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Background: The forward head posture is terrible habitual posture of neck that is characterized by forward cervical vertebral translation and upper cervical vertebral hyperextension. Forward head posture for prolonged period of time puts extra strain on posterior aspects of cervical region including ligaments which alters scapular kinetics and kinematics. Objective: To evaluate and assess the efficiency of active correction exercises in forward head posture of young adults. Methodology: A Total 30 subjects with forward head posture were chosen using convenient sampling technique based on inclusion and exclusion criteria. Patients were split into two groups (Intervention group-15, Conventional group-15). The Intervention group received active correction exercises for Thoracic Spine, Sternocleidomastoid, Upper Trapezius, Lower Trapezius, Deep Cervical Flexors. Conventional group were not given any intervention. As an outcome measure, the APECS posture evaluation and correction system was utilized to assess pre- and post-test measurements. Result: The mean value of pre-test was 25.720 and the post-test was 39.140 for conventional group and the mean value of pre-test was 22.187 and the post test was 25.533 for intervention group. Conclusion: As a result of this finding, it has been concluded that exercises on correcting forward head posture were more effective than conventional group. [ABSTRACT FROM AUTHOR]

Abstract Background Serum retinol-binding protein 4 (RBP4) plays a critical role in insulin resistance. The mechanism behind the impact of laparoscopic sleeve gastrectomy (LSG) on glucose metabolism is unclear. Hence, we aimed to investigate the triangle relationship between the RBP4, glucose metabolism, and LSG in patients of Chinese ethnicity. Methods The study enrolled eighty-two obese patients. Glucose-lipid metabolic index, uric acid (UA), superoxide dismutase (SOD), free triiodothyronine (FT3), free thyroxin (FT4) and thyrotropin (TSH) were measured. RBP4 levels were detected by enzyme-link immunosorbent assay. 30 obese patients underwent LSG were studied. All these markers were measured again at a time interval of 3 and 6 months after surgery. Results (1) Circulating RBP4 levels were positively associated with body mass index(BMI), blood glucose in 0 min (BG0), BG30, BG120, BG180, fasting inulin(FINS), fasting C peptide(FCP), homeostasis model of assessment for insulin resistance index (HOMA-IR), SOD, TSH and negatively associated with Matsuda index in obesity with a significant difference (P

BackgroundWe retrospectively data-mined the case records of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients hospitalized to a tertiary care centre to derive mortality predictors and formulate a risk score, for prioritizing admission.Methods and findingsData on clinical manifestations, comorbidities, vital signs, and basic lab investigations collected as part of routine medical management at admission to a COVID-19 tertiary care centre in Chengalpattu, South India between May and November 2020 were retrospectively analysed to ascertain predictors of mortality in the univariate analysis using their relative difference in distribution among 'survivors' and 'non-survivors'. The regression coefficients of those factors remaining significant in the multivariable logistic regression were utilised for risk score formulation and validated in 1000 bootstrap datasets. Among 746 COVID-19 patients hospitalised [487 "survivors" and 259 "non-survivors" (deaths)], there was a slight male predilection [62.5%, (466/746)], with a higher mortality rate observed among 40-70 years age group [59.1%, (441/746)] and highest among diabetic patients with elevated urea levels [65.4% (68/104)]. The adjusted odds ratios of factors [OR (95% CI)] significant in the multivariable logistic regression were SaO23; 3.01 (1.61-5.83), Age ≥50 years;2.52 (1.45-4.43), Pulse Rate ≥100/min: 2.02 (1.19-3.47) and coexisting Diabetes Mellitus; 1.73 (1.02-2.95) with hypertension and gender not retaining their significance. The individual risk scores for SaO23-11, Age ≥50 years-9, Pulse Rate ≥100/min-7 and coexisting diabetes mellitus-6, acronymed collectively as 'OUR-ARDs score' showed that the sum of scores ≥ 25 predicted mortality with a sensitivity-90%, specificity-64% and AUC of 0.85.ConclusionsThe 'OUR ARDs' risk score, derived from easily assessable factors predicting mortality, offered a tangible solution for prioritizing admission to COVID-19 tertiary care centre, that enhanced patient care but without unduly straining the health system.

