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Background: The Covid 19 was declared a global pandemic that had a sizeable impact on the health care services in the surgical field including the orthopaedic department. There was additionally a decreased accessibility to healthcare personnel and facilities reallocated to manage the Covid patients. The study was mainly conducted to find out the impact of the first wave of COVID-19 on the orthopaedic surgeries. Aim: The main aim of the study is to find out the alteration in the number, type of surgeries, financial implications, duration of hospital stay, delay in surgery during the first wave of the COVID-19 pandemic. Study Design: Retrospective crossectional study. Methods: All the surgeries conducted in the orthopaedic department in the year 2019 and 2020 following first peak in March including pre-op and post-op COVID cases are included in the study. The procedure conducted, date of admission, date of surgery, date of discharge, investigations done and the cost expenses are the various parameters that are taken into consideration. The results are analysed for each year and comparisons are made using statistical methods. Results: The comparative analysis of the data collected from the years 2019 and 2020 showed an increase in the duration of hospital stay, delay in surgery, additional expenditure, back log in the number of elective surgeries done during the Pandemic.

A 60 year married female from Chennai presented with pain and restricted abduction, adduction, external rotation and flexion of right shoulder both in active and passive movements for 2 months. She was diagnosed to be affected by adhesive capsulitis which is equated to Kumbavatham, one of the vatha diseases mentioned in Siddha system of medicine. She was treated with Siddha Varmam therapy and thokkanam with Vathakesari thylam. After 15 days of hospital stay the patient was discharged and was followed for 6 months. There were no adverse reactions/events observed during the course of treatment. The combination therapy has provided the reduction in pain and restricted movements which was measured using goniometer and SPADI index.

Fibre reinforced plastics-FRP have become an excellent alternate to upgrade and restore improving failure infrastructures. The failure progress may be due to change in inappropriate design and improper construction practices. Glass Fibre-reinforced plastics (GFRP) wraps/laminates have proved to be a better option for use in infrastructure applications. This study has been made on square conventional columns and GFRP wrapped nano concrete columns under axial loads. The experimental investigation was to consist of the effect of varying the grade of concrete strength to 20 MPa & 30 MPa. In this research work is to evaluate the enhances, the effectiveness of using externally confined single and double layer GFRP wrapped nano concrete columns. Square RC columns of dimensions 150 mm × 150 mm and 750 mm length were cast and tested. One column specimen was of conventional concrete to provide as a reference, while all the remaining Nano concrete columns (NCC) were strengthened with GFRP laminates. The column specimens were provided with Glass Fibre Reinforced Plastics (GFRP) laminates with two different thicknesses. The parameters selected are stiffness, ultimate failure load, interpretation strength at ultimate state, and service load conditions. Further, the loads versus axial behavior were also determined. The associated failure modes and crack patterns for the experimental test column specimens were also examined. The experimental work showed a great improvement in the more strength for single and double layer GFRP wrapped nano concrete columns when compared with reference conventional concrete columns.

Background: Autoimmunity has increased significantly, alarmingly secondary to global contraception, abortion, fragmenting germ cells; herewith three types of life threatening manifestations, are analysed. Case-1: 28-year-old afebrile lady, vegetarian, presented to emergency with impaired responsiveness, deep jaundice, menorrhagia of one day duration and she had been taking native treatment with leaves for primary infertility for the past five years; she had a few ecchymotic patches, investigations showed severe anaemia, thrombocytopenia, haemolytic jaundice, peripheral smear confirmed thrombotic thrombocytopenic purpura; she developed profound hematuria; she received treatment with intravenous immunoglobulin, fresh frozen plasma, platelet transfusions, packed red blood cells transfusions, plasmapheresis was planned; she improved gradually. In her sincere effort to conceive a baby, for the past five years, due to cultural ignorance which teaches only three days abstinence, instead of seven days abstinence after last menstrual periods, exposure of germ cells to raw endometrial surface, from 4th to 7th days of menstrual cycle, resulted in the cumulative autoimmunity-thrombotic thrombocytopenic purpura status. Case-2: 24-year-old lady who had undergone puerperal sterilisation, on the fourth day after last menstrual periods, presented, with unresponsiveness, to emergency, her investigations revealed prolonged prothrombin time, prolonged activated partial thromboplastin time, more than a minute, thrombocytopenia, reduced fibrinogen levels suggesting disseminated intravascular coagulation; her ultra sonogram abdomen showed, absence of gestational sac in the uterus; she received fresh frozen plasma transfusions, but succumbed within few hours. With puerperal sterilisation, [non evidence based medical practice], 20 million germ cells are fragmented to chromatid breaks, a-centric fragments, ring chromosomes, which get exposed to partly regenerated endometrial surface, on the fourth day after last menstrual periods, due to lack of awareness of abstinence upto seven days, initiating severe cumulative autoimmunity, resulting in fatal disseminated intravascular coagulation. Case-3: Fatal haemo-phagocytic lympho-histiocytosis-soaring autoimmunity, detected in the victim host of corona virus infection, correlated directly with extensive tissue damage produced in the victim host, by prior surgical abortions. Conclusion: Cases one and two followed absence of abstinence, with exposure of germ cells, to partly healed endometrial surface in the former culminating in thrombotic thrombocytopenic purpura; in the latter by exposure of fragmented 20 million germ cells [by contraception] to partly healed endometrial surface, culminating in fatal disseminated intravascular coagulation. In case three fatal autoimmune hemophagocytic lymphohistiocytosis followed corona virus infection, secondary to extensive tissue damage, of liberal global abortions. Red Russian riverways, is another evidence for global warming due to global aborted blood pollution, melting Perma-Frost crashing the Diesel tanks, with oil spill reflecting on aborted blood polluted river, turns bright red, similar to blood moon by abortion polluted air. Innumerable human lives with their iron of blood flowing within blood vessels, repelling magnet of earth, is mandatory to strengthen earth’s magnet. Arctic ozone hole closed this May, environmental pollution cleared, by absence of global abortions, contraception, and their ozone depleting blood pollution, due to lock down of corona virus pandemic.

