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Shareholders’ wealth maximisation is the prime goal of any organisation. This is mainly dependent on the firm’s performance which is connected with the return on the investment in lieu of the risk availed by the shareholders. Accordingly, sustaining the shareholders’ interest and stabilising the firm’s performance should be the core aspects of any organisation. Recently, the whole world has suffered from the pandemic effect which has impacted the whole financial condition of organisations and Indian companies are not an exception. Considering this aspect, the main aim of this paper is to examine the moderating effect of the crisis period which has arisen due to the pandemic on the relationship between the dividend policy and the firm’s performance. 433 companies listed on NSE has used for analysis purposes for the period of 2017 to 2021. The study evidenced the moderating effect of crisis on relationship between dividend policy and firm performance. More so, liquidity and leverage are positive and significant to the firm performance whereas dividend payout and firm size have no significant impact on firm performance. The results of the study are implicated to managers, stakeholders, investors as well as academicians as it contributes novelty in financial performance literature by addressing the moderating effect of the crisis period on the relationship between dividend policy and firm performance.

UNSTRUCTURED Coronavirus disease-19 (COVID-19) is global pandemic caused by a novel zoonotic RNA virus named (SARSCoV-2). It has varied with various of cutaneous manifestations associated with COVID-19 has been described, includes urticarial rash, confluent erythematous rash, papulovesicular exanthem, chilblain like acral pattern, livedo reticularis, purpuric “vasculitis” pattern. Here we are presenting a case of 45-year-old male presented with muco-cutaneous features of Steven–Johnson Syndrome.

β-Thalassemia carrier’s frequency is uneven in different districts in Gujarat (0–9.5%). Surat Raktadan Kendra & Research Centre (SRKRC), NABH accredited and regional blood Centre in Surat (Gujarat, India) running since 1976, provides free blood units to more than 350 Thalassemia Major Patients every year. Our DSIR (Department of Scientific and Industrial Research, Ministry of Science and Technology, Govt. of India) approved Research department has developed Multiplex ARMS-PCR including 4 common mutations which is a fast, reliable, and cost-effective method. Safe blood transfusion is a priority for these patients because of having transfusion-associated infections, formation of alloantibodies against donor’s antigens, developing different grades of Blood Transfusion Reactions (BTR’s), etc. Therefore, different approaches have been implemented as routine practice by our Blood Centre, like the use of saline washed and/or leuco-reduced Red Cell Concentrate for transfusion (reduces the risk of BTR’s), NAT testing for Transfusion Transmitted Infections (reduces window period of TTI’s), antibody screening of patient (if develop in patient) and molecular genotyping of clinically important blood group antigens (Difficult to type these patients serologically due to presence of donors’ red cells). Despite being Blood Centre, contributing to developing novel diagnostic techniques and strictly following all possible transfusion practices, SRKRC greatly helps in ensuring proper diagnosis, lengthening the transfusion period and providing the safest blood to these patients.

Phaeohypomycosis is a rare cutaneous and subcutaneous fungal infection caused by dematiaceous fungi. They have a widespread global distribution occasionally affecting humans. A 26-year-old woman presented with multiple skin lesions over her face and extremities for last 7 years, unresponsive to systemic amphotericin B and itraconazole. Further investigations revealed CARD9 mutation and phaeohyphomycosis caused by the pigmented fungus Exserohilum rosatratum. Lesions subsequently improved with oral flucytosine and itraconazole.

Primary ciliary dyskinesia (PCD) is a rare autosomal recessive disease with clinical features of ear, sinus, and pulmonary infections that overlap with common respiratory illnesses of childhood. It is a progressive disorder that has significant influence on quality of life, lung function, and survival. Given the considerable overlap of symptoms between common illnesses and PCD, a high index of suspicion by primary care providers is needed to consider the diagnosis. There is not a single “gold standard” diagnostic test for PCD and multiple diagnostic methods coupled with specialized expertise is often needed to make the diagnosis. Patients with PCD also have comorbidities requiring a multidisciplinary approach for optimal clinical management. It is important for primary care physicians to recognize the PCD clinical phenotype and have a diagnostic framework for these patients. [ Pediatr Ann . 2022;51(2):e82–e85.]

