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Background: Medicines are an integral part of health. It becomes essential to promote rational drug use. The relationship between doctors and the pharmaceutical industry has gained increasing attention recently. So there are chances that detailing activities by pharmaceutical representatives may lead to an undesirable effect on the prescribing pattern of doctors, like polypharmacy and use of fixed drug combinations; hence this study was planned to evaluate the effect of evaluation of the effect of drug promotional literature on prescribing using WHO prescribing indicators (DPL) on the prescribing pattern of doctors. Setting and Design: This prospective observational cross-sectional study was performed in a medical college and tertiary care center in Maharashtra. MATERIALS AND METHODS: 30 DPL and 10 prescriptions from each doctor were collected. Such total of 3000 DPL and 1000 prescriptions were collected from 100 doctors. Statistical Analysis: The prescriptions and DPL were analyzed together, and information was entered in Microsoft Excel; the parameters were calculated in percentage. Results: This study highlighted that drugs prescribed by generic name were 3.36%, the percentage of antibiotics prescribed was 27.37%, and the percentage of prescriptions containing medicines from the essential medicine list (EML) or formulary was 44.07%. In this study, 27.9% of drugs in the prescriptions were those drugs that are advertised in the DPL. Conclusion: Polypharmacy, prescribing drugs by brand names, drugs out of national list of essential medicine, use of more fixed drug combinations (FDC), antibiotics, and nutritional supplements could be attributed to the effect of DPL on the prescribing pattern. Hence it could be said that there is an association between a greater reliance on the promotion of medicines by the pharmaceutical companies and inappropriate prescribing patterns.

Background: Granulomatous mastitis is a rare and challenging condition that can mimic malignancy in the breast. This condition often presents with clinical and radiological features that overlap with those of breast cancer, making it difficult to differentiate between the two based solely on clinical assessment. Aims and Objective: The objective of this study is to highlight the diagnostic dilemmas, the clinico-pathological profile of such cases and what enables a correct diagnosis in such cases. MATERIALS AND METHODS: A retrospective study of 5 patients with histologically proven granulomatous mastitis attending OPD/IPD at a tertiary care center in south India during a period of 18 months from Jan 2022 – Jul 23. We present five cases of granulomatous mastitis highlighting the inconsistency of the clinical, imaging and initial biopsy findings, briefly review the relevant literature and discuss the challenges associated with its diagnosis. Results and Conclusion: This study highlights the importance of awareness of granulomatous mastitis and its clinicopathological characterstics. The study also emphasizes that a multidisciplinary approach involving Surgeons, radiologists, pathologists, and medical oncologists is crucial to accurately diagnose and manage this condition. Review of literature revealed few studies highlighting the clinic-radiological and histopathological profile of such cases of granulomatous mastitis mimicking malignancy however such studies are far less and encompass only isolated single case reports or occasional series of 2-3 cases. To our knowledge this is one of the largest case series with 5 cases highlighting the clinicopathological details and the diagnostic dilemmas.

Abstract Rice blast disease is the most devastating disease constraining crop productivity. Vertical resistance to blast disease is widely studied despite its instability. Clusters of genes or QTLs conferring blast resistance that offer durable horizontal resistance are important in resistance breeding. In this study, we aimed to refine the reported QTLs and identify stable meta-QTLs (MQTLs) associated with rice blast resistance. A total of 435 QTLs were used to project 71 MQTLs across all the rice chromosomes. As many as 199 putative rice blast resistance genes were identified within 53 MQTL regions. The genes included 48 characterized resistance gene analogs and related proteins, such as NBS–LRR type, LRR receptor-like kinase, NB-ARC domain, pathogenesis-related TF/ERF domain, elicitor-induced defense and proteins involved in defense signaling. MQTL regions with clusters of RGA were also identified. Fifteen highly significant MQTLs included 29 candidate genes and genes characterized for blast resistance, such as Piz, Nbs-Pi9, pi55-1, pi55-2, Pi3/Pi5-1, Pi3/Pi5-2, Pikh, Pi54, Pik/Pikm/Pikp, Pb1 and Pb2. Furthermore, the candidate genes (42) were associated with differential expression (in silico) in compatible and incompatible reactions upon disease infection. Moreover, nearly half of the genes within the MQTL regions were orthologous to those in O. sativa indica, Z. mays and A. thaliana, which confirmed their significance. The peak markers within three significant MQTLs differentiated blast-resistant and susceptible lines and serve as potential surrogates for the selection of blast-resistant lines. These MQTLs are potential candidates for durable and broad-spectrum rice blast resistance and could be utilized in blast resistance breeding.

Abstract Background The role of immune cells in collagen degradation within the tumor microenvironment (TME) is unclear. Immune cells, particularly tumor-infiltrating lymphocytes (TILs), are known to alter the extracellular matrix, affecting cancer progression and patient survival. However, the quantitative evaluation of the immune modulatory impact on collagen architecture within the TME remains limited. Methods We introduce CollaTIL, a computational pathology method that quantitatively characterizes the immune-collagen relationship within the TME of gynecologic cancers, including high-grade serous ovarian (HGSOC), cervical squamous cell carcinoma (CSCC), and endometrial carcinomas. CollaTIL aims to investigate immune modulatory impact on collagen architecture within the TME, aiming to uncover the interplay between the immune system and tumor progression. Results We observe that an increased immune infiltrate is associated with chaotic collagen architecture and higher entropy, while immune sparse TME exhibits ordered collagen and lower entropy. Importantly, CollaTIL-associated features that stratify disease risk are linked with gene signatures corresponding to TCA-Cycle in CSCC, and amino acid metabolism, and macrophages in HGSOC. Conclusions CollaTIL uncovers a relationship between immune infiltration and collagen structure in the TME of gynecologic cancers. Integrating CollaTIL with genomic analysis offers promising opportunities for future therapeutic strategies and enhanced prognostic assessments in gynecologic oncology.

Aim: Our study aimed to audit prescriptions for the prescription indicators given by WHO and to analyze prescription errors, evaluating the frequency and types of prescription errors. Methodology: Prospective study was done in Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, under Pharmacology Department in October 2020. The prescriptions from all the OPD (outpatient departments) were collected from the pharmacy store. Prescriptions for the follow-up medication and devoid of medicine were excluded from the study. Results: Total of 1451 errors were found from 400 collected prescriptions, out of which 324 (22.3%) were errors of omission and 145 (10.0%) were errors of commission related to drugs whereas 982 (67.7%) were the error of omission other than drug details. A total of 1257 drugs were prescribed making an average of 3.14 drugs per prescription, out of which 28.72% drugs were prescribed by generic name. About 34.0% of patients were prescribed antibiotics and 2.25% of patients were prescribed injectable drugs. All the drugs were prescribed from the National Essential Drug List (NEDL). Conclusion: The prescription audit showed that there is a need to train prescribing doctors as per the standard MMC and NMC guidelines for rational prescription writing to minimize the chance of major errors like not writing the dose of the drug, not writing it in capital letters, drug-related instructions, diagnosis and so on. The prescription audit should be carried out at regular intervals to improve prescription writing skills to establish a better healthcare system.

