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Background: Heat is one of the physical hazards that can cause health problems in the workplace, Brick field workers are widely exposed to risk factors for heat-related illnesses. Knowledge, attitudes, and practices (KAP) are three of the most important means of preventing such illnesses. Objectives: To determine the predictors of risk perception and to assess the vulnerability and adaptive capacity regarding heat-related illness among brick field workers in Rural Puducherry. Methodology: A cross-sectional study was conducted from March to June (2023). A total of 280 Brickfield workers were recruited from five rural commune areas of Puducherry, using the Multistage random sampling method. The data was collected on demographic characteristics, risk perception and spontaneous adaptation behaviours through KAP scores using structured questionnaires. Chi-square tests, correlation matrix and Linear Multiple regression models were employed to analyze the data. Results: 15.4% of the subjects suffered from HRIs, and 68.2% never received health education about HRIs. The mean for knowledge (K-score) was 13.5 (SD = 6.008) for attitudes (A-score) 4.21 (SD = 2.167) for practices (P-score) 4.23 (SD = 1.988). There were noticeable differences in KAP-score with respect to educational level (P < 0.05), income level (P < 0.05) and work relevant experience (P < 0.05). Eventually, higher educational achievements, higher income status and relevant years of work experience were positive predictors for higher risk perception. Conclusion: There is a large room for improving health risk perception and adaptation capacity to heat waves among the brickfield workers. It will be very important to develop health educational programmes and enrich systematic educational resources to raise awareness.

Background: Developing, maintaining, and sustaining undergraduate medical students’ research involvement will enable future healthcare practitioners to practice more appropriate evidence-based clinical medicine. Objective: To assess the participation in health research and factors promoting it among undergraduate medical students in Puducherry. Methodology: A descriptive cross-sectional study was conducted among undergraduate medical students in Puducherry over a period of three months (August-October 2023). Systematic random sampling was applied to recruit 360 study participants based on Chellaiyan et al. A pre-tested, semi-structured questionnaire was used to collect the data, including socio-demographic characteristics, academic performance, participants’ attitudes, perceived motivational and barrier factors towards health research, and current involvement in health research. Data were entered in MS Excel 2019 and analyzed using SPSS v16.0. Results: A total of 360 participants were interviewed, of whom 51.6% were female and the majority (86.7%) were hostelers. Among the 360 study participants, only around one-tenth of the participants”41 (11.39%)” have participated in the health research. The factors of gender, competency-based medical education approach, and grade of the participants in the recent university exam were associated with participation in health research. The majority (90.4%) of the participants were highly motivated to participate in health research. The main barriers identified are lack of funds, collaboration, mentorship, time to conduct, and systematic training in the research methodology. Conclusion: Participation in health research has doubled since the introduction of competency-based medical education. Still, participation could be improved by addressing the identified barriers. Studentship programs, young researcher awards, systematic training programs integrated into the curriculum, etc. could also compute the participation in health research among undergraduate medical students.

Background: Smartphone have revolutionized, and become an integral part of a child’s life. The child’s interaction with these modern devices needs to be assessed because it could have an enormous effect on their behavior, sleep habits, and psychological addiction. Objective: The objective of this study is to determine the pattern of exposure to smartphone, and the association between the exposure and behavioral, functional changes among under-five children in rural Puducherry Methodology: This community based cross-sectional study was done in the field practice area of a private medical college in Puducherry. A multistage sampling technique was used to select 340 eligible participants. A semi- structured questionnaire was used to assess the pattern of exposure, physical, social, and behavioral changes among study participants. The data were analyzed using SPSS software, and p-value of Results: Among 340 children, more than half of participants 180(52.9%) were female. Interestingly, around half of the study participants parents 181(53.2%) accepted that, their children were exposed to smartphone for entertainment purposes, and around one-tenth 35 (10.3%) of the participants viewed screen for more than the recommended screen time for age. Increased smartphone exposure was statistically associated with behavioral, and functional changes. Conclusion: Measures must be undertaken to prevent the deleterious behavioral and functional changes in under-five children due to excessive smartphone usage. Health education sessions and social behavioral change communication should be planned for the parents to protect the budding generation from the negative effects of smartphone usage.

