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Abstract Tissues undergo distinct morphogenetic processes to achieve similarly shaped structures. In the heart, cardiomyocytes in both the ventricle and atrium build internal structures for efficient contraction. Ventricular wall formation (trabeculation) is initiated by cardiomyocyte delamination. How cardiomyocytes build the atrial wall is poorly understood. Using longitudinal imaging in zebrafish, we found that at least 25% of the atrial cardiomyocytes elongate along the long axis of the heart. These cell shape changes result in cell intercalation and convergent thickening, leading to the formation of the internal muscle network. We tested factors important for ventricular trabeculation including Nrg/ErbB and Notch signaling and found no evidence for their role in atrial muscle network formation. Instead, our data suggest that atrial cardiomyocyte elongation is regulated by Yap, which has not been implicated in trabeculation. Altogether, these data indicate that distinct cellular and molecular mechanisms build the internal muscle structures in the atrium and ventricle.

Background: Nomophobia or “No Mobile Phone” phobia is the fear of being detached from one’s own mobile phone. Smartphones have been proven to have numerous advantages in recent times. However, on their excessive use, it can have physical, psychological, behavioral, social, and affective effects. Since the younger generation are the latest buyers of the mobile phones, and the under-25-year age group in professional colleges like medical colleges use mobile phones quite frequently, this study was conducted to find out the prevalence of nomophobia and its association with the coping styles and the perceived stress in undergraduate medical students of a medical college in New Delhi. Methodology: The study was a cross-sectional study conducted for 3 months (November 2022–January 2023) on M. B. B. S students. A total of 200 students were selected by purposive sampling. The data was collected using questionnaires. Nomophobia was assessed through Nomophobia Questionnaire. Coping and stress were assessed using Brief Cope and Perceived stress scales, respectively. Data were collected and analyzed using Microsoft Excel 2010 and SPSS software Version 21 (Statistical Package for the Social Sciences, IBM Corp, USA). Results: The study was conducted on a total of 197 students undergraduate MBBS students. The prevalence of nomophobia was found to be 99.5% which was higher among females (56%) than males (44%). Among the students with mild (24%) and moderate nomophobia (60%), problem-focused coping mechanism was the most commonly used coping mechanism. Those with severe nomophobia (15%) were found to lean more toward emotion focused followed by problem-focused coping mechanism. A statistically significant association was found between nomophobia and perceived stress. Conclusions: Smartphones have many benefits when used for their intended purpose but when used in a problematic way and excessively, they can cause various problems. The higher prevalence of nomophobia among medical students is an issue of concern and has possibly affected their mental health. Strategies are to be devised on a priority basis for minimizing nomophobia among the medical students.

Background: Effective communication between patients and healthcare providers is essential for optimal care outcomes, particularly in the field of ear, nose, and throat (ENT) medicine. Our study aimed to explore patient-centered communication approaches in the context of ENT advancements to bridge the knowledge gap between healthcare providers and patients. Methods: A mixed-methods approach was employed, including quantitative surveys, qualitative interviews, and medical record reviews for this cross-sectional observational study. A total of 120 patients and 40 ENT clinicians were included in the study, with data collected over a 1-year period. Demographic characteristics, patient understanding, satisfaction with communication, preferences for receiving information, and themes identified from qualitative interviews were analyzed. Results: The study revealed high levels of patient understanding and satisfaction with communication from ENT providers. Verbal communication was the most preferred method for receiving information, followed by written materials and online resources. Qualitative interviews identified themes emphasizing the importance of clear communication, desire for shared decision-making, and the need for accessible information. The survey among 40 ENT practitioners reveals that 25% utilize multimedia platforms frequently, 50% occasionally, 20% rarely, and 5% never. Conclusion: In conclusion, the findings of this study highlight the importance of patient-centered communication in enhancing patient understanding, satisfaction, and engagement in ENT healthcare speciality. By prioritizing clear communication, shared decision-making, and accessible information, healthcare providers can influence patients to play an active role in their care and improve healthcare outcomes.

Background and Aim: There is high prevalence of mental disorders in specialist treatment seekers across specialties. Still, psychiatry referral rates have been found to be very low. A physician refers a patient to psychiatric services for reasons like known case of mental disorder, physical symptoms without adequate explanation, or if the physician feels inadequate in dealing with psychological symptoms. A multi disciplinary approach should be encouraged for the management of such patients, facilitating early recognition and management of psychiatric problems. The aim is to study the sociodemographic variables of psychiatric referrals, reasons and diagnostic categories of psychiatric referrals, and the distribution of psychiatric diagnoses according to reasons and sources of referrals. Materials and Methods: A retrospective hospital based study was conducted in the Department of Psychiatry, Hamdard Institute of Medical Sciences and Research, New Delhi, by analyzing the recorded data of referrals to the Psychiatry Department from various other specialties from January 2019 to March 2020. All referred patients were evaluated by a Psychiatrist (MD Psychiatry) and the diagnosis was made as per the International Statistical Classification of Diseases 10 criteria. The data obtained were analyzed using descriptive statistical methods. Results: This study included 315 psychiatric referrals. The mean age and standard deviation of the entire sample were 37.75 ± 17.63. The referral rate was minimum from January to March 2020. The highest number of referrals was from Medicine Department (66.3%). Among those, the most common diagnoses were that of alcohol dependence (27%). The most common overall reason for referral was substance use (26.2%). The most common psychiatric diagnosis was alcohol dependence (24%). Hypertension was the most common physical comorbidity. The most common diagnosis for known case of psychiatric illness and follow ups were psychotic disorders (27.3% and 26.3%). Conclusion: The findings of this study give us insight that consultation liaison psychiatry should focus on early recognition and wholesome management of psychiatric disorders in patients with physical illness through consultation psychiatry services in general hospital settings.