Introduction A non-contrast CT head scan (NCCTH) is the most common cross-sectional imaging investigation requested in the emergency department. Advances in computer vision have led to development of several artificial intelligence (AI) tools to detect abnormalities on NCCTH. These tools are intended to provide clinical decision support for clinicians, rather than stand-alone diagnostic devices. However, validation studies mostly compare AI performance against radiologists, and there is relative paucity of evidence on the impact of AI assistance on other healthcare staff who review NCCTH in their daily clinical practice.Methods and analysis A retrospective data set of 150 NCCTH will be compiled, to include 60 control cases and 90 cases with intracranial haemorrhage, hypodensities suggestive of infarct, midline shift, mass effect or skull fracture. The intracranial haemorrhage cases will be subclassified into extradural, subdural, subarachnoid, intraparenchymal and intraventricular. 30 readers will be recruited across four National Health Service (NHS) trusts including 10 general radiologists, 15 emergency medicine clinicians and 5 CT radiographers of varying experience. Readers will interpret each scan first without, then with, the assistance of the qER EU 2.0 AI tool, with an intervening 2-week washout period. Using a panel of neuroradiologists as ground truth, the stand-alone performance of qER will be assessed, and its impact on the readers’ performance will be analysed as change in accuracy (area under the curve), median review time per scan and self-reported diagnostic confidence. Subgroup analyses will be performed by reader professional group, reader seniority, pathological finding, and neuroradiologist-rated difficulty.Ethics and dissemination The study has been approved by the UK Healthcare Research Authority (IRAS 310995, approved 13 December 2022). The use of anonymised retrospective NCCTH has been authorised by Oxford University Hospitals. The results will be presented at relevant conferences and published in a peer-reviewed journal.Trial registration number NCT06018545.

Introduction: A common neurosurgical condition, chronic subdural haematoma (cSDH) typically affects older people with other underlying health conditions. The care of this potentially vulnerable cohort is often, however, fragmented and suboptimal. In other complex conditions, multidisciplinary guidelines have transformed patient experience and outcomes, but no such framework exists for cSDH. This paper outlines a protocol to develop the first comprehensive multidisciplinary guideline from diagnosis to long-term recovery with cSDH. Methods: The project will be guided by a steering group of key stakeholders and professional organisations and will feature patient and public involvement. Multidisciplinary thematic working groups will examine key aspects of care to formulate appropriate, patient-centered research questions, targeted with evidence review using the GRADE framework. The working groups will then formulate draft clinical recommendations to be used in a modified Delphi process to build consensus on guideline contents. Conclusions: We present a protocol for the development of a multidisciplinary guideline to inform the care of patients with a cSDH, developed by cross-disciplinary working groups and arrived at through a consensus-building process, including a modified online Delphi.

Abstract Accurate diagnosis by precise identification of causative agents is essential for the effectiveness of any control interventions. Despite high zoonotic potential, available literature on hookworms in Bangladesh is still scarce and nonspecific. The objective of this study was to determine the occurrence of hookworms in public locations across northeastern Bangladesh (Sylhet metropolitan area) using integrated parasitological and molecular assays. A total of 130 samples (80 soil and 50 environmental canine feces) were collected and examined using modified flotation technique and formalin-ether sedimentation methods. Modified plate culture was used to isolate larvae. The identification was made based on morphometric features and confirmed by amplifying the ITS region of the nuclear rDNA. Overall, 66.2% (86/130) of examined samples were positive for hookworms infection. Characteristic eggs (61–68 × 29–37 μm) and/or larvae of hookworms were observed in 73.8% (59/80) soils and 54.0% (27/50) environmental fecal samples. Rhabditiform larvae (0.48–0.54 × 0.04–0.07 mm) were observed in cultured samples. Genetic analysis of rDNA sequences revealed the presence of Ancylostoma caninum and Ancylostoma ceylanicum. In this study, hookworms' contamination of the public environment was substantial. To the best of our knowledge, this is the first molecular proof of A. caninum and A. ceylanicum observed in urban public environment in Bangladesh.

Objective The von Willebrand disease (vWD) is one of the most common inherited bleeding disorders in India; however, the diagnostic tests and its interpretation require specialized laboratory and personnel which are not readily available in the eastern part of North India. The purpose of this study is to estimate the relative prevalence of vWD and study the clinical and laboratory features including advanced diagnostic tests. Methods All patients referred to the pathology department for evaluation of bleeding were evaluated for vWD during a period of 4 years. Clinical and laboratory features were analyzed and reported. Results A total of 1,126 cases of bleeding manifestations were evaluated, and 237 cases of inherited bleeding disorders were diagnosed; vWD was diagnosed in 38 (16%) of these 237 cases. Advanced diagnostic tests were done in all of these cases. Conclusion The vWD is among the most common inherited bleeding disorders in the country, second only to hemophilia A. Type-1 vWD was the most frequent with 25 cases (65.7%), followed by type-2N with 7 cases (18.4%).

Upsurge in mucormycosis cases in the second wave of SARS CoV2 infection in India has been reported. Uncontrolled diabetes is the major predisposing risk factor for these cases. The early diagnosis and surgical intervention with medical treatment may result in good clinical outcomes. The glycaemic control in diabetic patients also favours better treatment outcome in patients suffering from mucormycosis.

Lyme disease, caused by vector-borne Borrelia bacteria, can present with diverse multi-system symptoms that resemble other conditions. The objective of this study was to evaluate disease presentations and Borrelia seroreactivity in individuals experiencing a spectrum of chronic and complex illnesses. We recruited 157 participants from Eastern Canada who reported one or more diagnoses of Lyme disease, neurological, rheumatic, autoimmune, inflammatory, gastrointestinal, or cardiovascular illnesses, or were asymptomatic and presumed healthy. Intake categories were used to classify participants based on their perceived proximity to Lyme disease, distinguishing between those with a disclosed history of Borrelia infection, those with lookalike conditions (e.g. fibromyalgia syndrome), and those with unrelated ailments (e.g. intestinal polyps). Participants completed three questionnaires, the SF-36 v1, SIQR, and HMQ, to capture symptoms and functional burden, and provided blood serum for analysis at an accredited diagnostic lab. Two-tiered IgG and IgM serological assessments (whole cell ELISA and Western blot) were performed in a blinded fashion on all samples. The pattern of symptoms and functional burden were similarly profound in the presumptive Lyme and Lyme-like disease categories. Borrelia seroprevalence across the study cohort was 10% for each of IgG and IgM, and occurred within and beyond the Lyme disease intake category. Western blot positivity in the absence of reactive ELISA was also substantial. Fibromyalgia was the most common individual diagnostic tag disclosed by two-tier IgG-positive participants who did not report a history of Lyme disease. Within the IgG seropositive cohort, the presence of antibodies against the 31 kDa Outer Surface Protein A (OspA) was associated with significantly better health outcomes. Previously, this marker has been linked to treatment-refractory Lyme arthritis. Overall, our findings support prior observations of phenotypic overlap between Lyme and other diseases. Seropositivity associated with non-specific symptoms and functional impairment warrants further mechanistic investigation and therapeutic optimization.

