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Background: Platinum based doublets chemotherapy are the standard of care for metastatic or advanced non-small cell lung carcinoma. This leads to modest survival advantage and improve quality-of-life. However, patients with advanced or metastatic disease eventually present disease progression and needs second-line systemic therapy in a selected group of patients or other supportive measures. There is very little knowledge available from the literature about the prognostic variables in patients, who receive second-line therapy. Materials and Methods: We retrospectively reviewed 329 patients received second-line treatment from July 2007 to September 2011 in the Department of Radiation Oncology, Burdwan Medical College and Hospital. For statistical analysis, 12 potential prognostic variables included. Univariate and multivariate regression analysis carried out to identify the prognostic variables associated with survival. Results: The results of univariate analysis for overall survival (OS) and survival after second-line therapy identified to have prognostic significance: Age, sex, performance status, smoking history, serum lactate dehydrogenase, histopathology, first-line chemotherapy and its response and second-line therapy except the stage at diagnosis and site of failure after first-line therapy. The multivariate Cox regression analysis has shown that only performance and second-line therapy were independent prognostic variables for survival after second-line treatment and above these prognostic factors; age, smoking status and progression free survival also for OS. Conclusion: The performance status has shown consistent result as a prognostic factor in univariate and multivariate analysis for OS and survival after second-line therapy. These findings may also facilitate pretreatment prediction of survival and be used for selecting patients for the correct choice of cytotoxic therapy. [ABSTRACT FROM AUTHOR]

ObjectiveTo assess whether nutritional deficiency increases susceptibility to arsenic-related health effects.DesignAssessment of nutrition was based on a 24 h recall method of all dietary constituents.SettingEpidemiological cross-sectional study was conducted in an arsenic-endemic area of West Bengal with groundwater arsenic contamination.SubjectsThe study was composed of two groups – Group 1 (cases, n 108) exhibiting skin lesions and Group 2 (exposed controls, n 100) not exhibiting skin lesions – age- and sex-matched and having similar arsenic exposure through drinking water and arsenic levels in urine and hair.ResultsBoth groups belonged to low socio-economic strata (Group 1 significantly poorer, P < 0·01) and had low BMI (prevalence of BMI < 18·5 kg/m2: in 38 % in Group 1 and 27 % in Group 2). Energy intake was below the Recommended Daily Allowance (set by the Indian Council of Medical Research) in males and females in both groups. Increased risk of arsenical skin lesions was found for those in the lowest quintile of protein intake (v. highest quintile: OR = 4·60, 95 % CI 1·36, 15·50 in males; OR = 5·62, 95 % CI 1·19, 34·57 in females). Significantly lower intakes of energy, protein, thiamin, niacin, Mg, Zn and choline were observed in both males and females of Group 1 compared with Group 2. Significantly lower intakes of carbohydrate, riboflavin, niacin and Cu were also observed in female cases with skin lesions compared with non-cases.ConclusionsDeficiencies of Zn, Mg and Cu, in addition to protein, B vitamins and choline, are found to be associated with arsenical skin lesions in West Bengal. [ABSTRACT FROM PUBLISHER]

The star formation rate in galaxies should be related to the fraction of gas that can attain densities large enough for gravitational collapse. In galaxies with a turbulent interstellar medium, this fraction is controlled by the effective barotropic index γ=d log P/d log ρ which measures the turbulent compressibility. When the cooling time-scale is smaller than the dynamical time-scale, γ can be evaluated from the derivatives of cooling and heating functions, using the condition of thermal equilibrium. We present calculations of γ for protogalaxies in which the metal abundance is so small that H[sub 2] and HD cooling dominates. For a heating rate independent of temperature and proportional to the first power of density, the turbulent gas is relatively ‘hard’, with γ&gsim;1 , at large densities, but moderately ‘soft’, γ&lsim;0.8 , at densities below around 10[sup 4] cm[sup -3]. At low temperatures the density probability distribution should fall rapidly for densities larger than this value, which corresponds physically to the critical density at which collisional and radiative de-excitation rates of HD are equal. The densities attained in turbulent protogalaxies thus depend on the relatively large deuterium abundance in our Universe. We expect the same physical effect to occur in higher metallicity gas with different coolants. The case in which adiabatic (compressional) heating resulting from cloud collapse dominates is also discussed, and suggests a criterion for the maximum mass of Population III stars. [ABSTRACT FROM AUTHOR]

