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Nonalcoholic fatty liver disease (NAFLD) has been shown to be linked to inflammatory bowel disease (IBD) due to established risk factors such as obesity, age, and type 2 diabetes in numerous studies. However, alternative research suggests that factors related to IBD, such as disease activity, duration, and drug-induced toxicity, can contribute to NAFLD. Recent research findings suggest IBD relapses are correlated with dysbiosis, mucosal damage, and an increase in cytokines. In contrast, remission periods are characterized by reduced metabolic risk factors. There is a dichotomy evident in the associations between NAFLD and IBD during relapses and remissions. This warrants a nuanced understanding of the diverse influences on disease manifestation and progression. It is possible to provide a holistic approach to care for patients with IBD by emphasizing the interdependence between metabolic and inflammatory disorders.

Background: The burden of over 300 million individuals living with hypertension in India is increasing steadily. Most current guidelines recommend initial combination therapy for effective blood pressure (BP) control. However, there is no randomised evidence to inform which combinations to use in the South Asian population, who account for over one-quarter of the world's population. Methods: This multi-centre, single-blind, randomised, three-arm trial recruited men and women aged 30–79 years with hypertension. The trial compares the efficacy of commonly recommended single pill combinations (SPCs) of three drug classes – calcium channel blocker (amlodipine), ACE inhibitor (perindopril), and a thiazide-like diuretic (indapamide). The primary objective is to determine the most effective two-drug combination, initially at starting doses with forced up-titration at 2 months, in reducing 24-h ambulatory systolic blood pressure (ASBP) at 6 months. The trial has 85 % power to detect a difference of 3 mmHg in 24-h ASBP amongst the groups.Participant recruitment took place from August 2022 to February 2024. Baseline results: The 1981 participants (42.0 % women) enrolled had a mean age of 52.1 (SD 11.3) years and a mean body mass index of 26.5 (SD 4.2) kg/m2. 58.1 % of participants had a previous diagnosis of hypertension and 18.6 % of participants were known to diabetes. The mean ASBP was 135.6 (SD 17.0) mmHg, and the mean ambulatory diastolic BP was 84.5 (SD 10.9) mmHg. Conclusion: The TOPSPIN trial is the first randomised evaluation of commonly used BP-lowering combination therapies in a South Asian population. The results have potentially significant implications for choosing first-line antihypertensive agents among Indians and the South Asian diaspora.

Intensive care unit (ICU) admissions in the United States exceed 5.7 million annually, often leading to complications such as post-intensive care syndrome and high mortality rates. Among these challenges, critical illness-related corticosteroid insufficiency (CIRCI) requires emphasis due to its complex, multiple-cause pathophysiology and varied presentations. CIRCI, characterized by adrenal insufficiency during critical illness, presents in up to 30% of ICU patients and may manifest as an exaggerated inflammatory response. Factors such as dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, altered cortisol metabolism, tissue corticosteroid resistance, and drug-induced suppression contribute to CIRCI. Diagnosis is a complex process, relying on a comprehensive assessment including clinical presentation, laboratory findings, and dynamic stimulatory testing. Treatment involves intensive medical care and exacting glucocorticoid therapy. Recent guidelines advocate for individualized approaches tailored to patient presentation and etiology. Understanding the pathophysiology and treatment of CIRCI is vital for clinicians managing critically ill patients and striving to improve outcomes. This research paper aims to explore the latest developments in the pathophysiology and management of CIRCI.

The widespread use of nano-titanium dioxide (nano-TiO2) has raised concerns about its environmental impact, particularly in soil-plant systems. This study investigates the effects of nano-TiO2 on rice (Oryza sativa cv. PB1121) growth and enzymatic activities, compared to bulk TiO2, through a pot culture experiment. Eight doses of Ti were applied: six as soil treatments (0, 2.5, 5, 10, 25, and 50 mg Ti kg⁻¹) and two as foliar treatments (0.05 % and 0.1 %). Results showed that grain yield peaked at 25 mg Ti kg⁻¹ soil for both nano and bulk TiO2, while a 0.05 % foliar spray outperformed by 0.1 %. Titanium accumulated mostly in roots, followed by straw and grains. Nano-TiO2 significantly increased antioxidant enzyme activities—catalase (CAT), superoxide dismutase (SOD), guaiacol peroxidase, and ascorbate peroxidase (APX)—and lipid peroxidation (measured as malondialdehyde) in rice roots and shoots, indicating oxidative stress. The findings suggest that plant enzymatic activity serves as an early indicator of nano-TiO2 exposure, making it a valuable biomarker for environmental monitoring. However, higher Ti doses may inhibit plant growth depending on Ti source and concentration. Further studies should examine the effects of nano-TiO2 of different sizes, shapes, and charges on various crops and soil types to validate these results and assess the broader implications for agricultural and environmental health. This research highlights the dual potential of nano-TiO2 as both a growth enhancer and a stress-inducing agent, emphasizing the need for careful management in agricultural applications.

Post-intensive care syndrome (PICS) refers to persistent or new onset physical, mental, and neurocognitive complications that can occur following a stay in the intensive care unit. PICS encompasses muscle weakness; neuropathy; cognitive deficits including memory, executive, and attention impairments; post-traumatic stress disorder; and other mood disorders. PICS can last long after hospital admission and can cause significant physical, emotional, and financial stress for patients and their families. Several modifiable risk factors, such as duration of sepsis, delirium, and mechanical ventilation, are associated with PICS. However, due to limited awareness about PICS, these factors are often overlooked. The objective of this paper is to highlight the pathophysiology, clinical features, diagnostic methods, and available preventive and treatment options for PICS.

The ongoing existence of health disparities in marginalized communities in India can be attributed to social health determinants such as poverty, caste, gender, and limited access to education and healthcare. Dr. B.R. Ambedkar, an iconic figure in Indian social reform and the driving force behind the Indian Constitution, acknowledged the significance of the social determinants of health influencing health outcomes. This paper explores Dr. Ambedkar’s vision of addressing health disparities, with a focus on his contributions to public health policy and the promotion of social justice. Additionally, it analyses the ongoing perpetuation of inequality through the examination of social determinants of health and explores how Ambedkar’s vision can provide guidance for present public health strategies. The analysis highlights the importance of strong primary healthcare systems, recognizing universal healthcare as an essential human right through the vision of Dr. Ambedkar. It also advocates for greater government funding and policy coordination to effectively tackle health disparities.

Seed priming is a state-of-the-art, low-cost, and environment-friendly strategy to improve seed germination, seed vigor, abiotic and biotic stress tolerance, and the yield of field and horticultural crops. Seed priming involves imbibing the seeds in a priming solution under a desired set of environmental conditions for a period followed by drying before the radicle protrusion. Several seed priming approaches including hydropriming, osmopriming, bio-priming, hormonal priming, nutrient priming, nanoparticle priming, and electropriming can be effectively employed under different environmental conditions to improve crop growth and stress resilience. Seed priming is known to trigger enzymatic, hormonal, physiological, transcriptomic, metabolomic, and proteomic regulations in seed embryos during seed germination and plant growth, which leads to faster and synchronized seed germination and higher abiotic and biotic stress tolerance in crop plants. Furthermore, seed priming can induce cross-tolerance between abiotic and biotic stressors and induce stress memory for higher resilience of the next generation to environmental stresses. The present review paper discusses the applications of seed priming in biotic and abiotic stress tolerance and the underlying abiotic and biotic stress tolerance physiological, biochemical, and molecular mechanisms of seed priming. Furthermore, we discuss the current challenges/bottlenecks in the widespread application of seed priming in crop production.

