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Dual leucine zipper kinase (DLK) mediates multiple neuronal stress responses, and its expression levels are constantly suppressed to prevent excessive stress signaling. We found that Wallenda (Wnd), the Drosophila ortholog of DLK, is highly enriched in the axon terminals of Drosophila sensory neurons in vivo and that this subcellular localization is necessary for Highwire-mediated Wnd protein turnover under normal conditions. Our structure-function analysis found that Wnd palmitoylation is essential for its axon terminal localization. Palmitoylation-defective Wnd accumulated in neuronal cell bodies, exhibited dramatically increased protein expression levels, and triggered excessive neuronal stress responses. Defective intracellular transport is implicated in neurodegenerative conditions. Comprehensive dominant-negative Rab protein screening identified Rab11 as an essential factor for Wnd localization in axon terminals. Consequently, Rab11 loss-of-function increased the protein levels of Wnd and induced neuronal stress responses. Inhibiting Wnd activity significantly ameliorated neuronal loss and c-Jun N-terminal kinase signaling triggered by Rab11 loss-of-function. Taken together, these suggest that DLK proteins are constantly transported to axon terminals for protein turnover and a failure of such transport can lead to neuronal loss. Our study demonstrates how subcellular protein localization is coupled to protein turnover for neuronal stress signaling.

Background: Hypothyroidism is the result of impaired production and secretion of thyroid hormones. The cardiovascular system is affected by fluctuations in thyroid hormone levels. Stressful events or stressors can affect the hypothalamic–pituitary–thyroid (HPT) axis and psychological and physiological responses. Stress increases thyroid hormone levels while decreasing TSH levels, which exacerbates autoimmune thyroid disease. Aim: To evaluate the relationship between stress and primary hypothyroidism. Methods: A total of 77 newly diagnosed hypothyroid patients (TSH >5.0 mIU/L) and 77 healthy adults (TSH 0.5–5.0 mIU/L) were enrolled. During a brief general physical examination, the following values were measured: height, weight, blood pressure, pulse, and pulse rate. A brief systemic examination of the cardiovascular system and lungs was also performed to rule out systemic diseases. Heart rate variability (HRV) processing and analysis were performed using Pro LabChart (PowerLab 8Pro) data analysis software from AD Instrument. Results: Mean Avg. RR was significantly higher, RM SSD and pRR50 were significantly lower in cases than in controls. Mean HF was significantly lower and LF/HF (frequency range) was significantly higher in cases than in controls. Mean PSS was significantly higher in cases (25.82 ± 2.83) than in controls (22.47 ± 2.10). The majority of cases (54.5%) had a high stress level. The TSH level showed a highly significant correlation with the LF/HF ratio and with the PSS score. Conclusion: The mean Avg. RR and HF were significantly higher, RM SSD and pRR50 and LF/HF (frequency range) were significantly lower in hypothyroid patients.

Nasal mucosal melanoma (MM) is a rare and aggressive tumor, first described by Lucke in 1869. It accounts for 0.5%–2% of all melanomas. Its incidence is more in fair skinned individuals, and most commonly seen in the mean age of 60 years with slight male predominance. MMs are associated with poor prognosis and overall less survival rates as symptoms develop slowly; therefore, many patients are lately diagnosed. An Indian female in her early 50s came to the ear, nose, and throat outpatient department with complaints of bleeding from her nose for 20 days and mass in the right nasal cavity. On examination, a dirty black mass arising from the septum and deviated nasal septum to the right side were noted on rhinoscopy. Contrast-enhanced computed tomography showed features of nasal polyp. Fine-needle aspiration cytology was performed and found to be inconclusive. A punch biopsy was done and sent for histopathological examination (HPE), tiny biopsy showed features suggestive of melanosis with focal atypia. After 3 months, the patient reported with recurrence of nasal mass that was progressive in size. An excision biopsy was performed by endoscopic surgery under local anesthesia and sent for HPE. To confirm the diagnosis, immunohistochemistry was performed by application of S100, HMB45, and vimentin (after bleach treatment) showed diffuse strong intensity nuclear and cytoplasmic positivity in all pigmented cells. Thereafter, diagnosis of “Nasal mucosal melanoma” was awarded.

