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This study reports the enhanced photocatalytic performance of V2O5-ZnS nanocomposites over pure V2O5 nanocrystals and pure ZnS nanocrystals for the degradation of ciprofloxacin (CIP) and amoxicillin (AMX) antibiotics under simulated sunlight irradiation. Synthesis of the V2O5-ZnS nanocomposites was carried out in two steps, first synthesis of V2O5 by chemical co-precipitation method and then growth of ZnS over V2O5 following a chemical process. The X-ray diffraction (XRD) pattern of the V2O5-ZnS nanocomposites revealed the presence of V2O5 with orthorhombic crystal phase and ZnS with cubic crystal phase. The scanning electron microscopy (SEM) micrograph of the V2O5-ZnS nanocomposites showed the formation of disc shaped particles with rod like edges. The photoluminescence (PL) spectrum of the V2O5-ZnS nanocomposites exhibited vanadium interstitial, vanadium vacancy, oxygen vacancy and sulphur vacancy related emissions. The prepared V2O5-ZnS nanocomposites degraded 96% of CIP after 150 min of light exposure, while they degraded 94% of AMX after 100 min of light exposure. These degradation efficiencies of the nanocomposites were significantly higher than the degradation efficiencies of pure ZnS and pure V2O5 nanocrystals. The apparent rate constants for CIP and AMX degradation by the nanocomposites were 0.021 min−1 and 0.029 min−1, respectively. However, the degradation efficiency of the nanocomposites decreased significantly for the degradation of CIP+AMX mixture with more than 90% degradation efficiency being achievable after 200 min of light exposure. The type-II heterojunction formation between V2O5 and ZnS in the nanocomposites has been proposed to be the reason for the enhancement in the photocatalytic performance of the nanocomposites.

Abstract Background Diarrhoea has become one of the major areas of concern due to its high mortality rate contributing it to be the second largest cause of death in world. To explore the effectiveness of medicinal plant, the present investigation was undertaken to scientifically justify the traditional claim of the ethanolic root extract of the plant Begonia rubrovenia (EBV) against diarrhoea. Results EBV was standardized using HPLC with quercetin as marker and was further subjected to normal fecal excretion study at 100, 200 and 300 mg/kg, p.o. along with quercetin and loperamide. The study confirmed the effectiveness of EBV at 200 and 300 mg/kg followed by quercetin. In castor oil induced diarrhoea rat model, EBV at 200 and 300 mg/kg significantly delayed onset of diarrhoea, reduced the diarrhoeal faecal output which contributed in higher % protection. The effectiveness of EBV at 200 mg/kg was also confirmed through gastrointestinal motility, fluid accumulation and PGE2 induced enteropooling tests. EBV and its marker quercetin also reduced the elevated level of NO and cytokines and restored the alterations in antioxidant enzymes, ions and enhanced Na+/K+–ATPase activity. Molecular docking, dynamics and network pharmacology study confirmed the role of quercetin in modulating the inflammatory mediators IL-1β, TNF-α and EP3 prostanoid receptor, where quercetin formed more stable complex with EP3 prostanoid receptor. Conclusion The study has scientifically justified the traditional use of the plants B. rubrovenia in treating diarrhoea, where quercetin played a critical role in the observed antidiarrhoeal potential of B. rubrovenia contributing in maintaining electrolyte balance, antioxidant status and inhibiting inflammatory mediators.

Background and aim: Acacia catechu Wild. (Fabaceae) barks are traditionally used in the treatment of diabetes and wounds. Therefore, the objective of the present study was to evaluate the wound healing potential of the alcoholic extract of A. catechu (EAC) in streptozotocin-induced diabetic mice. Experimental procedures: EAC was first subjected to phytochemical estimations and standardization using (−) epicatechin as marker with the help of HPLC. Diabetes was induced in mice using streptozotocin and the wound healing potential of EAC was evaluated using excision and incision wound models on topical and oral treatment. Various biochemical parameters, in vivo antioxidants, cytokine profiling, VEGF, and histopathological examination were also performed. Further, molecular docking studies were performed using ligand (−) epicatechin on human inducible nitric oxide synthase. Results and conclusion: Phytochemically, EAC showed the presence of tannins, flavonoids, phenolic compounds, and saponins, while the content of (−) epicatechin was reported to be 7.81% w/w. The maximum healing of wounds (91.84 ± 1.10%) was observed in mice treated with a combination of both topical (10% gel) and oral (extract at 200 mg/kg) followed by topically and orally treated groups respectively after 14 days of treatment. These groups also showed significant restoration of altered biochemical parameters, antioxidant enzymes and cytokines. The molecular docking studies confirmed the role of (−) epicatechin in stabilizing the human inducible nitric oxide synthase with inhibitor showing binding energy of −8.31 kcal/mol. The present study confirmed the role of (−) epicatechin as a major marker in diabetic wound healing potential of A. catechu.

