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Background: Only a few studies have systematically assessed sexual dysfunction and marital adjustment in married men with alcohol dependence in India. Aim: To assess the prevalence and pattern of sexual dysfunction and marital adjustment in a clinical sample of married men with alcohol dependence. The association of sexual dysfunction and marital adjustment with the severity of alcohol dependence was also explored. Materials and Methods: This cross-sectional study included 100 consecutive married men attending psychiatry outpatient department (OPD) with a diagnosis of alcohol dependence syndrome (ADS). A pre-designed study proformawas used for collecting relevant socio-demographic and clinical details of the study participants. Sexual dysfunction, marital adjustment, and alcohol dependence were assessed using the following validated tools: the Arizona Sexual Experiences Scale (ASEX), the Marital Adjustment Questionnaire (MAQ), and the Severity of Alcohol Dependence Questionnaire (SADQ), respectively. Results: Of 100 patients, about 15% had clinical sexual dysfunction based on ASEX. The most commonly reported sexual dysfunction was difficulty with erection (24.0%), followed by problems in desire (18.0%), sexual arousal (12.0%), ability to reach orgasm (12.0%), and satisfaction with orgasm (9.0%). Sexual dysfunction (ASEX score) showed significant positive correlation (rs = 0.345; P < 0.001) with alcohol dependence severity (SADQ score). Also, the severity of alcohol dependence was negatively correlated (rs = -0.240; P = 0.016) with the overall level of marital adjustment (MAQ score) with spouse. Conclusion: Sexual dysfunction is common in married men with ADS, with both sexual dysfunction intensity and marital adjustment difficulties being positively associated with the severity of alcohol dependence.

Deep sea bacterial communities demonstrate remarkable adaptability to high-pressure environments coupled with low temperatures which has sparked curiosity about their diversity and exceptional metabolic pathways. Additionally, bacteria in the deep sea exert a substantial influence over various biogeochemical processes. To date, we have relatively very little information about the deep-sea bacterial communities and, they remain largely unexplored. We investigated the variability in the physicochemical conditions, heavy metals and their influence on deep-sea bacterial community structure across three different depths in the Bay of Bengal. The structural and metabolic diversity of deep-sea sediment microbial communities were examined through culture-based sequencing of 16S rRNA genes, ecto-enzymatic studies, and community-level physiological profiling. Bacillota was the most dominant phylum representing 61% of the cultured bacterial isolates, while the remaining belonged to Actinomycetota and Pseudomonodata. Five potential novel species belonging to the genera Fictibacillus, Lysinibacillus, Salinicola, Robertmurraya and Blastococcus were identified. The extracellular enzymatic activity was positive for >50% of the bacterial isolates, wherein the genera Bacillus and Micromonospora exhibited versatile profiles. High metabolic diversity was recorded through the carbon substrate utilization profiles indicating that microbial communities are active participants in biogeochemical cycles in the deep sea. The most prominently utilized carbon substrates were α-cyclodextrin, glucose-1-phosphate, D-xylose, glycogen, and 2-hydroxy benzoic acid which serve as organic substrates for microbial metabolism, facilitating the decomposition of organic matter and, recycling carbon in deep-sea ecosystems. Multivariate statistical analyses confirmed that the environmental variables had a profound influence on the bacterial community. The findings shed light on spatial variability in the bacterial community structure, enzyme activity and metabolic profiles, and enhance our understanding of Bay of Bengal deep-sea sedimentary microbial ecology.

Introduction: India is suffering from an epidemic of noncommunicable diseases. Type 2 diabetes and hypertension are two lifestyle diseases which are often coexistent. The present study aimed to assess whether blood pressure (BP) variability has any correlation with the prevalence of chronic complications of diabetes. Materials and Methods: In a hospital-based cross-sectional study, 116 patients of newly diagnosed type 2 diabetes were enrolled. Ambulatory BP monitoring (ABPM) for 24 h duration was performed in all the study participants. The abnormal patterns of BP were analyzed. Results: Out of 100 patients with valid ABPM data, 62% of patients had masked hypertension, 45% had nondipping pattern, and 13% had reverse dipping pattern. The prevalence of diabetes complications both macrovascular and microvascular was significantly higher in patients who had abnormal dipping patterns. Conclusion: Our findings highlight the importance of ABPM which detects masked hypertension, white-coat hypertension, and abnormal BP patterns which are related to complications of diabetes.

