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Abstract Objective: Despite the literature on dydrogesterone, studies on dydrogesterone utilization patterns are largely lacking in Indian patients. Methods: This was a multi-center, retrospective, observational, cross-sectional, and descriptive study across 817 centers in India. Data of patients who received dydrogesterone in past and provided consent for future use of their medical record for research purpose was were retrieved and analyzed. Results: Data of 7287 subjects (aged 29.55±4.84 years) was analyzed. Threatened abortion was the most common indication for which the subjects received dydrogesterone (46.9%) followed by recurrent pregnancy loss. Polycystic ovary syndrome (PCOS), thyroid disorders and anemia were the most common comorbid conditions and prior pregnancy loss, advanced maternal age and obesity were the most common risk factors seen in subjects who received dydrogesterone. Total 27.5% of subjects received a loading dose of dydrogesterone, and majority (64%) received 40 mg as loading dose. 10 mg dose was used as maintenance or regular dose in 81.4% of the subjects. Twice daily (BID) was the most common dosing frequency (66.6%). The most common concomitant medications being taken by the subjects on dydrogesterone included folic acid (45.1%), iron supplements (30.3%) and calcium and vitamin D3 supplements (25.5%). Another progesterone preparation (oral, injection, vaginal, tubal) other than dydrogesterone was used concurrently in 7.8% of subjects. Conclusion: The study helped to identify the patient population that is benefitted by dydrogesterone and the preferred indications, risk factors, comorbid conditions and concomitant medication used in this patient population at real-life scenario.

Instant noodles are a popular food consumed worldwide, lacking essential nutrients, particularly dietary fiber (DF). Therefore, in the present study, insoluble dietary fiber (IDF) extracted from two varieties of mango, i.e. Totapuri (A) and Safeda (B) and pomegranate, i.e. Bhagwa (C) and Daru (D) peel was incorporated into refined wheat flour at various concentrations as 1%, 3%, 5%, and 7% respectively to produce IDF rich instant noodles. The biophysical attributes that include nutritional and functional properties exhibited enhanced characteristics with the incorporation of IDF. The scanning electron microscopy revealed the rough and loosened structure of IDF-incorporated noodles. The textural analysis exhibited a significant (p

The study insights into the effect of temperature (80–160 °C), oxygen (O2), sunlight (SL), and storage on color attributes, shelf-life, and anthocyanins content on red cabbage (RC) anthocyanins (ANS) and their in-vitro bioaccessibility. The previously well-established encapsulating agent i.e. maltodextrin in combination with RC waste derived-pectin was used to stabilize the anthocyanins. The stability of encapsulated and non-encapsulated anthocyanins was accomplished in terms of total anthocyanin content under temperature, oxygen, sunlight, and storage. The individual content of 3,5-O-diglucoside and 3-O-glucoside of cyanidin exhibited 1.76% (SL), 1.56% (O2) & 1.8% (4 °C), 1.62% (25 °C) and 0.17% (SL), 0.15% (O2) & 0.259% (4 °C), 0.258% (25 °C) retention in maltodextrin/ pectin (MPC)-ANS, respectively. The encapsulated anthocyanins showed significantly improved stability against oxygen, sunlight, high temperature, and storage, with the highest anthocyanin retention, color, and hue angle, inducing very few color differences (ΔE). Besides, the MPC-ANS appeared to be a suitable encapsulating agent to delay anthocyanin release throughout the simulated gastrointestinal digestion.