Abstract Background Whether due to aging, disability, injury, or other circumstances, an increasing number of Canadians experience functional limitations that reduce their ability to participate in activities of daily life. While the built environment has become increasingly accessible, existing Canadian evacuation guidelines lack comprehensive strategies for evacuating individuals with functional limitations from buildings during emergencies. To inform guideline revisions, a map of existing solutions for evacuating such individuals is required. Therefore, this scoping review aims to provide an account of solutions that have been reported to safely evacuate individuals with functional limitations from the built environment. Methods We will conduct a scoping review using the Arksey and O’Malley methodological framework. To identify potentially relevant studies, comprehensive searches (from January 2002 onwards) of the CINAHL, Ei Compendex, Inspec, Embase, MEDLINE, KCI, RSCI, SciELO CI, Web of Science Collection, and Scopus databases will be performed. Using a set of inclusion and exclusion criteria, two reviewers will independently (1) classify identified studies as relevant, irrelevant, or maybe relevant by evaluating their titles and abstracts and (2) classify the relevant and maybe relevant studies as included or excluded by evaluating their full-text. From each included study, data on publication information, study purpose, methodological details, evacuation information, and outcomes will be extracted using a set of data extraction items. We will present a numerical summary of the key characteristics of the included studies. For each evacuation activity, reported evacuation solutions will be summarized, and citations provided for functional limitations that are targeted by a given evacuation solution. To inform Canadian evacuation guideline revisions, we will tabulate evacuation activities common to different types of buildings and emergencies. Discussion To our knowledge, this will be the first scoping review to identify the state and use of solutions for evacuating individuals with functional limitations from the built environment. Identifying solutions that enable all individuals to safely evacuate from different types of buildings will allow us to inform recommendations for the revision of evacuation guidelines in Canada and other jurisdictions. The findings of this scoping review will be published in a peer-reviewed journal, presented at relevant conferences, and made publicly available on the internet. Systematic review registration Open Science Framework: osf.io/jefgy

Background. Benign prostatic hyperplasia (BPH) can raise prostate-specific antigen (PSA) levels two to three times higher than the normal level. An increased PSA level does not indicate Prostate Cancer (PCa), but the higher the PSA level, the higher the chance of having PCa. Detection and treatment have been profoundly affected by the advent of Free/Total PSA ratio testing. Objectives. The aim of the study was to estimate free, total PSA levels and its ratio for serum levels of calcium, acid phosphatase and alkaline phosphatase in patients with BPH and PCa; to correlate clinical, biochemical and histopathological findings in the above patients. Methods. PSA levels were detected by Chemiluminescent assay; serum calcium – by Modified Arsenazo method; serum acid phosphatase – by Doumas et al method; and Alkaline phosphatase – by Lowry et al method. Results. Present study found high levels of total PSA in BPH and PCa. Levels of free PSA were high in BPH as compared to PCa rate. Free/Total PSA ratio is reduced considerably in PCa as compared to BPH. Serum acid phosphatase and alkaline phosphatase were considerably higher in PCa as compared to BPH. Serum calcium levels did not show significant difference in control and study groups. Conclusions. It was established that patients with PCa have a greater fraction of bound PSA and a lower percentage of free PSA than in those without PCa. Therefore, in clinical practice Free/Total PSA ratio helps clinicians to decide if a biopsy is necessary. Objectives: The study was carried out with the following objectives: to estimate free, total PSA levels and calculate Free/Total PSA ratio in patients with BPH and Carcinoma Prostate, to study the serum levels of calcium, acid phosphates, and alkaline phosphatase in patients with BPH and PCa. and to correlate clinical, biochemical and histopathological findings in the above patients. Methods. Free and total PSA levels were detected by Chemiluminescent assay; Serum Calcium was detected by Modified Arsenazo method. Serum acid phosphatase was detected by Doumas et al method and Alkaline phosphatase were detected by Lowry et al method Results: Present study found high levels of Total PSA in BPH and PCa. Levels of free PSA were high in BPH as compared to PCa ate. Free /Total PSA ratio is reduced considerably in PCa as compared to BPH. Serum acid phosphatase and alkaline phosphatase were slightly raised in PCa as compared to BPH. Serum calcium levels did not show a significant difference in control and study groups. Conclusion: We concluded that patients with PCa have a greater fraction of bound PSA and a lower percentage of free PSA than in men without PCa. There was a negative correlation found between the free/total PSA ratio and the histopathologic findings. The lower the ratio higher is the grade of malignancy. Therefore in clinical practice Free/Total PSA ratio helps clinicians to decide if a biopsy is necessary

Prostate cancer (PC) is the most prevalent malignancy in men (after lung cancer). It commonly presents with lower urinary tract symptoms such as urgency, hesitancy, and poor stream besides some patients may present with bone pain. Anemia is the most common presentation of solid tumors with bone marrow involvement, however, pancytopenia as the presenting feature is rare. Here, we describe a 60-year-old man with significant comorbidities in the past who now presented with symptomatic anemia without any urinary symptoms. On evaluation, he was found to have pancytopenia with elevated alkaline phosphatase levels. Work up for pancytopenia revealed metastatic deposits from the adenocarcinoma in the bone marrow. Further, he was diagnosed as a case of PC on transrectal prostate biopsy and managed with denosumab and maximal androgen blockade.

Abstract Probe-based confocal laser endomicroscopy (pCLE) allows for real-time diagnosis of dysplasia and cancer in Barrett’s esophagus (BE) but is limited by low sensitivity. Even the gold standard of histopathology is hindered by poor agreement between pathologists. We deployed deep-learning-based image and video analysis in order to improve diagnostic accuracy of pCLE videos and biopsy images. Blinded experts categorized biopsies and pCLE videos as squamous, non-dysplastic BE, or dysplasia/cancer, and deep learning models were trained to classify the data into these three categories. Biopsy classification was conducted using two distinct approaches—a patch-level model and a whole-slide-image-level model. Gradient-weighted class activation maps (Grad-CAMs) were extracted from pCLE and biopsy models in order to determine tissue structures deemed relevant by the models. 1970 pCLE videos, 897,931 biopsy patches, and 387 whole-slide images were used to train, test, and validate the models. In pCLE analysis, models achieved a high sensitivity for dysplasia (71%) and an overall accuracy of 90% for all classes. For biopsies at the patch level, the model achieved a sensitivity of 72% for dysplasia and an overall accuracy of 90%. The whole-slide-image-level model achieved a sensitivity of 90% for dysplasia and 94% overall accuracy. Grad-CAMs for all models showed activation in medically relevant tissue regions. Our deep learning models achieved high diagnostic accuracy for both pCLE-based and histopathologic diagnosis of esophageal dysplasia and its precursors, similar to human accuracy in prior studies. These machine learning approaches may improve accuracy and efficiency of current screening protocols.

