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Introduction The Gonds tribe, indigenous to the Sonbhadra region in Uttar Pradesh, India, faces unique challenges and disparities in women’s health, particularly in the domains of menstrual health, pregnancy, and postpregnancy care. This study aims to shed light on the demographic patterns of these critical aspects of women’s health among the Gonds tribe, providing valuable insights for healthcare interventions and policy development. Aim This study explores the demographic and socioeconomic factors affecting Gond women’s health, focusing on menstrual hygiene and life stages before, during, and after pregnancy. Methodology We collected data on menstruation wellness behaviors, pregnancy experiences, and postpregnancy care by conducting an extensive survey among Gonds women in the Sonbhadra area. In addition, focus groups and qualitative interviews were used to acquire greater knowledge of the socioeconomic and social factors impacting these health-distinctive characteristics. Result The Chi-square test shows no significant link between age group and menstrual hygiene product use. Young women (under 18) mostly use cotton cloth (56%). Women aged 18–49 prefer cotton cloth (53.2%). Women 50+ use cotton cloth (43.2%), cotton (29.7%), and sanitary napkins (27%). Marital status affects product use and cycle regularity. Cultural beliefs and education influence healthcare decisions. Menstrual hygiene mainly involves cotton cloth (45%) and cotton (26.1%). Conclusion In conclusion, our analysis uncovers key insights: Marital status, healthcare access, education, cultural beliefs, and reproductive health practices influence community healthcare decisions. These findings inform tailored interventions to enhance health outcomes and equity.

Background: Despite advancements in treatment, patients with Parkinson’s disease (PD) experience a range of symptoms that affect their quality of life. There is a need to integrate neuropalliative care into standard care. The aim of the study is to understand the psychosocial functioning in persons with PD and explore their caregivers’ burden. Methods: The study utilizes a mixed-methods design where 50 patient–caregiver dyads attending the outpatient services of the movement disorder clinic at a tertiary care hospital were measured on psychosocial functioning and caregiver burden and palliative care outcomes for a period of 6 months. Focus group discussions were conducted with 18 patient–caregiver dyads to understand the needs of palliative care. Results: It was found that caregiver burden was positively correlated with palliative care outcomes scores of patients (r = 0.586) and caregivers (r = 0.675) and psychosocial functioning was positively correlated with palliative care outcomes of patients (r = 0.708). The psychosocial functioning score was higher among female patients (indicating worse functioning) than males, and female caregivers experienced significantly higher caregiver burden. The qualitative findings reveal that there is a substantial gap in awareness about palliative care, lack of information, presence of stigmatizing beliefs, and lack of adequate accessibility to palliative facilities. Conclusion: The study lays the foundation for future PD neuropalliative care research, guiding interventions, and exploration of regional variations in PD experiences in India. There is a need to address caregiver burden in PD in India.

Recently, a plethora of advancements have been made in the area of polysaccharide research to improve their properties for human health care. The present research is an attempt to develop hydrogels from through grafting of methacrylamide (MAAm) and vinyl sulphonic acid (VSA) co monomers onto psyllium for use in drug delivery (DD) applications. Copolymer hydrogels were characterized by scanning electron micrographs (SEM), Atomic force microscopy (AFM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), 13C nuclear magnetic resonance (13C NMR), thermogravimetric analysis (TGA) and differential thermal analysis (DTG). SEM, AFM and XRD revealed heterogeneous morphology of the copolymer hydrogels with surface roughness and amorphous state of polymer chains in copolymer hydrogels due to graft-copolymerization reactions. The appearance of the FTIR bands at 1636.87 (amide-I), 1618.11 cm−1 (amide- II), 1469.58 cm−1 (amide- III) indicated presence of amide and bands at 1167.12 cm−1, 1112.06 cm−1 band (symmetric vibrations of SO3H groups and anti-symmetric & symmetric stretching modes of C–S) presence of VSA. The appearance of bands at 181.801 ppm and 62.053 ppm indicated presence of CO carbon of functional groups poly (MAAm) and −CH2–SO3H of poly (VSA) in copolymer hydrogels. Diffusion of the antibiotic drug vancomycin occurred in sustained manner with a non-Fickian diffusion mechanism. The release profile was best described by Korsmeyar-Peppas kinetic model. The copolymers exhibited biocompatible nature and revealed haemolytic index less than 5 % during polymer-blood interactions. The hydrogel demonstrated mucoadhesive character and required 0.135 ± 0.01 N force to detach from mucous membrane. These properties demonstrated the suitability of copolymer hydrogels for drug delivery applications.

Drawing on an analysis of 208 articles, this paper argues that while the fraud literature varies on the diagnosis of fraud, it is rooted in a common narrative as to its nature and causes. Specifically, this paper adopts an investigative approach to understand how fraud is often researched and shapes audit policies and practices. The findings reveal that fraud is generally looked at as an individual and/or organizational phenomenon, thereby allowing the meso-level of analysis to escape scrutiny. A gap, therefore, exists in being able to detect fraud at the meso-level, such as in financial services (i.e., LIBOR rigging). A meso-level analysis of fraud will allow researchers to highlight problems across the general field like the banks rigging the LIBOR or distorting the currency market as in the forex scandal. A meso-level analysis of fraud is important because it highlights the contagious behavior across the field and offers insights for fraud prevention and detection. Recognizing this unique epistemology will allow researchers to uncover new knowledge and not remain wedded to a reified understanding of fraud and fraud risks. Policymakers can derive insights and draft policies that reflect practitioners’ needs.