Black pea, a traditional Western Himalayan bio resource is an abundant store of nutrients and phytochemicals. In current research, moisture dependent physical properties of whole black pea seed (WBPS), nutritional and functional attributes of black pea whole (BPW), black pea husk (BPH), and black pea de-husked (BPDH) powder were determined. Besides, using response surface methodology (RSM), extraction conditions for phenols and flavonoids were effectively optimised and rendered ΔE* (11.89) and pH (6.78) values with mean TPC of 119.78 μg GAE/mg and TFC of 35.62 μg CE/mg for BPW extract. The optimised conditions were further carried for analysing extraction yield, TPC, TFC and antioxidant activities of WBPS fractions (BPH and BPDH). Also, maximum DPPH radical scavenging activity was observed in BPH whereas BPW indicated significantly stronger ABTS scavenging as well as metal chelating capacity. The HPLC quantification revealed highest concentration of gallic acid and catechin in BPW, chlorogenic and vanillic acid in BPDH, caffeic acid and rutin in BPH and trans-ferulic acid in all fractions. The cultivation of nutritionally rich pea crops has capability to boost economic prosperity in future, while also making it imperative to generate low operating advanced technologies for functional foods/nutraceuticals that would benefit human nutrition and well-being.

A detailed metabolomic study was performed on various maturation stages of Murraya koenigii fruit pulps, seed, and leaf. Among the fruit pulps, stage 6 had the highest TPC (13.27 mg/g of GAE) and TFC content (6.16 mg/g RE). The extracts also showed promising free radical scavenging activity, especially in the seed (IC50 DPPH 427 μg/mL). Metabolomics study revealed the identification of 133 metabolites in fruit pulps, seeds and leaves using the METLIN database. In silico PASS software analysis predicted the antimutagenic property of myricetin and bismurrayaquinone A. Pathway analysis revealed the phenylpropanoid biosynthesis pathway as one of the major pathways present in the fruit pulps. This detailed metabolic report of M. koenigii fruit maturation report brings a new insight into phytochemicals and their distribution in seed, pulps and leaves along with nutritive values and can be considered for nutritive and therapeutic purposes.

Introduction: Acute kidney injury (AKI) is an important risk factor associated with a high incidence of morbidity and mortality in critically ill children. Therapy for AKI is limited by the inability to reliably diagnose AKI in early stages. The renal angina index (RAI) may be a good clinical score to predict AKI in these children. The study aimed to predict development of subsequent AKI in children admitted in PICU using RAI score. Methodology: A prospective observational study was conducted in PICU including 280 children between one month to 18 years of age with no history of previous or existing kidney diseases. RAI was assessed on day 0 (within 8 to 12 hours of PICU admission) and positivity was defined as RAI score >8. On day 3, serum creatinine was performed and glomerular filtration rate (eGFR) was calculated using the Schwartz formula. RAI positivity correlated with the presence/absence of AKI on day 3. Duration of PICU stay, need of dialysis, need of inotropic support, duration of mechanical ventilation, and final out come were also studied in relation to RAI score. Results: Out of 280 patients, 58 (20.7%) had RAI score >8 (RAI +ve) on day 0. Out of these 58 RAI positive patients, 38 patients (65.51%) developed AKI on day 3 as compared to only 19 (8.56%) patients out of 222 in RAI negative group (p

Background In India, adolescents constitute 21.4% that is one-fifth of the total population and world adolescents' (10–19 years) population is more than 1.2 billion. The trend of consumption of fast food increases worldwide, and in India, fast food production and consumption is very high. The popularity of these food is because of easy preparation and more convenient to finish the meal in less time. Great taste, attractive packaging, and advertisement play a very important role in promotion of such food adolescents. Adolescents also develop the various problems related to health because of less nutritious diet, such as Chinese food, junk food, and beverages. Methodology The present study was a cross-sectional study and conducted for a duration of three months from January 2017 to March 2017. A total of 437 adolescents enrolled with their consent from five randomly selected schools of a city in Madhya Pradesh, India. All adolescents who were present in school on the day of visit and willing to participate were included in the study. Result In our study, a total of 437 students were registered, out of which 97.02% were boys. About 41.82% were of early adolescence and the rest of them were of late-adolescence group. Majority of the adolescents consumed regular meals such as chapati (84%), rice (79%), and dal (74%), they consumed relatively less, green leafy vegetables (60%) than the other vegetables (67%). Most of the participants consumed milk most of the days in a week, but more than 20% students consumed fried food/pizza/burger/fast food more frequently (more than 4 days a week) in a week, and only very few students were not consuming these foods or consuming less frequently. Conclusion Most of the adolescents consume regular meals, but adolescents consumed irregular or skipping of meal and breakfast is still high. And more than 50% adolescents consumed chocolate/pastries/sweet/cake/cookies/bread/toast/cookies/biscuits/cold drinks/soft drinks/potato chips/namkeens/deep-fried snacks/pizza/burger/Frankie, or any other fast food (including Chinese food), these foods are highly energy dense and have less nutritious value.