Transcriptional enhancers can be in physical proximity of their target genes via chromatin looping. The enhancer at the β-globin locus (locus control region [LCR]) contacts the fetal-type (HBG) and adult-type (HBB) β-globin genes during corresponding developmental stages. We have demonstrated previously that forcing proximity between the LCR and HBG genes in cultured adult-stage erythroid cells can activate HBG transcription. Activation of HBG expression in erythroid cells is of benefit to patients with sickle cell disease. Here, using the β-globin locus as a model, we provide proof of concept at the organismal level that forced enhancer rewiring might present a strategy to alter gene expression for therapeutic purposes. Hematopoietic stem and progenitor cells (HSPCs) from mice bearing human β-globin genes were transduced with lentiviral vectors expressing a synthetic transcription factor (ZF-Ldb1) that fosters LCR-HBG contacts. When engrafted into host animals, HSPCs gave rise to adult-type erythroid cells with elevated HBG expression. Vectors containing ZF-Ldb1 were optimized for activity in cultured human and rhesus macaque erythroid cells. Upon transplantation into rhesus macaques, erythroid cells from HSPCs expressing ZF-Ldb1 displayed elevated HBG production. These findings in two animal models suggest that forced redirection of gene-regulatory elements may be used to alter gene expression to treat disease.

Objective Accumulating evidence suggests increased cardiovascular risk in women with polycystic ovarian syndrome (PCOS) due to a cluster of factors, such as obesity, lipid abnormalities, impaired glucose tolerance (IGT), and hypertension. Markers such as high-sensitivity C-reactive protein (hs-CRP) and plasminogen activator inhibitor-1 (PAI-1) can provide an adjunctive method for the assessment of cardiovascular risk and can indicate future coronary heart diseases in women with lean PCOS.

Diabetic nephropathy (DN) is a serious microvascular consequence of diabetes mellitus (DM), posing an encumbrance to public health worldwide. Control over the onset and progress of DN depend heavily on early detection and effective treatment. DN is a major contributor to end-stage renal disease, and a complete cure is yet to be achieved with currently available options. Though some therapeutic molecules have exhibited promise in treating DN complications, their poor solubility profile, low bioavailability, poor permeation, high therapeutic dose and associated toxicity, and low patient compliance apprehend their clinical usefulness. Recent research has indicated nano-systems as potential theranostic platforms displaying futuristic promise in the diagnosis and treatment of DN. Early and accurate diagnosis, site-specific delivery and retention by virtue of ligand conjugation, and improved pharmacokinetic profile are amongst the major advantages of nano-platforms, defining their superiority. Thus, the emergence of nanoparticles has offered fresh approaches to the possible diagnostic and therapeutic strategies regarding DN. The present review corroborates an updated overview of different types of nanocarriers regarding potential approaches for the diagnosis and therapy of DN.

Introduction: Early identification of Left Ventricular Hypertrophy (LVH), a powerful and independent predictor of Cardiovascular Disease (CVD), is a key element for preventing Cardiovascular Events (CVE). High-Normal Blood Pressure (HNBP) was significantly associated with a new-onset Electrocardiogram (ECG) diagnosed LVH. The demographic and personal lifestyle characteristics could be related to HNBP in ECG diagnosed LVH. This relation, if found, can be useful as a factor for early identification of HNBP in relation to ECG diagnosed LVH. Aim: To compare demographic and personal lifestyle characteristics with HNBP in relation to ECG diagnosed LVH in healthy adults. Materials and Methods: The cross-sectional study was conducted in AIIMS Raipur (CG) from April 2021 to March 2022 among 95 healthy adult males between 20 to 39 years with a Blood Pressure (BP) of 130-139/85-89 mm Hg and no anti-hypertensive medications. Permission was obtained from the Ethics committee of AIIMS Raipur (CG). Data was collected from the individuals using health questionnaire, Personal Lifestyle Questionnaire (PLQ), validated anthropometric equipment stature meter for measuring height and weighing machine, a working electronic BP measuring instrument, and ECG. The present study included demographic factors like age, height, weight, Body Mass Index (BMI), educational level, marital status, occupation, and Socio-Economic Status (SES) classified based on Kuppuswamy’s classification. The personal lifestyle characteristics included physical activity, use of substances (alcohol, smoking, tobacco, gutkha), and diet. The unpaired t-test, Chi-square test and regression analysis were applied for the analysis of the collected data. Results: Representation of demographic factors were age (31.9±5.08), height (1.69±0.06), weight (68.3±10.2), BMI (23.8±3.05) in terms of (mean±SD) and SES in terms of n (%) were upper I-7 (7.4), upper middle II-31 (32.6), lower middle III-30 (31.6), upper lower IV-25 (26.3), lower V-2 (2.1). SES classes of modified Kuppuswamy’s SES scale had a significant relationship with LVH {p-value