Context Due to the wide spectrum of clinical illness in coronavirus disease 2019 (COVID-19) patients, it is important to stratify patients into severe and nonsevere categories. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been evaluated rapidly by a few studies worldwide for its association with severe disease, but practically none have been conducted in the Indian population. This study was undertaken to examine the role of NLR and PLR in predicting severe disease in Indian patients. Objectives The objective was to study the association of NLR and PLR observed at the time of admission with maximum disease severity during hospitalization and to study their role in predicting disease severity. Material and Methods A total of 229 COVID-19 patients were admitted at the center during the study period. After applying inclusion and exclusion criteria, 191 patients were included in the study. The demographic, clinical, and laboratory (complete blood count, NLR, and PLR) data of all patients were obtained at the time of admission. Maximum disease severity of all patients was assessed during hospitalization. Statistical Analysis Chi-square and Mann–Whitney U tests were used to assess statistical significance. Receiver operating characteristic curve (ROC) was plotted for NLR and PLR to estimate the cutoff values and sensitivity and specificity using Youden’s index for predicting severe disease. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals. Results Mean NLR and PLR were significantly higher in severe patients (NLR = 7.41; PLR = 204) compared with nonsevere patients (NLR = 3.30; PLR = 121). ROC analysis showed that NLR, in comparison to PLR, had a higher area under the curve (AUC) of 0.779, with a larger OR of 1.237 and cutoff of 4.1, and showed 69% sensitivity and 78% specificity in predicting severe disease. Cut off for PLR was 115.3, which showed 79% sensitivity and 62% specificity in predicting severe disease. Conclusion NLR and PLR, both showing acceptable AUCs, can be used as screening tools to predict disease severity. However, NLR was a better predictor of disease severity.

Abstract Galactomannan is a polymer of high economic importance and is extracted from the seed endosperm of clusterbean (C. tetragonoloba). In the present study, we worked to reveal the stage-specific galactomannan biosynthesis and its regulation in clusterbean. Combined electron microscopy and biochemical analysis revealed high protein and gum content in RGC-936, while high oil bodies and low gum content in M-83. A comparative transcriptome study was performed between RGC-936 (high gum) and M-83 (low gum) varieties at three developmental stages viz. 25, 39, and 50 days after flowering (DAF). Total 209,525, 375,595 and 255,401 unigenes were found at 25, 39 and 50 DAF respectively. Differentially expressed genes (DEGs) analysis indicated a total of 5147 shared unigenes between the two genotypes. Overall expression levels of transcripts at 39DAF were higher than 50DAF and 25DAF. Besides, 691 (RGC-936) and 188 (M-83) candidate unigenes that encode for enzymes involved in the biosynthesis of galactomannan were identified and analyzed, and 15 key enzyme genes were experimentally validated by quantitative Real-Time PCR. Transcription factor (TF) WRKY was observed to be co-expressed with key genes of galactomannan biosynthesis at 39DAF. We conclude that WRKY might be a potential biotechnological target (subject to functional validation) for developing high gum content varieties.

Background and Objectives: Aedes mosquito has been recognized as a global emerging threat with its potential to transmit fatal diseases of international public health importance such as dengue, chikungunya, and yellow fever. Prior attempts to manage the vector with various synthetic larvicides have resulted in emergence of resistance, thus necessitating search for a safer and effective alternative. The study was an experimental laboratory-based study to screen the recent World Health Organization (WHO)-approved insecticide spinosad for larvicidal activity and compare the efficacy of the same with other currently used larvicides, namely temephos and Bacillus thuringiensis var. israelensis (Bti). Methodology: An experimental setup was done as per the WHO Pesticide Evaluation Scheme to assess the larvicidal activity of the spinosad at varying concentrations along with a positive and negative control. A preliminary screening to assess the larvicidal property of the spinosad was undertaken with 0.5 ppm concentration as recommended by the WHO. The mortality was checked after 24 h and results were statistically analyzed and LC50 and LC90 values were calculated. Results: Spinosad brought about 100% larval mortality at the recommended dosage (0.5 ppm) as well as at a lower dosage of 0.1 ppm. The comparison with the other two commonly used larvicides, namely temephos and Bti, reveals 100% and 90% mortality, respectively, in wild Aedes larvae. Conclusion: The study concludes that spinosad is a promising larvicide that can be used in rotation with temephos against Aedes aegypti in potable water and may be used at a lower dosage of 0.1 ppm. However, large-scale field trials are required to ascertain the effectiveness of the larvicide in field conditions.

Abstract Based upon the morphological characteristics, tea is classified botanically into 2 main types i.e. Assam and China, which are morphologically very distinct. Further, they are so easily pollinated among themselves, that a third category, Cambod type is also described. Although the general consensus of origin of tea is India, Burma and China adjoining area, yet specific origin of China and Assam type tea are not yet clear. Thus, we made an attempt to understand the origin of Indian tea through the comparative analysis of different chloroplast (cp) genomes under the Camellia genus by performing evolutionary study and comparing simple sequence repeats (SSRs) and codon usage distribution patterns among them. The Cp genome based phylogenetic analysis indicated that Indian Tea, TV1 formed a different group from that of China tea, indicating that TV1 might have undergone different domestications and hence owe different origins. The simple sequence repeats (SSRs) analysis and codon usage distribution patterns also supported the clustering order in the cp genome based phylogenetic tree.

Background: Chronic Kidney Disease of uncertain etiology (CKDu) affecting many tropical countries in the world has reached epidemic proportions. Studies on the diagnostic accuracy including data on the performance of existing renal tests in targeted population screenings of CKDu are limited. Objectives: This study aimed to determine the point prevalence of CKDu using selected screening markers of kidney disease with predefined cutoffs established by the authors (Ratnayake et al., 2017). Method: One hundred individuals from a population of 5718 who lived in a CKDu-endemic region were selected. After the exclusion of diabetes, hypertension, and known renal diseases, dipstick proteinuria, serum cystatin C, serum creatinine, and urine albumin creatinine ratio (ACR) were estimated on fifty individuals recruited. Individuals with test results above the predefined cutoff values were considered as having or suspected to be having CKDu. Results: The respective determinations of diagnostic accuracy of each test at the optimal cutoff for a CKDu population, and detection of positive cases as a percentage of total tests were: serum cystatin-C accuracy - 0.8, detects14% at ≥1.22 mg/L, serum creatinine accuracy - 0.73, detects 6% at ≥115 and ≥96 μmol/L for males and females respectively, and ACR accuracy - 0.68, detects 8% and 26% at ≥ 30mg/g and ≥12.6 mg/g cutoffs respectively. Conclusion: In the targeted population screening of CKDu, detection of suspected cases, or point prevalence by serum creatinine was lower than that of cystatin C and ACR.