Background: The continuous spread of novel coronavirus (COVID-19) pandemic, home quarantine, strict isolation measures and delays in opening educational institutions across the country is expected to influence the mental health of college students. The aim of our study is to assess the psychological impact and its correlates following the COVID-19 lockdown period, among the MBBS exam going students of a private medical college, Puducherry. Methods: A Descriptive Cross-Sectional Study was conducted among Undergraduate students in a private medical college of Puducherry between January-March 2021. Around 204 exam going students from Pre-final and Final year MBBS were enrolled in the study with their consent. Depression, Anxiety, and Stress among the study participants following the COVID 19 lockdown period was assessed using Depression Anxiety Stress Scale (DASS 21). Data was captured and Spearman`s correlation, Ordinal logistics regression was applied to find the predictors of Depression, Anxiety and Stress. Results: Among 204 study participants, the distribution was almost equal between Pre-Final (52%) and Final year (48%) MBBS students. Prevalence of Stress, Anxiety and Depression among students was found to be 38.2%, 52.8% and 48% respectively. Practicing regular physical activity, history of contact with COVID19 patients, year of MBBS were found to be predictors of Stress, Anxiety and Depression. It was also found that Stress level increases with increase in age. Conclusion: Around half of the study participants have either of the psychological impact following COVID 19 lockdown period that may adversely affect their performance in university exams. Still, there is a scope of further research that could be planned by applying interventions to improve the mental health status of the students.

Invasive Lobular Carcinoma (ILC) is a common form of breast cancer that begins in milk-producing glands lobules and spreads to other parts of the breast. According to the American Cancer Society, about 10–15% of breast cancer cases are ILC. ILC risk rises with age. The number of deaths caused by this cancer each year can be decreased through early diagnosis and if accurate therapy is given. However, diagnosis of ILC is difficult due to its development pattern as it grows as single file strands and not as lumps. Treatments of ILC involve chemotherapy, hormonal therapy and radiation therapy. Drugs that are being used for ILC, are commonly used to treat all types of breast cancer and there are no specific drugs that target receptors of ILC are available. Microarray technology's emergence helps in finding the differentially expressed genes (DEGs) in malignant cells. From the DEGs, highly interacting genes were identified using the online tool, string. Seven key genes were identified based on the interaction and they are FN1, CDKN2A, COL1A1, COL3A1, COL11A1, LEF1 and IL1B. Thus, the drugs targeting these biomarkers were identified by doing molecular docking using the tool Autodock and molecular dynamic (MD) simulation using the tool iMODs. The response of the identified drugs to the ILC cell line was compared with the control drugs by in silico pharmacogenomic analysis and it was found that the identified drugs have a good response to the ILC cell line. This current research focuses on the search for key genes for the diagnosis and therapy of invasive lobular carcinoma using computational methods. The data on the differentially expressed genes of the ILC cell lines help in finding the key genes. Proteins expressed by these key genes are the targets of ILC therapy. Drugs targeting these proteins were found by molecular docking and molecular dynamic simulations. Pharmacogenomic in silico analysis was performed for dose-response prediction. [ABSTRACT FROM AUTHOR]

