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Modulation of proteasome function by pharmacological interventions and molecular biology tools is an active area of research in cancer biology and neurodegenerative diseases. Curcumin (diferuloylmethane) is a naturally occurring polyphenol that affects multiple signaling pathways and known to modulate PKC activities. The therapeutic significance of curcumin is often considered to reside in its anti-inflammatory, antioxidant, anti-angiogenic, or anti-apoptotic properties. However, recent research suggests that the therapeutic efficacy of curcumin may be due to its activity as a potent inhibitor of the proteasome. In this study, we show that both curcumin and its synthetic polyphenolic derivative (didemethylcurcumin), CUIII modulated proteasome activity in a biphasic manner. Curcumin and CUIII increased proteasome activity at nanomolar concentrations but inhibited proteasome activity at micromolar concentrations. Curcumin was more effective than CUIII in relative proteasome activity increase at nanomolar concentrations. Also, curcumin was more effective than CUIII in relative proteasome activity inhibition at micromolar concentration. The docking study was conducted on the 20S proteasome catalytic subunit. Estimated Kd values for curcumin and didemethylcurcumin are 0.0054μM and 1.3167μM, respectively. These values correlate well with the results of the effectiveness of modulation by curcumin compare to CUIII. The small size of CUIII makes its dock to the narrow cavity of the active site, but the binding interaction is not strong compare to curcumin. This study suggests that curcumin and its didemethyl derivative can be used to modulate proteasome activity. This communication implicates the reason why curcumin and its didemethyl derivative can be used to two different disease mechanisms, neurodegeneration, and cancer.

A monitoring survey was conducted in snake gourd agro ecosystem during the fruiting season at Gangnapur, West Bengal, India to generate extensive data on fruit fly diversity, population dynamics, infestation rates and evaluate the effect of trapping on fruit fly infestation rates vis-a-vis benefit cost ratio of snake gourd cultivation. Methyl Eugenol and Cue Lure traps were used to assess the fruit fly species diversity. The number of adult male flies trapped was used to calculate fruit fly per trap per day and assess the population dynamics. Bactrocera dorsalis, Zeugodacus cucurbitae and Zeugodacus tau were the predominant fruit fly species during the fruiting season. Maximum species diversity and evenness estimates were registered by Methyl Eugenol traps. Species richness estimates for Cue Lure and Methyl Eugenol traps during the entire experiment are analogous due to the trapping of two different types of fruit fly species. Zeugodacus cucurbitae is the most abundant species in the snake gourd ecosystem and dominated the community of fruit flies throughout the study. Fruit fly per trap per day values indicated that the Gangnapur area is at infestation level, for Zeugodacus cucurbitae and Bactrocera dorsalis, while, for Zeugodacus tau the area is at suppression level. The rate of infestation varied from 6.93 % to 44.09 %. Farmers with traps in their fields reported a benefit cost ratio of 0.73 to 4.63, while the no-trap group reported 0.34 to 1.56. This study at Gangnapur has proven the beneficial effect of trapping on the benefit cost ratio of snake gourd cultivation.

PURPOSE For unresectable gallbladder cancer (GBC), gemcitabine and platinum is standard combination; however, outcome is poor. We conducted this study to find feasibility of modified flourouracil, oxaliplatin, and irinotecan in this group. MATERIALS AND METHODS We conducted a prospective, phase II single-arm pilot study. Inclusion criteria were histologically proven GBC and Eastern Cooperative Oncology Group 0-1. Primary end points were overall response rates and overall survival. The following treatment was given: oxaliplatin 85 mg/m2, leucovorin 400 mg/m2, and irinotecan 150 mg/m2, all once on day 1, fluorouracil 2,400 mg/m2 continuous intra-venous infusion over 46 hours repeated every 2 weeks, and maximum 12 doses, with primary granulocyte colony-stimulating factor prophylaxis. RESULTS Between February 2019 and July 2020, 29 patients with unresectable GBC were enrolled. The median age was 52 years, and 18 were females. The Eastern Cooperative Oncology Group was 0 in 4. Five had bilirubin > normal, and 15 each had high serum alkaline phosphatase and carbohydrate antigen 19-9. Twenty-five patients had stage IV disease, and remaining unresectable locally advanced disease. A median of 8.5 cycles was given, and 11 completed treatment. Nine stopped chemotherapy because of progression, and one because of toxicity, and treatment is ongoing in three. Twenty-two required dose reduction. A treatment delay of 1-2 weeks was seen in 25 patients. Best response was complete response 1, partial response 13 (overall response rate 48.2%), and stable disease 9. Four patients with metastatic disease underwent R0 resection. As on cutoff date, nine are surviving (three without disease). Eighteen died of PD, and in two, cause was unknown. There was no toxic death. The median overall survival and progression-free survival were 309 and 252 days, respectively. Twenty-three patients experienced grade III or IV toxicity, and common were diarrhea (13), vomiting (12), and anemia (7). CONCLUSION First-line modified flourouracil, oxaliplatin, and irinotecan is feasible in unresectable GBC with encouraging responses. Toxicities are higher but manageable. Higher response rates make this an option to explore in borderline resectable cases.