The course of coronavirus disease-2019 (COVID-19) in pregnancy is unpredictable with outcome trends ranging from milder disease with zero mortality to severe forms and deaths in different parts of the world. We did a comprehensive review of the literature to understand maternal deaths due to COVID-19 in detail. The search was conducted in the PubMed, Embase, and Google Scholar databases, using the keywords “maternal mortality”, “maternal death”, “COVID-19”, “septic shock” and “DIC”. The search included original articles, review articles, case reports published till date. We found varying case fatality rates ranging from 0.1% to 12.9%. There are various predictors of maternal death, notably the presence of symptoms, comorbidities, severe disease with cytokine storm and multi-organ dysfunction. We also report higher maternal deaths from low-resource regions owing to gaps in expected and delivered maternal care. While reviewing our institutional data, we found 3 maternal deaths related to COVID-19 in pregnancy. We discussed our experience at our institute of three COVID-19 related maternal mortalities to add evidence to the present data. Most maternal deaths occurred in postpartum period. Late referral, loss to follow-up and inadequate care were important determinants of maternal mortality. We concluded that pregnancy cases with or without complications must be considered high risk and addressed judiciously beginning from infection prevention, early diagnosis, disease categorization, and multidisciplinary approach of management to prevent morbidity and mortality. We strongly suggest strengthening the health care delivery system to save pregnant women from dying, particularly in low-resource countries.

Diagnosing a urinary tract infection (UTI) is typically a clinical procedure involving multiple steps. The need to perform a test depends on the presence of relevant symptoms. Given the current pandemic situation, visiting a clinic may not be a preferable choice for many users. Many vulnerable groups of patients, namely, males with certain predispositions and pregnant women, may not present with symptoms of UTI and may go undiagnosed, which could give rise to a more complicated situation. So far, microbial cultures have been used as the gold standard for the diagnosis of an infection. However, performing microbial cultures currently requires trained professionals and laboratory grade equipment. Therefore, there is a need for a home-use culture kit that can serve this purpose. To our knowledge, no such kit exists. Here, we present a feasibility study of an affordable and easy-to-use home-based setup for quantifying bacterial load in a urine. We believe that such a system can be used by people at home to monitor recurrent UTI infections and also by physicians to remotely monitor and prescribe narrow-spectrum antibiotics for more effective treatment.

Objective: This study was conducted to formulate locationwise radiologic diagnostic algorithms and assess their concordance with the final histopathological diagnosis of intracranial mass lesions to evaluate their utility in a rural setting where only basic facilities are available. Material and Method: In present study seventy two cases were analyzed.Histopathological evaluation was done from biopsy sample sent in formalin, tissue processing was done by standard procedure, tissue sections were routinely stained by H&E, immunohistochemical examination was performed in case of histopathological discrepancies. Radiological findings were correlated with histopathological diagnosis and concordances were calculated. Statistical Analysis: Frequencies and crosstabs were used for calculation. Result: This was a study of seventy-two patients with age ranging from 9months to 65 years. In these entire 72 cases, male patients were 42(58%), female patients were 30(42%). M: F was 1.38:1. Most of patient presented with headache, and frontal lobe was the most common location. In all these lesions, 88.8% cases were neoplastic lesions. Among all neoplastic lesions, 52.7% were malignant tumors and 34.7% were benign tumors. Among all malignant tumors, Astrocytoma was the most common malignant tumor.Meningioma was the second most commonly encountered lesion. In the present study radiological and histopathological correlation was present in84.7% of cases. IHC was performed wherever needed, to support diagnosis. Conclusion: Radiological investigations are reliable diagnostic tools for space occupying central nervous system lesions, but histopathology is still the gold standard. So multidisciplinary approach is the ideal approach for space occupying lesions of central nervous system

Background: Dengue has emerged as a major public health problem in India. It presents more aggressively among younger age groups as compared to adults. Therefore, it necessitates the accurate estimation of prevalence in younger age groups. Materials and Method: Of all the 1026 clinically suspected cases of dengue up to the age of 18 years were enrolled in this study and grouped into four age groups (Group I -

Background: Menstruation is a normal physiological phenomenon for females indicating her capability for procreation. Menstrual problems are common in adolescent girls, which may affect their life and outdoor activities. Adolescent girls with abnormal body mass index (BMI) suffer even more often. Objectives: To assess the relationship between menstrual patterns and problems with BMI among adolescent school girls of Delhi. Materials and Methods: This study was a cross-sectional study conducted among 210 adolescent school girls of Delhi. Permission was obtained from principal of the school and written informed consent was taken from the parents of the school girls before taking part in the study. All the data were collected, entered, and analyzed in SPSS 17.0. The data were analyzed using percentages and proportions through tables. Results: Out of 210 adolescent girls, 114 (54.3%) were having BMI 50% of the girls were undernourished. Only 13 (6.2%) of adolescent girls were overweight. Adolescent girls who had BMI