Background: With advance in technologies, there is a notable shift in healthcare industry towards integrating mobile health solutions. Medical students are at the forefront to be proficient in the use of cutting-edge medical technologies. This study gives insight about the penetration of m-health among the budding young doctors of Puducherry. Materials and Methods: A facility based analytical cross-sectional study was conducted among 390 undergraduate medical students over a period of two months (Aug-September 2023). Pre-tested semi-structured questionnaire was used to estimate the m-health app/device user, usage pattern and attitude towards m-health apps/devices. Data collected in google form and descriptive statistics was done using MS Excel 2019. Chi square test was applied to find the association between study participant characteristic and m-health app/device user. Results: Proportion of the participants using m-health app was 31.8%. The M-health devices used by the participants were smartphone (100.0%), smartwatch (54%), wrist band (32.2%), blood pressure monitoring device (13.7%). They were using for physical fitness (85.5%), clinical training (32.3%) and disease monitoring (26.6%). Around half 46% of the participants were using it for at least once in a day. Majority (91.1%) were highly confident and confident on the results provided by m-health apps/devices. Proportion of male participants using were higher compared to the female participants. Conclusion: Around one-third of the participants are using mhealth. Almost majority for physical fitness. Male gender was associated with m-health app use. Though there are few downsides with the advancing technology it will be addressed with its evolution.

Context: Health of the elderly will be an important issue in defining the health status of a population in coming years. There is a paucity of information with regard to quality of life (QOL) among malnourished elderly. Aims: To assess the QOL among malnourished elderly in a rural field practice areas of tertiary care hospital, Puducherry, and to find the sociodemographic factors associated with QOL among malnourished elderly population. Settings and Design: A community-based cross-sectional study in the rural field areas of Government Medical College of Puducherry. Subjects and Methods: After obtaining ethical approval, the study was conducted among 225 malnourished elderly (>60 years) from April to June 2019 using multistage random sampling technique. Sociodemographic data were obtained using a semistructured questionnaire. Malnutrition was screened using Mini Nutritional Assessment Short Form and QOL was assessed using World Health Organization QOL-BREF questionnaire. Results: The mean and standard deviation of the study participants' age was 69.89 + 6.3 years. 57.8% of them were female, 81.3% were unemployed, and 73.3% were dependent on their old age pension for their livelihood. QOL of malnourished elderly was poor in all the domains when compared to those without malnourished and this is found to be statistically significant. In binomial logistic regression analysis, the presence of comorbidity (adjusted odds ratio [AOR]: 2.4 and 95% confidence interval: 1.3–4.4), unemployed (AOR: 4.8; 1.4–15.9), and living without family (AOR: 0.2; 0.06–0.7) revealed the statistically significant association with low QOL score among malnourished elderly. Conclusions: The mean score of QOL among malnourished elderly was below average in all four domains in which psychosocial domain was badly affected.

Background: Nephron-sparing surgery (NSS) is the standard of care for small renal masses whenever feasible. This study aims to evaluate the perioperative outcomes of NSS performed by open (open partial nephrectomy [OPN]) or laparoscopic (laparoscopic PN [LPN]) or robotic (robotic PN [RPN]) approach over the past 6 years and to study the correlation of histopathological grade of renal cell carcinoma with the RENAL score. Materials and Methods: A retrospective analysis of prospectively collected data of all patients who underwent NSS was done. Results: A total of 135 patients underwent NSS. The mean tumour size was 4.4 cm. About 61 patients underwent OPN, 24 had LPN and 50 had RPN. Although tumour size was larger in OPN group (P = 0.01), tumour complexity based on the RENAL score was similar in OPN and RPN groups (P = 0.15). The OPN group had shorter operative time (P = 0.008) but more blood loss (P = 0.001) and length of hospital stay (P = 0.049) as compared to LPN or RPN group. Maximum radiological diameter of tumour (P = 0.017) appeared to be a significant predictor of operative time, while the open surgical approach (P = 0.003) and tumour stage (P = 0.044) were found to be significant predictors of blood loss. Hilar clamping time was similar in OPN and RPN groups (P = 0.054) but higher in LPN group (P = 0.01). However, post-operative decline in renal function (estimated glomerular filtration rate) (P = 0.08) and margin status were comparable among the three groups. The most common histopathology was clear cell carcinoma (70%), and RENAL score was identified as a significant predictor of histopathological grade of tumour (P = 0.008). Conclusion: Open, laparoscopic and robotic approaches to PN provide similar patient outcomes. OPN was usually preferred for larger tumours. The post-operative decline in renal functions and complications were comparable among the three approaches. RENAL score correlated significantly with histopathological grade and hence could help in predicting tumour behaviour pre-operatively.