PURPOSE The outcomes of patients with myeloma from developing countries are often lacking because of poor record maintenance. Publications from such settings are also limited because of the retrospective nature of the data collection. Information technology can bridge these gaps in developing countries with real-time data maintenance. We present the real-time survival data of the patients with myeloma from a tertiary care center in North India using one such indigenously built software. PATIENTS AND METHODS These are real-time data of all patients with myeloma presenting to a tertiary care center from North India. The patient characteristics (demographics, baseline disease characteristics, risk stratification, and outcomes) were recorded contemporaneously. The survival of the study population was analyzed and grouped based on various disease characteristics at diagnosis. RESULTS The median age of the study population (N = 696) was 65.9 (34.9-94.9) years with male predominance (65%). The median follow-up was 3.7 years (0-18.6 years) with the median overall survival (OS) not achieved. The OS of the study population at 1, 3, and 5 years was 94% (n = 558), 87.5% (n = 394), and 83.1% (n = 267), respectively. Most of the patients presented in advanced stages based on International Staging System (III:70%). On Kaplan-Meier analysis, the presence of weight loss ( P = .01), renal dysfunction ( P = .047), and anemia at diagnosis ( P = .004) had a significant impact on survival. On Cox proportional model univariate analysis, the presence of renal dysfunction, anemia, and weight loss had the significant hazard ratio of 1.68 (1-2.82, P = .049), 3.18 (1.39-7.29, P = .0063), and 2.81 (1.22-6.42, P = .014), respectively, whereas on multivariate analysis of hypercalcemia, renal disease, anemia, and bone disease (CRAB) features, only anemia was found to have a significant hazard ratio of 2.56 (1.01-6.47, P = .046). CONCLUSION The real-world data show OS comparable with the published western literature. Only anemia was found to have significant impact on survival. The use of such software can aid in better data-keeping in resource-constrained settings.

Background Kyasanur forest disease (KFD), known as monkey fever, was for the first time reported in 1957 from the Shivamogga district of Karnataka. But since 2011, it has been spreading to the neighbouring state of Kerala, Goa, Maharashtra, and Tamil Nadu. The disease is transmitted to humans, monkeys and by the infected bite of ticks Haemaphysalis spinigera. It is known that deforestation and ecological changes are the main reasons for KFD emergence, but the bio-climatic understanding and emerging pathways remain unknown. Methods The present study aims to understand the bio-climatic determinants of distribution of tick vector of KFD in southern India using the Maximum Entropy (MaxEnt) model. The analysis was done using 34 locations of Haemaphysalis spinigera occurrence and nineteen bio-climatic variables from WorldClim. Climatic variables contribution was assessed using the Jackknife test and mean AUC 0.859, indicating the model performs with very high accuracy. Results Most influential variables affecting the spatial distribution of Haemaphysalis spinigera were the average temperature of the warmest quarter (bio10, contributed 32.5%), average diurnal temperature range (bio2, contributed 21%), precipitation of wettest period (bio13, contributed 17.6%), and annual precipitation (bio12, contributed 11.1%). The highest probability of Haemaphysalis spinigera presence was found when the mean warmest quarter temperature ranged between 25.4 and 30 °C. The risk of availability of the tick increased noticeably when the mean diurnal temperature ranged between 8 and 10 °C. The tick also preferred habitat having an annual mean temperature (bio1) between 23 and 26.2 °C, mean temperature of the driest quarter (bio9) between 20 and 28 °C, and mean temperature of the wettest quarter (bio8) between 22.5 and 25 °C. Conclusions The results have established the relationship between bioclimatic variables and KFD tick distribution and mapped the potential areas for KFD in adjacent areas wherein surveillance for the disease is warranted for early preparedness before the occurrence of outbreaks etc. The modelling approach helps link bio-climatic variables with the present and predicted distribution of Haemaphysalis spinigera tick.