Health literacy, which is defined as being able to understand and utilize information related to one’s health, is an essential part of the health care process as it is related to health outcomes. However, little is known about health literacy in Black Belt communities in Alabama although this rural area has shown very high rates of health concerns such as diabetes, cardiovascular disease, stroke, and cancer (CDC Interactive Atlas, 2022). Study participants were recruited from the Black Belt areas of Alabama. A total of 180 African-American participants with a mean age of 57.5 completed a survey. A regression analysis was conducted to understand if sociodemographic and other relevant factors would predict health literacy. Lower education, gender, age, perceived racism, and perception that race impacts health care quality predicted health literacy. Interestingly, those with less internet access had significantly lower health literacy. Access to internet and smart phones was a reported concern for over a third of the participants. Only a quarter of participants reported use of the internet to assist with lifestyle modifications while almost half reported internet use to obtain health information; suggesting this as a potential means to improve health literacy and even potential lifestyle modification in health behaviors. Recommendations are made for interventions to improve health literacy in minority populations of this underserved region.

Cardiac rehabilitation is a setting in which integrating social work services can benefit older adults. Many cardiac rehabilitation patients endorse symptoms of stress and depression following a cardiac event, impeding their ability to participate fully in cardiac rehabilitation services or recover from a heart attack. Gerontologically trained social workers can improve the care of older adults with heart disease in a variety of ways and this paper discusses the potential roles social workers can play in enhancing care. Two examples demonstrating how community academic partnerships can lead to improved options for older adults following a heart attack are discussed. First, using a microsystems approach, social workers embedded within cardiac rehabilitation may improve patient quality of life, address social service needs, provide mental health treatment, and assist in the completion of standard cardiac rehabilitation assessments. Second, using a macrosystems approach, social workers can help communities by developing partnerships to establish infrastructure for new cardiac rehabilitation clinics that are integrated with mental health services in rural areas. Social workers can serve an important role in addressing the psychological or social service needs of cardiac rehabilitation patients while increasing access to care.

Background: The purpose of this paper is to discuss the development of two novel technology-based interventions for depression in older adults while comparing older adults' preferences for audio-based and computer-based cognitive behavioral therapy for depressive symptoms. The audio program consisted of eight compact discs and a workbook while the computer program consisted of 11 modules of similar duration provided on a tablet PC. Both interventions consisted of the following topics: 1) introduction, 2) identifying and changing unhelpful thoughts, 3) addressing feelings, 4) relaxation, 5) engaging in pleasant events, 6) assertiveness, and 7) problem-solving. Methods: Fifty-one older adults were recruited from medical settings and rural communities and randomly assigned to an immediate treatment group (computer or audio) with minimal contact or a four-week minimal contact delayed treatment control condition. Results: Participants rated computer-based and audio-based cognitive behavioral therapy fairly equally, with 75% of those who received audio treatment and 85% of those who received computer-based treatment indicating benefits to their mood.Discussion: Computer-based or audio-based cognitive behavioral treatments may be valuable, low-cost modalities to deliver psychotherapy to older adults with depressive symptoms within a health care setting. Both modalities seem to be accepted by older adults.

The purpose of this manual is to provide standardized guidance on the application of the Tolin et al. (2015) Criteria for the purpose of inclusion on the Division 12 Society of Clinical Psychology’s Empirically Supported Treatments (ESTs) list or providing an updated rating on a given EST.

Background Multitransfused β-thalassemia major patients are always at high risk of having Transfusion Transmitted Infections (TTIs). This study was aimed to determine the seroprevalence of HBsAg, Anti-HIV-1/2, and Anti-HCV among these patients and to correlate the same with NAT testing. Methods A total of 196 patients with β-thalassemia were included in the study. Patients were screened for the presence of viral markers by third-generation ELISA test as well as for viral DNA/RNA by NAT test. Results Among 196 multi-transfused Beta-thalassemia patients, the seroprevalence of anti-HCV was very high 100 (51.1%), however, anti-HIV1/2 was 6 (3.1%), and HBsAg were 3 (1.5%). Surprisingly similar patterns were observed in the prevalence of molecular markers, as HCV-RNA were 66 (33.7%) of the patients along with HIV-1 RNA were 8 (4.1%), and HBV-DNA were 5 (2.5%) patients. Overall eight (4.1%) patients were found to have coinfections, where two were positive for HBsAg/anti-HCV by ELISA along with 3 (1.5%) were positive for HBV-DNA/ HCV-RNA, 1 (0.5%) was positive for HIV-RNA/HBV-DNA, and 2 (1%) had coinfection of HIV-RNA/ HCV RNA by NAT testing Conclusion The prevalence of HCV infection among multi-transfused β-thalassemia patients is significantly higher than that of the HBV and HIV infections. This scenario should be controlled and monitored by doing regular follow-up testing schedules of such patients and also the administration of the booster dose of the HBV vaccine along with HCV treatment with antiviral DAAs.

