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Abstract Background This study aimed to assess the factors influencing health-related quality of life (HRQoL) in patients experiencing adverse drug reactions (ADRs) at a tertiary care public sector hospital. A cross-sectional study was conducted over a period of 18 months, and included both male and female patients aged 18 years and above. Patients who visited the outpatient and inpatient departments with complaints associated with ADRs were included in this study. HRQoL data were collected using the EuroQol—5 Dimension—5 Level (EQ-5D-5L) questionnaire to assess five dimensions of health on a five-level scale. Descriptive statistics, t-tests, and analysis of variance were used to analyze the data. Multivariate regression analysis was performed to identify the potential determinants of HRQoL. Results A total of 316 patients were included in the study among these participants, of which 54% were female, and 65% were from rural areas. The majority (68%) of the patients had moderately severe ADRs, and 63% of the participants had an income

Background: Antibiotics are the most commonly used drugs to treat bacterial infections; however, these life-saving drugs can also cause adverse drug reactions. In several pharmacovigilance studies, adverse drug reactions are a cause of prolonged hospitalization. The development of hypersensitivity reactions even after a negative skin test and patch test makes antibiotic-associated adverse reactions unpredictable. Owing to the scarcity of data on antibiotic desensitization, these drugs are important for pharmacovigilance. Most of the previous studies conducted were retrospective and lacked data regarding the duration of adverse drug reactions. Aim: This study aimed to examine adverse drug reactions associated with antibiotics and to provide knowledge on the duration of these reactions. Method: A prospective observational study was conducted on patients receiving antibiotics at a tertiary care hospital. The patients were followed until discharge, and causality and severity assessments were performed. Descriptive statistical analyses were performed to summarize the data. Results: The study results show the median duration of adverse drug reactions was two days, with an interquartile range of two to four days. Most (21,3%) of the reactions were caused by cephalosporins. The majority (44.7%) of the reactions were skin and subcutaneous tissue disorders. The majority (78.7%) of the reactions were moderately severe and were not responsible for prolonged hospital stay. Conclusion: The patients receiving antibiotics require close monitoring for early detection and management of adverse reactions to reduce the duration of hospital stay and the duration of adverse drug reactions.

The Gene Ontology Consortium (GOC) provides the most comprehensive resource currently available for computable knowledge regarding the functions of genes and gene products. Here, we report the advances of the consortium over the past two years. The new GO-CAM annotation framework was notably improved, and we formalized the model with a computational schema to check and validate the rapidly increasing repository of 2838 GO-CAMs. In addition, we describe the impacts of several collaborations to refine GO and report a 10% increase in the number of GO annotations, a 25% increase in annotated gene products, and over 9,400 new scientific articles annotated. As the project matures, we continue our efforts to review older annotations in light of newer findings, and, to maintain consistency with other ontologies. As a result, 20 000 annotations derived from experimental data were reviewed, corresponding to 2.5% of experimental GO annotations. The website (http://geneontology.org) was redesigned for quick access to documentation, downloads and tools. To maintain an accurate resource and support traceability and reproducibility, we have made available a historical archive covering the past 15 years of GO data with a consistent format and file structure for both the ontology and annotations.

To reduce the geothermal exploration risk, a feasibility study is performed for a deep direct-use (DDU) system proposed at the West Virginia University (WVU) Morgantown campus. This study applies numerical simulations to investigate reservoir impedance and thermal production. Because of the great depth of the geothermal reservoir, few data are available to characterize reservoir features and properties. As a result, the study focuses on the following three aspects: 1. model choice for predicting reservoir impedance and thermal breakthrough: after investigating three potential models (one single permeability model and two dual permeability models) for flow through fractured rock, it is decided only the single permeability model is needed; 2. well placement (horizontal vs. vertical) options: horizontal well placement seems to be more robust to heterogeneity and the impedance is more acceptable; 3. Prediction uncertainty: the most influential parameters are identified using a First-Order-Second-Moment uncertainty propagation analysis, and the uncertain range of the model predictions is estimated by performing a Monte Carlo simulation. Heterogeneity has a large impact on the prediction, therefore, heterogeneity is included in the predictive model and uncertainty analysis. The numerical model results and uncertainty analysis will be used for further economic studies.

