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On behalf of Cell Therapy Transplant Canada (CTTC), we are pleased to present the Abstracts of the CTTC 2023 Annual Conference. The conference was held in-person, 31 May–2 June 2023, in Halifax, Nova Scotia at the Westin Nova Scotian hotel. Poster authors presented their work during a lively and engaging welcome reception on Thursday, 1 June, and oral abstract authors were featured during the oral abstract session in the afternoon of Friday, 2 June 2023. Twenty-three (23) abstracts were selected for presentation as posters and four (4) as oral presentations. Abstracts were submitted within four categories: (1) Basic/Translational Sciences, (2) Clinical Trials/Observations, (3) Laboratory/Quality, and (4) Pharmacy/Nursing/Other Transplant Support. The top four (4) oral abstracts and top four (4) poster abstracts were selected to receive an award. All of these were marked as “Award Recipient” within the relevant category. We congratulate all the presenters on their research and contributions to the field.

ABSTRACTThe diet during pregnancy, or antenatal diet, influences the offspring’s intestinal health. We previously showed that antenatal butyrate supplementation reduces injury in adult murine offspring with dextran sulfate sodium (DSS)-induced colitis. Potential modulators of butyrate levels in the intestine include a high fiber diet or dietary supplementation with probiotics. To test this, we supplemented the diet of pregnant mice with high fiber, or with the probiotic bacteria Lactococcus lactis subspecies cremoris or Lactobacillus rhamnosus GG. We then induced chronic colitis with DSS in their adult offspring. We demonstrate that a high fiber antenatal diet, or supplementation with Lactococcus lactis subspecies cremoris during pregnancy diminished the injury from DSS-induced colitis in offspring. These data are evidence that antenatal dietary interventions impact offspring gut health and define the antenatal diet as a therapeutic modality to enhance offspring intestinal health.

Abstract Antibodies to programmed cell death protein 1 (anti‐PD‐1) have become a promising immunotherapy for triple negative breast cancer (TNBC), blocking PD‐L1 signaling from pro‐tumor cells through T cell PD‐1 receptor binding. Nevertheless, only 10%–20% of PD‐L1+ metastatic TNBC patients who meet criteria benefit from immune checkpoint blockade (ICB), and biomarkers to predict patient response have been elusive. We have previously developed an immunological niche, consisting of a microporous implant in the subcutaneous space, that supports tissue formation whose immune composition is consistent with that within vital organs. Herein, we investigated dynamic gene expression within this immunological niche to provide biomarkers of response to anti‐PD‐1. In a 4T1 model of metastatic TNBC, we observed sensitivity and resistance to anti‐PD‐1 based on primary tumor growth and survival. The niche was biopsied before, during, and after anti‐PD‐1 therapy, and analyzed for cell types and gene expression indicative of treatment refractivity. Myeloid cell‐to‐lymphocyte ratios were altered between ICB‐sensitivity and resistance. Longitudinal analysis of gene expression implicated dynamic myeloid cell function that stratified sensitivity from resistance. A niche‐derived gene signature predicted sensitivity or resistance prior to therapy. Analysis of the niche to monitor immunotherapy response presents a new opportunity to personalize care and investigate mechanisms underlying treatment resistance. Summary: A remote implant identified biomarkers that predict anti‐PD‐1 response before therapy, providing a unique tool to understand heterologous immunotherapy resistance in triple negative breast cancer.

Abstract Biomaterial scaffolds mimicking the environment in metastatic organs can deconstruct complex signals and facilitate the study of cancer progression and metastasis. Here we report that a subcutaneous scaffold implant in mouse models of metastatic breast cancer in female mice recruits lung-tropic circulating tumor cells yet suppresses their growth through potent in situ antitumor immunity. In contrast, the lung, the endogenous metastatic organ for these models, develops lethal metastases in aggressive breast cancer, with less aggressive tumor models developing dormant lungs suppressing tumor growth. Our study reveals multifaceted roles of neutrophils in regulating metastasis. Breast cancer-educated neutrophils infiltrate the scaffold implants and lungs, secreting the same signal to attract lung-tropic circulating tumor cells. Second, antitumor and pro-tumor neutrophils are selectively recruited to the dormant scaffolds and lungs, respectively, responding to distinct groups of chemoattractants to establish activated or suppressive immune environments that direct different fates of cancer cells.