Breast cancer remains a pervasive health challenge worldwide, prompting the exploration of novel therapeutic prospects. Datura metel has long been recognized for its pharmacological properties, particularly in containing various bioactive compounds like alkaloids, flavonoids, and terpenoids. This review focuses on the potential of chemical constituents sourced from Datura metel, a traditional medicinal plant, in combating breast cancer, primarily through molecular docking studies. The review meticulously scrutinizes the chemical composition of Datura metel, emphasizing the identified compounds known for their therapeutic attributes. Through an extensive analysis of molecular docking studies, the interactions between these Datura metel constituents and crucial molecular targets associated with breast cancer are elucidated. The phytoconstituents (compound 1-13) were found to be more potent as compare to Tomoxifen citrate as standard anticancer drug. The findings presented herein beckon for further exploration, highlighting a promising avenue in the pursuit of effective and targeted treatments for breast cancer. In conclusion, this review emphasizes the synergistic integration of computational approaches with traditional knowledge, accelerating the discovery and development of innovative breast cancer therapies.

Abstract Background The trigger thumb is a clinically unusual and rare phenomenon. The trigger finger is most observed on the ring or middle fingers. Clinical signs include reduced tendon excursion and the formation of nodules at the base of the metacarpals. As a result, grip strength may be reduced, making gripping tasks uncomfortable. Many treatments have been proposed to treat trigger finger symptoms; however, the effectiveness of shockwave therapy is still being contested. As a result, the purpose of this trigger thumb case study is to assess the effect of shockwave therapy on grip performance. Case presentation A 53-year-old housewife reported to the outpatient department with pain at the base of her right thumb, recurring locking episodes, morning pain and stiffness, and a 10-year history of diabetes. Based on the clinical presentation and physical examination of the patient, an orthopedic sports physician diagnosed it as a trigger thumb. Analgesics were initially administered, and the patient was then referred to physiotherapy for rehabilitation. All outcomes improved substantially during the follow-up after six sessions of physical therapy, which included shockwave therapy and an exercise program. Conclusion This study concluded that the protocol developed specifically for the treatment of the trigger thumb is efficacious. Therefore, future research with a larger number of participants is required to validate this approach.

Heart diseases is the world’s principal cause of death, and arrhythmia poses a serious risk to the health of the patient. Electrocardiogram (ECG) signals can be used to detect arrhythmia early and accurately, which is essential for immediate treatment and intervention. Deep learning approaches have played an important role in automatically identifying complicated patterns from ECG data, which can be further used to identify arrhythmia. In this paper, deep-learning-based methods for arrhythmia identification using ECG signals are thoroughly studied and their performances evaluated on the basis of accuracy, specificity, precision, and F1 score. We propose the development of a small CNN, and its performance is compared against pretrained models like GoogLeNet. The comparative study demonstrates the promising potential of deep-learning-based arrhythmia identification using ECG signals.

Background: Coronavirus disease 2019 (COVID-19) infection in India demonstrated three peaks in India, with differences in presentation and outcome in all the three waves. The aim of the paper was to assess differences in the epidemiological, clinical features and outcomes of patients with COVID-19 presenting at a tertiary care hospital in the three waves at Jaipur, India. Methods: This was a retrospective study conducted at a tertiary care hospital at Jaipur, India. Demographic, clinical features and outcomes were compared of confirmed COVID-19 cases admitted during the first wave (16-7-2020 to 31-1-2021), second wave (16-3-2021 to 6-5-2021) and third wave (1-1-22 to 20-2-22) of the outbreak. Results: There were 1006 cases, 639 cases and 125 cases admitted during the three waves, respectively. The cases presenting in the second wave were significantly younger, with significantly higher prevalence of symptoms such as fever, cough, sore throat, nausea, vomiting, headache, muscle ache, loss of appetite and fatigue (P < 0.05). A significantly higher proportion of patients received Remdesivir in the second wave (P < 0.001). However, in the second wave, the use of low molecular weight heparin, plasma therapy, non-invasive and invasive ventilator were higher (P < 0.001). Co-morbid conditions were significantly higher in the admitted patients during the third wave (P < 0.05). Radiological scores were similar in second and third wave, significantly higher than the first wave. Lymphopenia and rise of inflammatory markers including C-reactive protein and interleukin-6 were more evident in the second wave (P < 0.001). The mean mortality, hospital stay and air-leak complications were also significantly higher in the second wave (P < 0.001). Conclusions: The second wave was more vicious in terms of symptoms, inflammatory markers, radiology, complications, requirement of ventilation and mortality. Mutation in the virus, lack of immunity and vaccination at the time point of second wave could have been the possible causes. The ferocity of the second wave has important implications for the government to formulate task forces for effective management of such pandemics.