To reduce the geothermal exploration risk, a feasibility study is performed for a deep direct-use (DDU) system proposed at the West Virginia University (WVU) Morgantown campus. This study applies numerical simulations to investigate reservoir impedance and thermal production. Because of the great depth of the geothermal reservoir, few data are available to characterize reservoir features and properties. As a result, the study focuses on the following three aspects: 1. model choice for predicting reservoir impedance and thermal breakthrough: after investigating three potential models (one single permeability model and two dual permeability models) for flow through fractured rock, it is decided only the single permeability model is needed; 2. well placement (horizontal vs. vertical) options: horizontal well placement seems to be more robust to heterogeneity and the impedance is more acceptable; 3. Prediction uncertainty: the most influential parameters are identified using a First-Order-Second-Moment uncertainty propagation analysis, and the uncertain range of the model predictions is estimated by performing a Monte Carlo simulation. Heterogeneity has a large impact on the prediction, therefore, heterogeneity is included in the predictive model and uncertainty analysis. The numerical model results and uncertainty analysis will be used for further economic studies.

The objective of this work was to examine the impact of conventional and RAFT-modified SiO₂ nanoparticles on the mechanical characteristics and crystallinity of poly(ethylene oxide) (PEO) composites. Preparation of PEO composites included the incorporation of 5 wt% of both unaltered SiO₃ and SiO₃ that had been changed via reversible addition-fragmentation chain transfer (RAFT) polymerization. We assessed the mechanical characteristics, such as strain at fracture, ultimate tensile strength, and Young’s modulus. The inclusion of unaltered SiO₂ decreased the strain at fracture (570 ± 18%) and ultimate tensile strength (22.5 ± 0.8 MPa) in comparison to pure PEO (850 ± 25%, 32.0 ± 1.2 MPa). Nevertheless, the inclusion of RAFT-modified SiO₂ led to improved tensile characteristics, including a strain at break of 800 ± 30%, ultimate tensile strength of 35.2 ± 2.5 MPa, and Young’s modulus of 260 ± 13 MPa. The effective dispersion of RAFT- modified SiO₂ in the PEO matrix was verified by X-ray diffraction (XRD), leading to enhanced mechanical characteristics. This research points that the using the RAFT polymerization to alter the surface of nanoparticles is a good strategy to enhance the efficiencies of PEO composite for potential application in versatile electronics, membranes and other polymers technologies.

Tuberculosis (TB) is caused by Mycobacterium tuberculosis and it can affect multiple organ systems. Cutaneous TB, a less common type of extrapulmonary TB can coexist with TB of other organs. Here, we describe a case of multifocal cutaneous TB suggestive of two different morphological types with concomitant miliary pulmonary TB.

Introduction: Human behavior is very complex and driven by different motivations. At times, we find a deviant escape behavior in some situations, characterized by streaks of self-destruction or “suicidal behavior.” Defeat and entrapment have been hypothesized as central to this behavior. Aim: We aimed to study the relationship between defeat, entrapment, suicidal ideation, and suicidal attempt. Materials and Methods: This study was a cross-sectional study of fifty patients who attempted suicide and survived the attempt. When medically fit for psychological assessment, they were approached in a person in the hospital psychiatric ward. These patients were subjected to a detailed psychiatric interview, and any psychiatric illness in the patients was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders V criteria. They were assessed on the defeat and entrapment scales by Gilbert and Allan. The Modified Scale for Suicidal Ideation by Ivan W. Miller was used to determine the presence or absence of suicidal ideation and severity of suicidal ideation. Results: The presence of a current depressive disorder diagnosis and planning of attempt had a significant association with higher scores on internal entrapment, total entrapment, defeat, and suicidal ideation scales. The scores on defeat, internal entrapment, total entrapment, and suicidal ideation scales correlated positively and highly significantly. Conclusion: Entrapment and defeat are identified as important in the pathogenesis of depression and self-harm. Arrested escape and flight appear as motivation for suicidal behavior.