Abstract The present study aimed to identify the bioactive constituents in the chloroform extract of H. spicatum rhizomes (HS-RCLE), further evaluated for its in-vitro pesticidal activities validating via molecular docking techniques. GC/MS analysis of HS-RCLE identified 14 compounds contributing 84.1 % of the total composition. The extract was dominated by oxygenated sesquiterpenes (43.1 %) with curcumenone (25.2 %) and coronarin E (14.8 %) as the major compounds. The extract recorded 89.4 % egg hatchability inhibition and 82.6 % immobility of Meloidogyne incognita, 66.7 % insecticidal activity on Spodoptera litura, 100 % phytotoxic activity on Raphanus raphanistrum seeds, and 74.7 % anti-fungal activity on Curvularia lunata at the respective highest dose studied. The biological activities were furthermore validated by using docking studies on certain proteins/enzymes namely acetylcholinesterase (PBD ID: IC2O), carboxylesterase (PDB ID: 1CI8), acetohydroxyacid synthase (PBD ID: 1YHZ) and trihydroxy naphthalene reductase (PBD ID: 3HNR). The bioactivity of the major constituents of the extract was predicted with the help of in silico PASS studies. HS-RCLE was observed to be a viable alternative source of natural pesticidal agents and paves the way for further studies on its mechanistic approaches and field trials to ascertain its pesticidal studies.

Background and Objectives: Tibia is a superficial long bone, with one third of its surface being subcutaneous. An increasing incidence of road traffic accidents, farm accidents, gunshot wound predisposes it for open fracture. Open fractures of the tibia are the most common open long bone fractures. High-energy trauma is the primary mechanism of injury, with over 50% of cases being attributed to road traffic accidents are frequently contaminated. The treatment of open tibia fractures is still controversial. This prospective study was conducted at a tertiary care trauma center to evaluate the functional outcome and complications following primary debridement and nailing in type I to type IIIA open tibia fractures. Materials and Methods: A total of 30 patients diagnosed with open tibial diaphyseal fractures, who underwent primary debridement and fixation with intramedullary interlocking nail were included in the study and type III B, type III C open fractures were excluded. Patients were followed for a period of 12 months and assessed using Modified Ketenjian criteria and Johner − Wruhs' criteria. Results: Out of 30 patients who underwent primary nailing for open tibia fractures, 66.67% had excellent, 26, 67% good, and 6.66% of patients had fair results. 93.33% of the patients had union within 9 months and 6.66% of the cases had delayed union. Conclusion: Primary intramedullary interlocking nailing in open tibia fractures is a good treatment option, it aids early patient mobilization and early resume to work. It avoids multiple surgical procedures and promotes early fracture union.

Suppressive myeloid cells, including monocyte and neutrophil populations, play a vital role in the metastatic cascade and can inhibit the anti-tumor function of cytotoxic T-cells. Cargo-free polymeric nanoparticles (NPs) have been shown to modulate innate immune cell responses in multiple pathologies of aberrant inflammation. Here, we test the hypothesis that the intravenous administration of drug-free NPs in the 4T1 murine model of metastatic triple-negative breast cancer can reduce metastatic colonization of the lungs, the primary metastatic site, by targeting the pro-tumor immune cell mediators of metastatic progression. In vivo studies demonstrated that NP administration reprograms the immune milieu of the lungs and reduces pulmonary metastases. Single-cell RNA sequencing of the lungs revealed that intravenous NP administration alters myeloid cell phenotype and function, skewing populations toward inflammatory, anti-tumor phenotypes and away from pro-tumor phenotypes. Monocytes, neutrophils, and dendritic cells in the lungs of NP-treated mice upregulate gene pathways associated with IFN signaling, TNF signaling, and antigen presentation. In a T-cell deficient model, NP administration failed to abrogate pulmonary metastases, implicating the vital role of T-cells in the NP-mediated reduction of metastases. NPs delivered as an adjuvant therapy, following surgical resection of the primary tumor, led to clearance of established pulmonary metastases in all treated mice. Collectively, these results demonstrate that the in vivo administration of cargo-free NPs reprograms myeloid cell responses at the lungs and promotes the clearance of pulmonary metastases in a method of action dependent on functional T-cells.

The management of immune thrombocytopenic purpura (ITP) in children show great variation among physicians and centers. American Society of Hematology (ASH) has recently (2019) come up with updated guidance on the management of ITP in children and adults. There is no major change compared to ASH 2011 guidance, except for thrombopoietic receptor agonists (TPO-RAs) finding significant space in the ITP management armamentarium in the latest guidelines and steroids being recommended as a first line therapy. The ASH 2019 guideline is discussed in this review with realworld case examples. ASH 2019 guidelines help physicians manage patients with ITP in a rational way. The limitations of ASH guidelines, especially in Indian settings, are highlighted.

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a source of significant morbidity and death worldwide, and effective treatments are urgently needed. Clinical trials have focused largely on direct antiviral therapies or on immunomodulation in patients with severe manifestations of COVID-19. One therapeutic approach that remains to be clinically investigated is disruption of the host-virus relationship through amino acid restriction, a strategy used successfully in the setting of cancer treatment. Arginine is an amino acid that has been shown in nonclinical studies to be essential in the life cycle of many viruses. Therefore, arginine depletion may be an effective therapeutic approach against SARS-CoV-2. Several arginine-metabolizing enzymes in clinical development may be a viable approach to induce a low arginine environment to treat COVID-19 and other viral diseases. Herein, we explore the rationale for arginine depletion as a therapeutic approach for COVID-19.