Abstract Realistic models based on the renormalizable grand unified theories have varieties of scalars, many of which are capable of mediating baryon (B) and lepton (L) number non-conserving processes. We identify all such scalar fields residing in 10, 126 ¯ $$ \overline{\mathbf{126}} $$ and 120 dimensional irreducible representations of SO(10) which can induce baryon and lepton number violating interactions through the leading order d = 6 and d = 7 operators. Explicitly computing their couplings with the standard model fermions, we derive the effective operators including the possibility of mixing between the scalars stemming from a given representation. We find that such interactions at d = 6 are mediated by only three sets of scalars: T(3, 1, −1/3), T $$ \mathcal{T} $$ (3, 1, −4/3) and T $$ \mathbbm{T} $$ (3, 3, −1/3) and their conjugates. In the models with 10 and 126 ¯ $$ \overline{\mathbf{126}} $$ , only the first has appropriate couplings to mediate the proton decay. While T $$ \mathcal{T} $$ and T $$ \mathbbm{T} $$ can induce baryon number violating interactions when 120 is present, T $$ \mathcal{T} $$ does not contribute to the proton decay at tree level because of its flavour antisymmetric coupling. Three additional colour triplets and their conjugates can mediate nucleon decay via d = 7 operators which violate also the B − L. We give general expressions for partial widths of proton in terms of the fundamental Yukawa couplings and use these results to explicitly compute the proton lifetime and branching ratios for the minimal non-supersymmetric SO(10) model based on 10 and 126 ¯ $$ \overline{\mathbf{126}} $$ Higgs. We find that the proton preferably decays into ν ¯ $$ \overline{\nu} $$ K + or μ + K 0 and list several distinct features of scalar mediated proton decay. If the latter dominates over the gauge mediated contributions, the proton decay spectrum provides a direct probe to the flavour structure of the underlying grand unified theory.

The pathogenesis of COVID-19 is complicated by immune dysfunction. The impact of immune-based therapy in COVID-19 patients has been well documented, with some notable studies on the use of anti-cytokine medicines. However, the complexity of disease phenotypes, patient heterogeneity and the varying quality of evidence from immunotherapy studies provide problems in clinical decision-making. This review seeks to aid therapeutic decision-making by giving an overview of the immunological responses against COVID-19 disease that may contribute to the severity of the disease. We have extensively discussed theranostic methods for COVID-19 detection. With advancements in technology, bioinformatics has taken studies to a higher level. The paper also discusses the application of bioinformatics and machine learning tools for the diagnosis, vaccine design and drug repurposing against SARS-CoV-2.

The purpose of this study was to describe the development of a solar-powered submersible pump system without the use of batteries in agriculture. The submersible pump system used a solar drive to run it. The implementation uses a combination of solar trackers, water storage tanks, power converters, and stabilizers. The results of the study explained that solar trackers increased the efficiency of solar units that track the sun throughout the day and convert solar energy into DC electrical power.

Abstract The bulk carrier excitation influences the phonon dynamics, which can alter and modulate the surface charge density of topological insulators such as bismuth selenide (Bi2Se3). This work investigates the charge carrier and phonon dynamics in Bi2Se3 grown on various substrates. The orientation of the substrate, the size of the crystallites, and the misfit of the lattice affect the carrier and phonon dynamics. Bi2Se3 thin films are grown under the same growth conditions on SiO2, Si(111), and SiN. Bi2Se3 overlayers exhibit substrate‐dependent charge carrier relaxation channels and phonon dynamics. It is evident from Raman spectroscopy and ultrafast transient absorption spectroscopy that the heterointerface interactions of all three samples affect the vibration modes of Bi2Se3 and coherent acoustic phonon oscillations in the NIR range. At 13.6, 41.2, and 34.4 GHz, the vibration modes of SiO2, Si(111), and SiN are equivalent. The propagation depth of phonon waves is shown by measuring the speed of sound in Bi2Se3 overlayers on SiO2, Si(111), and SiN. This study demonstrates that the surface and bulk‐bound charge carriers of a topological insulator determine the frequency and velocity of the generated sound.

Post burn contractures are a common occurrence after severe burn injuries. In more than 80% of all burns, the hand is involved (Fufa et al., 2014). This article aims to emphasize on the need of detailed pre-operative scrutiny of hand deformities and guide a burn surgeon in obtaining optimal hand function and avoid pit falls at different stages of management of hand burns. The study is a prospective, non-randomized, observational study of patients presenting with post burn deformities of hand(s) requiring surgical intervention. McCauley’s classification of burn scar contracture in hand was used to classify the post burn deformities. A total of 1021 patients with 23 cases of both hands (total, 1044 hands) were included over a period of 60 months (5 years) from Jan 2015 to Dec 2019. A total of 449 cases (43%) were reconstructed with STSG, FTSG in 261 (25%) cases, Z-plasty in 86 (8.2%) cases, FTSG & Z-plasty in 136 (13%) cases, local, loco-regional and distant flaps in 98 (9.3%) and 14 (1.3%) cases required amputations for uncorrectable deformities. Overall functional improvement in the study was satisfactory, with good recovery in 689 (66%) resurfacing procedures, average recovery in 282 (27%) procedures and poor recovery in only 73 (7%) procedures. Preoperative assessment, surgical planning and meticulous execution, extensive physiotherapy, proper splintage and regular follow-up at least for 3 to 5 years after operation are the secrets of better functional recovery.