A new series of C4- N, N-dialkylaniline-substituted 4-aryl-4 H-chromenes were synthesized, and their anti-proliferative properties were evaluated against human cancer cell lines, namely, laryngeal carcinoma (Hep2), lung adenocarcinoma (A549), and cervical cancer (HeLa). The best among them, the 4-aryl-4 H-chromene with C4-1-phenylpiperidine substitution was selected for further structure activity relationship (SAR) studies. Among the derivatives, N,6-dimethyl-3-nitro-4-(4-(piperidine-1-yl)phenyl)-4 H-chromene-2-amine 3k showed most potent cytotoxic activity against all three cancer cell lines. Toxicity studies revealed that the 4-aryl-4 H-chromenes specifically target the cancer cell lines. Molecular docking studies of this compound revealed its efficient interaction with the active site of αβ-tubulin protein. [ABSTRACT FROM AUTHOR]

AimsTo investigate the predictive value of baseline serum triglyceride (TG) levels for improvements of metabolism after laparoscopic sleeve gastrectomy (LSG).Methods112 obese patients [body mass index (BMI) ≥ 35 kg/m2] underwent LSG and with complete information of anthropometric and metabolic parameters were divided into normal TG group (group A) and high TG group (group B), while group A had TG levels ≤ 1.7 mmol/L, and group B had TG levels > 1.7 mmol/L. The post-operative changes (Δ) in metabolic parameters between the two groups were compared.ResultsIn the whole cohort, the metabolic parameters were significantly improved at 6 months after LSG. BMI and waist circumference (WC) decreased significantly in the two groups. The ΔBMI among group A and group B were 11.42±3.23 vs 9.13±2.77 kg/m2 (p

A combinatorial library of eighteen C4-active methine-substituted 4 H-chromenes were synthesized, and their anti-cancer properties were evaluated against four human cancer cell lines, namely laryngeal carcinoma (Hep2), lung adenocarcinoma (A549), colon carcinoma (HT-29) and cervical cancer (HeLa). Out of them, six displayed significant anti-proliferative activity. The best among them, the 4 H-chromene with C4-malononitrile substitution, was selected for further structure-activity relationship studies. Six analogues were synthesized and subjected to in vitro studies on above four cancer cell lines. The best among them was subjected to detail in silico studies by binding with Bcl-2 protein, and the results corroborated those obtained from in vitro studies. Our findings show that the C4-malononitrile and C2- N-phenyl-substituted 4 H-chromene are the most promising lead molecules for treatment of cancer. [ABSTRACT FROM AUTHOR]

Context: It is evident that about 30-50% of patients with Vitamin D deficiency (VDD) do not manifest develop secondary hyperparathyroidism (SHPT). A number of theories have been proposed to explain this lack of SHPT, including hypomagnesemia. Settings and Design: Retrospective review of laboratory database. Materials and Methods: We evaluated the differences in serum magnesium (Mg) levels among those with VDD with or without SHPT. A retrospective review of 6255 laboratory data of bone mineral profiles performed in the period of 2007--2013. After excluding patients with hypercalcemia, renal dysfunction/unknown kidney function and primary hypothyroidism, the remaining 1323 patient data were analyzed. SHPT was defined as serum parathyroid hormone >65 in those with VDD. Statistical Analysis Used: ANOVA and Wilcoxon tests as appropriate to compare means. Multivariate logistic regression to analyze relation between variables and outcome of SHPT. Results: We noted that 55% patients (n = 727) had VDD, and among those who had VDD, 23% (n = 170) were hypocalcemic (corrected serum calcium <8.5). Patients with VDD who did not exhibit SHPT were 56% (n = 407). The mean (±standard deviation) serum Mg levels in the entire cohort (n = 1323) was 1.94 ± 0.26 mg/dl and 1.95 ± 0.26 mg/dl in VDD cohort and 2 ± 0.31 mg/dl in the VDD-hypocalcemic cohort. There was no statistical difference in the Mg levels among those with SHPT compared to those without SHPT (P = 0.14). Serum calcium and phosphorus were lower in those with SHPT (P = 0.06 and P < 0.001, respectively). In multivariate logistic regression, serum calcium (P = 0.043), phosphorus (P < 0.001) and severe VDD (P < 0.001) independently correlated with occurrence of SHPT in VDD. Conclusions: Serum Mg levels did not explain the functional hypoparathyroidism seen in about half of the patients with VDD. A low normal serum calcium and phosphorus levels are more likely to be associated with VDD patients who develop SHPT. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the risk-stratifying utility of tumor size and a threshold for further stratification on cancer-specific mortality of thyroid cancer (TC) patients in stage IVB.Methods: One thousand three hundred and forty-five patients (620 males and 725 females) with initial distant metastasis over 55 years between 2004 and 2016 from Surveillance, Epidemiology, and End Results databases were investigated, with a median follow-up time of 23 months [interquartile range (IQR), 5–56 months] and a median age of 70 years (IQR, 63–77 years). TC-specific mortality rates were calculated under different classifications. Cox regressions were used to calculate hazard ratios (HRs) and Kaplan-Meier Analyses were conducted to investigate TC-specific survivals.Results: In the whole cohort, patients with tumors >4 cm had the highest TC-specific mortality (67.9%, 330/486), followed by tumor size >1 cm but ≤ 4 cm (43.08%, 190/441), and tumor size ≤ 1 cm (32.69%, 34/104). Kaplan-Meier curves showed the increased tumor size was associated with a statistically significant decrease in TC-specific survival (P < 0.001). Papillary thyroid cancer (PTC) patients with tumors >4 cm had significantly higher hazard ratios (HRs) of 2.84 (1.72–4.70) and 3.11 (1.84–5.26) after adjusting age, gender, race, and radiation treatment, compared with patients with tumors ≤ 1 cm (P < 0.001). The TC-specific mortalities and survivals were further investigated among more detailed subgroups divided by different tumor size, and a threshold of 3 cm could be observed (P < 0.005) for risk stratification.Conclusions: Mortality risk increased with tumor size in PTC patients in stage IVB. Our findings demonstrated the possibility of further stratification in IVB stage in current TNM staging system. Patients with tumor size over 3 cm had an excessively high risk of PTC-specific mortality, which may justify the necessity of more aggressive treatment for them.

