Search

Background and objectives: Inhibition of tumor angiogenesis is a promising strategy employed in the treatment of various cancer types. Its clinical effectiveness is however constrained due to the adverse side effects of antiangiogenic drugs. There is growing interest in the use of medicinal plants for the development of novel drugs with enhanced efficacy. In the present study, we have evaluated three evergreen plants namely, Alstonia scholaris, Polyalthia longifolia, and Terminalia catappa for antiangiogenic properties. Methods: The leaf extracts of the selected plants were investigated for antiproliferative effects on cervical cancer (SiHa) and Human endothelial (HUVEC) cell lines. The anti-angiogenic properties were evaluated in vitro using HUVEC tube formation and cell migration assays, and in vivo using chick chorioallantoic membrane (CAM) assay. They were further assessed for the expression of key angiogenesis-promoting genes HIF1 α, COX-2, VEGFA, and VEGFR2 using quantitative real-time PCR. Results: The three samples showed significant inhibition of the growth and differentiation of HUVEC cells, as well as the vascularization of CAM layer. Additionally, the extracts displayed a notable down-regulatory effect on the expression of angiogenesis promoter genes. Terminalia catappa demonstrated the highest efficacy in downregulating all genes. Polyalthia longifolia and Alstonia scholaris exhibited selective inhibition of HIF1 α and VEGFA genes, indicating variations in their anti-angiogenesis potential. Conclusion: The study highlighted the remarkable efficacy of Terminalia catappa in inhibiting angiogenesis and its associated genes across multiple pathways. Overall, the study, for the first time, identified the promising potential of three natural candidates for arresting angiogenesis.

Introduction: Individuals with diabetes have higher risk of developing depression, cognitive impairment, and dementia compared to those who do not have diabetes. The present study aims to assess the level of cognitive functions and the presence of depression in diabetes patients and healthy controls. The study also explores the level of cognition among the normal control, diabetes without depression, and diabetes with depression. Methods: In the present study, the presence of depression and the level of cognitive functions of 59 cases of diabetes mellitus type-2 were compared with an age- and gender-matched control group of 40 individuals. Clinical and demographic details were recorded on a semi-structured performa. Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9) were applied to both diabetes patients and healthy controls to assess the level of cognitive functions and the presence of depression, respectively. Results: On applying odds ratio (OR), it was observed in the present study that there were 93.50% more chances [OR 1.935 with 95% confidence interval (CI) being 0.481–7.789] of depression among diabetic cases as compared to the control group. Similarly, the chance of MoCA score being less than 26 was twice among the diabetic group as compared to the control group (OR 2.208 with 95% CI being 0.702–6.946). On application of the Chi-square test, the association of depression was significant with HBA1C level, level of education, and presence of complications. Conclusions: Patients with diabetes had almost double the risk of developing depression and poor cognitive functions as compared to the healthy control. High HbA1C level, level of education, and presence of complication in diabetes had a positive statistical association with depression. Thus, it is advisable to investigate patients with diabetes for the presence of depression and cognitive dysfunction by applying simple tools.

We have presented simple two step process to synthesize CuO nanowires - ZnO microrods composite using thermal oxidation and hydrothermal method respectively. The synthesized composite showed monoclinic CuO and hexagonal ZnO. Field emission scanning electron microscopy of the samples showed the randomly oriented CuO nanowires have average diameter ∼200 nm and length ∼10 μm. The ZnO microrods have diameter ∼1 μm and length ∼4 μm. The Raman spectrum of sample of CuO nanowires showed the peaks for Raman active (Ag + 2Bg) modes, while that of composite showed E1 and E2 modes of ZnO indicating lattice disorder and oxygen vacancy, along with Bg mode of CuO. Cyclic voltammetry in 0.1 M NaoH electrolyte of the samples showed pseudocapacitance nature of the material. At scan rate of 10 mV/s the CuO–ZnO composite showed specific capacitance of 57 F/g, while CuO nanowires showed ∼5 mF/g at 5 mV/s scan rate.