Chylothorax is an infrequent cause of pleural effusion that is most commonly caused by the obstruction or disruption of the thoracic duct. Chylothorax is rare in nephrotic syndrome. Unilateral chylothorax of the right side is due to the transdiaphragmatic shunting of chylous ascites. It is usually transient and self-limiting but a massive chylothorax requiring therapeutic thoracentesis can also be encountered. Here, we present a rare cause of chylous ascites–nephrotic syndrome resulting in chylothorax, where initially therapeutic thoracentesis is done followed by the management of nephrotic syndrome with modified Ponticelli regimen. This case highlights the need to consider chylous ascites as a cause of chylothorax via transdiaphragmatic shunting in patients with nephrotic syndrome to institute the appropriate treatment.

Background and Aims: There is increasing awareness about an association between type 2 diabetes mellitus (T2DM) and male hypogonadism. However, data are sparse and less uniform with respect to factors associated with hypogonadism in males with T2DM. This study aimed to assess the frequency and correlates of hypogonadism in these subjects. Materials and Methods: This cross-sectional study included 130 males with T2DM, age 25-60 years. Study subjects were screened for hypogonadal symptoms using androgen deficiency in aging male (ADAM) questionnaire. Serum total testosterone was measured in subjects with positive ADAM score. Hypogonadism was defined as the presence of positive ADAM score and low serum total testosterone (

Here the authors show that the preference of yeast chromatin remodeler ISW1a for dinucleosomes hinges on conformational changes that occur in the transition from binding mononucleosomes to dinucleosomes. These changes are critical for ISW1a organizing chromatin at promoters and regulating transcription in conjunction with other chromatin remodelers.

This study presents the classification of malaria-prone zones based on (a) meteorological factors, (b) demographics and (c) patient information. Observations are performed on extended features in dataset over the spiking and non-spiking classifiers including Quadratic Integrate and Fire neuron (QIFN) model as a benchmark. As per research studies, parasite transmission is highly dependent on the (i) stagnant water, (ii) population of area and the (iii) greenery of the locality. Considering these factors, three more attributes were added to the existing novel dataset and comparison on the results is presented. For four feature dataset, QIFN exhibited an accuracy of 97.08% in K10 protocol, and with extended dataset; QIFN yields an accuracy of 99.58% in K10 protocol. The benchmarking results showed reliability and stability. There is 12.47% improvement against multilayer perceptron (MLP) and 5.39% against integrate-and-fire neuron (IFN) model. The QIFN model performed the best over the conventional classifiers for deciphering the risk of acquiring malaria in different geographical regions worldwide.

Malaria is an infectious disease caused by parasitic protozoans of the Plasmodium family. These parasites are transmitted by mosquitos which are common in certain parts of the world. Based on their specific climates, these regions have been classified as low and high risk regions using a backpropagation neural network (BPNN). However, this approach yielded low performance and stability necessitating development of a more robust model. We hypothesized that by spiking neuron models in simulating the characteristics of a neuron, which when embedded with a BPNN, could improve the performance for the assessment of malaria prone regions. To this end, we created an inter-spike interval (ISI)-based BPNN (ISI-BPNN) architecture that uses a single-pass spiking learning strategy and has a parallel structure that is useful for non-linear regression tasks. Existing malaria dataset comprised of 1296 records, that met these attributes, were used. ISI-BPNN showed superior performance, and a high accuracy. The benchmarking results showed reliability and stability and an improvement of 11.9% against a multilayer perceptron and 9.19% against integrate-and-fire neuron models. The ISI-BPNN model is well suited for deciphering the risk of acquiring malaria as well as other diseases in prone regions of the world.

Background and objective: Potentilla fulgens (Rosaceae) is an edible medicinal herb which is widely used in Indian and Chinese traditional medicine for treating gastric ulcer, diabetes, cancer and diarrhea. Literature reveals that the crude ethanolic extract (EPF) of the plant possessed promising gastroprotective effects in rodents. However, the actual chemical marker with a probable mechanism of action responsible for its anti-secretory efficacy is still left unexplored. Hence, the present investigation was aimed to examine the phytoconstituents responsible for gastric anti-secretory effect incorporating in vivo study supported by in silico molecular docking techniques. Methods: Experimentally, four EPF bioactive fractions were tested viz. chloroform (PFCH), ethylacetate (PFEA), n-butanol (PFBu) and aqueous (PFAq). As per the bioactivity guided assay, the most bioactive fraction (PFEA) was subjected to column chromatography and the isolated component (-) epicatechin (EC) was screened for its effects on gastric ulceration induced by pyloric ligation (PL) and absolute ethanol. Various gastric secretion parameters such as gastric juice volume, pH, H+, K+-ATPase activity and histamine levels were determined. In silico molecular docking study was performed to predict the binding efficacy of EC responsible for the inhibition of H+, K+-ATPase enzyme. Results: Results from the PL model indicate that PFEA, PFBu and EC showed significant gastroprotective effect (p