Background: Existing literature around pandemics suggests that preventive measures during lockdown have an adverse impact on psychological well-being across different demographic groups. In particular, parents' stress is somewhat complex and influenced by the demands of looking after children, homeschooling, and an increase in domestic chores and needs exploration and timely attention. Aims: The aim is to study the psychological impact of the COVID-19 pandemic and various associated factors on parents. Settings and Design: This was a cross-sectional study done online using Google Forms sent to WhatsApp groups in an urban setting in Andhra Pradesh, on a purposive sampling basis. Materials and Methods: A purposive sampling approach using a survey questionnaire through WhatsApp produced data from 159 parents who completed the Depression, Anxiety and Stress Scale (DASS-21) short version and the Parental Stress Scale (PSS). Results and Conclusions: Criteria for severe stress on the DASS-21 were met in 47% of parents. Severe anxiety and depression were noted in 39% and 40% of the sampled parents, respectively. Mean parental stress scale score significantly correlated with the depression, anxiety, and stress subscales of the DASS-21. These findings indicate that pandemics and subsequent disease-containment responses such as lockdown may create a condition that parents may find overwhelming and one that could have a negative impact on parents and children. Pandemic planning must address these needs within the disease-containment measures.

Background: Internet is a tool that is evolving into an essential part of everyday life all over the world and its use is high among young people, not only in India but also worldwide in the last decade. Medical and engineering students in particular are the vulnerable group, considering that technology is incorporated into their education and they often have easy access to the internet at their respective campus. Aim: To compare severity of internet addiction among medical and engineering students. Methods: A cross sectional study was conducted among first year to final year M.B.B.S & engineering students. The students were recruited from a medical college and an engineering college in coastal Andhra Pradesh during 1st October 2016 to 31st March 2017. 100 medical students and 100 engineering students were selected for the study, after obtaining informed consent the subjects were subjected to a semi structured proforma wherein their demographic profiles were recorded and the main study tool Internet Addiction Test was used on the subjects. Results: Out of a sample of 200 undergraduate students, 52% were mildly addicted, 79(39.5%) were moderately addicted while 9(4.5%) were severely addicted to internet. 8% of engineering students and 1% of medical students were found to have severe internet addiction. Conclusion: Engineering students are severely addicted than medical students. Education curriculum also shows impact on severity of internet addiction.

Background: A large number of doctors are experiencing Burnout during the present COVID-19 pandemic. Excessive workload, uncertainty, longer working hours, work - family conflicts, and difficult working conditions during the pandemic are some of the reasons for physician Burnout. The greatest risk of Burnout is that doctors may feel disconnected with their profession and are more likely to suffer from various mental health issues. Aim: To assess Burnout and its impact on mental health of physicians during the COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted on physicians working at Government designated COVID-19 Hospitals of a city in South India in May 2020. Purposive sampling technique was used in the study. One hundred and eighty eight (188) physicians were included in the study and were given the requisite material and study tools via email, after providing them with information about the study and tools for assessment. Oldenburg Burnout Inventory (OLBI) was used to assess Burnout. Hospital Anxiety and Depression scale (HADS) was used for screening of anxiety and depression in physicians. Chi-square test and Pearson’s correlation were used in statistical analysis. Results: Burnout was noted in 54.3% of physicians. Anxiety and Depression was seen in 14.9% and 15.4% of the physicians respectively. Age, presence of anxiety and depression had a significant association with Burnout. Disengagement group showed a stronger positive correlation with depression, while exhaustion group showed a stronger positive correlation with anxiety. Conclusion: Burnout, anxiety and depression levels amongst physicians noted in the current study seem to be far less when compared to other existing studies. This could be resultant from better preparedness of physicians for public health crisis compared to other health care workers. The high rates of Burnout, anxiety and depression among physicians during the pandemic highlights the need for designing the appropriate psychological interventions by the healthcare system to support the physicians working in the midst of COVID-19 pandemic and in the post-pandemic era.