Purpose: We aimed to characterize the fetal buccal fat pad (BFP) on magnetic resonance imaging (MRI) to determine the frequency and types of sequences on which the BFP demonstrates low signal intensity and determine any possible correlation with timing of the MRI during fetal development. Materials and Methods: A retrospective review of all fetal MR studies was performed, and a pediatric radiologist blinded to the referring and final fetal diagnosis as well as outcome evaluated the included cases. A positive buccal fat pad sign (BFS) was recorded as present if a round, symmetric, and bilateral area was seen in the submalar region of the face with the following signal characteristics: T1 hyperintensity, low signal on echo planar imaging (EPI), low signal on true fast imaging with steady-state free precession (TRUFI), and with restriction on diffusion-weighted imaging (DWI). Results: A total of one hundred sixty-seven (167) fetal MRI studies: one hundred fourteen (114) body (68%) and fifty-three (53) neuro (32%) scans were reviewed during the study period. The BFS was most commonly seen on EPI (63%) and TRUFI (49%) sequences. Substantial agreement between TRUFI and EPI (κ = 0.68; p < 0.01); moderate agreement between TRUFI and T1 (κ = 0.53; p < 0.01) as well as T1 and EPI (κ = 0.53; p < 0.01), and fair agreement between EPI and Diffusion (κ = 0.28; p < 0.01) was observed. The median gestational age (GA) was 24 weeks (IQR 22–30 weeks). The fetuses with a positive BFS were significantly older (mean GA of 27 weeks or higher) than those without, for each sequence. Conclusions: The focal low signal in the fetal buccal fat pad, termed the fetal BFS, is a commonly encountered normal finding in the majority of fetal MRI scans on TRUFI and EPI sequences. This finding may be related to the presence and development of brown adipose tissue in the buccal fat pad resulting in T2* effects, but further studies are needed in order to confirm this. Further work can incorporate any of the sensitive sequences demonstrating low signal in brown adipose tissue to map its distribution and development in the fetus and beyond.

Background: Chronic venous disease is a prevalent and progressive disease. There has been a tremendous increase in venous technologies and procedural volumes over the past decade, but still, there is a great deficiency in available clinical data. Reporting of clinical outcomes in a standard fashion is the need of the hour required to compare devices and other therapeutic methods intended to improve clinical outcomes. Materials and Methods: This is a prospective observational study carried out between November 2016 and October 2018 on 200 consecutive cases that underwent surgical management for varicose veins. Results: Revised venous clinical severity score (RVCSS) scores reduced significantly after surgical intervention and subsequent follow-up; however, when comparing the scores between the two groups, there was no significant statistical difference. Conclusion: RVCSS coupled with Clinical-Etiology-Anatomy-Pathophysiology provides a standard clinical language to report and compare different approaches to cardiovascular diseases management. Ligation and stripping (L and S) are the gold standard for the treatment of varicose veins, endovascular procedures are expensive and have similar efficacy as L and S, however, are preferred in the present era due to better cosmetic and faster recovery.

Organ-specific vasculitis is an uncommon, delayed complication of COVID-19 infection. It is usually seen in mildly symptomatic or asymptomatic patients. Underlying endothelitis is the most likely pathophysiological mechanism for such a manifestation. We report two infants with renal artery stenosis, most likely consequent to COVID-19 infection.

Objective: Magnetic resonance imaging (MRI) can accurately quantify liver iron concentration (LIC), eliminating the need for an invasive liver biopsy. Currently, the most widely used relaxometry methods for iron quantification are R2 and R2*, which are based on T2 and T2* acquisition sequences, respectively. We compared the rate of change of LIC as measured by the R2-based, FDA-approved commercially available third-party software with the rate of change of LIC measured by in-house analysis using R2*-relaxometry-based MR imaging in patients undergoing follow-up MRI scans for liver iron estimation. Methods: We retrospectively included patients who had undergone serial MRIs for liver iron estimation. The MR studies were performed on a 1.5T scanner; standard multi-slice, multi-echo T2- and T2*-based sequences were acquired, and LIC was estimated. The comparison between the rate of change of LIC by R2 and R2* values was performed via correlation coefficients and Bland–Altman difference plots. Results: One hundred and eighty-nine MR abdomen studies for liver iron evaluation from 81 patients (male: 38; female: 43) were included in the study. Fifty-nine patients had two serial scans, eighteen patients had three serial scans, three patients had four serial scans, and one patient had five serial scans. The average time interval between the first and last scans for each patient was 13.3 months. The average rates of change of LIC via R2 and R2* methods were −0.0043 ± 0.0214 and −0.0047 ± 0.012 mg/g per month, respectively. There was no significant difference in the rate of change of LIC observed between the two methods. Linearity between the rate of change of LIC measured by R2 (LIC R2) and R2* (LIC R2*) was strong, showing a correlation coefficient of r = 0.72, p < 0.01. A Bland–Altman plot between the rate of change of the two methods showed that the majority of the plotted variables were between two standard deviations. Conclusion: There was no significant difference in the rate of change of LIC detected between the R2 method and the R2* method that uses a gradient echo (GRE) sequence acquired with breath-hold. Since R2* is relatively faster and less prone to motion artifacts, R2*-derived LIC is recommended for iron homeostasis follow-up in patients with liver iron overload.