Background: Since December 2019, SARS-CoV-2 had been a significant threat globally, which has accounted for about two million deaths. Several types of research are undergoing and have reported the significant role of repurposing existing drugs and natural lead in the treatment of COVID-19. The plant Phyllanthus emblica (Synonym-Emblica officinalis) (Euphorbiaceae) is a rich source of vitamin C, and its use as an antiviral agent has been well established. Purpose: The present study was undertaken to investigate the potency of the several components of Phyllanthus emblica against three protein targets of 2019-nCoV viz. NSP15 endoribonuclease, main protease, and receptor binding domain of prefusion spike protein using molecular docking and dynamics studies. Methods: The docking simulation studies were carried out using Schrödinger maestro 2018-1 MM share version, while dynamics studies were conducted to understand the binding mechanism and the complexes' stability studies. Results: Out of sixty-six tested compounds, Chlorogenic acid, Quercitrin, and Myricetin were most effective in showing the highest binding energy against selected protein targets of SARS-CoV-2. The network pharmacology analysis study confirmed these compounds' role in modulating the immune response, inflammatory cascade, and cytokine storm through different signaling pathways. Conclusion: Current pharmacoinformatic approach shows possible role of Phyllanthus emblica in the treatment and management of COVID-19.

Introduction: A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However, these guidelines are for patients living in high-income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for congenital heart diseases, as often these patients present late in the course of the disease and may have co-existing morbidities and malnutrition. Process: Guidelines emerged following expert deliberations at the National Consensus Meeting on Management of Congenital Heart Diseases in India, held on the 10th and 11th of August, 2018 at the All India Institute of Medical Sciences. Objectives: The aim of the study was to frame evidence-based guidelines for (i) indications and optimal timing of intervention in common congenital heart diseases and (ii) follow-up protocols for patients who have undergone cardiac surgery/catheter interventions for congenital heart diseases. Recommendations: Evidence-based recommendations are provided for indications and timing of intervention in common congenital heart diseases, including left-to-right shunts, obstructive lesions, and cyanotic congenital heart diseases. In addition, protocols for follow-up of postsurgical patients are also described. Keywords: Congenital heart disease, Intervention, Surgery

A number of guidelines are available for the management of congenital heart diseases (CHD) from infancy to adult life. However, these guidelines are for patients living in high-income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for CHD, as often these patients present late in the course of the disease and may have coexisting morbidities and malnutrition. Guidelines emerged following expert deliberations at the National Consensus Meeting on Management of Congenital Heart Diseases in India, held on August 10 and 11, 2018, at the All India Institute of Medical Sciences. The meeting was supported by Children's HeartLink, a nongovernmental organization based in Minnesota, USA. The aim of the study was to frame evidence-based guidelines for (i) indications and optimal timing of intervention in common CHD; (ii) follow-up protocols for patients who have undergone cardiac surgery/catheter interventions for CHD; and (iii) indications for use of pacemakers in children. Evidence-based recommendations are provided for indications and timing of intervention in common CHD, including left-to-right shunts (atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductus arteriosus, and others), obstructive lesions (pulmonary stenosis, aortic stenosis, and coarctation of aorta), and cyanotic CHD (tetralogy of Fallot, transposition of great arteries, univentricular hearts, total anomalous pulmonary venous connection, Ebstein's anomaly, and others). In addition, protocols for follow-up of postsurgical patients are also described, disease wise. Guidelines are also given on indications for implantation of permanent pacemakers in children.

Purpose: The role of erectile dysfunction (ED) has recently shown an association with the risk of stroke and coronary heart disease (CHD) via the atherosclerotic pathway. Cardiovascular disease (CVD)/stroke risk has been widely understood with the help of carotid artery disease (CTAD), a surrogate biomarker for CHD. The proposed study emphasizes artificial intelligence-based frameworks such as machine learning (ML) and deep learning (DL) that can accurately predict the severity of CVD/stroke risk using carotid wall arterial imaging in ED patients. Methods: Using the PRISMA model, 231 of the best studies were selected. The proposed study mainly consists of two components: (i) the pathophysiology of ED and its link with coronary artery disease (COAD) and CHD in the ED framework and (ii) the ultrasonic-image morphological changes in the carotid arterial walls by quantifying the wall parameters and the characterization of the wall tissue by adapting the ML/DL-based methods, both for the prediction of the severity of CVD risk. The proposed study analyzes the hypothesis that ML/DL can lead to an accurate and early diagnosis of the CVD/stroke risk in ED patients. Our finding suggests that the routine ED patient practice can be amended for ML/DL-based CVD/stroke risk assessment using carotid wall arterial imaging leading to fast, reliable, and accurate CVD/stroke risk stratification. Summary: We conclude that ML and DL methods are very powerful tools for the characterization of CVD/stroke in patients with varying ED conditions. We anticipate a rapid growth of these tools for early and better CVD/stroke risk management in ED patients.