Linz-Donawitz (LD) slag is a solid industrial waste generated during the production of steel. In general, the amount of LD slag produced varies from 300 to 400 kg ton-1 of steel. Presently only 25 % of the steel slag, which is also rich in various macro and micro-nutrients, is being reused in India compared to 70–100 % in other countries. The present study deals with the possibility of utilizing LD slagas a nutrient rich low-cost soil conditioner in agriculture. An experiment was thus conducted to determine the effect of LD slag application at rates 0.25, 0.50 and 1 t ha-1 in two particle sizes i.e.,

Chapattis have been a global dietary staple since ancient times serving as a primary source of carbohydrates, proteins, dietary fiber and minerals. The escalating prevalence of health challenges such as diabetes, cardiovascular diseases etc. driven by evolving lifestyles, environmental factors, underscores the urgent need for innovative chapatti formulations. To address current and future challenges effectively, there is a compelling requirement to explore novel formulations that not only maintain low glycemic-index and high protein content of chapattis but also enrich them with minerals, vitamins and dietary fibers. The review delves into key quality attributes that define the nutritional and textural characteristics of wheat including the presence of essential micronutrients and bioactive compounds to highlight the potential health benefits associated with regular consumption. The role of different processing parameters in enhancing the quality and shelf stability of wheat chapatti along with the critical aspect of utilizing additives, elucidating various factors influencing the preservation of wheat chapatti over time has been investigated. Furthermore, the findings offer practical insights for food industry professionals contributing to the overall improvement of global food security and dietary well-being.

Abstract The current piece of research intends to evaluate the potential of combining etodolac with deformable-emulsomes, a flexible vesicular system, as a promising strategy for the topical therapy of arthritis. The developed carrier system featured nanometric dimensions (102 nm), an improved zeta potential (− 5.05 mV), sustained drug release (31.33%), and enhanced drug deposition (33.13%) of DE-gel vis-à-vis conventional system (10.34% and 14.71%). The amount of permeation of the developed nano formulation across skin layers was demonstrated through CLSM and dermatokinetics studies. The safety profile of deformable-emulsomes has been investigated through in vitro HaCaT cell culture studies and skin compliance studies. The efficacy of the DE-gel formulation was sevenfold higher in case of Xylene induced ear edema model and 2.2-folds in CFA induced arthritis model than that of group treated with conventional gel (p

Abstract Background The filamentous fungus Rasamsonia emersonii has immense potential to produce biorefinery relevant thermostable cellulase and hemicellulase enzymes using lignocellulosic biomass. Previously in our lab, a hyper-cellulase producing strain of R. emersonii was developed through classical breeding and system biology approaches. ACE1, a pivotal transcription factor in fungi, plays a crucial role in negatively regulating the expression of cellulase genes. In order to identify the role of ACE1 in cellulase production and to further improve the lignocellulolytic enzyme production in R. emersonii, CRISPR/Cas9 mediated disruption of ACE1 gene was employed. Results A gene-edited ∆ACE1 strain (GN11) was created, that showed 21.97, 20.70 and 24.63, 9.42, 18.12%, improved endoglucanase, cellobiohydrolase (CBHI), β-glucosidase, FPase, and xylanase, activities, respectively, as compared to parental strain M36. The transcriptional profiling showed that the expression of global regulator (XlnR) and different CAZymes genes including endoglucanases, cellobiohydrolase, β-xylosidase, xylanase, β-glucosidase and lytic polysaccharide mono-oxygenases (LPMOs) were significantly enhanced, suggesting critical roles of ACE1 in negatively regulating the expression of various key genes associated with cellulase production in R. emersonii. Whereas, the disruption of ACE1 significantly down-regulated the expression of CreA repressor gene as also evidenced by 2-deoxyglucose (2-DG) resistance phenotype exhibited by edited strain GN11 as well as appreciably higher constitutive production of cellulases in the presence of glucose and mixture of glucose and disaccharide (MGDs) both in batch and flask fed batch mode of culturing. Furthermore, ∆ACE1 strains were evaluated for the hydrolysis of biorefinery relevant steam/acid pretreated unwashed rice straw slurry (Praj Industries Ltd; 15% substrate loading rate) and were found to be significantly superior when compared to the benchmark enzymes produced by parent strain M36 and Cellic Ctec3. Conclusions Current work uncovers the crucial role of ACE1 in regulating the expression of the various cellulase genes and carbon catabolite repression mechanism in R. emersonii. This study represents the first successful report of utilizing CRISPR/Cas9 genome editing technology to disrupt the ACE1 gene in the thermophlic fungus R. emersonii. The improved methodologies presented in this work might be applied to other commercially important fungal strains for which genetic manipulation tools are limited.

Vasopressin and oxytocin are well known and evolutionarily ancient modulators of social behavior. The distribution and relative densities of vasopressin and oxytocin receptors are known to modulate the sensitivity to these signaling molecules. Comparative work is needed to determine which neural networks have been conserved and modified over evolutionary time, and which social behaviors are commonly modulated by nonapeptide signaling. To this end, we used receptor autoradiography to determine the distribution of vasopressin 1a and oxytocin receptors in the Southern giant pouched rat (Cricetomys ansorgei) brain, and to assess the relative densities of these receptors in specific brain regions. We then compared the relative receptor pattern to 23 other species of rodents using a multivariate ANOVA. Pouched rat receptor patterns were strikingly similar to hamsters and voles overall, despite the variation in social organization among species. Uniquely, the pouched rat had dense vasopressin 1a receptor binding in the caudate-putamen (i.e., striatum), an area that might impact affiliative behavior in this species. In contrast, the pouched rat had relatively little oxytocin receptor binding in much of the anterior forebrain. Notably, however, oxytocin receptor binding demonstrated extremely dense binding in the bed nucleus of the stria terminalis, which is associated with the modulation of several social behaviors and a central hub of the social decision-making network. Examination of the nonapeptide system has the potential to reveal insights into species-specific behaviors and general themes in the modulation of social behavior.

Wheat (Triticum aestivum L) is one of the major staple food crops consumed globally. Nonetheless, the cultivation of wheat is influenced by various environmental factors, with the planting date being significantly impacted by the effects of climate change. Addressing these changes could involve evaluating wheat genotypes to identify appropriate planting dates. A phenotypic screening experiment was conducted in the field crop station of Agriculture College of Tikrit University to determine the suitable planting time for wheat cultivars under local environmental conditions during 2022-23. Several morpho-physiological, quality, and yield traits were measured. Factorial experiment using spilt plot through randomized completely block design (RCBD). was used with three replications. The five planting dates (5-10, 25-10, 15-11, 5-12, and 25-12) were considered as the main plot, and the eight wheat cultivars (Ipaa99, Al-Rasheed, Al-Baraka, Sham6, Tammuz2, Al-Hashimiya, Al-Noor, and Al-Adnanieh) as sub-main plot. Data were used to calculate the Individual, Cumulative, and Total Vigor Response Indices (IRI, CRI & TRI). Cultivars were classified into different categories using total cumulative early or late planting date vigor response index values (TRI-e) or (TRI-l) and standard deviation (SD). The (TRI-e) values ranged from 36.07 (sensitive) for the cultivar Al-Baraka to 39.13 (tolerant) for the cultivar Al-Hashimiya. However, the (TRI-l) values ranged from 36.59 (sensitive) for the cultivar Al-Noor to 39.52 (tolerant) for the cultivar Al-Hashimiya. The correlation coefficient (r2) between the (TRI-e) and cumulative very early/early planting date vigor response index was positively correlated (r2 = 0.70 for very early planting date (5-Oct) and r2 = 0.60 for early planting date (25-Oct). Furthermore, 76% of the total variation in the (TRI-l) was explained by the cumulative very late planting date vigor response index (CRI-vl) while just 49% of the total variation was explained by the cumulative late planting date vigor response index (CRI-l). Based on those results, wheat producers could select either tolerant cultivars for early planting or tolerant cultivars for late planting to maximize wheat production in their specific growing environments including planting dates.

Abstract Diabetes has become a serious health concern for the global population. An estimated 643 million people will have type 2 diabetes mellitus by the year 2030. A sedentary lifestyle is one of the important risk factors along with obesity, hypertension, and diet. Exercise improves blood glucose levels and reduces glycosylated hemoglobin (HbA1c). Physical aerobic exercise utilizes energy stored in the form of ATP and helps to burn stored fat. The process of muscular contraction during a physical workout controls the mechanisms responsible for improving blood glucose levels. These involve complex pathways that ultimately increase the uptake of blood glucose, improve insulin sensitivity and blood flow, and optimize the functioning of the endocrine pancreas. An overall reduction in HbA1C can be achieved through the interplay of all these pathways.

