these tumours. Aim: To analyse the round cell tumours according to site, gender and age of the patient and ascertain the significance of IHC for its accurate morphological characterisation. Materials and Methods: This prospective cohort study was conducted at Department of Pathology, Guntur Medical College, Andhra Pradesh, India, which included 53 patients from August 2013 to August 2015. Immunohistochemical studies were done to categorise the tumours using the relevant panel of immunohistochemical antibodies streptavidin biotin detection method. Frequency and percentage statistics was used to present the results. Results: Out of 53 cases there were 29 cases of Non Hodgkin Lymphoma (NHL), eight cases of Ewing’s Sarcoma/PNET, four cases of Esthesioneuroblastoma, three cases of small cell carcinoma, two cases of medulloblastoma, each one case of ependymoblastoma, alveolar rhabdomyosarcoma, sinonasal Undifferentiated Carcinoma (SNUC), mesenchymal chondrosarcoma, nephroblastoma, desmoplastic small round cell tumour and small cell carcinoma ovary. Conclusion: Most common tumour was NHL with highest incidence in males and age group of more than 40 to 60 years years. Immunohistochemistry represents an adjunctive tool for accurate typing and classification of round cell tumours.

Background and objectives: Turnaround time (TAT) is an important quality indicator for benchmarking laboratory performance. Delay in TAT may affect patient safety; thus, continuous monitoring and analysis of laboratory workflow is mandatory. This study was designed to improve the TAT of two biochemistry laboratories serving in tertiary care teaching hospitals (multispecialty and super-specialty) through the application of quality tools namely quality failure reporting, the Fishbone model, and process mapping. Methods: First, TAT was defined for routine (four hours) and urgent samples (two hours). Then, TAT failureincidents in 2018-2019 were analyzed using the Fishbone model. The process map of TAT was studied and made more value streamed and lean after removal of waste steps.Corrective action plans were prioritized and implemented for potential causes with more adverse outcomes. Pilot solutions were implemented for six months and TAT failures incidents were reanalyzed. Results: The quality failure in TAT reporting was reduced by 22% (from 34% to 12%) for urgent samples and by 19% (from 27% to 8%) for routine samples after the implementation of quality tools in multispecialty hospital laboratory. In the super-specialty hospital laboratory, the improvement was more profound and the TAT percentage achieved after the corrective actions was 96.57% and 98% for urgent and routine samples, respectively. Conclusion: Implementation of quality failure reporting culture along with quality tools led to significant improvement in TAT and higher quality laboratory performance in terms of efficiency, reliability, and increased patient safety.

Abstract Viruses cause many severe plant diseases, resulting in immense losses of crop yield worldwide. Therefore, developing novel approaches to control plant viruses is crucial to meet the demands of a growing world population. Recently, RNA interference (RNAi) has been widely used to develop virus-resistant plants. Once genome replication and assembly of virion particles is completed inside the host plant, mature virions or sometimes naked viral genomes spread cell-to-cell through plasmodesmata by interacting with the virus-encoded movement protein (MP). We used the RNAi approach to suppress MP gene expression, which in turn prevented potato leafroll virus (PLRV) systemic infection in Solanum tuberosum cv. Khufri Ashoka. Potato plants agroinfiltrated with MP siRNA constructs exhibited no rolling symptoms upon PLRV infection, indicating that the silencing of MP gene expression is an efficient method for generating PLRV-resistant potato plants. Further, we identified novel ATPase motifs in MP that may be involved in DNA binding and translocation through plasmodesmata. We also showed that the ATPase activity of MP was stimulated in the presence of DNA/RNA. Overall, our findings provide a robust technology to generate PLRV-resistant potato plants, which can be extended to other species. Moreover, this approach also contributes to the study of genome translocation mechanisms of plant viruses.

Background: Ensuring that the patient comprehends and correctly implements the physician's/health care worker's instructions is crucial in the treatment of Tuberculosis (TB). Our study aimed to assess the Heath Literacy (HL) of patients with TB using the Newest Vital Sign (NVS) HL tool translated to Kannada language. Aim and Objectives: To develop a translated version of the NVS HL tool in the Kannada language and assess the HL of patients with TB. Material and Methods: Two professional translators translated the NVS-United Kingdom version to Kannada language independently. The content of the translated version was assessed by a team of six medical and non-medical personnel, followed by back-translation of the modified version. The translated NVS tool, which was modified to culturally adapt the contents to the Indian scenario, was pilot tested among 15 individuals from the general population to determine the internal validity of the questionnaire, which indicated good reliability (Cronbach's alpha 0.806). Further, a cross-sectional study was conducted at a TB center in Karnataka, India. The translated NVS was administered to 50 patients with drug-sensitive and drug-resistant TB each. The correlation between the HL scores and educational and socioeconomic status was determined. Results: The median HL score of the study participants was 1, and the median time to answer the questionnaire was 10 minutes. The percentage of patients with limited, intermediate, and adequate HL scores were 54%, 32%, and 14%, respectively. A moderate positive correlation was seen between the educational level and the NVS scores (r = 0.480, P < 0.001). Conclusion: A large number of patients with TB have limited HL. The HL status of an individual correlates with the level of education but not with gender or socioeconomic status. NVS-Kannada is a reliable tool to measure HL in the Kannada-speaking population.

