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Frailty is an age-associated state of increased vulnerability due to declines in physiologic systems, leading to compromised ability to withstand stressors. Given India’s rapidly aging population, our study aims to estimate the pooled prevalence of frailty and its associated factors in hospital settings. An extensive search was conducted across four databases, up to January 2024. A random-effects model was utilized. To quantify heterogeneity, the I² statistic, prediction interval, and the Chi-square-based Q test were employed. Outliers were identified using a Baujat plot and influence analysis. Doi plot, luis furuya kanamori (LFK) index and funnel plot were used to assess publication bias. The current meta-analysis determined a pooled frailty prevalence of 42.3% (95%CI: 34.8%−50.1%) and prefrailty prevalence of 39.8% (95%CI: 30.4%−49.8%), both exhibiting high heterogeneity (I² values of 96.9% and 95.3%, respectively). A high degree of variability was indicated by a prediction interval ranging from 9% to 76%, while Egger’s test suggested no evidence of publication bias. Our systematic review and meta-analysis, encompassing 6,856 individuals, revealed a considerable prevalence of frailty at 42.3%, underscoring its ubiquity across health spectra and demographics in India.

Background and Aim: Management of pain and anxiety associated with dental procedures in pediatric age group is a big challenge. In this part of the world, counselling has been the main modality for managing such patients. It is associated with mixed outcome. We share our experience of managing 23 patients using a combination of inhalational nitrous oxide- oxygen and intravenous midazolam with satisfactory outcomes. Material and Methods: Patients aged more than six years, American society of anaesthesiologists classification (ASA) I or II, procedure that could be finished within one hour like pulpectomies, root canal treatments, extraction and multiple restorations were accepted for conscious sedation. Complete blood count was done and pre-anaesthetic checkup (PAC) with written informed consent from the parent was taken for the dental procedure under conscious sedation. We placed the nasal mask of the Conscious sedation anesthesia machine and made the child inhale Oxygen/Nitrous oxide mixture. After inhaling variable concentration of nitrous oxide/ oxygen mixture in proportion increasing from 30:70 to 70:30, procedure was done. After completion of the procedure, the patient was administered hundred percent oxygen for five minutes. Results: We have done a total of twenty-three cases till now with ages between five to seventeen years. The duration of procedures ranged from 30 min to one and half hour. Two patients less than six years were found to be uncooperative for the procedure. Conclusion: Minimum age group that was suitable for conscious sedation was six years and above. Frequent meetings and counselling by the same team should be facilitated prior to taking up for the procedure.

Abstract The present study aimed to identify nutrients (UPLC-PDA-ESI-MS/MS, HPLC-RI method) and biological activities (antioxidant activity to reduce Fe3+ and ABTS·+, pancreatic lipase inhibitory effect, α-amylase, and α-glucosidase, anti-bacterial) of 14 highbush blueberries (Vaccinium corymbosum L.) cultivars (Northern type) as well as a principal component analysis (PCA) to assess the variation of these properties in the context of biodiversity. Most of the cultivars in this research have been first presented in this paper. Phytochemical profiling of the tested highbush blueberry fruit revealed 75 bioactive compounds, including 5 macroelements, 7 microelements, 7 monophosphate nucleotides, 15 anthocyanins, 1 phenolic acid, 14 flavonols, 11 essential amino acids, 8 non-essential amino acids, 2 sugars, 7 organic acids. The PCA showed that the profile and contents of the analyzed compounds as well as their anti-bacterial, antioxidant, anti-diabetic, and anti-obesity potentials depended significantly on the tested cultivars. Thus, the study provides comprehensive data on cultivar-specific biodiversity and correlations that can be used to design novel extracts rich in polyphenolic, amino acids, and/or minerals extracts from the selected cultivars of highbush blueberry as natural and alternative sources to fulfill the growing industry demand for supplements, pharmaceuticals, and nutraceutical products.

Dengue virus infection can cause a wide spectrum of clinical manifestations, ranging from mild fever to lethal dengue shock syndrome. Neurological manifestations include encephalitis, acute disseminated encephalomyelitis, Transverse myelitis, Guillain-Barre syndrome, and neuro-ophthalmic complications. We report a case of a 44-year-old male who was admitted to our hospital with high-grade fever, myalgia, retro-orbital pain, visual disturbances, and drowsiness. Hematological and serological parameters confirmed the diagnosis of dengue fever. Brain imaging demonstrated altered signal intensity in the splenium of the corpus callosum and eventually a diagnosis of a cytotoxic lesion of the corpus callosum (CLOCC) was made. The patient was managed conservatively and discharged 7 days after admission and imaging findings were resolved completely 3 weeks later.

Abstract The level of phosphorus must be carefully monitored for proper and effective utilization of coal and coal ash. The phosphorus content needs to be assessed to optimize combustion efficiency and maintenance costs of power plants, ensure quality, and minimize the environmental impact of coal and coal ash. The detection of low levels of phosphorus in coal and coal ash is a significant challenge due to its complex chemical composition and low concentration levels. Effective monitoring requires accurate and sensitive equipment for the detection of phosphorus in coal and coal ash. X-ray fluorescence (XRF) is a commonly used analytical technique for the determination of phosphorus content in coal and coal ash samples but proves challenging due to their comparatively weak fluorescence intensity. Fourier Transform Infrared spectroscopy (FTIR) emerges as a promising alternative that is simple, rapid, and cost-effective. However, research in this area has been limited. Until now, only a limited number of research studies have outlined the estimation of major elements in coal, predominantly relying on FTIR spectroscopy. In this article, we explore the potential of FTIR spectroscopy combined with machine learning models (piecewise linear regression—PLR, partial least square regression—PLSR, random forest—RF, and support vector regression—SVR) for quantifying the phosphorus content in coal and coal ash. For model development, the methodology employs the mid-infrared absorption peak intensity levels of phosphorus-specific functional groups and anionic groups of phosphate minerals at various working concentration ranges of coal and coal ash. This paper proposes a multi-model estimation (using PLR, PLSR, and RF) approach based on FTIR spectral data to detect and rapidly estimate low levels of phosphorus in coal and its ash (R $$^2$$ 2 of 0.836, RMSE of 0.735 ppm, RMSE (%) of 34.801, MBE of − 0.077 ppm, MBE (%) of 5.499, and MAE of 0.528 ppm in coal samples and R $$^2$$ 2 of 0.803, RMSE of 0.676 ppm, RMSE (%) of 38.050, MBE of − 0.118 ppm, MBE (%) of 4.501, and MAE of 0.474 ppm in coal ash samples). Our findings suggest that FTIR combined with the multi-model approach combining PLR, PLSR, and RF regression models is a reliable tool for rapid and near-real-time measurement of phosphorus in coal and coal ash and can be suitably modified to model phosphorus content in other natural samples such as soil, shale, etc.