Background: The clinical diagnosis of stroke in a patient admitted in the intensive care unit (ICU) is undeniably challenging. Several point-based risk scores have been developed to predict clinical outcomes after ischemic stroke. Objective: To assess the Siriraj stroke score and Guy’s Hospital stroke score in the clinical diagnosis of acute stroke. Materials and Methods: All patients were subjected to Computed tomography (CT) scan head within 72 hours of admission. The sensitivity, specificity, positive predictive value was calculated for both the scores. Comparability between the scores and CT scan head finding was determined with the help of Kappa statistic program. Results: Sensitivity of Guy’s Hospital stroke score for ischemic stroke is 100%, specificity is 96.4%, accuracy 97.1%, positive predictive value of 87.5% and negative predictive value 100%. The sensitivity of Guy’s Hospital stroke score for hemorrhage stroke is 96.4%, specificity is 100%, accuracy 97.1%, positive predictive value of 100% and negative predictive value 87.5% Conclusion: Siriraj stroke score as a simple method of screening patients for intracerebral hemorrhage, as it is easier to use at bedside and has a greater accuracy in diagnosing hemorrhage than Guy’s Hospital score. KYAMC Journal. 2021;12(3): 142-146

The way communicable diseases do spread from one person to another, depending upon the specific disease or causative infectious agent. Out of these diseases, some are incurable and the health care workers during their practice or otherwise acquire such infections and transmit them further to innocent patients who are unaware of about the health status of health care workers. The rights of an infected health care worker and patients are protected by many laws but in case of conflict of interests between the individual right of the health care worker and life of a patient, then obviously by the principle of natural justice, saving the life of a person from such incurable infection gets the privilege. Therefore, there is a lot of ethical and professional dilemma, arising out, in such a type of scenario, irrespective of concealed or disclosed health status and the question mark is raised on whether clinical practice may be allowed in such cases. Some of the studies show the actual but very little risk of transmission from infected health care workers to patients. Therefore, in the current scenario, many western countries such as USA and UK are following different guidelines in this regard but the same is lacking in India. So, this article critically analyses the various issues arising out of it and thereby justifies the need to have a uniform infection control policy in this regard apart from legal and ethical binding on infected health care workers.

Background Deep brain stimulation (DBS) is an effective surgical therapy for individuals with essential tremor (ET). However, DBS operates continuously, resulting in adverse effects such as postural instability or dysarthria. Continuous DBS (cDBS) also presents important practical issues including limited battery life of the implantable neurostimulator (INS). Collectively, these shortcomings impact optimal therapeutic benefit in ET. Objective The goal of the study was to establish a physiology-driven responsive DBS (rDBS) system to provide targeted and personalized therapy based on electromyography (EMG) signals. Methods Ten participants with ET underwent rDBS using Nexus-D, a Medtronic telemetry wand that acts as a direct conduit to the INS by modulating stimulation voltage. Two different rDBS paradigms were tested: one driven by one EMG (single-sensor) and another driven by two or more EMGs (multi-sensor). The feature(s) used in the rDBS algorithms was the pow2er in the participant's tremor frequency band derived from the sensors controlling stimulation. Both algorithms were trained on kinetic and postural data collected during DBS off and cDBS states. Results Using established clinical scales and objective measurements of tremor severity, we confirm that both rDBS paradigms deliver equivalent clinical benefit as cDBS. Moreover, both EMG-driven rDBS paradigms delivered less total electrical energy translating to an increase in the battery life of the INS. Conclusions The results of this study verify that EMG-driven rDBS provides clinically equivalent tremor suppression compared to cDBS, while delivering less total electrical energy. Controlling stimulation using a dynamic rDBS paradigm can mitigate limitations of traditional cDBS systems.

