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Heavy metals, a major source of pollution in the environment, pose a substantial threat due to their non‐biodegradability and ability to accumulate in living organisms, causing health problems. Recently, researchers have been searching for cost‐effective and safe ways to remove heavy metals from polluted waterways using agricultural waste substitutes. The present study focused on the low‐cost treatments for the reduction of chromium Cr+6 metal from the effluent, wherein it has been found that chemically and bacterially treated agro‐waste had increased heavy metal ion adsorption capabilities. A sequential optimization of the process parameters was attempted using Plackett–Burman design (PBD) and central composite design of response surface methodology (CCD‐RSM) for the maximum reduction of the chromium metal from the effluent. A total of eight parameters were screened out using a 12‐run PBD experiment. Out of the eight parameters, time, HCl, NaOH, and bacterial treatments were found to be significantly affecting the maximum reduction of Cr+6 from the effluent. To investigate the interactions' effects of the chosen parameters, they were evaluated using CCD‐RSM. Maximum 74% Cr+6 reduction was achieved under the optimum treatment to rice husk of HCl 4.52 N, NaOH 3.53 N, bacterial suspension 7.41%, and with an interaction time 14.32 min using 30 run CCD‐RSM experiment. A scanning electron microscope was used to confirm the effects of selected variables on the agro‐waste for the Cr+6 reductions, as well as a Fourier transform infrared spectrometer. [ABSTRACT FROM AUTHOR]

Background/Objectives: Acute ischemic stroke is an uncommon but potentially devastating complication of Transcatheter Aortic Valve Implantation (TAVI). Despite improvements in device technology and procedural techniques, stroke rates have remained stable, with cerebral embolic protection devices demonstrating only limited efficacy to date. Therefore, the management of acute ischemic stroke complicating TAVI (AISCT) remains a key priority. We conducted a systematic review of the management of AISCT and provided multidisciplinary consensus recommendations for optimal management. Methods: PubMed, Google Scholar, and Cochrane databases were searched from inception to October 2023. All the original studies focusing on the treatment of AISCT were included. Non-English language studies, review articles, and studies in pediatric populations were excluded. Consensus recommendations were made by a working group comprising experts in stroke medicine and structural interventional cardiology. Results: A total of 18 studies met the inclusion criteria, including 14 case reports/series and 4 observational studies. No clinical trials were identified. The included case reports and series suggest that tissue-type plasminogen activator (tPA) and mechanical thrombectomy (MT) might be effective strategies for managing AISCT. However, significant bleeding complications were reported in two out of the four patients receiving tPA. Four observational studies also suggest an association between tPA and/or MT and improved functional outcomes and survival compared to conservative management. Higher bleeding rates were reported following tPA. Observational data suggest that there is currently little real-world utilization of either reperfusion strategy. Conclusions: There is an absence of high-quality randomized data to guide clinical decision making in this important area. Observational data suggest reperfusion strategies are associated with improved clinical outcomes once important confounders such as stroke severity have been accounted for. While MT can be recommended as the standard of care in appropriately selected patients, significantly increased rates of bleeding with tPA following large-bore arterial access raise important safety concerns. We present simple clinical guidance for AISCT based on the limited available data. Close multidisciplinary work and patient-specific consideration of ischemic and bleeding risk is essential. [ABSTRACT FROM AUTHOR]

Naturally occurring stilbenoids, such as the (E)-stilbenoid resveratrol and the (Z)-stilbenoid combretastatin A4, have been considered as promising lead compounds for the development of anticancer drugs. The antitumour properties of stilbenoids are known to be modulated by cytochrome P450 enzymes CYP1A1 and CYP1B1, which contribute to extrahepatic phase I xenobiotic and drug metabolism. Thirty-four methyl ether analogues of resveratrol were synthesised, and their anticancer properties were assessed, using the MTT cell proliferation assay on a panel of human breast cell lines. Breast tumour cell lines that express CYP1 were significantly more strongly affected by the resveratrol analogues than the cell lines that did not have CYP1 activity. Metabolism studies using isolated CYP1 enzymes provided further evidence that (E)-stilbenoids can be substrates for these enzymes. Structures of metabolic products were confirmed by comparison with synthetic standards and LC-MS co-elution studies. The most promising stilbenoid was (E)-4,3′,4′,5′-tetramethoxystilbene (DMU212). The compound itself showed low to moderate cytotoxicity, but upon CYP1-catalysed dealkylation, some highly cytotoxic metabolites were formed. Thus, DMU212 selectively affects proliferation of cells that express CYP1 enzymes.