Introduction: Iron deficiency anemia (IDA) is the most common cause of anemia worldwide, especially in adolescent girls, women of reproductive age group, and young children. The clinical presentation and the other biochemical parameters differ in a different age, sex, and geographical group. A study to evaluate the clinical and biochemical profile of patients with IDA at a tertiary care hospital. Materials and Methods: One hundred and two Cases of IDA were taken from the outpatient department (OPD) and ward. After taking consent, the workup was done. Complete history and physical examination were done, and patients were evaluated for signs and symptoms of IDA. Laboratory investigations such as complete blood count with differential count, reticulocyte count, peripheral blood smears, serum iron, total iron binding capacity, serum ferritin, lactic dehydrogenase, stool for occult blood and ova, cysts, liver and renal function were done in all the patients. Results: One hundred and two patients of IDA were enrolled from OPD and ward. The majority of the patients were from the 21 to 30 years age group (25.5%). 37.3% were male and 62.7% were female patients. The main presenting complaint was weakness and easy fatigability (91%). Among the associated comorbidities, the most common were hypertension (13.7%). The majority of the patients had severe pallor (54.9%). Icterus was found in 1.9%. Splenomegaly was found in 4.9%. General blood pictures showed 97.1% had microcytes, 96.1% had hypochromasia and 97.1% had Anisocytosis, which is characteristic of IDA. Conclusion: The majority of patients came to the hospital after developing clinical features due to severe anemia. Therefore, a population based study to evaluate the mild form of IDA or to evaluate a preanemic iron deficiency state can help in the early diagnosis of these patients before they develop severe form.

Abstract Objective Low DNA sequence polymorphism despite enormous phenotypic variations in peanut indicates the possible role of epigenetic variations. An attempt was made to analyze genome-wide DNA methylation pattern and its influence on gene expression across 11 diverse genotypes of peanut. Results The genotypes were subjected to bisulfite sequencing after 21 days of sowing (DAS). CHG regions showed the highest (30,537,376) DNA methylation followed by CpG (30,356,066) and CHH (15,993,361) across 11 genotypes. The B sub-genome exhibited higher DNA methylation sites (46,294,063) than the A sub-genome (30,415,166). Overall, the DNA methylation was more frequent in inter-genic regions than in the genic regions. The genes showing altered methylation and expression between the parent (TMV 2) and its EMS-derived mutant (TMV 2-NLM) were identified. Foliar disease resistant genotypes showed significant differential DNA methylation at 766 sites corresponding to 25 genes. Of them, two genes (Arahy.1XYC2X on chromosome 01 and Arahy.00Z2SH on chromosome 17) coding for senescence-associated protein showed differential expression with resistant genotypes recording higher fragments per kilobase of transcript per million mapped reads (FPKM) at their epialleles. Overall, the study indicated the variation in the DNA methylation pattern among the diverse genotypes of peanut and its influence of gene expression.

Background: In these desperate times when the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic has caught the entire world off guard, we have very few evidence-based preventive measures currently available. Various preventive practices, which include both pharmacological interventions (PIs) and non-PIs (NPI), adopted by the health-care workers (HCWs) might play a crucial role in protecting them against COVID-19. This study aims to identify these preventive measures adopted by HCWs in a dedicated 1000-bedded temporary COVID-19 hospital in northern India, with HCWs coming from various parts of the country. Objectives: The objective was to study the various forms of preventive measures undertaken by HCWs and to calculate their prevalence. Methodology: This cross-sectional web-based survey was conducted in a population of HCWs in a 1000-bedded COVID-19 hospital in northern India. Results: Most HCWs included in the study were using multiple preventive measures not necessarily backed by evidence. In this study, 81.8% of the participants were using hydroxychloroquine (HCQ) prophylaxis. Nurses had the highest adherence to HCQ prophylaxis, however they were also the most concerned regarding side effects. Increase in the frequency of hand hygiene and bathing practices was seen in majority of the participants. HCWs were also found to practice various preventive measures such as Vitamin C supplements (37.8%), yoga (37.1%), and warm saline gargles (36.3%). Other less common methods noted were steam inhalation, amlaki, kaadha, tulsi drops, chyawanprash, and nasya. The Internet served as the main source of information. Conclusion: The role of various preventive practices in the setting of a novel infection needs to be studied further. With no dearth in information advocating various proven or unproven strategies available on the Internet, their use by both HCWs and general population is inevitable. This is irrespective of their job or educational profiles. Whether or not such practices are useful in our fight against COVID-19 is a question that can only be answered through further studies.

COVID-19 pandemic has adversely affected every tenet of societies all across the world. The gruesome disease, which is primarily a respiratory illness, as is being unmasked with each passing day, has been reported to have a variety of presentations. Here, we report three such cases with atypical manifestation in COVID-19 who were managed in a resource-limited makeshift COVID-19 temporary hospital in Northern India. The dictum to avoid unnecessary exposure by restricting investigations or procedures that would not directly aid in management has been reiterated in this series of cases.

Aims and Objectives: The aim and objective of this study is to detect invasive fungal infections (IFIs) early and with more sensitivity by the nested polymerase chain reaction (PCR) for fungus as compared to fungal culture in clinically suspected patients and also explore its correlation in reference to age, duration of symptoms, immunocompromised status, and other risk factors predisposing to IFIs. Materials and Methods: In this cross-sectional study, 50 suspected patients admitted in medical acute care unit/intensive care unit (ACU/ICU) of Sir Sunderlal Hospital, Banaras Hindu University, Varanasi, India, comprised the study. All cases were selected based on the predefined inclusion and exclusion criteria. A detailed history, clinical examination, and all required investigations were done in all suspected patients. Blood samples were taken for nested-PCR for fungus and culture. Nested PCR was performed on extracted DNA form samples collected from all participants under the study. Results: Our study comprised of 50 suspected immunocompromised patients of IFIs. Among the participants under the study, the most common risk factor was diabetes mellitus (28% cases). Nearly two-thirds (60%) of the cases were 50 years or more. Around 70% of the cases had a history of illness more than 2 weeks. Nested PCR for fungus came out to be positive in 21/50 patients (42%); however, fungal culture was positive in none. Among the admitted patient in ACU/ICU, 75% were neutropenic. Conclusions: IFIs are more common in immunocompromised individuals, patients with comorbidities, long history of symptoms, and elderly population. Nested PCR for fungus has a high sensitivity (as compared to the fungal culture), and also they are rapid in giving the results. Thus, nested PCR for fungus can be used in a cost-effective manner for the early and reliable diagnosis of clinically suspected IFIs.

Summary: Background: We aimed to understand the relationship between serum biomarker concentration and lesion type and volume found on computed tomography (CT) following all severities of TBI. Methods: Concentrations of six serum biomarkers (GFAP, NFL, NSE, S100B, t-tau and UCH-L1) were measured in samples obtained

Sickle cell trait (SCT), a heterozygous state characterized by hemoglobin AS, occurs commonly in sub-Saharan Africa, South America, Central America, India, and the Mediterranean countries. SCT is compatible with a normal lifespan and is not commonly regarded as a cause of morbid illness or death compared to its homozygous counterpart. We describe a case of fatal sickling-associated microvascular crisis, identified on post mortem evaluation in a previously undiagnosed 21-year-old military recruit with sickle cell trait. The individual presented with repeated syncope episodes during his training and was autopsied in the pursuit of cardiac anomalies and heat syncope. During the terminal episode, he collapsed and died of severe metabolic complications as he struggled to complete an organized run during routine training activities. To our knowledge, this is the first report of fatal sickling-associated crisis in a military recruit with sickle cell trait from India. This case serves to remind all armed forces and sports physicians of the importance of screening a recruit who is unable to complete exertional physical training for the presence of sickle cell trait.