Child welfare workers (CWWs) face challenges to engaging families, including initial parental resistance, service plan noncompliance and other barriers. Adopting a motivational interviewing (MI) framework may improve engagement and collaboration between CWWs and parents, thereby leading to better child welfare (CW) outcomes. This comprehensive narrative review identifies the use of MI in CW, the outcomes of MI use and the gaps in the literature. Of the 16 articles that met inclusion criteria for our search, 12 suggested MI’s value in parenting skills, parent/child mental health, retention in services, substance use, and CW recidivism. Four of these studies specifically focused on CWW. Future studies should examine specific CW outcomes such as reunification, parent/child relationships, recidivism and parent/child mental health.

This paper discusses a relatively undocumented movement by clinical social workers to gain mental health diagnostic privileges as part of their scope of practice across the United States. The primary purpose of this paper is to identify which states permit social workers to diagnose. Reviewers located the state regulatory codes on social work scope of practice to determine if diagnosis of mental disorders was permitted and contacted corresponding state boards and NASW chapters to understand diagnostic privileges and grassroots movements in this area. We found that only three states do not authorize social workers to diagnose mental disorders: Alabama, Pennsylvania, and Indiana. The secondary purpose is to determine what percentage of graduate social work programs require a mental health assessment course to understand how graduate students are being prepared to diagnose. A minimum of two reviewers evaluated social work curricula for Masters-level programs (N = 226) accredited by the Council on Social Work Education. A majority of programs offered or required coursework on the assessment of mental disorders. We also discuss the state training requirements as they apply to diagnosis. As clinical social workers begin to practice in new areas, it is worthwhile examining efforts in addressing policies to expand social work scope of practice. This paper provides examples of successful and unsuccessful efforts to expand scope of practice on diagnosis to inform future efforts to impact policy change as applied to professional practice. A coordinated effort to align academic requirements with clinical social work scope of practice and professional practice guidelines can better prepare the clinical social work workforce.

Background Extended phenotyping is one of the important method of reducing red cell alloimmunisation. Extended phenotyping of red cells from voluntary donors have many uses in addition to its application in population genetics. As there was very little data extended phenotyping on a cohort of Indian Voluntary blood donors this project was undertaken. Study design & methodology 200 regular voluntary blood donors having ‘O’ blood group were included for red cell antigen typing of Rh (D,C,E,c,e), Kell (K, k, Kpa, Kpb), Duffy (Fya, Fyb), Kidd (Jka, Jkb), Lewis(Lea, Leb), P(P1), MNS (M, N,S,s), and Lutheran (Lua, Lub), Colton (Coa, Cob), Diago (Diaa, Wra), Vw and Xga antigens using conventional antisera provided by DIAGAST. Calculations of antigen and phenotypes frequencies were expressed as percentages. Results Out of 200 ‘O’ group blood donors, 96.5% were Rh D and 2.5% were K positive. Amongst Rh antigens, e was the most common (100%) followed by D, C (91.0%), c (50.5%) and E (16.5%) with DCe/DCe (R1R1, 48.0%) being the most common phenotype. In Kell blood group system, we found k antigen to be 100% and a rare phenotype Kp (a + b+) was found in 1% of the donors. For Kidd and Duffy blood group systems, Jk (a + b+) and Fy (a + b-) were the most common phenotypes (39.0% and 64.0%, respectively). In the MNS blood group system, M + N+ (67.5%) and S + s+(43.5%) were the most common phenotypes. There were antigens like Cw(3.5%), K(2.3%), Kpa(1.2%), Ina(1.0%), Vw(1.2%), Coa(4.5%), Cob(1%), Lua(1.75%), Dia+(1.2%), and Wra+(0.6%) with frequency Conclusion Extensively antigen phenotypes group ‘O’ red cells showed significant variation with other population from India as well as with Caucasian and black population. Extensive phenotyping ‘O’ group regular blood donors of red cell antigens is very useful to prepare in-house red cell panels for identification of alloantibodies.