Background: The standard imaging technique for the diagnosis of intestinal malrotation remains the upper gastro-intestinal series (UGIS). The lateral view is promoted as important for making a diagnosis. For this, the lateral view should be of adequate quality, and radiologists must know the normal appearance as well as the appearance of duodenal variants, as misdiagnosis may lead to unnecessary surgery. Objective: We aimed to evaluate the quality, findings including the prevalence of the ”descending staircase” configuration and its correspondence to a diagnosis of duodenum redundum. Materials and Methods: This was a retrospective study and was conducted in a large tertiary children’s hospital in the United States. A retrospective review of UGI fluoroscopy exams in children aged ≤ 18 years between January and December 2018 was performed by a pediatric radiologist. First, the lateral view images/cine-loops were assessed independently, followed by the anteroposterior (AP) view. The studies which were designated to have an adequate lateral view were evaluated for configuration of the duodenum and recorded as: normal, abnormal, or normal variant. Also, the presence of a descending staircase configuration was correlated with an AP view for a diagnosis of duodenum redundum. Results: A total of 26 children (26%) (males:16; females:10) with age range 0 to 16 years had adequate lateral views during UGI exams for inclusion. Of the 26, 18 (69%) were reported as normal, 7 (27%) were reported as having a descending staircase and 1 (4%) was reported as abnormal. The AP view demonstrated 2 abnormal studies (1 malrotation and 1 non-rotation), 6 duodenum redundum and 18 normal exams. The one abnormal lateral duodenum was confirmed as a non-rotation on AP view; the second patient with an abnormal AP view had a normal appearance on the lateral view. Conclusions: A total of 26% of UGI studies had adequate lateral views for interpretation. Of these, nearly a quarter (23%) demonstrated the descending stair-case sign corresponding to a diagnosis of duodenum redundum on the AP view. If the lateral view had been used alone, there would have been a missed diagnosis in one patient.

Wire electric discharge machining (WEDM) has become a key unconventional technology, as it offers a perfect solution for manufacturing machine-made components such as oil hardened nickel (non-shrinking) steel (OHNS) stainless steel and full forms which are not feasible with traditional machining techniques. Few scholars have tried to model this method due to an outdated number of operation variables and answers. In this paper, we will take the readings from the following parameters in WEDM including dielectric conductivity pulse width, time between pulses, maximum feed rate, servo control mean reference voltage, short pulse time, wire feed rate, wire mechanical tension, injection pressure on a distinct procedure responses including MRR and SR. In this various optimization and relation finding methods are shown. The cutting of OHNS steel using a wire electro-discharge machining method with copper electrodes was studied in this article. During this project L36 orthogonal array supporting the in the tests, Taguchi laboratory architecture was used. The analysis of variance is accustomed to evaluate data to find the right answer parameter conditions. The most machining parameters are performance measurements for dielectric conductivity (DC), pulse width (PW), time between pulses (TBW), maximum feed rate (MFR), servo control mean reference voltage (SCMRV), short pulse time (SPT), wire feed rate (WFR), wire mechanical tension (WMT), material removed rate (MRR), and surface roughness (SR) have been chosen to calculate the parameters. The use of response tables and graphs to determine the best parameter levels is common within the WEDM process.

Objective An experiment was conducted to determine the effects of supplementing graded concentrations of inorganic sulphur (S) without and with folic acid (FA) in maize-soybean meal diets on performance, slaughter and anti-oxidant variables, immune responses and serum protein fractions in broiler chicken. Methods Inorganic S was supplemented at 0.05%, 0.10%, 0.15%, and 0.20% alone or in combination with FA (4 mg/kg) in basal diet (BD) containing no supplemental methionine (Met) and FA. A control group was fed with the recommended concentration of Met. Each diet was offered to 10 pens of 5 male broiler chicks (Cobb 400) and fed ad libitum from day 1 to 42. Results The broilers fed the BD had lower body weight gain (BWG), feed efficiency (FE), higher lipid peroxidation (LP), lower activity of glutathione peroxidase (GSHPx), lower lymphocyte proliferation ratio (LPR), and reduced concentrations of total protein, albumin, and globulin in serum. Supplementation of FA and S to the BD improved the BWG (all concentrations of S) and FE (0.20% S) similar to the control group. Similarly, the combination of S and FA significantly improved the concentrations of total protein, albumin, and globulin in serum, reduced the LP and increased the activity of GSHPx and LPR. However, responses in the above parameters were related to the concentration of S in the diet. The slaughter variables and antibody titres against the Newcastle disease were not affected with the treatments. Conclusion Based on the results, it is concluded that the combination of S (0.2%) and FA (4 mg/kg) improved the BWG and FE, similarly supplementation of these nutrients improved the concentration of protein fractions and reduced the stress (reduced LP and improved GSHPx) variables in serum and improved the cell mediated immune response (LPR) in broilers fed sub-optimal concentrations of Met in diet.