Early pulmonary congestion detection and surveillance in acute heart failure patients can prevent decompensation, minimize hospitalizations, and improve prognosis. In India, the warm and wet types of HF are still the most common types and residual congestion at discharge is still a significant concern. Thus, there is an urgent need for a reliable and sensitive means of identifying residual and subclinical congestion. Two such monitoring systems are available and approved by US FDA. These include CardioMEMS HF System (Abbott, Sylmar, California) and ReDS System (Sensible Medical Innovations, Ltd., Nanya, Israel). CardioMEMS is a wireless pressure-sensitive implantable device, while ReDS is a wearable noninvasive device for measurement of the lung fluid and hence direct detection of PC. This review discusses the role of noninvasive assessment in PC monitoring in patients with heart failure and its implications from an Indian perspective.

Industrial wastes and agricultural by-products are increasingly used in crop production as supplements along with fertilizers. An experiment was conducted during the winter (rabi) seasons of 2021 and 2022 at the research farm of the ICAR-Indian Agricultural Research Institute, New Delhi to determine the individual and combined effects of bioaugmented Linz-Donawitz (LD) slag and biochar on physiological and yield attributes of wheat (Triticum aestivum L.) variety HD 2967. Bioaugmented products with cow-dung, LD slag and biochar in different combinations were prepared in laboratory scale and applied in crates. All the treatments were applied with 100%RDF except control. Growth parameters such as total leaf area, chlorophyll content, NDVI; and leaf photosynthetic attributes such as net photosynthetic rate, stomatal conductance and transpiration rate were affected by bio-augmentation. Our study reported an increase in total leaf area (18.2–21.3%), chlorophyll content (26.5–31.0%), net photosynthetic rate (93.2%), stomatal conductance (61.3%), transpiration rate (24.7%) in bioaugmented treatments with LD slag and biochar over 100%RDF. A yield increase of 25.6 and 27.1% was found in bioaugmented treatments with a combination of LD slag (2 t/ha) and biochar (1 t/ha) over 100%RDF during 2021 and 2022, respectively. No. of spikes, grains per spike and dry biomass weight were positively influenced by bioaugmentation. The bioaugmented treatments with a combination of LD slag and biochar gave significantly higher grain yield, followed by bioaugmented LD slag compared to bioaugmented biochar alone in the respective application rate of treatments.

The concept of human rights has long been an integral part of global discourse, championed as a fundamental pillar of social justice and equity. In recent decades, the intersection of human rights, global health, and sustainable development has emerged as a critical area of concern and opportunity. This research paper delves into the dynamic intersection of human rights, global health, and sustainable development, with a particular focus on Sustainable Development Goal 3 (SDG 3) - Good Health and Well-Being. In the context of our rapidly changing world, by applying a multidisciplinary research method, this paper explores the evolving landscape of human rights preservation and the challenges posed by emerging global governance issues. By examining the role of law in promoting and safeguarding human rights within the framework of SDG 3, it offers a comprehensive analysis of the evolving global governance challenge in the quest for a healthier and more sustainable world.

Introduction: The prevalence of lower extremity artery disease (LEAD) continues to increase worldwide. This is expected to translate into logarithmic rise in lower-limb amputations especially in the developing world. Majority of patients suffering from LEAD remain asymptomatic until late and are vulnerable to limb-threatening complications unless actively screened and treated. Methods: This was a prospective, single-center, observational study to determine the prevalence and predictors of LEAD. Patients with known atherosclerotic vascular disease (but not known LEAD) or those at risk were enrolled. All underwent ankle brachial index (ABI) measurement as per the standard protocol. A threshold of ABI ≤0.90 was taken to diagnose LEAD. Results: A total of 1000 patients were enrolled. The mean age of the group was 61.4 ± 10.0 years and the prevalence of LEAD was 10.2%. Amongst those who had LEAD, the majority of patients (69.6%) had no symptoms. The prevalence of LEAD in diabetic population in our study was 13.2% and it was 30.9% in coronary artery disease patients . Factors independently linked to LEAD on regression analysis included advanced age, presence of diabetes, smoking history, lower serum HDL and a lower ejection fraction. Conclusions: The vast majority of patients suffering from LEAD are asymptomatic. Early diagnoses and institution of appropriate medical and physical therapy can prevent excess morbidity and mortality due to LEAD. Factors independently linked to LEAD are advanced age, presence of diabetes, smoking history, lower serum HDL and a lower ejection fraction. The presence of either of these should signal undertaking of appropriate steps to unmask underlying LEAD.

Limited data exists on patients with cardiac amyloidosis (CA) in India, due to underdiagnosis and late presentation. We present single centre data from 13 patients over a 4 year period with a median age of 65 years. A majority presented with symptomatic heart failure (69%) and eight patients had confirmed AL amyloidosis. At the end of the follow up period, 46% patients died, with 30% of the overall cohort dead within six months. Among the survivors, 71% continue to have NYHA grade III/IV symptoms. A suggested algorithm for earlier diagnosis in resource constrained settings is also presented.

Abstract Background Takotsubo cardiomyopathy (TCM) is a rare disease entity characterized by acute, non-ischemic, reversible myocardial dysfunction that mimics acute myocardial infarction. Activation and excessive outflow of sympathetic nervous system are believed to be central to the figure in the disease pathogenesis. Adrenocortical hormones potentiate the systemic actions of sympathetic nervous system and accordingly are essential for regulation of myocardial function. We present an unusual case of a middle-aged woman with primary adrenal insufficiency who presented paradoxically with TCM. Case presentation A 50-year-old woman with past history of hypothyroidism presented to emergency department with history of acute chest pain and syncope. There was no significant drug history or history of an emotional or physical stimulus prior to admission. Prominent pigmentation over the tongue and skin creases of hands were noted. On presentation, she was in shock and had ventricular tachycardia which required electrical cardioversion. The subsequent electrocardiogram demonstrated diffuse T-wave inversions with prolonged QTC. There was apical hypokinesia on echocardiogram, and cardiac biomarkers were elevated. There was persistent inotropic requirement. She had marked postural symptoms, and a postural blood pressure drop of 50 mm Hg was present. Initial laboratory parameters were significant for hyperkalemia (7.8 mEq/L) and hyponatremia (128 mEq/L). These findings prompted evaluation for adrenal insufficiency which was confirmed with appropriate tests. Autoimmune polyendocrine syndrome II was thus diagnosed based on the above findings. Coronary angiography revealed normal coronaries. The diagnoses of TCM was established in accordance with the International Takotsubo Diagnostic Criteria. She was started on stress dose steroid replacement therapy and improved dramatically. At one month of follow-up, the patient is asymptomatic, and there was normalization of her left ventricular function. Conclusions Intricate relationship and interplay exist between the steroid hormones and catecholamines in the pathogenesis of TCM. Steroid hormones not only potentiate the actions of catecholamines, but they also regulate and channelize catecholaminergic actions preventing their deleterious effects on the cardiac tissue. Hence, both steroid deficiency and exogenous steroid replacement may precipitate TCM. Evidence from more such cases and larger perspective studies in future will further improve our understanding of this complex disease process and its myriad associations.