Introduction: Deletion of critical regions on long arm of chromosome 7 is important in pathogenesis of acute myeloid leukemia (AML). These regions include 7q22 and 7q31 which carry certain tumor suppressor genes which if deleted can result in uncontrolled division of myeloid cells. Aims: To estimate prevalence of 7q deletion in patients with acute myeloid leukemia (AML). Materials and methods: Retrospective study was done on 25 bone marrow samples diagnosed with Acute myeloid leukemia referred to Division of Human Genetics St.John’s Medical college, Bangalore. Samples were subjected to standard protocol for karyotyping and FISH. Percentage of patients who were positive for 7q deletion was calculated. Results: Out of 25 samples, 5 samples were positive for 7 q deletion accounting to 20% of total patients diagnosed with AML. Conclusion: Presence of 7q deletion can be a poor prognostic marker since tumour suppressor genes are present in these regions. Hence cytogenetic markers are very important in deciding treatment and prognosis in these patients.

In a context of ongoing biodiversity erosion, obtaining genomic resources from wildlife is essential for conservation. The thousands of yearly mammalian roadkill provide a useful source material for genomic surveys. To illustrate the potential of this underexploited resource, we used roadkill samples to study the genomic diversity of the bat-eared fox (Otocyon megalotis) and the aardwolf (Proteles cristatus), both having subspecies with similar disjunct distributions in Eastern and Southern Africa. First, we obtained reference genomes with high contiguity and gene completeness by combining Nanopore long reads and Illumina short reads. Then, we showed that the two subspecies of aardwolf might warrant species status (P. cristatus and P. septentrionalis) by comparing their genome-wide genetic differentiation to pairs of well-defined species across Carnivora with a new Genetic Differentiation index (GDI) based on only a few resequenced individuals. Finally, we obtained a genome-scale Carnivora phylogeny including the new aardwolf species.

Tuberculosis (TB) strains with drug resistance are more difficult to treat than drug susceptible ones and jeopardise global progress towards the targets set by the World Health Organisation’s End TB Strategy. Although disseminated TB is well known as an opportunistic infection in HIV infected individuals, it is uncommon in HIV negative individuals. The present case is a rare case of Extensively Drug Resistant (XDR)-TB in disseminated TB involving the extrapulmonary sites in an immunocompetent adult. We report a case of a young man who has disseminated TB involving pleura and peritoneum. Prior to this, he had taken category II anti-TB treatment with no satisfactory response. Drug sensitivity test of pleural fluid revealed resistance to quinolones, kanamycin, isoniazid and rifampicin. Patient was administered second line anti-TB therapy with remarkable response. Therefore, this case highlights the importance of investigating aggressively for Drug Resistance (DR) in suspected cases of extrapulmonary TB.

Soil salinization is a serious problem for cultivation of rice, as among cereals rice is the most salt sensitive crop, and more than 40% of the total agricultural land amounting to approximately 80 million ha the world over is salt affected. Salinity affects a plant in a varieties of ways, including ion toxicity, osmotic stress and oxidative damage. Since miRNAs occupy the top place in biochemical events determining a trait, understanding their role in salt tolerance is highly desirable, which may allow introduction of the trait in the rice cultivars of choice through biotechnological interventions. High throughput sequencing of sRNAs in the root and shoot tissues of the seedlings of the control and NaCl treated Pokkali, a salt-tolerant rice variety, identified 75 conserved miRNAs and mapped 200 sRNAs to the rice genome as novel miRNAs. Expression of nine novel miRNAs and two conserved miRNAs were confirmed by Northern blotting. Several of both conserved and novel miRNAs that expressed differentially in root and/or shoot tissues targeted transcription factors like AP2/EREBP domain protein, ARF, NAC, MYB, NF-YA, HD-Zip III, TCP and SBP reported to be involved in salt tolerance or in abiotic stress tolerance in general. Most of the novel miRNAs expressed in the salt tolerant wild rice Oryza coarctata, suggesting conservation of miRNAs in taxonomically related species. One of the novel miRNAs, osa-miR12477, also targeted L-ascorbate oxidase (LAO), indicating build-up of oxidative stress in the plant upon salt treatment, which was confirmed by DAB staining. Thus, salt tolerance might involve miRNA-mediated regulation of 1) cellular abundance of the hormone signaling components like EREBP and ARF, 2) synthesis of abiotic stress related transcription factors, and 3) antioxidative component like LAO for mitigation of oxidative damage. The study clearly indicated importance of osa-miR12477 regulated expression of LAO in salt tolerance in the plant.

BACKGROUND: Candida spp. secretes various extracellular hydrolytic enzymes. These enzymes are the important virulence factor for the pathogenesis of Candida. We assessed four different enzymatic activities of Candida isolates obtained from bloodstream infections. MATERIALS AND METHODS: We isolated 79 strains of different Candida species from the blood of the Intensive Care Unit-admitted patients. Species were identified by conventional methods including culture characteristic, germ tube, sugar assimilation, and Dalmau's culture technique. Phospholipase, proteinase, hemolysin, and esterase enzymatic activities were determined by the Plate method. RESULTS: Non albicans candida were the most common isolates from the blood of the ICU admitted patient with a predominance of Candida tropicalis. Hemolytic activity was the most prominent enzyme activity followed by the proteinase activity. Candida albicans (89.86%) was the major proteinase producer, while 95.8% of C. tropicalis produced hemolysin. No esterase activity was shown by the Candida glabrata and Candida krusei. CONCLUSION: No significant difference was observed between the two most common causative agents of candidemia: C. albicans and C. tropicalis.

The COVID-19 infection has been causing significant burden on the health infrastructure of almost every country and the COVID-related mortalities and morbidities translate into a significant impact on the societal perspective. Adequate precautions are mandatory for the healthcare workers managing patients at healthcare facilities like use of personal protective equipment (PPE) while handling patients. The clinical examination forms an important tool in the evaluation of any patient. For the last few years, the clinical skills of the clinicians have been on the decline noticed by the medical fraternity. The clinicians have become increasingly reliant on investigation reports and imaging technologies to diagnose and manage the patient. The situation of COVID-19 and management of these patients in COVID care hospitals and centers have further diminished the role of clinical skills with the added difficulties of wearing the full component of PPE during the patient evaluation and care. Patients are isolated as per the protocol, and doctors are forced to avail the telemedicine facilities and depend on the objective data provided by the junior doctors or paramedics. The pondering question is, have we reached a new tipping point in the utility of clinical diagnosis, making it further alienated in the future? We will have to wait and see if the clinical skill utility change caused by this pandemic would have a lasting effect.