Background Given the shortage of cardiac rehabilitation (CR) programs in India and poor uptake worldwide, there is an urgent need to find alternative models of CR that are inexpensive and may offer choice to subgroups with poor uptake (e.g., women and elderly). Objectives This study sought to evaluate the effects of yoga-based CR (Yoga-CaRe) on major cardiovascular events and self-rated health in a multicenter randomized controlled trial. Methods The trial was conducted in 24 medical centers across India. This study recruited 3,959 patients with acute myocardial infarction with a median and minimum follow-up of 22 and 6 months. Patients were individually randomized to receive either a Yoga-CaRe program (n = 1,970) or enhanced standard care involving educational advice (n = 1,989). The co-primary outcomes were: 1) first occurrence of major adverse cardiovascular events (MACE) (composite of all-cause mortality, myocardial infarction, stroke, or emergency cardiovascular hospitalization); and 2) self-rated health on the European Quality of Life–5 Dimensions–5 Level visual analogue scale at 12 weeks. Results MACE occurred in 131 (6.7%) patients in the Yoga-CaRe group and 146 (7.4%) patients in the enhanced standard care group (hazard ratio with Yoga-CaRe: 0.90; 95% confidence interval [CI]: 0.71 to 1.15; p = 0.41). Self-rated health was 77 in Yoga-CaRe and 75.7 in the enhanced standard care group (baseline-adjusted mean difference in favor of Yoga-CaRe: 1.5; 95% CI: 0.5 to 2.5; p = 0.002). The Yoga-CaRe group had greater return to pre-infarct activities, but there was no difference in tobacco cessation or medication adherence between the treatment groups (secondary outcomes). Conclusions Yoga-CaRe improved self-rated health and return to pre-infarct activities after acute myocardial infarction, but the trial lacked statistical power to show a difference in MACE. Yoga-CaRe may be an option when conventional CR is unavailable or unacceptable to individuals. (A study on effectiveness of YOGA based cardiac rehabilitation programme in India and United Kingdom; CTRI/2012/02/002408)., Central Illustration

Background: Autoimmunity has increased significantly, alarmingly secondary to global contraception, abortion, fragmenting germ cells; herewith three types of life threatening manifestations, are analysed. Case 1: 28 year old afebrile lady, vegetarian, presented to emergency with impaired responsiveness, deep jaundice, menorrhagia of one day duration and she had been taking native treatment with leaves for primary infertility for the past five years; she had a few ecchymotic patches, investigations showed severe anaemia, thrombocytopenia, haemolytic jaundice, peripheral smear confirmed thrombotic thrombocytopenic purpura; she developed profound hematuria; she received treatment with intravenous immunoglobulin, fresh frozen plasma, platelet transfusions, packed red blood cells transfusions, plasmapheresis was planned; she improved gradually. In her sincere effort to conceive a baby, for the past five years, due to cultural ignorance which teaches only three days abstinence, instead of seven days abstinence after last menstrual periods, exposure of germ cells to raw endometrial surface, from 4th to 7th days of menstrual cycle, resulted in the cumulative autoimmunity thrombotic thrombocytopenic purpura status. Case 2: 24 year old lady who had undergone puerperal sterilisation, on the fourth day after last menstrual periods, presented, with unresponsiveness, to emergency, her investigations revealed prolonged prothrombin time, prolonged activated partial thromboplastin time, more than a minute, thrombocytopenia, reduced fibrinogen levels suggesting disseminated intravascular coagulation; her ultra sonogram abdomen showed, absence of gestational sac in the uterus; she received fresh frozen plasma transfusions, but succumbed within few hours. With puerperal sterilisation, [non evidence based medical practice], 20 million germ cells are fragmented to chromatid breaks, acentric fragments, ring chromosomes, which get exposed to partly regenerated endometrial surface, on the fourth day after last menstrual periods, due to lack of awareness of abstinence upto seven days, initiating severe cumulative autoimmunity, resulting in fatal disseminated intravascular coagulation. Case 3: Fatal haemo-phagocytic lympho-histiocytosis soaring autoimmunity, detected in the victim host of corona virus infection, correlated directly with extensive tissue damage produced in the victim host, by prior surgical abortions. Conclusion: Cases one and two followed absence of abstinence, with exposure of germ cells, to partly healed endometrial surface in the former culminating in thrombotic thrombocytopenic purpura; in the latter by exposure of fragmented 20 million germ cells [by contraception] to partly healed endometrial surface, culminating in fatal disseminated intravascular coagulation. In case three fatal autoimmune hemo-phagocytic lympho-histiocytosis followed corona virus infection, secondary to extensive tissue damage, of liberal global abortions. Red Russian riverways, is another evidence for global warming due to global aborted blood pollution, melting Perma Frost crashing the Diesel tanks, with oil spill reflecting on aborted blood polluted river, turns bright red, similar to blood moon by abortion polluted air. Innumerable human lives with their iron of blood flowing within blood vessels, repelling magnet of earth, is mandatory to strengthen earth’s magnet. Arctic ozone hole closed this May, environmental pollution cleared, by absence of global abortions, contraception, and their ozone depleting blood pollution, due to lock down of corona virus pandemic.