Jasbir Makker,1,2 Danial Shaikh,1,2 Harish Patel,1,2 Siddarth Hanumanthu,1,2 Haozhe Sun,1 Bushra Zaidi,1 Madhavi Ravi,1,2 Bhavna Balar1,2 1Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, USA; 2Division of Gastroenterology, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, USACorrespondence: Danial ShaikhBronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai Bronx, 1650 Selwyn Ave, Bronx, NY 10457, USATel +1 718-974-7383Fax +1 718-960-2055Email dshaikh@bronxcare.orgBackground: Colonoscopy, although a low-risk procedure, is not without associated adverse events. The rates of major adverse events such as perforation and bleeding after a colonoscopy are well reported. The rates of minor incidents following a colonoscopy, however, are less well examined. Recently the Centers for Medicare and Medicaid Services (CMS) started public reporting on the quality of outpatient endoscopy facilities by using a measure of risk-standardized rates of unplanned hospital visits within 7 days of colonoscopy.Aim: We intended to record and present the characteristics of our patient population who had an unplanned hospital visit within 7 days after undergoing colonoscopy in an outpatient setting.Methods: This is a retrospective single-center observational study. During the study period of July 2018 to December 2019, we reviewed charts of all patients who returned to the emergency room within a week of undergoing an outpatient colonoscopy. Patient demographics, clinical data and details of colonoscopy were collected and analyzed.Results: Of the 5344 outpatient colonoscopies performed, our post-colonoscopy emergency room visit rate was 1.05% (n=56). The mean age of the participants was 58 years and 55% were male; 32% of our patients reported gastrointestinal symptoms such as abdominal pain or gastrointestinal bleeding. Patients with gastrointestinal symptoms had a higher rate of polypectomies performed (36.4% vs 11.8%, P = 0.04) and reported higher illicit drug use (31.9% vs 5.9%, P = 0.02) compared with those with non-gastrointestinal complaints. After colonoscopy, 41% of the patients reported reasons for emergency room visits that were entirely unrelated to the procedure.Conclusion: Our study highlights that unplanned visits within 7 days of colonoscopy are not necessarily related to the procedure, and those that are, tend to be due to unavoidable patient factors. Hence the CMS measure may not be an accurate determinant of the quality of procedure or facility care delivered.Keywords: colonoscopy, Centers for Medicare and Medicaid Services, CMS, 7-day readmission, adverse events, gastrointestinal symptoms, post-colonoscopy, unplanned visit

Hassan Tariq, 1, 2 Harish Patel, 1, 2 Muhammad Umar Kamal, 1 Naeem Abbas, 1, 2 Muhammad Ameen, 1 Sara Azam, 1 Kishore Kumar, 1, 2 Madhavi Ravi, 1, 2 Vamshidhar Vootla, 1, 2 Danial Shaikh, 1, 2 Vamsi Amanchi, 1 Ali N Hussain, 3 Jasbir Makker 1, 2 1Department of Medicine, BronxCare Health System, Bronx, NY 10457, USA; 2Division of Gastroenterology, BronxCare Health System, Bronx, NY 10457, USA; 3Baruch College, City University of New York (CUNY), New York, NY 10010, USACorrespondence: Muhammad Umar KamalBronxCare Health System, 1650 Selwyn Ave, Suite #10C, Bronx, NY 10457, USATel +1 718-960-1234Fax +1 718-960-2055Email muhammadumarkamal@gmail.comBackground: Helicobacter pylori is a common cause of gastritis, peptic ulcer disease, and non-ulcer dyspepsia, and is also associated with gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Despite being known about for more than 30 years, finding an effective therapeutic strategy against it remains a challenge.Aim: There are no US studies evaluating the efficacy of a Levofloxacin based therapy for H. pylori infection. We here intend to study the efficacy of Levofloxacin based triple antibiotic regimen as compared to Clarithromycin based triple therapy and Bismuth based quadruple therapy in our patient population.Methods: This is a retrospective single center observational study. Patients with Helicobacter pylori infection who underwent treatment for H. pylori with one of the three therapies, i.e. Clarithromycin triple, Bismuth Quadruple or Levofloxacin triple, were included in the study and the eradication rates were compared. The confirmation of the H. pylori was done 4 weeks after the completion of anti-microbial therapy.Results: A total of 177 individuals underwent the H. pylori treatment in our retrospective review. Of these, 54% (n=97) of patients were treated with Clarithromycin based triple therapy (Group 1), 35% (n=63) were treated with Levofloxacin based regimen (Group 2), and the remaining 11% (n=17) were treated with Bismuth based quadruple therapy (Group 3). The eradication rates were significantly higher in patients treated with Clarithromycin based triple therapy as compared to Levofloxacin based triple therapy and Bismuth quadruple therapy (78.3% vs 49.2% vs 41.1% P=0.001).Conclusion: In conclusion, our study shows significantly lower eradication rates with Levofloxacin triple therapy among a selected US population. Thus, it may not be a good first-line therapy among this US population and the Clarithromycin based regimen may still be used successfully.Keywords: Helicobacter pylori, clarithromycin, levofloxacin, quadruple therapy, peptic ulcer