The de-loading technique in photovoltaics is used to reserve some active power for frequency regulation purposes. However, the selection of the de-loading method depends upon the shading conditions of photovoltaics. Many de-loading methods have already been developed for uniform shading conditions. Whereas for partial shading conditions, few methods are available for static shading patterns, while, the area of dynamic shading is untouched. Under dynamic shading, the global maximum power point changes continuously. Therefore, in this paper, in order to develop a power reserve under dynamic shading patterns of partial shading conditions, a trained artificial neural network is used. The information about the local and global maximum points is obtained from this neural network, whereas, the system de-loading is achieved using a de-loading algorithm. The neural network is trained using different irradiance patterns which lead to two or three peaks on the power vs. voltage curve of photovoltaics. The control is easy to implement and can handle up to three peak system. The simulation and experimental results have been used to verify the effectiveness of the control.

The marine environment is most vital and flexible with continual variations in salinity, temperature, and pressure. As a result, bacteria living in such an environment maintain the adaption mechanisms that are inherent in unstable environmental conditions. The harboring of metal-resistant genes in marine bacteria contributes to their effectiveness in metal remediation relative to their terrestrial counterparts. A total of four mercury-resistant bacteria (MRB) i.e. NIOT-EQR_J7 (Alcanivorax xenomutans); NIOT-EQR_J248 and NIOT-EQR_J251 (Halomonas sp.); and NIOT-EQR_J258 (Marinobacter hydrocarbonoclasticus) were isolated from the equatorial region of the Indian Ocean (ERIO) and identified by analyzing the 16S rDNA sequence. The MRBs can reduce up to 70% of Hg(II). The mercuric reductase (merA) gene was amplified and the mercury (Hg) volatilization was confirmed by the X-ray film method. The outcomes obtained from ICP-MS validated that the Halomonas sp. NIOT-EQR_J251 was more proficient in removing the Hg from culture media than other isolates. Fourier transform infrared (FT-IR) spectroscopy results revealed alteration in several functional groups attributing to the Hg tolerance and reduction. The Gas Chromatography-Mass Spectrometry (GC-MS) analysis confirmed that strain Halomonas sp. (NIOT-EQR_J248 and NIOT-EQR_J251) released Isooctyl thioglycolate (IOTG) compound under mercury stress. The molecular docking results suggested that IOTG can efficiently bind with the glutathione S-transferase (GST) enzyme. A pathway has been hypothesized based on the GC-MS metabolic profile and molecular docking results, suggesting that the compound IOTG may mediate mercuric reduction via merA-GST related detoxification pathway.

Nursery practice in Dalbergia sissoo seedlings was performed in order to establish the efficacy of the rhizobial inoculants for future nurseries. The rhizospheric bacteria were isolated from different geographic locations of Himachal Pradesh and Uttrakhand. The nursery was set up by sowing the seeds collected from these locations. The rhizospheric bacterial inoculants isolated from D. sissoo rhizosphere were treated in the nursery for the establishment of a successful nursery. The nursery was observed for root, shoot parameters, and nodulation status showing variation in these characters with different geographic locations. From the same nursery, rhizobia were isolated from root nodules in YEMA media. Based on PGPR traits, two rhizobia, i.e., PGPR1 (DBD1) and PGPR2 (DRT5) were treated in the second nursery along with different levels of nitrogenous fertilizers. The consortium of PGPR1+PGPR2 was observed to be the best treatment that significantly increased the growth parameters, i.e., root, shoot parameters and nodulation status, and nitrogenase activity in D. sissoo seedlings.

Dental fluorosis changes the colour and/or structure of enamel, leading to an unaesthetic appearance. One of the main goals in the treatment is aesthetic improvement of the affected teeth. Two clinical cases of patients with white spot fluorosis lesions on frontal teeth are presented. All treated teeth are infiltrated with low-viscous light-curing resin (ICON, DMG). A significant improvement in the aesthetic appearance of all the treated tooth surfaces is visible immediately after resin infiltration, and in most of the teeth - a complete disappearance of the white spots. Resin infiltration is an alternative micro-invasive approach for treatment of white spot lesions of different origin. It allows a quick and natural recovery of the affected teeth.