Abstract Background Histiocytic sarcoma (HS) is defined as neoplasm resembling morphological and immunophenotypic characteristics of mature histiocytes. It is a rare form of lymphoid neoplasms. Despite advances in treatment and diagnosis of histiocytic sarcoma, majority of cases had poor prognosis due to progressive nature of the disease. In the following article, all reported cases of histiocytic sarcoma in renal transplant patients are reviewed. Methods In our literature review, all relevant reports were collected electronically by entering the necessary keywords. A Boolean approach using Medical Subject Heading (MeSH) keywords was implemented. After establishing the inclusion/exclusion criteria, article titles and abstracts were evaluated by Systematic Reviews and Meta-Analyses (PRISMA) standards for 2020. All cases of histiocytic sarcoma in renal transplant patients were included. Result Based on our inclusion and exclusion criteria 4 case reports were yielded in this review. Two were males and 2 were females with the mean age of 42.25 years. Fever was the most common symptom. Although tumor originated from the native kidney on one patient, the site of the primary tumor was thorax, oropharynx, and transplanted kidney in the rest. Metastasis was detected in all cases. Prednisone was used for all cases. EBV was positive in 2 cases and negative in one of them. Histology was diagnostic and similar in all cases. Immunohistochemistry was done for 3 cases. Although chemotherapy was done for 3 patients, all 4 cases ended in mortality. Conclusion Despite the fact that neoplasms are post renal transplant complications, histiocytic sarcoma is a scarce and fatal entity in such patients. Histological and immunohistochemistry tests are the corner stone in diagnosis of histiocytic sarcoma.

Aims: 1. To compare the outcome of tympanoplasty alone with tympanoplasty combined with cortical mastoidectomy in patients with quiescent Chronic otitis media (COM). 2. To assess gain in hearing in dB. Materials and Methods: Patients diagnosed with mucosal type of chronic otitis media in the quiescent stage were selected. Two groups were formed. Patients were selected randomly and alternately they were included in groups A and B. The patients underwent otomicroscopy. Pure tone audiometry would depict pure conductive hearing of hearing loss. Group A (50% patients) were subjected to tympanoplasty alone and group B (other 50% patients) were subjected to tympanoplasty combined with cortical mastoidectomy. Prior to surgery, all patients underwent routine blood and urine examination, pure tone audiometry, and B/L mastoid X-ray Schuller’s view. Results: In our study, hearing gain in decibels in the tympanoplasty group was 17.1% and in tympanoplasty combined with cortical mastoidectomy was 21.1%. Graft uptake was 94% in the tympanoplasty group and 96% in tympanoplasty combined with cortical mastoidectomy. Recurrence of discharge was seen in three cases of tympanoplasty. Though tympanoplasty combined with cortical mastoidectomy is better in hearing improvement, graft uptake but the difference in two groups is statistically insignificant. Conclusion: Hearing improvement and graft uptake were statistically insignificant in two groups. Combining cortical mastoidectomy with tympanoplasty will not give additional benefits in terms of hearing gain and graft uptake in patients with quiescent mucosal chronic otitis. Media: Clinical significance: Hearing improvement and graft uptake were statistically insignificant in two groups. Combining cortical mastoidectomy with tympanoplasty will not give additional benefits in terms of hearing gain and graft uptake in patients with quiescent mucosal chronic otitis media.

Introduction: Influenza is a highly communicable viral respiratory illness known to cause outbreaks, such as the current H3N2 outbreak in India. YouTube is one of the most popular sources to obtain information regarding symptoms, treatments, and prevention of diseases like influenza in the general public. Aim: To assess the quality and reliability of information related to H3N2 influenza using the Global Quality Score (GQS) and reliability score, respectively. Materials and Methods: A cross-sectional study was conducted to evaluate the type of information, quality, and reliability of videos about Influenza H3N2 on YouTube using the GQS and the Reliability Score (DISCERN) scale, respectively. The Kruskal-Wallis test was used to assess differences in quality and reliability depending on the type of uploader. Results: The study found that 85% of videos focused on prevention/vaccination, 83.3% discussed the cause/aetiology of influenza, while only 31.7% covered investigations/tests. News agencies uploaded the most videos (46.7%), followed by doctors (18.3%), with minimal contribution from hospitals (8.3%). News agencies had the highest Video Power Index (VPI) compared to other groups, and there were no significant differences in GQS score across different groups. Conclusion: Verified information from proper resources should be uploaded by responsible healthcare professionals like doctors and health organisations. The videos should have an exceptional reliability score and Global Quality Index. The quality of content should be easy to understand for the general public and should provide additional sources of information, educating the viewer to contact his/her physician concerning the diagnosis and further evaluation of the same.

Paroxetine is a commonly used drug in psychiatric settings for disorders such as major depressive disorder, obsessive-compulsive disorder, social anxiety disorder, generalized anxiety disorder, panic disorder, premenstrual dysphoric disorder, and posttraumatic stress disorder. However, this drug comes with its own series of adverse effects, including dry mouth, drowsiness, constipation, sexual side effects, etc. In our case study, we wish to highlight a case of depression who developed a rarely documented side effect of serial nightmares after prescribing paroxetine. On cross-tapering it with sertraline, her nightmares gradually resolved with no deterioration of depressive symptoms. By reporting this case, we wish to emphasize on this potential side effects of paroxetine which should be kept in mind while choosing this agent. Such reporting is important as this rare side effect could be confused with other clinical pictures, thereby affecting management. It also helps us enhance our knowledge of how selective serotonin reuptake inhibitors can lead to the development of nightmares.

This article designs a cleaner production scheduling model for defective products with flexible rework rate and shortages by considering the transportation cost as proportional to pandemic intensity. The model incorporates a variable setup cost and carbon emissions originating from various activities, both of which are targeted for reduction through investments in green technologies. The main aim of this work is to determine optimal production strategies for firms operating in emergency situations like pandemics, conflicts, and other unforeseen circumstances. The scenario is mathematically formulated with the objective of minimizing both total cost and overall emissions by optimizing decision variables such as production lot size, backorder, setup cost, and green investment. A numerical example is stated to validate the mathematical formulation, and the discussion of parameter effects on optimal solutions, along with managerial insights, is conducted through sensitivity analysis.

In December 2019, a novel coronavirus disease (COVID-19) outbreak occurred due to a human respiratory virus that originated in the city of Wuhan, China. During the COVID-19 lockdown, there was a significant improvement in the air quality across the world. We analyzed the data for BTEX over the three years (January to December 2019 to 2021) with pairwise comparison and trend analysis for pre-, during, and post-pandemic periods. This study demonstrates the substantial changes in the concentration of VOCs in the urban area (Punjab) due to the lockdown effects. The results indicate a substantial reduction in the mean TVOCs concentration for all the monitoring stations was found to be 8.89 ± 1.80, 5.59 ± 1.71, and 5.57 ± 1.43 μg/m3 for before, during, and post-pandemic, respectively. The level of TVOCs declined by −43% for all monitoring stations during the lockdown period compared to the previous years. A higher T/B ratio was found in Patiala (2.97 μg/m3) before the pandemic, which may indicate vehicle emission sources. The LCR values for benzene were found to be higher in children than in males and females, which indicated the possible risk. The LCR values for benzene exceeded the prescribed value by CPCB for children.