Background: The prevalence of dermatophytes varies with season, geographical area, socio-economic factors and effective management strategies. Aims: The aim of the study was to assess the prevalence of pathogenic dermatophytes, clinical types of dermatophyte fungal infection, and in vitro antifungal drug susceptibility testing against dermatophytes. Methods: Three hundred and ninety five patients with dermatophytosis were enrolled from five cities (Mumbai, Delhi, Lucknow, Kolkata and Hyderabad) across India. All patients were subjected to clinical examination and investigations, including potassium hydroxide microscopy, fungal culture and antifungal drug susceptibility testing. Results: Trichophyton rubrum was the most common species identified (68.4%), followed by T. mentagrophytes (29.3%). Within species, T. mentagrophytes was prevalent in humid environmental conditions (Mumbai and Kolkata), whereas T. rubrum was prevalent in noncoastal areas (Delhi, Lucknow and Hyderabad). Tinea corporis (71.4%) and tinea cruris (62.0%) were the common clinical types observed. antifungal drug susceptibility testing data indicated that minimum inhibitory concentration required to inhibit the growth of 90% of organisms (MIC-90) was lowest for griseofulvin (0.25–3.0 μg/mL). Among oral antifungals, the mean MIC of itraconazole was within the range (0.84 [0.252] μg/ mL), whereas high mean MIC values were reported for terbinafine (0.05 [0.043] μg/mL). Among topical agents, lowest mean MIC values were reported for luliconazole (0.29 [0.286] μg/mL), eberconazole (0.32 [0.251]) μg/mL and amorolfine (0.60 [0.306]) μg/mL. Limitations: Lack of correlation between in vitro antifungal susceptibility and clinical outcome and absence of defined MIC breakpoints. Conclusion: T. rubrum was the most common, followed by T. mentagrophytes as an emerging/codominant fungal isolate in India. Tinea corporis was the most common clinical type of dermatophytosis. Mean MIC of terbinafine was above the reference range, while it was within the range for itraconazole; griseofulvin had the lowest mean MIC. Luliconazole presented the lowest mean MIC values across cities.

Macrothrombocytopenia is being increasingly described across the globe. There is paucity of data on the prevalence of this condition from different parts of India. 10,047 healthy college students from the city of Surat in western India were investigated for macrothrombocytopenia i.e. those with Mean platelet Volume of > 11 fL and platelet count of less than 150 × 10(9)/L. ABO blood groups, complete blood counts, peripheral smear examination and haemoglobinopathy work up was also done. Siblings and parents of the macrothrombocytopenic individuals were also studied when available. Bleeding assessment tool of International society of thrombosis and haemostasis were applied to see if there were excessive bleeding in macrothrombocytropenia patients. One hundred and ninety-six students (1.95%) had asymptomatic macrothrombocytopenia. More female students (P

Professional shortages of geriatrically trained social workers pose a barrier to mental health care for older adults. Integrating graduate social work interns into primary care settings may increas...

In 2015, India had an estimated 69.2 million people with diabetes and a national prevalence of 8.7%. Evidence is mounting for the benefits of telemedicine in diabetes care, but remains limited on mobile-health (m-Health) interventions.This study assessed the impact of an m-Health diabetes platform on clinical outcomes, patient-reported outcomes, patient and provider satisfaction, and app usage.This open-label, two-arm parallel study enrolled 91 people at 3 sites in India, aged 18-65, with type 2 diabetes, and an A1c between 7.5% and 12.5% (58-113 mmol/mol). Participants were randomly assigned 1:1 to m-Health or usual care and observed for 6 months. All received free visits, laboratory tests, transportation fees, and strips and lancets. Intervention participants received the m-Health app and a mobile phone data stipend.A1c change was previously reported as statistically significant. Significantly more participants in intervention than control had improved medication adherence (39.0% vs. 12.8%; p = 0.03) and increased frequency of blood glucose (BG) self-testing (39.0% vs. 10.3%; p = 0.01) at 6 months from baseline. No other outcomes were significantly different. Among m-Health users, 75% of participants actively used the app at week 24. Participants entered 29,668 medications and 2,575 BG readings, sent 497 messages, and received 890 messages. Most participants (80%) were satisfied with all aspects of the app and all seven providers rated the software very acceptable.Participants assigned to m-Health had increased medication adherence and frequency of BG testing compared with usual care participants.This tool could be an effective way to expand access to quality chronic disease care and improve outcomes.