In low voltage (LV) distribution systems, the problem of overvoltage is common during the lower load intervals. This problem arises because of the high value of R/X ration of these systems. Many techniques are available in literature to cope up with this problem at the converter level; mostly these methods control the reactive or active power of the photovoltaic (PV) systems. However, there are certain restrictions and complications with the reactive power control of PV systems. Most of the active power control methods have been implemented at the inverter stage of the PV system, resulting in implementation complexities and excessive oversizing of the converter. Therefore, in this paper, a simple, de-rating based voltage control algorithm is proposed to overcome the problem of overvoltage. So far de-rating technique has been used to enable frequency support functions in PVs; in a first of its kind, de-rating technique is used here to control the voltages in PV rich LV distribution systems. The entire control is implemented on the dc/dc converter stage of the PV system and the inverter stage is kept untouched. The effectiveness of the control is verified by simulating a sample PV-rich three bus LV distribution system on the MATLAB software. The proposed control avoids the overvoltage by approx. 700 V for the best-case scenario.

Abstract Background Maternal anaemia prevalence in Bihar, India remains high despite government mandated iron supplementation targeting pregnant women. Inadequate supply has been identified as a potential barrier to iron and folic acid (IFA) receipt. Our study objective was to examine the government health system’s IFA supply and distribution system and identify bottlenecks contributing to insufficient IFA supply. Methods Primary data collection was conducted in November 2011 and July 2012 across 8 districts in Bihar, India. A cross-sectional, observational, mixed methods approach was utilized. Auxiliary Nurse Midwives were surveyed on current IFA supply and practices. In-depth interviews (n = 59) were conducted with health workers at state, district, block, health sub-centre, and village levels. Results Overall, 44% of Auxiliary Nurse Midwives were out of IFA stock. Stock levels and supply chain practices varied greatly across districts. Qualitative data revealed specific bottlenecks impacting IFA forecasting, procurement, storage, disposal, lack of personnel, and few training opportunities for key players in the supply chain. Conclusions Inadequate IFA supply is a major constraint to the IFA supplementation program, the extent of which varies widely across districts. Improvements at all levels of infrastructure, practices, and effective monitoring will be critical to strengthen the IFA supply chain in Bihar.

Young Indian women may be at risk of poor bone health due to malnutrition. The aim of this study was to examine the effects on bone metabolism of a nutritional supplement in women aged 25 to 44. The nutritional supplement was a protein-rich beverage powder fortified with multi-micronutrients including calcium (600 mg), vitamin D (400 IU), and vitamin K (55 mcg) per daily serving, while a placebo supplement was low-protein non-fortified isocaloric beverage powder. This 6-month randomised, controlled trial showed favorable changes in bone turnover markers (decreased) and calcium homeostasis; such changes in older adults have been associated with slowing of bone loss and reduced fracture risk. For example, serum CTX decreased by about 30% and PINP by about 20% as a result of the increase in calcium intake. There were also changes in the ratio of carboxylated to undercarboxylated osteocalcin and such changes have been linked to a slowing of bone loss in older subjects. For example, the ratio increased by about 60% after 3 months as a result in the improvement in vitamin K status. Finally, there were improvements in the status of B vitamins, and such changes have been associated with reductions in homocysteine, but it is uncertain whether this would affect fracture risk. The product was generally well tolerated. This study shows the nutritional supplement holds promise for improved bone health among young Indian women.

Background: Due to lack of training in emergency care, basic emergency care in India is still in its infancy. We designed All India Institute of Medical Sciences basic emergency care course (AIIMS BECC) to address the issue. Aim: To improve the knowledge and skill of healthcare workers and laypersons in basic emergency care and to identify impact of the course. Materials and Methods: Prospective study conducted over a period of 4 years. The target groups were medical and nonmedical personnel. Provider AIIMS BECC is of 1 day duration including lectures on cardio-pulmonary resuscitation, choking, and special scenarios. Course was disseminated via lectures, audio-visual aids, and mannequin training. For analysis, the participants were categorized on the basis of their education and profession. A pre- and a post-course evaluation were done and individual scores were given out of 20 and compared among all the groups and P value was calculated. Results: A total of 1283 subjects were trained. 99.81% became providers and 2.0% were trained as instructors. There was a significant improvement in knowledge among all the participants irrespective of their education level including medicos/nonmedicos. However, participants who had higher education (graduates and postgraduates) and/or belonged to medical field had better knowledge gain as compared to those who had low level of education (≤12th standard) and were nonmedicos. Conclusion: BECC is an excellent community initiative to improve knowledge and skill of healthcare and laypersons in providing basic emergency care.