Background & objectives: The main aim of this research is to provide literature on the Ocimum plant, and to know the significance of the Ocimum species carried out by pharmacognostic study and experimental design for GC-MS. Ocimum genus are very important for their therapeutic potential among the most important aromatic herbs. Methods: Extreme attention has been put on literature reports in which the utilization of tulsi and their pharmacognostic study has been done by performing morphological and microscopic leaf experimental design and by using essential oil through the GC-MS instrumentation method. Results: The utilization of these characteristics would be important for the drug discovery scientist to develop a specific formulation of the crude drug, which will be a magical therapeutic agent in the future, with many advantages. GC-MS chromatogram of Ocimum sanctum, Ocimum canum, and Ocimum gratissimum oil showed major peaks and has been identified after comparison of the mass spectra with the NIST library, indicating the presence of three phytocomponents. From the results, the GC-MS study suggested that anethole which is well reported antimicrobial compound is more in O. canum (2.66%) in comparison to O. sanctum (1,28%) but absent in O. gratissimum. The results indicated that the antimicrobial activity is more in O. canum due to the presence ofa high amount of anethole in comparison to O. gratissimum and O. sanctum. Interpretation & conclusion: The result revealed that O. canum has a microscopic character that can be identified by the characteristic GC MS analysis of extracts to distinguish between different species of the ocimum plant.

Neuropalliative care is an emerging sub-specialty of neurology and palliative care that aims to relieve suffering from symptoms, reduce distress and improve the quality of life of people with life-limiting neurological conditions and their family caregivers. As advances are being made in the prevention, diagnosis, and treatment of neurological illnesses, there is an increasing need to guide and support patients and their families through complex choices involving immense uncertainty and important life-changing outcomes. The unmet need for palliative care in neurological illnesses is high, especially in a low-resource setting like India. This article discusses the scope of neuropalliative care in India, the barriers and challenges that impede the specialty's development, and the factors that could facilitate the development and scale-up delivery of neuropalliative services. The article also attempts to highlight priority areas for advancing neuropalliative care in India which include context-specific assessment tools, sensitization of the healthcare system, identification of intervention outcomes, the need for developing culturally sensitive models based on home-based or community-based care, evidence-based practices, and development of manpower and training resources.

Mucocutaneous diseases are the most common manifestation of human immunodeficiency virus and because of abnormal presentation, diagnosis and management is a challenge for clinicians. Here, we present three cases of unusual and severe presentation of common sexually transmitted diseases, out of which two patients had ulcerative lesions in genitals and one patient had cauliflower-like growth involving the pubic and anal region.

Plain language summary Menstrual hygiene management (MHM) and practices by adolescent females of low and middle-income countries (LMICs) are severe problems for girls, parents, society, and policymakers. Menstrual-related problems are widespread among adolescent girls in India. Different menstrual abnormalities are found in different populations, suggesting socio-cultural and regional variation. Menstrual abnormalities and disorders are frequently linked to physical, mental, social, psychological, and reproductive issues, affecting adolescents' daily lives and their families lives by various psychosocial problems such as anxiety. We have the intention to compile, summarise, and critically analyse peer-reviewed and published scientific evidence from 2011 to 2021 on menstrual hygiene management methods used, most typical menstrual morbidities and their associated factors among Indian adolescent girls, and to evaluate the evidence for existing interventions like educational programs and absorbent distribution. Program planners and policymakers could use the findings of this study to build relevant initiatives to incorporate safe MHM in the country so that interventions can be designed taking into account the current needs of adolescent girls to reduce menstrual morbidities and improve their quality of life. A statistically significant improvement in knowledge and practice on menstruation was observed. Learning about menstrual hygiene and health is an essential aspect of adolescent girls’ health education to continue working and maintaining hygienic habits. Infections of the reproductive system and their repercussions can be avoided with better awareness and safe menstruation practices.