The process of assigning bugs to particular programmers is called bug assignment in software engineering. The programmer can fix the bugs by applying their knowledge. This research article presents an Ant colony optimization-based programmer recommendation model (ProRE) to manage software bugs precisely. The proposed ProRE model performs four operations: data pre-processing, i.e., data Pre-processing, extraction, feature selection, and programmer recommendation process. The feature selection stage utilized the Ant colony optimization (ACO) method to determine the appropriate subsets of features from all features. In the programmer recommendation stages, three programmer metrics, i.e., functionality ranking, bug occurrence, and mean Bug fixing time, are utilized for the recommendation assignment. The effectiveness of the proposed programmer recommendation system is assessed using datasets from Mozilla, Eclipse, Firefox, JBoss, and OpenFOAM. It is noted that the proposed model offers a better recommendation strategy over the other available systems. The simulation findings of the proposed ProRE model are also analyzed with well-known available ML methods, i.e., SVM, NB, and C4.5. It is observed that the recommendation results have improved by an average of 4%, 10%, and 12% compared to SVM, C4.5, and NB-based models. Programmer recommendation software is implemented for allocating the bugs to accurate programmers. It has been found that the proposed ProRE model generates more optimistic outcomes than existing ones.

During the COVID-19 pandemic, many children from limited-literacy communities in India did not receive information regarding COVID-19 safety due to the sudden shutdown of schools. Many parents from these communities could not afford virtual learning and lacked the ability to educate the children themselves. In July 2021, the research team developed comic, coloring, and activity books to provide children with fun, yet readable, educational materials. We consulted with teachers to simplify the language and understand the popularity of different cartoon characters. Between August 2021 and January 2022, our community health partners distributed the books to two age groups, ages 6–10 (n = 116, mean age 8.72) and 11–14 (n = 81, mean age 12.05). We conducted surveys with the children during and a week after distribution to assess any change in their knowledge about COVID-19 safety. The average age of children in this study was 10.09 (SD = 2.01) years. All resided in underresourced urban communities with low literacy rates and limited education. All questions were answered more correctly in the postsurvey, with the social distancing question having the greatest and most statistically significant increase (33.6%, p < 0.0001). The average increase in knowledge among children aged 6–10 (16.9%) was greater, though not statistically significantly so, than the average increase among children aged 11–14 (4.7%). These results indicate that child-friendly books can increase health education for children ages 6–14 in low-literacy populations. Additionally, the mechanism of the program is fit to be used in other low-resource populations globally.

BACKGROUND: Tobacco use remains a significant global health challenge, contributing to 8 million annual deaths and potentially reaching 1 billion deaths in the 21st century. Despite taking efforts like India’s National Tobacco Control Program, the country faces a persistent 39% tobacco use prevalence, particularly in low-income communities like those from Madanpur Khadar, Delhi. This study explores the effectiveness of behavior modification therapy in addressing this challenge. MATERIALS AND METHODS: In a community-based trial, 400 adult tobacco users from Madanpur Khadar were enrolled and randomization and allocation concealment were done (CTRI no.: CTRI/2021/06/034298). Participants were randomly assigned to intervention and control groups during the study period of 18 months. Data on sociodemographic characteristics, smoking behaviors, and motivation levels were collected. The intervention included behavior modification therapy, while the control group received brief advice. Motivation levels were assessed using the contemplation ladder, and carbon monoxide levels were measured with piCO + Smokerlyzer. The study adhered to ethical considerations and obtained approval from Jamia Hamdard’s Institutional Ethical Committee. RESULTS: Sociodemographic characteristics revealed a predominantly male (88%) population, aged above 30 years (68.5%), with lower middle class representation (51%). The intervention group exhibited a 7% smoking cessation rate, which is significantly higher than the control group (1%). piCO+ Smokerlyzer confirmed a 41.7% reduction in carbon monoxide levels among participants in the intervention group. High motivation levels correlated with successful quitting, with a 6.5 times higher odds ratio for highly motivated individuals compared to low or moderately motivated ones. CONCLUSIONS: The study highlights the cost-effective impact of behavior modification therapy in promoting tobacco cessation, particularly in resource-constrained settings. The significant association between motivation levels and quitting underscores the importance of tailored interventions in public health initiatives aimed at reducing tobacco use.

Background: A characteristic feature of the cervical vertebrae (C1–C7) is the presence of a foramen tranversarium on the transverse process. The cervical vertebrae are the smallest in size as compared to the thoracic and lumbar vertebrae and are characterized by a foramen in each transverse process, which is not found in any other vertebra. Except for the seventh cervical vertebra, which transmits only the vertebral vein, this foramen transmits the vertebral artery, vein, and sympathetic nerves (a branch from the cervicothoracic ganglion) in all cervical vertebrae. Any deviation in the development of the foramen transversarium (FT) causes changes in the course, relationships, and structure (stenosis and lumen narrowing) of the vertebral artery and its associated structures. Aims and Objectives: The aims of this study were to establish the location, shape, size, and incidence of accessory FT in dry human cervical vertebrae of Eastern Indian population. Materials and Methods: An observational cross-sectional study was conducted on 170 dry cervical vertebrae (Typical-123 and Atypical-47) of unknown sex and age after getting approval from the Institutional Ethics Committee. Range, frequencies, percentage, mean, standard deviation, and P value were calculated. P

Abstract Pathogen contamination of water has a massive impact on global human health. In particular, viruses pose unique challenges to water treatment techniques due to their small size and presence in water as both individual virions and when absorbed onto larger particles. Low-energy water treatment processes such as media filtration are not capable of completely removing viruses owing to their small size. Hence, less sustainable processes with high chemical or energy consumption such as chemical disinfection, ultraviolet irradiation, and membrane filtration are usually required. To overcome high energy and/or chemical requirements for virus treatment, designs for sustainable fiber filters fabricated from minimally processed natural materials for efficient virus (MS2) and bacteria (E. coli) removal are presented in this work. These filters were created by functionalizing readily accessible natural fibers including cotton, silk, and flax with a simple aqueous extract containing cationic proteins from Moringa oleifera seeds. The proposed filters offer a comprehensive low cost, low energy, and low environmental impact solution for pathogen removal from water with removals of >7log10 (99.99999%) for viruses and bacteria.