Phenotyping of immune cell subsets in clinical trials is limited to well-defined phenotypes, due to technological limitations of reporting flow cytometry multi-dimensional phenotyping data. We developed a multi-dimensional phenotyping analysis tool and applied it to detect nitric oxide (NO) levels in peripheral blood immune cells before and after adjuvant ipilimumab co-administration with a peptide vaccine in melanoma patients. We analyzed inhibitory and stimulatory markers for immune cell phenotypes that were felt to be important in the NO analysis. The pipeline allows visualization of immune cell phenotypes without knowledge of clustering techniques and to categorize cells by association with relapse-free survival (RFS). Using this analysis, we uncovered the potential for a dichotomous role of NO as a pro- and anti-melanoma factor. NO was found in subsets of immune-suppressor cells associated with shorter-term (≤ 1 year) RFS, whereas NO was also present in immune-stimulatory effector cells obtained from patients with significant longer-term (> 1 year) RFS. These studies provide insights into the cell-specific immunomodulatory role of NO. The methods presented herein can be applied to monitor the pro- and anti-tumor effects of a variety of immune-based therapeutics in cancer patients.Clinical Trial Registration Number: NCT00084656 (https://clinicaltrials.gov/ct2/show/NCT00084656).

Traditional medicine comprises of health related knowledge, skill and practices indigenous to different cultures. India has a rich heritage of traditional system of medicine that emphasizes the close link between mind and body like the psychosomatic medicine. The government of India has set up a department of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy). The importance of life style, dietary and environmental factors in the development of various psychosomatic disorders has been emphasized in all the Indian traditional systems of medicine. Although studies have shown acceptability and beneficial role of traditional medicinal practices, efforts should be made to tease out and conduct research on the practices, which can help physicians in improving well-being of the patients. More rigorous research is required in the direction to generate evidence base for these practices so that their full potential can be realized.

Chromatin remodellers usually mobilize or disassemble nucleosomes by translocating along the nucleosomal DNA at the H3-H4 interface. Here, the authors provide evidence chromatin remodeller INO80 translocates along DNA at the H2A-H2B interface and displaces DNA from the surface of H2A-H2B.

Summary: Nucleosomes are the fundamental building blocks of chromatin that regulate DNA access and are composed of histone octamers. ATP-dependent chromatin remodelers like ISW2 regulate chromatin access by translationally moving nucleosomes to different DNA regions. We find that histone octamers are more pliable than previously assumed and distorted by ISW2 early in remodeling before DNA enters nucleosomes and the ATPase motor moves processively on nucleosomal DNA. Uncoupling the ATPase activity of ISW2 from nucleosome movement with deletion of the SANT domain from the C terminus of the Isw2 catalytic subunit traps remodeling intermediates in which the histone octamer structure is changed. We find restricting histone movement by chemical crosslinking also traps remodeling intermediates resembling those seen early in ISW2 remodeling with loss of the SANT domain. Other evidence shows histone octamers are intrinsically prone to changing their conformation and can be distorted merely by H3-H4 tetramer disulfide crosslinking. : Hada et al. show that ISW2 catalyzes DNA movement through nucleosomes with a short stretch of DNA persistently exiting the nucleosome before DNA enters nucleosomes. A consequence of asynchronous DNA movement is distortion of the histone octamer structure in which the rotational phasing of DNA is maintained on the octamer surface. Keywords: ISWI, nucleosome dynamics, nucleosome structure, SANT domain, chromatin remodeling, nucleosome movement, histones, gene regulation, transcription

A patient presented with dyspnea, chest pain, and hemoptysis. Clinical findings revealed evidence of severe pulmonary hypertension and cyanosis with clubbing and a wide split second sound. Investigations including cardiac catheterization and oxygen study were performed, and the patient was referred for surgical repair. This article discusses various aspects of history, clinical examination, and cardiac catheterization that were utilized to decide the management.

Background and study aims The role of endoscopic-ultrasound (EUS) guided fine-needle aspiration (FNA) in patients with lymphadenopathy in terms of diagnostic adequacy and safety in large population is not well defined. The aim of this study was to evaluate diagnostic adequacy and safety of EUS-FNA in patients with lymphadenopathy. Patients and methods Retrospective study from October 2010 to September 2015 at tertiary care center in Delhi-NCR. We analyzed data from 1005 EUS- FNAs of lymph nodes. Results The study cohort comprised 1005 lymph nodes in 865 patients; 68 % were males, mean age was 50 ± 14 years. Indications of FNA were to look for etiology of pyrexia of unknown origin or staging of malignancy mainly. FNA was taken from mediastinal nodes (n = 528, 52.5 %) and intra-abdominal nodes (n = 477, 47.5 %). Median size of nodes at long axis and short axis was 17 (12 – 25.7) and 10 (8 – 15) mm respectively. Adequate material by FNA was obtained in 92.8 % cases. The cytopathologic diagnosis were malignancy in 153 (15.2 %), granulomatous change in 452 (42 %), and reactive lymphadenopathy in 328 (35.6 %). There was statistically significant difference seen between groups with pathological and reactive lymph nodes regarding size at long and short axis, hypoechoic nature, well defined borders and presence of necrosis and calcification. Procedure-related adverse effects were encountered in 6 patients (0.8 %). Four patients had mild mucosal bleeding in chronic liver disease patients and two had mild hepatic encephalopathy related to sedation. Conclusion EUS-FNA of lymph nodes has good diagnostic adequacy and safety.