The expeditious and world pandemic viral disease of new coronavirus (SARS-CoV-2) has formed a prompt urgency to discover auspicious target-based ligand for the treatment of COVID-19. Symptoms of novel coronavirus disease (COVID-19) typically include dry cough, fever, and shortness of breath. Recent studies on many COVID-19 patients in Italy and the United Kingdom found increasing anosmia and ageusia among the COVID-19-infected patients. SARS-CoV-2 possibly infects neurons in the nasal passage and disrupts the senses of smell and taste, like other coronaviruses, such as SARS-CoV and MERS-CoV that could target the central nervous system. Developing a drug based on the T2Rs might be of better understanding and worth finding better molecules to act against COVID-19. In this research, we have taken a taste receptor agonist molecule to find a better core molecule that may act as the best resource to design a drug or corresponding derivatives. Based on the computational docking studies, the antibiotic tobramycin showed the best interaction against 6LU7 COVID-19 main protease. Aromatic carbonyl functional groups of the molecule established intermolecular hydrogen bonding interaction with GLN189 amino acid and it showed the two strongest carbonyl interactions with receptor protein resulting in a glide score of −11.159. To conclude, depending on the molecular recognition of the GPCR proteins, the agonist molecule can be recognized to represent the cell secondary mechanism; thus, it provides enough confidence to design a suitable molecule based on the tobramycin drug.

We report the influence of β-cyclodextrin on the binding of the drug dronedarone with bovine serum albumin. The stoichiometry, the binding constant, and the mode of binding of the derivative with β-cyclodextrin are studied by UV–Visible absorption, fluorescence, and 2 Dimensional Rotating Frame Overhauser Effect Spectroscopy (2D ROESY NMR) spectroscopic techniques. The structure of the 1:1 inclusion complex is proposed. The binding of free dronedarone with bovine serum albumin and β-cyclodextrin-bound dronedarone are studied by fluorescence quenching and Förster resonance transfer. The decreased magnitude of the Stern–Volmer constant and the binding constant for the interaction of dronedarone with bovine serum albumin in the presence of β-cyclodextrin are articulated. The donor-to-acceptor distances in the presence and the absence of β-cyclodextrin are compared. The binding sites of the dronedarone with bovine serum albumin are reported by molecular modeling. Dronedarone binds to the sub-domain III of bovine serum albumin. The 3-(dibutylaminopropoxy)benzoyl moiety of dronedarone binds with bovine serum albumin. Encapsulation with β-cyclodextrin decreases the binding strength of dronedarone with bovine serum albumin. [ABSTRACT FROM AUTHOR]