Introduction Despite several ongoing efforts in biomedicine and traditional medicine, there are no drugs or vaccines for coronavirus disease 2019 (COVID-19) as of May 2020; Kabasura Kudineer (KSK), a polyherbal formulation from India’s Siddha system of medicine, has been traditionally used for clinical presentations similar to that of COVID-19. We explored the efficacy of KSK in reducing viral load and preventing the disease progression in asymptomatic, COVID-19 cases. Methods A prospective, single-center, open-labeled, randomized, controlled trial was conducted in a COVID Care Centre in Chennai, India. We recruited reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 of 18 to 55 years of age, without clinical symptoms and co-morbidities. They were randomized (1:1 ratio) to KSK (60 mL twice daily for 7 days) or standard of care (7 days supplementation of vitamin C 60,000 IU morning daily and zinc 100 mg evening daily) groups. The primary outcomes were reduction in the SARS-CoV-2 load [as measured by cyclic threshold (CT) value of RT-PCR], prevention of progression of asymptomatic to symptomatic state, and changes in the immunity markers including interleukins (IL-6, IL-10, IL-2), interferon gamma (IFNγ), and tumor necrosis factor (TNF α). Siddha clinical assessment and the occurrence of adverse effects were documented as secondary outcomes. Paired t-test was used in statistical analysis. Results Viral load in terms of the CT value (RdRp: 95% CI = 1.89 to 5.74) declined significantly on the seventh day in the KSK group and that of the control group, more pronounced in the study group. None progressed to the symptomatic state. There was no significant difference in the biochemical parameters. We did not observe any changes in the Siddha-based clinical examination and adverse events in both groups. Conclusion KSK significantly reduced SARS-CoV-2 viral load among asymptomatic COVID-19 cases and did not record any adverse effect, indicating the use of KSK in the strategy against COVID-19. Larger, multi-centric trials can strengthen the current findings. Trial registration Clinical Trial Registry of India CTRI2020/05/025215. Registered on 16 May 2020

Background Soybean is subjected to genetic manipulation by breeding, mutation, and transgenic approaches to produce value-added quality traits. Among those genetic approaches, mutagenesis through fast neutrons radiation is intriguing because it yields a variety of mutations, including single/multiple gene deletions and/or duplications. Characterizing the seed composition of the fast neutron mutants and its relationship with gene mutation is useful towards understanding oil and protein traits in soybean. Results From a large population of fast neutron mutagenized plants, we selected ten mutants based on a screening of total oil and protein content using near infra-red spectroscopy. These ten mutants were regrown, and the seeds were analyzed for oil by GC-MS, protein profiling by SDS-PAGE and gene mapping by comparative genomic hybridization. The mutant 2R29C14Cladecr233cMN15 (nicknamed in this study as L10) showed higher protein and lower oil content compared to the wild type, followed by three other lines (nicknamed in this study as L03, L05, and L06). We characterized the fatty acid methyl esters profile of the trans-esterified oil and found the presence of five major fatty acids (palmitic, stearic, oleic, linoleic, and linolenic acids) at varying proportions among the mutants. Protein profile using SDS-PAGE of the ten mutants did exhibit discernable variation between storage (glycinin and β-conglycinin) and anti-nutritional factor (trypsin inhibitor) proteins. In addition, we physically mapped the position of the gene deletions or duplications in each mutant using comparative genomic hybridization. Conclusion Characterization of oil and protein profile in soybean fast neutron mutants will assist scientist and breeders to develop new value-added soybeans with improved protein and oil quality traits.

Grass pea is an orphan legume that is grown in many places in the world. It is a high-protein, drought-tolerant legume that is capable of surviving extreme environmental challenges and can be a sole food source during famine. However, grass pea produces the neurotoxin β

Background: Universal concern is an increased prevalence of morbidity, mortality; with improper comprehension, the globe has implemented, non evidence-based medical practice, without therapeutic indication, therapeutic protocols, policies-contraception, abortion, annihilating human race by therapy, destroying germ cells with consecutive systemic inflammatory response syndrome, associated with decreased androgen oestrogen resulting in metabolic syndrome, increased neoplasms—due to lacuna of this comprehension—cholesterol was blamed, resulting in essential fatty acids deprived diet, promoting sunflower seed oil, refined oil, lipid-lowering agents prescription like water, for the past >40 years; the tragedy of this false concept of refined oil, essential fatty acids deprived diet, [against God-ordained marvelous cell metabolism, from cholesterol] resulting in degenerative diseases, defaulted genomic repertoire, as cause and effect phenomenon in the two following morbid, fatal case presentations; contraception, abortion is the culprit and not cholesterol which is the basic life moiety of cell membrane, cell metabolism governing steroid hormones-androgen oestrogen derived from cholesterol. Case 1: 76-year-old male, vegetarian, presented with lethargy, hypotension, unexplained hyponatremia, on fludrocortisone for 2 years. MRI detected empty sella; hence hypopituitarism with cortisol deficiency, resulting in hyponatremia was considered and with hydrocortisone replacement, patient improved. Low levels of LDL, HDL, suggested chronic [>40 years] deprivation of diet containing essential fatty acids had resulted in degenerative—empty sella status with hypopituitarism. Case 2: 17-year-old girl presented with headache, vomiting, feeble pulse; 6 months prior platybasia had been diagnosed and she had undergone corrective neurosurgery, to widen bilaterally, narrowed, base of skull foramina, to prevent compression on the exiting neurovascular bundles; urgent CT scan of brain confirmed significant narrowing of foramen magnum, compressing brainstem; she expired within 30 minutes secondary to brainstem edema. Low levels of HDL, LDL confirmed, long term [~16 years] deprivation of essential fatty acids intake, leading to decreased steroid hormone synthesis—including oestrogen—the surveilling hormone for cell metabolism, including skull base, having resulted in progressive Platybasia, compressing brainstem. Conclusion: Though both patients belonged to affluent society it was the sincere adherence to the false detrimental concept of essential fatty acids deprived diet, which was the cause and effect phenomenon of degenerative empty sella syndrome, ineffectual cell-bone metabolism presenting as platybasia.

BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity.Methods and resultsCLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure.Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest.ConclusionIn patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes.ClinicalTrials identifierISRCTN43070564

Objectives The primary objectives of this study are to determine efficacy of Siddha medicine, Kabasura kudineer in reduction of SARS-CoV-2 viral load and reducing the onset of symptoms in asymptomatic COVID-19 when compared to Vitamin C and Zinc (CZ) supplementation. In addition, the trial will examine the changes in the immunological markers of the Siddha medicine against control. The secondary objectives of the trial are to evaluate the safety of the Siddha medicine and to document clinical profile of asymptomatic COVID-19 as per principles of Siddha system of Medicine. Trial design A single centre, open-label, parallel group (1:1 allocation ratio), exploratory randomized controlled trial. Participants Cases admitted at non-hospital settings designated as COVID Care Centre and managed by the State Government Stanley Medical College, Chennai, Tamil Nadu, India will be recruited. Eligible participants will be those tested positive for COVID-19 by Reverse Transcriptase Polymerase Chain reaction (RT-PCR) aged 18 to 55 years without any symptoms and co-morbidities like diabetes mellitus, hypertension and bronchial asthma. Those pregnant or lactating, with severe respiratory disease, already participating in COVID trials and with severe illness like malignancy will be excluded. Intervention and comparator Adopting traditional methods, decoction of Kabasura kudineer will be prepared by boiling 5g of KSK powder in 240 ml water and reduced to one-fourth (60ml) and filtered. The KSK group will receive a dose of 60ml decoction, orally in the morning and evening after food for 14 days. The control group will receive Vitamin C (60000 IU) and Zinc tablets (100mg) orally in the morning and evening respectively for 14 days. Main outcomes The primary outcomes are the reduction in the SARS-CoV-2 load [as measured by cyclic threshold (CT) value of RT-PCR] from the baseline to that of seventh day of the treatment, prevention of progression of asymptomatic to symptomatic state (clinical symptoms like fever, cough and breathlessness) and changes in the immunity markers [Interleukins (IL) 6, IL10, IL2, Interferon gamma (IFNγ) and Tumor Necrosis Factor (TNF) alpha]. Clinical assessment of COVID-19 as per standard Siddha system of medicine principles and the occurrence of adverse effects will be documented as secondary outcomes. Randomisation The assignment to the study or control group will be allocated in equal numbers through randomization using random number generation in Microsoft Excel by a statistician who is not involved in the trial. The allocation scheme will be made by an independent statistician using a sealed envelope. The participants will be allocated immediately after the eligibility assessment and informed consent procedures. Blinding (masking) This study is unblinded. The investigators will be blinded to data analysis, which will be carried out by a statistician who is not involved in the trial. Numbers to be randomised (sample size) Sample size could not be calculated, as there is no prior trial on KSK. This trial will be a pilot trial. Hence, we intend to recruit 60 participants in total using a 1:1 allocation ratio, with 30 participants randomised into each arm. Trial status Protocol version 2.0 dated 16th May 2020. Recruitment is completed. The trial started recruitment on the 25th May 2020. We anticipate study including data analysis will finish on November 2020. We also stated that protocol was submitted before the end of data collection Trial registration The study protocol was registered with clinical trial registry of India (CTRI) with CTRI/2020/05/025215 on 16 May 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).

UV light triggers thymine to form thymine dimers inducing cell death. Though the sun provides heat and light, which are essential for life on Earth, ultraviolet (UV) rays in sunlight can cause damage to DNA.In this science fair project, I will experiment with a strain of yeast that is super-sensitive to UV light.The goal for this project is to find out what percent of yeast colony growth has been killed. Bakers yeast, or saccharomyces cerevisiae, is a eukaryotic unicellular organism. Cerevisiae is used in many laboratories as a model organism because it has internal organs such as a nucleus and a mitochondria. Since cerevisiae’s genes have been well-studied, researchers are able to separate genes of interest from others, called knockout genes. In this project, a knockout strain of yeast will be used. This modified yeast is designed to be DNA-repair deficient which means that this strain of yeast does not have the enzymes needed to repair damaged cells while regular yeast and human cells do. When UV light destroys DNA the light initiates a reaction with thymine creating a thymine dimer. If the thymine dimer does not repair properly there are two paths it can follow, become a cancer cell if the thymine dimers are not widespread, or die, if they are widespread. In this project, there are many thymine dimers that will be formed when the modified yeast is exposed to UV light causing the yeast to die. There will be two dishes next to each other with grown modified yeast. One dish will have aluminum foil on the top and the other one will not have aluminum foil. Then both of them will be exposed to UV light. This is the equation that is used to find out what percent of the yeast colony has died: $100 \times$ (1-colonies on exposed plate/colonies on control plate) =% killed Two more tests will be done on the effects of pure UV light and the effects of regular light with no UV rays on yeast cells. This will show that the light is not effecting the yeast but the UV rays are. This project will demonstrate how DNA in yeast cells are damaged by UV light, causing yeast cells to die. Similarly, UV rays cause human cells to mutate by destroying DNA, which leads to skin cancer. Although modified yeast does not have the enzymes that unmodified baker’s yeast and human cells have, it will still show how UV rays affect eukaryotic cells’ DNA. A future application for this project would be using skin cells to see how they interact with UV rays and by doing this more research can be done on skin cancer. When I find out what percent of yeast died when exposed to UV lights I will compare it to the effects of skin cancer and see how the enzymes react differently to UV light and look at the difference between the modified yeast and the skin cell.