Abstract Next-generation sequencing (NGS) is emerging as a powerful tool for molecular diagnostics but remains limited by cumbersome and inefficient sample preparation. We present an innovative automated NGS library preparation system with a simplified mechanical design that exploits both macro- and microfluidic properties for optimizing heat transfer, reaction kinetics, mass transfer, fluid mechanics, adsorption–desorption rates, and molecular thermodynamics. Our approach introduces a unique two-cannula cylindrical capillary system connected to a programmable syringe pump and a Peltier heating element able to execute all steps with high efficiency. Automatic reagent movement, mixing, and magnetic bead-based washing with capillary-based thermal cycling (capillary-PCR) are completely integrated into a single platform. The manual 3-h library preparation process is reduced to less than 15 min of hands-on time via optimally pre-plated reagent plates, followed by less than 6 h of instrument run time during which no user interaction is required. We applied this method to two library preparation assays with different DNA fragmentation requirements (mechanical vs. enzymatic fragmentation), sufficiently limiting consumable use to one cartridge and one 384 well-plate per run. Our platform successfully prepared eight libraries in parallel, generating sequencing data for both human and Escherichia coli DNA libraries with negligible coverage bias compared to positive controls. All sequencing data from our libraries attained Phred (Q) scores > 30, mapping to reference genomes at 99% confidence. The method achieved final library concentrations and size distributions comparable with the conventional manual approach, demonstrating compatibility with downstream sequencing and subsequent data analysis. Our engineering design offers repeatability and consistency in the quality of sequence-able libraries, asserting the importance of mechanical design considerations that employ and optimize fundamental fluid mechanics and heat transfer properties. Furthermore in this work, we provide unique insights into the mechanisms of sample loss within NGS library preparation assays compared with automated adaptations and pinpoint areas in which the principles of thermodynamics, fluid mechanics, and heat transfer can improve future mechanical design iterations.

Background: Prostate cancer (PCa) is the second most common malignancy in men and the sixth leading cause of death. Clinical course of PCa is highly variable and current clinico pathological parameters are unable to predict accurately the course of the disease because of genetic heterogeneity seen in this tumor. Aims and Objectives: The aim of the study was to study the prevalence of E26 transformation-specific-related gene (ERG) expression in benign and malignant lesions of prostate in Northern Indian patients. Whether ERG expression using immunohistochemical (IHC) methods can also be used for differentiating various lesions of the prostate gland is also evaluated. Materials and Methods: This is an observational study conducted on 50 biopsy specimens encompassing different lesions of prostate. The study was carried out in the Department of Pathology at Integral Institute of Medical Sciences and Research, Lucknow, India, during the period January 2020–September 2022. Results: Amongst 50 cases of prostatic lesions included in the study, there were 20 cases of benign prostatic hyperplasia (BPH), 17 cases of benign mimicker lesions and 13 cases of PCa. ERG expression was absent in all cases of BPH and benign mimicker lesions. ERG expression was seen in 38.5% of cases of PCa. Conclusion: In our study, none of the patients of BPH or benign mimicker lesion expressed ERG on IHC, while 38.5% of patients of PCa showed positive staining. This figure differs from reports from other parts of the world. ERG expressions can be a potential therapeutic target for personalized treatment in a subset of patients of PCa. However, it was not found to be a sensitive marker for the diagnosis of PCa.

Abstract Activation-induced cytidine deaminase (AID) is the key mediator of antibody diversification in activated B-cells by the process of somatic hypermutation (SHM) and class switch recombination (CSR). Targeting AID to the Ig genes requires transcription (initiation and elongation), enhancers, and its interaction with numerous factors. Furthermore, the HIRA chaperon complex, a regulator of chromatin architecture, is indispensable for SHM. The HIRA chaperon complex consists of UBN1, ASF1a, HIRA, and CABIN1 that deposit H3.3 onto the DNA, the SHM hallmark. We explored whether UBN1 interacts with AID using computational and in-vitro experiments. Interestingly, our in-silico studies, such as molecular docking and molecular dynamics simulation results, predict that AID interacts with UBN1. Subsequently, co-immunoprecipitation and pull-down experiments established interactions between UBN1 and AID inside B-cells. Additionally, a double immunofluorescence assay confirmed that AID and UBN1 were co-localized in the human and chicken B-cell lines. Moreover, proximity ligation assay studies validated that AID interacts with UBN1. Ours is the first report on the interaction of genome mutator enzyme AID with UBN1. Nevertheless, the fate of interaction between UBN1 and AID is yet to be explored in the context of SHM or CSR.

Abstract Recent advances in peptide delivery and nanotechnology has resulted in emergence of several non-parenteral administration routes that replace subcutaneous injections associated with patient discomfort. Thiolated biopolymers are relatively new materials being explored to enhance mucoadhesivity and permeability in these efforts, yet their pH dependent reactivity remains an obstacle. This work focussed on improving the mucoadhesivity of thiolated chitosans by activating them with mercaptonicotinic acid, in a bid to create a novel thiomerized chitosan that can open cell tight junctions for application in oral delivery. The synthesized mercaptonicotinic acid activated thiolated chistoan (MNA-TG-chitosan), along with thiolated chitosan (TG-chitosan) and unmodified chitosan were then used to create insulin nanoparticles (insNPs) using spray drying encapsulation process. Use of MNA-TG-chitosan in place of chitosan resulted in reduction of particle size of insNPs from 318 to 277 nm with no significant changes in polydispersity index (~ 0.2), encapsulation efficiency (~ 99%), insulin loading content (~ 25%) and morphology. Results from in-vitro cytotoxicity on TR146, CaCo2 and HepG2 cell lines revealed no significant effects on cell viability at 50–1000 μg/mL concentration. insNPs encapsulated with the new material, MNA-TG-chitosan, resulted in a 1.5-fold and 4.4-fold higher cellular uptake by HepG2 liver cells where insulin is metabolized, approximately 40% and 600% greater insulin transport through TR146 buccal cell monolayers, and 40% and 150% greater apparent permeability than insNPs encapsulated with unmodified chitosan and TG-chitosan respectively. The higher permeation achieved on using MNA-TG chitosan was attributed to the greater opening of the cell tight junction evidenced by reduction of transepithelial electrical resistance of TR146 buccal cell monolayers. This study demonstrates MNA-TG-chitosan as a promising material for improved peptide oral delivery.

Abstract Changes in the full-field flash and flicker electroretinogram (ERG) that accompany normal aging were evaluated in mice. ERGs were recorded from a single cohort of C57BL/6J mice from 5 to 70 weeks of age using conventional techniques. Dark-adapted ERGs were recorded for flash luminances of − 3.0 to 1.5 log cd-s-m−2; a- and b-wave amplitude and implicit time (IT) were calculated from these responses. In addition, light-adapted flicker ERGs elicited by sinusoidally modulated light were measured for temporal frequencies of 2 to 31 Hz. Amplitudes and phases were extracted from the flicker responses using Fourier analysis. Linear quantile mixed models were used for statistical comparisons of the effects of age on amplitude and timing. There was a significant decrease in a-wave amplitude (p 0.06). These results indicate that age scales the single flash and flicker ERG similarly, reducing response amplitude by a factor of approximately 2, from 5 to 70 weeks, with small or no effect on response timing. These data may be useful for guiding future longitudinal pre-clinical therapeutic studies.