BMP7/BMP2 or BMP7/BMP4 heterodimers are more active than homodimers in vitro, but it is not known whether these heterodimers signal in vivo. To test this, we generated knock in mice carrying a mutation (Bmp7R-GFlag) that prevents proteolytic activation of the dimerized BMP7 precursor protein. This mutation eliminates the function of BMP7 homodimers and all other BMPs that normally heterodimerize with BMP7. While Bmp7 null homozygotes are live born, Bmp7R-GFlag homozygotes are embryonic lethal and have broadly reduced BMP activity. Furthermore, compound heterozygotes carrying the Bmp7R-G allele together with a null allele of Bmp2 or Bmp4 die during embryogenesis with defects in ventral body wall closure and/or the heart. Co-immunoprecipitation assays confirm that endogenous BMP4/7 heterodimers exist. Thus, BMP7 functions predominantly as a heterodimer with BMP2 or BMP4 during mammalian development, which may explain why mutations in either Bmp4 or Bmp7 lead to a similar spectrum of congenital defects in humans.

Metal Tolerance Proteins (MTPs) are the class of membrane proteins involved in the transport of metals, mainly Zn, Mn, Fe, Cd, Co and Ni, and confer metal tolerance in plants. In the present study, a comprehensive molecular analysis of rice MTP genes was performed to understand the evolution, distribution and expression dynamics of MTP genes. Exploration of the whole genome re-sequencing information available for three thousand rice genotypes highlighted the evolution and allelic diversity of MTP genes. Based on the presence of non-synonymous single nucleotide polymorphism (SNP), MTP1, MTP6, MTP8 and MTP9 were found to be the most conserved genes. Furthermore, results showed localization of MTP1, MTP8.1 and MTP9, and MTP11, respectively with QTLs/m-QTLs for Zn and Cd accumulation, making these genes promising candidates to understand the QTL regulation. Expression profiling of the entire set of 10 MTP genes revealed root and shoot specific expressions of MTP9 and MTP8.1, respectively, under all tested vegetative stages. Expression of seed-specific MTPs increased as seed maturation progressed, which revealed their potential role in transporting metals during seed filling. Upon exposure to harmful heavy metals, expression of most MTP genes decreased in root and increased in shoot, suggests that different mechanisms are being employed by MTPs in different tissues. Contrastingly, only a few MTPs were found to be responsive to Fe and/or Zn starvation conditions. The extensive analysis of MTPs presented here will be helpful in identifying candidate MTP genes for crop biofortification and bioremediation purposes.

Rice blast, caused by the ascomycete fungus Magnaporthe oryzae is a destructive disease of rice and responsible for causing extensive damage to the crop. Pi54, a dominant blast resistance gene cloned from rice line Tetep, imparts a broad spectrum resistance against various M. oryzae isolates. Many of its alleles have been explored from wild Oryza species and landraces whose sequences are available in the public domain. Its cognate effector gene AvrPi54 has also been cloned from M. oryzae. Complying with the Flor's gene-for-gene system, Pi54 protein interacts with AvrPi54 protein following fungal invasion leading to the resistance responses in rice cell that prevents the disease development. In the present study Pi54 alleles from 72 rice lines were used to understand the interaction of Pi54 (R) proteins with AvrPi54 (Avr) protein. The physiochemical properties of these proteins varied due to the nucleotide level polymorphism. The ab initio tertiary structures of these R- and Avr- proteins were generated and subjected to the in silico interaction. In this interaction, the residues in the LRR region of R- proteins were shown to interact with the Avr protein. These R proteins were found to have variable strengths of binding due to the differential spatial arrangements of their amino acid residues. Additionally, molecular dynamic simulations were performed for the protein pairs that showed stronger interaction than Pi54tetep (original Pi54 from Tetep) protein. We found these proteins were forming h-bond during simulation which indicated an effective binding. The root mean square deviation values and potential energy values were stable during simulation which validated the docking results. From the interaction studies and the molecular dynamics simulations, we concluded that the AvrPi54 protein interacts directly with the resistant Pi54 proteins through the LRR region of Pi54 proteins. Some of the Pi54 proteins from the landraces namely Casebatta, Tadukan, Varun dhan, Govind, Acharmita, HPR-2083, Budda, Jatto, MTU-4870, Dobeja-1, CN-1789, Indira sona, Kulanji pille and Motebangarkaddi cultivars show stronger binding with the AvrPi54 protein, thus these alleles can be effectively used for the rice blast resistance breeding program in future.

Only a small number of muscle activation patterns from lower limbs have been reported and simultaneous muscle activation from several lower limb muscles have not yet been investigated. The purpose of this study was to examine any gender differences in surface electromyography (EMG) activity from six recorded lower limb muscles of the dominant limb at baseline (i.e., with the foot placed flat on the floor and in the neutral position), and during concentric and eccentric phases when performing a heel raise task. In total, 10 females and 10 males performed a standing heel raise task comprising of three continuous phases: baseline, unloading (concentric muscle action), and loading (eccentric muscle action) phases. Muscle activation from six muscles (gastrocnemius medialis, gastrocnemius lateralis, soleus, tibialis anterior, peroneus longus, and peroneus brevis) were measured using the Myon 320 EMG System. Root mean squared values of each muscle were calculated for each phase. Descriptive and inferential statistics were incorporated into the study. Statistically significant p values were set at 0.05. The results showed no significant differences between baseline, concentric, and eccentric phases with respect to each of the muscles investigated. Except for the gastrocnemius medialis at baseline and concentric phases, no significant differences were observed between genders or contractions. The data suggests that gender does not significantly influence the eccentric phase during the standing heel raise task.

Introduction: Endoparasites in captive wildlife might pose a threat to public health; however, very few studies have been conducted on this issue, and much remains to be learned, especially in limited-resource settings. This study aimed to investigate endoparasites of captive wildlife in Bangladesh. Perception and understanding of veterinarians regarding one health and zoonoses were also assessed. Materials and Methods: A cross-sectional study was conducted from October 2019 to August 2020. A total of 45 fecal samples from 18 different species of wild animals (i.e., 11 species of mammals: herbivores, carnivores, and omnivores, six birds, and a single reptile species) were collected randomly. Parasitological assessments were done by modified formalin ether sedimentation technique and rechecked by Sheather’s sugar floatation technique. Molecular identification of Spirometra spp. was conducted by amplifying the cytochrome c oxidase 1 (cox1) gene. Questionnaire surveys among 15 veterinarians and an in-depth interview (IDI) with a zoo officer were conducted. Results: Helminths (Spirometra sp., Capillaria sp., Ascaridia/Heterakis, opisthorchiid, strongyles, acuariid, hookworms, roundworms, and unidentified nematode larvae) and protozoa (coccidian oocyst) were identified, and the overall prevalence was 48.9% (22/45). The cox1 sequences (341 bp) of the Bangladesh-origin Spirometra species from lion showed 99.3–99.7% similarity to the reference sequences of Spirometra decipiens (GenBank No: KJ599679.1; MT122766). The majority of study participants (86.6%) agreed about the importance of endoparasite control in zoo animals, and 73.3% expressed that the one health concept should be promoted in Bangladesh. Only 6.7% of veterinarians perceived confidence in diagnosing parasitic diseases and preventing antiparasiticidal resistance. Conclusions: In the present survey, we found a considerable prevalence of endoparasites in captive wildlife. For the first time, zoonotically important S. decipiens from lion was molecularly characterized in Bangladesh. Veterinarian training is required to improve parasite control knowledge and practice. This study highlights the need for routine parasitological assessment, promotion of one health, and improvement of the implementation of current parasite control strategies in zoo animals.