In this study, nutritionally enhanced pasta was prepared with common wheat and supplemented with highland crops i.e. hull-less barley and buckwheat. Pasta samples were prepared using different ratios of hull-less barley and buckwheat from 0-40% and their nutritional, functional, phenolic, textural and organoleptic properties were evaluated. Pasta made by incorporating 40% of buckwheat flour in common wheat exhibited highest protein content (13.22 ± 0.24%) and total ash content (2.90 ± 0.10%) as compared to other prepared pasta formulations. The color evaluation showed that incorporation of these crop flour decreases the brightness and redness in pasta samples. Water activity recorded least in pasta prepared with 40% buckwheat flour incorporation i.e. 0.25 ± 0.04 aw. Addition of barley and buckwheat flour enhanced the phenolic and flavonoid content as compared to control pasta. Cooking loss of the 40% buckwheat flour substituted pasta was recorded as the highest (10.30%). Pasta prepared from barley and buckwheat flour incorporation has increase the optimum time of cooking in comparison to control pasta. As per the organoleptic results of the pasta samples, addition of barley and buckwheat shows positive effect on the color, texture, and taste of prepared pasta. Pasta prepared from 20% barley and 20% buckwheat each showed higher general acceptability. Hence hull-less barley and buckwheat seems very potential crops and their incorporation in making products like pasta enhanced product nutritional, antioxidant potential and many other essential nutrients which are required for maintaining healthy health.

Atherosclerosis is a chronic lipid-driven inflammatory condition of the arteries and is a leading cause of stroke, myocardial infarction, and other peripheral arterial diseases. Plant products rich in polyphenols such as pomegranate juice and peel extract are known to have beneficial effects in suppressing atherogenesis. However, the mechanism of action and its effect on advanced atherosclerosis progression which results in adverse clinical outcomes are not well understood. Herein, we use a standardized hydroethanolic extract of Punica granatum (pomegranate) peel in the Apoe-/- a murine model of advanced atherosclerosis. It was observed that the pomegranate peel extract fed mice have decreased plaque necrosis and elevated lesional collagen content which was associated with a favorable metabolic profile including lowering of blood glucose, cholesterol, and triglyceride. The decrease in plaque necrosis was linked with increased lesional macrophage efferocytosis efficiency which was associated with enhanced expression of the efferocytosis receptor Mertk. Using in vitro studies, we show that pomegranate peel extract blocks the shedding of Mertk and preserves macrophage efferocytosis efficiency. These data identify a novel mechanism by which pomegranate peel extract promotes the resolution of inflammation in atherosclerosis.

In the current study, fermentation conditions for pearl millet flour were optimized using baker's yeast. A central composite experimental design with three independent variables, temperature (30°C-45°C), yeast concentration (2%–4%) and time (18–24h) was used to study the dependent variables (total protein, total sugar, total phenolics, total flavonoids, total Titratable acidity, total soluble solids and pH). Based on response surface methodology, twenty run were processed. Regression model interpretation revealed the significant relationship between considered dependent and independent variables. Also all linear terms, two quadratic terms (fermentation temperature and time) and all interactive terms had significant (p

