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Koro, a culture-bound syndrome originating from Southeast Asia is characterized by a perception of acute retraction of the penis, accompanied by an acute panic-like reaction of impending danger or death. Koro-like symptoms are considered variants of classical Koro syndrome and differ from it phenomenologically. We described here a case series of secondary Koro, presenting as a delusional disorder who remitted on treatment with antipsychotics and maintained the improvement on follow-up. It is important to differentiate between classical Koro with Koro-like syndrome, with exploration of any delusional core during clinical assessment for better categorization and management.

Introduction: [177Lu]Lu-prostate-specific membrane antigen (PSMA)-617 has emerged as a promising radiopharmaceutical for targeting PSMA in metastatic castrate-resistant prostate carcinoma (mCRPC). ...

BACKGROUND Upper gastrointestinal bleeding (UGIB) is one of the common medical emergencies throughout the world that may require hospital admission and results in high patient morbidity and mortality. The presentation of UGI bleeding depends on the amount and location of haemorrhage. Upper gastrointestinal endoscopy (UGIE) is the preferred investigative procedure for UGIB because of its accuracy, low rate of complication, and its potential for therapeutic interventions. The present study has been carried out to evaluate the different aetiological causes of UGIB in a tertiary care centre in the North Eastern part of India and compare the same with other studies done globally. METHODS This was a hospital based observational study with cross sectional design carried out in the Department of Medicine at Tripura Medical College & DR BRAM Teaching Hospital, Agartala. Total 376 patients were selected for this study for over a period of 2 years from January 2017 to December 2018. Upper GI endoscopy was performed in all patients after hemodynamic stabilisation. Rockall scoring system was used in non-variceal cases to predict the mortality in patients with upper GI bleeding. RESULTS A total of 376 patients had endoscopy for UGIB which included 260 (69.1 %) males and 116 (30.9 %) females, and the mean age was 47.9 (± 17.0) years. The most common cause of UGIB was peptic ulcer disease (duodenal ulcer and gastric ulcer) consisting of 31.38 %, followed by erosive gastritis (23.94 %), oesophageal varix (11.17 %), portal hypertensive gastropathy (10.64 %), duodenitis (8.51 %). Gastrointestinal malignancy (gastric and oesophageal cancers) was reported in 3.98 % and rare causes of UGIB were Mallory-Weiss syndrome (1.86 %), and esophagitis (1.60 %). Among them 4.26 % of the patients had normal endoscopy findings. CONCLUSIONS In the present study, peptic ulcer disease was the most common cause of upper gastrointestinal bleeding, followed by erosive gastritis. Rockall score of more than 4 was numerically associated with increased incidence of mortality. KEYWORDS Upper Gastrointestinal Bleeding (UGIB), Upper Gastrointestinal Endoscopy (UGIE

A prototype, semi-automated, indigenous solid-target assembly has been developed to produce clinical grade 111InCl3 from natCd targets. Fluka Monte Carlo code was used to estimate the optimum proton energy range for 111Cd(p,n)111In production route and suitable decay time to get high specific-activity of 111In. The radiochemical purification and separation have been optimized using column chromatography separation method. The quality of 111InCl3 has been established by radiolabeling of Pentetreotide yielding 111In-Pentetreotide, in acceptable radiochemical purity (RCP), with expected biological efficacy in in-vitro and in-vivo models. Pre-clinical translation of 111InCl3 in formulation of 111In-Pentetreotide adds support toward its use as a clinical grade radiochemical.

Introduction: The quality control parameters of in-house-produced 90Y-Acetate from high-level liquid waste (HLLW) using supported liquid membrane (SLM) technology were validated and compared with t...

An automated production of pharmaceutical grade 3′-deoxy-3′-[18F]fluorothymidine ([18F]FLT) with solid phase extraction (SPE) purification using 5′-O-(Benzoyl)-2,3′anhydrothymidine precursor (Benzoyl-Anhydro) poses a major challenge. Herein, an automated, one-pot, two-step, radiochemical synthesis of [18F]FLT using benzoyl-anhydro precursor and subsequent optimization of SPE purification (using readily available SepPak® cartridges) while maintaining radiochemical purity, chemical purity and residual solvent levels within the specified limits has been reported. The current method yields pharmaceutical grade [18F]FLT suitable for inclusion as a generic product in different pharmacopeia. The desired clinical results add support to indigenously produced Sep-Pak® purified [18F]FLT as a pharmaceutical grade diagnostic radiopharmaceutical.