Abstract Bilateral thalamic infarction resulting from the occlusion of the artery of Percheron (AOP) is a rare cerebrovascular event with distinctive clinical presentations. This case report explores the intricate relationship between vascular anatomy, midbrain function, and clinical manifestations. A 48‐year‐old male farmer with a history of diabetes mellitus presented with sudden‐onset visual disturbances, diplopia, bilateral eyelid drooping, and loss of consciousness. Extensive evaluations, including advanced imaging techniques, led to the diagnosis of bilateral upper midbrain infarction involving AOP. This case underscores the complexity of neurovascular interactions, highlighting the importance of precise diagnosis, and tailored management in addressing rare cerebrovascular conditions.

Abstract Depression is a growing global crisis, with females at a higher rate of diagnosis than males. While the percentage of patients on prescribed antidepressants have tripled over the last two decades, we are still at a crossroad where the discrepancy lies between finding a drug to suit a patient and monitoring the abundance of it in the body to prevent unwanted side effects. Liquid Chromatography tandem mass spectrometry (LC–MS/MS) has garnered the attention of clinicians as a technique to accurately monitor therapeutic drugs in human serum with high specificity and accuracy. This may be a potential solution, but the challenge persists in the realm of sample preparation, where a method is automatable. We have developed and validated an LC–MS/MS-based assay for simultaneous quantification of 4 different classes of commonly prescribed antidepressants in women that is automated using a JANUS G3 Robotic Liquid Handler. Our method utilizes a simple sample preparation technique, utilizing only 20 μL of a serum sample, to accurately measure Bupropion, Citalopram, Desipramine, Imipramine, Olanzapine, Sertraline and Vilazodone across a range of 1.0 to 230 ng/mL. Our method exhibits a linearity of R2 ≥ 0.99 when detected in MRM mode and % CV of ≤ 20% for all analytes across the board. In addition, we have designed a prototype that can be utilized at a clinical mass spectrometry lab and assessed the long-term use of this prototype using an accelerated stability study. Overall, our developed method has the potential to be translated to clinical settings to monitor postpartum depression for a large number of patient samples using automation.

Chronic kidney disease (CKD) is a complex disease that is asymptomatic in its early stages. Its delayed recognition may predispose patients to adverse outcomes. Early detection and management of kidney disease through screening programs is widely recommended. In the present study, we conducted a screening program at a hospital set up on World Kidney Day for 10 years to detect patients with CKD. The current study constituted 1324 apparently healthy adults, aged >18 years. Information on age, sex, height, weight, history of diabetes mellitus (DM) and hypertension (HTN), and familial history of kidney disease was recorded. Systolic and diastolic blood pressure, random blood sugar; urinalysis, and serum creatinine (Cr) levels were measured. The study outcome was the presence of CKD. Binary logistic regression analysis was applied to find the predictors of CKD. The median age of the study subjects was 40 years. CKD was found in 35.6% of subjects. Age, DM, HTN, and abnormal Cr levels were associated with increasing risk of CKD. The main objective of the present study was to identify the extent of risk relative to the co-factors of CKD and thereby target those who are potentially modifiable, like DM, to intervene at the earliest possible stage to treat the current disease condition and prevent the future health impairment.

Background: Acute upper gastrointestinal bleeding is one of the common and life threatening condition presenting in emergency. The aim of the present study was to determine the clinical profile and in-hospital outcomes in these patients admitted at a tertiary care center in Kathmandu, Nepal. Materials and Methods: This is a descriptive, observational study conducted over 9 months (October 2021– July 2022). All consecutive patients aged 16 years and above admitted in the hospital ward with the history of acute bleeding were included in the study after informed consent. Demographic data, clinical, laboratory and endoscopic data were noted during the hospital stay. Statistical analysis was done used SPSS v.24. Results: The mean age of our study population (N = 132) was 46.92 years. Among 132 patients who underwent endoscopy, 43.9% had portal hypertension related bleeding, 41.7% had ulcer related bleeding, 5.3% had malignancies, 3% had corrosive intake. No etiology was found in 3 patients. Hematemesis with melena was the most common mode (53.8%) of presentation to the hospital.Shock was preset in 25% of patients at presentation to the hospital. In-hospital re-bleeding rate and mortality were 12.7% and 9.8% respectively. Conclusion: Portal hypertension related bleeding followed by ulcers related bleeding is the common cause of acute upper gastrointestinal bleeding. In-hospital mortality was 9.8%.

Introduction: Leptin is secreted in concentrations proportional to body fat mass. The anthropometric parameter among Sagittal Abdominal Diameter (SAD), Body Mass Index (BMI), Hip Circumference (HC), Waist Circumference (WC), Waist-Hip Ratio (WHR), and Waist-Height Ratio (WHtR) that correlates maximally with serum leptin levels could be used preferably to assess adiposity. Aim: The present study aims to correlate serum leptin levels with SAD, BMI, HC, WC, WHR and WHtR in young and healthy North Indian adults. Materials and Methods: The present cross-sectional study was conducted jointly in the Department of Physiology and Biochemistry at the King George’s Medical University, Lucknow, Uttar Pradesh, India from September 2015 to August 2016 and it included apparently healthy individuals, aged 18-25 years, native to North India, after obtaining an informed consent. A convenient sample size of 100 was taken. One investigator took all anthropometric measurements. (SAD, BMI, HC, WC, WHR and WHtR) RayBio human leptin ELISA kit was used for the estimation of leptin level. For statistical analysis, Pearson’s correlation coefficient was used. P

Abstract Single-Cell Analysis is a growing field that endeavors to obtain genetic profiles of individual cells. Disruption of cell–cell junctions and digestion of extracellular matrix in tissues requires tissue-specific mechanical and chemical dissociation protocols. Here, a new approach for dissociating tissues into constituent cells is described. Placing a tissue biopsy core within a liquid-filled cavity and applying an electric field between two parallel plate electrodes facilitates rapid dissociation of complex tissues into single cells. Different solution compositions, electric field strengths, and oscillation frequencies are investigated experimentally and with COMSOL Multiphysics. The method is compared with standard chemical and mechanical approaches for tissue dissociation. Treatment of tissue samples at 100 V/cm 1 kHz facilitated dissociation of 95 ± 4% of biopsy tissue sections in as little as 5 min, threefold faster than conventional chemical–mechanical techniques. The approach affords good dissociation of tissues into single cells while preserving cell viability, morphology, and cell cycle progression, suggesting utility for sample preparation of tissue specimens for direct Single-Cell Analysis.