For a long-time men had a philosophic view of health and disease, and this lasted till almost 2500 years back. Hippocrates, the great Greek physician, is believed to have seperated the "art of healing" and philosophy. An astute observer, Hippocrates during his practice employed principles that laid the foundation of modern medicine. The medical fraternity worldwide unanimously bestowed the title of "father of medicine" to this great man. Apart from being a physician, he was instrumental in bringing about the concept of ethics in the realm of medicine. The famous document "Hippocratic Oath" while being respected by almost all has generated a great amount of debate among historians. Nonetheless, almost all medical schools across the world have the Oath ceremony where medical graduates agree to the commandments of the Hippocratic Oath, either in its original or modified form. Although a statement of promise this Oath does not have any legal implications as might be seen by a person outside the medical community. This article outlines the contributions made by Hippocrates to the medical world with an emphasis on the Hippocratic Oath.

The 5 th Congress of Asia Pacific Pediatric Cardiac Society was held in New Delhi from 6-9 March 2014. This article describes the journey of preparing and hosting one of the largest international events in the specialty of Pediatric Cardiac Care ever held in India. A total of 938 delegates, including 400 from outside India, participated. The scientific program was inclusive keeping in mind the diverse background of delegates from the member nations. Large numbers of research papers were presented, mostly by fellows in training.

Aortic atresia with an associated ventricular septal defect and adequate sized left ventricle is extremely rare. We present two cases in which an alternate diagnosis was suggested on echocardiography because the hypoplastic aortic trunk was missed due to its small caliber. The final diagnosis was, however, clinched on dual source computed tomography, which not only showed the thin aortic trunk but also clearly depicted the coronary artery origins from the hypoplastic aortic root. To the best of our knowledge, use of multi-detector computed tomography in aortic atresia with well developed left ventricle has not been reported in literature till date.

Background and study aim Different types of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) techniques are used in clinical practice; the best method in terms of outcome has not been determined. The aim of the study was to compare the diagnostic adequacy of aspirated material, and the cytopathological and EUS morphological features between capillary action, suction, and no-suction FNA methods. Patients and methods This was a prospective, single-blinded, randomized study conducted at a tertiary care hospital. Patients were randomized to the three groups: capillary action, suction, and no suction. A total of 300 patients were included, with 100 patients in each arm. Results A total of 300 patients (195 males) underwent EUS-FNA of 235 lymph nodes and 65 pancreatic masses (distribution not statistically different between the groups). The mean age was 52 ± 14 years. A 22 gauge needle was used in the majority (93 %) of procedures. There was no statistical difference between the three groups regarding lymph node size at the largest axis and ratio, type of needle, echo features, echogenicity, calcification, necrosis, shape, borders (lymph nodes), number of passes, and cellularity. Diagnostic adequacy of the specimen was 91 %, 91 %, and 94 % in the capillary, suction, and no suction groups, respectively (P = 0.67). Significantly more slides and blood clots were generated by the suction method compared with the other methods. Conclusion The capillary action, suction, and no suction methods of EUS-FNA are similar in terms of diagnostic adequacy of the specimen. The suction method has the disadvantages of causing more bleeding and generating more slides.

Background and aims Endoscopic ultrasound (EUS) guided drainage of symptomatic pancreatic walled-off necrosis (WON) followed by fully covered self-expanding metal stent (FCSEMS) placement offers several advantages such as higher technical success rate and the option of necrosectomy. The aim of this study was to evaluate the safety and efficacy of EUS guided drainage of patients with WON by using FCSEMS and intracavitary lavage with a solution containing hydrogen peroxide and adopting a step-up approach. Methods A prospective open label study was carried out at a single tertiary care center between January 2014 and January 2016. Patients with symptomatic WON who underwent EUS guided drainage followed by FCSEMS placement were included. Primary end points were complete drainage with improvement in symptoms or major adverse events. Secondary end points were minor adverse events related to the procedures. Results A total of 64 patients (mean age 36 years; 52 males) were included. Technical success was achieved in 100 % of patients and clinical success was achieved in 90.6 %. Complete drainage was achieved with FCSEMS alone in 18 (28.1 %), FCSEMS with necrosectomy using lavage in 40 (62.5 %), FCSEMS with percutaneous drainage (PCD) in 5 (7.8 %), and 1 (1.6 %) patient required salvage surgery. The major adverse event was life threatening bleeding in 3 (4.7 %) patients. Minor adverse events were non-life threatening bleeding in 2 (3.1 %) patients and stent migration in 3 (4.7 %) patients. Conclusion EUS guided WON drainage with FCSEMS followed by necrosectomy with lavage using a solution containing hydrogen peroxide as a step-up approach is a minimally invasive and effective method with a high technical and clinical success rate. Patients with solid debris > 40 % need aggressive management.