Introduction: Cognitive dysfunction is a hallmark feature of many psychiatric disorders. We aimed to study the prevalence and predictors of cognitive dysfunction (CD) among U.S. high school students and its association with time spent on digital devices. Methods: We performed a cross-sectional survey study using YRBSS 2019 data of U.S. high school students in grades 9–12. Cognitive dysfunction was defined by difficulties with remembering, concentrating, and making decisions due to emotional, physical, or mental problems. Digital screen time was described by daily time spent on TV, computers, tablets, and phone. We performed univariate and multivariable survey logistic regression analysis to identify the prevalence of cognitive dysfunction and its association with time spent on digital devices. Results: Out of 10,317 total participants, 3914 (37.9%) reported CD. The prevalence of CD was higher in females compared to males (46.0% vs. 29.9%). Compared to participants with no CD, participants with CD reported substance abuse, such as alcohol (35.8% vs. 26.6%), marijuana (28.3% vs. 17.6%), cigarette (8.1% vs. 4.7%), and illicit drugs (18.9% vs. 9.0%) and they reported a higher prevalence (p < 0.0001 for all substances). Participants who felt sad and hopeless (62.8 vs. 22.1%) reported a high prevalence of CD, whereas participants with adequate sleep reported low prevalence (15.7% vs. 25.6%). In a regression, daily video game/internet use for non-work-related activities for 4 h (aOR:1.27; p = 0.03) and ≥5 h (aOR:1.70; p < 0.0001) demonstrated higher odds of CD, compared to participants with no daily use. Female sex, substance use, and depressed mood were additional predictors of CD. Conclusion: The prevalence of CD is high in U.S. high-school students. Female sex, substance abuse, depressed mood, and excessive VG/PC use is associated with high odds of cognitive dysfunction. Further research is needed to explore the complex relationship between screen time and cognitive dysfunction.

An unprecedented global health crisis has developed due to the emergence of the mysterious coronavirus-2 of the severe acute respiratory syndrome, which has resulted in millions of deaths around the globe, as no therapy could control the ‘cytokine storm’. Consequently, many vaccines have been developed and several others are being developed for this infection. Although most of the approved vaccines have been highly effective, many developing, and economically poor countries are still deprived of vaccination against SARS-CoV-2 due to the unequal distribution of vaccines worldwide. Furthermore, the uncertainty about the effectiveness of the available vaccines against the emerging mutants and variants also remains a matter of concern. Due to the multistep pathogenesis and unique features, combination therapy using safe immunomodulatory and antiviral drugs should be considered as the most effective and acceptable therapeutic regimen for this infection. Based on a thorough assessment of the literature, it was determined that it would be interesting to study the therapeutic potential of ivermectin and doxycycline, given their roles in several biological pathways involved in SARS CoV-2 pathogenesis. Following that, a comprehensive literature search was undertaken using Scopus, Web of Science, and Pubmed, depending on the inclusion and exclusion criteria. The present study provides a mechanism and comprehensive report, highlighting the role of combined therapy with ivermectin and doxycycline in alleviating the ‘cytokine storm’ of COVID-19 infection.

Antibody engineering has developed into a wide-reaching field, impacting a multitude of industries, most notably healthcare and diagnostics. The seminal work on developing the first monoclonal antibody four decades ago has witnessed exponential growth in the last 10–15 years, where regulators have approved monoclonal antibodies as therapeutics and for several diagnostic applications, including the remarkable attention it garnered during the pandemic. In recent years, antibodies have become the fastest-growing class of biological drugs approved for the treatment of a wide range of diseases, from cancer to autoimmune conditions. This review discusses the field of therapeutic antibodies as it stands today. It summarizes and outlines the clinical relevance and application of therapeutic antibodies in treating a landscape of diseases in different disciplines of medicine. It discusses the nomenclature, various approaches to antibody therapies, and the evolution of antibody therapeutics. It also discusses the risk profile and adverse immune reactions associated with the antibodies and sheds light on future applications and perspectives in antibody drug discovery.

Objectives: Obsessive–compulsive disorder (OCD) is estimated to be the 10th leading cause of disability in the world with a point prevalence of OCD at 3.3%. The present study was aimed at understanding the role of insight and self-efficacy in OCD and the relationship between these variables with OCD severity. Materials and Methods: It was a cross-sectional correlational study. The sample consisted of 100 males and females with a diagnosis of OCD. The variables were measured using the Yale-Brown Obsessive–Compulsive Scale (Y-BOCS) Symptom Checklist, Y-BOCS II, Brown Assessment of Beliefs Scale, and Self-Efficacy Scale. Results: The study revealed that a large portion of the patients fell in the “Severe”' range on Y-BOCS. Females reported a higher percentage of contamination and ordering obsessions as compared to males. Thirty-seven percent (37%) of the patients scored “Average” on self-efficacy results. A positive correlation between OCD severity and insight was found. Conclusion: Findings have important implications in clinical settings and can be used in the development of more focused, brief intervention strategies based on insight and self-efficacy. The primary limitation of the study was that data were obtained in a tertiary care hospital from an urban setting.

Abstract C‐reactive protein (CRP) is an early‐stage acute phase protein and highly upregulated in response to inflammatory reactions. We recently identified a novel mechanism that leads to a conformational change from the native, functionally relatively inert, pentameric CRP (pCRP) structure to a pentameric CRP intermediate (pCRP*) and ultimately to the monomeric CRP (mCRP) form, both exhibiting highly pro‐inflammatory effects. This transition in the inflammatory profile of CRP is mediated by binding of pCRP to activated/damaged cell membranes via exposed phosphocholine lipid head groups. We designed a tool compound as a low molecular weight CRP inhibitor using the structure of phosphocholine as a template. X‐ray crystallography revealed specific binding to the phosphocholine binding pockets of pCRP. We provide in vitro and in vivo proof‐of‐concept data demonstrating that the low molecular weight tool compound inhibits CRP‐driven exacerbation of local inflammatory responses, while potentially preserving pathogen‐defense functions of CRP. The inhibition of the conformational change generating pro‐inflammatory CRP isoforms via phosphocholine‐mimicking compounds represents a promising, potentially broadly applicable anti‐inflammatory therapy.