Objectives This study aimed to assess older adults' (OAs') attitudes toward depression screening in primary care settings with a survey and explore the impact of an educational pamphlet on these attitudes. Methods Older adults above age 55 (N = 140) were randomly stratified by sex to an intervention or control group. The study included a baseline assessment, posttest, the Geriatric Depression Scale-Short Form, a two-page pamphlet on health and mood, and a 10-question quiz. Results On the basis of survey responses, most participants (93.6%) were willing to complete a depression screen at their doctor's office, and 92.1% perceived depression screening as valuable to their health care. Participants rated the Geriatric Depression Scale-Short Form positively. The survey also provided information on how screening could be conducted in primary care settings to maximize OAs' comfort. Participants preferred screening in the waiting room or examination room instead of the nurse's station. Those receiving the pamphlet became significantly more willing to be screened for depression than those who did not, F(1, 134) = 4.47, p = 0.04. Conclusion Most OAs appear receptive to completing a depression screen in primary care settings. Educating OAs about the value of depression screening and tailoring recognition systems to account for preferences may be an initial step in improving recognition rates. Copyright © 2017 John Wiley & Sons, Ltd.

We examined the effects of home-delivered cognitive-behavioral therapy (CBT) for depression on anxiety symptoms in an ethnically diverse, low resource, and medically frail sample of rural, older adults.This was a secondary analysis of a randomized clincial trial with 134 rural-dwelling adults 65 years and older with decreased quality of life and elevated psychological symptomatology. Anxiety symptoms were assessed with the anxiety and phobic anxiety subscales of the Symptom Checklist-90-Revised (SCL-90-R).Compared to a minimal support control condition, CBT for depression resulted in significantly greater improvements in symptoms of anxiety and phobic anxiety from pre-treatment to post-treatment.Home-delivered CBT for depression can be an effective treatment for anxiety in a hard-to-reach older populations.Additional research should explore integrated anxiety and depression protocols and other treatment modalities, including bibliotherapy or telehealth models of CBT, to reduce costs associated with its in home delivery. Flexibility in administration and adaptations to the CBT protocol may be necessary for use with vulnerable, rural older adults.

Context and Objectives: Upper limb surgeries are most commonly performed under brachial plexus block (BPB). A variety of adjuvants have been used to enhance the effect of local anesthetics in peripheral nerve block. We evaluated the effect of dexmedetomidine as an adjuvant to 0.25% bupivacaine in supraclavicular block (SCB) in terms of onset and duration of sensory and motor block, analgesia, and quality of block. Subjects and Methods: Sixty American Society of Anesthesiologists physical status I and II patients undergoing upper limb surgery, in which SCB was used, were enrolled. Patients were assigned to one of the following groups alternatively: Group C received BPB with bupivacaine 0.25% (34 ml) + normal saline 1 ml. Group D received BPB with bupivacaine 0.25% (34 ml) + dexmedetomidine 1 μg/kg. Onset and duration of sensory and motor block, duration of analgesia, sedation score, and hemodynamic parameters were studied in both the groups. Results: There were no significant differences in patient and surgery characteristics between two groups. In Group D, shorter time to onset of sensory block (09.8 vs. 15.3 min, P = 0.006) and longer duration (691.3 vs. 395.6 min, P = 0.006) was observed. Onset time to achieve motor block (11.8 vs. 17.3 min, P = 0.009) was also short and duration was longer (637 vs. 367.6 min, P< 0.001) in Group D. Duration of analgesia (735.6 vs. 423.6 min, P< 0.001) was higher as compared to control group. Conclusions: Adding dexmedetomidine to bupivacaine during supraclavicular BPB shortens sensory and motor block onset time, increases the sensory and motor block duration, and prolongs the duration of postoperative analgesia without any significant side effect.

Background Several retrospective studies have suggested that transfusion with red blood cells (RBCs) stored for longer periods is associated with increased mortality. The Age of Blood Evaluation (ABLE) study randomized subjects to receive fresh vs. standard issue RBC units and showed no difference in the primary or secondary endpoints of mortality or change in multi-organ dysfunction syndrome (MODS) score. Methods In this study a subset of 100 ABLE subjects were enrolled to measure coagulation and immune parameters. Samples were collected pre-transfusion and on days 2, 6, 28, and 180 post-transfusion. Levels of 16 coagulation parameters, regulatory and functional T cells, 25 cytokines, and 16 markers of extracellular vesicles (EVs) were determined. Results Changes from baseline in levels of protein C, factor V, and EVs expressing phosphatidyl serine and CTLA-4 (CD152) differed between recipients of fresh and standard storage age RBC units, with the vast majority of coagulation and EV markers and all cytokines tested showing no difference between study arms. Although most analytes showed no difference between subjects in the fresh and standard arms of the study, 6 coagulation parameters, 15 cytokines, and 7 EV parameters changed significantly in the period post-transfusion. Discussion Transfusion of fresh vs. standard issue RBC units does not result in substantial changes in coagulation or immune parameters, up to day 35 of RBC storage. Furthermore, significant changes in multiple coagulation and immune parameters are detectable post-transfusion, though causality cannot be determined based on the current study.