Abstract Background Health behaviors including smoking cessation, physical activity (PA), and alcohol moderation are key aspects of cancer survivorship. Immigrants may have unique survivorship needs. We evaluated whether immigrant cancer survivors had health behaviors and perceptions that were distinct from native‐born cancer survivors. Methods Adult cancer patients from Princess Margaret Cancer Centre were surveyed on their smoking, PA, and alcohol habits and perceptions of the effects of these behaviors on quality of life (QoL), 5‐year survival, and fatigue. Multivariable models evaluated the association of immigration status and region‐of‐origin on behaviors and perceptions. Results Of the 784 patients, 39% self‐identified as immigrants. Median time of survey was 24 months after histological diagnosis. At baseline, immigrants had trends toward not meeting Canadian PA guidelines or being ever‐drinkers; patients from non‐Western countries were less likely to smoke (aORcurrent = 0.46, aORex‐smoker = 0.47, P = 0.02), drink alcohol (aORcurrent = 0.22, aORex‐drinker = 0.52, P

Context: Understanding the role of fibroblast growth factor receptor (FGFR) in the regulation of bone development and disease will ultimately lead to better prevention and treatment of related bone deformities and disorders. Aims: To evaluate the role of gene FGFR3 in individuals with retrognathic maxilla by polymerase chain reaction (PCR) technique at molecular level and evaluate the significance of the same. Settings and Design: Hospital based fundamental research involving individuals having maxillary retrognathism. Methodology: A total of 62 individuals (30M and32F) who were willing to take part in the study were selected from cephalometric measurements of N I A and the length PNS to ANS. The institution based basic genetic research study involved collection of fresh blood samples, DNA extraction, PCR analysis, and amplification using the specifically designed forward and reverse primers for targeting the commonly occurring mutations in FGFR3 gene. Further the products were sequenced to evaluate the presence of any novel mutations. Results: The targeted single-nucleotide polymorphisms, at position 1138 in exon 10 of the FGFR3 gene were not identified in the analyzed blood samples. The detailed sequencing of full gene revealed the presence of 2 novel mutations, Exon 3: A213G and Exon 3: A223A/G in one individual. Conclusions: The present study indicated 2 novel mutations in gene FGFR3 in individual with maxillary retrognathism. The genetic–environmental interactions might have played a significant role in the expression of retrognathic maxilla.

Abstract Background Necrotizing enterocolitis (NEC) is a leading cause of neonatal morbidity and mortality in premature infants. To date, no effective biomarkers exist to predict which premature infants will develop NEC, limiting targeted prevention strategies. Multiple observational studies have reported an association between the exposure to red blood cell (RBC) transfusion and/or anemia and the subsequent development of NEC; however, the underlying physiologic mechanisms of how these factors are independently associated with NEC remain unknown. Methods In this paper, we outline our prospective, multicenter observational cohort study of infants with a birth weight ≤ 1250 g to investigate the associations between RBC transfusion, anemia, intestinal oxygenation and injury that lead to NEC. Our overarching hypothesis is that irradiation of RBC units followed by longer storage perturbs donor RBC metabolism and function, and these derangements are associated with paradoxical microvascular vasoconstriction and intestinal tissue hypoxia increasing the risk for injury and/or NEC in transfused premature infants with already impaired intestinal oxygenation due to significant anemia. To evaluate these associations, we are examining the relationship between prolonged irradiation storage time (pIST), RBC metabolomic profiles, and anemia on intestinal oxygenation non-invasively measured by near-infrared spectroscopy (NIRS), and the development of NEC in transfused premature infants. Discussion Our study will address a critical scientific gap as to whether transfused RBC characteristics, such as irradiation and metabolism, impair intestinal function and/or microvascular circulation. Given the multifactorial etiology of NEC, preventative efforts will be more successful if clinicians understand the underlying pathophysiologic mechanisms and modifiable risk factors influencing the disease. Trial registration Our study is registered in ClinicalTrials.gov Identifier: NCT02741648.

Multicentric reticulohistiocytosis also known as lipoid dermatoarthritis is a rare multisystem disorder that affects skin, mucosa and joints and has distinct histopathological features. We report a case of a 31 year old female who presented to us for joint pain involving knees and wrists and asymptomatic papulonodules over forearms knuckles and periungual region. The diagnosis of multicentric reticulohistiocytosis was made on the basis of typical histopathological features which showed multinucleated giant cells and sheets of histiocytes with abundant granular eosinophilic cytoplasm. Work up for associated diseases was negative. The patient was put on systemic steroids however was lost for follow up. The worldwide incidence of the disease is very low (around 300 cases in recent years) and it is mainly seen in Caucasians although Hispanic, African and Asian cases have also been described. Reports from India are limited and hence the present case is being reported with a brief review of the disease.