Abstract Insulin nanoparticles (NPs) with high loading content have found diverse applications in different dosage forms. This work aimed to evaluate the impact of freeze-drying and spray drying process on the structures of insulin-loaded chitosan nanoparticles, with or without mannitol as cryoprotectants. We also assessed the quality of these nanoparticles by redissolving them. Before dehydration, the chitosan/sodium tripolyphosphate/insulin crosslinked nanoparticles were optimized to 318 nm of particle size, 0.18 of PDI, 99.4% of entrapment efficiency, and 25.01% of loading content. After reconstitution, all nanoparticles, except the one produced by the freeze-drying method without using mannitol, maintained their spherical particle structure. The nanoparticles dehydrated by spray drying without mannitol also showed the smallest mean particle size (376 nm) and highest loading content (25.02%) with similar entrapment efficiency (98.7%) and PDI (0.20) compared to mannitol-containing nanoparticles dehydrated by either spray drying or freeze-drying techniques. The nanoparticles dried by spray drying without mannitol also resulted in the fastest release and highest cellular uptake efficacy of insulin. This work shows that spray drying can dehydrate insulin nanoparticles without the need for cryoprotectants, creating a significant advantage in terms of greater loading capacity with lower additive requirements and operating costs as compared to conventional freeze drying approaches.

Introduction: Thalassaemia is one of the most common genetic disorders. Iron overload due to repeated blood transfusions and chelating therapy leads to oxidative stress and possible irreversible brain tissue damage, causing cognitive impairment in these children. Aim: To study cognitive impairment in children with beta thalassaemia major in a tertiary care centre in Bikaner, Rajasthan, India. Materials and Methods: This was a hospital-based cross-sectional observational study conducted in the Department of Paediatrics, Sardar Patel Medical College, Bikaner, Rajasthan, India from September 2019 to August 2020. Sixty-five children with thalassaemia and 65 children without thalassaemia (as controls) were recruited and assessed using modified Mini-Mental State Examination (MMSE) for cognitive impairment. Results: Majority of children belonged to age group 6-11 years (67.7% in cases and 68.8% in controls). The mean MMSE scores were significantly lower among children with thalassaemia (26.82±6.45) compared to the controls (29.08±5.71). There was a significantly higher prevalence of cognitive dysfunction in thalassaemia children (72.3%) as compared to controls (33.8%). Children who were compliant with chelation medications (n=30) were found to have a lesser prevalence of cognitive dysfunction (60%) than those who were not compliant (n=35) with medications (82.86%) (p-value=0.013). Among cases, the mean ferritin levels were higher in children with cognitive dysfunction (3399.00±1489.18) compared to those with normal cognitive function (2412.38±1117.26) (p-value=0.046). There was moderate positive correlation between thalassaemia child’s Body Mass Index (BMI) and modified MMSE score. Conclusion: This study highlights the higher prevalence of cognitive impairment in children with thalassaemia (72.3%). The key contributing factors were- lack of compliance to chelation therapy, higher serum ferritin levels and low BMI.

Expansion microscopy (ExM), by physically enlarging specimens in an isotropic fashion, enables nanoimaging on standard light microscopes. Key to existing ExM protocols is the equipping of different kinds of molecules, with different kinds of anchoring moieties, so they can all be pulled apart from each other by polymer swelling. Here we present a multifunctional anchor, an acrylate epoxide, that enables proteins and RNAs to be equipped with anchors in a single experimental step. This reagent simplifies ExM protocols and reduces cost (by 2-10-fold for a typical multiplexed ExM experiment) compared to previous strategies for equipping RNAs with anchors. We show that this united ExM (uniExM) protocol can be used to preserve and visualize RNA transcripts, proteins in biologically relevant ultrastructures, and sets of RNA transcripts in patient-derived xenograft (PDX) cancer tissues and may support the visualization of other kinds of biomolecular species as well. uniExM may find many uses in the simple, multimodal nanoscale analysis of cells and tissues.

Curcumin is the major bioactive component in turmeric with potent antioxidant activity. Little is known about how pulsed light (PL) technology (an emerging non-thermal food processing technology relying on high intensity short duration flashes of light) can affect the chemical stability and antioxidant capacity of curcumin. This study found that PL treatment of fluence levels from 0 to 12.75 J/cm2 produced a fluence-dependent reduction in curcumin content. These results paralleled the production of a tentative curcumin dimer, identified as a potential photochemical transformation product. PL-treated curcumin at relatively higher fluence levels decreased chemical-based ORAC and ABTS antioxidant capacity, relative to control (P < 0.05). This contrasted the effect observed to increase coincidently both intracellular antioxidant capacity (e.g., DCFH-DA (P < 0.05)) and GSH/GSSG ratio (P < 0.05), respectively, in cultured differentiated Caco-2 cells. In conclusion, the application of PL on curcumin results in photochemical transformation reactions, such as dimerization, which in turn, can enhance biological antioxidant capacity in differentiated Caco-2 cells.

Abstract Helicobacter pylori is a Gram-negative bacterium that causes chronic inflammations in the stomach area and is involved in ulcers, which can develop into gastric malignancies. H. pylori attaches and colonizes to the human epithelium using some of their outer membrane proteins (OMPs). HomB and HomA are the most studied OMPs from H. pylori as they play a crucial role in adherence, hyper biofilm formation, antibiotic resistance and are also associated with severe gastric malignancies. The role of HomA and HomB in pathogenesis concerning their structure and function has not been evaluated yet. In the present study, we explored the structural aspect of HomA and HomB proteins using various computational, biophysical and small-angle X-ray scattering (SAXS) techniques. Interestingly, the in-silico analysis revealed that HomA/B consists of 8 discontinuous N and C terminal β-strands forming a small β-barrel, along with a large surface-exposed globular domain. Further, biophysical experiments suggested that HomA and HomB are dimeric and most likely the cysteine residues present on surface-exposed loops participate in protein–protein interactions. Our study provides essential structural information of unexplored proteins of the Hom family that can help in a better understanding of H. pylori pathogenesis.

Introduction: Mother-to-child transmission of HIV can occur during pregnancy, labour, or breastfeeding. The first-line regimen for prophylaxis in HIV infected pregnant women is combination of Tenofovir, Lamivudine and Efavirenz (TLE). Aim: To evaluate the safety and efficacy of the TLE regimen in the Prevention of Mother-To-Child Transmission (PMTCT) of HIV. Materials and Methods: The present hospital-based, retrospective cohort study was conducted at ART centre, Prevention of Parent to Child Transmission (PPTCT) centre, and Department of Medicine, SP Medical College, Bikaner from July 2016 to June 2019. HIV positive gravidas, on triple-drug regimen TLE (Tenofovir 300 mg, Lamivudine 300 mg, Efavirenz 600 mg) before conception and, those detected HIV reactive antenatally during study period were included in this study and started on TLE regimen. After delivery, these newborns were given syrup Nevirapine as per the PPTCT guidelines. Infants were tested with Rapid test and PCR for HIV, at six weeks, six months, 12 months, and 18 months of life. Results: Out of 87 pregnant women, enrolled and delivered at the study institute, 85 were live births and two were stillbirths. Out of 85 live-born babies, four have died during infancy and two were lost to follow-up despite repeated counselling. Five babies were referred to nearby Anti-Retroviral Therapy (ART) centers. So, the study followed 74 babies out of which one girl child was found to be positive for HIV-1 at 18 months of age (transmission rate of HIV was 1.35 and efficacy of TLE 98.65%). No major adverse effects of TLE were noted and all women continued TLE. Conclusion: The use of a triple-drug regimen (TLE) declined the risk of transmission of HIV from mother-to-child at negligible level, without drug resistance and with safety and tolerability as compared to single drug.