Background: Rigorous exercise is a hallmark of military training and more than often gives rise to dehydration and stress related injuries. Proper hydration and carbohydrate loading can overcome dehydration and protein supplement can prevent its imminent complications. Severe dehydration gives rise to loss of fluid, electrolyte imbalance and acid base disorders and needs to be managed with correct fluids, quantitatively and qualitatively. Objectives. To develop and implement a new hydration protocolfor military endurance training in hot and humid climatic conditions. Methodology: A longitudinal pilot study was conducted amongst the under trainees in a military academy in Southern India which has a hot and humid climate throughout the year. Data was collected for all heat exhaustion and heat stroke cases admitted to the hospital A new hydration and diet protocol based on extensive review of existing and current literature was developed The protocol was divided into three parts Le. pre exercise, during exercise and post exercise. Results: Out of a total of 1200 under trainees being trained in each term of six months (both in 2014 and 2015), there were a total of 95 cases of heat exhaustion and 05 cases of heat stroke in 2014 and 48 cases of heat exhaustion and 05 cases of heat stroke in 2015. Conclusion: The results of implementation of the new protocol for endurance training is encouraging with a sharp decline in number of cases of heat exhaustion in 2015 post introduction of the new hydration and dietprotocol An appropriate selection of food andfluid, timing of intake, and supplement choices as per the new hydration protocol we developedfor the study are highly recommended for optimal health and exercise performance in military training and to prevent heat related illnesses.

Background: Coronary artery disease (CAD) has been the leading cause of morbidity and mortality worldwide. Studies indicate that patients with CAD show higher degree of pulp calcifications. Localized pulp calcifications are microscopically apparent in more than half of the teeth in young adolescents. However, pulp stones extending to the entire dentition are infrequent and need further evaluation to predict the risk of other probabilities of associated diseases. The present study was planned to estimate the prevalence of pulp stones in patients diagnosed with or, undergoing treatment for CAD. Methods: The present study consisted of 300 subjects within an age range of 20-55 years who were divided into the study group consisting of 150 patients including 108 males and 42 females as well as 150 age- and sex-matched healthy controls. Pulp stones were imaged using bitewing radiographs using paralleling technique under standard conditions. Statistical Analysis Used: The statistical analysis was performed using IBM SPSS statistics 20 Core system software (SPSS Inc., Chicago, IL, USA) while Chi-square test was used to check the prevalence of pulp stones in patients with CAD in addition to their arch-wise and region-wise distribution. P value

How information is communicated influences the public's environmental perceptions and behaviors. Information channels and sources both play an important role in the dissemination of information. Trust in a source is often used as a proxy for whether a particular piece of information is credible. To determine preferences for information channels and trust in various sources for information on nature-related topics, a mail-out survey was sent to randomly selected U.S. addresses (n = 1,030). Diverse groups of people may have differing communication preferences. Therefore, we explored differences in channel preferences and trust by demographics using regression models. Overall, the most preferred channels were personal experience, reading online content, and watching visual media online. The most trusted sources were science organizations, universities, and friends/family. Channel preferences varied the most by education level and age, while source trust was most influenced by education, race, age, and size of current residence (rural-urban). The influence of demographics varied depending on the individual channel and source, with some groups preferring certain channels or sources but not others. Results are useful to consider when disseminating information on nature-related topics to a general public audience. More broadly, results also suggest spreading information using different channels and sources depending on the specific audience being targeted.

BACKGROUND:Myocardial infarction is the most common cause of heart failure. MI has been intricately linked to ventricular remodeling, subsequently leading to the reduction in the cardiac ejection fraction causing HF. The cumulative line of evidence suggests an important role of several biomarkers in modulating the cardiac vasculature, further contributing towards the progression of post-MI complications. Studies have demonstrated, yet not fully established, that an important biomarker, IL-10, has a causal relationship with MI and associated cardiac dysfunction. HYPOTHESIS:This study aims to establish the role of IL-10 as a prognostic marker for the cardiovascular outcomes and to develop a panel of biomarkers and circulating miRNAs that could potentially result in the early detection of HF resulting from MI, allowing for early intervention strategies. METHODS AND RESULTS:Blood was withdrawn and echocardiography assessment was performed on a total of 43 patients that were enrolled, within 24 hours of the incidence of MI. Patients were divided in three main groups, based on the ejection fraction measurement from echocardiography: control (n = 14), MI with normal EF (MI+NEF, n = 13) and MI with low EF (MI+LEF, n = 16). Our results showed that TGFβ-1, TNF-α, IL-6 and MMP-9 were upregulated significantly in MI+NEF group and more so in MI+LEF group, as compared to control group (p

Healthy behaviors in pregnant women have a major effect on pregnancy outcomes; however, only few studies have explored the relationship of multiple psychosocial factors with healthy lifestyles during pregnancy. The objective of this study was to investigate whether the five psychosocial factors of anxiety, stress, depression, marital dissatisfaction, and social support are associated with six domains of healthy lifestyles in pregnant women, including nutrition, physical activity, health responsibility, stress management, interpersonal relationships, and self-actualization. In this cross-sectional study, 445 pregnant women from the obstetrics clinics of the teaching hospitals of Babol University of Medical Sciences were included. The subjects answered six questionnaires, including the Health-Promoting Lifestyle Profile, Beck Depression Inventory, Prenatal Distress Questionnaire, State-Trait Anxiety Inventory, Social Support Questionnaire, and Marital Satisfaction Scale. We developed a series of simple linear regression models based on each subscale of lifestyle (nutrition, physical activity, health responsibility, stress management, interpersonal relationships, and self-actualization) as the dependent variables and the five psychological variables (anxiety, stress, depression, marital dissatisfaction, and social support) as the independent variables. State and trait anxieties were the strongest negative predictors of all aspects of a healthy lifestyle. Furthermore, depression was negatively associated with all of the six subscales of a healthy lifestyle. Pregnancy-specific stress was the only negative predictor of stress management and self-actualization. Marital dissatisfaction was negatively associated with nutrition, stress management, health responsibility, and self-actualization. Social support had negative and positive associations with healthy behaviors. The study suggests that more attention should be paid to identifying the psychological risk factors in pregnancy in addition to providing suitable interventions for improving the lifestyle of pregnant women.