Biosensors, in particular nanobiosensors, have brought a paradigm shift in the detection approaches involved in healthcare, agricultural, and industrial sectors. In accordance with the global expansion in the world population, there has been an increase in the application of specific insecticides for maintaining public health and enhancing agriculture, such as organophosphates, organochlorines, pyrethroids, and carbamates. This has led to the contamination of ground water, besides increasing the chances of biomagnification as most of these insecticides are non-biodegradable. Hence, conventional and more advanced approaches are being devised for the routine monitoring of such insecticides in the environment. This review walks through the implications of biosensors and nanobiosensors, which could offer a wide range of benefits for the detection of the insecticides, quantifying their toxicity status, and versatility in application. Unique eco-friendly nanobiosensors such as microcantilevers, carbon nanotubes, 3D printing organic materials and nylon nano-compounds are some advanced tools that are being employed for the detection of specific insecticides under different conditions. Furthermore, in order to implement a smart agriculture system, nanobiosensors could be integrated into mobile apps and GPS systems for controlling farming in remote areas, which would greatly assist the farmer remotely for crop improvement and maintenance. This review discusses about such tools along with more advanced and eco-friendly approaches that are on the verge of development and could offer a promising alternative for analyte detection in different domains.

Bone Marrow Cancer is a type of cancer that develops in the stem cells of the bone marrow that are responsible for blood formation. AML(Acute Myeloid Leukaemia) and MM(Multiple Myeloma) are both types of malignancy that can affect bone marrow. Conventionally, the process was carried out manually by a skilled professional in a considerable amount of time. Hence, in order to provide accurate treatment, a better diagnosis technique is required. In this regard, the suggested study has improved a unique technique, specifically classification and segmentation, allowing for the identification of more intricate disorders. The study's findings on the accuracy of cancer cell identification, as well as the decrease in the possibility of false alarm rates, continue to fall on the negative side of the outcome spectrum, according to the researchers. The hybrid approach has been proposed in this article that includes deep convolutional neural networks, hyperparameter sets utilising adaptive multi-objective CAT algorithms and other image processing techniques. To train the suggested model, it is critical to use previously processed cell images. The suggested model is then used to train an Optimized Convolutional Neural Network (OCNN), which is then used to determine the type of tumour identified in the bone area. The SN-AM datasets were thoroughly examined, and a number of presentation measures, such as accuracy (recall), F1-score, and specificity (specificity), were generated and analysed. When it came to predicting different types of cancer, researchers observed that they had an overall accuracy of 99.45 percent. In terms of recognizing the sorts of cancer cells, the proposed model surpassed all existing learning models.

A. baumannii is a ubiquitously found gram-negative, multi-drug resistant bacterial species from the ESKAPE family of pathogens known to be the causative agent for hospital-acquired infections such as pneumonia, meningitis, endocarditis, septicaemia and urinary tract infections. A. baumannii is implicated as a contributor to bloodstream infections in approximately 2% of all worldwide infections. Hence, exploring novel therapeutic agents against the bacterium is essential. LpxA or UDP-N-acetylglucosamine acetyltransferase is an essential enzyme important in Lipid A biosynthesis which catalyses the reversible transfer of an acetyl group on the glucosamine 3-OH of the UDP-GlcNAc which is a crucial step in the biosynthesis of the protective Lipopolysaccharides (LPS) layer of the bacteria which upon disruption can lead to the elimination of the bacterium which delineates LpxA as an appreciable drug target from A. baumannii. The present study performs high throughput virtual screening of LpxA against the enamine-HTSC-large-molecule library and performs toxicity and ADME screening to identify the three promising lead molecules subjected to molecular dynamics simulations. Global and essential dynamics analysis of LpxA and its complexes along with FEL and MM/PBSA based binding free energy delineate Z367461724 and Z219244584 as potential inhibitors against LpxA from A. baumannii.

Background and Objective: A narrow alveolar ridge is an obstacle to optimal rehabilitation of the dentition. There are several complex and invasive techniques to counter the ridge augmentation dilemma, with most of them exhibiting low feasibility. Hence, this randomized clinical trial aims to evaluate the effectiveness of a Minimalistic Ridge Augmentation (MRA) technique, in conjunction with low-level laser therapy (LLLT). Materials and Methods: A total of 20 patients (n = 20) were selected, with 10 assigned to the test group (MRA+LLLT) and the other 10 to the control group (MRA). A vertical incision of approximately 10 mm was placed mesial to the defect and tunneled to create a subperiosteal pouch across the entire width of the defect. At the test sites, a diode laser (AnARC FoxTM Surgical Laser 810 nm) was used to deliver LLLT (parameters: 100 mW, with a maximum energy distribution of 6 J/cm2 in the continuous wave mode for 60 s per point) to the exposed bone surface inside the pouch, followed by graft (G-Graft, SurgiwearTM, Shahjahanpur, India) deposition with a bone graft carrier. The control sites were not irradiated with a laser. Results: A horizontal ridge width gain of >2 mm was observed in both groups. The changes in bone density for the test and control groups were −136 ± 236.08 HU and −44.30 ± 180.89 HU, respectively. Furthermore, there was no statistically significant difference between the test and control groups in these parameters. Conclusion: The study findings reveal that the MRA technique is relatively simple and feasible for alveolar ridge augmentation. The role of LLLT in the process requires further elucidation.

Fluvoxamine is a commonly used drug in obsessive-compulsive disorder (OCD) and has shown remarkable results in the recovery of such patients. Fluvoxamine is generally well tolerated. However, this drug comes with its own series of adverse effects such as nausea, headaches, diarrhea, sleep disturbance, agitation, anorexia, tremulousness, and decreased libido. It has also been less commonly associated with convulsion, dyskinesia, dystonia, extrapyramidal syndrome, and twitching. In this case report, we wish to highlight a case of OCD, who was prescribed tablet fluvoxamine as a treatment and subsequently developed tics. On reducing the dose of fluvoxamine, her tics gradually resolved with no deterioration of OC symptoms. By reporting this case, we wish to emphasize the potential side effect of fluvoxamine which should be kept in mind while choosing this antidepressant agent. The rising number of cases of movement disorder along with their varied clinical features undermines the importance of considering drugs as a possible cause of tics.