Medulloblastoma (MB) is a malignant pediatric brain tumor with a poor prognosis. Post-surgical radiation and cisplatin-based chemotherapy have been a mainstay of treatment, which often leads to substantial neurocognitive impairments and morbidity, highlighting the need for a novel therapeutic target to enhance the sensitivity of MB tumors to cytotoxic therapies. We performed a comprehensive study using a cohort of 71 MB patients' samples and pediatric MB cell lines and found that MB tumors have elevated levels of nucleosome remodeling FACT (FAcilitates Chromatin Transcription) complex and DNA repair enzyme AP-endonuclease1 (APE1). FACT interacts with APE1 and facilitates recruitment and acetylation of APE1 to promote repair of radiation and cisplatin-induced DNA damage. Further, levels of FACT and acetylated APE1 both are correlate strongly with MB patients' survival. Targeting FACT complex with CBL0137 inhibits DNA repair and alters expression of a subset of genes, and significantly improves the potency of cisplatin and radiation in vitro and in MB xenograft. Notably, combination of CBL0137 and cisplatin significantly suppressed MB tumor growth in an intracranial orthotopic xenograft model. We conclude that FACT complex promotes chemo-radiation resistance in MB, and FACT inhibitor CBL0137 can be used as a chemo-radiation sensitizer to augment treatment efficacy and reduce therapy-related toxicity in high-risk pediatric patients.

Objective: The present research work was designed to investigate the gastroprotective potentials of methanol extract of Tephrosia villosa. Methods: The aerial parts of Tephrosia villosa were dried under shade, powdered and deffated with petroleum ether and then marc leftover was subjected to methanol extraction using soxhlet apparatus using soxh-let apparatus. Antiulcer activity of methanol extract was determined against stress-induced and aspirin-induced ulcers in experimental animal models. The total number of ulcers formed, ulcer index, percentage inhibition, ulcerated area, protected area, pH and Total acidity were parameters in the study. Results: Methanol extract of Tephrosia villosa at medium (200 mg/kg) and high (200 mg/kg) could significantly (P

Introduction:Preeclampsia is a potentially fatal disorderof pregnant women; it remains an important cause of maternal mortality throughout the world. More than 50,000 maternal deaths occur worldwideeach year. Various researchers of different countries suggested an association of increase level of serumprolactin in preeclamptic patient. Estimation of serum prolactin level in pregnancy may be helpful in diagnosis of preeclampsia. Objective: Theobjective of the study is to observe the association of serum prolactin level with severity of preeclampsia. Materials and Methods: This cross-sectionalstudy was conducted from March 2020 to February 2021 in the Department of Laboratory Medicine, Department of Fetomaternal Medicine and Obstetrics and Gynecology, BSMMU and Dhaka Medical College Hospital, Dhaka. Fifty diagnosed patients of preeclampsia who fulfilled the inclusion and exclusioncriteria were selected as study population. At the same time 50 normal pregnant women were taken in another group. In both groups gestational age was calculated from last Menstrual date and confirmed by early ultrasound which wasdone at

Biallelic pathogenic variants in the TANGO2 (transport and Golgi organization 2 homolog) gene have been identified as causing a rare metabolic disorder characterized by susceptibility to recurrent rhabdomyolysis, lactic acidosis, encephalopathy, and life-threatening tachyarrhythmias. Recently published reports suggest variable clinical severity and phenotypes. This study details five new patients from two families with biallelic pathogenic variants in the TANGO2 gene identified by whole exome sequencing and includes the largest number of affected individuals from a single family reported to date. We document significant intrafamilial variability and highlight that milder phenotypes may be underrecognized. We present biochemical and clinical data to help highlight the features that aid in consideration of this condition in the differential with disorders of fatty acid oxidation. We also present a comprehensive literature review summarizing the molecular, clinical, and biochemical findings for 92 individuals across 13 publications. Of the 27 pathogenic variants reported to date, the recurrent exons 3-9 deletion represents the most common variant seen in 42% of individuals with TANGO2 deficiency. Common clinical features seen in >70% of all individuals include acute metabolic crisis, rhabdomyolysis, neurologic abnormalities, developmental delay, and intellectual disability. Findings such as elevated creatine kinase, hypothyroidism, ketotic hypoglycemia, QT prolongation, or abnormalities of long-chain acylcarnitines and urine dicarboxylic acids should raise clinical suspicion for this life-threatening condition.