Vestibular rehabilitation therapy (VRT) mainly comprises physical therapies that encourage head, eye, and truncal movements, accelerating the recovery of patients with acute peripheral labyrinthine dysfunction. VRT aims to improve vestibular hypofunction by reinforcing vestibulo-ocular, vestibulospinal, and vestibulocollic reflexes. An asymmetry in peripheral vestibular inputs from the pair of membranous labyrinths to the central nervous system frequently results from vestibular lithiasis, causing benign paroxysmal positional vertigo (BPPV). The article discusses the pathophysiology, subtypes, and diagnostic oculomotor patterns generated during positional tests in each subtype of BPPV. Accurate identification of the pathophysiology (canalolithiasis versus cupulolithiasis) as well as the involved semicircular canal (localization and lateralization) is crucial for the unerring VRT of BPPV by physical therapies and/or repositioning maneuvers. The article elaborates the currently known variants of BPPV, the anatomico-physiological correlation between otoconial location and oculomotor patterns generated during the diagnostic positional tests in terms of the direction, latency, and duration of the elicited positional nystagmus [Figures 1 and 2; Table 2]. A detailed description of the treatment of different BPPV subtypes with repositioning maneuvers and/or physical therapy is given [Figures 3-8; Table 3]. [ABSTRACT FROM AUTHOR]

The characterization of the various rock types through petrophysical data analysis is essential for comprehending geological processes and enhancing the efficacy of geophysical approaches aimed at mineralization zones. In the present study, a Fuzzy C-Means (FCM) clustering algorithm was employed to automatically classify lithounits within the western sector of the North Singhbhum Mobile Belt based on the petrophysical properties. Laboratory measurements of 326 rock samples from the study area show a wide range of density (~2350–3150 kg/m3) and magnetic susceptibility (10−5 SI to 10−1 SI) values. Further FCM analysis reveals three distinct clusters: (i) cluster 1 displays high density and low magnetic susceptibility responses and comprises majorly metabasic, phyllite, and mica schist rocks, (ii) cluster 2 shows low density and low magnetic susceptibility characteristics and contains mainly metasedimentary rocks (phyllite, quartzite, and mica schist) and (iii) cluster 3 also primarily encompasses metasedimentary rocks, but it displays the low density and high magnetic susceptibility characteristics. Overlap of rock types in different clusters probably indicates the influence of secondary geological processes on the petrophysical measurements such as metamorphism, alteration, and weathering, which is also supported by the petrographical studies. Overall, the present study demonstrates the potential utility of the FCM algorithm for automatic lithology classification and inferring the associated geological processes from the petrophysical measurements. Furthermore, the correlation between the geophysical and petrophysical clusters highlights the role of petrophysical information in the automatic geological/mineral mapping. However, the complexity in cluster attributes on a detailed scale suggests that future studies in the NSMB should focus on comprehensive multi-parameter petrophysical and geochemical measurements. This approach will help in developing better strategies for 3D geophysical data inversion and resolve the complexities in petrophysical data interpretation. [ABSTRACT FROM AUTHOR]

We explore a two component dark matter model with a fermion and a scalar. In this scenario the Standard Model (SM) is extended by a fermion, a scalar and an additional pseudo scalar. The fermionic component is assumed to have a global $$\mathrm{U(1)}_\mathrm{DM}$$ and interacts with the pseudo scalar via Yukawa interaction while a $$\mathbb {Z}_2$$ symmetry is imposed on the other component - the scalar. These ensure the stability of both dark matter components. Although the Lagrangian of the present model is CP conserving, the CP symmetry breaks spontaneously when the pseudo scalar acquires a vacuum expectation value (VEV). The scalar component of the dark matter in the present model also develops a VEV on spontaneous breaking of the $$\mathbb {Z}_2$$ symmetry. Thus the various interactions of the dark sector and the SM sector occur through the mixing of the SM like Higgs boson, the pseudo scalar Higgs like boson and the singlet scalar boson. We show that the observed gamma ray excess from the Galactic Centre as well as the 3.55 keV X-ray line from Perseus, Andromeda etc. can be simultaneously explained in the present two component dark matter model and the dark matter self interaction is found to be an order of magnitude smaller than the upper limit estimated from the observational results. [ABSTRACT FROM AUTHOR]