Abstract Diabetes increases the risk of bacterial infections. We investigated whether common genetic variants associate with infection susceptibility in Finnish diabetic individuals. We performed genome-wide association studies and pathway analysis for bacterial infection frequency in Finnish adult diabetic individuals (FinnDiane Study; N = 5092, Diabetes Registry Vaasa; N = 4247) using national register data on antibiotic prescription purchases. Replication analyses were performed in a Swedish diabetic population (ANDIS; N = 9602) and in a Finnish non-diabetic population (FinnGen; N = 159,166). Genome-wide data indicated moderate but significant narrow-sense heritability for infection susceptibility (h2 = 16%, P = 0.02). Variants on chromosome 2 were associated with reduced infection susceptibility (rs62192851, P = 2.23 × 10–7). Homozygotic carriers of the rs62192851 effect allele (N = 44) had a 37% lower median annual antibiotic purchase rate, compared to homozygotic carriers of the reference allele (N = 4231): 0.38 [IQR 0.22–0.90] and 0.60 [0.30–1.20] respectively, P = 0.01). Variants rs6727834 and rs10188087, in linkage disequilibrium with rs62192851, replicated in the FinnGen-cohort (P

Abstract This proposal investigates the effect of vegetation height and density on received signal strength between two sensor nodes communicating under IEEE 802.15.4 wireless standard. With the aim of investigating the path loss coefficient of 2.4 GHz radio signal in an IEEE 802.15.4 precision agriculture monitoring infrastructure, measurement campaigns were carried out in different growing stages of potato and wheat crops. Experimental observations indicate that initial node deployment in the wheat crop experiences network dis-connectivity due to increased signal attenuation, which is due to the growth of wheat vegetation height and density in the grain-filling and physical-maturity periods. An empirical measurement-based path loss model is formulated to identify the received signal strength in different crop growth stages. Further, a NSGA-II multi-objective evolutionary computation is performed to generate initial node deployment and is optimized over increased coverage, reduced over-coverage, and received signal strength. The results show the development of a reliable wireless sensor network infrastructure for wheat crop monitoring.

Several new heterocyclic systems based on a hydroxybenzofuro[2,3-b]pyridine building block were prepared. This benzofuropyridine is easily available from the Meerwein reaction of benzoquinone and a heterocyclic diazonium salt, followed by reduction and cyclization. Electrophilic substitution and further condensations give polycyclic systems, including oxazolo- and chromeno-fused analogues.

The aim of our study was to test the hypothesis that administration of Regenerating islet-derived protein 3α (Reg3α), a protein described as having protective effects against oxidative stress and anti-inflammatory activity, could participate in the control of glucose homeostasis and potentially be a new target of interest in the treatment of type 2 diabetes. To that end the recombinant human Reg3α protein was administered for one month in insulin-resistant mice fed high fat diet. We performed glucose and insulin tolerance tests, assayed circulating chemokines in plasma and measured glucose uptake in insulin sensitive tissues. We evidenced an increase in insulin sensitivity during an oral glucose tolerance test in ALF-5755 treated mice vs controls and decreased the pro-inflammatory cytokine C-X-C Motif Chemokine Ligand 5 (CXCL5). We also demonstrated an increase in glucose uptake in skeletal muscle. Finally, correlation studies using human and mouse muscle biopsies showed negative correlation between intramuscular Reg3α mRNA expression (or its murine isoform Reg3γ) and insulin resistance. Thus, we have established the proof of concept that Reg3α could be a novel molecule of interest in the treatment of T2D by increasing insulin sensitivity via a skeletal muscle effect.

Background: In December 2019, in Wuhan a new contagious disease outbreak occurred. In Aurangabad, the first case of Covid19 was reported on 3rd March, 2020. There is paucity of data on clinical characteristics and treatment outcomes. Objective: To find out the determinants of outcome in Covid19 patients. Method: A cross- sectional analytical study was done on patients of Covid19 admitted in Dedicated Covid Hospital- Government Medical College, Aurangabad from 1st April, 2020 to 31st July, 2020 to identify potential risk factors of mortality by using Cox proportional Hazards model. Results: Out of total 1442 patients admitted during study period 831(56%) recovered and 636(25%) died. Hypertension (21.4%) and Diabetes (18.5%) were most common underlying comorbidities. Age>65 years, associated comorbidities like Hypertension, Diabetes, COPD, Thyroid disorder were predictors of mortality among Covid19 patients (p

Abstract Background The COVID-19 pandemic caused by SARS-CoV-2 has shown an exponential trend of infected people across the planet. Crediting its virulent nature, it becomes imperative to identify potential therapeutic agents against the deadly virus. The 3-chymotrypsin-like protease (3CLpro) is a cysteine protease which causes the proteolysis of the replicase polyproteins to generate functional proteins, which is a crucial step for viral replication and infection. Computational methods have been applied in recent studies to identify promising inhibitors against 3CLpro to inhibit the viral activity. Main body of the abstract This review provides an overview of promising drug/lead candidates identified so far against 3CLpro through various in silico approaches such as structure-based virtual screening (SBVS), ligand-based virtual screening (LBVS) and drug-repurposing/drug-reprofiling/drug-retasking. Further, the drugs have been classified according to their chemical structures or biological activity into flavonoids, peptides, terpenes, quinolines, nucleoside and nucleotide analogues, protease inhibitors, phenalene and antibiotic derivatives. These are then individually discussed based on the various structural parameters namely estimated free energy of binding (ΔG), key interacting residues, types of intermolecular interactions and structural stability of 3CLpro-ligand complexes obtained from the results of molecular dynamics (MD) simulations. Conclusion The review provides comprehensive information of potential inhibitors identified through several computational methods thus far against 3CLpro from SARS-CoV-2 and provides a better understanding of their interaction patterns and dynamic states of free and ligand-bound 3CLpro structures.

Abstract Background The location and time of snack consumption may influence the composition, nutrient content and portion sizes of snacks. In this study, we aimed to determine and compare the time, location and frequency of snack consumption among different age groups of Canadians. Methods Nationally representative dietary data from the 2015 Canadian Community Health Survey (CCHS) were used (19,677 participants aged ≥2 years). Dietary data were obtained using 24-h dietary recalls. Participants were categorized according to the frequency of snack consumption (1 time, 2–3 times, ≥4 times). The snack consumption over 24 h was divided into four time periods: before 10 am, 10 am to 3 pm, 3 pm to 8 pm and 8 pm to 12 am. Meal and snack location was categorized as at home; someone else’s home; restaurants; and other. Results Snacking 2–3 times per day was the most common reported frequency (53.0%). Snacking at home (73.0%) was more prevalent than snacking away from home (27.0%). The most frequently reported time for snacking among Canadians was 3 pm to 8 pm (36.3%), and the least frequently reported time was before 10 am (8.1%). Snacking contributed to a high proportion of Milk and Alternatives (23.7%) and Vegetables and Fruit (23.4%) food groups and lesser proportions of Grain Products (15.4%) and Meat & Alternatives (9.4%) food groups among Canadians. Conclusions Home is the main location, 3 pm to 8 pm is the main time, and 2–3 times per day is the most common reported frequency for snacking. A full understanding of snacking behaviors is needed in order to develop targeted strategies to improve the quality of snack food choices.