The limited availability of effective treatment against SARS-CoV-2 infection is a major challenge in managing COVID-19. This scenario has augmented the need for repurposing anti-virals for COVID-19 mitigation. In this report, the anti-SARS-CoV-2 potential of anti-HCV drugs such as daclatasvir (DCV) or ledipasvir (LDP) in combination with sofosbuvir (SOF) was evaluated. The binding mode and higher affinity of these molecules with RNA-dependent-RNA-polymerase of SARS-CoV-2 were apparent by computational analysis. In vitro anti-SARS-CoV-2 activity depicted that SOF/DCV and SOF/LDP combination has IC50 of 1.8 and 2.0 µM, respectively, comparable to remdesivir, an approved drug for COVID-19. Furthermore, the clinical trial was conducted in 183 mild COVID-19 patients for 14 days to check the efficacy and safety of SOF/DCV and SOF/LDP compared to standard of care (SOC) in a parallel-group, hybrid, individually randomized, controlled clinical study. The primary outcomes of the study suggested no significant difference in negativity after 3, 7 and 14 days in both treatments. None of the patients displayed any worsening in the disease severity, and no mortality was observed in the study. Although, the post hoc exploratory analysis indicated significant normalization of the pulse rate showed in SOF/DCV and SOF/LDP treatment vs. SOC. The current study highlights the limitations of bench side models in predicting the clinical efficacy of drugs that are planned for repurposing.

Iatrogenic bile duct injuries (BDI) are commonly encountered after laparoscopic cholecystectomy. Timely recognition of these injuries is important as the outcome depends on the optimal management and there is significant impact on the patient’s quality of life. Therapeutic management is guided by the type and extent of the bile duct injury and availability of expertise, and includes involvement of endoscopic, surgical, and radiological approaches.

The current study investigates the prebiotic potential of Murraya koenigii and Brassica oleracea var. botrytis leaves extract on different lactobacilli strains along with its antioxidant property. The high performance anion exchange chromatography (HPAEC) quantified various free sugars with higher sucrose (34.16 mg/g) in 50 % ethanolic extract of Murraya koenigii and minimum amount of raffinose (0.002 mg/g) in hot water extract of Brassica Oleracea. The different extracts exhibited efficient resistance against α-amylase and artificial gastric juice hydrolysis compared to standard prebiotics fructo-oligosaccharide (FOS) and inulin. The hot water extract of Brassica Oleracea and 50 % ethanolic extract of Murraya koenigii have shown efficient activity necessary for the augmentation of almost all strains of lactobacilli. In vitro studies, also exhibited that lactobacilli amount was significantly higher in medium supplemented with extract compared to control and standard prebiotics (p

We report a case of 61-year-old immunocompetent man with no comorbidity presenting with unexplained weight loss. All routine investigations could not point to the etiology of weight loss, but duodenal biopsy taken on upper gastrointestinal endoscopy revealed larvae of Strongyloides stercoralis, a nematode endemic to Indian subcontinent. The patient recovered after course of albendazole, and in the absence of other causality, weight loss was attributed to strongyloidiasis.

Introduction: The World Health Organization (WHO) declared tuberculosis(TB) as a global emergency in 1993 and still is a major health problem across the world.The basis of the WHO recommendation comes from a Meta analysis and several studies which showed same day sputum microscopy has similar diagnostic accuracy as compared to the conventional technique.The rationale behind this research is to generate evidence in favour for same day microscopy with the conventional technique in routine programme settings. Objective: Comparative assessment of same day (Spot1-Spot2) and Conventional (Spot1-Morning sputum) methods in TB suspects. Material & Method: The study was Cross sectional conducted from the 1st March 2015 to 28th Feburary.2016. Data was collected by using predesigned questionnaire for sample collection. Results: On comparison with conventional approach it was found that same day approach had sensitivity 95%, specificity 100% and PPV, NPV in same day approach are 100%, 99.03% respectively. McNemar test (p =0.074), it indicates statistically insignificant difference in the two approaches. Conclusion: Implication of same day approach helps the patients to get results and initiation of TB treatment on same day, will help to reduce the burden of TB treatment and make the programme successful in real way.