Objective: To assess the prevalence of high central aortic pressure (CAP) in Indian patients with uncontrolled essential hypertension while on anti-hypertensive monotherapy. Also, to determine correlation between brachial blood pressure (BBP) and CAP, and ascertain if it is impacted by anti-hypertensive drug class and patients’ age. Methods: In this real-world, observational, prospective study, patients (30–70 years) with uncontrolled BBP (systolic BP [SBP] ≥140 mmHg or diastolic BP [DBP] ≥90 mmHg) were enrolled. Treatment was adjusted at Visit 1 (baseline), based on BBP and at treating physicians’ discretion. Primary endpoint was proportion of patients with uncontrolled central aortic SBP (>125 mmHg) at baseline. Secondary endpoints were comparison of BBP and CAP across drugs classes and age groups at baseline and Visit 2 (End-of-study, ∼8 weeks post-baseline), and proportion of patients with uncontrolled central SBP at end-of-study. Results: Of 2030 patients screened, 1949 patients reported at baseline and 1740 patients completed end-of-study visit. Central SBP was >125 mmHg for 84.3% patients at baseline, and 48% patients at end-of-study. Interestingly, at end-of-study, 6.6% patients still had uncontrolled brachial SBP and controlled central SBP, while 13.6% patients had uncontrolled central SBP and controlled brachial SBP. At both visits, brachial SBP and central SBP showed positive correlation across most drug classes and age groups. At baseline, ACE inhibitors showed better efficacy than other drug classes. At end-of-study, BP control was better with fixed-dose combinations, though free–drug combinations were more frequently prescribed. Conclusion: Measurement of CAP along with BBP can be vital in management of hypertension. Ctri registration number: CTRI/2015/10/006302. Keywords: Brachial blood pressure, Central aortic pressure, Hypertension, India, Real-world study

Śrīdhara Svāmī’s commentary on the Bhāgavata Purāṇa, called Bhāvārtha-dīpikā and composed sometime between the mid-fourteenth to the mid-fifteenth centuries, has exerted extraordinary influence on later Bhāgavata commentaries, and indeed, on Vaiṣṇava traditions more generally. This article raises a straightforward question: “Why Śrīdhara?” Focusing on the Caitanya Vaiṣṇava tradition, particularly Jīva Gosvāmī, for whom Śrīdhara is foundational, we ask, “What is it about Śrīdhara Svāmī’s commentary—both stylistically and theologically—that made it so useful to Caitanya Vaiṣṇavas and other Bhāgavata commentators?” This question, to the extent that it can be answered, has implications for our understanding of Śrīdhara’s theology as well as the development of the early Caitanya Vaiṣṇava tradition, but it can also lend insight into the reasons for Śridhara’s influence more generally in early modern India.

Introduction: Acutediarrheal diseases constitute one of the leading cause of morbidity & mortality in children below five years of age. Assessing the prevalence of diarrhea and associated factors among children of age under five will be helpful in determining the disease burden and in planning and implementation of prevention strategies at the community level. The study was conducted with the objectives to assess the prevalence and factors associated with diarrhea among under five childrenwith diarrhea Methodology: This is across sectional study with sample size of 429. Eight villages from V.Kota and Kuppam mandals, 25 houses from each village were selected randomly. Data regarding various sociodemographic factors, environmental and behavior factors were collected. Statistical analysis was done using Chi-square test and odds ratio was calculated for various factors. Results: the prevalence of diarrhea was estimated to be 47.6% (CI 42.4 – 51.7). Factors such as education of the mother, hand washing practices, use of soap during hand washing, source of drinking water, disposal of stools were significantly associated with prevalence of diarrhea Conclusion: Awareness of factors influencing diarrhea and simple interventions can reduce the burden of the diarrheal diseases.