During cardiac development, endocardial cells (EdCs) produce growth factors to promote myocardial morphogenesis and growth. In particular, EdCs produce neuregulin which is required for ventricular cardiomyocytes (CMs) to seed the multicellular ridges known as trabeculae. Defects in neuregulin signaling, or in endocardial sprouting toward CMs, cause hypotrabeculation. However, the mechanisms underlying endocardial sprouting remain largely unknown. Here, we first show by live imaging in zebrafish embryos that EdCs interact with CMs via dynamic membrane protrusions. After touching CMs, these protrusions remain in close contact with their target despite the vigorous cardiac contractions. Loss of the CM-derived peptide Apelin, or of the Apelin receptor, which is expressed in EdCs, leads to reduced endocardial sprouting and hypotrabeculation. Mechanistically, neuregulin signaling requires endocardial protrusions to induce extracellular signal-regulated kinase (Erk) activity in CMs and trigger their delamination. Altogether, these data show that Apelin signaling-dependent endocardial protrusions modulate CM behavior during trabeculation.

Cervical cancer is the second most common cancer among Indian women. Screening is an effective prevention strategy, but achieving high screening rates depend upon identifying barriers at multiple levels of healthcare delivery. There is limited research on understanding the perspectives of providers who deliver cancer prevention services. The objective of this study was to explore physician perspectives on cervical cancer prevention, barriers to effective implementation, and strategies to overcome these barriers in India. Guided by the "Multilevel influences on the Cancer Care Continuum" theoretical framework, we conducted semi-structured interviews with physicians in Mysore, India. From November 2015- January 2016, we interviewed 15 (50.0%) primary care physicians, seven (23.3%) obstetrician/gynecologists, six (20.0%) oncologists, and two (6.7%) pathologists. We analyzed interview transcripts in Dedoose using a grounded theory approach. Approximately two-thirds (n = 19, 63.3%) of the participants worked in the public sector. Only seven (23.3%) physicians provided cervical cancer screening, none of them primary care physicians. Physicians discussed the need for community-level, culturally-tailored education to improve health literacy and reduce stigma surrounding cancer and gynecologic health. They described limited organizational capacity in the public sector to provide cancer prevention services, and emphasized the need for further training before they could perform cervical cancer screening. Physicians recommend an integrated strategy for cervical cancer prevention at multiple levels of uptake and delivery with specific efforts focused on culturally-tailored stigma-reducing education, community-level approaches utilizing India's community health workers, and providing physician training and continuing education in cancer prevention.

The transcription factor Snai1, a well-known regulator of epithelial-to-mesenchymal transition, has been implicated in early cardiac morphogenesis as well as in cardiac valve formation. However, a role for Snai1 in regulating other aspects of cardiac morphogenesis has not been reported. Using genetic, transcriptomic, and chimeric analyses in zebrafish, we find that Snai1b is required in cardiomyocytes for myocardial wall integrity. Loss of snai1b increases the frequency of cardiomyocyte extrusion away from the cardiac lumen. Extruding cardiomyocytes exhibit increased actomyosin contractility basally as revealed by enrichment of p-myosin and α-catenin epitope α-18, as well as disrupted intercellular junctions. Transcriptomic analysis of wild-type and snai1b mutant hearts revealed the dysregulation of intermediate filament genes, including desmin b (desmb) upregulation. Cardiomyocyte-specific desmb overexpression caused increased cardiomyocyte extrusion, recapitulating the snai1b mutant phenotype. Altogether, these results indicate that Snai1 maintains the integrity of the myocardial epithelium, at least in part by repressing desmb expression.

RhoGTPase activation of non-muscle myosin II regulates cell division, extrusion, adhesion, migration, and tissue morphogenesis. However, the regulation of myosin II and mechanotransduction is not straightforward. Increasingly, the role of myosin II on the feedback regulation of RhoGTPase signaling is emerging. Indeed, myosin II controls RhoGTPase signaling through multiple mechanisms, namely contractility driven advection, scaffolding, and sequestration of signaling molecules. Here we discuss these mechanisms by which myosin II regulates RhoGTPase signaling in cell adhesion, migration, and tissue morphogenesis.

Delivering nucleic acids into the endothelium has great potential in treating vascular diseases. However, endothelial cells, which line the vasculature, are considered as sensitive in nature and hard to transfect. Low transfection efficacies in endothelial cells limit their potential therapeutic applications. Towards improving the transfection efficiency, we made an effort to understand the internalization of lipoplexes into the cells, which is the first and most critical step in nucleic acid transfections. In this study, we demonstrated that the transient modulation of caveolae/lipid rafts mediated endocytosis with the cholesterol-sequestrating agents, nystatin, filipin III, and siRNA against Cav-1, which significantly increased the transfection properties of cationic lipid-(2-hydroxy-N-methyl-N,N-bis(2-tetradecanamidoethyl)ethanaminium chloride), namely, amide liposomes in combination with 1,2-Dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE) (AD Liposomes) in liver sinusoidal endothelial cells (SK-Hep1). In particular, nystatin was found to be highly effective with 2–3-fold enhanced transfection efficacy when compared with amide liposomes in combination with Cholesterol (AC), by switching lipoplex internalization predominantly through clathrin-mediated endocytosis and macropinocytosis.

Valproate (VPA) is a well-tolerated and commonly used drug to treat variety of psychiatric and neurological disorders. VPA-induced hyperammonemic encephalopathy is a rare adverse effect which can commonly occur in the background of normal liver function and therapeutic serum levels. Any delay in treatment of VPA-induced hyperammonemic encephalopathy can lead to life-threatening coma thus a strong clinical suspicion, fair understanding of the pathophysiology, and management of this drug-related complication can prevent fatal outcome. We hereby report a series of cases admitted to a tertiary care center that developed hyperammonemia and all patients recovered on stopping VPA. This case series cautions the clinicians about hyperammonemia as an uncommon but highly plausible life-threatening side effect, emphasizing astute observation, and high degree of clinical suspicion to prevent mortality and limit morbidity. Early recognition of subtle gastrointestinal, cognitive, and behavioral signs can lead to immediate intervention with satisfying results.