Ethernet Passive Optical Network (EPON) is that technology that can rule out the congestion in local loop at the level of user and local exchange. At present, there are many simulators to analyze the EPON but the simplest one is using MATLAB. In this paper, we have first analyzed the bit rate performance of WDM EPON and verified the result using NS2 software. After that in the presented WDM EPON model, we proposed an algorithm for wavelength and bandwidth allocation with full QoS support. The result indicates that traffic generation in both NS2 and MATLAB follow the same trend and the proposed algorithm optimizes the various throughput parameters. We found that the bit error rate varies from 14-22 Mbps, 14-55 Mbps, and 36-48 Mbps for EF, AF, and BE traffic respectively.

Objective Methionine (Met) is involved in methyl group transfer besides protein synthesis. As the availability is limited and cost is high for synthetic Met, reductions in its inclusion in broiler diet may be possible by supplementing the low Met diets with methyl donors (MD) like betaine (Bet), folic acid (FA), vitamin B12 (B12), and biotin (Bio). An experiment was conducted to study the effects of supplementing the MD on performance (average daily gain [ADG], daily feed intake, feed efficiency [FE]), anti-oxidant variables, immune responses and serum protein concentration in broilers fed sub-optimal concentrations of dietary Met. Methods Maize-soybean meal diet was used as control (CD). Different MD like Bet (0.2%), B12 (0.1 mg), FA (4 mg), or Bio (1.5 mg/kg) were supplemented to basal diet (BD) having no supplemental Met. The BD without MD was kept for comparison. Each diet was fed ad libitum to 10 replicates of 25 chicks in each from 1 to 42 d of age. Results At the end of experiment, the ADG in MD group was higher than BD and lower than CD. The FE improved with FA or Bet compared to the BD. Breast meat weight was higher in Bet compared to the BD, while it was intermediate between BD and CD in other groups. The lipid peroxidation reduced with Bio, B12, or Bet, while the glutathione peroxidase activity improved with Bio or B12 compared to the BD. Lymphocyte proliferation improved with Bet compared to the BD. The serum protein concentrations increased with FA, Bio, or Bet compared to those fed BD. Conclusion It can be concluded that the ADG can be improved partially with supplementation of MD while the FE improved with FA or Bet. Some MD also reduced the stress indices and improved immune responses compared to the BD fed broilers.

Background: Tobacco consumption and smoking are causative factors that can create a favorable environment for tuberculosis and increase the morbidity and mortality attributed to it. Tobacco use is the leading global cause of preventable death (6 million deaths per year). This study compares the treatment outcome in pulmonary tuberculosis patients on DOTS daily regimen with respect to consumption of tobacco and smoking. Aims: 1. To study the prevalence of tobacco consumption and smoking among microbiologically confirmed new pulmonary tuberculosis patients. 2. To study the effect of tobacco consumption and smoking on the outcome of microbiologically confirmed new pulmonary tuberculosis patients. Material and Method: The prospective observational study was conducted on microbiologically confirmed new pulmonary tuberculosis patients enrolled during the first quarter of the year 2019 (i.e., from 01/01/2019 to 03/31/2019) at the four selected DMCs of Amritsar City. In total, 197 patients were included in the study depending on the inclusion and exclusion criteria. The prevalence of tobacco consumption and smoking at the start of treatment was noted and the effect on outcome was observed. Results: Prevalence of tobacco consumption and smoking was found to be 24.37% and 21.83%, respectively. In addition, 93.96% of non-tobacco consumers and 94.15% of non-smokers had favorable outcomes as compared to 83.34% of tobacco consumers and 81.4% of smokers, which is statistically significant. Conclusion: Tobacco consumption and smoking have significantly higher chances of unfavorable outcomes (loss to follow up, change in treatment regimen, and death) as compared to non-consumption and non-smoking.