A frameshift mutation in Yippee-like (YPEL) 3 was recently found from a rare human disorder with peripheral neurological conditions including hypotonia and areflexia. The YPEL gene family is highly conserved from yeast to human, but its members’ functions are poorly defined. Moreover, the pathogenicity of the human YPEL3 variant is completely unknown. We generated a Drosophila model of human YPEL3 variant and a genetic null allele of Drosophila homolog of YPEL3 (referred to as dYPEL3). Gene-trap analysis suggests that dYPEL3 is predominantly expressed in subsets of neurons, including larval nociceptors. Analysis of chemical nociception induced by allyl-isothiocyanate (AITC), a natural chemical stimulant, revealed reduced nociceptive responses in both dYPEL3 frameshift and null mutants. Subsequent circuit analysis showed reduced activation of second-order neurons (SONs) in the pathway without affecting nociceptor activation upon AITC treatment. Although the gross axonal and dendritic development of nociceptors was unaffected, the synaptic contact between nociceptors and SONs was decreased by the dYPEL3 mutations. Furthermore, expressing dYPEL3 in larval nociceptors rescued the behavioral deficit in dYPEL3 frameshift mutants, suggesting a presynaptic origin of the deficit. Together, these findings suggest that the frameshift mutation results in YPEL3 loss of function and may cause neurological conditions by weakening synaptic connections through presynaptic mechanisms.

Teeth are the most resistant and hardest structures of human body which are usually better preserved than other parts of skeleton and maintain their forensic odontological significance for a comparatively longer period of time. They retain their unique features even in the worst environmental conditions from taphonomic degradations to biological or chemical destructions. They can survive all sorts of natural or man-made disasters and the taphonomic destructions. Besides the unique odontological, molecular and chemical characteristics of teeth; the dental pathologies and structural anomalies also play crucial role in forensic identification of unknown human skeletal remains. The idiosyncratic features like tooth staining/coloration patterns, developmental defects, tooth wear and attritions, dental restorations/implants, cultural tooth modifications, tobacco or nut-chewing signs, occupational stigmas etc., act as valuable adjuncts to forensic examination of teeth found in forensic or bio-archaeological contexts. Dental pathologies and anomalies may reflect the oral hygiene, dietary patterns (like consumption of sweets and sugar, fats, proteins) socio-economic or socio-cultural, and the occupational status of an individual. Present review article presents a brief overview of different dental defects and their putative role in forensic anthropological identification of unknown human remains.

Age and stature estimation have apparent implications in personal identification in the events of murder, accidents or natural disaster mainly concern with forensic identification analysis. Self-reported anthropometric data is convenient and inexpensive, but relying on this data requires an accurate estimation of age and height. The biasness, precision, and accuracy of adult’s self-reported age and height across subpopulations were examined using a representative sample of adults. Aim of the present study is to report bias in an individual’s reported and documented age and height estimates. The study sample were included more than 200 young adult students (100 male and 100 female subjects approximately) from Panjab university, Chandigarh, age from 18 to 25. Linear and multiple regression analysis were done to formulate equations which would be helpful for estimation of stature and age from self-reported data for both male and females. The best correlation estimation in multiple and linear regression equations for age estimation in male was shown self-reported data whereas in females reported to be data from parents rather than self-reported data , females tends to decrease their age number as shown in results while in stature best variable is self-reported. The weakest correlation was reported to be data from close friends in both males and females.

Background: Iron deficiency is the most common and widespread nutritional disorder in the world, affecting a large number of children and women in developing countries and constituting a public health condition of epidemic proportions. Weekly iron and folic acid supplementation (WIFS) with health education has been demonstrated to be effective in reducing anemia in adolescent school going girls. We assessed the impact of WIFS with and without health education on anemia in adolescent school girls of Delhi. Methods: This is a school-based intervention study conducted in two government senior secondary schools of Delhi. A total of 210 adolescent school girls from two schools were included in the study. In one school (intervention group), weekly ironfolic acid with health education once a month was given, and in the second school (control group), only WIFS was given for 6 months. Iron–folic acid supplementation containing 100 mg of elemental iron and 0.5 mg of folic acid was given on a weekly basis, and health education was provided once a month for 6 consecutive months. Hemoglobin (Hb) estimation was done at the beginning and the end of the study using the Hemocue method. Mean Hb change after intervention between the control and experimental groups was compared using a t test. Pre and post differences within the control and experimental groups were assessed using a paired-t test. Results: After intervention, there was a significant decline in prevalence of anemia in both the intervention (54.7 percentage points decline) and the control (26 percentage points decline) groups (P < 0.001). Conclusions: WIFS with once a month health education can be effective in reducing the prevalence of anemia in adolescent school girls.