Bacterial contamination of water and food is a grave health concern rendering humans quite vulnerable to disease(s), and proving, at times, fatal too. Exploration of the novel diagnostic tools is, accordingly, highly called for to ensure rapid detection of the pathogenic bacteria, particularly Escherichia coli. The current manuscript, accordingly, reports the use of silane-functionalized glass matrices and antibody-conjugated cadmium telluride (CdTe) quantum dots (QDs) for efficient detection of E. coli. Synthesis of QDs (size: 5.4–6.8 nm) using mercaptopropionic acid (MPA) stabilizer yielded stable photoluminescence (∼62%), corroborating superior fluorescent characteristics. A test sample, when added to antibody-conjugated matrices, followed by antibody-conjugated CdTe-MPA QDs, formed a pathogen-antibody QDs complex. The latter, during confocal microscopy, demonstrated rapid detection of the selectively captured pathogenic bacteria (10 microorganism cells/10 μL) with enhanced sensitivity and specificity. The work, overall, encompasses establishment and design of an innovative detection platform in microbial diagnostics for rapid capturing of pathogens in water and food samples. HIGHLIGHTS Antibody-mediated fluorescent biosensor for efficient capturing and detection of E. coli.; Bioconjugation of QDs and E. coli antibodies.; Qualitative, quantitative and selective assessment of E. coli in contaminated water using CLSM.; High sensitivity of glass matrix biosensor, with detection limit of 10 microorganisms/10 mL.; Capability of technology extension for detecting other microbial pathogens.;

Diazotrophic cyanobacteria are known to influence nutrient availability in soil, however, their benefits under elevated CO2 environment, particularly on fruit quality attributes, is a less investigated aspect. Laboratory developed cyanobacterium-fungal biofilm (An-Tr), composed of Anabaena torulosa (An) as the matrix with the partner as Trichoderma viride (Tr), along with the individual partners were evaluated under ambient (aCO2-400 ± 50 ppm) and elevated (eCO2-700 ± 50 ppm) conditions, with and without tomato plants. An-Tr inoculation exhibited distinct and significantly higher values for most of the soil microbiological parameters, plant growth attributes and antioxidant/defense enzyme activities measured at 30 and 60 DAI (days after inoculation). Significant enhancement in soil nutrient availability, leaf chlorophyll, with 45–50% increase in the enzyme activities related to carbon and nitrogen assimilation, higher yields and better-quality parameters of tomato, with An-Tr biofilm or An inoculation, were recorded, particularly under eCO2 conditions. The fruits from An-Tr treatments under eCO2 exhibited a higher titrable acidity, along with more ascorbic acid, carotenoids and lycopene content, highlighting the superiority of this inoculant. Multivariate analyses revealed significant (p ≤ 0.05) interactions among cultures, DAI, and CO2 levels, illustrating that cyanobacterial inoculation can be advocated as a strategy to gainfully sequester eCO2. Significant improvement in yield and fruit quality along with 50% N savings, further attest to the promise of cyanobacterial inoculants for tomato crop in the climate change scenario.

Objectives: The environmental effect in heart failure (HF) patients is well established. However, the data is limited from low-to middle-income countries like India. This study determined the impact of environment on acute decompensated HF (ADHF) admissions and mortality in India. Methods: Retrospectively, the data of all HF patients admitted between April 2017 and March 2019 was accessed through electronic hospital records. Simultaneously, the environmental-related data was collected from the central pollution control board. Results: The study included 4561 patients of ADHF. The peak of monthly ADHF events (admission and mortality) was observed during the chilly month (January) while the lowest rates were observed in summer months (May–June). The most significant factor correlating inversely with the monthly ADHF admission (r = −0.78, p = 0.003) and mortality (r = −0.65, p = 0.004) was the maximum air temperature, and it was found to be the independent predictor for both ADHF mortality [t = −2.78, β = −0.84; 95%CI(-6.0 to −0.6), p = 0.021] and admission [t = −4.83, β = −0.91; 95%CI(-19.8 to −6.9), p = 0.001]. The above correlation was better seen in the elderly subset and male gender. Humidity and the air pollution attributes did not have a significant correlation with ADHF admission or mortality. Conclusion: In conclusion, even in low-to middle-income country like India, a periodic effect of season was demonstrated for ADHF mortality and admission, with a peak in ADHF events noted during winter months especially in the regions having extremes of seasons. Air pollution could not affect the ADHF outcome for which further studies are needed.

High temperatures present a formidable challenge to the cultivation of hot pepper, profoundly impacting not only vegetative growth but also leading to flower and fruit abscission, thereby causing a significant reduction in yield. To unravel the intricate genetic mechanisms governing heat tolerance in hot pepper, an F2 population was developed through the crossing of two distinct genotypes exhibiting contrasting heat tolerance characteristics: DLS-161-1 (heat tolerant) and DChBL-240 (heat susceptible). The F2 population, along with the parental lines, was subjected to comprehensive phenotyping encompassing diverse morphological, physiological, and biochemical heat-related traits under high temperature conditions (with maximum temperature ranging from 31 to 46.5°C and minimum temperature from 15.4 to 30.5°C). Leveraging the Illumina Nova Seq-6000 platform, Double digest restriction-site associated DNA sequencing (ddRAD-seq) was employed to generate 67.215 Gb data, with subsequent alignment of 218.93 million processed reads against the reference genome of Capsicum annuum. Subsequent variant calling and ordering resulted in 5806 polymorphic SNP markers grouped into 12 LGs. Further QTL analysis identified 64 QTLs with LOD values ranging from 2.517 to 11.170 and explained phenotypic variance ranging from 4.05 to 19.39%. Among them, 21 QTLs, explaining more than 10% phenotypic variance, were identified as major QTLs controlling 9 morphological, 3 physiological, and 2 biochemical traits. Interestingly, several QTLs governing distinct parameters were found to be colocalized, suggesting either a profound correlation between the QTLs regulating these traits or their significant genomic proximity. In addition to the QTLs, we also identified 368380 SSR loci within the identified QTL regions, dinucleotides being the most abundant type (211,381). These findings provide valuable insights into the genetics of heat tolerance in hot peppers. The identified QTLs and SSR markers offer opportunities to develop heat-tolerant varieties, ensuring better crop performance under high-temperature conditions.

Linz-Donawitz Slag is regarded as a soil conditioner and can be exploited for its mineral and nutritional value in agriculture, however, it is necessary to check the Potentially Toxic Elements (PTEs) which could impact the soil rapidly and crop production adversely. Environmental hazards associated with mounting piles of Linz-Donawitz slag emanating from the steel producing industry and its sustainable management are a major challenge. A research study was carried out using different chemical chelating agents to achieve reduction in PTEs' concentration in Linz-Donawitz slag and to study the effect of transfer of PTEs’ from the treated and untreated LD Slag applied to the spinach. Optimization was done using response surface methodology, and the highest extraction efficiency for Cadmium (Cd) and Lead (Pb) removal was observed using a concentration of 10 mM, liquid-to-solid ratio of 5:1, and shaking time of 60 min to obtain Low heavy metal Linz-Donawitz slag (Low HM-LD Slag). The highest chelation was observed while using the chelating agent Ethylene diamine-N, N'-Di succinic acid (EDDS) followed by Ethylene diamine tetra acetic acid (EDTA) then Diethylene triamine penta acetate (DTPA), and the least extraction was observed using the Citric acid (CA). The Low HM-LD Slag so obtained was assessed for its response on Spinach under the varied level of Recommended Dosage of Fertilizer (RDF) under field soil in pot culture. A significant difference in the growth of spinach was observed between 100% RDF treated Low HM-LD Slag and 50% RDF treated Low HM-LD Slag derived using different chelating agents The PTE analysis of soil and plant showed an undetectable level of Cd, Pb in both the shoot and root samples Under Low HM-LD Slag treatments @ 100% and 50% RDF condition. The present work advocates the use of chemical chelators reducing PTEs' load in Linz-Donawitz slag before using it for application in agriculture as a soil conditioner or as a fertilizer.