A series of N-methyl-3-nitro-4-(nitromethyl)-4 H-chromen-2-amine derivatives 8 were synthesized from 2-(( E)-2-nitrovinyl)phenol 7 and (( E)- N-methyl)-1-(methylthio)-2-nitroethenamine 5. The cytotoxic activity of these molecules was tested against two cancer cell lines namely HeLa (cervical cancer) and HEp-2 (epidermoid laryngeal carcinoma). Among them, two molecules (4 H-chromenes 8h and 8i) displayed potent anti-proliferative activity with IC values of 115.04 and 18.96 μM for HeLa and 86.94 and 25.08 μM for Hep-2 cell lines, respectively. Morphological evaluation of the cell lines revealed that both 8h and 8i induce the apoptotic process. Molecular docking studies of all the 4 H-chromenes 8 with anti-apoptotic Bcl-2, Bcl-w, and Bcl-xL proteins revealed that the 4 H-chromenes 8h and 8i have good docking score and thus corroborated in vitro studies. Furthermore, evaluation of Lipinski and ADMET properties revealed their drug-like pharmacokinetic profiles. Thus, 4 H-chromenes 8h and 8i exhibit promising anti-cancer properties and can be used as lead compounds for further development. [ABSTRACT FROM AUTHOR]

Anomalous action of human acetylcholinesterase (hAChE) in Alzheimer's disease (AD) was restrained by various AChE inhibitors, of which the specific and potent lead candidate Donepezil is used for treating the disease AD. Besides the specificity, the observed undesirable side effects caused by Donepezil invoked the quest for new lead molecules with the increased potency and specificity for AChE. The present study elucidates the potency of six 1 N-methyl-1 S-methyl-2-nitroethylene (NMSM) derivatives to form a specific interaction with the peripheral anionic site and catalytic anionic subsite residues of hAChE. The NMSMs were prepared in good yield from 1,1-di(methylsulfanyl)-2-nitroethylene and primary amine (or) amino acid esters. In silico interaction analysis reveals specific and potent interactions between hAChE and selected ligand molecules. The site-specific interactions formed between these molecules also results in a conformational change in the orientation of active site residues of hAChE, which prevents them from being accessed by beta-amyloid protein (Aβ), which is a causative agent for amyloid plaque formation and acetylcholine (ACh). In silico interaction analysis between the ligand-bounded hAChE with Aß and ACh confirms this observation. The variation in the conformation of hAChE associated with the decreased ability of Aβ and ACh to access the respective functional residues of hAChE induced by the novel NMSMs favors their selection for in vivo analysis to present themselves as new members of hAChE inhibitors. [ABSTRACT FROM AUTHOR]