Introduction: Since, thousands of years we have been using natural medication in Indian system of medicine. Till today lots of work has been done to study their toxicity, but very few studies have been undertaken on genotoxicity. There is urgent requirement for taking initiative in this regard. Hence, interested in evaluating the genotoxicity potential of Tamra Bhasma well known metallic (Copper) preparation widely used in alternative system of medicine. Aim: To evaluate the genotoxicity profile of Tamra Bhasma drug (a copper based metallic formulation in Indian system of Medicine) with main emphasis on comet assay, micronucleus assay and chromosomal aberration assay in Swiss albino mice. Materials and Methods: Animals were randomly grouped into four different groups containing ten mice (five male and five female) in each group. Group I considered as normal control which received only vehicle (0.5% CMC). The Group II considered as positive control and on 28th day which received cyclophosphamide (40 mg/kg/body weight) through intra-peritoneal injection for comparative assessment. The Groups III and IV administered with test drug Tamra Bhasma 2.86 mg/kg and 14.3 mg/kg respectively. These groups were administered the test drug for 28 consecutive days. On 29th day blood was collected into heparinized tubes for comet assay analysis. Half of the animals were injected with colchicine (4 mg/kg IP) in order to arrest the cells into metaphase stage and then sacrificed the animals to collect the bone marrow from the both the femurs for chromosomal aberration analysis. The rest of the animals were also sacrificed and bone marrow was collected for micronuclei analysis. Results: The repeated administration of test drug Tamra Bhasma of both the dose levels didn’t produce remarkable genotoxicity, DNA damage or chromosomal abnormalities both numerically as well as structurally. However, Tamra Bhasma administered at both the dose level groups showed slight increase in comet height, comet tail length, % DNA and Tail movement. But increase was not significant as compare to normal control. Conclusion: The repeated administration of test drug Tamra Bhasma at therapeutic dose level confirms its relative safety and did not produce any marked toxic effect or genetic material abnormalities. This work may inspire more efficacious and safer use in clinical set up and global acceptance of the test formulation.

Introduction: Most of the disease burden because of hypertension is preventable if right action is taken at right time. Public health intervention at the pre-hypertensive stage becomes important in this regard. Hence this study was conducted with an objective to estimate the prevalence of prehypertension and determine the factors associated with prehypertesion. Methods: Cross sectional study with 389 participants was carried out among urban population. Data regarding basic demographic characteristics including anthropometric measurements height and weight were collected. Systolic blood pressure between 120-139 mm Hg and/or diastolic blood pressure between80-89 mm Hg was taken as cut off values to define prehypertension. Statistical analysis was done using Chi-square test, t-test and multiple linear regression analysis. Results: Prevalence of prehypertension was estimated to be 33.7%. Various factors such as age, extra salt intake, alcohol consumption, BMI were significantly associated with prehypertension. Conclusion: There is increasing prevalence of prehypertension. Simple lifestyle modifications such as low intake of salt, reducing alcohol can reduce overall blood pressure. Early intervention would decrease the future burden of hypertension.

The changing landscape of healthcare and recent formal Standards for innovation in pharmacy education presents a unique opportunity. To realize this opportunity, pharmacy should learn from the successes of other fields to make use of the rich environment for improvement in healthcare. The University of Pittsburgh School of Pharmacy presents one example of a Program that utilizes a curriculum, projects, and partners to realize innovation. Educators in pharmacy can make use of the opportunity for innovation by learning from successful examples and embracing the process’s challenges of iteration. Type: Commentary

Background and Objectives: Buccal corridor space has been thought of primarily in terms of maxillary width, but there is also evidence that they are heavily influenced by the antero-posterior position of maxilla. The present study was undertaken with an aim of evaluating and comparing the dental and skeletal factors related to buccal corridor space in individuals having Class I and Class II Division 1 malocclusions. Materials and Methods: A total of 80 subjects of which 40 were males and 40 were females in the age group of 20-30 years were selected as per inclusion criteria and were grouped as Group I having Class I malocclusion and as Group II having Class II malocclusions based on angle ANB. 12 linear and 2 angular cephalometric measurements and 4 study cast measurements were used to correlate with the buccal corridor linear ratio (BCLR), calculated on smile photograph using the Adobe Photoshop 7.0 software (Adobe Systems Inc., San Jose, California, USA). The data obtained was statistically evaluated using independent t-test and multiple linear regression analysis. Result: Buccal corridor space is larger in individuals with Class II Division 1 malocclusion when compared with individuals with Class I malocclusions. There exists a significant difference in buccal corridor space between males and females. Conclusion: The present study helps in establishing the correlation between certain factors and the amount of buccal corridor space in individuals having skeletal Class II pattern.

Aim of this study was to evaluate the in vitro genotoxicity and cytotoxicity of two orthodontic adhesives and to determine the type of cell death they induce on human lymphocytes. The materials tested were 1.Light cure orthodontic adhesive with conventional primer (Transbond XT3M) and 2. Self cure orthodontic adhesive (Unite, 3M). Cured sterile individual masses were immersed in DMEM and left at 370C for 24 h. Then a volume of 200 μL of the extract medium was mixed with human peripheral blood lymphocyte tested for comet assay by Single cell DNA Damage assay and Apoptosis by DNA diffusion agar assay. Evaluation of Cytotoxicity was carried out by Hemolysis assay method. Hemolytic activity of Self cure orthodontic adhesive (52.9± 1.82) was significantly more than that of Light Cure orthodontic adhesive (48.9±1.23). The results showed all parameters studied by comet assay were significant (P>0.05).In Case of Apoptosis, Light cure orthodontic adhesive (155.11±6.03) and self cure orthodontic adhesives (154.77±13.17) showed slightly increased diffusion of DNA compared to normal lymphocyte (111.22±8.78).However the level of DNA diffusion was not significantly different between the two adhesives. Light Cure orthodontic and self cure orthodontic adhesives were cytotoxic and induced apoptosis. The self cure orthodontic adhesive was found to be significantly more toxic than that of Light Cure orthodontic adhesive. Both the adhesives had no significant effect on the percentage of DNA tail and Tail length of the human lymphocyte. [Med-Science 2013; 2(4.000): 820-9]