Abstract Sorafenib tosylate (SFB) is a multikinase inhibitor that inhibits tumour growth and proliferation for the management of breast cancer but is also associated with issues like toxicity and drug resistance. Also, being a biopharmaceutical class II (BCS II) drug, its oral bioavailability is the other challenge. Henceforth, this report intended to encapsulate SFB into a biocompatible carrier with biodegradable components, i.e., phospholipid. The microemulsion of the SFB was prepared and characterized for the surface charge, morphology, micromeritics and drug release studies. The cell viability assay was performed on 4T1 cell lines and inferred that the IC50 value of sorafenib-loaded microemulsion (SFB-loaded ME) was enhanced compared to the naïve SFB at the concentrations of about 0.75 µM. More drug was available for the pharmacological response, as the protein binding was notably decreased, and the drug from the developed carriers was released in a controlled manner. Furthermore, the pharmacokinetic studies established that the developed nanocarrier was suitable for the oral administration of a drug by substantially enhancing the bioavailability of the drug to that of the free SFB. The results bring forth the preliminary evidence for the future scope of SFB as a successful therapeutic entity in its nano-form for effective and safer cancer chemotherapy via the oral route.

Abstract Tetrahydrocurcumin (THC), a principal metabolite of curcumin, was tested in a rat model of type 2 diabetes mellitus. THC was administered via daily oral gavage with the lipid carrier polyenylphosphatidylcholine (PPC) as add‐on therapy to losartan (angiotensin receptor blocker) to examine effects on kidney oxidative stress and fibrosis. A combination of unilateral nephrectomy, high‐fat diet and low‐dose streptozotocin was used to induce diabetic nephropathy in male Sprague–Dawley rats. Animals with fasting blood glucose >200 mg/dL were randomized to PPC, losartan, THC + PPC or THC + PPC + losartan. Untreated chronic kidney disease (CKD) animals had proteinuria, decreased creatinine clearance, and evidence of kidney fibrosis on histology. THC + PPC + losartan treatment significantly lowered blood pressure concurrent with increased messenger RNA levels of antioxidant copper‐zinc‐superoxide dismutase and decreased protein kinase C‐α, kidney injury molecule‐1 and type I collagen in the kidneys; there was decreased albuminuria and a trend for increased creatinine clearance compared to untreated CKD rats. There was decreased fibrosis on kidney histology in PPC‐only and THC‐treated CKD rats. Plasma levels of kidney injury molecule‐1 were decreased in THC + PPC + losartan animals. In summary, add‐on THC to losartan therapy improved antioxidant levels and decreased fibrosis in the kidneys, and lowered blood pressure in diabetic CKD rats.

Introduction: A proximal femur fracture is the most serious complication of osteoporosis, due to the high mortality and morbidity associated with it. Its risk in the elderly is a function of multiple factors, including bone mineral density, muscle strength, and balance, all of which have been related to Vitamin D status and function. Materials and Methods: This was a prospective hospital-based study conducted over 2 years in the hilly state of Himachal Pradesh, India, to evaluate any correlation between Vitamin D levels and proximal femur fractures (PFFs). We also studied the influence of age and sex on Vitamin D levels in PFFs. Results: In our study, the female patients had lower Vitamin D levels (19.85 ± 5.28) as compared to males (20.436 ± 9.36), but this decrease was not found to be statistically significant (P = 0.2374). There was an average decrease of Vitamin D levels in patients of higher age group (20.770 ± 6.57 vs. 19.692 ± 8.40), but this was not statistically significant (P = 0.613). Thirty-four patients, i.e., 68%, had hypocalcemia, while 16 patients, i.e., 32%, had normal levels of serum calcium. Similarly, 30 patients, i.e., 70%, had hypomagnesemia, while 20 patients, i.e., 40%, had normal serum magnesium levels. The mean level of alkaline phosphatase in PFF was found to be 116.36 IU/L, i.e., within normal limits. The average Vitamin D level in our patients who were adequately exposed to sunlight was 22.5 ± 8.80 ng/ml, while the average Vitamin D level in patients who were inadequately exposed was 16.925 ± 5.98 ng/ml. The mean Vitamin D levels in vegetarian and nonvegetarian patients were 19.17 ± 6.05 ng/ml and 19.83 ± 9.56 ng/ml, respectively. We found that vitamin levels were relatively low (19.46 ng/dL) in patients from high altitudes as compared to patients from low altitudes (22.62 ng/dL), but the difference was insignificant (P = 0.3925). Conclusion: In our study, almost all patients (96%) were suffering from hypovitaminosis D (Vitamin D levels

Background: Classroom teaching has been found to be the most common modality used for teaching. The unusual situation of the coronavirus disease 2019 (COVID-19) pandemic led to the shutdown of all educational institutions across the country. To limit the spread of the coronavirus, classroom teaching had to be abandoned and online teaching was sought for to continue the learning process. The study was conducted with the aim of assessing the perception of faculty as well as undergraduate medical students toward online teaching and learning methodology. Methods: A cross-sectional observational study using two separate pretested, structured questionnaires for faculty and students was conducted. The questionnaire had a total of 45 questions for collecting data on demographic information, awareness, perception and knowledge toward online teaching, perception about establishing connect between teachers and students through online portal, and operational and technical aspects. These questionnaires were mailed to faculty and students using Google forms (Google Survey platform). Results: A total of 47 teaching faculty and 386 students responded to the questionnaires. More than 70% faculty availed the training and guidance provided for online teaching. The move to switch over to online mode of teaching during lockdown was appreciated by majority (95%) of respondents. The faculty members made use of online polls, surveys, and educational videos for making online lectures interesting. In addition, online assessments (72%) and use of an interactive software (70%) were found worthy and useful. Majority of (80%) students missed direct and in person contact with instructor. Majority of the students (60%) felt isolated and alone during online teaching sessions. One-third of the students believed that instructors were able to generate interest in the topic and 63% of students were satisfied with the explanations delivered with regard to queries during online lectures. The major disadvantages that surfaced were limited options for two-way communication (55%), technical glitches (70%), social isolation (63%), eye strain, and other health-related issues (62%). Internet connectivity emerged as the biggest limitation by faculty members. Conclusion: Overall, the respondents were of the opinion that online teaching was a useful modality during COVID-19 and can be used as a complementary aid to regular teaching in. Adequate infrastructure and uninterrupted internet connectivity is vital for smooth conduct of online teaching.

The microbiological profile, associated risk factors and demographic characteristics of patients with IE has changed in the recent times. In the present study, the antibiotic susceptibility profile of 66 isolates (40 from IDU and 26 from non IDU) recovered over a period of three years from the patients with definitive diagnosis of IE along with their absolute minimum inhibitory concentrations (MIC-μg/ml) was determined as per CLSI, 2017 guidelines. Staphylococcus aureus was found to be the predominant pathogen associated with IE out of which 90.2% isolates were MRSA, although none of the isolates were found resistant to vancomycin, teicoplanin, daptomycin and linezolid. Pseudomonas aeruginosa isolates were 100% susceptible to carbapenams, however variable resistance was observed against other antimicrobials. All Enterococci were found to be 100% susceptible to linezolid and daptomycin, whereas vancomycin resistant enterococci phenotype was observed in 25% of the Enterococcal isolates. A noticeable difference in the antimicrobial susceptibility profile and their MICs were observed in the present study, as compared to published literature across the globe and within the country. However, no statistically significant difference (λ 2 test, p > 0.01)in the AST pattern of isolates from IDU vs. Non IDU was observed. After reviewing the local antibiogram it seems that we need to have our own regional guidelines, which may partially replace the currently prevailing AHA/ESC guidelines.