Chronic liver disease (CLD) represents different liver disorders of varying severity and etiology in which hepatic inflammation and fibrosis continue at least for 6 months. Portal hypertension is one of the important complications of CLD and its early recognition is of paramount importance. Though liver biopsy remains the gold standard for diagnosing liver fibrosis and upper gastrointestinal (GI) endoscopy plays an important role in diagnosing different findings of portal hypertension, various noninvasive methods like FibroScan are being increasingly used to diagnose liver fibrosis.Study the FibroScan and endoscopic findings in patients of CLDs and the objectives are to find the prevalence of portal hypertension and to find various grades of esophageal varix and portal hypertensive gastropathy (PHG) and its relationship with liver fibrosis by FibroScan.A total of 114 patients of CLD and compensated cirrhosis having childturcotte- pugh (CTP) stages A and B were included in the study fulfilling inclusion and exclusion criteria, after calculating the sample size of 100. All the patients underwent detailed history, physical and gastrointestinal examination. Complete blood count (CBC), liver function test (LFT), kidney function test (KFT), viral markers were done. Aspartate aminotransferase (AST) to platelet ratio index (APRI) score was calculated, liver fibrosis was estimated by FibroScan and evidence of portal hypertension was documented by upper GI endoscopy. Cutoff value of FibroScan, APRI score, and model for end-stage liver disease (MELD) score for portal hypertension was decided by receiver operating characteristic (ROC) curve.Alcoholic liver disease (ALD) was the most common cause (43%) of CLD closely followed by nonalcoholic fatty liver disease (NAFLD) in 42% cases followed by chronic viral hepatitis, 75% patients had evidence of portal hypertension with PHG being the most common followed by esophageal varix. F4 fibrosis was found in 73% of cases followed by F3, F2, and F1 fibrosis. FibroScan value of 12.2 kPa was predictive of presence of portal hypertension and value of 26.6 mm predicted the presence of large esophageal varices.

Right from its introduction, fault attacks (FA) have been established to be one of the most practical threats to both public key and symmetric key based cryptosystems. Statistical Ineffective Fault Analysis (SIFA) is a recently proposed class of fault attacks introduced at CHES 2018. The fascinating feature of this attack is that it exploits the correct ciphertexts obtained during a fault injection campaign, instead of the faulty ciphertexts. SIFA has been shown to bypass almost all of the existing fault attack countermeasures even when they are combined with masking schemes for side-channel resistance. The goal of this work is to propose a countermeasure framework for SIFA. It has been observed that a randomized domain transformation of the intermediate computation combined with bit-level error correction can prevent SIFA attacks. The domain transformation ( Transform ) can be realized by standard masking schemes. In fact, we prove that if biased faults are injected at the state register of a block cipher at a certain target round, then masking is sufficient for SIFA protection, until all the shares for a specific bit are corrupted. However, masking alone cannot prevent SIFA if the faults are injected at certain specific locations inside the S-Boxes. To address this issue, we incorporate a bit-level error-correction mechanism ( Encode ). An instantiation of this Transform -and- Encode (TaE) framework, called AntiSIFA, has been proposed and realized for the block cipher PRESENT as a proof-of-concept. Practical evaluation of the countermeasure implementation in both hardware and software ensures our theoretical claims regarding SIFA security, as well as protection against Side-Channel-Attacks (SCA).

A 46 years of rt handed Hindu grocer male with history of nasal polyp, allergic rhinitis for 12 years and off and on cough was admitted at Tripura Medical College & Dr. B.R.A.M. teaching hospital with chief complaints of tingling and numbness of extremities for 45 days and weakness of the lower limbs for 30 days. Forty five days before hospitalization he developed decreased sensation over both feet which progressed up to both legs below knee level over few days and was associated with burning, tingling, pins and needle sensation. Simultaneously he developed weakness of the lower limb, unable to maintain slippers, difficulties in standing up from squatting and required assistance of family member to walk. From the day of admission he developed decreased sensation over left hand then right hand with similar upward progression. He developed weakness of upper limbs in holding cup & raising hand arm above head. There was no history suggestive of involvement of any cranial nerves. There was no history of convulsion, loss of consciousness, headache, neck pain, radiculopathy, stiffness, itching, joint aches, swellings. In his past he was treated with montelukast, inhaled bronchodilators, and intranasal corticosteroids of and on for 08 years. He was on self-medication with Montelukast for last 10 years. There was No history of diabetes, hypertension, and tuberculosis. He had no history of any high-risk behaviour, no addiction. His bowel & bladder habit was normal. He has four family members all are healthy. He is allergic to dust and had off and on malaise, feverishness with intermittent non pruritic rash over legs. He is alert, co-operative, well oriented with time, place & person. Having BMI (21.08). His vitals were stable. Central nervous system examination shows he is conscious, GCS scale 15/15, MMSE- 30/30. Appearance, behaviour, speech, language is normal. No evidence of hallucination, delusion. All twelve pairs of cranial nerves examination were found to be normal. Muscle bulk symmetrical on either side. No evidence of atrophy, wasting, fasciculation, tremors, no involuntary movement. Tone decreased in all group of muscles in both upper & lower limbs. Power around shoulder, elbow are 4+/5 and power around the hip joint, knee joint, ankle joint respectively are 4/5, 4/5, 3/5. Small muscles of hand & foot are both weak. Superficial reflexes are normal. Planter reflex is bilateral flexor. Deep tendon reflexes in upper limb triceps, biceps & supinator are 1+/4, 1+/4 & 0 bilaterally. In lower limb knee reflexes are bilaterally reduced to 1/4. Ankle reflexes were absent bilaterally. No evidence of presence of any primitive reflexes. There was evidence of loss of pain, touch, temperature up to knee & wrist. Vibration & join position was lost up to knee & wrist. There was no evidence of cerebellar involvement. Gait was stepping gait. Romberg’s sign was positive. Cranium & spine were normal and there were no signs of meningeal irritation. In respiratory system examination nasal polyp was seen in left side & there was paranasal sinus tenderness over left maxillary sinus. All quadrant of lung were equally resonant. In auscultation vesicular prolonged expiration was heard in all quadrants of lung. Bilateral polyphonic wheeze heard. Cardio vascular system and gastro intestinal were essentially normal.