DRDE-07, a newly synthesized amifostine analog currently under clinical investigation in a phase I trial, is a potent antidote against sulfur mustard toxicity. The purpose of this research was to evaluate the pharmacokinetic profile of DRDE-07 in female Swiss Albino mice after a single oral dose of 400 or 600 mg/kg. The physicochemical properties of DRDE-07, including solubility, pKa, Log P, plasma protein binding and plasma/blood partitioning, were determined to support the pharmacokinetic characterization. DRDE-07 concentration was determined by an HPLC-UV method. The profile of plasma concentration versus time was analyzed using a non-compartmental model. Plasma protein binding was assessed using ultrafiltration. DRDE-07 appeared rapidly in plasma after oral administration with peak plasma levels (Cmax) observed in less than 15 min. There was a rapid decline in the plasma levels followed by a smaller second peak about 90 min after dosing. The plasma protein binding of DRDE-07 was found to be less than 25% at all concentrations studied. Plasma clearance of DRDE-07 is expected to be ~1.5 fold higher than the blood clearance of DRDE-07. The probable metabolite of DRDE-07 was identified as phenyl-S-ethyl amine.

Transfusion-related acute lung injury (TRALI) is a serious clinical syndrome associated with the transfusion of plasmacontaining blood components. Recently, TRALI has come to be recognized as the leading cause of transfusion-related mortality. This complication typically presents as shortness of breath, hypoxemia, hypotension, fever, and non cardiogenic pulmonary edema, occurring within 6 h after transfusion. Although the mechanism of TRALI has not been exactly known, it has been associated with human leukocyte antigen antibodies and with biologically active mediators in stored cellular blood components. We, hereby, present a case of a patient with dengue fever who developed acute lung injury (ALI), presumably TRALI, after transfusion of platelet concentrates. He was treated with supportive measures and mechanical ventilation. Greater knowledge and increased awareness especially amongst the clinicians regarding TRALI is needed for prevention and treatment of this potentially severe complication of blood/component transfusion.

Context: Infertility is regarded as a trigger for psychological morbidity. Infertile couples often suffer from anxiety, depression and lack of self confidence. Aims: To study the demographic factors associated with infertility in a tertiary care setup and to determine the level of anxiety and depression associated with it by using standardized scales. The study protocol also included studying the various coping strategies employed by these patient groups. Settings and Design: Case control study. Materials and Methods: A prestructured questionnaire based study conducted for a span of 6 months. The study population included the patients attending the infertility and the family planning outpatient department. We applied the Hospital Anxiety and Depression scale (HADS) and the Becks Depression Inventory (BDI). Brief COPE Inventory was applied to look for the various coping measures that are employed by the anxious and depressed patients. Statistical Analysis: Data analysis was done using SPSS ver20. Results: A total of 280 study subjects were included in the study; which included 140 women from the infertility clinic and 140 from the family planning OPD. A total of 56.4% (79/140) of the females were found to be suffering from depression and 68.9% (96/140) of the females were found to be suffering from anxiety and depression both. Seven risk factors were found to be significant for depression based on the Beck Depression Inventory (BDI) scale and 6 risk factors were found to be significant based on the Hospital Anxiety and Depression Scale (HADS). The most common coping method employed by depressed women was venting 72.2% (57/79) followed by behavioural disengagement 70.9% (56/79); whereas the most important coping method employed by the anxious and depressed women was behavioural disengagement 71.9% (69/96). Conclusion: Anxiety and depression is common among patients suffering from infertility and measures should be taken to alleviate it.

Substance abuse has been defined as the use of chemical substances for non medical purposes in order to achieve alterations in psychological functioning. The substances commonly abused in India include nicotine, alcohol, cannabis and opioids. However, the use of solvents and propellants is also on the rise as these are inexpensive, legally available household, industrial, office and automobile products; which are more commonly available to children and adolescents. We hereby describe a 16-year-old boy with combined volatile and alcohol abuse; who presented with increasing ataxia, visual and hearing disturbances.

Primary pulmonary sporotrichosis, a rare fungal disease was found in chronic alcoholic farmer from the sub-Himalayan region, an endemic mycoses area. Primary pulmonary sporotrichosis is a hidden entity, at times mimicking tuberculosis, and often under or lately diagnosed due to lack of awareness. We should consider the possibility of pulmonary sporotrichosis in patients with chronic cough and cavitary parenchymal disease, particularly in chronic alcoholics, gardeners, and forest workers. Sputum culture for fungus as a part of diagnostic studies is needed especially in endemic mycoses areas for early detection and management of such fungal diseases.