We develop integrated co-evolution and dynamic coupling (ICDC) approach to identify, mutate, and assess distal sites to modulate function. We validate the approach first by analyzing the existing mutational fitness data of TEM-1 β-lactamase and show that allosteric positions co-evolved and dynamically coupled with the active site significantly modulate function. We further apply ICDC approach to identify positions and their mutations that can modulate binding affinity in a lectin, cyanovirin-N (CV-N), that selectively binds to dimannose, and predict binding energies of its variants through Adaptive BP-Dock. Computational and experimental analyses reveal that binding enhancing mutants identified by ICDC impact the dynamics of the binding pocket, and show that rigidification of the binding residues compensates for the entropic cost of binding. This work suggests a mechanism by which distal mutations modulate function through dynamic allostery and provides a blueprint to identify candidates for mutagenesis in order to optimize protein function.

Introduction: Keeping in view the role of polysaccharide gums in pharmaceutical applications. Herein this research, Moringa gum (MOG) and Sterculia gum (SG) polysaccharides have been explored to design the network structure in the form of hydrogels which can act as a wound dressing for better wound healing. Both gums are hydrophilic stem exudate and their anti-fungal and antioxidant activities have been reported for wound healing which can help the increase in wound healing potential of the antibiotic drug encapsulated hydrogel dressings. Objectives: To design the moringa gum, sterculia gum and polyacrylic acid based hydrogel wound dressings by graft copolymerization method impregnated with antibiotic drug levofloxacin for better wound care. Methodology: The co-polymers were prepared by grafting and crosslinking of the polyacrylic acid onto MOG and SG. The copolymers were characterized by cryo-SEM, AFM, FTIR, 13C NMR and swelling studies along with the evaluation of blood compatibility, wound fluid absorption, antioxidant activity, permeability (O2, H2O and, microbial), mucoadhesion, mechanical and in vitro release dynamics of antibiotic drug levofloxacin. Results and conclusion: The Cryo-SEM and AFM images of the hydrogels showed the porous nature and rough surface morphology of the hydrogels. The porosity in the hydrogel controlled the wound fluid absorption and drug diffusion from dressing. The release of the levofloxacin from MOG-cl-SG-co-poly(AAc) hydrogel occurred by the non-Fickian diffusion mechanism and release profile was best fitted in the Korsmeyer-Peppas kinetic model of drug release in the simulated wound fluid . The gum-based dressings were found permeable and antioxidant in nature. Overall, these hydrogels could be proposed as suitable materials for biomedical applications including drug delivery and wound dressing for better wound care.

Abstract P2Y12 blockade improves patient outcomes after myocardial infarction. As well as antithrombotic effects, anti-inflammatory effects may contribute to this beneficial clinical outcome. Here we aimed to identify potential anti-inflammatory effects of P2Y12 receptor blockers on monocytes and macrophages. Using flow cytometry, migration assays, flow chambers and RNA microarrays, we investigated the effects of adenosine diphosphate (ADP) and P2Y12 receptor blockers on blood monocytes, THP-1 monocytes and THP-1 monocytes after differentiation to macrophages. P2Y12 -expressing platelets can form aggregates with monocytes in circulating blood. Mediated by platelets, ADP results in activation of the integrin receptor Mac-1 on blood monocytes, as detected by the conformation-specific single-chain antibody MAN-1. Via the same association with platelets, THP-1 monocyte adhesion to the endothelial intercellular adhesion molecule 1 (ICAM-1) is induced by ADP. P2Y12 receptor blockers prevent these ADP effects on monocytes. Interestingly, in contrast to THP-1 monocytes, THP-1 monocytes, after differentiation to macrophages, directly expressed the P2Y12 receptor and consequently ADP was found to be a potent chemoattractant. Again, P2Y12 receptor blockers antagonised this effect. Accordingly, stimulation of THP-1 macrophages with ADP caused a substantial change in gene expression pattern and upregulation of several genes associated with inflammation and atherogenesis. These data establish novel anti-inflammatory effects of P2Y12 receptor blockers on monocytes and macrophages, which are expected to contribute to cardiovascular risk reduction.

The Indian leafwing butterfly Kallima paralekta (Horsfield, 1829) (Nymphalidae) is an Asian forest-dwelling, leaf-mimic. Genome skimming by Illumina sequencing permitted assembly of a complete circular mitogenome of 15,200 bp from K. paralekta consisting of 79.5% AT nucleotides, 22 tRNAs, 13 protein-coding genes, two rRNAs and a control region in the typical butterfly gene order. Kallima paralekta COX1 features an atypical CGA start codon, while ATP6, COX1, COX2, ND4, ND4L, and ND5 exhibit incomplete stop codons completed by 3’ A residues added to the mRNA. Phylogenetic reconstruction places K. paraleckta within the monophyletic genus Kallima, sister to Mallika in the subfamily Nymphalinae. These data support the monophyly of tribe Kallimini and contribute to the evolutionary systematics of the Nymphalidae.