Abstract In this work, we demonstrate a method to quantify uncertainty in corrections to density functional theory (DFT) energies based on empirical results. Such corrections are commonly used to improve the accuracy of computational enthalpies of formation, phase stability predictions, and other energy-derived properties, for example. We incorporate this method into a new DFT energy correction scheme comprising a mixture of oxidation-state and composition-dependent corrections and show that many chemical systems contain unstable polymorphs that may actually be predicted stable when uncertainty is taken into account. We then illustrate how these uncertainties can be used to estimate the probability that a compound is stable on a compositional phase diagram, thus enabling better-informed assessments of compound stability.

Introduction Obesity has emerged as one of the major risk factors of severe morbidity and cause-specific mortality among severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infected individuals. Patients with obesity also have overlapping cardiovascular diseases and diabetes, which make them increasingly vulnerable. This novel ecological study examines the impact of obesity and/or body mass index (BMI) on rates of population-adjusted cases and deaths due to coronavirus disease 2019 (COVID-19). Material and methods Publicly available datasets were used to obtain relevant data on COVID-19, obesity and ecological variables. Group-wise comparisons and multivariate logistic regression analyses were performed. The receiver operating characteristic curve (ROC) was plotted to compute the area under the curve. Results We found that male BMI is an independent predictor of cause-specific (COVID-19) mortality, and not of the caseload per million population. Countries with obesity rates of 20–30% had a significantly higher (approximately double) number of deaths per million population to both those in 30% slabs. We postulate that there may be a U-shaped paradoxical relationship between obesity and COVID-19 with the cause-specific mortality burden more pronounced in the countries with 20–30% obesity rates. These findings are novel along with the methodological approach of doing ecological analyses on country-wide data from publicly available sources. Conclusions We anticipate, in light of our findings, that appropriate targeted public health approaches or campaigns could be developed to minimize the risk and cause-specific morbidity burden due to COVID-19 in countries with nationwide obesity rates of 20–30%.

Abstract This paper theorizes the existence of a constant optimum ultrasound process time for any size-reduction operation, independent of process parameters, and dependent on product parameters. We test the concept using the case of ‘ultrasonic preparation of oil-in-water nanoemulsions’ as model system. The system parameters during ultrasonication of a hempseed oil nanoemulsion was evaluated by a response surface methodology, comprising lecithin and poloxamer-188 as surfactants. Results revealed that the particle size and emulsion stability was affected significantly (p 0.05) affected by process parameter (‘ultrasonication process time’). Next, other process parameters (emulsion volume and ultrasonic amplitude) were tested using kinetic experiments. Magnitude of particle size reduction decreased with increasing ‘ultrasonication process time’ according to a first order relationship, until a minimum particle size was reached; beyond which ultrasonication no longer resulted in detectable decrease in particle size. It was found that the optimal ultrasonication process time (defined as time taken to achieve 99% of the ‘maximum possible size reduction’) was 10 min, and was roughly constant regardless of the process parameters (sample volume and ultrasonic amplitude). Finally, the existence of this constant optimal ultrasonication process time was proven for another emulsion system (olive oil and tween 80). Based on the results of these case studies, it could be theorized that a constant optimum ultrasonication process time exists for the ultrasonication-based size-reduction processes, dependent only on product parameters.

Abstract Emerging formulation technologies aimed to produce nanoemulsions with improved characteristics, such as stability are attractive endeavors; however, comparisons between competing technologies are lacking. In this study, two formulation techniques that employed ultrasound and microfluidic approaches, respectively, were examined for relative capacity to produce serviceable oil in water nanoemulsions, based on hempseed oil (HSO). The ultrasound method reached > 99.5% entrapment efficiency with nanoemulsions that had an average droplet size (Z-Ave)

To elucidate the molecular mechanisms that manifest lung abnormalities during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, we performed whole-transcriptome sequencing of lung autopsies from 31 patients with severe COVID-19 and ten uninfected controls. Using metatranscriptomics, we identified the existence of two distinct molecular signatures of lethal COVID-19. The dominant ‘classical’ signature (n=23) showed upregulation of the unfolded protein response, steroid biosynthesis and complement activation, supported by massive metabolic reprogramming leading to characteristic lung damage. The rarer signature (n=8) that potentially represents ‘cytokine release syndrome’ (CRS) showed upregulation of cytokines such as IL1 and CCL19, but absence of complement activation. We found that a majority of patients cleared SARS-CoV-2 infection, but they suffered from acute dysbiosis with characteristic enrichment of opportunistic pathogens such as Staphylococcus cohnii in ‘classical’ patients and Pasteurella multocida in CRS patients. Our results suggest two distinct models of lung pathology in severe COVID-19 patients, which can be identified through complement activation, presence of specific cytokines and characteristic microbiome. These findings can be used to design personalized therapy using in silico identified drug molecules or in mitigating specific secondary infections.

Introduction: In India, infectious Hepatitis is one of the major health care burdens, with viral hepatitis being the most common culprit, followed by dengue, typhoid, and malarial hepatitis. Fulminant hepatitis manifests as a sudden abnormality in liver function enzymes in a child with no prior hepatic pathology. Aims and Objects: This study was aimed at identifying the various etiological factors and correlating clinical features of viral hepatitis, and fulminant liver failure. Materials and Methods: This observational study was conducted in the paediatrics in-patient department of S.P. Medical College & P.B.M. Associated Group of Hospitals, Bikaner (Rajasthan) over a period of one year. A total of 125 children with a clinical and lab-confirmed diagnosis of acute infective hepatitis were included. Data including clinical signs, symptoms, and laboratory parameters were obtained and analyzed. Results: Most commonly affected age group was between 5-10 years with the mean age being 7.1±4.6 years. The most common etiology was hepatitis A (n=39), followed by hepatitis E (n=24) and mixed hepatitis A virus (HAV)/hepatitis E virus (HAE) infection (n=20). Other causative organisms were dengue virus (n=16), typhoid (n=13), malaria (n=9), and hepatitis B. The most common clinical symptoms were fever, jaundice, loss of appetite, and vomiting/nausea. There were some clinical features seen more commonly in case of infection with certain organisms. High frequency of diarrhoea, arthralgia, and thrombocytopenia was seen with HAV. Neurological, renal complications and high mortality were associated with HEV or HAV/HEV co-infection. While retroorbital pain and purpuric rash were exclusive with dengue, malarial hepatitis was strongly associated with pallor and altered sensorium. Conclusion: Acute infective hepatitis is most commonly caused by HAV and HEV in Western Rajasthan. It is imperative to educate the masses regarding the prevention of common infections transmissible by infected drinking water, poor hand hygiene, improper waste disposal, and open defecation.