A bilayered nanofibrous scaffold with rapid wound healing properties is found to be suitable for tissue regeneration applications. The objective of this study is to reveal the fabrication of a poly(3-hydroxybutyric acid) (P)–gelatin (G) nanofibrous mat through electrospinning, with a horn keratin–chitosan-based biosheet (KC) as a bilayered nanofibrous scaffold. The mupirocin (D)-loaded horn KC biosheet (KCD) acts as the primary layer over which PG nanofibers were electrospun to act as the secondary layer. It is shown that this engineered bilayered nanofibrous scaffold material (KC–PG) should fulfill the functions of the extracellular matrix (ECM) by elucidating its function in vitro and in vivo. The bilayered nanofibrous scaffold was designed to exhibit improved physiochemical, biological and mechanical properties, with better swelling and porosity for enhanced oxygen permeability, and it also exhibits an acceptable antibacterial property to prevent infection at the wound site. The bilayered nanofibrous scaffold assists in better biocompatibility towards fibroblast and keratinocyte cell lines. The morphology of the nanofibrous scaffold aids increased cell adhesion and proliferation with cell material interactions. This was elucidated with the help of in vitro fluorescence staining against both cell lines. The bilayered KCD–PG nanofibrous scaffold material gives accelerated wound healing efficiency during in vivo wound healing. The results showed the regulation of growth factors with enhanced collagen synthesis, thereby helping in faster wound healing.

Using high throughput tandem mass tag (TMT) based tagging technique, we identified 4,172 proteins in three developmental stages: early, mid, and late seed filling. We mapped the identified proteins to metabolic pathways associated with seed filling. The elevated abundance of several kinases was observed from the early to mid-stages of seed filling, indicating that protein phosphorylation was a significant event during this period. The early to late seed filling stages were characterized by an increased abundance of proteins associated with the cell wall, oil, and vacuolar-related processes. Among the seed storage proteins, 7S (β-subunit) and 11S (Gy3, Gy4, Gy5) steadily increased in abundance during early to late stages of seed filling, whereas 2S albumin exhibited a decrease in abundance during the same period. An increased abundance of proteases, senescence-associated proteins, and oil synthesis proteins was observed from the mid to late seed filling stages. The mid to late stages of seed filling was also characterized by a lower abundance of transferases, transporters, Kunitz family trypsin, and protease inhibitors. Two enzymes associated with methionine synthesis exhibited lower abundance from early to late stages. This study unveiled several essential enzymes/proteins related to amino acid and protein synthesis and their accumulation during seed development. All data can be accessed through this link: https://massive.ucsd.edu/ProteoSAFe/dataset.jsp?task=38784ecbd0854bb3801afc0d89056f84. (Accession MSV000087577) This article is protected by copyright. All rights reserved.

Background: Globally, depression and depressive disorder are common amongst people of all ages, especially amongst 15–29 years old. The prevalence of depression amongst medical students was studied on the World Health Day 2017 using the Brief Patient Health Questionnaire. Objective: The objective was to study the prevalence of depression and depressive symptoms amongst students of a class of MBBS based on responses collected anonymously in the year 2017. Materials and Methods: A class of students in a medical college was administered the questionnaire consisting of nine items, and 81 students participated in this study. Each item was explained, and the students were given time to think and mark their respective responses. The results of responses of 79 students who answered all questions are reported. Based on the cumulative score of their responses, depression was graded as minimal, mild, moderate, moderately severe and severe depression. Results and Discussion: Twenty-four male students and 55 female students constituted the study population. Overall, 91% of the students reported some degree of depression in the previous 2 weeks. Nearly 8.9% of the students did not have any depressive symptoms over the previous 2-week period. Almost 12.7% and 5.1% of the students reported moderately severe and severe depression, respectively. Minimal, mild and moderate depression were reported by 21.5%, 32.9% and 22.8% of the students, respectively. Students with depression were informed to consult with a psychiatrist for formal evaluation. Conclusion: The prevalence of depressive symptoms is very high amongst medical students, and a formal study with intervention is the need of the hour.

Introduction and objectives Currently three main classes of biologics are licensed for severe asthma treatment in the UK. These classes target IgE (omalizumab) and IL-5/IL-5R (mepolizumab/reslizumab and benralizumab). The stratification factors that identify response to omalizumab and mepolizumab beyond the licensing criteria are poorly understood in clinical practice. However, the GINA 2019 severe asthma guidelines advocate clinical stratification when >1 biologic choice exists. The study aim was to evaluate the clinical characteristics that can predict response to omalizumab and mepolizumab. Methods Over a prospective period (April 2017 to July 2019) we evaluated 105 patients initiated on biologic treatment (omalizumab n=27 [GINA 4=9, GINA 5=18 (oral corticosteroids (OCS) median (IQR):10 mg (10–15) and mepolizumab n=78 (GINA 4=13, GINA 5=65 (OCS:12.5 mg (10–15)] at a single severe asthma centre. Omalizumab response was assessed at 16 weeks as per NICE recommendations, and on-going response at one year; according to MDT defined response markers. Mepolizumab response was assessed based on NICE criteria at 1 year. We looked at the GINA 2019 treatment selection criteria (omalizumab: blood eosinophils ≥260 cells/µl, FeNO ≥20ppb, childhood-onset asthma and mepolizumab: higher blood eosinophils, more exacerbations in the previous year, adult-onset asthma (≥18 years), nasal polyposis) as baseline stratifiers of early and 1 year response using Receiver operator curve analyses (ROC). Results 35% of patients were eligible for both biologics based on baseline characteristics. When assessing response to biologics [R+ (responder)/R- (non-responder)]: we identified for omalizumab 80.8%/19.2% (16 weeks), 69.2%/30.8% (1 year) response rates and mepolizumab: 71.8%/21.2% (16 weeks), 75.9%/24.1% (1 year) response rates. None of the GINA 2019 baseline stratifiers were predictive of treatment response. The best predictor of response to omalizumab (AUC:0.810,p=0.054) and mepolizumab (AUC:0.746,p=0.006) was exacerbations in the previous year. Conclusions We have identified that >1:3 patients are eligible for more than one class of biologic. Treatment failure rates in this highly refractory population at 1 year were relatively high with between 20–30% of patients failing therapy. Only exacerbations in the previous year was a significant predictor of treatment response to both biologics. Therefore, more effective decision support tools are required to guide biologic prescribing in clinical practice.