In this report, a series of novel 6-(4-(4-aminophenylsulfonyl)phenylamino)-5 H-benzo[ a]phenoxazin-5-one derivatives were synthesized. Their molecular docking with histone deacetylase (HDAC8) and cytotoxicity against cervical cancer cell line (SiHa) were studied. Among all the molecules studied, compounds 3h, 3a, 3e, and 3f exhibited better IC value when compared to the other molecules. All the IC values were compared with the standard drug Doxorubicin (µg/mL) as standard. In the molecules synthesized ( 3a- h), the aromatic sulfonyl group is found in the linker region and the carbonyl group in the aromatic system acts as the zinc-binding group (ZBG). Among the ten molecules docked, compound 3b was the one with the best glide and E model score of −9.23 and −75.81, respectively; which is close to the glide score of Suberoyl Anilide Hydroxamic Acid (SAHA, used as standard). Compound 3a comes next with a glide and E model score of −8.89 and −70.11, respectively. Among the compounds studied, compound 3f exhibited the least glide and E model score of −3.96 and −67.24. The antibacterial study was carried out by agar dilution method, and their minimum inhibition concentration was calculated using Sparfloxacin and Norfloxacin as standards. The compounds 3b, 1, 3c, and 3d exhibited better MIC values against Gram-positive bacteria of Bacillus Subtilis than Sparfloxacin. All the synthesized compounds ( 1, 2, 3a- h) exhibited better MIC values against Gram-negative bacteria of Staphylococcus aureus than Norfloxacin. Among all the molecules studied, the compound 3e exhibited potent antimicrobial MIC value against the Gram-negative bacteria of Proteus vulgaris when compared to the standards used. Graphical Abstract: Compound 1 was synthesized by a green route and was then subjected to phenoxazin cyclization ( 2) with 2-amino phenol, and this product was acetylated in acetone medium without the aid of any base. Compound 3h exhibits better cytotoxicity (22 µg/mL) against cervical cancer cell line, and compound 3b exhibits better antibacterial activity (0.9 µg/mL) against Bacillus Subtilis[Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) infections are associated with a wide spectrum of mucocutaneous diseases ranging from benign skin warts through different grades of precancer to invasive cancer. There are over 120 types of molecularly identified HPVs: With the advances in the understanding of human papillomaviruses, their molecular biology, transforming mechanisms, and etiology of HPV diseases, better primary and secondary prevention strategies can now be designed and implemented. Many more drug derivatives are available to act against HPV among that vaccination was widely used in medication to get relive from the HPV .In this study the factors behind the need of novel antiviral drugs for Human Papilloma viruses most essential to potentate the malignant transformation of the lesions. [ABSTRACT FROM AUTHOR]

BACKGROUND: The role of medical undergraduates is limited while interacting with the community related to issues involving human behavior. Since qualitative research seeks to build a holistic understanding of social phenomena, we designed this project to expose them to the basics of qualitative research in a real-world setting of experiential learning. The aim of this study is to sensitize the medical undergraduates to the basics of qualitative research and able to apply it in the context of experiential learning in the community. MATERIALS AND METHODS: In this current educational intervention, a structured teaching program was designed and applied for the first time, to our students to effectively sensitize them to qualitative research in a natural community setting, intended to provide them a solid base for experiential learning. A batch of students (n = 50) was selected by convenient sampling method who had their clinical postings with us. At first, a “session planning guide” was drawn on the plan of conduction of this program. We followed the “facilitators reference manual by research consortium on educational outcomes and poverty (RECOUP) for our teaching sessions. The framework of our study was executed in the following sequence: sensitization of the learners, exposure to structured quality experience, systematic debriefing sessions with evaluation of learner experiences, and the process and outcome feedbacks from the learners. The students were monitored by trained facilitators. The various study tools used in the structured teaching program included, the teaching sessions using the RECOUP manual, didactic lectures and short group interactive sessions to teach qualitative research and photographs and video clips to facilitate the sessions, mock demonstrations and role plays on interviewing techniques, use of case vignettes on the theme “perception of psychosis” for interviewing the community, structured debriefing guide, and various self-reflective exercises. Learners' perspective of community perception, debriefing sessions, and self-reflective responses were transcribed, and manual content analysis was done to identify the codes and interpret the results. RESULTS: Majority could appreciate the uniqueness of qualitative research over the quantitative counterpart. They could enumerate the attributes of a good qualitative researcher. The debriefing exercises made them summarize their experiences and the self-reflective exercises enabled them to identify their abilities and critique their ideas. It was a different experience to our learners as they could identify themselves with the sentiments of the community. To them, the facilitating points were the interviewing skills and confidence gained in facing the community. However, they felt time constraint for exploring the sensitive issues during the fixed posting schedule. CONCLUSIONS: The experience of learning beyond the boundaries of a classroom setting sensitized them to various community perceptions and reactions. The students perceived the qualitative methods well and could apply the lessons learnt in the facility. They also felt that this learning exposure gave them community orientation and confidence in dealing with community issues.