An otherwise healthy male child of 9 years presented with paroxysmal fever and diffuse abdominal pain along with loss of appetite and nausea lasting for 3-4days every 4-6 weeks for last 2 years. He also has stretchable skin and hypermobile joint which he inherited from his mother who never suffered any paroxysmal attack of the kind. Work up for acute intermittent porphyria, lead poisoning and familial mediterranean fever was negative. A novel harmful sequence change in NLRP12 gene was detected and a diagnosis of NLRP12 associated autoinflammatory syndrome was made. This sequence change with disease has not yet been reported in the literature and is the first such case of NLRP12 related autoinflammatory syndrome from India.

Background Serological testing for extended RHCcEe, Kell, Kidd and Duffy blood grouping from multitransfused patients may not give correct blood grouping of the recipient. Hence molecular testing for these blood groups was compared with serological groups in a cohort of multitransfused thalassemia mjor and sickle cell anaemia patients. Objective Molecular genotyping of antigens of Rh (D, C, c, E, e), Kell (K, k), Duffy (Fya, Fyb) and Kidd (Jka, Jkb) blood group antigens by PCR and PCR-RFLP methods and comparison of predicted genotypes with their serological phenotypes. Materials and methods A cohort of multitransfused thalassemia and sickle cell anemia patient were serologically and molecularly tested for RHCc, RHEe, K, k Fya, Fyb, Jka and Jkb antigens and compared. Serological testing was done by tube agglutination and molecular testing was done either by allele specific PCR or by RFLP technique just before next transfusion. Results In more than 80% of the cases recipient’s molecular testing blood groups were at variance with serologically tested blood groups (p Discussion Extended phenotyping in multitransfused thalassemia patients by serological technique often donot detect the exact red cell phenotype of the recipient and molecular techniques for such grouping is preferable, especially in multitransfused thalassemia patients where red cells from previous transfusions continues to be present in significant numbers whenever the testing is done.

Most published gamma irradiation studies are on the cytokines secreted by leucocytes than platelet cytokines. If cytokines secretion is suppressed by irradiation then it will be an important application of irradiation. To know this we planned to measure cytokines like Regulated upon activation normal T cells expressed and secreted (RANTES), platelet factor 4 (PF-4), Transforming growth factor βeta1 (TGF-β) and βeta Thromboglobulin (β TG) during the storage of irradiated (IR) and non-irradiated (NI) platelets. Ten platelet concentrate (PCs) were prepared using platelet rich plasma and buffy coat methods each and 10 by apheresis on Trima Cell separator. Each PC was transferred in a transfer bag and IR at about 25 Gy and stored at 22 °C in platelet agitator. Samples were taken from NI and IR bag each on 0 day, 3rd day and 5th day from supernatant for cytokine analysis. The samples were stored below −50 °C for cytokines assays using commercial ELISA kits. RANTES levels were in the range of 12–400 ng/ml on 0 day and increased to 108–800 ng/ml on 5th day in NI platelets and 104–800 ng/ml in IR platelet. PF4 increased from 0 day to 5th day showing levels 300–1500 ng/ml in both types of PC. β-TG range was 748–5258 ng/ml in NI and 878–4638 ng/ml in IR platelets on 5th day. TGF-β1 increased up to 780–38431 pg/ml in NI and 461–50,000 pg/ml in IR PC. The study showed that comparison of cytokine levels during the storage in NI and IR platelets was not significant by Mann–Whitney U- test (p > 0.05). Significant increase was observed in these cytokine levels from 0 day to 3rd and 5th day in NI as well as IR samples by Wilcoxon Signed- Rank test (p