The study focuses on chances of profit from Saudi IT company to increase with few losing trade and a less margin winning investing decisions. Fear and greed are two psychological points that dominates the investing decisions. The main objective of the research to study the risk management related to Al Moammar Information Systems that is listing on Saudi Share market. Previous Research relied on limited methods for prediction of accurate price for investing in the current bullish Markets. The research also emphasizes on predicting the right price for investing on the basis of Supervised Learning methods involving Support Vector Machine, Random Forest Regression, XGBoost, Auto Arima and Quasi Poisson Regression. Research has found that the right price to investing in this company comes out to be 106.945 on the prediction of previous 6 months period data. Data is sourced though Yahoo Finance api in form of Date, Open, High, Low, Close, Volume, Dividends and Stock Splits. This solution can be fruitful for newly trained investors who are willing to invest for long term basis.Support Vector Machine;

Objectives: Venous thromboembolism (VTE) is a major cause of mortality and morbidity worldwide. This study describes a real-world scenario of VTE presenting to a tertiary care hospital in India. Methods: All patients presenting with acute VTE or associated complications from January 2017 to January 2020 were included in the study. Results: A total of 330 patient admissions related to VTE were included over 3 years, of which 303 had an acute episode of VTE. The median age was 50 years (IQR 38–64); 30% of patients were younger than 40 years of age. Only 24% of patients had provoked VTE with recent surgery (56%) and malignancy (16%) being the commonest risk factors. VTE manifested as isolated DVT (56%), isolated pulmonary embolism (PE; 19.1%), combined DVT/PE (22.4%), and upper limb DVT (2.3%). Patients with PE (n = 126) were classified as low-risk (15%), intermediate-risk (55%) and high-risk (29%). Reperfusion therapy was performed for 15.7% of patients with intermediate-risk and 75.6% with high-risk PE. In-hospital mortality for the entire cohort was 8.9%; 35% for high-risk PE and 11% for intermediate-risk PE. On multivariate analysis, the presence of active malignancy (OR = 5.8; 95% CI: 1.1–30.8, p = 0.038) and high-risk PE (OR = 4.8; 95% CI: 1.6–14.9, p = 0.006) were found to be independent predictors of mortality. Conclusion: Our data provides real-world perspectives on the demographic sand management of patients presenting with acute VTE in a referral hospital setting. We observed relatively high mortality for intermediate-risk PE, necessitating better subclassification of this group to identify candidates for more aggressive approaches.

Anaerobic soil disinfestation (ASD) is a preplant pest management technique that involves amending the soil with a labile carbon source, irrigating the soil to stimulate decomposition, and then covering the soil with polyethylene film (polyfilm) to limit gas exchange. During the ASD process, soil microorganisms shift from aerobic to anaerobic metabolism and release phytotoxic byproducts such as organic acids and gases. Although it has been shown that these phytotoxic by-products have a negative impact on weed survival, questions remain about whether commercial-level weed control can be achieved using ASD alone or in combination with other chemicals. Greenhouse and field studies were conducted to evaluate ASD with mustard (Brassica sp.) meal, molasses, and herbicide applications for yellow nutsedge (Cyperus esculentus) control in tomato (Solanum lycopersicum). The treatments in these studies included factorial of two carbon sources [mustard meal + molasses (MMM) or no carbon amendment], three herbicide treatments [halosulfuron applied preemergence (PRE), halosulfuron applied postemergence (POST), and no herbicide] and two polyfilm treatments (polyfilm cover or polyfilm uncover). In field trials two polyfilm cover treatments were punctured and nonpunctured. Soil treatments included molasses at 14,000 L·ha−1 and mustard meal at 2100 kg·ha−1. Halosulfuron was applied at a rate of 1 oz/acre for PRE or POST applications. Greater anaerobic conditions were achieved in polyfilm cover treatments amended with MMM. In greenhouse and field trials, the most effective treatments for reducing yellow nutsedge populations were ASD with MMM or combined with halosulfuron application (PRE- or POST-ASD), which delivered significantly higher weed control than all other treatments tested or controls. In field trials, ASD with MMM caused plant growth stunting 14 d after transplantation (DAT); however, plants recovered, and stunting or injury was often not observed at 42 DAT. These studies demonstrated that ASD using MMM can be an effective strategy for reducing yellow nutsedge populations; however, the more research is needed to ensure crop safety while using ASD technology.

Nitrogen (N) fertilizer recommendations based on yield goals are common and do not consider variability in soil N supply between fields. Nitrogen transformations in soils are dynamic and may vary widely among different soils, climates, cropping systems, and management practices, making it difficult to provide general N recommendation rates for a region, state, or even a county. To optimize N fertilization rates for corn (Zea mays L.), eight field trials were conducted on different fields at the Edisto Research and Education Center of Clemson University in 2018–2021. The soils varied in pH, inorganic N, management practices (irrigate, dryland, cover, and no-cover crop), and climatic conditions (temperature and precipitation). Six nitrogen fertilizer rate treatments were used during 2018 and 2019, eight in 2020, and five in 2021 trials. Test sites were different in each year except in 2021 in which trials were conducted on the same site but were differentiated by multi-species and no-cover crop treatments. Nitrogen fertilizer was applied as a complete one-time dose in all trials in 2018 and 2021 and in several splits in 2019 and 2020. The corn yields generally increased with N fertilization rates; however, a strong variation of up to 4–11 Mg ha−1 existed at each N level among different fields. Based on yield responses, the eight field trials were divided into two groups: low-yielding and high-yielding sites. The low-yielding sites on average produced 3.8 Mg ha−1 of corn, which was 137% less than the corn harvested from high-yielding sites (9.0 Mg ha−1). The agronomic N use efficiency (AgNUE) in high-yielding sites was almost double (32.68 kg kg−1 N) compared to low-yielding sites (17.16 kg kg−1 N), and the differences were even wider for partial factor productivity of N (PFPN). The economic optimum N rate (EONR) remained below 300 kg N ha−1 for all sites with no marked difference among sites. However, relative yield (ratio of corn yield in unfertilized control to the N level giving the highest yield) was comparatively lower in low-yielding sites (29.45%). Baseline inorganic N, pH, and precipitation were identified as the major factors controlling corn yield responses to N fertilization. The yield variations driven by several factors make N management challenging, indicating the need for site-specific N management for corn in the southeast United States.

Introduction: Metacarpal fractures account for upto 10% of all body fractures and 36% of all hand fractures in adolescents, young adults, and active adults. Among metacarpal fractures, fracture of the metacarpal shaft and neck are most common after direct trauma, roadside accidents, or sports injuries. The ratio of the shaft to the neck is 1:2. Closed reduction and plaster of paris cast can be used to treat the majority of these fractures conservatively. Unstable and comminuted fractures necessitate surgery. Aim: To compare the clinical, functional and radiological outcomes in antegrade intramedullary fixation and transverse pinning of metacarpal fractures in patients of unstable and displaced metacarpal shaft and neck fractures. Materials and Methods: A single-institutional prospective interventional study identified 60 cases of metacarpal fractures between November 2019 to August 2021 in the Maharishi Markandeshwar Medical college and Hospital, Kumarhatti, Himachal Pradesh, India. Each of the cases met the inclusion criteria for closed extra-articular fractures, displaced and unstable fractures of the metacarpal bone. The patients were divided into two groups having 30 subjects each, randomly allotted to two groups (Antegrade intramedullary K-wiring and Transverse Pinning). Outcomes were compared for range of movement by the American Society of Hand Surgeons Total Active Motion score (ASSH TAM), Visual Analog Scale (VAS), and radiological parameters (Angulation). Patients were followed-up for 12 weeks. Complications were listed in terms of pin site infection. Results: Most of the patients were found to be in the third decade of life. The fracture union was achieved at 8±2 weeks. Clinical evaluation done by VAS score which was found to be statistically insignificant between two groups (p-value=0.243). Radiological assessment evaluated by measuring postoperative angulation between two groups was found to be statistically insignificant (p-value=0.248). Difference in functional evaluation between the two groups done by ASSH TAM was found to statistically significant between the groups (p-value=0.036). Conclusion: Both antegrade intramedullary K-wiring and transverse pinning demonstrate good and comparable results for extra-articular neck and shaft metacarpal fractures. However, the former is superior in terms of final range of motion as per ASSH TAM score.