SUMOylation is a post-translational, reversible modification process which occurs in eukaryotes. Small Ubiquitin like MOdifier or (SUMO) proteins are a family of small proteins that are covalently attached to and detached from other proteins to modify the target protein function. In pathogenic fungi, SUMO has been identified and preliminary studies indicate its importance either for survival and/or for virulence. In this review we provide an overview of the current state of knowledge of SUMOylation in fungi and the effects on pathogenesis. Subsequently we identify the orthologs of the SUMOylation pathway components across fungi. We also show the level of conservation of the proteins involved and identify the similarities/differences in the orthologs across fungi and the human and plant hosts to identify potential targets of intervention.

BackgroundIn the Indian state of Bihar, visceral leishmaniasis (VL) is a major public health issue that has been aggravated by the rising incidence of new Human immunodeficiency virus (HIV) infections. In endemic areas, the risk of VL infections in patients living with HIV (PLHIV) is higher. It is important to investigate the disease-related knowledge, attitude, and practices (KAP) of PLHIV in Bihar in order to monitor HIV/VL co-infection. Adequate knowledge, a positive attitude, and good practices for VL control are essential to stamp out the disease. This study investigated the KAP towards VL in HIV patients attending antiretroviral therapy (ART) clinic at ICMR-RMRIMS, Patna.MethodsA questionnaire based cross-sectional study was performed among 120 HIV patients aged ≥18 years, to evaluate their KAP regarding visceral leishmaniasis. For the KAP indicators, each correct answer received a score of 1, while unsure and incorrect responses received a score of 0. Descriptive statistics and logistic regression were used for the analysis. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 27.ResultsThe study population had a male (68.30%) preponderance with a mean age of 37.03 years ± 9.80 years of standard deviation. The majority (93.30%) of the study participants had previously heard about VL. Only 32.10% of those who had heard about VL knew that the disease was transmitted by the sandfly. Most (80.40%) of the study respondents were ignorant of the sandfly breeding grounds. The vast majority (75.90%) had no idea how to recognize sandflies and were unaware of their biting time, leishmaniasis transmission season, and preventive practices. Although PLHIV are vulnerable to VL, only 27.70% of them agreed that VL is a fatal disease if untreated, and 42.90% believed they wear not at risk of developing the disease. Regarding the control methods of sandflies, 28.60% of participants did not use any methods to avoid sandfly bites. The multivariable analysis revealed that occupation and family history were the two independent predictor variables of the knowledge index. Age and gender were significantly associated with attitude towards VL. Participants working as laborers had significantly lesser odds (AOR: 0.248, 95% CI: 0.073-0.844) to follow good preventive practices. There were significantly higher odds of having good practice among participants aged 18-40 years (AOR: 6.866, 95% CI: 1.694-27.834) and those residing in urban areas (AOR: 4.159, 95% CI: 1.317-13.139) than their peers. Overall, 27.7% of respondents were knowledgeable, 41.1% had a positive mindset, and 33.9% had strong VL preventive habits, according to the study.ConclusionThe study determined a remarkable gap in the knowledge attitude and practices towards VL among PLHIV. This underscores the need of augmented health education initiatives for PLHIV in endemic areas for good VL awareness and preventive practices.

Paragangliomas are rare neuroendocrine tumors that arise from chromaffin-containing tissue. Surgical resection and/or radiation are used for locoregional disease, and reduction of tumor burden with systemic therapy is reserved for metastatic disease. Iobenguane I-131, somatostatin analog (octreotide), and Sunitinib are noncytotoxic options for treatment, while cyclophosphamide, vincristine, and dacarbazine (CVD) and temozolomide are often used as initial chemotherapy options as studies have shown that they offer some tumor response. However, there are no randomized clinical trials demonstrating prolonged survival with the use of chemotherapeutics in metastatic cases. Investigation of alternative therapies that provide survival benefit is thus necessary. We present a case of a 69-year-old female with metastatic malignant paraganglioma presenting as a left parapharyngeal neck mass, which metastasized after surgery, requiring radiation therapy for bony metastasis who was treated with a radioisotope somatostatin analog for disease progression.