Introduction: In this paper, we consider a fundamental problem of testing faced by the health staff on testing COVID 19 patients. In general, the number of testing kits or testing capabilities is limited, and the number of COVID 19 patients is much larger than that. This paper tries to answer this fundamental question that how to perform COVID 19 testing to reduce the death rate. Materials and Methods: We consider that the survival rate of patients is dependent over two parameters: their age and severity of symptoms at a time. Based on these observations, we propose a survival rate function. Using the survival rates, the death rate for an individual is obtained. MATLAB was used for plotting the graphs. Results: It is shown by numerical results that by using the proposed mechanism, the average death rate can be significantly reduced. Conclusion: It is proposed to conduct the testing for those patients who lie in the high death rate regimen.

Background: Tobacco dependence is a major public health problem that results in significant morbidity and mortality. Approximately, 5 million people are killed annually by tobacco use. Aim: To assess the oral health status among adult tobacco and non-tobacco users attending outreach activities in Ghaziabad District, Uttar Pradesh. Methods: A cross-sectional study was conducted on 800 subjects from all the 4 blocks of Ghaziabad district visiting the outreach activities. A pre-tested questionnaire was used to assess the demographic variables and oral hygiene practices. Oral health status was assessed using WHO (World Health Organization) 2013 Oral Health Assessment Form and the Smith and Knight Tooth wear index was used to assess the degree of tooth wear. Statistical analysis was done by the Statistical Package for Social Sciences (SPSS) version 20.0. Result: The mean age of the tobacco users in the study was 40.94 (13.83) years. The prevalence of dental caries and tooth wear was 88.0% and 89.2%, respectively. Majority of tobacco users consumed a smokeless form of tobacco 67.5%, followed by smoke 21.5% and followed by both form 11.0%. Conclusion: The present study concluded that adult population of Ghaziabad lack the knowledge and awareness regarding consumption of areca nut, gutka, and tobacco smoking. Hence, there is an urgent need to take effective steps, especially on launching community awareness programs for the adult population and public to educate them about the consequences of tobacco use, and on assessing their effectiveness in curbing the problem.

Laparoscopic adjustable gastric banding (LAGB) is a minimally invasive bariatric procedure. However troublesome complications can arise later with this procedure including band slippage and erosion. Intra-gastric erosion is a rare but major bothersome late complication after LAGB and requires band removal. A 35-year-old lady with BMI of 45.03 and hypertension as co-morbidity opted for LAGB. The patient started losing significant weight, however patient noticed sero-purulent discharge from epigastric port site after three months. Investigations were not suggestive of any leak, but persistent discharge led to wound exploration and infected band tubing was removed. The patient again noticed discharge from the port site after 20 months of primary surgery along with weight regain. Oral gastrograffin study was performed, which showed no evidence of contrast leak, however band seemed lower in position. Upper gastrointestinal (UGI) endoscopy showed a part of circumference of the band in the gastric cavity confirming intra-gastric migration and not retrieved due to adhesions with gastric wall. The band was removed by laparoscopic converted to open procedure due to dense adhesions. The patient recovered well. Migration of the band through the stomach wall is an uncommon late complication that may remain asymptomatic but must be thought in presence of weight regain or port-related complications. UGI endoscopy is diagnostic and therapeutic in most cases, rest of the cases require laparoscopy or laparotomy for band removal, depending upon surgeon or endoscopist expertise.

Abstract Isolated anterior dislocation of the radial head is rarely reported. To date, only five cases have been reported in the world literature. In all of these cases, the patients presented with restricted supination-pronation movements of the forearm with maintained elbow flexion-extension. We report an unusual case of isolated anterior radial head dislocation in an 18-year-old male, who presented with maintained supination-pronation movements of the forearm but restricted elbow flexion-extension. Closed reduction was attempted, but it failed. Hence, an open reduction was performed. However, the reduction was unstable due to rupture of the annular ligament. Hence, the repair of the annular ligament was performed, and a radio-ulnar Kirschner wire was passed to maintain the reduction of the proximal radio-ulnar joint, thus keeping the annular ligament stress-free, facilitating its healing. At 12 months of follow-up, the patient had normal elbow function and complete range of motion.

Background/Aims Cronobacter sakazakii, an emergent pathogen is considered as a major concern to infants and neonates fed on reconstituted powdered infant milk formula. In conjunction with many other factors, biofilm forming capacity adds to its pathogenic potential. In view of the facts that infants are at highest risk to C. sakazakii infections, and emerging antibiotic resistance among pathogens, it is imperative to evaluate probiotic cultures for their efficacy against C. sakazakii. Therefore, pure probiotic strains were isolated from commercial probiotic products and tested for their antimicrobial and anti-biofilm activities against C. sakazakii. Methods A total of 6 probiotic strains were tested for their antibiotic susceptibility followed by antimicrobial activity using cell-free supernatant (CFS) against C. sakazakii. The inhibitory activity of CFS against biofilm formation by C. sakazakii was determined using standard crystal violet assay and microscopic observations. Results All the probiotic strains were sensitive to ampicillin, tetracycline, vancomycin and carbenicillin whereas most of the strains were resistant to erythromycin and novobiocin. Four of the 6 probiotic derived CFS possessed antimicrobial activity against C. sakazakii at a level of 40 μL. A higher biofilm inhibitory activity (>80%) was observed at initial stages of biofilm formation with weaker activity during longer incubation upto 48 hours (50%–60%). Conclusions The study indicated the efficacy of isolated commercial probiotics strains as potential inhibitor of biofilm formation by C. sakazakii and could be further explored for novel bioactive molecules to limit the emerging infections of C. sakazakii.

Acute Pancreatitis is one of the commonest gastro-intestinal diseases, in which patients need emergency hospitalization. It carries 10-30% mortality in severe cases. Early identification of severe cases helps in prognostication of the disease and institution of aggressive treatment. Aim To evaluate the severity of acute gall stone pancreatitis using Modified Atlanta Classification at admission and 48 hours. To compare severity of acute pancreatitis as assessed by Modified Atlanta Classification with Modified CT Severity Index (CTSI) in the second week. Materials and Methods We use Modified Marshal Score, as recommended by Revised Atlanta Classification, in our study group of 26 patients. Patients were classified into Mild, Moderate, and Severe categories at 48hrs. Contrast Enhance Computer Tomography of chest and abdomen (Gold standard) was performed at 2 weeks of presentation. Using Modified CTSI Score, patients were again categorised into Mild, Moderate, Severe cases. Results Modified Atlanta Classification correctly picked up the severe pancreatitis cases, as early as at 48hrs, with 100% sensitivity and specificity, which corresponded with CTSI at 2wks.