Objective The COVID-19 pandemic necessitated the use of telemedicine to maintain continuity of care for patients with cardiovascular diseases (CVDs). This study aimed to demonstrate the feasibility of implementing a nurse-led teleconsultation strategy for CVD management during the COVID-19 pandemic in India and evaluated the impact of nurse-led teleconsultations on patient treatment satisfaction.Design, setting and participants We developed a two-stage teleconsultation strategy and tested the feasibility of implementing a nurse-led teleconsultation strategy to manage CVD in a northern state (Punjab) in India. A multidisciplinary team of experts developed the treatment protocol used for teleconsultations to manage CVD. Nurses were trained to provide teleconsultation, triaging of patients and referrals to the physicians. Patients with CVD who had an outpatient visit or hospitalisation between September 2019 and March 2020 at the Dayanand Medical College Hospital, Ludhiana, India, were contacted by phone and offered teleconsultations. Telemedicine strategy comprised: stage 1 nurse-led teleconsultations and stage 2 physician-led teleconsultations. Descriptive analysis was performed to report the proportion of patients triaged by the two-stage telemedicine strategy, and patient’s clinical characteristics, and treatment satisfaction between the nurse-led versus physician-led teleconsultations.Results Overall, nurse-led stage 1 teleconsultations were provided to 12 042 patients with CVD. The mean (SD) age of the participants was 58.9 years (12.8), and men were 65.4%. A relatively small proportion of patients (6.3%) were referred for the stage-2 physician-led teleconsultations and of these only 8.4% required hospitalisations. During stage 1 nurse-led teleconsultations, patients were referred to the physicians due to uncontrolled diabetes (24.9%), uncontrolled hypertension (18.7%) and congestive heart failure (16.2%). The patient’s treatment satisfaction was similar between the nurse-led versus physician-led teleconsultations (p=0.07).Conclusion This study showed that a nurse-led telemedicine strategy is feasible to implement in a resource-constraint setting for triaging patients with CVD and reduces physician’s burden.

Abstract Background Increase in the number of infections caused by Gram-negative bacteria in neutropenic cancer patients has prompted the search for novel therapeutic agents having dual anticancer and antimicrobial properties. Bacteriocins are cationic proteins of prokaryotic origin that have emerged as one of the most promising alternative antimicrobial agents with applications as food preservatives and therapeutic agents. Apart from their antimicrobial activities, bacteriocins are also being explored for their anticancer potential. Results In this study, a broad-spectrum, cell membrane-permeabilizing enterocin with a molecular weight of 65 kDa was purified and characterized from the culture supernatant of vaginal Enterococcus faecium 12a. Enterocin 12a inhibited multidrug-resistant strains of various Gram-negative pathogens such as Salmonella enterica, Shigella flexneri, Vibrio cholerae, Escherichia coli and Gram-positive, Listeria monocytogenes, but had no activities against different strains of gut lactobacilli. The mass spectrometric analysis showed that the enterocin 12a shared partial homology with 4Fe-4S domain-containing redox protein of E. faecalis R712. Further, enterocin 12a selectively inhibited the proliferation of various human cancer cell lines in a dose-dependent manner but not that of normal human peripheral blood mononuclear cells. Enterocin 12a-treated cancer cells showed apoptosis-like morphological changes. Conclusion Enterocin 12a is a novel bacteriocin that has anticancer properties against human cell lines and negligible activity towards non-malignant cells. Therefore, it should be further evaluated for its anticancer potential in animal models.

Background: Hypertrophic cardiomyopathy (HCM) is a genetic disorder with a heterogeneous phenotype. Historically, only obstructive and nonobstructive forms have been described. Improvements in imaging techniques have led to elaborative description of various new phenotypes, although there are limited epidemiological data regarding these phenotypes from within our population. Aims and Objectives: •To identify HCM patients from a cohort of cardiomyopathy patients. •To describe their demographic profile and mode of presentation based on the presenting symptoms. •To subclassify the selected HCM population into various phenotypes based on echocardiography. Results: There were 233 patients of HCM in this study. The mean age of the patients was 53 ± 14.5 years with male preponderance (70%). Thirty-six percent patients were asymptomatic, 37% mildly symptomatic (in class I-II), and 27% severely symptomatic (in class III-IV). Patients were classified into six phenotypes consisting of five classically described phenotypes and one atypical phenotype. Reverse curvature phenotype was most prevalent (49%) and symptomatic phenotype with 19.3% having significant resting left ventricular outflow tract (LVOT) obstruction. Other phenotypes were 19% apical mid, 11% neutral, 6% sigmoid, and 4% atypical. Male: female ratio for reverse curvature phenotype was 3:1, apical (mid) phenotype 2.4:1, and both apical and neutral phenotypes 2:1. Sigmoid phenotype had female-to-male ratio of 2.5:1. Conclusion: HCM patients require phenotype specific approach for complete assessment. Transthoracic echocardiography with myocardial contrast plays a pivotal role in identifying morphological phenotypes, effects on cardiac remodeling and hemodynamics which consequently influence mode of presentation. Reverse curvature, apical mid, and sigmoid phenotypes are comparatively more symptomatic, have larger left atrial size and segment thickness compared to less symptomatic apical and neutral phenotypes. Symptom status of the patient seems to be dependent on age, septal contour, severity of LVOT obstruction, left atrial volume, and maximal segment thickness.

Abstract Background To compare the efficacy and safety of bioavailable turmeric extract versus paracetamol in patients with knee osteoarthritis (OA). Methods In this randomized, non-inferiority, controlled clinical study, patients of knee OA were randomized to receive bioavailable turmeric extract (BCM-95®) 500 mg capsule two times daily or paracetamol 650 mg tablet three times daily for 6 weeks. The primary outcome measure was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale. The secondary outcome measures were WOMAC total, WOMAC stiffness, and WOMAC physical function scores. Responder analysis of individual patients at different levels (≥ 20%, ≥ 50%, and ≥ 70%) for WOMAC score was calculated. TNF alpha and CRP levels were evaluated and adverse events (AE) were also recorded. Results Seventy-one and seventy-three knee OA patients, respectively in bioavailable turmeric extract and paracetamol groups, completed the study. Non-inferiority (equivalence) test showed that WOMAC scores were equivalent in both the groups (p value

Abstract Background Incidence of pulmonary aspergillosis is rising worldwide, owing to an increased population of immunocompromised patients. Notable potential of the pulmonary route has been witnessed in antifungal delivery due to distinct advantages of direct lung targeting and first-pass evasion. The current research reports biomimetic surface-active lipid-polymer hybrid (LPH) nanoparticles (NPs) of voriconazole, employing lung-specific lipid, i.e., dipalmitoylphosphatidylcholine and natural biodegradable polymer, i.e., chitosan, to augment its pulmonary deposition and retention, following nebulization. Results The developed nanosystem exhibited a particle size in the range of 228–255 nm and drug entrapment of 45–54.8%. Nebulized microdroplet characterization of NPs dispersion revealed a mean diameter of ≤ 5 μm, corroborating its deep lung deposition potential as determined by next-generation impactor studies. Biophysical interaction of LPH NPs with lipid-monolayers indicated their surface-active potential and ease of intercalation into the pulmonary surfactant membrane at the air-lung interface. Cellular viability and uptake studies demonstrated their cytocompatibility and time-and concentration-dependent uptake in lung-epithelial A549 and Calu-3 cells with clathrin-mediated internalization. Transepithelial electrical resistance experiments established their ability to penetrate tight airway Calu-3 monolayers. Antifungal studies on laboratory strains and clinical isolates depicted their superior efficacy against Aspergillus species. Pharmacokinetic studies revealed nearly 5-, 4- and threefolds enhancement in lung AUC, Tmax, and MRT values, construing significant drug access and retention in lungs. Conclusions Nebulized LPH NPs were observed as a promising solution to provide effective and safe therapy for the management of pulmonary aspergillosis infection with improved patient compliance and avoidance of systemic side-effects.

Coronavirus disease 2019 pandemic spreads through inhalation of aerosols or droplets. Therefore, the use of face masks, alcohol-based sanitizers, and most importantly practicing quarantine/ isolation and social distancing are the main modalities for its prevention and control. Although isolation is essential, various psychological effects have been implicated with its practice in most of the age groups. Longstanding isolation and negligible interpersonal interactions can have changes in psychological processes and neurological and morphological changes in the brain. Morphological changes as seen through the neuroimaging studies include reduced volume of the structures involved in the synthesis of various nerve growth factors leading to impaired neurogenesis and subsequently psychological changes which can manifest as mood alterations such as anxiety, depression, feeling demoralized, obsessive thinking, and altered sleep–wake cycles besides others especially, in the vulnerable age groups such as children and the elderly. Although quarantine remains the cornerstone to contain the spread of the pandemic, its psychological impact run simultaneously, which should be, understood, and addressed to ameliorate its long-term impact.