Objectives: COVID-19 incidence became a pandemic immediately after its origin and spread. Apart from death because of coronavirus infection, the pandemic brought unbearable psychological pressure to all. We assessed the psychological pressure on college and university students in India through cluster sampling., Methods: The students responded ( n  = 209) to an online questionnaire following the Generalized Anxiety Disorder Scale (GAD-7) and Hamilton Anxiety Rating Scale (HAM-A) with some other basic information., Results: According to GAD-7 scoring, we found the respondent students had severe anxiety (1.44%), moderately severe anxiety (14.35%), moderate anxiety (36.36%) and mild anxiety (47.85%). Following HAM-A scoring, anxiety level among the students could be scaled as severe (0.96%), high (4.31%), moderate (13.40%) and mild anxiety (34.93%) level. Age of the students was a confounding factor ( p  = 0.049, HAM-A) of experiencing anxiety, students <20 years of age were more anxious. We found female students to be more anxious than the males following the HAM-A scoring tool. Academic delays (R 2  = 0.996, p  = 0.036) and impact on daily life (R 2  = 0.996, p  = 0.117) were positively associated with anxiety symptoms, while social support was marginally correlated (R 2  = 0.726, p  = 0.069) with the anxiety level., Conclusions: As the study found almost all the students are experiencing anxiety because of the current pandemic situation, continuous observation of psychological health for all is recommended as well as establishing psychological intervention during the preparedness phase., Competing Interests: Conflict of interestThe authors declare no conflict of interest., (© Springer-Verlag GmbH Germany, part of Springer Nature 2021.)

Arsenic exposure route for humans is through the drinking of contaminated water and intake of arsenic-contaminated foods, particularly in arsenic-exposed areas of Bengal delta. Transport of the arsenic-contaminated crops and vegetables grown using arsenic-contaminated groundwater and soil in arsenic-exposed areas to the uncontaminated sites and consequent dietary intakes leads to great threats for the population residing in non-endemic areas with respect to consumption of arsenic through drinking water. We have studied the food materials collected from 30 families and their dietary habits, apparently who consume arsenic-free drinking water as well as 9 well-known markets of Kolkata city. The total and inorganic arsenic intake has been estimated from the collected foodstuffs from the market basket survey (n = 93) and household survey (n = 139), respectively for human risk analysis. About 100% of the collected samples contained detectable amount of arsenic (range 24-324 μg/kg), since the origin of the food materials was somewhere from arsenic-endemic areas. The daily consumption of inorganic arsenic (iAs) from rice grain and vegetables for adult and children is 76 μg and 41.4 μg, respectively. Inorganic arsenic (mainly arsenite and arsenate) contributes approximately 88% of the total content of arsenic in vegetable. In most of the cases, insufficient nutrient intake by the studied population may lead to arsenic toxicity in the long run. An independent cancer risk assessment study on the same population indicates that the main risk of cancer might appear through the intake of arsenic-contaminated rice grain and cereals.

The present systematic review synthesizes the diverse documentation of research on the occurrence of arsenic in soil-water systems and the human and animal bio-availability scenarios related to food chain contamination by arsenic. Humans and animals may drink arsenic-contaminated groundwater in addition to consuming foods that have been grown in arsenic-contaminated groundwater and soils. Rice grain is a potential arsenic carrier and the staple food in many parts of the world, particularly in Southeast Asian countries. Data have been summarized from 183 articles describing different aspects of arsenic flow in the food chain, that is, the soil-water-rice-human system and the water-crops-animals system and the bio-availability of arsenic to humans and animals. The phyto-availability of arsenic depends on the physicochemical and biological conditions of soil and water. In humans, the bio-accessibility of inorganic arsenic is 63-99%. Arsenic is more bio-available from rice than from other foods: different food materials differ in bio-accessible potential. Additionally, the review identifies trends in research on arsenic contamination and food chain flow considering arsenic species, toxicity assessment, and bio-accessibility studies. This systematic review provides a comprehensive assessment of the documented evidence to be used to guide future research on arsenic availability for the rice plant and subsequent availability to humans from cooked rice that can determine arsenic toxicity. The review also highlights how the focus of research on arsenic as a pollutant has changed in the past decades.