Background : Neurodevelopmental abnormalities are common in congenital heart disease (CHD), more so in cyanotic CHDs. Perioperative factors have been known to affect neurodevelopmental outcomes. Aim : We aimed to determine the neurodevelopmental outcomes following open-heart surgery in cyanotic CHD. Methods : In this prospective observational study, eligible infants and children ≤21 months with cyanotic CHD planned for open-heart surgery underwent preoperative neurodevelopmental assessment using Developmental Assessment Scale for Indian Infants (DASII) to look for any motor and/or mental delay. A second neurodevelopmental assessment was performed after 9 months ± 2 weeks of cardiac surgery. Follow-up DASII was conducted through interactive video conferencing in 23 of 60 patients due to COVID-19 pandemic. The univentricular and biventricular repair groups were compared in terms of their neurodevelopmental outcomes. Perioperative factors were compared between neurodevelopmental “delay” and “no delay” groups. Results : Of the 89 children enrolled, preoperative motor and mental delay were present in 29 and 24 children, respectively. Follow-up DASII could be performed in 60 children. At follow-up, motor delay was present in seven and mental delay in four children. Overall, there was a significant improvement in both motor and mental developmental quotient at follow-up. There was no significant difference in either motor or mental domains between univentricular and biventricular groups. Among the perioperative variables, only the postoperative length of stay in intensive care unit was significantly different between neurodevelopmental “delay” and “no delay” groups (P = 0.04). Conclusion : Neurodevelopmental delay occurred substantially among unoperated children with cyanotic CHD. The neurodevelopmental status improved significantly following open-heart surgery among the survivors. Delay was associated with length of stay in intensive care following cardiac surgery.

IntroductionRice crop meets the calorie and nutritional requirements of a larger segment of the global population. Here, we report the occurrence of intra-varietal variation in a popular rice landrace C14-8 traditionally grown under the geographical isolation of the Andaman Islands.MethodsBased on grain husk color, four groups were formed, wherein the extent of intra-varietal variation was studied by employing 22 agro-morphological and biochemical traits.ResultsAmong the traits studied, flavonoid and anthocyanin contents and grain yield exhibited a wider spectrum of variability due to more coefficients of variation (>25%). The first five principal components (PCs) of principal components analysis explained a significant proportion of the variation (91%) and the first two PCs explained 63.3% of the total variation, with PC1 and PC2 explaining 35.44 and 27.91%, respectively. A total of 50 highly variable SSR (HvSSR) markers spanning over 12 chromosomes produced 314 alleles, which ranged from 1 to 15 alleles per marker, with an average of 6.28. Of the 314 alleles, 64 alleles were found to be rare among the C14-8 selections. While 62% of HvSSR markers exhibited polymorphism among the C14-8 population, chromosomes 2, 7, 9, and 11 harbored the most polymorphic loci. The group clustering of the selections through HvSSR markers conformed to the grouping based on grain husk coloration.DiscussionOur studies on the existence and pertinence of intra-varietal variations are expected to be of significance in the realms of evolutionary biology and sustainable food and nutritional security under the changing climate.

Abstract SARS-CoV2 pandemic exposed the limitations of artificial intelligence based medical imaging systems. Earlier in the pandemic, the absence of sufficient training data prevented effective deep learning (DL) solutions for the diagnosis of COVID-19 based on X-Ray data. Here, addressing the lacunae in existing literature and algorithms with the paucity of initial training data; we describe CovBaseAI, an explainable tool using an ensemble of three DL models and an expert decision system (EDS) for COVID-Pneumonia diagnosis, trained entirely on pre-COVID-19 datasets. The performance and explainability of CovBaseAI was primarily validated on two independent datasets. Firstly, 1401 randomly selected CxR from an Indian quarantine center to assess effectiveness in excluding radiological COVID-Pneumonia requiring higher care. Second, curated dataset; 434 RT-PCR positive cases and 471 non-COVID/Normal historical scans, to assess performance in advanced medical settings. CovBaseAI had an accuracy of 87% with a negative predictive value of 98% in the quarantine-center data. However, sensitivity was 0.66–0.90 taking RT-PCR/radiologist opinion as ground truth. This work provides new insights on the usage of EDS with DL methods and the ability of algorithms to confidently predict COVID-Pneumonia while reinforcing the established learning; that benchmarking based on RT-PCR may not serve as reliable ground truth in radiological diagnosis. Such tools can pave the path for multi-modal high throughput detection of COVID-Pneumonia in screening and referral.

This case study deals with a 32-year-old Indian male patient who presented with a traumatic head injury in the hospital, experienced uncontrolled bleeding after conducting surgery, and was eventually diagnosed with Glanzmann thrombasthenia. Glanzmann thrombasthenia is a rare hereditary blood clotting disorder characterised by a lack of platelet aggregation due to the absence of platelet glycoprotein IIb/IIIa. This occurrence is generally triggered by consanguineous marriages and is apparent in approximately one in one million people. Education and raising awareness about consanguinity in communities may help to reduce challenging, unusual genetic diseases.

Despite optimal medical management, an 8-year-old boy had persistent pleural drainage following total cavopulmonary connection. Detailed evaluation, including computed tomography angiography, confirmed obstruction at the lower end of the circuit due to infolding of the polytetrafluoroethylene graft. Balloon dilation of the obstruction resulted in prompt resolution of pleural effusion with sustained relief at 1-year follow-up. The case demonstrates the importance of careful assessment in the diagnosis and successful nonsurgical management of an unusual cause of obstruction in the Fontan circuit.