Background: Blood transfusion is a lifesaving therapy for patients with hemoglobinopathies. However, the need of frequent transfusion carries the risk of transfusion-transmitted infections (TTIs). This study was aimed to determine the seroprevalence of Hep-B, Hep-C and HIV-1infections among the multi-transfused Beta-thalassemic patients and correlate the same with NAT testing. Methods: Total 196 patients with Beta-thalassemia were included in the study. Patients were screened for the presence of viral markers by third generation ELISA test as well as for viral DNA/RNA by NAT. Results: Among these 196 multi-transfused Beta-thalassemia patients, 32.1% were females and 67.8% were males. A total of 100 (51.1%) patients were found to be anti-HCV antibody reactive, while HCV-RNA was positive in 66 (33.7 %) of the 196 patients tested. There were 6 (3.1%) patients reactive for anti-HIV-1 antibody, while 8 (4.1%) were positive for HIV-RNA. There were only 3 (1.5%) patients that were found to be reactive for HBsAg, however 5 (2.5%) were positive for HBV-DNA. Two (1%) patients had co-infection of anti-HCV antibody and HBsAg,whereas 6 patients were found co-infected by NAT testing, in-which 3 (1.5%) were positive for HBV-DNA and HCV-RNA, 1 (0.5%) was positive for HIV-RNA and HBV-DNA, and 2 (1%) had co-infection of HIV-RNA and HCV RNA. Conclusion: Prevalence of HCV among multi-transfused Beta-thalassemia patients is significantly higher than the normal population. On the other hand, the study showed low prevalence of HBV. Therefore, a follow-up schedule and administration of booster dose of HBV vaccine is strongly recommended for thalassemia patients. To the best of our knowledge, this is the foremost work that shows prevalence of HIV, HBV and HCV in thalassemia patients using both serology and molecular markers in Western India.

Background:Sickle cell anaemia is common amongst Tribal population of south Gujrat. Alloimmunisation in multitransfused sickle cell anaemia patient is 10 times commoner in these patients than beta Thalassemia major patients from regular blood donor communities. Study design & methodology: Red cell antigen typing of Rh (D,C,E,c,e ), Kell (K, k), Duffy (Fya, Fyb) and Kidd (Jka, Jkb) were carried out in 222 regular voluntary blood donors who belonged to non-tribal population and in 113 samples of tribal population using conventional antisera. Results: Rh D antigen frequency was 96.6% in non-tribal and 96.5% in tribal population. 2.4% of K antigen was found in non-tribal population whereas the antigen was absent in tribal population .Amongst Rh antigens, e was the most common (100%) followed by D, C (91.0%, 85.8%), c (50.5%, 44.2%) and E (16.5%, 17.0%) with DCe/DCe (R1R1, 48.0%, 55.8%) being the most common phenotype in both the groups. In Kell antigens k antigen was 100% ,Kidd and Duffy antigens Jk (a+b-) (39.2%, 46.9%) and Fy (a+b-) (64.2%, 52.2%) were the most common phenotypes in non-tribal and tribal population respectively. Conclusion: There is significant difference in Duffy , Kidd and Kell (k) antigen distribution between non tribal and tribal population . Total absence of Kell antigen in tribalsalong with. E antigen in a significant portion of blood donors and its absence in large number of tribals also increase the risk of alloimmunisation.

The study aims to examine the effects of diabetes and depression on executive functioning (EF) and to review the effects of EF deficits on diabetes management. Both type 2 diabetes and depression influence EF, and in turn, EF has an impact on diabetes management. Individuals with both comorbidities (i.e., diabetes and depression) experience greater deficits in EF than individuals with just one of the morbidities (i.e., depression or diabetes). The disruption in EF results in poor diabetes management and poor emotion regulation which ultimately increases the probability of a recursive cycle of depression and hyperglycemia. This recursive cycle can ultimately lead to diabetes-related complications.

There is limited research on mental health interventions delivered in a digital game format and even less to guide developers on how to develop such games. This review focuses on understanding how to develop therapeutic digital games based primarily on mental health intervention games that have been empirically tested. The review was generated through database searches and backward search techniques for digital game-based interventions for specific mental disorders. We evaluated digital games that were based on validated psychological treatments. We located 24 studies and 18 games that met our search criteria. These games and their outcomes have been summarized. This review showed that these types of games have the potential to make an impact on mental health concerns but that there are currently few digital games available for the treatment or prevention of mental disorders. In addition, guidelines for digital mental health intervention game development have been presented. The consolidation of guidelines addressing multiple game development factors (e.g., time, cost, engagement) may help those interested in developing new therapeutic games that target a greater variety of disorders, thereby expanding access to larger populations.