Skin lesion is one of the important health hazards caused by high intake of arsenic through drinking water and diet, and the other hazards include several types of cancers (viz. skin, lung and urinary bladder), ischemic heart disease, hypertension, etc. Two most important biomarkers to measure arsenic intake in a human body are arsenic concentration in urine and hair. The primary interest of this paper is the association between skin lesion and arsenic concentration in hair for participants with chronic arsenic exposure from West Bengal, India, using bivariate regression model based on copula function. The result showed participants with high arsenic concentration in hair had higher incidence of developing skin lesion. Arsenic concentration in hair was significantly higher for the participants with an arsenic concentration in water > 10 mg/L.

Objective: Patients with vestibular vertigo suffer from disabling symptoms which affect their quality of life. This article presents the efficacy and safety profile of betahistine hydrochloride in Indian patients suffering from vestibular vertigo (OSVaLD study)., Methods: Study included patients suffering from vertigo, who were prescribed betahistine (48 mg/day) according to local label. Safety and efficacy populations of this study included 80 and 75 subjects respectively. The study included three visits: an initial baseline visit, and two follow-up visits (one month and three months [final visit] post-commencement of betahistine therapy). Efficacy was assessed by administering three patient-reported outcomes (PROs) namely, Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS), and Medical Outcome Study Short Form-36 version2 (SF-36®v2). Safety assessment was made by reports of Suspected Adverse Drug Reactions (SADRs) which began during the study., Results: Mean changes in total DHI score for Indian efficacy population at follow-up and final visits were 31 and 44 points respectively. These changes indicated significant improvements in self-perceived impairment associated with vertigo. Similar improvements in quality of life were observed by HADS subscales (HADS-A and HADS-D) and SF-36®v2 summary scores (PCS [physical component summary] and MCS [mental component summary]). There was only one report of SADR in this study in a female subject receiving betahistine 16 mg t.i.d. This SADR was gastritis of mild severity and was probably not related to betahistine., Conclusions: A significant number of vestibular vertigo patients reported fair degree of spontaneous recovery. Betahistine treatment improved quality of life, was safe and well-tolerated by Indian patients suffering from vertigo.

Composite nanofibers of Eu 3+ doped poly(vinylidene fluoride-co-hexafluoropropylene) (P(VDF-HFP))/graphene are prepared by the electrospinning technique for the fabrication of ultrasensitive wearable piezoelectric nanogenerators (WPNGs) where the post-poling technique is not necessary. It is found that the complete conversion of the piezoelectric β-phase and the improvement of the degree of crystallinity is governed by the incorporation of Eu 3+ and graphene sheets into P(VDF-HFP) nanofibers. The flexible nanocomposite fibers are associated with a hypersensitive electronic transition that results in an intense red light emission, and WPNGs also have the capability of detecting external pressure as low as ~23 Pa with a higher degree of acoustic sensitivity, ~11 V Pa -1 , than has ever been previously reported. This means that ultrasensitive WPNGs can be utilized to recognize human voices, which suggests they could be a potential tool in the biomedical and national security sectors. The capacitor's ability to charge from abundant environmental vibrations, such as music, wind, body motion, etc, drives WPNGs as a power source for portable electronics. This fact may open up the prospect of using the Eu 3+ doped P(VDF-HFP)/graphene composite electrospun nanofibers, with their multifunctional properties such as vibration sensitivity, wearability, red light emission capability and piezoelectric energy harvesting, for various promising applications in portable electronics, health care monitoring, noise detection and security monitoring.