Microorganisms swimming through viscous fluids imprint their propulsion mechanisms in the flow fields they generate. Extreme confinement of these swimmers between rigid boundaries often arises in natural and technological contexts, yet measurements of their mechanics in this regime are absent. Here, we show that strongly confining the microalga Chlamydomonas between two parallel plates not only inhibits its motility through contact friction with the walls but also leads, for purely mechanical reasons, to inversion of the surrounding vortex flows. Insights from the experiment lead to a simplified theoretical description of flow fields based on a quasi-2D Brinkman approximation to the Stokes equation rather than the usual method of images. We argue that this vortex flow inversion provides the advantage of enhanced fluid mixing despite higher friction. Overall, our results offer a comprehensive framework for analyzing the collective flows of strongly confined swimmers.

Behavioral addiction has been defined as a repeated behavior which is perceived as pleasurable and which persists over a significant period, is not reduced by the person, and leads to significant functional impairment. In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the only condition that is currently included in the category for behavioral addiction is gambling disorder, while internet gaming disorder included in Appendix III as a potential addition to the category. However, recent research in the field of behavioral addiction has reported several other maladaptive behaviors, a significant one of them being maladaptive daydreaming (MD). Maladaptive daydreaming (MD) has been described as engagement in fanciful daydreaming for hours, leading to neglect of real-life relationships and responsibilities, resulting in clinical distress and functional impairment. This case series describes two cases of “MD” referred to the behavioral addiction clinic of the psychiatry outpatient department of a tertiary hospital in North India from a phenomenological perspective.

A subset of expressed genes is associated with a broad H3K4me3 (histone H3 trimethylated at lysine 4) domain that extends throughout the gene body. Genes marked in this way in normal cells are involved in cell-identity and tumor-suppressor activities, whereas in cancer cells, genes driving the cancer phenotype (oncogenes) have this feature. Other histone modifications associated with expressed genes that display a broad domain have been less studied. Here, we identified genes with the broadest H3K79me2 (histone H3 dimethylated at lysine 79) domain in human leukemic cell lines representing different forms of leukemia. Taking a bioinformatic approach, we provide evidence that genes with the broadest H3K79me2 domain have known roles in leukemia (e.g., JMJD1C). In the mixed-lineage leukemia cell line MOLM-13, the HOXA9 gene is in a 100 kb broad H3K79me2 domain with other HOXA protein-coding and oncogenic long non-coding RNA genes. The genes in this domain contribute to leukemia. This broad H3K79me2 domain has an unstable chromatin structure, as was evident by enhanced chromatin accessibility throughout. Together, we provide evidence that identification of genes with the broadest H3K79me2 domain will aid in generating a panel of genes in the diagnosis and therapeutic treatment of leukemia in the future.

Context: Holoptelea integrifolia is most widely used as a traditional ethnomedicine in India by the local tribal, especially for the treatment of hyperglycemia and as an anti-inflammatory drug. Aims: To evaluate the acute oral toxicity, in vivo anti-inflammatory and in vitro antioxidant therapeutic potential of chloroform and n-butanol fractions of H. integrifolia barks and leaves using appropriate experimental models. Methods: Acute oral toxicity of chloroform and n-butanol fractions were evaluated by 423-acute toxic class method using OECD guidelines. The anti-inflammatory effect of chloroform and n-butanol fractions of H. integrifolia barks (CHIB) and leaves (CHIL) were evaluated at 400 mg/kg (po) on carrageenan-induced hind paw edema in Wistar rats. The observed anti-inflammatory effect was compared to the reference drug, indomethacin (10 mg/kg). The total reducing power of both fractions was determined in vitro and the results were compared with ascorbic acid. Results: The TLC analysis of the bark and leaf extracts revealed the presence of beta-sitosterol. The results of the evaluation of the anti-inflammatory activity of CHIB and CHIL fractions showed a time-dependent reduction of carrageenan-induced paw edema in statistical analysis. In addition, chloroform fraction of H. integrifolia was found to show notable antioxidant activity against hydrogen peroxide radicals scavenging. Conclusions: Experimentally studied CHIB and CHIL possessed interesting anti-inflammatory and antioxidant potential without inducing any apparent acute toxic properties. These pharmacological effects may be attributed, at least in part, to the presence of phenolic compounds/steroidal terpenoids. These results provide scientific support for the traditional use of H. integrifolia in the management of various inflammatory diseases.