Iron-induced experimental epilepsy in rodents reproduces features of post-traumatic epilepsy (PTE) in humans. The neural network of the brain seems to be highly affected during the course of epileptogenesis and determines the occurrence of sudden and recurrent seizures. The aim of the current study was to evaluate astroglial and neuronal response as well as dendritic arborization, and the spine density of pyramidal neurons in the cortex and hippocampus of epileptic rats. We also evaluated the effect of exogenous administration of a neuroactive steroid, dehydroepiandrosterone (DHEA), in epileptic rats. To induce epilepsy, male Wistar rats were given an intracortical injection of 100 mM solution (5 µL) of iron chloride (FeCl3). After 20 days, DHEA was administered intraperitoneally for 21 consecutive days. Results showed epileptic seizures and hippocampal Mossy Fibers (MFs) sprouting in epileptic rats, while DHEA treatment significantly reduced the MFs’ sprouting. Astroglial activation and neuronal loss were subdued in rats that received DHEA compared to epileptic rats. Dendritic arborization and spine density of pyramidal neurons was diminished in epileptic rats, while DHEA treatment partially restored their normal morphology in the cortex and hippocampus regions of the brain. Overall, these findings suggest that DHEA’s antiepileptic effects may contribute to alleviating astroglial activation and neuronal loss along with enhancing dendritic arborization and spine density in PTE.

Aims : The utility of beta-blocker therapy in infants with heart failure (HF) due to significant left-to-right shunt lesions is not known. The study aimed to assess the efficacy and safety of propranolol in infants with HF due to moderate-to-large ventricular septal defect (VSD). Methods : The prospective randomized trial included 80 infants with HF and moderate-to-large VSD, randomly allocated to receive either conventional therapy alone (n = 40) or propranolol plus conventional therapy (n = 40). The primary endpoint was a composite of all-cause mortality, hospitalization for HF and/or chest infection, and referral for surgery. The secondary clinical outcomes were the individual components of the composite endpoint. In addition, the patients were followed up to detect safety outcomes, for example, bronchospasm, bradyarrhythmia, and worsening HF symptoms. Results : The addition of propranolol therapy to the conventional medications did not result in significant improvement in the primary composite endpoint (32.50% vs. 52.50%; P = 0.07). There was a trend toward improvement, but the study is underpowered for this important question. However, propranolol therapy significantly decreased the risk of hospitalization (12.50% vs. 32.50%; P = 0.03) and worsening of Ross HF class (5.41% vs. 28.21%; P = 0.01) as compared to conventional therapy (estimated number needed to treat = 5). Propranolol did not result in any significant safety concerns in these infants except bronchospasm in an infant. Conclusions : Propranolol therapy in infants with significant left-to-right shunt may prevent worsening in HF symptoms and hospitalization and is well tolerated. However, it does not reduce mortality or need for surgery.

Background : COVID-19 pandemic has disrupted pediatric cardiac services across the globe. Limited data are available on the impact of COVID.19 on pediatric cardiac care in India. Aims : The aims are to study the impact of COVID-19 pandemic on the care of children with heart disease in India in terms of number of outpatient visits, hospitalizations, catheter-based interventions, and cardiac surgeries. Settings and Design : This is a retrospective, multicentric, observational study. Methods : We collected monthly data on the number and characteristics of outpatient visits, hospitalizations, catheter-based interventions, and cardiac surgeries and major hospital statistics, over a period of 5 months (April to August 2020), which coincided with the first wave of COVID-19 pandemic in India and compared it with data from the corresponding months in 2019. Results : The outpatient visits across the 24 participating pediatric cardiac centers decreased by 74.5% in 2020 (n = 13,878) as compared to the corresponding period in 2019 (n = 54,213). The reduction in the number of hospitalizations, cardiac surgeries, and catheterization procedures was 66.8%, 73.0%, and 74.3%, respectively. The reduction in hospitalization was relatively less pronounced among neonates as compared to infants/children (47.6% vs. 70.1% reduction) and for emergency surgeries as compared to elective indications (27.8% vs. 79.2%). The overall in-hospital mortality was higher in 2020 (8.1%) as compared to 2019 (4.8%), with a higher postoperative mortality (9.1% vs. 4.3%). Conclusions : The current COVID-19 pandemic significantly impacted the delivery of pediatric cardiac care across India with two-third reduction in hospitalizations and cardiac surgeries. In an already resource-constrained environment, the impact of such a massive reduction in the number of surgeries could be significant over the coming years. These findings may prove useful in formulating strategy to manage subsequent waves of ongoing COVID-19 pandemic.