Recent advances in clinical and technological domains have created a huge impact towards handling newborns related issues and viable solutions towards reducing the mortality rate. In today’s scenario, preterm neonates admitted to Neonatal Intensive Care Units (NICU) pose huge challenges to the neonatologists. Assessment of pain in neonates can help in identifying the risk factors. Neonates cry can be considered as fundamental communication where the mechanism in cry variation indicates various levels of pain. This specific study emphasizes the preterm neonates cry pattern recognition using Bark frequency cepstral coefficients with neural network classifiers. Cry recordings were collected from local hospital after appropriate ethical clearance. Preterm neonates at NICU with n=200 with three conditions hunger, pain and discomfort was considered. Binary pattern classification was employed using Support Vector Machine (SVM) and Recurrent Elman Neural Network (REN). Overall classification accuracy (average) of 94.58% was obtained using REN classifier for recognition of hunger (vs) discomfort, hunger (vs) pain, discomfort (vs) pain respectively.

A 42-year-old man with the complaints of left knee swelling, severe pain, difficult to stand was reported to Siddha Varmam division after a road accident. He was diagnosed as acute avulsion of Posterior cruciate ligament (PCL). It was diagnosed based on the history of trauma, knee pain and swelling after trauma, positive posterior drawer test and avulsion fracture shown by radiograph. He was treated with Siddha Varmam therapy and traditional bone setting. After a month of treatment, the PCL avulsion fracture got healed without any surgical interventions and patient able to walk normally. This case report summarises the novel Siddha Varmam therapy and traditional bone setting treatments for acute avulsion of PCL with bony fragment. Keywords: Siddha varmam therapy, Bone setting, PCL fracture

Maize ( Zea mays L.) is the world’s leading edible oil and third largest important cereal. In addition to it is used as food for human consumption as well as food grain for livestock. High concentrations of NaCl in soils account for large decrease in the yield of a large variety of crops all over the globe. The objective of the present study was conducted to evaluate NaCl stress on growth and mineral nutrient composition of maize plants. Maize seeds were grown in plastic pots having fine sand. After 20 days of germination, the plants were subjected to seven different concentrations (Control, 25mM, 50mM, 75mM, 100mM, 125mM and 150mM) of NaCl. Plants were analyzed on 15 th day after salt treatment. Factorial experiments in a completely randomized design (CRBD) with three replications were applied. The growth parameters and mineral contents Na, Ca, K and Cl were investigated from saline treated and non saline treated plants. Results indicated that the NaCl stress markedly reduced the shoot and root length fresh and dry masses. Moreover Na + , Cl - content increased with increase in NaCl stress, while Ca 2+ and K + were decreased significantly.

There is limited information on the influence of genetic and environmental variability on soybean protein composition. This study aimed to determine the role of genotype (G), environments (E), and the interrelationship of genotype and environment (G×E) on soybean seed protein. Three sets of nine soybean genotypes were grown in replicated trials at Maryland, South Carolina, and South Dakota. At each location, the nine genotypes were grown with two planting/sowing dates. We applied two-dimensional gel electrophoresis and mass spectrometry to study the variability of soybean storage and allergen proteins. Statistical analysis of 47 storage and 8 allergen proteins, in terms of differentially expressed protein spots significant at the p

Wound healing is a global health care problem. The use of a suitable dressing material by means of a nanofibrous scaffold with traditionally important medicine can help to repair the damaged skin tissue. An ideal wound dressing material should mimic the function of an extracellular matrix with its improved physiochemical, biological and antimicrobial properties. In this study, the significance features of a collagen coated electrospun poly(3-hydroxybutyric acid)–gelatin nanofibrous scaffold with a bioactive Coccinia grandis extract (CPE) meets the requirements for a wound dressing material. The nanofibrous scaffold with collagen has an attraction for fibroblast, which increases cell adhesion and proliferation. The fabricated nanofibrous scaffold with collagen was characterized physio-chemically using Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and it showed acceptable antibacterial property with both Gram positive and Gram negative bacteria. The thermal and in vitro stability of the nanofibrous scaffold was studied and it was found to have stability more than that required for a wound dressing material. The nanofibrous scaffold supports good swelling property with better porosity for oxygen permeability. The mechanical property of the nanofibrous scaffold showed a Young's modulus of 2.99 ± 0.16 MPa. The biocompatibility of the nanofibrous scaffold exhibits increased cell adhesion and proliferation of both NIH 3T3 fibroblast and human keratinocytes (HaCaT) cell line. The in vitro fluorescence staining of the nanofibrous matrix using Calcein AM and DAPI exhibits the cell material interaction of the collagen coated nanofibrous scaffold corresponding to increased cell adhesion and proliferation. This approach with a nanofibrous scaffold coated with collagen can be a promising tool in skin tissue engineering and can be useful as a wound dressing material in skin tissue engineering applications.