With the upsurge in the cases of COVID-19 around the world, plenty of potential COVID-19 complications are becoming more prevalent, including a higher risk of secondary bacterial and fungal infections. Mucormycosis is one such condition which has high prevalence among individuals with diabetes who were infected with COVID-19.The usage of steroids in the treatment further inflates the risk of infection and exacerbation of disease in pre-existent mucormycosis patients. Generally, Corticosteroid-induced diabetes can arise on long-term steroid medication, increasing the likelihood of mucormycosis. In patients with COVID-19, the indications and dose of corticosteroids should be properly regulated, and persons with diabetes who take insulin or oral anti-diabetic medicines should be cautious. To avoid poor outcomes, strategies to improve glycemic management should be emphasized. This narrative review elucidates different disciplines on rampant use of steroids, iron and zinc supplements as well as the methods utilized as primary or adjunctive treatment of this fatal condition. This article may help to pave the way for robust research that needs to be done to tackle the deadly triple burden of the disease.

The development of a robust microbiome is critical to the health of dairy calves, but relatively little is known about the progression of the microbiome through the weaning transition. In this study, fecal samples were obtained from ten female Holstein calves at 6 timepoints between 2-13 weeks of age. Calves were fed acidified milk until weaning at 8 weeks old and had access to starter grain throughout the study. Fecal samples were extracted for genomic DNA, PCR-amplified for the V1-V2 region of the 16S rRNA bacterial gene, sequenced on the Illumina MiSeq platform, and analyzed using the QIIME2 pipeline. Bacterial richness, estimated by number of observed species, and bacterial diversity, estimated by Shannon diversity index, both differed significantly between timepoints and both increased over time (P

Nowadays multilevel inverters (MLIs) have been preferred over conventional two-level inverters due to reduced harmonic distortions, lower electromagnetic interference, and higher DC link voltages. However, the increased number of components, complex PWM control, voltage-balancing problem, and component failure in the circuit are some of the disadvantages. The topology suggested in this paper provides a DC voltage in the shape of a staircase that approximates the rectified shape of a commanded sinusoidal wave to the bridge inverter, which in turn alternates the polarity to produce an AC voltage with low total harmonic distortion and power loss. This topology requires fewer components and hence it leads to the reduction of overall cost and complexity particularly for higher output voltage levels. The component fault diagnostic algorithm is developed using wavelets transform tool. Finally an experimental prototype is developed and validated with the simulation results. Keywords: Field programmable gate array (FPGA), In-phase disposition (IPD) PWM, Least number of switching devices, Multi level inverter, Total harmonic distortion, Wavelet transform tool

Abstract Background The nuclear envelope (NE) that encapsulates the nuclear genome is a double lipid bilayer with several integral and peripherally associated proteins. It is a characteristic feature of the eukaryotes and acts as a hub for a number of important nuclear events including transcription, repair, and regulated gene expression. The proteins associated with the nuclear envelope mediate the NE functions and maintain its structural integrity, which is crucial for survival. In spite of the importance of this structure, knowledge of the protein composition of the nuclear envelope and their function, are limited to very few organisms belonging to Opisthokonta and Archaeplastida supergroups. The NE composition is largely unknown in organisms outside these two supergroups. Results In this study, we have taken a comparative sequence analysis approach to identify the NE proteome that is present across all five eukaryotic supergroups. We identified 22 proteins involved in various nuclear functions to be part of the core NE proteome. The presence of these proteins across eukaryotes, suggests that they are traceable to the Last Eukaryotic Common Ancestor (LECA). Additionally, we also identified the NE proteins that have evolved in a lineage specific manner and those that have been preserved only in a subset of organisms. Conclusions Our study identifies the conserved features of the nuclear envelope across eukaryotes and provides insights into the potential composition and the functionalities that were constituents of the LECA NE.