Maladaptive daydreaming (MD) is an immersive fantasy activity that leads to distress and socio-occupational dysfunction. MD has many features suggestive of behavioural addiction, but research exploring the phenomenology of this clinical construct is limited. MD has also been purported to be a maladaptive strategy to cope with distress, but often leads to uncontrollable absorption in fantasy world, social withdrawal and neglected aspects of everyday life. In this paper, we report the case of a 16-year-old boy who developed internet gaming disorder and MD after experiencing cyberbullying from his peers. The patient engaged in vivid, fanciful imagery that lasted for hours, leading to social dysfunction and academic deterioration. Baseline assessment revealed a Maladaptive Daydreaming Scale-16 score of 65 (cut-off 50) and an Internet Gaming Test-20 score of 86 (cut-off 71). The patient was managed primarily with psychological intervention. The therapy focused on behaviour modification and cognitive restructuring. Patients in clinical setting should be questioned about MD when presenting with excessive use of technology or other forms of behavioural addictions. Further studies are necessary to determine the biopsychosocial factors of MD and its correlates. There is also a need to study treatment and management approaches for treating MD.

The COVID-19 has emerged as a public health emergency across the globe. Countries all over the world have been forced to enforce nationwide lockdowns to curb the transmission of this illness, affecting millions of people. The disorder and the lockdowns enforced have resulted in a complex set of psychosocial stressors in the lives of people, affecting their resilience and causing psychological stress and mental health issues. In this case series, we aim to highlight the role of such psychosocial stressors in causing mental health problems, especially in a vulnerable individual. The first case reports the onset of first-episode mania in a healthy individual with a family history of mental illness, after the sudden demise of the patient’s mother due to COVID-19. The second case highlights the onset of psychosis in an adolescent girl following academic stress due to the inability to carry on her education through online classes. The third case demonstrates the exacerbation of dissociative episodes in a child following the financial crisis in the family during the lockdown period. In low-income to middle-income countries such as India, there is a complex interplay of the psychosocial stressors due to the COVID-19 pandemic with pre-existing issues such as poverty, socioeconomic disparity and inequity of resources leading to a ‘double hit’ for people from disadvantaged sections of the society and individuals with pre-existing mental illness or vulnerability for mental illness.

BackgroundPeople living with human immunodeficiency virus (PLWH) are at risk of developing pulmonary hypertension (PH) and right ventricular (RV) dysfunction, but understanding of the relationship of RV function to afterload (RV-PA coupling) is limited. We evaluated the clinical and hemodynamic characteristics of human immunodeficiency virus (HIV)-associated PH.MethodsWe performed a retrospective review of patients with a diagnosis of HIV undergoing right heart catheterization (RHC) from 2000-2016 in a tertiary care center. Inclusion criteria were diagnosis of HIV, age ≥ 18 years and availability of RHC data. PH was classified as either pulmonary arterial hypertension (PAH; mean pulmonary arterial pressure [mPAP] ≥ 25mmHg with pulmonary artery wedge pressure [PAWP] ≤ 15mmHg) or pulmonary venous hypertension (PVH; mPAP ≥ 25mmHg with PAWP > 15). We collected demographics, CD4 cell count, HIV viral load, RHC and echocardiographic data. The single beat method was used to calculate RV-PA coupling from RHC.ResultsSixty-two PLWH with a clinical likelihood for PH underwent RHC. Thirty-two (52%) met PH criteria (15 with PAH, 17 with PVH). Average time from diagnosis of HIV to diagnosis of PH was 11 years. Eleven of 15 individuals with PAH were on antiretroviral therapy (ART) while all 17 patients with PVH were on ART. Compared to PLWH without PH, those with PH had an increased likelihood of having a detectable HIV viral load and lower CD4 cell counts. PLWH with PAH or PVH had increased RV afterload with normal RV contractility, and preserved RV-PA coupling.ConclusionPLWH with PH (PAH or PVH) were more likely to have a detectable HIV viral load and lower CD4 count at the time of RHC. PLWH with PAH or PVH had increased RV afterload, normal RV contractility, with preserved RV-PA coupling suggestive of an early onset, mild, and compensated form of PH. These results should be confirmed in larger studies.

Buckling and wrinkling are instabilities which involve thin elastic sheets and are well-investigated phenomena at the macroscale. Here Saikia et al. investigate curvature instabilities at the colloidal lengthscale in quasi-2D monolayers of rod-like viruses across the fluid-crystal phase transition.

Aims: The aim of this study was to assess for and compare the effect of prone and supine position on cardiorespiratory outcome among infants with respiratory distress (RD) and to screen any complications during positioning. Settings and Design: Quantitative experimental research approach was adopted for the study. It was a randomized clinical trial with parallel group design conducted in pediatric unit of St. Stephen's Hospital, Delhi. Methods: The population comprised infants with RD having a score of 3–7 Downes score system scale admitted in pediatric unit. Participants were randomized and treatment allocation by permuted block design. No blinding was done. Pre- and post-intervention cardiorespiratory outcomes (heart rate [HR], respiratory rate [RR], oxygen saturation level (SpO2), and RD) were assessed. Statistical Analysis Used: SPSS version 20 was used for our analysis. Descriptive and inferential statistics was used for the analysis. Results: Total sample size included 60 infants with RD, 30 in each group (prone and supine position). The analysis showed that both intervention group had led to an improvement in HR, RR, SpO2, and RD with both group, but the effectiveness was more among the infants receiving prone position as evidenced by the pre- and post-intervention mean changes for all the variables (HR, RR, SpO2, and RD). Conclusions: The present study revealed that the introduction of prone position leads to an improvement in HR, RR, SpO2, and RD among infants with RD, without any complications such as apnoea or vomiting as compared to supine position.