In order to generate meaningful information from the large datasets, mining algorithms have been used. Mining algorithms are used to abstract the unknown pattern from the immense database. The medical domain contains large databases, so to extract the information about the particular disease, mining algorithms can be applied on it. The human diseases can be predicted using predictive data mining algorithms. According to the recent trends data mining algorithms has been applied on biometric modalities like face, iris and tongue to predict the human age and gender. To archive better accuracy, fusion can be performed on biometric traits. The fusion uses the concept of the multimodal system. This paper is the review of different predictive mining algorithm, biometric traits, multimodal system, and the performance parameters of the predictive systems and biometric systems.

Cancer remains a leading cause of death, especially among older adults. While spouses are commonly involved in the provision of emotional and practical assistance to their ill spouse, their caregiving is not without cost. Although knowledge of an impending death permits preparation for the loss, a long and protracted illness, or one marked by intense caregiving demands, can deplete the well spouse’s personal resources, increasing the risk of morbid bereavement outcomes. Well spouses (n=138), aged 50 and older (mean age 63.6), 41% male, providing 8+ hours of caregiving to a spouse with advanced cancer and a life expectancy of 6 months or less were followed over the terminal illness period. Caregiving spouses’ anticipatory grief, depression and anxiety were all significantly, inversely correlated with sufficiency of social support, specifically tangible, informational and emotional support (p

Extracellular vesicles (EVs) range in size from 50 nm to 1 µm. Flow cytometry (FCM) is the most commonly used method for analyzing EVs; however, accurate characterization of EVs remains challenging due to their small size and lack of discrete positive populations. Here we report the use of optimization techniques that are especially well-suited for analyzing EVs from a high volume of clinical samples. Utilizing a two pronged approach that included 1) pre-filtration of antibodies to remove aggregates, followed by 2) detergent lysis of a replicate sample to account for remaining false positive events, we were able to effectively limit false positive non-EV events. In addition, we show that lysed samples are a useful alternative to isotypes for setting gates to exclude background fluorescence. To reduce background, we developed an approach using filters to "wash" samples post-staining thus providing a faster alternative to ultracentrifugation and sucrose gradient fractionation. In conclusion, use of these optimized techniques enhances the accuracy and efficiency of EV detection using FCM.

The purpose of this study was to develop and explore the feasibility of audio-based (ACBT) and computer-based (CCBT) cognitive behavioral therapies for older adults with depressive symptoms. The audio program consisted of 8 compact discs and a workbook while the computer program consisted of 11 modules of similar duration provided on a tablet PC. Both interventions consisted of the following topics: identifying and changing unhelpful thoughts, addressing feelings, relaxation, engaging in pleasant events, assertiveness, and problem-solving. Fifty-one older adults were recruited from medical settings and rural communities. Participants were randomly assigned to immediate treatment (ACBT or CCBT) or delayed treatment control condition. Analyses were conducted to examine change on interviewer-based and self-reported depression. A significant interaction effect between time and condition was found on the interviewer-based depression scale. This suggests that both types of treatments decreased depressive symptoms over time when compared to a delayed treatment control. Computer-based and audio-based cognitive behavioral treatments may be valuable low-cost modalities to deliver psychotherapy to older adults with depressive symptoms.

Background β-thalassaemia is a group of inherited single-gene disorders worldwide. Each ethnic population has its own common mutations. Heterogeneity of β-thalassaemia mutations in multi-ethnic population of Surat, makes molecular diagnosis expensive and time consuming. Methods Specific primers were used to differentiate four common mutations, IVS I-5 (G→C), Codon 41/42 (- TCTT), 619-bp deletion and FS 8/9 (+G), by a simple PCR involving a multiplex amplification refractory mutation system. Results Several high prevalence β-Thalassemia trait groups constituted by Muslims, Patels, Sindhis, ModhBanias, and Mahayavanshi. Four most common mutations detected in them are IVS I-5 (G→C), Codon 41/42 (- TCTT), 619-bp deletion and FS 8/9 (+G). We identified each of these β-thalassemia mutations in multiplexed ARMS from positive control samples. Our multiplex-ARMS-PCR system was first standardized on positive DNA samples with above known four most common β-thalassemia mutations, and these positive samples had been diagnosed with β-thalassemia and also all these samples belonged to Surat ethnic groups. The system was subsequently tested on 110 blood samples from different ethnic backgrounds with unknown β-thalassemia mutations which were in all specimens. Conclusion The ARMS multiplex system was found reliable, cost effective, fast and most applicable for mutation screening of Thalassemia in Surat populations.