Background: Chronic otitis media is a highly prevalent middle ear disease in the developing countries which causes various pathological changes in the tympanic membrane and middle ear. Treatment of chronic otitis media involve medical and surgical methods. There are many surgical techniques followed regarding the grafts used, temporalis fascia remains the most commonly used. There are some studies debating the usefulness of dry grafts and wet grafts. Our study is aimed at comparing the both and evaluating the outcome.Methods: A prospective comparative study conducted in the department of Otorhinolaryngology and Head and Neck surgery, Government Stanley Medical College, Chennai, with 64 patients for the period of 1 year from July 2017 to June 2018.Results: Graft uptake of temporalis fascia in dry group is 93.8% and wet group has graft uptake of 87.5%, failure rate is low in dry group when compared with wet group. And also, this study showed higher graft uptake in small and medium sized perforation (95%) than the larger perforation (87.5%) and also there is no relationship between the duration of inactive stage and the graft uptake has been observed in our study.Conclusion: Temporalis fascia is a reliable graft material for reconstruction of tympanic membrane perforations. In our study dry graft has shown more success rate than the wet graft. Hearing improvement was the same in dry and wet group in which the grafts have been up taken well.

Metabolic syndrome (MetS) is a major public health challenge in the USA and elsewhere. MetS generates high costs to national healthcare system, as well as causing deteriorating health condition in individuals. Studies indicate that MetS may be influenced by demography, race, income, education level and access to healthcare system. Using 2015 national survey data - Behavioural Risk Factor Surveillance System (BRFSS) - this article analyses the prevalence of MetS across ethnic and socio-economic sections of population. The analysis supports the prevailing knowledge that MetS is influenced by access to healthcare, race, income and education level of population. An interesting finding of this work is that those who reported not having any kind of health coverage had a significantly lower prevalence of MetS compared to those who reported having health coverage.

The COVID-19 pandemic has taken tragic proportions and has disrupted lives globally. In the wake of governmental lockdowns, ophthalmologists need practical and actionable guidelines based on advisories from national health departments on how to conduct their duties during nationwide lockdowns and after these are lifted. In this paper, we present a preferred practice pattern (PPP) based on consensus discussions between leading ophthalmologists and health care professionals in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. In this document, the expert panel clearly defines the range of activities for Indian ophthalmologists during the ongoing lockdown phase and precautions to be taken once the lockdown is lifted. Guidelines for triage, governmental guidelines for use of personal protective equipment from ophthalmologists' point of view, precautions to be taken in the OPD and operating room as well as care of various ophthalmic equipment have been described in detail. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics and should help Indian ophthalmologists in performing their professional responsibilities without being foci of disease transmission.

Seed deterioration during storage is associated with various metabolic and chemical alterations that vary among genotypes in soybean. In the present study, five genotypes with good storability viz., kalitur, MACS 1416, EC 18761, CO1 and DSB21 and five genotypes with poor storability viz., JS 71-05, DS 228, MAUS 61, NRC 93 and DSB 24 were selected and evaluated for biochemical changes to identify the best donors for storability. Among the genotypes, all the poor storer genotypes showed faster accumulation of free amino acids, free fatty acids and malondialdehyde content as a result of oxidative stress. Poor storer genotypes also showed the increased lipoxygenase I and II enzymes activity. All the good storer genotypes showed higher anti-oxidative enzymes activity causing slower lipid peroxidation. Among the good storers, kalitur showed favourable biochemical features for storability while MAUS-61 was identified as poor storer exhibiting less favourable biochemical features.

Background and Purpose— EmboTrap is a novel stent retriever designed to achieve rapid and substantial flow restoration in acute ischemic stroke secondary to large-vessel occlusions. Here, we evaluated EmboTrap’s safety and efficacy compared with established stent retrievers. Methods— ARISE II (Analysis of Revascularization in Ischemic Stroke With EmboTrap) was a single-arm, prospective, multicenter study, comparing the EmboTrap device to a composite performance goal criterion derived using a Bayesian meta-analysis from the pivotal SWIFT (Solitaire device) and TREVO 2 (Trevo device) trials. Patients at 11 US and 8 European sites were eligible for inclusion if they had large-vessel occlusions and moderate-to-severe neurological deficits within 8 hours of symptom onset. The primary efficacy end point was achievement of modified Thrombolysis in Cerebral Ischemia (mTICI) reperfusion scores of ≥2b within 3 EmboTrap passes as adjudicated by the core laboratory. The primary safety end point was a composite of symptomatic intracerebral hemorrhage and serious adverse device effects. Secondary end points included functional independence (modified Rankin Scale, 0–2) and all-cause mortality at 90 days. Results— Between October 2015 and February 2017, 227 patients were enrolled and treated with the EmboTrap device. The primary efficacy end point (mTICI ≥2b within 3 passes) was achieved in 80.2% (95% confidence interval, 74%–85% versus 56% performance goal criterion; P value, Conclusions— The EmboTrap stent-retriever mechanical thrombectomy device demonstrated high rates of substantial reperfusion and functional independence in patients with acute ischemic stroke secondary to large-vessel occlusions. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT02488915.

In a fresh RD surgery, what technique would you use to identify a retinal hole or microtear if you could not find it after looking for it?

Eosinophilic annular erythema (EAE) is a rare and relatively newly described eosinophil-rich dermatosis. Debate still exists as to whether it represent a subtype of Well syndrome or a separate disease entity. We report an 8-year-old boy with a 4-year history of recurrent, asymptomatic annular lesions, which were diagnosed after clincopathological correlation as EAE. This condition usually runs a relapsing and remitting course with resistance to multiple treatments. Prednisolone and hydroxychloroquine have been reported as successful but the response to these was limited in this case. Complete resolution occurred after treatment with ultraviolet B (UVB) therapy. To our knowledge, this is the first report of a favourable response of EAE to such therapy.