Introduction: Infective endocarditis (IE) is the most dreaded complication of intravenous drug abuse (IVDA). IVDA is present in significant proportions in India. Since there is scarcity of Indian data on IVDA associated IE, we report a study comparing IVDA to non IVDA associated IE. We compare differences in clinical profile, microbiology, echocardiography and clinical outcome from a tertiary care hospital. Methods: A total of 133 patients admitted from 1st January 2017 to 31st December 2019 who met the Modified Duke ‘‘definitive’’ criteria for IE were included. Detailed Information was collected regarding demography, clinical data and laboratory investigations. All patients underwent transthoracic echocardiography and trans-esophageal echocardiogram wherever necessary. Results: Among a total of 133 patients, 54 patients (40.6%) were iv drug abusers. Patients in IVDA-group were younger, mostly males, more likely to have concomitant HCV and HIV infections compared to non IVDA-group. Chronic comorbidities such as DM and CKD were more common in non IVDA-group. Rate of positive blood culture was higher in IVDA-group compared to non IVDA-group (74.1%v/s 32.9%,p

Abstract Background The COVID-19 pandemic brought restriction to the movement of people due to the implementation of lockdown across various regions around the world. In India, most of the patients belong to rural areas and hence were unable to come for a follow-up visit. Hence, we reached out to patients on oral anticoagulation using telemedicine with aim of communicating with the patient concerning drug compliance, titration of dose of anticoagulation, health education, and identification of high-risk patients needing referral to the nearest health facility/our institute. This study was conducted at the Hero DMC heart institute (a tertiary care center for cardiac diseases). The study design is cross-sectional and involves a comparison of the pre-COVID-19 phase with the COVID-19 phase. We asked a five-component (Likert scale) questionnaire from patients for satisfaction after the consult. All symptoms, need for hospitalization and clinical events were recorded. The events were compared in both groups. Results We contacted 628 patients through telemedicine and 600 patients gave consent for participation in the study. For comparison, we analyzed data of 614 patients in the pre-COVID-19 phase. The mean age during the pre-COVID-19 phase was 55.27 + 17.09 years and the COVID-19 phase was 56.97 + 15.09 years with males more than females in both groups. There was no significant difference in the number of patients on oral anticoagulants and novel oral anticoagulants (NOAC). However, there were higher number of patients on antiplatelets in the pre-COVID phase (p value0.01). 37% in the pre-COVID-19 phase and 40.31 % in the COVID-19 phase were noted to have out of target range INR (International normalized ratio). There was no difference in the number of bleeding or thromboembolic events seen. Patient response as assessed by a questionnaire (Likert scale) showed that >75% of patients were satisfied. Conclusion Through telemedicine, we were able to approach our patients on oral anticoagulation and achieved titration of anti-coagulation, and health education similar to pre-COVID-19 times. During pandemics, telemedicine offers a promising option for patient management with chronic cardiac conditions. It also provides us an opportunity for the management of patients on oral anticoagulation involving titration of drug dosages (anti-coagulation), identification of high-risk patients, and health education.

The entire world has recently been witnessing an unprecedented upsurge in microbial lung infections. The major challenge encountered in treating the same is to ensure the optimum drug availability at the infected site. Aerosolization of antimicrobials, in this regard, has shown immense potential owing to their localized and targeted effect. Efforts, therefore, have been undertaken to systematically develop lung-phosphatidylcholine-based lipid nanovesicles of voriconazole for potential management of the superinfections like aspergillosis. LNVs, prepared by thin-film hydration method, exhibited a globule size of 145.4 ± 19.5 nm, polydispersity index of 0.154 ± 0.104 and entrapment efficiency of 71.4 ± 2.2% with improved in vitro antifungal activity. Aerodynamic studies revealed a microdroplet size of ≤5 μm, thereby unraveling its promise to target the physical barrier of lungs effectively. The surface-active potential of LNVs, demonstrated through Langmuir-Blodgett troughs, indicated their ability to overcome the biochemical pulmonary surfactant monolayer barrier, while the safety and uptake studies on airway-epithelial cells signified their immense potential to permeate the cellular barrier of lungs. The pharmacokinetic studies showed marked improvement in the retention profile of voriconazole in lungs following LNVs nebulization compared to pristine voriconazole. Overall, LNVs proved to be safe and effective delivery systems, delineating their distinct potential to efficiently target the respiratory fungal infections.

The current study was undertaken to evaluate the efficacy of a novel nano-lipoidal eye drop formulation of triamcinolone acetonide (TA) for the topical treatment of uveitis. The triamcinolone acetonide-loaded nanostructured lipid carriers (cTA-NLC) were developed by employing ‘hot microemulsion method’ using biocompatible lipids, which exhibited a sustained release nature and enhanced efficacy when evaluated in vitro. The in vivo efficacy of this developed formulation was tested on Wistar rats, and a single-dose pharmacokinetic study was conducted in rabbits. The eyes of animals were examined for any signs of inflammation using the ‘Slit-lamp microscopic’ method. The aqueous humor collected from the sacrificed rats was tested for total protein count and cell count. The total protein count was determined using BSA assay method, while the total cell count was determined by Neubaur’s hemocytometer method. The results showed that the cTA-NLC formulation had negligible signs of inflammation, with a clinical score of uveitis 0.82 ± 0.166, which is much less than control/untreated (3.80 ± 0.3) and free drug suspension (2.66 ± 0.405). The total cell count was also found to be significantly low for cTA-NLC (8.73 ± 1.79 × 105) as compared to control (52.4 ± 7.71 × 105) and free drug suspension (30.13 ± 3.021 × 105). Conclusively, the animal studies conducted showed that our developed formulation holds the potential for effective management of uveitis.

Phosphorus (P) is the second most important mineral nutrient for plant growth and plays a vital role in maintaining global food security. The natural phosphorus reserves [phosphate rock (PR)] are declining at an unprecedented rate, which will threaten the sustainable food supply in near future. Rendered animal byproducts such as meat and bone meal (MBM), could serve as a sustainable alternative to meet crop phosphorus demand. Even though nitrogen (N) from MBM is readily mineralized within a few days, >75% of the P in MBM is present as calcium phosphate that is sparingly available to plants. Thus, application of MBM with the aim of meeting crop N demand could result in buildup of P reserves in soil, which necessitates the need to improve the P mobilization from MBM to achieve higher plant P use efficiency. Here, we tested the potential of two microbial inoculum-arbuscular mycorrhizal fungi (AMF) and P solubilizing fungi (Penicillium bilaiae), in improving the mobilization of P from MBM and the subsequent P uptake by maize (Zea mays). Compared to the non-inoculated MBM control, the application of P. bilaiae increased the P mobilization from MBM by more than two-fold and decreased the content of calcium bound P in the soil by 26%. However, despite this mobilization, P. bilaiae did not increase the tissue content of P in maize. On the other hand, AMF inoculation with MBM increased the plant root, shoot biomass, and plant P uptake as compared to non-inoculated control, but did not decrease the calcium bound P fraction of the soil, indicating there was limited P mobilization. The simultaneous application of both AMF and P. bilaiae in association with MBM resulted in the highest tissue P uptake of maize with a concomitant decrease in the calcium bound P in the soil, indicating the complementary functional traits of AMF and P. bilaiae in plant P nutrition from MBM. Arbuscular mycorrhizal fungi inoculation with MBM also increased the plant photosynthesis rate (27%) and root phosphomonoesterase activity (40%), which signifies the AMF associated regulation of plant physiology. Collectively, our results demonstrate that P mobilization and uptake efficiency from MBM could be improved with the combined use of arbuscular mycorrhizal fungi and P. bilaiae.