Trace elements play an important and complex role in the human metabolism and, although present in only minute concentrations, can be either beneficial or detrimental to health. Qualitative and quantitative analyses of the trace elements from human teeth are performed using various methods. Atomic absorption spectroscopy (AAS) and Inductively coupled plasma atomic emission spectroscopy (or mass spectroscopy) (ICP-AES, MS) are the most popular methods for trace element analysis Previous studies have set the framework for developing methods aimed at elemental analysis from bones and teeth but there are areas in which the field still needs to progress. Research must be undertaken to expand the techniques to include more precision, non-destructiveness and accuracy and high detection limit, including additional human bones and teeth, non-human bones and teeth, non-skeletal materials, and to trace present and past life behaviours like migration pattern, nutrition status and occupational or environmental exposure, human provenance and reconstruction of migration pathways as well substance abuse in human skeletal remains and in living beings.

Introduction: Determination of Estrogen Receptor (ER), Progesterone Receptor (PR) and HER2/neu in primary Invasive Ductal Carcinoma (IDC) breast is the standard of care parameter for determining treatment options. Whether or not Neoadjuvant Chemotherapy (NAC) affects the receptor status is still an unanswered question. Aim: To compare immunohistochemical (IHC) profiles of ER, PR and HER2/neu in primary IDC breast before and after NAC to assess the subsequent effects on receptor status. Materials and Methods: Thirty two patients diagnosed with primary IDC breast who had a previous breast core biopsy with complete IHC profile followed by NAC and Modified Radical Mastectomy (MRM) were included. For each case demographic and histologic data was collected, including age, grade, amount of necrosis post NAC and IHC panel for ER, PR and HER2/ neu in core biopsies. The same IHC panel was applied on Post NAC MRM specimen. Pre- and post NAC IHC expression was compared. Results: Patients ranged from 30 years to 75 years in range. ER, PR and HER2/neu status of core biopsies and MRM specimen were compared and overall agreement was noted. Comparison for each receptor was done using McNemar’s test and significance was calculated. There was no statistically significant difference in ER and Her2/neu expression between pre- and post-NAC specimens. However, a statistically significant loss of PR expression was noted between the two groups. Conclusion: Accurate determination of ER, PR and Her2/ neu status in primary IDC breast is important to guide further treatment. Change in receptor status post NAC may warrant corresponding change in hormonal therapy.

Granular Cell Tumour (GCT), also known as Abrikossoff’s tumour is a rare neural tumour, mostly benign and solitary but rare malignant and multifocal occurrence are also reported. Location of tumour varies widely within body with tongue, skin and subcutaneous tissue being the most common sites. We report a case of malignant GCT in a 17-year-old male presented with a paravertebral swelling. Radiological and histopathological findings along with immunohistochemistry were of malignant GCT. We emphasize this case for its uncommon age and site of presentation in addition to invasive nature.

Nolla’s radiographic method of dental age estimation for sub-adult individuals has been commonly used for forensic purposes. To identify the accuracy and credibility of this method, a review has been conducted for estimating the variations/discrepancies between actual chronological and estimated ages of sub-adults individuals calculated by applying Nolla’s radiographic method in different population groups. The articles using Nolla’s method of age estimation and those published between 2006 and 2016 were used after relevant searches in PubMed, EMBASE, SCOPUS, COCHRANE and Web of Science databases. Studies conducted with dental radiographs of healthy subjects between 3 and 18 years of age and those reporting mean differences between the estimated dental age (DA) and chronological age (CA) as a measure of variation were included in the review for meta-analysis. A total of 5813 subjects (2839 boys and 2974 girls) between the age of 3 and 18 years were examined in the study, which were chosen from a total of 87 peer-reviewed articles. Quantitative (10 studies) and qualitative (12 studies) analyses of the results revealed that dental age of most sub-adults was found under-estimated using this method based developmental stages of teeth. The underestimation varied from +0.26 to +1 years for males, and +0.051 to +1.15 for females; with an average mean of 0.35 years and 0.20 years for males and females, respectively. Thus, it can be concluded that Nolla’s method of dental age estimation underestimates the age of an individual in almost all the studies reviewed here. It should be carefully applied for forensic cases requiring legal scrutiny by courts of law.