4 H-chromenes are among the essential groups of biologically important compounds used as synthetic ligands for drug designing and discovery process. In this study, we have presented the single-crystal structure analysis of racemic 4 H-chromene derivative namely N-methyl-3-nitro-4-(nitromethyl)-4 H-chromen-2-amine. The optical rotation measurement data is supporting that the title compound is racemic in nature. The compound was crystallized in monoclinic crystal system in the non-centrosymmetric space group P2 with unit cell parameters a = 5.1041 (3), b = 7.7519 (4), c = 14.7974 (8), α = 90°, β = 97.088 (5)° and γ = 90°. The nitro group of title compound is disordered over two orientations (N3A/O4A/O5A & N3B/O4B/O5B) with the refined site-occupancy ratio of 0.626(6)/0.374(6). The structure was solved by direct methods using the program SHELXS-97 and refined by SHELXL-97 with the full-matrix least square procedure to a final R-value of 0.0429 and Goodness of Fit (GooF) of 0.982. The molecules in the unit cell are stabilized by N-H···O and C-H···O types of hydrogen bonds. The intermolecular hydrogen bonds are forming C (6) motifs, which is observed to contribute the crystal packing stability. Moreover, the intramolecular hydrogen bonds are forming S (6) motif essential to stabilize the molecular structure of title compound. Graphical Abstract: Graph-set S (6) and C (6) motifs are involved in stability of the structure and packing respectively. [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Background and Purpose:Tuber melanosporum (black truffle) has been considered as a medicinal mushroom for a long time. T. melanosporum has the ability to attenuate oxidative stress and in turn diabetes mellitus (DM). DM has become an awfully common chronic unwellness, threatening people’s well-being. There are nearly 1 in 10 people in the world affected by diabetes. Oxidative stress plays a crucial role in vascular complications related to DM. Our study aimed to attain an effective treatment method to alleviate oxidative stress by scavenging free radicals and reducing inflammation, to display how truffle aqueous extract (TE) attenuates hyperglycemia.Methods: Streptozotocin (STZ)-induced hyperglycemic rat model was accustomed to check the hypoglycemic effect of black truffle by relating it with Nrf2 and NF-κB pathways. Varied biomarkers and inflammatory markers were analyzed.Results: Rats treated with TE showed reduced glucose levels, attenuated oxidative stress through regulation of SOD, CAT, VIT-E, and VIT-C. The gene expression of Nrf2 and NF-κB in rats treated with TE was increased to normal group level. The mRNA expression of inflammatory pathway genes and oxidative stress pathway genes in rats treated with TE was brought back normal. Similar results were achieved in the rats treated with standard drug, glibenclamide (GB). TE conjointly inhibits the state of inflammation within the tissues generally littered with the symptoms of hyperglycemia.Conclusion: The results of our study show the hypoglycemic impact of black truffle on STZ-induced hyperglycemia in rats via Nrf2 and NF-κB pathways, and both pathways have significant improvement that may support the hypoglycemic impact of truffle.

Colorectal cancer (CRC) is a fatal disease caused by the uncontrolled propagation and endurance of atypical colon cells. A person’s lifestyle and eating pattern have significant impacts on the CRC in a positive and/or negative way. Diet-derived phytochemicals modulate the microbiome as well as targeting colon cancer stem cells (CSCs) that are found to offer significant protective effects against CRC, which were organized in an appropriate spot on the paper. All information on dietary phytochemicals, gut microbiome, CSCs, and their influence on CRC were accessed from the various databases and electronic search engines. The effectiveness of CRC can be reduced using various dietary phytochemicals or modulating microbiome that reduces or inverses the progression of a tumor as well as CSCs, which could be a promising and efficient way to reduce the burden of CRC. Phytochemicals with modulation of gut microbiome continue to be auspicious investigations in CRC through noticeable anti-tumorigenic effects and goals to CSCs, which provides new openings for cancer inhibition and treatment.

Inguinal hernia with appendix as content, classically called as Amyand's Hernia has been well documented in children. Undescended testis with an associated hernia is also not uncommon and is an indication for early orchidopexy. We report a case of undescended testis which presented as an irreducible right inguinal hernia, which on exploration was found to have an inflamed appendix.