Aim: To assess the association between maternal dental anxiety and its effect on the oral health status of their child, in Murad nagar –An institutional cross-sectional study. Materials and Methods: Among the randomly selected 200 mother-child pairs, a cross-sectional study was done. The children of 2–5 years were selected for the study. A five-level Modified Dental Anxiety Scale (MDAS), Hindi edition, was used to assess dental anxiety among the mothers. Clinical examination of the wards was finished by using a modified gingival record and WHO dentition status (2013). The SPSS software version 20 was used for statistical analysis. Results: Approximately, 61% of the children were males, and 39% were females. The modified gingival index (MGI) score was high, if there should arise an occurrence of high MDAS values. The mean MGI score was most astounding in phobic class of MDAS and least in the not anxious classification. The MGI score expanded on increment in maternal anxiety. Dental caries expanded in kids, if there should be an occurrence of high maternal dental uneasiness. The MDAS demonstrated a critical association with clinical oral health results of the child. The children whose mothers were “extremely anxious” (phobic) had the highest mean decayed, missing, or filled teeth. Conclusion: Maternal dental anxiety significantly affects the oral health status of their ward.

Background: Tobacco is the second driving reasons for mortality worldwide and its broad utilization in the smoking and smokeless form have added to the expanding weight of non-communicable disease. Aim: To study the prevalence of periodontal status among nicotine dependent individuals of 35-44 years attending community dental camps in Ghaziabad District, Uttar Pradesh. Methods: A cross-sectional study was conducted on 800 individuals with the age range of 35-44 years. A pre-tested questionnaire was used to gather information about the sociodemographic profile and the pattern of substance use. Fagerstrom Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST) and for smokers; Fagerstrom Test for Nicotine Dependence (FTND) for testing dependence. Periodontal status was assessed by Community Periodontal Index (Modified CPI WHO 2013) and loss of attachment (LOA). Statistical analysis was done by the Statistical Package for Social Sciences (SPSS) version 20.0. Result: The prevalence of periodontal disease was found to be 78.5% with maximum disease prevalence among males of 42-44 age. Majority of male consumed a smokeless form of tobacco (50.23%), followed by smoke (14.19%) form whereas females predominantly consumed smokeless form (37.36%). The mean number of teeth with pocket (3.37 ± 1.86) and mean of loss of attachment of more than 9 mm (0.67 ± 0.88) was higher among smokeless form of tobacco users as compared to other habit groups Conclusion: Higher prevalence of periodontal disease was seen among nicotine dependent individuals. A model for a comprehensive program in the dental office including the five A's and five R's for tobacco counseling must be applied at every institute.

The present work aims to assess the biological potential of polyphenolic compounds in different parts (flowers, leaves, stems, and roots) of Stachys palustris L. Towards secondary metabolites profile, 89 polyphenolic compounds (PCs) were identified by UPLC-PDA-ESI-TQD-MS/MS, with a total average content of 6089 mg/100 g of dry matter (d.m.). In terms of biological activity, antioxidant activity (radical activity, reducing power), digestive enzyme inhibitory (α-glucosidase, α-amylase, pancreatic lipase) effect, and antiproliferative activity (inhibition of cell viability and induction of apoptosis in different human cancer cell lines) were explored. Leaves, flowers, stems, and roots of S. palustris L. have not been studied in this regard until now. Vescalagin and cocciferin d2, isoverbascoside (verbascoside), luteolin 6-C-glucoside, luteolin 6-C-galactoside, apigenin 6-C-glucoside, (−)-epicatechin, ellagic acid, and malvidin 3-O-diglucoside were detected as main ingredients in the studied parts. Methanolic extract of S. palustris L. leaves and flowers revealed the highest amount of PCs with the strongest antiradical (18.5 and 15.6 mmol Trolox equivalent (TE)/g d.m., respectively) and reducing power effects (7.3 and 5.6 mmol TE/g d.m.). Leaf extracts exhibited better α-amylase and pancreatic lipase inhibition effects, while flower extracts exhibited better α-glucosidase inhibition effect. Regarding antiproliferative activity, extracts of the leaves and flowers significantly reduced cell viability and induced a high level of apoptosis in human lung, pancreatic, bladder, and colon cancer cell lines, as well as in human acute myeloid leukemia; whereas the extracts from stems and roots revealed the weaker effects. The results of this work showed anti-proliferative and potentially anti-diabetic, anti-obesity properties of S. palustris L., especially for flowers and leaves, which may have wide potential applications in the functional food, special food, pharmaceutical, cosmetics industries, and/or in medicine.

Introduction: As per the International Diabetes Federation (IDF) statistics, around 463 million people are presently living with diabetes worldwide, and this is anticipated to be 578.4 million by 2030. Awareness regarding diabetes is a major determinant for early detection and prevention of diabetes. Information regarding Knowledge, Attitude, and Practice (KAP) among diabetics from Northwest Rajasthan, India is not readily available. Aim: This study was designed to assess KAP regarding diabetes among patients with Type 2 Diabetes Mellitus (T2DM). Materials and Methods: This hospital based, cross-sectional study was conducted over a period of one and half years from July, 2018 to December, 2019 in a Tertiary Care Center in Northwest Rajasthan, India among 960 patients with T2DM. KAP was assessed by a structured questionnaire derived from a validated set of questionnaires and was categorised as poor, average, and good. Bivariate and multivariate analyses were done to assess the association between diabetes-related KAP and sociodemographic variables. Results: The mean age of the subjects was 55.45±11.64 years. The proportion of good, average, and poor knowledge scores among subjects were 10.83%, 65.84% and 23.33%, respectively. The corresponding values for attitude scores were 9.16%, 74.17% and 16.67%, respectively. Subjects from young age group, urban habitats, higher educational background, upper socioeconomic class, longer duration of diabetes, with a family history of diabetes, those who attended diabetes education program and with higher Body Mass Index (BMI) demonstrated significantly greater KAP score (r=0.73, p=0.001). Better knowledge was associated with a better attitude and practice (r=0.81, p=0.001) and better attitude was associated with better practice (r=0.77, p=0.001). Conclusion: The overall level of KAP regarding diabetes was average. To prevent diabetes and its complications, there is an urgent need to carry out extensive awareness programs with a prioritised focus on poorer, rural and less educated groups.