Primitive neuroectodermal tumors (PNETs) are a group of highly malignant tumors composed of small round cells of neuroectodermal origin that affect soft tissue and bone. PNET of the larynx is extremely rare. We report a case of a 41-year-old male who presented with the complaints of progressively increasing stridor of 3 months duration, which was diagnosed as a case of neuroectodermal tumor in the subglottis. Patient was subjected to microlaryngeal surgery and the tumor was excised. Postoperatively, patient was given three cycles of chemotherapy comprising of ifosfamide, etoposide, and mesna, along with granulocyte colony stimulating factor, with 21 days interval. After chemotherapy repeat computed tomography scan showed no evidence of the tumor and no lymphadenopathy. Patient is symptom free for 18 months following completion of treatment. He is under regular follow-up and is undergoing monthly serial endoscopic evaluation.

Mechanical coherence of cell layers is essential for epithelia to function as tissue barriers and to control active tissue dynamics during morphogenesis. RhoA signaling at adherens junctions plays a key role in this process by coupling cadherin-based cell-cell adhesion together with actomyosin contractility. Here we propose and analyze a mathematical model representing core interactions involved in the spatial localization of junctional RhoA signaling. We demonstrate how the interplay between biochemical signaling through positive feedback, combined with diffusion on the cell membrane and mechanical forces generated in the cortex, can determine the spatial distribution of RhoA signaling at cell-cell junctions. This dynamical mechanism relies on the balance between a propagating bistable signal that is opposed by an advective flow generated by an actomyosin stress gradient. Experimental observations on the behavior of the system when contractility is inhibited are in qualitative agreement with the predictions of the model.

Although considered rare, airborne pollen can be deposited far from its place of origin under a confluence of favorable conditions. Temporally anomalous records of Cupressacean pollen collected from January air samples in London, Ontario, Canada have been cited as a new case of long-distance transport. Data on pollination season implicated Juniperus ashei (mountain cedar), with populations in central Texas and south central Oklahoma, as the nearest source of the Cupressacean pollen in the Canadian air samples. This finding is of special significance given the allergenicity of mountain cedar pollen. While microscopy is used extensively to identify particles in the air spora, pollen from all members of the Cupressaceae, including Juniperus, are morphologically indistinguishable. Consequently, we implemented a molecular approach to characterize Juniperus pollen using PCR in order to test the long-distance transport hypothesis. Our PCR results using species-specific primers confirmed that the anomalous Cupressacean pollen collected in Canada was from J. ashei. Forward trajectory analysis from source areas in Texas and the Arbuckle Mountains in Oklahoma and backward trajectory analysis from the destination area near London, Ontario were completed using models implemented in HYSPLIT4 (Hybrid Single-Particle Lagrangian Integrated Trajectory). Results from these trajectory analyses strongly supported the conclusion that the J. ashei pollen detected in Canada had its origins in Texas or Oklahoma. The results from the molecular findings are significant as they provide a new method to confirm the long-distance transport of pollen that bears allergenic importance.

Pharyngocele is a benign anomalous pouch formed by hernial protrusion of the mucous membrane through a defect in the hypopharynx. Here we report a 58-year male presenting with large submandibular swelling with complaints of dysphagia and regurgitation. MRI suggested presence of a large pharyngocele. In view of size of swelling external surgical approach was considered as a therapeutic option for the management.

Variants in the growth factor receptor-bound protein 10 (GRB10) gene were in a GWAS meta-analysis associated with reduced glucose-stimulated insulin secretion and increased risk of type 2 diabetes (T2D) if inherited from the father, but inexplicably reduced fasting glucose when inherited from the mother. GRB10 is a negative regulator of insulin signaling and imprinted in a parent-of-origin fashion in different tissues. GRB10 knock-down in human pancreatic islets showed reduced insulin and glucagon secretion, which together with changes in insulin sensitivity may explain the paradoxical reduction of glucose despite a decrease in insulin secretion. Together, these findings suggest that tissue-specific methylation and possibly imprinting of GRB10 can influence glucose metabolism and contribute to T2D pathogenesis. The data also emphasize the need in genetic studies to consider whether risk alleles are inherited from the mother or the father.

Pathogenesis related (PR) proteins are one of the major sources of plant derived allergens. These proteins are induced by the plants as a defense response system in stress conditions like microbial and insect infections, wounding, exposure to harsh chemicals, and atmospheric conditions. However, some plant tissues that are more exposed to environmental conditions like UV irradiation and insect or fungal attacks express these proteins constitutively. These proteins are mostly resistant to proteases and most of them show considerable stability at low pH. Many of these plant pathogenesis related proteins are found to act as food allergens, latex allergens, and pollen allergens. Proteins having similar amino acid sequences among the members of PR proteins may be responsible for cross-reactivity among allergens from diverse plants. This review analyzes the different pathogenesis related protein families that have been reported as allergens. Proteins of these families have been characterized in regard to their biological functions, amino acid sequence, and cross-reactivity. The three-dimensional structures of some of these allergens have also been evaluated to elucidate the antigenic determinants of these molecules and to explain the cross-reactivity among the various allergens.

Fluorescence Recovery After Photobleaching (FRAP) (Lippincott-Schwartz et al., 2003; Reits and Neefjes, 2001) was employed to determine dynamic properties of proteins localized at the ephitelial zonula adherens (ZA) (Kovacs et al., 2011; Otani et al., 2006). The proteins of interest were expressed in cells using a knockdown and reconstitution approach in which endogenous proteins were depleted by RNA interference (RNAi) and replaced by expression of an RNAi-resistant gene fused to GFP (Priya et al., 2013; Smutny et al., 2010; Smutny et al., 2011; Vitriol et al., 2007). By choosing expression levels of GFP-tagged proteins that were comparable to endogenous levels, we minimized transient overexpression artifacts due to overcoming regulatory mechanisms that directly affect protein dynamics (Goodson et al., 2010). Using this approach, junctional E-cadherin-GFP or GFP-Ect2 were subjected to FRAP analysis in small areas corresponding to the ZA using confocal microscopy (Priya et al., 2013; Ratheesh et al., 2012; Gomez et al., 2005; Trenchi et al., 2009). Although in principle this approach is similar in every case, bleaching conditions, acquisition parameters and analysis details might differ depending on the time scale of the recovery process (Lippincott-Schwartz et al., 2003). In this protocol we will describe the experimental procedure to perform FRAP experiments and how to optimize bleaching and acquisition conditions for optimal measurements of protein dynamics at cell-cell junctions.