Introduction. Listeria monocytogenes is a food-borne pathogen which can cause invasive infection in immunocompromised adults. Listeria has been known to cause infections during pregnancy and in older adults. Listeria endocarditis is a rare condition. A case of listeria-related intracardiac device infection is reported below. Case Report. A 74-year-old male with a past medical history of coronary artery disease, congestive cardiac failure, permanent atrial fibrillation status after nodal ablation, and placement of a biventricular pacemaker presented to the hospital with complaints of generalized fatigue. He was found to have listeria bacteremia, and transthoracic echocardiogram (TTE) showed pacemaker lead vegetation. The patient was treated with 6 weeks of vancomycin followed by oral suppression with amoxicillin. Discussion. Listeria can affect native valves, prosthetic valves, or nonvalvular intracardiac devices. The mean age of prosthetic valve endocarditis has been reported to be 67 years with male-to-female ratio 1.7 : 1 and mitral-to-aortic valve ratio 1.3 : 1. There have been case reports of listeria prosthetic valve endocarditis; however, there is paucity of literature on listeria-related pacemaker lead infection. Treatment is mostly a combination of penicillin and aminoglycosides for 4–6 weeks. Surgical removal of the infected device is preferred. Invasive listeriosis is a rare but fatal entity which should be identified and treated promptly to ensure a good outcome.

Water quality of Ganges river was evaluated using the Water Quality Index (WQI) tool. Water sampled at five designated locations from Rishikesh to Allahabad (about 720 km long stretch). Collected samples were measured by ion chromatography, titrimetry and aquameter kit methods. The parameters like pH, electrical conductivity (EC), dissolved oxygen (DO), total dissolved solids (TDS), turbidity, salinity, major cations e.g. Na+, K+, Mg2+, Ca2+, major anions e.g. F-, Cl-, SO42-, NO32- and alkalinity of samples were measured at designated locations. Subsequently, WQI has been calculated from all the measured parameters. The result showed WQI of Ganges river water from Rishikesh to Allahabad ranged from 28.93 to 73.24 which denotes degradation of water quality along the downstream. In addition, values of most of the evaluated parameters increased significantly along the downstream of river suggesting that local environmental pollutants contributed incrementally in deterioration of the quality of river water. Pearson correlation matrix analysis showed a strong correlation between some of the measured parameters suggesting their origin from common source. WQI values showed easy understanding and trend of water quality of Ganges river. These results point towards requirement of urgent plans for prevention of river water pollution.

Introduction: Dentoalveolar trauma is a very common and avulsion is the most frequent injury. Treatment of choice following avulsion is immediate reimplantation. However, in cases where this might not be possible the prognosis of reimplanted teeth can be improved by the selection of an appropriate storage media. Prevention of ankylosis and replacement resorption depends more on the potential of storage media to maintain cell viability rather than the extraalveolar time period. Aim: To compare and evaluate the efficacy of different storage media in maintaining the viability of Periodontal Ligament (PDL) cells in an avulsed tooth. Materials and Methods: A total of 58 freshly extracted human premolar teeth were divided into four experimental groups and two control groups. The positive and negative controls corresponded to 0 minute and an eight hours dry time, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in one of the four media: Hank’s Balanced Salt Solution (HBSS), coconut water, aloe vera and saline for 45 minutes. The teeth were then treated with Collagenase Type II and Dispase for 30 minutes. The number of viable PDL cells were counted with a haemocytometer and analysed. The statistical analysis was done using SPSS version 15.0. The Analysis of Variance (ANOVA) and Post-hoc tests (Tukey-HSD) were performed to reveal the statistical significance. The values were represented in number (%) and mean±SD. Results: Statistical analysis demonstrated that among the experimental groups maximum percentage of viable cells were seen in HBSS (87.33%) followed by coconut water (79.87%), aloe vera (70.59%) and saline (50.56%). Conclusion: Within the parameters of this study, it can be concluded that the HBSS is the most effective storage media in maintaining the viability of PDL cells. However, in Indian scenario where availability of HBSS is questionable, coconut water can be considered as the best natural storage media for an avulsed tooth followed by aloe vera.