Leptospirosis, a common zoonotic disease, may present with variable clinical manifestations in between two extremes. Possibility must be excluded in any febrile patient with hepatorenal derangement. There are different reports regarding prevalence pattern, presentations and case fatality rate from different parts of the country. The purpose of this study was to find out the mode of presentation, biochemical profile and complications of leptospirosis cases in an apical level and make a comparison of same with other parts of India. Fifty-one consecutive cases of leptospirosis were selected for this study. Thorough clinical examination was done. ELISA test was done in the second week of illness. Haemogram, liver and renal function tests, coagulation profile, creatine phosphokinase (CPK), chest xray, ECG were done in all patients. Presenting features were fever (100%), myalgia (78.4%), headache (41.2%), jaundice (17.6%), oliguria (29.4%), respiratory distress (25.5%), bleeding manifestations (9.8%), altered sensorium (21.6%). Icterus was found in 74.5% of patients, hepatosplenomegaly in 72.5%, tachypnoea in 52.9%, bleeding manifestations in 35.3%, encephalopathy in 21.6%, hypotension in 15.7% and meningeal signs in 5.9% cases. Case fatality rate was 7.8%. From the study, it becomes evident that though severe leptospirosis has declined, mild leptospirosis has Increased. The reasons for decline of severe leptospirosis may be greater awareness, availability of better diagnostic tool along with widespread use of antibiotics. So, high index of suspicion may eventually reduce complications. It would be wise to start appropriate antibiotics empirically in suspected cases of leptospirosis.

Aims and Objective: Cardiac affection in human iummunodeficiency virus (HIV) infection is a recognized entity. Some form of heart disease is demonstrable at autopsy in approximately 40 percent of cases and by echocardiography in approximately 25 percent of patients with HIV. the studies indicate that cardiac involvements associated with HIV are mainly characterized by cardiomyopathy and pericardial disease. HIV infection is a global pandemic which is also rapidly spreading in india. We conducted the study to have some insight into the profile oflndian patients., Material & Methods: In this cross sectional hospital based study, we evaluated immunological (CD4 count) and echocardiographic status of 45 asymptomatic HIV seropositive patients who did not receive anti-retroviral therapy. The results were compared with age and sex matched controls. Statistical analysis was done using appropriate statistical methods., Results: Most common cardiovascular abnormalities were diastolic dysfunction (18%) followed by pericardial effusion (13%) and systolic dysfunction (7%). When compared with controls the study population had statistically higher number of diastolic dysfunction (p value = 0.035) but not systolic dysfunction (p value = 0.61); none of the control population was having pericardial effusion. Low CD4 count was significantly associated with pericardial effusion (p value 0.048) but the association with diastolic dysfunction (p value = 0.46) or systolic dysfunction (p value = 0.84) was not statistically significant., Conclusion: Cardiovascular complications are common among HIV infected patients in india, most common being diastolic dysfunction and pericardial effusion. Low CD4 counts are associated significantly with pericardial effusion. These abnormalities are likely to be found with greater frequency in clinical practice as management of opportunistic infections continues to improve.

Closed pleural biopsy is known to be diagnostic in approximately 75% of pleural effusion undiagnosed by thoracocentesis or pleural fluid evaluation. The purpose of this study was to determine the efficacy of closed pleural biopsy in a teaching hospital, Eastern India. The study was undertaken in all patients with exudative pleural effusion who were admitted in the department of chest medicine, Burdwan Medical College and Hospital, Burdwan, during the period from January 2001 to December 2005. Abram's needle was used for closed pleural biopsy in every case. One hundred and thirty-three pleural biopsies were performed with the needle. Twenty-three cases were excluded due to obtaining no pleural tissue. Specific diagnoses were obtained in 64 cases giving a diagnostic yield of 48.12%. Of these 17 revealed malignancy, 37 tuberculosis, and 10 empyema. A non-specific diagnosis was obtained in 46 cases (34.58%). By closed pleural biopsy 48.12% of undiagnosed exudative pleural effusions could be diagnosed which shows that closed pleural biopsy is still of value as a diagnostic procedure, and should be carried out prior to invasive procedures such as thoracoscopy or open pleural biopsy.

The study was carried out to find out the cognitive impairment if any, in early stages of human immunodeficiency virus-positive patients and if there is any cognitive impairment, then its association with duration of illness detection. Fifty patients with early stages of HIV and 50 matched controls were compared in various neuropsychological tests along with demographic profiles. Seropositive patients had poorly performed in digit symbol substitution test, trail making test and controlled word association test. This impairment had no association with duration of detection of illness. It is not known whether mild neurocognitive disorder predisposes patients to the development of frank dementia. Cognitive impairment should be identified early in order to maximise functional status, enhance quality of life and survival time.