Background: Amplatzer vascular plugs (AVPs) are devices ideally suited to close medium-to-large vascular communications. There is limited published literature regarding the utility of AVPs in congenital cardiovascular malformations (CCVMs). Aims: To describe the use of AVPs in different CCVMs and to evaluate their safety and efficacy. Materials and Methods: All patients who required an AVP for the closure of CCVM were included in this retrospective review of our catheterization laboratory data. The efficacy and safety of AVPs are reported. Results: A total of 39 AVPs were implanted in 31 patients. Thirteen (33%) were AVP type I and 23 (59%) were AVP type II. AVP type III were implanted in two patients and type IV in one patient. The major indications for their use included closure of pulmonary arteriovenous malformation (AVM) (n = 7), aortopulmonary collaterals (n = 7), closure of a patent Blalock-Taussig shunt (n = 5), systemic AVM (n = 5), coronary AVM (n = 4), patent ductus arteriosus (PDA) (n = 3), pulmonary artery aneurysms (n = 3), and venovenous collaterals (n = 2). Deployment of the AVP was done predominantly via the 5 - 7F Judkin′s right coronary guide catheter. Overall 92% of the AVPs could be successfully deployed and resulted in occlusion of the target vessel in all cases, within 10 minutes. No procedure-related or access site complication occurred. Conclusions: AVPs are versatile, easy to use, and effective devices to occlude the vascular communications in a variety of settings. AVP II is especially useful in the closure of tubular structures with a high flow.

Spontaneous spinal epidural hematoma (SSEH) is a rare cause of acute spinal cord compression. The exact etiology of this entity is not known, and it has been associated with blood dyscrasias, coagulopathy, infection, tumor, vascular malformations, and hypertension in the literature. Emergency surgical decompression is the treatment of choice, however, lately conservative management of SSEH has been advocated in the literature for a particular group of patients whose clinical profile shows early improvement of their neurological status. We report a case of SSEH in a 24-year-old male who had severe hypertension at the onset of the SSEH leading to quadriparesis, and he was managed conservatively. The patient’s blood pressure (BP) normalized over the next few weeks as the patient recovered neurologically. This direct association of hypertension with SSEH has been reported only in a few case reports. The normalization of BP in this case is unexplainable.

Aortopulmonary collaterals (APCs) are occluded either preoperatively or at the time of cardiac surgery in patients with pulmonary atresia and ventricular septal defect (PAVSD). If left untreated, APCs are an important cause of deterioration in the early postoperative period. We present here an unusual case with a large residual APC causing refractory low-output state in the early postoperative period. Usual arterial approach failed due to extensive angulation with ostial narrowing. The large residual APC was successfully closed with an Amplatzer duct occluder (ADO) device delivered through the transvenous route.

“Neurocysticercosis” - involvement of the central nervous system (CNS) by taenia solium, is one of the most common parasitic diseases of the CNS. However, spinal involvement by neurocysticercosis is uncommon. Spinal intramedullary cysticercosis involving the conus medullaris is an uncommon clinical condition, which may mimic an intramedullary tumor and can lead to irreversible neurological deficits if untreated. Here, we report a 31-year-old male patient with cysticercosis in the conus medullaris of the spinal cord. Magnetic resonance imaging revealed a well-defined round intramedullary lesion at D12-L1 vertebral levels, which was homogeneously hypointense on T1WI and hyperintense on T2WI with peripheral edema. Since the patient had progressive neurological deficits, surgery was performed to decompress the spinal cord. Histopathology examination of the removed lesion proved it to be cysticercosis. In this report, we also discuss the principles of diagnosis and treatment of intramedullary cysticercosis in combination with literature review.

Patients with laryngeal cancer have a high risk of developing lung cancer in the future. A patient presented with a complaint of left-sided chest pain for the last 3 months. Chest X-ray posterior-anterior view showed a homogeneous opacity in the left upper lung field with elevation of the diaphragm on the left side. CECT thorax revealed a heterogeneously enhancing soft tissue density mass lesion in the superior segment of the lingular lobe. On histopathological examination of the mass lesion, it was diagnosed as adenocarcinoma of the lung. About 10 months previously, the patient was treated for a laryngeal squamous cell carcinoma. Patients with laryngeal cancer should be routinely screened during follow-up with chest X-ray or CT scan for the early detection of lung cancer.

Changes in climate because of global warming during the 20th and 21st centuries have a direct impact on the hydrological cycle as driven by precipitation. However, studying precipitation over the Western Maritime Continent (WMC) is a great challenge, as the WMC has a complex topography and weather system. Understanding changes in precipitation patterns and their groupings is an important aspect of planning mitigation measures to minimize flood and drought risk as well as of understanding the redistribution of precipitation arising from climate change. This paper employs Ward’s hierarchical clustering on regional climate model (RCM)-simulated monthly precipitation gridded data over 42 approximately evenly distributed grid stations from the years 2030 to 2060. The aim was to investigate spatial and temporal groupings over the four major landmasses in the WMC and to compare these with historical precipitation groupings. The results showed that the four large-scale islands of Java, Sumatra, Peninsular Malaysia and Borneo would experience a significant spatial redistribution of precipitation over the years 2030 to 2060, as compared to historical patterns from 1980 to 2005. The spatial groups were also compared for two future forcing scenarios, representative concentration pathways (RCPs) 4.5 and 8.5, and different groupings over the Borneo region were observed.