Anaemia is one of the major causes of severe and complicated malaria. Malaria associated anaemia are due to decreased production of RBCs and lysis of infected and uninfected erythrocytes. The role of anti-malarial treatment in correcting anaemia are not studied extensively. The present work was undertaken to study the changing pattern of haemoglobin level following anti-malarial therapy. A total of 201 microscopically positive mono-infected with P. vivax (103) and P falciparum (98) patients were recruited and treated with antimalarial drugs and followed up on day 3, 14, and 28 to study the changing pattern of haemoglobin level. Among the P. falciparum positive patients mean haemoglobin level on Day 0 and day 28 was 13.17 g/dl and 13.31 g/dl whereas among P. vivax cases mean haemoglobin level was 13.28 g/dl and 13.29g/dl, respectively. Among the P. falciparum cases (n = 98), 4.08%, 16.33% and 79.59% was classied as moderate anaemia, mild anaemia and normal, respectively. Similarly, among the P. vivax cases (n = 103), 1.94%, 17.47% and 80.58% had moderate anaemia, mild anaemia and normal, respectively. Mean haemoglobin level was declined on day 3 which gradually increased to its initial level by day 28 among both P. falciparum and P. vivax cases. Similar study in other malaria endemic areas will be helpful for better understanding the changing pattern of haemoglobin level among malaria patients.

Amyloid aggregation is a pathological trait observed in many incurable and fatal neurodegenerative and metabolic diseases associated with misfolding and self-assembly of various proteins. Noncovalent interactions between these structural motifs and small molecules can, however, prevent this aggregation. Herein, five structurally different synthetic (Cz1-Cz4) and naturally occurring (Cz5, mahanimbine) fluorescent carbazole analogs are explored for their comparative amyloid aggregation inhibitory activities. Cz3 inhibited the amyloid deposition on the pancreatic β-cells of diabetic mice. Moreover, Cz3 and Cz5 also showed efficacy as the fluorescent cell (MIN6) imaging agents. Further structural modifications of these carbazoles may lead to development of low-cost and non-toxic therapeutic agents for Type 2 diabetes and other amyloidosis-related diseases.

Chronic pulmonary diseases encompass different persistent and lethal diseases, including chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), cystic fibrosis (CF), asthma, and lung cancers that affect millions of people globally. Traditional pharmacotherapeutic treatment approaches (i.e., bronchodilators, corticosteroids, chemotherapeutics, peptide-based agents, etc.) are not satisfactory to cure or impede diseases. With the advent of nanotechnology, drug delivery to an intended site is still difficult, but the nanoparticle's physicochemical properties can accomplish targeted therapeutic delivery. Based on their surface, size, density, and physical-chemical properties, nanoparticles have demonstrated enhanced pharmacokinetics of actives, achieving the spotlight in the drug delivery research field. In this review, the authors have highlighted different nanoparticle-based therapeutic delivery approaches to treat chronic pulmonary diseases along with the preparation techniques. The authors have remarked the nanosuspension delivery via nebulization and dry powder carrier is further effective in the lung delivery system since the particles released from these systems are innumerable to composite nanoparticles. The authors have also outlined the inhaled particle's toxicity, patented nanoparticle-based pulmonary formulations, and commercial pulmonary drug delivery devices (PDD) in other sections. Recently advanced formulations employing nanoparticles as therapeutic carriers for the efficient treatment of chronic pulmonary diseases are also canvassed.

Objective The aim of this study was to investigate the normal tissue complication probability (NTCP) for parotid gland of ca tongue patients from two different radiobiological models and to establish a dosimetric validity. Methods Lyman–Kutcher–Burman (LKB) model and linear quadratic (LQ) model were considered for determination of NTCP and tolerance dose (TD5/5 and TD50/5) for the parotid gland of 67 number of ca tongue patients who were treated with the volumetric arc therapy (VMAT) technique. An in‐house developed software on Excel (VBA) was used for this study. Results The equivalent uniform dose (EUD) was linearly proportional to the effective volume (veff) for parotid glands and there was a strong correlation between EUD and veff. At EUD = 46 to 47 Gy, the NTCP of parotid was 0.5 for both the models. The tolerance doses, TD5/5 (veff) and TD50/5 (veff) were exponentially reduced with increase of veff for LKB model; whereas these parameters were volume‐independent in the LQ model. TD5/5 (veff) and TD50/5 (veff) were 31.98 Gy and 45.98 Gy respectively for all 67 patients in the LQ model. Below TD50/5, NTCP of LKB model was less than the NTCP , calculated from LQ model. Conclusion One may consider radiobiological LQ model for estimation of clinical tolerance dose for OARs. Due to lack of clinical data, there are inaccuracy in determination of NTCP from LQ model. If sufficient number of tolerance data for partial volumes are available, the prediction of NTCP would be more confident.