Introduction: Distal tibia fractures are challenging injuries with multiple fixation options. Minimal invasive plating for distal tibia fracture is becoming more popular with documented good outcomes. Aim: To evaluate the functional and radiological results of fixation of distal tibia fractures with locking plates with Minimally Invasive Plate Osteosynthesis (MIPO) technique. Materials and Methods: Fifty fractures of distal tibia without Intra-articular extension were operated with locking compression plating with MIPO technique. They were followed up at regular intervals. Functional and radiological results were evaluated at the end on one year. Results: The fractures united in 48 (96%) patients with 2 (4%) cases of delayed union which took 30 weeks of time. Postoperatively, 2 patients developed superficial skin infection, 2 patients developed deep infection and 3 patients developed ankle stiffness due to loss of postoperative protocol and 4 patients had implant failure in form of screw breakage. Good amount of range of mobility of ankle joint was present in almost all patients. Conclusion: MIPO with locking plates for distal tibia fractures is associated with good functional outcomes and is an effective treatment for distal tibia fractures. Although, a larger sample of patients and longer follow up are required to fully evaluate this method of treatment, we strongly encourage its consideration in the treatment of such complex fractures.

Aim: To assess the effect of feeding live Saccharomyces cerevisiae on serum biochemistry in early weaned cross bred (Landrace × Desi) piglets Materials and Methods: 48 piglets assigned to four different groups (T1, T2, T3 and T4: n=12) following completely randomized design. T1 and T2 were weaned at age of 28 days while T3 and T4 were weaned at age of 42 days. T1 and T3 were fed basal diet without S. cerevisiae, however, T2 and T4 were supplemented with live S. cerevisiae (200 g/d/h containing 2- 3×106 cfu/g). Results: The period-wise comparison of mean values of serum albumin and globulin were similar, however, period-wise comparison of protein was significant. The mean glucose value of T4 was statistically higher than T1 and comparable with T2 and T3. The serum total cholesterol level was found to be lower in T2 and T4 as compared to T1 and T3. Conclusion: Results of study suggest that supplementation of live Saccharomyces cerevisiae was effective in improving the health status of early weaned piglets. [Vet World 2012; 5(11.000): 663-666]

This study was undertaken to determine the effect of different treatments such as roasting, puffing and germination of white sorghum, red sorghum and ragi grains on physicochemical, antioxidant, protein, amylose, bulk density, colour index and rheological properties of respective flour. In case of ragi, after roasting treatment, total phenolic content (TPC) content for flour was increased from 0.331 ± 0.001 to 0.373 ± 0.004 mg of gallic acid equivalents per gram of dry sample. However, total flavonoids content was also increased slightly after different processing treatments. The rheological properties of respective flour were studied using Chopin Mixolab, where wheat flour dough profile acts as a reference to study the effect of different treatments. Dough elasticity which is expressed by the values of amplitude (Nm) was found to be low in case of untreated flour as compared to wheat flour dough. Elasticity values of untreated flour such as white sorghum, red sorghum and ragi were 0.02, 0.00 and 0.06 Nm, respectively. Whereas, after processing treatments, values of elasticity for roasted flour dough of white sorghum, puffed flour dough of red sorghum and roasted flour dough of ragi increased to 0.36, 0.11 and 0.15 Nm, respectively, as compared to wheat flour dough of 0.10 Nm. The results found that roasted ragi flour had higher rate of starch gelatinization, lower starch retrogradation, high antioxidant and amylose contents which were found to be prospective ingredients in whole wheat flour in various baked and fermented food applications.

Gastrointestinal (GI) mucormycosis commonly affects adults with neutropenia or other immunocompromising conditions. GI mucormycosis is uncommon but has high mortality rate. We report a case of colonic mucormycosis in a patient of chronic obstructive airway disease who presented with massive lower GI bleed.

Most of the ingested foreign bodies pass uneventfully through the gastrointestinal tract. However, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation, and bleeding. Spontaneous passage of a toothbrush has not been reported till date and the technique of its removal is a curiosity for surgeons. Endoscopy is a recommended technique for the removal of such complex foreign bodies. However, if it fails, the foreign body can be removed successfully with a laparoscopic gastrotomy. We devised an innovative technique by using pneumatic gastric insufflation and extracted the toothbrush by a tiny gastrotomy under local anesthesia.