Limited national fossil fuel resources and sustained increases in energy prices have resulted in nationwide efforts to study and deploy alternative energy sources. Despite high prospect, biomass resources has not been effectively utilized in India due to the lack of information on amount, type and time of its availability on a geospatial frame work to facilitate its transportability, establishment of bio-fuel plants tailor made for specific crop residues. Hence, a comprehensive approach towards geospatial mapping of bio-energy potential from surplus crop residues of selected crops (rice. wheat, cotton and sugarcane) over the Haryana state of India is implemented by utilizing a hybrid model combining both statistical and remote sensing technique. Bioenergy potential was calculated from crop production statistics collected at district level. The grain production data were converted into gross residue potential using residue production ratio. The crop residue was further converted into collectable crop residue using collectable coefficient. To generate the spatial map of the selected crops, potential crop masks were prepared using multi-temporal satellite data. These crop masks were then converted to crop fraction at 1 km grid level. MODIS NPP data product was then processed and converted into same 1 km to account the spatial variability of biomass potential. Using these crop fractions as independent variables, relationship was established with NPP as dependent variable using a machine learning technique (Random Forest algorithm). These crop specific response curves (crop fraction vs NPP) were utilized as a weight to disaggregate district level gross biomass potential to 1 km grid level. The spatial map thus generated provided spatial details of the type and amount surplus crop residues and could be vital input for planning and policy making of utilization of the surplus biomass resources of India.

Letrozole (LET), an aromatase inhibitor widely used as a first-line drug for the estrogen-dependent breast cancer treatment in postmenopausal women. In this study, an attempt has been made to develop LET topical drug delivery which would be a more efficient system to treat elevated blood levels of estrogen found in breast cancer patients. The technique involves, encapsulation of the LET in phospholipids using spray dryer. The LET spray-dried powder (LT-SDP) powder was tested by Fourier transform infrared, X-RD, and differential scanning calorimetry. These studies confirm the entrapment efficiency (EE) of the system. The LT-SDP in the form dispersion was further evaluated. The confocal laser scanning microscopy (CLSM) showed spherical vesicles, the particle size, polydispersity index, and the EE was found to be 284.0 nm, 0.247, and 59.08%, respectively. LT-SDP dispersion was added into a cream base with peppermint and olive oil as natural penetration enhancers. Optimized formulation showed superior skin targeting in in vitro and in vivo studies. Cell proliferation assay and flow cytometry was carried out using human cancer cell line of breast MDA-MB-231 which showed superior anti-proliferative action and enhanced apoptosis activity of LT-SDP cream (43.9%) in comparison. The CLSM micrograph, skin irritation, and histopathology studies showed the penetration ability and inertness of the LT-SDP cream, respectively. In vivo bioavailability studies showed an almost four-fold increase in the plasma concentration (11.3 versus 4.2) while the mean residence time (81.11 versus 64.42 h) and half-life (51.01 versus 39.36 h) were reasonably higher than plain LET cream.