Early diagnosis and complete treatment is one of the important aspects of malaria elimination programme worldwide. In many areas the diagnosis is based on detection of malarial antigen using commercially available rapid diagnostic kits. The problem remains with persistence of antigen following parasite clearance by proper treatment. The present work was undertaken to study the pattern of persistent antigen of P. vivax and P. falciparum following antimalarial treatment. Atotal of 300 microscopically positive mono-infected with P. vivax (160) and P. vivax (140) patients were recruited, treated with antimalarial drugs and followed up on day 3, 7, 14, 21 and 28 for persistent parasites and antigen. P. vivax specic pLDH antigen was disappeared from peripheral blood within 14 days post treatment period. P. falciparum specic HRP-2 antigen was persisted even after 28 days of treatment. Depending only on antigen based diagnosis, attention should be paid before treatment, particularly in areas with high malaria transmission

Background: COVID-19 is the current pandemic infection caused by severe acute respiratory syndrome coronavirus-2 (SARS Cov-2). Pulmonary collapse in severe critical COVID-19 patients may be due to development of multiple micro thrombi within pulmonary vasculature. As COVID-19 pandemic is accelerating, it is important to understand the molecular mechanism through which SARSCov2 induces hypercoagulopathy and intravascular thrombosis to be able to design more appropriate therapy. Focus of this review is to identify mechanisms through re-analysis of publicly available data by which SARS-Cov2 infection induce mortality by augmenting intravascular thrombosis and attempt to understand therapeutic approach to it. Findings: SARS Cov-2 accesses host cells via membrane bound angiotensin converting enzyme-2 (ACE2). This leads to imbalance of renin angiotensin system (RAS) increase ratio of Ag-II: Ag-1-7. Ag-II stimulates release of IP-10 from endothelium which upregulates local renin angiotensin system in endothelial cell by positive feedback process. Therefore it is suggested that angiotensin-II of renin angiotensin systemr in endothelial cells sustained proinflammatory signal and developed microvascular thrombosis. During inflammation both extrinsic and intrinsic coagulation pathways are activated. Fibrinolysis is suppressed by imbalance activity of two system: Ang-II-PAI-1 (plasminigen activator inhibitor-1) and Bradykinin-tPA (tissue plasminogen activator) system. Therapy with low molecular weight heparin (LMWH), which have anticoagulant and anti-inflammatory property, is associated with better prognostic in patients with severe COVID-19. ACE inhibitors decrease production of Ag-II and increases availability of bradykinin and consequence reduces coagulopathy Conclusion: Thus it is concluded that SARS-Cov2 infection induces microvascular thrombosis from hyperinflammation, misbalance between Ag-II and Ag-1-7 and imbalance activity of two system: Ang-II-PAI-1 and bradykinin-tPA system. ACE inhibitor and anticoagulant mainly LMWH and UFH may serve potential role in COVID-19 therapy particularly in patients with hypercoagulopathy and microvascular thrombosis. Keywords: COVID19; angiotensin converting enzyme; renin angiotensin system; fibrinolysis; microvascular thrombosis; ACE inhibitor; heparin