Corticobasal degeneration (CBD) rarely presents with rapidly progressive dementia (RPD). Its description primarily exists as case reports and case series only. This case report describes and discusses RPD as an initial manifestation of CBD for the benefit of clinician. A 75-year-old male who presented initially with complaints of difficulty in money handling, repetitive activities, irritability, and naming difficulty for 8 months. Later, he developed complaints of forgetfulness, navigational difficulty, dystonia, and rigidity in the right hand. This case demonstrates that patients who are presenting with RPD in geriatric mental health, motor symptoms must be evaluated to rule out corticobasal degeneration.

Aim: To evaluate the color stability and flexural strength of poly (methyl methacrylate) (PMMA) and bis-acrylic composite based provisional crown and bridge auto-polymerizing resins exposed to tea, coffee, cola, and food dye. Materials and Methods: Two provisional crown and bridge resins, one DPI self-cure tooth molding powder (PMMA) (Group A), and one Protemp 4 Temporization Material (bis-acrylic composite) (Group B) were used. Disk-shaped specimens for color stability testing (n = 30 for each material) and bar-shaped specimens for flexural strength testing (n = 30 for each material) were fabricated using a metal mold. The specimens were immersed in artificial saliva, artificial saliva + tea, artificial saliva + coffee, artificial saliva + cola, and artificial saliva + food dye solutions and stored in an incubator at 37°C. Color measurements were taken before immersion, and then after 3 and 7 days of immersion. Flexural strength was evaluated after 7 days of immersion. Results: Group A showed significantly higher color stability as compared to Group B, and artificial saliva + coffee solution had the most staining capacity for the resins. Test solutions had no effect on the flexural strength of Group A, but Group B specimens immersed in artificial saliva + cola showed significantly lower flexural strength values as compared to the control group. Conclusion: The findings of the study showed that for materials used in the study, PMMA was more color stable than bis-acrylic composite based resin. Also, material based on PMMA was more resistant to damage from dietary beverages as compared to bis-acrylic composite based provisional crown and bridge resin.

Background: The thickness of the masseter muscle during relaxation and contraction states was measured by ultrasonography. Subjects were classified according to their sagittal skeletal relationships. The association between muscle thickness and facial morphology was studied. Context: Masseter muscle thickness influences the skeletal patterns. Aim: To measure and compare the thickness of the masseter muscle in individuals with skeletal class I occlusion and skeletal class II malocclusions and to correlate its relationship with craniofacial morphology. Settings and Design: The study was conducted in a hospital setup and was designed to study the thickness of the masseter muscle in different skeletal morphologies. Materials and Methods: Seventy two individuals between the ages of 18 and 25 years were divided into Group I, Group IIA and Group IIB according to their skeletal relationships. Masseter muscle thickness was measured by ultrasonography. Eight linear and six angular cephalometric measurements were assessed. Statistical Analysis Used: Analysis of variance and Pearson′s correlation analysis. Results: There was a statistically significant difference in muscle thickness between subjects of different skeletal patterns. Significant positive correlation between masseter muscle thickness and posterior total face height, jarabak ratio, ramus height, mandibular length and significant negative correlations with mandibular plane angle, gonial angle and PP-MP angle were observed. Conclusion: This study indicates the strong association between the masseter muscle and skeletal morphology.

Background: Patients with fracture femur experience severe pain on movement during positioning for spinal anaesthesia. Fascia Iliaca Compartment Block (FICB) has been used effectively for providing analgesia during positioning of the patient for spinal anaesthesia. Aim: To test the hypothesis that, adding dexamethasone would significantly prolong the duration of Bupivacaine in FICB. Materials and Methods: Sixty patients aged 18 to 80 years posted for ORIF (Open Reduction and Internal Fixation) of fracture femur were included to receive FICB. This was a prospective, randomized, double blind study done at tertiary medical college hospital. Thirty patients received 38ml of 0.25 % bupivacaine with 2ml saline and another 30 patients received 38ml of 0.25 % bupivacaine with 2ml dexamethasone (8mg). Thirty minutes after FICB, patient satisfaction during positioning for spinal anesthesia was recorded. In the post-operative period, duration of analgesia and the total doses of rescue analgesics were recorded in both the groups. Results: Patients who received Bupivacaine with dexamethasone had significant prolongation of analgesia and required fewer doses of rescue analgesics as compared to patients who received Bupivacaine alone for FICB. However, the onset of analgesia, VAS scores and patient satisfaction during positioning for spinal anaesthesia were similar in both groups. Conclusion: Our study shows that adding Dexamethasone (8mg) to Bupivacaine for FICB significantly prolonged the duration of block and decreased the requirement of rescue analgesics as compared to patients who received Bupivacaine alone. FICB is relatively easy and safe to perform. In our study we did not encounter any complication while doing the procedures and also by adding dexamethasone.