Byline: Deepika. Saroha, Jigish. Ruparelia, Samhita. Panda, Suryanarayanan. Bhaskar, Sarbesh. Tiwari Stereotypies are involuntary, coordinated, repetitive, patterned, rhythmic, and seemingly purposeless movements.[1] Only a few cases of stroke-induced stereotypies have [...]

Tardive Dyskinesia is a movement disorder characterized by involuntary repetitive body movements, like chewing motions, cheek puffing, tongue protrusion and lip pursing. These symptoms appear during sleep and/or wakefulness. Report of involuntary movements of tongue is very rare, with a prevalence of only 15%–20%. Risk factors include old age, female gender, and patients receiving drugs with anti-dopaminergic activity, for long term. We report a case of 62 years old male patient with a long history of antidepressants and mood stabilizers, who presented with involuntary tongue movements. The patient was treated by altering the dose and discontinuation of a few medicines, which resulted in a slight decrease in the frequency of the movement. The case is discussed here to spread awareness and vigilance about this condition, in order to aid in early diagnosis and management, to avoid negative impacts on psychologic health and quality of life of the patient.

Introduction: Several morphological alterations and remodelling occur in the mandibular condyle and glenoid fossa to adapt to trauma, malocclusion and other developmental disorders. Understanding these changes will aid healthcare providers in comprehending the pathophysiology of various Temporomandibular Joint (TMJ) problems. Aim: To evaluate the morphometric attributes of the condyle and glenoid fossa in the Gujarati population using Cone Beam Computed Tomography (CBCT). Materials and Methods: This cross-sectional radiographic morphometric investigation was conducted at the Department of Oral Medicine and Radiology at the College of Dental Sciences and Research Centre in Bopal, Gujarat, India using departmental archives from September 2019 to September 2022. A total of 40 CBCT scans (80 TMJs) were performed and analysed using the Papaya 3D and Genoray CBCT machines, along with Triana imaging software. Measurements were taken for condylar length, width, height, joint space (anterior, superior, posterior, medial, lateral) and the thickness of the Roof of the Glenoid Fossa (RGF) (sagittal, coronal) on the CBCT images. The aforementioned parameters were compared between genders, age groups and sides using a paired t-test and statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software package (Chicago, IL, USA), version 21.0 for Microsoft (MS) Windows. Results: The mean age of the study participants was 34±9.6 years. The condylar width between males and females was the only condylar characteristic that differed significantly (p-value 0.001). Apart from the gender analysis, no statistically significant variations (p>0.05) were found in the thickness of the RGF when comparing age or side. However, in the gender-wise examination of joint space, males had significantly higher measurements of Superior Joint Space (SJS), Medial Joint Space (MJS) and Lateral Joint Space (LJS) than females. Conclusion: Gujarati males had a significantly larger condylar width compared to females. When considering gender-specific data, males also exhibited greater SJSs, MJSs and LJSs, as well as increased thickness of the RGF. The results of the present study may provide a relevant and comparable reference for the clinical assessment of individuals with healthy, functional, or pathological TMJs. [ABSTRACT FROM AUTHOR]

A focussed library of pyridyl and 2-hydroxyphenyl chalcones were synthesized and tested for growth inhibitory activity against Mycobacterium tuberculosis H37Rv, and normal and cancer breast cell lines. Pyridyl chalcones bearing lipophilic A-ring, e.g., dichloro-phenyl-(14), pyrene-1-yl (20)- and biphenyl-4-yl (21) moieties were found to be the most potent of the series inhibiting the growth of M. tuberculosis H37Rv with IC90 values ranging from 8.9–28 µM. Aryl chalcones containing a 3-methoxyphenyl A-ring and either p-Br-phenyl (25) or p-Cl-phenyl (26) B-rings showed an IC90 value of 28 µM. Aryl-chalcones were generally less toxic to HepG2 cells compared to pyridyl-chalcones. Dose-dependent antiproliferative activity against MDA468 cells was observed for trimethoxy-phenyl (16) and anthracene-9-yl (19) pyridyl-chalcones with IC50 values of 0.7 and 0.3 µM, respectively. Docking studies revealed that chalone 20 was predicted to bind to the M. tuberculosis protein tyrosine phosphatases B (PtpB) with higher affinity compared to a previously reported PtpB inhibitor. [ABSTRACT FROM AUTHOR]