Risky gait activities lead to severe wear in orthopaedic implants during postoperative periods. The aim of the present study is to predict the linear and volumetric wear of zirconia (ZrO2) vs alumina (Al2O3) hip implants subject to risky and normal gait activities. Initially, the gait loads pertaining to risky gait activities were converted to equivalent normal loads. Then using the computed normal loads, friction and wear coefficients of ZrO2 ball against Al2O3 disc were calculated from Pin-on-Disc (POD) tribometer under dry and lubricating conditions. Saline solution, a bio-lubricant was utilized for lubrication purpose to mimic synovial fluid properties. Nineteen gait activities stair ascending or descending, carrying load, lifting load and ladder up or down etc., grouped as A, B, C and D were used to determine friction and wear coefficients. Finite Element Method (FEM) was employed to predict the wear of the bearing couple. The developed contact pressure for these gait activities was then utilized to compute linear and volumetric wear for 2 million cycles. Our findings suggests that, patients regularly involved in group C and D type gait activities were likely to cause more wear which may accelerate early implant failure. Refereed/Peer-reviewed

Finite element (FE) simulation plays a major role in computing stress and predicting the failure of biomedical components. Normally in past, researchers focused on developing a global computational model from the scanned data of patients to analyze the stresses and deformations.To compute the wear of the hip prosthesis, mostly the global model (GM) is used to predict the expected life for million cycles using nodal updating technique which leads to high computational effort and time. The proposed work utilizes a submodeling finite element technique to analyze the contact pressure and wear of biomaterials for three different combinations in hip prosthesis including metal, ceramic and polycrystalline diamond materials. Initially the global model boundary and loading conditions are transferred to the submodel. The mesh is refined further using finer mesh and then the results are computed which consumes lesser time. The contact stress as well as the linear wear of biomaterials is found to be quite high for the local model (LM) when compared with the global model. However, no changes in volumetric wear of these biomaterials are observed when compared with previous experimental results. The computational time as well as accuracy in estimating the contact stress and the wear of bearings is improved effectively. Among local model with different element sizes, 0.75mm element size of local model showed improved results in estimating the contact stress and linear wear of bearing. Refereed/Peer-reviewed

Breast cancer is the most common type of malignancy among ladies (around 30% of newly diagnosed patients every year). To date, various modern treatment modalities for breast cancer, such as radiotherapy, surgical method, hormonal therapy, and chemotherapeutic drug utilisation, are available. However, adverse drug reactions, therapeutic resistance, metastasis, or cancer reoccurrence chances remain the primary causes of mortality for breast cancer patients. To overcome all the potential drawbacks, we need to investigate novel techniques and strategies that are not considered previously to treat breast cancer effectively with safety and efficacy. For centuries, we utilise phytochemicals to treat various diseases because of their safety, low-cost, and least or no side effects. Recently, naturally produced phytochemicals gain immense attention as potential breast cancer therapeutics because of their ideal characteristics; for instance, they operate via modulating molecular pathways associated with cancer growth and progression. The primary mechanism involves inhibition of cell proliferation, angiogenesis, migration, invasion, increasing anti-oxidant status, initiation of the arrest of the cell cycle, and apoptosis. Remedial viability gets effectively enhanced when phytochemicals work as adjuvants with chemotherapeutic drugs. This comprehensive review revolves around the latest chemopreventive, chemotherapeutic, and chemoprotective treatments with their molecular mechanisms to treat breast cancer by utilising phytochemicals such as vinca alkaloids, resveratrol, curcumin, paclitaxel, silibinin, quercetin, genistein, and epigallocatechin gallate. The authors wish to extend the field of phytochemical study for its scientific validity and its druggability.

Objectives: According to the recent studies, it is seen that coronavirus disease 2019 (COVID-19) infection is associated with many bacterial and fungal infections. In case of COVID-19 patients, diabetes mellitus (DM) and hypertension (HTN) are the prime risk factors and during the course of treatment, patients develop secondary fungal infections like mucormycosis. We conducted a systemic review of the present scenario and tried to evaluate the association of mucormycosis with COVID-19. Methods: We searched articles related to the COVID-19 associated mucormycosis, in PubMed, IndMed, and Cochrane Library. We conducted a meta-analysis on the basis of systemically reviewed all articles which reported COVID-19 associated with mucormycosis. We analyzed comorbidity, treatment, and outcome of patients in association with COVID-19 and mucormycosis. Results: We found a total of 196 articles based on mucormycosis, out of which only 25 were selected on the basis of our inclusion and exclusion criteria. 71 cases were found and most of the cases were from India and USA. We also found that it was more prevalent among male patients and patients with DM, and in association with HTN. Conclusion: It is seen from the studies that patients already suffering from DM and HTN when infected with coronavirus are most likely to develop mucormycosis. Treatment of latent DM, prediabetic patients, conversely, that efforts to diagnose, detect, and treat DM may have a beneficial influence in the treatment of secondary fungal infections like mucormycosis. Finding out all the cases of DM and treatment of DM can carry out an advantageous effect in all patients suffering from COVID-19.