BACKGROUND: Stroke is responsible for the largest proportion of neurological disorders causing a significant morbidity. Gamma-glutamyl transferase (GGT) enzyme has an active involvement in atherosclerosis through its role in oxidative and inflammatory mechanisms. Recent evidence suggests that serum GGT is related to the risk and prognosis of cerebrovascular diseases. METHODS: A total of 200 patients (100 with acute ischemic stroke and 100 without stroke) were recruited from various medical wards and medical intensive care unit. Categorical variables were compared between two groups using Chi-squared test and odds ratio (OR). Independent sample t-test was used to see to compare mean GGT level of stroke patients with control. RESULTS: There was no statistical difference with respect to distribution of age groups (χ2 = 1.25, P = 0.741) and gender (χ2 = 2.678, P = 0.1018) between cases and controls. Mean age of stroke patients (mean [M] = 61.7, standard deviation [SD] = 13.8) did not differ from controls (M = 62.2, SD = 13.6), P = 0.80. The odds of suffering from diabetes were significantly higher in stroke patients than cases (OR = 2.25, P = 0.005). Independent sample t-test found a significant difference in serum GGT level between cases (M = 57.47, SD = 11.8) and control (M = 41.72, SD = 7.5), P ≤ 0.0001. CONCLUSIONS: Serum GGT was significantly higher in stroke patients than age-sex-matched nonstroke patients. Association remained significant in stroke patients irrespective of age, gender, and other risk factors. Stroke patients with diabetes, hypertension, dyslipidemia, obesity, and smoking had higher level serum GGT level than those without these risk factors. Prospective cohort studies can further explore the potential of GGT as a predictor of acute ischemic stroke.

The aim of the study was to investigate potential evidence for spread of antimicrobial resistance (AMR) from urban migrant labourers to labourers from local resident rural community due to sharing of common residential premises and other civic amenities. Two groups of unskilled labourers, enrolled for civil construction in a peri-urban area viz. (i) labourers having migrated from urban zone and (ii) labourers from local resident village community were compared in terms of demographic profile, history of various risk factors towards acquisition of AMR and prevalence of extended-spectrum beta-lactamase (ESBL), carbapenemase and New Delhi metallo-beta-lactamase type 1 (NDM-1) categories of AMR at enrolment and after one year of sharing of common residential premises with associated sanitation facilities using Escherichia coli as indicator organism. Higher percentage of urban migrant labourers were characterised by low literacy level, history of inhabitation in makeshift shelters without dedicated access to drinking water or cooking space, practice of defecation in open, episodes of illness suggestive of bacterial infections, faulty treatment seeking behaviour and intestinal carriage rate of E. coli with various categories of AMR compared to the non-migrant labourers from rural community. The later group showed an increase in the prevalence of carbapenem resistance with NDM-1 production during the duration of co-inhabitation with urban migrant labourers. The present study provided potential evidence for transfer of AMR by urban migrant labourers to non-migrant labourers from rural community that may serve as vehicle for further transmission of AMR to the rural community hitherto unexposed or less exposed to the problem.

Exploratory ventures outside the established disciplinary boundaries can yield added insights and explanatory power. Imposing cognitive limitations on human logical reasoning ability (bounded rationality) is a well-known case in point. Extending cognition to parts of body outside the brain, and to environment outside the body is another. In contrast, the present article takes a constructive approach, also in an exploratory spirit. For the sake of exposition, we consider three tiered realms of scientific inquiry: physical or inanimate, biological or animate, and socio-psychological or sentient. In this three-tier framework, we explore the extent of gains in modeling human action within the confines of physical principles such as optimization. In this exercise, concepts of complexity and emergence account for the absence of analytically derivable mapping from micro or finer grain phenomena to macro or coarser grain phenomena. A general notion of embodiment captures the inclusion of a more expansive range of explanatory factors in modeling and understanding a given phenomenon. Emergence and embodiment play complementary roles in exploration of human behavior.

Tributyl phosphate (TBP) is extensively used in nuclear industry and is a major environmental pollutant. The mechanism for TBP degradation is not identified in any TBP-degrading bacteria. Here, we report identification of an acid phosphatase from Sphingobium sp. RSMS (Aps) that exhibits high specific activity towards monobutyl phosphate (MBP) and could be a terminal component of the TBP degradation process. A genomic DNA library of the bacteria was screened using a histochemical method which yielded 35 phosphatase clones. Among these, the clone that showed the highest MBP degradation was studied further. DNA sequence analysis showed that the genomic insert encodes a protein (Aps) which belongs to class C acid phosphatase. The recombinant Aps was found to be a dimer and hydrolysed MBP with a Kcat 68.1 ± 5.46 s−1 and Km 2.5 mM ± 0.50. The protein was found to be nonspecific for phosphatase activity and hydrolyzed disparate organophosphates.