Transcatheter aortic valve implantation (TAVI) has emerged as a safe and effective treatment for severe aortic stenosis across the spectrum of surgical risk cohorts. Subsequently, the dramatic increase in procedural volume worldwide has placed significant financial and logistical pressures on healthcare institutions, particularly regarding hospital length of stay (LOS), which can adversely affect patient flow. In this review article, we discuss different peri-procedural strategies developed to reduce LOS and facilitate early discharge after TAVI. [ABSTRACT FROM AUTHOR]

Balvir S Tomar,1 Mahaveer Singh,2 Deepak Nathiya,3 Abhishek Sharma,4 Eshan Sharma,4 Hemant Bareth,3 Supriya Suman,3 Darshan Purshotambhai Ruparelia,4 Jaykumar Bharatbhai Patel,4 Vikrant Kantilal Gajera4 On Behalf of the NIMS COVID 19 Investigator Group1Institute of Gastroenterology, Hepatology & Transplant, Nims University Rajasthan, Jaipur, India; 2Department of Endocrinology, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, 303121, India; 3Department of Pharmacy Practice, Institute of Pharmacy, Nims University Rajasthan, Jaipur, India; 4Department of General Medicine, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, IndiaCorrespondence: Mahaveer SinghDepartment of Endocrinology, National Institute of Medical Sciences and Research Hospital, Nims University Rajasthan, Jaipur, 303121, IndiaTel +91 8949836075Email drms.mamcmed@gmail.comDeepak NathiyaDepartment of Pharmacy Practice, Institute of Pharmacy, Nims University Rajasthan, Jaipur, 303121, IndiaTel +91 9929600137Email dnathiya@nimsuniversity.orgPurpose: To assess the prevalence of post-COVID symptoms in patients with recovered COVID-19 (nasopharyngeal RT PCR negative) who were discharged from an acute COVID care facility at a tertiary care teaching hospital in North India.Methods: This study was an observational study with retrospective data collection, conducted in the COVID follow-up clinic, a combined clinic of medicine and endocrinology. Patients discharged from the acute COVID care facility were recruited after 14 days of discharge if they fulfilled inclusion and exclusion criteria. The retrospective data was collected from the hospital records/EMR and analysed by the SPSSv23.Results: Fifty patients, who fulfilled the inclusion and exclusion criteria, were included in the study. The Mean age of patients was 53.4± 13.8 years (range 28– 77). Seventy six percent were male, and 38% had type 2 diabetes. Fever (94%), cough (78%) and breathlessness (68%), were the most common symptoms at presentation to acute care facility. Oxygen saturation at presentation had a negative correlation with D-Dimer, age, and C reactive protein. When patients were evaluated clinically, after 14 days (range 15 to 50 days) of the discharge, 82% of patients had at least one persistent symptom. Fatigue (74%) was the most common symptoms in follow-up followed by breathlessness (44%), and muscle weakness (36%). Two patients had persistent fever, even after negative RT PCR status.Conclusion: Patients discharged from the acute COVID care facility had a high prevalence of post-COVID symptoms even after 14 days.Keywords: COVID-19, diabetes, SARS-CoV-2, oxygen saturation, post-COVID

Aims: To assess left ventricular (LV) function before and after transcatheter aortic valve implantation (TAVI) using conventional echocardiographic parameters and global longitudinal LV strain (GLS) and compare outcomes between Edwards S3 and Evolut R valves. Methods and results: Data were collected for consecutive patients undergoing TAVI at Hammersmith hospital between 2015 and 2018. Of the 303 patients, those with coronary artery disease and atrial fibrillation were excluded leading to a total of 85 patients, which constituted our study group. The mean follow-up was 49 ± 39 days. In total, 60% of patients were treated with Edwards S3 and 40% Evolut R. TAVI resulted in an early improvement of GLS (−13.96 to −15.25%, P = 0.01) but not ejection fraction (EF) (47.6 to 50.1%, P = 0.09). LV mass also improved, especially in patients with marked baseline LV hypertrophy (P < 0.001). There were no appreciable differences of LV function improvement and overall LV remodelling after TAVI between the two types of valves used (P = 0.14). Conclusions: TAVI results in reverse remodelling and improvement of GLS, especially in patients with impaired baseline LV function. There were no differences in the extent of LV function improvement between Edwards S3 and Evolut R valves but there was a greater incidence of aortic regurgitation with Evolut R.