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The established method represents the development and validation of a straight forward, precise, accurate, specific and reproducible method for the simultaneous estimation of Efonidipine Hydrochloride Ethanolate and Telmisartan in synthetic mixture. First order derivative of the overlay spectra was used for quantification of both drugs. This method involving the determination of both drugs at their respective zero crossing point working wavelength was observed 231.00 nm (Zero crossing point of Telmisartan) for Efonidipine hydrochloride ethanolate and 238.60 nm (Zero crossing point of Efonidipine Hydrochloride Ethanolate) for Telmisartan using methanol as diluent. International conference on harmonization (ICH) (Q2R1) guideline was used for method validation. The Beer-Lambert’s law obeyed in the concentration range of 2-18 μg/ml and 4-36 μg/ml for Efonidipine Hydrochloride Ethanolate and Telmisartan, respectively. The percentage recovery was found in the range of 98-101 % of Efonidipine Hydrochloride Ethanolate and 98.46-99.77% of Telmisartan. The % relative standard deviation of precision and repeatability study was found beneath 1%. This simple and precise method can be used of both drugs in quality control laboratories. Keywords: Efonidipine Hydrochloride Ethanolate, First order derivative, ICH Q2 (R1), Telmisartan, UV spectroscopy.

Purpose Colorectal cancer (CRC) is the fifth most common cancer in India, however, there is a paucity of systematically collected data related to its molecular epidemiology, specifically related to tumour microsatellite instability (MSI) and Lynch syndrome prevalence. Methods We prospectively recruited 207 unrelated patients who were diagnosed with CRC from whom primary tumour biopsy along with a matched blood sample was obtained. A sequential genetic testing approach for Lynch syndrome detection in colorectal cancer patients in accordance with the UK’s National Institute of Health and Care Excellence’s guideline (DG27) was utilised. Briefly, DNA from tumour biopsies were tested for MSI status followed BRAF V600E testing in samples which showed MSI-high result. Germline testing for the mismatch repair genes was carried in patients who had MSI-high and BRAF V600E negative tumours. Seventeen patients recanted their consent to participate in the study and therefore, results from 190 out of 207 patients is presented here. Results Mean age at cancer diagnosis across the cohort was 52.3 years with male to female ratio of 2:1 and 57.3% of the patients had tumours in the descending colon or rectum. MSI-high status was observed in 79 patients (42.6%) and, was inversely associated with age (OR = 0.95, 95% CI = 0.92–0.97, p = BRAF V600E negative mutation status (96%) and of these, 48 were diagnosed with Lynch syndrome (63%; MLH1 = 38, MSH2 = 4, MSH6 = 4, PMS2 = 1, EPCAM = 1). The variants c.154del and c.306G > T in the MLH1 gene were most commonly observed across Lynch syndrome patients in our cohort. Conclusions This is the first systematic evaluation of the molecular epidemiology of CRC in India. We observe a high proportion of patients with young onset CRC coupled with high prevalence of MSI-high status and Lynch syndrome. The study provides a unique opportunity to explore development of novel Lynch syndrome detection and cancer prevention pathway in Indian healthcare settings.

Alopecia areata is a chronic hair loss disorder that involves autoimmune disruption of hair follicles by CD8+ T cells. Most patients present with patchy hair loss on the scalp that improves spontaneously or with topical and intralesional steroids, topical minoxidil, or topical immunotherapy. However, recurrence of hair loss is common, and patients with extensive disease may require treatment with oral corticosteroids or oral Janus kinase (JAK) inhibitors, both of which may cause systemic toxicities with long-term use. Itaconate is an endogenous molecule synthesized in macrophages that exerts anti-inflammatory effects. To investigate the use of itaconate derivatives for treating alopecia areata, we designed a prodrug of 4-methyl itaconate (4-MI), termed SCD-153, with increased lipophilicity compared to 4-MI (CLogP 1.159 vs. 0.1442) to enhance skin and cell penetration. Topical SCD-153 formed 4-MI upon penetrating the stratum corneum in C57BL/6 mice and showed low systemic absorption. When added to human epidermal keratinocytes stimulated with polyinosinic-polycytidylic acid (poly I:C) or interferon (IFN)γ, SCD-153 significantly attenuated poly I:C-induced interleukin (IL)-6, Toll-like receptor 3, IL-1β, and IFNβ expression, as well as IFNγ-induced IL-6 expression. Topical application of SCD-153 to C57BL/6 mice in the resting (telogen) phase of the hair cycle induced significant hair growth that was statistically superior to vehicle (dimethyl sulfoxide), the less cell-permeable itaconate analogues 4-MI and dimethyl itaconate, and the JAK inhibitor tofacitinib. Our results suggest that SCD-153 is a promising topical candidate for treating alopecia areata.