Introduction. Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany. Case Report. 23-year-old female patient presented with carpopedal spasms and tingling sensations in hands. Patient was being treated with capreomycin for two months for tuberculosis. On further investigation, hypocalcemia, hyponatremia, hypomagnesemia, hypokalemia, and hypochloremic metabolic alkalosis were noted. Vitamin D and serum PTH levels were within normal limits. Hypercalciuria was confirmed by urine calcium/creatinine ratio. Calcium, potassium, and magnesium supplementation was given and capreomycin was discontinued. Electrolytes normalized in two days after cessation of capreomycin with no further abnormalities on repeat investigations. Discussion. Aminoglycosides can result in renal tubular dysfunction leading to Fanconi syndrome, Bartter syndrome, and distal tubular acidosis. Impaired mitochondrial function in the tubular cells has been hypothesized as the possible cause of these tubulopathies. Acquired Bartter-like syndrome phenotypically resembles autosomal dominant type 5 Bartter syndrome. Treatment consists of correction of electrolyte abnormalities, indomethacin, and potassium-sparing diuretics. Prompt diagnosis and treatment of severe dyselectrolytemia are warranted in patients on aminoglycoside therapy.

Direct measurement of absorbed dose rate in air due to exposure from outdoor terrestrial γ radiation and assessment of consequent public health hazard continues to be of environmental and public concern. Present study was aimed to establish a baseline data of annual effective dose and to assess the associated health risk from outdoor terrestrial γ radiation along the river Alaknanda and Ganges of India. Terrestrial γ radiation exposure doses (excluding cosmic radiation) were measured using a Plastic Scintillation Counter. Absorbed dose rates in air were measured at eight designated locations from Nandprayag to Allahabad along the river. From the average absorbed dose rates, annual effective dose (AED) and excess life time cancer risks (ELCR) were calculated by standard method. Results showed that absorbed dose rates in air ranged between 81.33 ± 2.34 nSv.h−1 and 144 ± 5.77 nSv.h−1 and calculated AED ranged between 0.10 ± 0.012 mSv.y−1 to 0.18 ± 0.007 mSv.y−1 at the designated locations along these rivers. Calculated ELCR were found in the range of 0.375 × 10−3 to 0.662 × 10−3. Present study measured the outdoor γ radiation levels along the rivers. The calculated annual effective doses and life time cancer risk were found higher than the world average value at higher altitudes. But the measured doses and calculated risks at plains were close to that of reported average values. Keywords: River, Ganges, Alaknanda, Terrestrial gamma radiation, Health hazard

Using spectroscopic, calorimetric and microscopic methods, we demonstrate that calcium binds to beta-2-microglobulin (β2m) under physiological conditions of pH and ionic strength, in biological buffers, causing a conformational change associated with the binding of up to four calcium atoms per β2m molecule, with a marked transformation of some random coil structure into beta sheet structure, and culminating in the aggregation of the protein at physiological (serum) concentrations of calcium and β2m. We draw attention to the fact that the sequence of β2m contains several potential calcium-binding motifs of the DXD and DXDXD (or DXEXD) varieties. We establish (a) that the microscopic aggregation seen at physiological concentrations of β2m and calcium turns into actual turbidity and visible precipitation at higher concentrations of protein and β2m, (b) that this initial aggregation/precipitation leads to the formation of amorphous aggregates, (c) that the formation of the amorphous aggregates can be partially reversed through the addition of the divalent ion chelating agent, EDTA, and (d) that upon incubation for a few weeks, the amorphous aggregates appear to support the formation of amyloid aggregates that bind to the dye, thioflavin T (ThT), resulting in increase in the dye's fluorescence. We speculate that β2m exists in the form of microscopic aggregates in vivo and that these don't progress to form larger amyloid aggregates because protein concentrations remain low under normal conditions of kidney function and β2m degradation. However, when kidney function is compromised and especially when dialysis is performed, β2m concentrations probably transiently rise to yield large aggregates that deposit in bone joints and transform into amyloids during dialysis related amyloidosis.

The identification of B-cell epitopes is an important step to study the antigen- antibody interactions for diagnosis and therapy. The present study aimed to identify B- cell epitopes of osmotin using bioinformatic tools and further modify these regions to study the allergenic property. B-cell epitopes were predicted based on amino acid physicochemical properties. Three single point mutations M1, M2, and M3 and a multiple point mutant (M123) were selected to disrupt the IgE binding. These mutants were cloned, expressed and proteins purified to homogeneity. The IgE binding of the purified proteins was evaluated by ELISA and ELISA inhibition with patients' sera. Three regions of osmotin M1 (57-70 aa), M2 (72-85 aa) and M3 (147-165 aa) were identified as potential antibody recognition sites using in silico tools. The sequence similarity search of the predicted epitopes of osmotin using Structural Database of Allergenic proteins (SDAP) showed similarity with known allergens from tomato, kiwifruit, bell pepper, apple, mountain cedar and cypress. Mutants M1, M2 and M3 showed up to 72%, 60% and 76% reduction, respectively in IgE binding whereas M123 showed up to 90% reduction with patients' sera. The immunoblot of M123 mutant showed 40% reduction in spot density as compared to osmotin. All mutants showed decreased inhibition potency with M123 exhibiting lowest potency of 32% with osmotin positive pooled patients' sera. The three B- cell epitopes of osmotin predicted by in silico method correlated with the experimental approach. The mutant M123 showed a reduction of 90% in IgE binding. The present method may be employed for prediction of B- cell epitopes of allergenic proteins.