Introduction: Open radical cystectomy (ORC) is the most common surgical approach for invasive carcinoma of the urinary bladder, but robot-assisted radical cystectomy (RARC) has recently gained popularity. There is limited data from the Indian subcontinent on RARC . The aim of this study was to assess the perioperative, pathological, and oncological outcomes of RARC and follow-up in our initial 63 cases. Materials and Methods: A retrospective analysis of prospectively maintained data of 63 RARC procedures performed in our tertiary care institute from July 2006 to January 2016 was done. All patients underwent RARC with extracorporeal urinary diversion. We analyzed perioperative parameters, length of hospital stay, pathological and oncological outcomes, and rate of complications. Follow-up data were analyzed for disease recurrence and survival. Results: The mean age of the patients was 58 years. The mean American Society of Anesthesiologists (ASA) score was 1.66. Mean operative time was 348.6 min and mean blood loss was 868.2 ml. Mean hospital stay was 10.4 days (±5.4 days). 42.8% patients had pT2 disease, 49.2% pT3, 1.58% pT1, and 6.34% had pT4 disease. Mean lymph node yield was 12.4 (3-25). One patient had positive surgical margins. Twenty-four patients had postoperative complications of which four were major complications (Clavien-Dindo 3 or higher). At a median follow-up of 60 months (range: 3–108 months), 11 patients were lost to follow-up 10 patients developed metastasis, out of which 4 died. Four had recurrence, two died and two are receiving chemotherapy. Conclusion: This study shows the feasibility and safety of RARC. The operative time, blood loss, return of bowel activity and hospital stay were higher than those reported in the literature but may reflect the learning curve.

The whole plant ethanol and chloroform aqueous extract of Heliotropium indicum Linn. showed promising antibacterial, antifungal activities. (Family: Boraginaceae) were separately evaluated for their antifungal and antimicrobial activity using micro organism. The extracts were obtained by concentration in vacuo at 40oC using rotary evaporator. Phytochemical screening of the extracts showed the presence of Alkaloids, saponins, tannins, glycosides, carbohydrates, phytosterols, and flavonoids while phlobotamins, steroids, coumarin and cardiac glycosides are absent in all the crude extracts. The antimicrobial screening of the extracts showed significant zones of inhibition against 70% of the test organisms. The Minimum Inhibition Concentration (MIC), Minimum Bactericidal Concentration (MBC) and Minimum Fungicidal Concentration (MFC) against various organisms were conducted. The antimicrobial analysis of the isolated components was also conducted. These prove the folkloric usage of the plant and also indicated a broad spectrum activity of the plant extracts. The methanolic extract afforded white crystalline solids which were characterized using Infra-red Spectroscopy. [ABSTRACT FROM AUTHOR]

Introduction: Apart from the complexity of procedure and surgeon's experience, surgical complication rates depend on case definition and method of recording data. We prospectively evaluated the complications of laparoscopic nephrectomy (LN) in a current cohort of patients, graded on the modified Clavien–Dindo (CD) scale and compared them with historical cohorts. Methods: In the Institutional Review Board approved protocol, all patients undergoing LN over a 30-month were enrolled in the study. Clinical parameters, operative data, inhospital course, and 30-day follow-up were recorded prospectively in an electronic database by a resident who did not perform any of the surgeries. The complications were analyzed using the CD scale. Results: A total of 103 patients (age 14–80 years) underwent LN (30 radical, 73 simple) during the study period. Forty-three of these procedures were for inflammatory conditions (stone disease or tuberculosis). Six procedures were converted to open surgery due to vascular injury (2), bowel injury (1), and adhesions (3). There were 45 (46%) complications in the 97 procedures completed laparoscopically including 34 low-grade (CD grade 1, 2) and 11 high-grade (CD grade 3, 4) complications. There was no mortality. Complications were similar in patients undergoing surgery for inflammatory or noninflammatory conditions. Conclusions: LN continues to be associated with postoperative complications in 46% of cases. However, the complication rates appear to be higher than historical series, possibly due to the more rigorous case-definition and prospective recording.