BACKGROUND: COVID-19 pandemic has changed the life of people in many facets, economic, social, and psychological. Frontline health-care workers (HCWs) fighting against this pandemic faced some psychological as well as social issues which are of major concern. The objective of the study is to evaluate the magnitude of mental health problems, namely depression, anxiety, and stress among frontline HCWs as well as their perception on ongoing events and surroundings. MATERIALS AND METHODS: It was a prospective, observational study on n = 85 HCWs over a 4-month period. Study participants were sampled purposively in accordance with inclusion and exclusion criteria; data were collected by online survey method. A semi-structured scale was used: Part A of which assessed the demography and perception of HCWs on surrounding along with ongoing social events and Part B consisted of the Depression, Anxiety, and Stress Scale-21 that was used to assess mental health issues. All the associations were tested in percentages and proportions. Statistics was calculated by using SPSS 24th version. RESULTS: Majority of the participants were female doctors and belonged to 21–30 years' age group. Most of them were marginally worried of contacting infection (73%) but were substantially apprehensive of transmitting infection to their family (56.5%) and hoped positive outcome ultimately in the form of recovery from infection. Majority (96.4%) gathered information from authentic sources and were confident of adequacy of their knowledge. Majority (88.3%) were satisfied about their occupational safety and responded on scientific solution of pandemic. However, we got a mixed result about their professional appreciation. Depression symptom score was higher than anxiety and stress symptom score in our participants. CONCLUSIONS: Doctors and nurses both were suffering from mental health issues, and provision of adequate information and occupational safety may lessen these burdens.

In this chapter, we present the analytical model of a gate-engineered dielectric modulated junctionless nanowire transistor to efficiently detect biomolecules electrically and in a label-free manner. The change in the threshold voltage of the device due to the immobilization of the biomolecules in the nanogap cavity region has been considered the chief sensing metric for the detection of biomolecules. Per the principal of dielectric modulation, the presence of biomolecules in the nanogap cavity region causes a change in the surface potential and channel center potential of the device, which in turn causes a change in the threshold voltage of the device. In this chapter, an analytical model of channel center potential has been developed by solving two-dimensional Poisson’s equation in the channel region using the parabolic approximation method. The proposed model provides analytical expression of electrostatic potential distribution along the channel. Furthermore, an expression of threshold voltage of the device and expression of current in different regions has been obtained from this potential model developed. To efficiently detect the biomolecules, the variation of the threshold voltage as the sensitivity parameter has been analyzed. The results clearly reveal that a gate-engineered junctionless nanowire transistor provides higher sensitivity over its non-gate-engineered counterpart. Moreover, the effect of different device dimensional parameters and position of the nanogap cavity on the sensitivity of the biosensor has been investigated to study the changes in the permittivity of the dielectric region due to the presence of biomolecules in the nanocavity region. The results obtained from the analytical model have been verified and validated through comparison with TCAD device simulator results.

Rheumatological manifestations (RM) are very common in human immunodeficiency virus (HIV)-infected patients. The aim of this study was to determine the clinical spectrum of musculoskeletal involvement and relationship with the Centers for Disease Control and Prevention (CDC) stage and CD4+ cells and other factors. A cross-sectional study was conducted involving 75 patients of over 18 years of either sex with confirmed HIV status attending a tertiary care hospital in north India in one calendar year. Baseline demographic details, relevant history including duration of combination antiretroviral therapy (cART), RM, joints involved, CD4 cell count, and biochemical parameters were evaluated. Of 75 patients, 54 were male and 21 were female (mean age 33.15 ± 5.00 years, range 21–48 years). Most common RM was arthralgia (26.67%), followed by myalgia (18.67%), and arthritis (13.33%). Keratoderma blennorrhagicum (1.33%), tendo-achilles tendinitis (2.67%), and plantar fasciitis (2.67%) were other manifestations. Spondyloarthritis (SpA) was seen in 8% patients (undifferentiated SpA 4%, reactive arthritis 2.67%, psoriatic arthritis 1.67%). HIV-associated arthritis was seen in 2.67% while septic arthritis, rheumatoid arthritis, vasculitis, and diffuse infiltrative lymphocytic syndrome were seen in one patient (1.33%) each. The mean duration of disease in patients with RM was significantly less than patients without RM (p

Silk fibroin nanoparticles possess the hydrophobic nature which assists them to become a good substrate for reticulo-endothelial system (RES) and macrophageal uptake. Surface coating of these nanoparticles with hydrophilic stabilizers, like Tween-80 make them long circulating and facilitate their uptake by low density lipoprotein (LDL) receptors to cross blood brain barrier (BBB). Surface modified silk fibroin nanoparticles bearing anti-cancer agent doxorubicin (DOX) were fabricated by desolvation method and coated with Tween-80 as surface modifier. The prepared nanoparticles were characterized for various physicochemical parameters, like particle size, surface charge, surface morphology by scanning electron microscope (SEM) and transmission electron microscopy (TEM), and in vitro drug release along with in vitro cell cytotoxicity, flow cytometry and cellular uptake studies by flourocytometry on glioblastoma cell lines. Entrapment efficiency for the silk fibroin nanoparticles were found to be >85% for coated and uncoated nanoparticles. Nanoparticles with average diameter less than 150 nm having negative charge were found to show no toxicity of its own. The pro-inflammatory response of nanoparticles was observed by determining the cytokines level, such as TNF-α and IL-1β. Sustained drug release pattern from the nanoparticles with better cytotoxicty as compared to free drug was observed, signifying their potential ability to work as a drug delivery system.