Primary tracheal malignancies are rare and present with non specific symptoms hence delaying the diagnosis. A 41-year-old male presented with repeated paroxysmal episodes of breathlessness for which he was being treated with bronchodilators and steroids. Computed Tomography (CT) chest was done revealing a small polypoidal mass lesion arising from lower trachea/carina. On fibre optic bronchoscopy an infiltrative growth was seen at the lower end of trachea following which biopsy was obtained. On histopathologic examination a diagnosis of primary adenoid cystic carcinoma was made. It was concluded that in a case of refractory obstructive pulmonary disease, primary tracheal tumours should be considered as an important differential diagnosis. CT chest, bronchoscopy and biopsy play a vital role in making an accurate diagnosis of such a clinical masquerader.

Collision tumours are composed of two histologically distinct neoplasms in the same organ without intermixture of cell types. Here the author present a case series of 4 cases of collision tumours of ovary with brief review of literature. Two cases have a combination of mucinous cystadenoma and teratoma whereas third case is a combination of serous papillary cystadenoma with teratoma and the fourth case has a combination of serous papillary cystadenocarcinoma and teratoma. The cases were diagnosed post-operatively. It is important to correctly diagnose the component of tumour for further management and favourable prognosis.

Capsazepine, an antagonist of capsaicin, is discovered by the structure and activity relationship. In previous studies it has been found that capsazepine has potency for immunomodulation and anti-inflammatory activity and emerging as a favourable target in quest for efficacious and safe anti-inflammatory drug. Thus, a 2D quantitative structural activity relationship (QSAR) model against target tumor necrosis factor-α (TNF-α) was developed using multiple linear regression method (MLR) with good internal prediction (r2 = 0.8779) and external prediction (r2pred = 0.5865) using Discovery Studio v3.5 (Accelrys, USA). The predicted activity was further validated by in vitro experiment. Capsazepine was tested in lipopolysaccharide (LPS) induced inflammation in peritoneal mouse macrophages. Anti-inflammatory profile of capsazepine was assessed by its potency to inhibit the production of inflammatory mediator TNF-α. The in vitro experiment indicated that capsazepine is an efficient anti-inflammatory agent. Since, the developed QSAR model showed significant correlations between chemical structure and anti-inflammatory activity, it was successfully applied in the screening of forty-four virtual derivatives of capsazepine, which finally afforded six potent derivatives, CPZ-29, CPZ-30, CPZ-33, CPZ-34, CPZ-35 and CPZ-36. To gain more insights into the molecular mechanism of action of capsazepine and its derivatives, molecular docking and in silico absorption, distribution, metabolism, excretion and toxicity (ADMET) studies were performed. The results of QSAR, molecular docking, in silico ADMET screening and in vitro experimental studies provide guideline and mechanistic scope for the identification of more potent anti-inflammatory & immunomodulatory drug.

Objectives: To determine the role of doppler indices in the prediction of perinatal outcome in pre eclampsia. Materials & Methods: A prospective study was conducted at Patna Medical College and Hospital between March 2008-March 2009 on 50 pregnant patients with preeclampsia at ≥32 weeks gestation .All these patients were subjected to a detailed history ,clinical examination and laboratory investigations. Study of fetal vessels was performed serially using a pulsed Doppler ultrasound .Resistance index (RI), pulsatility index(PI) and systolic / diastolic ratio (S/D) were measured in middle cerebral artery (MCA) and umbilical artery (UA). FL/AC (femur length/abdominal circumference) ratio was also measured. Results: 30 patients had IUGR(intrauterine growth restriction). The patients with abnormal indices had higher incidence of caesarean delivery(44%), low apgar score(32%), need for admission to NICU(26%)and neonatal complications(24%)as compared to those with normal indices. Conclusion: Doppler indices were more accurate than FL/AC ratio in the early detection of IUGR. MCA/UA ratios were more accurate than the individual components of MCA and UA.Abnormal Doppler ratios were significant predictors of IUGR and adverse perinatal outcome

Objective: To compare modified Misgav ladach technique of LSCS with conventional method. Method: This was a prospective study conducted over 200 patients undergoing primary LSCS for various reasons. Patients were randomly allocated into two groups of 100 each; group A underwent LSCS by the Misgav ladach method and group B by the conventional method. The peri operative and short term postoperative outcomes of both groups were compared. T test and Mann whitney test were used to analyze outcomes. Result: The operating time, incision delivery interval and febrile morbidity was significantly reduced in group underwent LSCS by modified Misgav ladach technique compare to comparison group who underwent LSCS by conventional technique.. Conclusion: Misgav ladach technique is a fast and advantageous method of LSCS and is cost effective as well.