Introduction: Lucio phenomenon (LP) is characteristic reaction pattern seen in patient of diffuse lepromatous leprosy(DLL). Dual infection of M. leprae and M. lepromatosis in case of DLL is confirmed from other endemic country but same is yet to be documented from India. Conventionally LP is treated with high dose of systemic glucocorticoid (GC) and anti-leprosy treatment (ALT). Here we are reporting an interesting case of leprosy lymphadenitis as initial presentation in case of LP and DLL due to dual infection with M. leprae and M. lepromatosis who responded favorably to tofacitinib as adjuvant to ALT and systemic GC therapy. Case report: A 24-year-old man presented with complaint of swelling over bilateral inguinal region, pus filled skin lesions with multiple ulcers, fever and joint pain. Post hospitalization investigations showed presence of anemia, leukocytosis and elevated acute and chronic inflammatory markers. Skin and lymph node biopsies were suggestive of LP and Leprosy lymphadenitis. Presence of M.leprae and M. lepromatosis was confirmed by PCR study of tissue. Despite of anti-leprosy treatment, oral GC and thalidomide therapy patient continue developing new lesions. Post one-month commencement of adjuvant tofacitinib, patient experienced excellent clinical improvement as healing of all existing lesions and cessation of new lesion of LP. Conclusion: Our case confirms the presence of dual infection with M. leprae and lepromatosis in India. Lymph node involvement as initial presentation of DLL should be considered in endemic area. Tofacitinib can emerge as promising new adjuvant therapy for recalcitrant lepra reaction.

Introduction: The global scale of COVID-19 has been enormous, with the disease affecting 20 million people worldwide and resulting in 751,154 deaths by August 14, 2020. An increase in mental health problems is expected with an event of such scale, given past experience with epidemics such as severe acute respiratory syndrome and Ebola, among various vulnerable populations. One such population may be the family members of patients affected with COVID-19. Methods: This was a cross-sectional study. Five hundred and forty-one relatives of patients admitted in the COVID-19 wing of a tertiary care hospital were studied. Sociodemographic details were recorded and a Gujarati version of General Health Questionnaire-28 (GHQ-28) was applied. A total score of ≥4 on GHQ-28 was considered indicative of “caseness” or psychiatric morbidity and the population was divided into two groups based on whether the score was

In an age of increasing digital reading it is interesting that University students’ are not adapting innovative technologies for academic study. This is even more surprising because today’s university students are purportedly digitally native keen to use new technologies in comfortable personal spaces but adhere to traditional paper when studying. There is a distinct paucity of research with respect to how students use technology for academic purposes, particularly independent study. This small-scale qualitative evaluation investigates how undergraduate students respond to a refined Rapid Serial Visual Presentation speed reading application called Spritz, which claims to significantly increase users’ ability to skim read and comprehend content effectively. We evaluated the tool and asked students to express which affordances they would forego to make the technology acceptable. The sample of students focused on those enrolled on a module about academic reading were introduced to Spritz (N = 55). Nine students agreed to take part in the trials. Participants used the Sprtizlet App which enables a reading speed of up to four hundred words a minute to perform reading tasks. The findings suggest the technology is acceptable for certain types of skim reading and scanning, but Spritz did not meet the varied requirements of the participants’’ academic study practices.

BackgroundElectrical storm can be challenging to treat, requiring a multidisciplinary team to coordinate medical management and invasive procedures. As the stellate ganglion provides efferent sympathetic outflow to the myocardium, stellate ganglion blocks (SGB) can be used to combat ventricular arrhythmias that arise from sympathetic overactivity. Data are scarce regarding SGB catheters as a treatment for electrical storm. We reviewed our use of SGB catheters for refractory electrical storm using our pathway collaboratively developed by critical care, cardiology, and regional anesthesia teams.MethodsWe conducted a retrospective cohort study of patients who underwent an SGB for electrical storm between January 2020 and April 2022 in our cardiovascular intensive care unit. The primary outcome was the sustained cessation of electrical storm for 24 hours.ResultsUpon chart review, 27 patients were identified and 11 met inclusion criteria. Cessation of electrical storm for 24 hours was achieved in 90% (n=10) of patients after left SGB. Similarly, 90% (n=10) had no documented episodes of ventricular arrhythmias requiring intervention within 6 hours after SGB.ConclusionsSGBs can interrupt or treat electrical storm. SGB catheters allow for prolonged arrhythmia cessation without repeated blocks and decrease the risk of repeat episodes of ventricular arrhythmias.