Abstract Antigen identification is an important step in the vaccine development process. Computational approaches including deep learning systems can play an important role in the identification of vaccine targets using genomic and proteomic information. Here, we present a new computational system to discover and analyse novel vaccine targets leading to the design of a multi-epitope subunit vaccine candidate. The system incorporates reverse vaccinology and immuno-informatics tools to screen genomic and proteomic datasets of several pathogens such as Trypanosoma cruzi, Plasmodium falciparum, and Vibrio cholerae to identify potential vaccine candidates (PVC). Further, as a case study, we performed a detailed analysis of the genomic and proteomic dataset of T. cruzi (CL Brenner and Y strain) to shortlist eight proteins as possible vaccine antigen candidates using properties such as secretory/surface-exposed nature, low transmembrane helix (

Abstract Cinnamaldehyde (Cin) is a natural product obtained from cinnamon and is reported to have a potential anti-fungal, anti-oxidant, anti-inflammatory and anticancer effect. The present study investigated the possible protective role of Cin against tenuazonic acid-induced mycotoxicity in the murine model. Tenuazonic acid (TeA), a toxin produced by Alternaria is a common contaminant in tomato and tomato-based products. Here, Swiss male mice were administered with TeA isolated from Paradendryphiella arenariae (MW504999) (source-tomato) through injection (238 µg/kg BW) and ingestion (475 µg/kg BW) routes for 2 weeks. Thereafter, the prophylaxis groups were treated with Cin (210 mg/kg BW). The experiment was carried out for 8 weeks. The treated groups were compared to the oral and intra-peritoneal experimental groups that received the toxin solely for 8 weeks. Haematological, histopathological and biochemical aspects of the experimental and the control mice were analysed. Sub-chronic intoxication of mice with TeA showed elevated malondialdehyde (MDA), reduced catalase (CAT) and superoxide dismutase (SOD) production; abnormal levels of aspartate transaminase (AST) and alanine transaminase (ALT). Treatment with Cin reversed TeA-induced alterations of antioxidant defense enzyme activities and significantly prevented TeA-induced organ damage. Thus, cinnamaldehyde showed therapeutic effects and toxicity reduction in TeA induced mycotoxicosis.

Abstract During 2018 an intensive study was conducted to determine the viruses associated with cucurbitaceous crops in nine agroclimatic zones of the state of Uttar Pradesh, India. Total of 563 samples collected and analysed across 14 different cucurbitaceous crops. The results showed the dominance of Begomovirus (93%) followed by Potyvirus (46%), cucumber green mottle mosaic virus (CGMMV-39%), Polerovirus (9%), cucumber mosaic virus (CMV-2%) and Orthotospovirus (2%). Nearly 65% of samples were co-infected with more than one virus. Additionally, host range expansion of CMV, CGMMV and polerovirus was also observed on cucurbit crops. A new potyvirus species, zucchini tigre mosaic virus, earlier not documented from India has also been identified on five crops during the study. Risk map generated using ArcGIS for virus disease incidence predicted the virus severity in unexplored areas. The distribution pattern of different cucurbit viruses throughout Uttar Pradesh will help identify the hot spots for viruses and will facilitate to devise efficient and eco-friendly integrated management strategies for the mitigation of viruses infecting cucurbit crops. Molecular diversity and evolutionary relationship of the virus isolates infecting cucurbits in Uttar Pradesh with previously reported strains were understood from the phylogenetic analysis. Diverse virus infections observed in the Eastern Plain zone, Central zone and North-Eastern Plain zone indicate an alarming situation for the cultivation of cucurbits in the foreseeable future.

Background Previous studies have examined the mode specificity of eccentric and concentric isokinetic training, but have reported conflicting results. Few studies have reported that eccentric and concentric isokinetic training are mode-specific, i.e., they will increase only the eccentric or concentric strength, respectively. Other studies have reported that mode specificity does not exist. Therefore, this study aimed to assess the mode-specific effects of eccentric and concentric isokinetic training of the hamstring muscle at slow angular velocity on eccentric peak torque of the hamstring (PTecc), concentric peak torque of the quadriceps (PTcon), acceleration time of the hamstring (AThams) and quadriceps (ATquad), deceleration time of the hamstring (DThams) and quadriceps (DTquad), time to peak torque of the hamstring (TPThams) and quadriceps (TPTquad), and functional Hamstring-to-Quadriceps ratio (PTecc/PTcon). Subjects A total of 30 participants were randomly divided into eccentric and concentric groups. Methods Two groups pre-test-post-test experimental design was used. In the eccentric and concentric groups, eccentric and concentric isokinetic training of hamstring muscle was performed respectively, at an angular velocity of 60°/s for 6 weeks duration. PTecc, PTcon, AThams, ATquad, DThams, DTquad, TPThams, TPTquad, and PTecc/PTcon were measured before and after the completion of training. Results In the eccentric group, a significant difference (p < 0.05) was observed in PTecc (increased by 21.55%), AThams (decreased by 42.33%), ATquad (decreased by 28.74%), and PTecc/PTcon (increased by 17.59%). No significant difference (p > 0.05) was observed in PTcon, TPThams, TPTquad, DThams, and DTquad. In the concentric group, a significant difference (p < 0.05) was observed in PTecc (increased by 12.95%), AThams (decreased by 27.38%) ATquad (decreased by 22.08%), DTquad (decreased by 26.86%), and PTecc/PTcon (increased by 8.35%). No significant difference (p > 0.05) was observed in PTquad, TPThams, TPTquad, and DThams. Between-group analysis revealed a significant difference (p < 0.05) only in TPTquad; otherwise, in the rest of the parameters, no significant difference (p > 0.05) was observed. Conclusions Both eccentric and concentric isokinetic training of the hamstring for 6 weeks increased PTecc, PTecc/PTcon, and decreased AThams and ATquad. The effects of eccentric and concentric isokinetic training of the hamstring on PTecc, PTecc/PTcon, AThams, and ATquad were not mode specific.