The desmosome anchors keratin filaments in epithelial cells leading to the formation of a tissue wide IF network. Loss of the desmosomal plaque protein plakophilin3 (PKP3) in HCT116 cells, leads to an increase in neoplastic progression and metastasis, which was accompanied by an increase in K8 levels. The increase in levels was due to an increase in the protein levels of the Phosphatase of Regenerating Liver 3 (PRL3), which results in a decrease in phosphorylation on K8. The increase in PRL3 and K8 protein levels could be reversed by introduction of an shRNA resistant PKP3 cDNA. Inhibition of K8 expression in the PKP3 knockdown clone S10, led to a decrease in cell migration and lamellipodia formation. Further, the K8 PKP3 double knockdown clones showed a decrease in colony formation in soft agar and decreased tumorigenesis and metastasis in nude mice. These results suggest that a stabilisation of K8 filaments leading to an increase in migration and transformation may be one mechanism by which PKP3 loss leads to tumor progression and metastasis.

The goal of understanding how discourse is more than a sequence of sentences has engaged researchers for many years. Researchers in the 1970's attempted to gain such understanding by identifying and classifying the phenomena involved in discourse. This was followed by attempts in the 1980s and early 1990s to explain discourse phenomena in terms of theories of abstract structure. Recent efforts to develop large-scale annotated discourse corpora, along with more lexically grounded theories of discourse are now beginning to reveal interesting patterns and show where and how early theories might be revised to better account for discourse data.

In the present study, efficacy of minimally-invasive serum Raman spectroscopy (SRS) in stratification of congenital heart diseases was explored. Blood was collected from 62 subjects [42 congenital heart defect (CHD) patients (19 with atrial septal defect, 13 with ventricular septal defect and 10 with tetralogy of fallot) and 20 controls], and serum separated. Raman spectra of sera were recorded, pre-processed and subjected to spectral and multivariate analyses. Multivariate curve resolution-alternating least squares (MCR-ALS) analyses indicated alterations in lipid and protein levels between the study groups. Principal Component Analysis (PCA) and Principal Component based Linear Discriminant Analysis (PC-LDA), cross-validated with Leave-one-out cross validation (LOOCV), were employed to study stratification between the different groups. CHD could be classified from controls with 76 % efficiency. The different CHD subtypes could be distinguished with efficiencies as high as ∼90 %. To the best of our knowledge, differentiation between controls and CHDs as well as the stratification between controls and CHDs subtypes was for the first time successfully accomplished by serum-based Raman spectroscopy., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Congenital Heart diseases (CHDs) account for 1/3rd of all congenital birth defects. Etiopathogenesis of CHDs remain elusive despite extensive investigations globally. Phenotypic heterogeneity witnessed in this developmental disorder reiterate gene-environment interactions with periconceptional factors as risk conferring; and genetic analysis of both sporadic and familial forms of CHD suggest its multigenic basis. Significant association of de novo and inherited variants have been observed. Approximately 1/5th of CHDs are documented in the ethnically distinct Indian population but genetic insights have been very limited. This pilot case-control based association study was undertaken to investigate the status of Caucasian SNPs in a north Indian cohort., Method: A total of 306 CHD cases sub-classified into n = 198 acyanotic and n = 108 cyanotic types were recruited from a dedicated tertiary paediatric cardiac centre in Palwal, Haryana. 23 SNPs primarily prioritized from Genome-wide association studies (GWAS) on Caucasians were genotyped using Agena MassARRAY Technology and test of association was performed with adequately numbered controls., Results: Fifty percent of the studied SNPs were substantially associated in either allelic, genotypic or sub-phenotype categories validating their strong correlation with disease manifestation. Of note, strongest allelic association was observed for rs73118372 in CRELD1 (p < 0.0001) on Chr3, rs28711516 in MYH6 (p = 0.00083) and rs735712 in MYH7 (p = 0.0009) both on Chr 14 and were also significantly associated with acyanotic, and cyanotic categories separately. rs28711516 (p = 0.003) and rs735712 (p = 0.002) also showed genotypic association. Strongest association was observed with rs735712(p = 0.003) in VSD and maximum association was observed for ASD sub-phenotypes., Conclusions: Caucasian findings were partly replicated in the north Indian population. The findings suggest the contribution of genetic, environmental and sociodemographic factors, warranting continued investigations in this study population., (© 2023. The Author(s).)

Introduction: To study the clinical presentation, laboratory profile, echocardiographic details, management, and outcomes of children who were diagnosed to have multisystem inflammatory syndrome in children (MIS-C) in the immediate postoperative period after surgery for congenital heart defects (CHDs)., Materials and Methods: This is a prospective case-control study that included children diagnosed to have MIS-C in the postoperative period based on clinical signs, rise in inflammatory markers, and echocardiographic features of ventricular dysfunction or coronary involvement. Management included intravenous immunoglobulin (IVIG), steroids, and antiplatelet medications in addition to routine postoperative care. Out of the 461 children who underwent surgery for CHD between April 1 st , 2021, and November 30 th , 2021, 18 children were diagnosed with MIS-C. After the initial routine postoperative course, all 18 children had sudden worsening in clinical and laboratory parameters. Other causes such as bacterial infection were ruled out. All of these children had features of MIS-C with ventricular dilatation and dysfunction, coronary artery involvement, and reactive COVID-19 immunoglobulin G antibody. There was a significant improvement in coronary artery dimensions after IVIG administration ( P = 0.001). The involvement of the left main coronary artery was associated with significantly increased length of intensive care unit (ICU) and hospital stay ( P = 0.019). Mean ICU and hospital stay was prolonged in the MIS-C group. There were two deaths in this group due to severe left ventricular dysfunction., Conclusions: During the pandemic, a proportion of patients undergoing elective cardiac surgery may develop unexpected worsening in clinical status due to MIS-C. A high index of suspicion and prompt treatment with IVIG and steroids may be helpful in improving outcomes., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Annals of Pediatric Cardiology.)