Photovoltaic solar modules, which are mostly made of silicon based solar cells, are still expensive to the common people of Nepal. The high cost is, mainly, due to the processing difficulties to get pure crystalline silicon. Here, we present results on devising efficient and low-cost dye sensitized solar cells (DSSCs). The solar cells were fabricated from transparent thin film of zinc oxide (ZnO), as a semiconductor, on top of which a thin layer of synthetic organic dye was deposited for efficient light harvesting. In order to achieve the films with optimum conditions for solar cell fabrication, we prepared transparent thin films of ZnO of various thicknesses and characterized by measuring their light transmittance by UV-Visible spectrophotometry. The results clearly show variation in transmittance curves with variation in film’s thickness. Also for finding appropriate sensitizer for ZnO nanoparticles, we extensively investigated the light absorbance of synthetic organic dyes. Among the dye species investigated, Green-VS, Patent-Blue, and Black-ADLI show strong absorbance over the wide range in the visible spectrum, demonstrating prospect of utilizing for DSSCs. Then prototype solar cells from ZnO film with various thicknesses were constructed and were sensitized with the mixture of Green-VS and Black-ADLI dyes (with 1:1 ratio). The measured photo-voltage and photo-current from solar cell, from our modest ZnO film, after irradiation with 200 W commercial bulb (calibrated with Pyranometer) as a light source, were about 20 mV and 1 μA, respectively. Also, with increment of the power of radiation both the measured photo-current and photo-voltage increase. Performance of the cell in real sun condition has also been made. With the solar radiation power of 930 W, the observed photo-voltage and photo-current were ca. 230 mV and 50 μA, respectively. DOI: http://dx.doi.org/10.3126/bibechana.v11i0.10380 BIBECHANA 11(1) (2014) 53-59

Background: Fine needle aspiration cytology (FNAC) of broad and highly sensitive head and neck region is particularly suitable for confirming non-neoplastic and metastatic lesions as it can prevent a surgical process and anaesthetic conditions and can provide a suitable guidance for conservative management. Aim and objective: To access the role of FNAC in diagnosing various head and neck swellings. Material and methods: This retrospective study was done in a tertiary care hospital from 1/1/2012 to 31/12/2012 in patients having swelling in head and neck region. Total 701 cases were evaluated in the cytopathology section and aspiration was done using 10ml syringe and 22-23 gauge needles. Results: Cytodiagnostic yield was 90% while in only 10% cases, no diagnosis was given. Lymph node lesions were most common with granulomatous/ tuberculous lesions being the commonest variety. In salivary gland lesions, neoplastic lesions (benign: Pleomorphic adenoma) were commonest. Other common lesions were squamous cell carcinomas and lipomas as common malignant and benign tumours respectively. Conclusion: FNAC provides a reliable, cost effective, convenient, easily accessible and non-traumatic method as the best initial work up and management of swellings of sensitive head and neck region.

Purpose. To evaluate treatment outcomes of minimally invasive plate osteosynthesis (MIPO) for distal femoral fractures in 31 patients. Methods. 22 male and 9 female consecutive patients aged 21 to 65 (mean, 42) years underwent minimally invasive plate osteosynthesis using a locking compression plate (LCP) for distal femoral fractures. The causes of injury were vehicular accidents (n=24), falls (n=6), and assault (n=1). According to the AO classification, the fractures were classified as types A1 (n=10), A2 (n=7), and A3 (n=14). Most fractures were closed; 3 were Gustilo type-II fractures. Clinical and functional outcomes were assessed using the Knee Society Scores. Results. The mean operating time was 70 (range, 60–100) minutes. The mean length of hospital stay was 9 (6–14) days. The mean time to union was 3.7 (range, 2.8–4.6) months. The mean follow-up period was 18 (14–26) months. At the one-year follow-up, 29 of the patients had good or excellent outcomes. No patient had angular or rotational deformity of >10°. One osteoporotic woman with a type-A1 fracture had implant failure at 10 weeks and underwent revision surgery. Another patient with a type-A1 fracture had persistent pain on the lateral aspect of the distal thigh and underwent implant removal at 22 months. No patient developed deep infection, malunion or nonunion. Conclusion. MIPO using a LCP achieves favourable biological fixation for distal femoral fractures with few complications. Bone grafting is not needed even in cases of metaphyseal comminution. Proper patient selection and preoperative planning are essential to prevent complications.