Subhasish Pramanik,1 Lakshmi Kanta Mondal,2 Suman Kalyan Paine,3 Sneha Jain,2 Subhankar Chowdhury,1 Upasana Ganguly,4 Sayantan Ghosh,2 Chiranjit Bose,1 Koena Bhattacharjee,2 Gautam Bhaduri5 1Institute of Post Graduate Medical Education and Research (IPGMER), Kolkata, 700020, India; 2Regional Institute of Ophthalmology (RIO), Medical College and Hospital, Kolkata, 700073, India; 3National Institute of Biomedical Genomics (NIBMG), Kalyani, West Bengal, India; 4Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India; 5MGM Medical College, Kishanganj, Bihar, IndiaCorrespondence: Lakshmi Kanta MondalRegional Institute of Ophthalmology, Medical College, Kolkata, IndiaTel +91 9830830216Email Lakshmi.mondal62@gmail.comPurpose: In the present study, we aimed to evaluate the efficacy, safety, and cost-effectiveness of the anti-vascular endothelial growth factor (anti-VEGF), namely ranibizumab (RBZ) or bevacizumab (BVZ), after either focal or grid or scatter laser photocoagulation, for the treatment of diabetic macular edema (DME) in the Indian population.Methods: Retrospective data were collected in the Regional Institute of Ophthalmology, Kolkata, India between January 2018 and June 2019. Seventy-seven eyes received 3 consecutive monthly intravitreal injections of RBZ (0.5 mg) and were followed by prompt laser photocoagulation (within 7– 10 days after the third injection). Similarly, 51 eyes received 3 consecutive monthly intravitreal injections of BVZ (1.25 mg), an off-label drug, and were followed by prompt laser therapy. Safety assessments of the therapy, as well as surrogate markers of biochemical derangements related to diabetic retinopathy (DR), were also investigated at the end of 12 months.Results: Seventy-seven subjects who were given a treatment of RBZ+laser therapy showed average 6.87± 5.53 letters gain in their best-corrected visual acuity (BCVA) score, whereas the ones treated with off-label BVZ+ laser therapy demonstrated improvement in BCVA of an average 6.82± 5.76 letters in “Early Treatment Diabetic Retinopathy Study” (ETDRS) chart. The study also highlights the cost-effectiveness of both RBZ+laser and BVZ+laser therapies for the treatment of DME in DR. The results demonstrated that a subject has to pay 20.951 times more cost (in INR) for RBZ+laser therapy compared to BVZ+laser therapy, to get an almost similar outcome.Conclusion: BVZ is found to be the more attractive option for treating DME in DR for its cost-friendliness over RBZ in terms of BCVA outcome, as well as the safety perspectives, at least for the economically backward population in developing countries, like India.Keywords: diabetic retinopathy, diabetic macular edema, ranibizumab, bevacizumab, laser therapy, cost-effectiveness

Purpose Assessment of children's behavior in the dental setting and its correlation with thumb print and lip print. Materials and methods The behavior pattern, lip print pattern, and thumb print pattern of 518 children aged 5–12 years were recorded in their first dental visit. The behavior pattern, lip print pattern, and thumb print pattern were determined using Frankl's Behavior Rating Scale, Tsuchihashi's classification, and Cummin's classification, respectively. The data were tabulated according to the classified criteria and statistically analyzed. Results It was observed that positive and definitely positive Frankl Behavior was associated with the children bearing an arch pattern of thumb print, whereas their lip pattern had no association with their behavior pattern, particularly in dental sittings. Conclusion Thumb print pattern can aid as a behavior marker before a child's first dental appointment and this can prove beneficial for both the child and the clinician in providing a high quality of dental care and modify behavior for future dental appointments. How to cite this article Navit S, Pramanik S, Khan SA, et al. Cheiloscopy and Dactyloscopy as Behavior Assessment Tool in Dental Settings: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(2):238–242.