Background: It is generally acknowledged that patients with diabetes mellitus are more susceptible to fungal infections, particularly with Candida albicans. Oral infection by Candida can result in a number of clinical lesions, including median rhomboid glossitis (central papillary atrophy), denture stomatitis, squamous cell carcinoma, Radiation therapy, immunocompromised status, etc. Different studies have shown that patients with diabetes mellitus have increased frequency of oral candidal carriage and increased risk of candidiasis, which is related to poor metabolic control, neutrophil dysfunction, reduced salivary flow, high glucose concentration in blood and saliva and in medications.Materials and Methods: Subjects of both the groups were given 10 ml of sterile normal saline and asked to rinse the mouth for one minute. The subjects were then asked to return the oral rinse in a sterile clean, broad-mouthed container which was capped, labelled and taken to the laboratory. The samples were then inoculated onto the culture medium (Sabouraud’s dextrose agar with Chloramphenicol) with minimal delay (within 6-8 hours of collection of oral rinse). Candidal colonies were counted and compared with non-diabetics.Results: Statistically significant increase in colony forming units (p=0.0324) were obtainedin patients with diabetes mellitus.Conclusion: The results indicate significant increase in colonization and carriage of candida in the oral cavity among diabetics when compared with non-diabetics. However, further research using larger samples is required which may lend credibility to the suggestion of increased candidal CFUs in diabetics serving as a surrogate marker of serum glucose levels.Journal of Pathology of Nepal (2015) Vol. 5, 733-738

MDS are clonal pluripotent, stem cell disorders characterized by ineffective hematopoiesis resulting in blood cytopenias contrasting with a typically cellular marrow. MDS evolve frequently to acute myeloid leukemia (AML), and are the most frequent preleukemic states in adults.MDS predominate in the elderly, with a median age at diagnosis of about 70 years. Their incidence is 4 to 5 per 100,000 persons per year. Their etiology is generally unknown. In 15 to 20% of cases, however, MDS are secondary [...]

A single step method for encapsulation of clinically relevant proteins viz., Bovine Serum Albumin (BSA), Lysozyme and Insulin molecules, inside core-sheath structured polymer fibres using coaxial electrospinning technique, is described. Transmission electron microscopic pictures show the formation of core-sheath structure. The secondary structure of the proteins was characterized through CD spectroscopy. The secondary conformation was retained with a minor decrease in ?-conformation and an increase in the random and turn conformations after coaxial electrospinning. This method of encapsulation is simple and requires little or no harsh treatment of sensitive biomolecules like insulin. Thus, the core-sheath structure of the fibres might apparently help protect the biomolecules during and after electrospinning, in addition to providing a high interactive surface area for controlled release. This scheme will be suitable for applications in cell culture and tissue regeneration. � 2013 American Scientific Publishers, All rights reserved.

Objective To identify the effect of different concentrations of NaCl on some antioxidant enzyme activities of leaves of salt-stressed true mangrove. Methods Excoecaria agallocha (E. agallocha) subjected to varying levels of NaCl. Salt stress was imposed on 60 days old plants with ten different concentrations of NaCl (0, 100, 200, 300, 400, 500, 600, 700, 800, 900, 1 000 mM). Results E. ahallocha seedlings survived up to 500 mM. Above 500 mM the seedlings did not survived. The leaves of 60 day old plants were used for the analysis of enzyme activities. NaCl stress enhanced the enzymatic antioxidants such as catalase, peroxidase, polyphenoloxidase and superoxide dismutase. The highest CAT, PPO activities in the leaves enhanced gradually up to 300 mM NaCl concentrations, the highest SOD, POX activities in the leaves were observed at NaCl concentrations of 400 mM (SOD), and 500 mM (POX) respectively. Conclusion Increase in anti-oxidant enzyme activity could be a response to cellular damage induced by NaCl.

The aim of this study was to analyse the outcome of surgical Haglund deformity is a prominence in the postero superolateral aspect of the calcaneum. Haglund deformity is a prominence in the postero superolateral aspect of the calcaneum, causing a painful bursitis, which may be difficult to treat by non-operative measures alone. Various surgical methods are available for effective treatment of refractory Haglund’s deformity. This study is to evaluate whether adequate resection of Haglund deformity by a lateral approach provides good to excellent results. During the period from 2009 to 2012, 40 patients with 46 feet had undergone resection of Haglund deformity using lateral approach and the outcome was analysed using AOFAS Ankle-Hind Foot Scale. The mean AOFAS score at the follow up was 86/100, with the majority of patients reporting alleviation of pain at one year follow up. The lateral approach to calcaneal ostectomy can be an effective treatment for those suffering from refractory Haglund deformity. However, the patient must be made aware of the duration of recovery being long.

Incisional hernia remains a very common postoperative complication. These are encountered with an incidence of up to 20 % following laparotomy. These hernias enlarge over time, making the repair difficult, and serious complications like bowel obstruction, strangulation and enterocutaneous fistula can occur. Hence, elective repair is indicated to avoid these complications. Implantation of a prosthetic mesh is nowadays considered as the standard treatment due to low hernia recurrence. The most common mesh repair techniques used are the onlay repair, sublay repair and laparoscopic intraperitoneal onlay mesh (IPOM). However, it is still not clear which technique among the three is superior. A study consisting of 30 patients who underwent incisional hernia repair by onlay, laparoscopic and preperitoneal mesh repair with abdominoplasty was conducted in the Coimbatore Medical College and Hospital. Of the three groups, the preperitoneal repair with abdominoplasty was found to have better patient compliance and satisfaction with regard to occurrence of complications and appearance of the abdominal wall without laxity in a single sitting.

2-DE reference maps of Heterodera glycines were constructed. After in-gel digestion with trypsin, 803 spots representing 426 proteins were subsequently identified by LC-MS/MS. Proteins with annotated function were further categorized by Gene Ontology. The results showed that proteins involved in metabolic, developmental and biological regulation processes were the most abundant.