In this study, temperature studies were studied on the production of a product from selected eucalyptus leaving samples. The bio-diesel yield from these samples was further determined using non-model methods and analytical pyrolysis-gas chromatography / mass spectrometry (Py-GC / MS). The fresh eucalyptus leaves were obtained from nearby forest of Godhra (Gujarat), India. Results of the Proximate analysis of eucalyptus leaves powder sample study shows that volatile matter, fixed carbon, ash content and moisture content are 61.70 %, 26.37%, 8.36 % and 3.57%, The results of the basic analysis indicate that the carbon, hydrogen, nitrogen, oxygen, and sulfur content is 89.17%, 7.36%, 1.01%, 1.98% and 0.26%, respectively. The higher heating value (HHV) of the biodiesel obtained from the biomass samples is 32.81 MJ/kg. Chemical composition analysis of Eucalyptus Biodiesel carried out and compared with standards. The study revealed that pyro-fuel is not only used as fuel but also can be purified and used as a commodity in the chemical and processing industries.

Phagocytes form a family of immune cells that play a crucial role in tissue maintenance and help orchestrate the immune response. This family of cells can be separated by their nuclear morphology into mononuclear and polymorphonuclear phagocytes. The generation of these cells in the bone marrow, to the blood and finally into tissues is a tightly regulated process. Ensuring the adequate production of these cells and their timely removal is key for both the initiation and resolution of inflammation. Insight into the kinetic profiles of innate myeloid cells during steady state and pathology will permit the rational development of therapies to boost the production of these cells in times of need or reduce them when detrimental.

Mononuclear phagocytes (MNPs) encompass dendritic cells, monocytes, and macrophages (MoMac), which exhibit antimicrobial, homeostatic, and immunoregulatory functions. We integrated 178,651 MNPs from 13 tissues across 41 datasets to generate a MNP single-cell RNA compendium (MNP-VERSE), a publicly available tool to map MNPs and define conserved gene signatures of MNP populations. Next, we generated a MoMac-focused compendium that revealed an array of specialized cell subsets widely distributed across multiple tissues. Specific pathological forms were expanded in cancer and inflammation. All neoplastic tissues contained conserved tumor-associated macrophage populations. In particular, we focused on IL4I1+CD274(PD-L1)+IDO1+ macrophages, which accumulated in the tumor periphery in a T cell-dependent manner via interferon-γ (IFN-γ) and CD40/CD40L-induced maturation from IFN-primed monocytes. IL4I1_Macs exhibited immunosuppressive characteristics through tryptophan degradation and promoted the entry of regulatory T cell into tumors. This integrated analysis provides a robust online-available platform for uniform annotation and dissection of specific macrophage functions in healthy and pathological states.

A simple, rapid, precise, and accurate isocratic reversed-phase stability indicating HPLC method was developed and validated for simultaneous determination of the nebivolol and valsartan in the tablet dosage form. The effective chromatographic separation was achieved by a YMC pack pro octadecyl silane (150×4.6 mm, 3 µm) column using a mobile phase composed of methanol: acetonitrile: 0.05 M potassium dihydrogen phosphate buffer (Ph=3.0 with 10% ortho phosphoric acid after addition of 0.2% triethylamine) (30:30:40, v/v/v) at a flow rate of 1 mL/min and UV detection at 282 nm. Drugs were subjected to the acid, base, oxidation, heat, and photolysis to apply the stress. Linearity ranges were 5–30 µg/mL (r2= 0.9989) for nebivolol and 80-480 µg/mL (r2=0.9991) for valsartan. Limit of detection was 0.38 µg/mL and 1.08 µg/mL for nebivolol and valsartan, respectively. The limit of quantification for the nebivolol and valsartan was 1.15 µg/mL and 3.27 µg/mL, respectively.

Prostate adenocarcinoma is a common urologic malignant neoplasm in man. Distant cutaneous metastases (CMs) of prostate carcinoma are extremely rare with a reported incidence of 0.36% and usually they occur late. Clinically, cutaneous metastasis of prostate carcinoma can mimic other skin conditions such as cellulitis, sebaceous cyst, zosteriform lesions, telangectasias, and more, resulting in a poor recognition. Few cases of true cutaneous metastatic prostate carcinoma exist in the literature. We present a case, where the first sign of carcinoma of the prostate was CM over the anterior abdominal wall. Radiological and histopathological confirmation pointed to a diagnosis of carcinoma of the prostate. The patient was treated with orchidectomy and was started on bicalutamide. After 1 month of bicalutamide therapy there was subjective decrease in the size of the metastasis. A high index of suspicion is required while evaluating the different differential diagnoses of this entity particularly in elderly patients.