Introduction: The differential diagnoses of patients hospitalised for Influenza-Like Illness (ILI) due to swine influenza virus vs other pathogens are challenging. Aim: To evaluate haematological indices such as lymphocyte (LYM), platelet (PLT), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Lymphocyte multiplied by Platelet Count (LYM×PLT) as potential indicators to discriminate swine influenza virus infection from another ILI in Adults. Materials and Methods: This study was conducted among 332 patients, admitted with ILI from January 2019 to December 2019. Complete Blood Count (CBC) and Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) to detect swine influenza virus from throat/nasal swab were performed in each patient. Based on results, patients were divided into swine influenza-positive and swine influenza-negative groups. ANOVA test was used to compare different groups. The diagnostic values of the haematological indices in swine influenza infection were evaluated, using the ROC curve. p-value

We recently developed expansion microscopy (ExM), which achieves nanoscale-precise imaging of specimens at ~70 nm resolution (with ~4.5x linear expansion) by isotropic swelling of chemically processed, hydrogel-embedded tissue. ExM of C. elegans is challenged by its cuticle, which is stiff and impermeable to antibodies. Here we present a strategy, expansion of C. elegans (ExCel), to expand fixed, intact C. elegans. ExCel enables simultaneous readout of fluorescent proteins, RNA, DNA location, and anatomical structures at resolutions of ~65–75 nm (3.3–3.8x linear expansion). We also developed epitope-preserving ExCel, which enables imaging of endogenous proteins stained by antibodies, and iterative ExCel, which enables imaging of fluorescent proteins after 20x linear expansion. We demonstrate the utility of the ExCel toolbox for mapping synaptic proteins, for identifying previously unreported proteins at cell junctions, and for gene expression analysis in multiple individual neurons of the same animal.

Microplastics or plastic particles less than 5 mm in size are a ubiquitous and damaging pollutant in the marine environment. However, the interactions between these plastic particles and marine microorganisms are just starting to be understood. The objective of this study was to measure the responses of a characteristic marine organism (Synechococcus sp. PCC 7002) to an anthropogenic stressor (polyethelene nanoparticles and microparticles) using molecular techniques. This investigation showed that polyethylene microparticles and nanoparticles have genetic, enzymatic and morphological effects on Synechococcus sp. PCC 7002. An RT-PCR analysis showed increases in the expression of esterase and hydrolase genes at 5 days of exposure to polyethylene nanoparticles and at 10 days of exposure to polyethylene microparticles. A qualitative enzymatic assay also showed esterase activity in nanoparticle exposed samples. Cryo-scanning electron microscopy was used to assess morphological changes in exopolymer formation resulting from exposure to polyethylene microparticles and nanoparticles. The data from this paper suggests that microplastic and nanoplastics could be key microbial stressors and should be investigated in further detail.

Abstract Imputation is a computational method based on the principle of haplotype sharing allowing enrichment of genome-wide association study datasets. It depends on the haplotype structure of the population and density of the genotype data. The 1000 Genomes Project led to the generation of imputation reference panels which have been used globally. However, recent studies have shown that population-specific panels provide better enrichment of genome-wide variants. We compared the imputation accuracy using 1000 Genomes phase 3 reference panel and a panel generated from genome-wide data on 407 individuals from Western India (WIP). The concordance of imputed variants was cross-checked with next-generation re-sequencing data on a subset of genomic regions. Further, using the genome-wide data from 1880 individuals, we demonstrate that WIP works better than the 1000 Genomes phase 3 panel and when merged with it, significantly improves the imputation accuracy throughout the minor allele frequency range. We also show that imputation using only South Asian component of the 1000 Genomes phase 3 panel works as good as the merged panel, making it computationally less intensive job. Thus, our study stresses that imputation accuracy using 1000 Genomes phase 3 panel can be further improved by including population-specific reference panels from South Asia.

Median arcuate ligament syndrome or coeliac artery compression syndrome is one of the abdominal vascular compression syndromes characterized by postprandial intestinal angina in the expiratory phase of respiration due to focal proximal coeliac root compression by a fibrous ligamentous band with resultant inadequate blood supply to the respectively supplied part of the gastrointestinal tract. Multi-detector computed tomography is extremely useful noninvasive modality in differentiating the cause of compression of the coeliac artery along with evaluation of collaterals due to multiplanar imaging capability.

The association of aortopulmonary (AP) window with total anomalous pulmonary venous connection (TAPVC) has so far not been reported. We report a unique case of an 8-month-old child who presented with congestive cardiac failure and severe pulmonary arterial hypertension. Initial echocardiography revealed supracardiac TAPVC. Cardiac computed tomography showed the presence of Type I AP window along with the TAPVC. In the presence of severe pulmonary hypertension and dilated right ventricle, AP window may easily be missed if not actively looked for.

Interrupted aortic arch (IAA) is a rare congenital vascular malformation, which is defined as lack of luminal continuity, between the ascending and descending thoracic aorta. Many times it is associated with various congenital cardiac anomalies. Early diagnosis is mandatory to assess the patient condition and to plan medical and surgical treatment. Traditionally, chest X-ray, echocardiography, and conventional catheter angiography are the imaging tools being used. Multi-detector computed tomography (MDCT) can accurately diagnose and characterize the various forms of IAA and associated cardiac defects. We report a case of 8-year-old male child detected to have Type A IAA on MDCT with an associated ventricular septal defect and patent ductusarteriosus.

Optic neuritis (ON) is an acute inflammatory disorder of the optic nerve and is characterized by a unilateral sudden visual loss in the affected eye, often accompanied by periocular pain. We report a classical case of neuroretinitis (a subtype of ON) with vitiligo in a 52-year-old female. Vitiligo is associated with a few ocular disorders, and neuroretinitis is not one of them. Autoimmune etiologies are associated with both the diseases. To the best of our knowledge and after extensive literature search, this is probably the first reported case of neuroretinitis with vitiligo.

A 30-year-old female presented with recurrent red, painful right eye. Ocular examination revealed nodular scleritis and on complete workup, tuberculosis was found to be the causative agent. Stargardt’s disease in the same patient was noted as an incidental finding. To the best of our knowledge and after extensive literature search on the internet, this is probably the first reported case of both these diseases of total different etiologies occurring together.

Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by congenital absence of the uterus and upper 2/3 rd of vagina with a normal 46, XX karyotype and normally developed secondary sexual characteristics. It affects 1:4000 women. It may be isolated (Type I) or frequently associated with renal, vertebral anomalies and less frequently associated with auditory, cardiac defects (Type II). It presents with primary amenorrhea in young women with normal external genitalia and normal development of secondary sexual characteristics with normal functioning ovaries and karyotype 46, XX without visible chromosomal anomaly. It was considered as sporadic anomaly but an increasing number of familial cases is suggestive of genetic cause in whom it is transmitted as autosomal dominant trait with incomplete penetrance and variable expressibility. This is suggestive of involvement of mutation in a major development gene or a limited chromosomal imbalance. Etiology of MRKH syndrome is still unclear. In order to allow sexual intercourse, treatment is aimed at creation of neovagina. Patients and their families must attend counseling before and throughout treatment as psychological distress is very important in young women with MRKH. We hereby report a rare case of MRKH syndrome in a 19-year-old married female patient presenting with primary amenorrhea, coital difficulty and no other clinical disorder.