BACKGROUND:Lesishmaniasis is a neglected tropical disease endemic in Bihar, India. Inappropriate health seeking behaviour of post kala-azar dermal leishmaniasis (PKDL) patients may increase the disease duration, severity and transmissibility. Simultaneously, lack of knowledge and perceived stigma may also increase the length of delay in receiving treatment. This ultimately effects the kala-azar elimination program. METHODS:A cross sectional study was conducted in 120 confirmed PKDL patients, aged 18 years and older. Data related to knowledge and health seeking behaviour was collected by a pre-tested questionnaire. EMIC stigma scale was used for assessing the perceived stigma. Patients were personally interviewed after taking informed consent. Data analysis was done by using SPSS 16 software. RESULTS:The time between appearance of symptoms and first medical consultation (patient delay) ranged from 15 days to 5475 days (15 years) with a median of 285 days. The time between first medical consultations to onset of specific treatment (system delay) ranged from 2 to 5475 days with a median of 365 days. Many patients approached first to quacks (8.4%), homeopathic and ayurvedic practitioners (25.8%) upon recognition of symptoms. Majority of the patients (68.3%) had poor knowledge about PKDL and its vector. Type of skin lesions and gender had significant association with patient delay and system delay respectively (p

Hox genes impart segment identity to body structures along the anterior–posterior axis and are crucial for proper development. A unique feature of the Hox loci is the collinearity between the gene position within the cluster and its spatial expression pattern along the body axis. However, the mechanisms that regulate collinear patterns of Hox gene expression remain unclear, especially in higher vertebrates. We recently identified novel histone-free regions (HFRs) that can act as chromatin boundary elements demarcating successive murine Hox genes and help regulate their precise expression domains (Srivastava et al., 2013). In this report, we describe in detail the ChIP-chip analysis strategy associated with the identification of these HFRs. We also provide the Perl scripts for HFR extraction and quality control analysis for this custom designed tiling array dataset.

Edward John Mostyn Bowlby was a British psychiatrist who had contributed to the field of childhood and developmental psychiatry. His early loss of a ‘mother figure’ left an impression which has laid foundations for his future work on attachment theory. Initially he became a surgeon and later joined the institute of psychoanalysis and worked on delinquent children. The work of John Bowlby has influenced, and been the foundation of, several other theories in behavioral psychology.

Crohn’s disease (CD) is a debilitating, systemic inflammatory disorder with both gastrointestinal and extraintestinal manifestations. Its existence predates modern medicine, but its precise etiology remains incompletely understood. Most authorities suggest a multifactorial pathogenesis owing to a mixture of genetic disorders, immunologic dysregulation, microbiota disequilibrium and environmental influences. Of these factors, the overactive immunologic response seen in CD appears to be the most promising target of medical therapy. Biological agents comprise a relatively new class of drugs that can induce and maintain remission in moderate to severe CD, as well as in ulcerative colitis. This review will provide an overview of CD, its history, clinical features, pathophysiology, and treatment options focusing on current and future biological agents with an emphasis on drug development, dosage and administration.

Background and Objectives: The microbial flora of the oral cavity is extremely diverse. Residual bacteria in the oral cavity may remain at the tooth restoration interface and increase the risk of developing recurrent caries. The aim of this study is to evaluate the immediate and long term antibacterial effect of polymerised self etching adhesive systems. Materials and Methods: Streptococcus mutans were used as a test organism. The self etching dental adhesives that were used are Adper Easy One, G-Bond, Clearfil S3 bond and Xeno V. Agar diffusion test (ADT) was performed on agar plates, in which four holes that were 4mm in diameter were punched. Then 200 µL of freshly grown S.mutans spread evenly. The four holes were immediately filled with the four tested materials and light polymerised them using a light curing unit. The agar plates were incubated for 72h at 37°C. For the direct contact test (DCT), the bonding agents were placed on the side walls of microtiter plate wells and light polymerized according to the manufacturer’s instructions. A 10µL bacterial suspension was placed on the tested material samples. Bacteria were allowed to directly contact the polymerized dental adhesives for 1h at 37oC. Fresh Brain heart infusion broth was then added. The bacterial growth was then spectrophotometrically measured in the wells every 30 min for 16h for 1,2, 7 and 14 days. Results: In the ADT, inhibitory halos were found around all the bonding agents, with greater inhibition halo seen around Xeno V after incubating for 72 h at 37ºC. The readings obtained through DCT were subjected to ANOVA and Tukey’s multiple comparisons tests, which showed no bacterial growth on fresh samples and after aging for one day in PBS with self etching adhesives. Results of DCT after aging for 2 days, 7 days and 14 days showed bacterial growth in all the bonding agents used with no significant difference from the control group.(p