A new series of 1,2,4-oxadiazole incorporated (2-(oxazol)-1H-imidazole derivatives 9a-j have been developed and synthesized. Further, the newly prepared compounds (9a-j) compounds were evaluated for their preliminary anticancer properties against four human cancer cell lines like prostate cancer (PC3&DU-145), lung cancer (A549), and breast cancer (MCF-7) by using of MTT method and etoposide used as a positive reference. The obtained results indicated that most of the tested compounds displayed excellent to moderate activity. Among all derivatives, six compounds 9a, 9b, 9c, 9d, 9e, and 9f exhibited more potent anticancer activity than etoposide.

Flavonoids, a group of natural compounds with phenolic structure, are becoming popular as alternative medicines obtained from plants. These compounds are reported to have various pharmacological properties, including attenuation of inflammatory responses in multiple health issues. Epilepsy is a disorder of the central nervous system implicated with the activation of the inflammatory cascade in the brain. The aim of the present study was to summarize the role of various neuroinflammatory mediators in the onset and progression of epilepsy, and, thereafter, to discuss the flavonoids and their classes, including their biological properties. Further, we highlighted the modulation of anti-inflammatory responses achieved by these substances in different forms of epilepsy, as evident from preclinical studies executed on multiple epilepsy models. Overall, the review summarizes the available evidence of the anti-inflammatory potential of various flavonoids in epilepsy.

Background: Heart failure (HF), which is an emerging public health issue, adversely affects the strained health system in India. The adverse impact of HF on the economic well-being has been narrated in various anecdotal reports from India, with affected individuals and their dependents pushed into the vicious cycle of poverty. There is limited research quantifying how HF impacts the economic well-being of households from low- and middle-income countries. Methods: We describe the methods of a detailed economic impact assessment of HF at the household level in India. The study will be initiated across 20 hospitals in India, which are part of the National heart Failure Registry (NHFR). The selected centres represent different regions in India, stratified based on the prevailing stages of epidemiological transition levels (ETLs). We will collect data from 1800 patients with acute decompensated HF and within 6-15 months follow-up from the time of initial admission. The data that we intend to collect will consist of a) household healthcare expenditure including out-of-pocket expenditure, b) financing mechanisms used by households and (c) the impoverishing effects of health expenditures including distress financing and catastrophic health expenditure. Trained staff at each centre will collect data by using a validated and structured interview schedule. The study will have 80% power to detect an 8% difference in the proportion of households experiencing catastrophic health expenditures between two ETL groups. After considering a non-response rate of 5%, the target sample size is approximately 600 patients from each group and the total sample size is 1800 patients. Potential Impact: Our study will provide information on catastrophic health spending, distress financing and household expenditure in heart failure patients. Our findings will help policy makers in understanding the micro-economic impact of HF in India and aid in allocation of appropriate resources for prevention and control of HF.

Background and study aims Walled-off necrosis (WON) is a known complication of acute necrotizing pancreatitis (ANP). There is no study comparing nasocystic irrigation with hydrogen peroxide (H2O2) versus biflanged metal stent (BMS) in the management of WON. The aim of this study was to compare the clinical efficacy of both the treatment strategies. Patients and methods This study was conducted on patients with symptomatic WON who were randomized to nasocystic irrigation with H2O2 (Group A) and BMS placement (Group B). Primary outcomes were clinical and technical success while secondary outcomes were procedure time, adverse events, need for additional procedures, duration of hospitalization, and mortality. Results Fifty patients were randomized into two groups. Group A (n = 25, age 37.8 ± 17.6 years, 16 men) and Group B (n = 25, age 41.8 ± 15.2 years, 17 men). There were no significant differences in baseline characteristics between the two groups. The most common etiology of pancreatitis was alcohol, observed in 27 (54 %) patients. Technical success (100 % vs 96 %, P = 0.98), clinical success (84 % vs 76 %, P = 0.76), requirement of additional procedures (16 % vs 24 %, P = 0.70) and adverse events (4 vs 7, P = 0.06) were comparable in both the groups. The duration to clinical success (34.4 ± 12 vs 14.8 ± 10.8 days, P = 0.001) and procedure time (36 ± 15 vs 18 ± 12 minutes, P = 0.01) were longer in Group A compared to Group B. Conclusions Nasocystic irrigation with H2O2 and BMS are equally effective in the management of WON but time to clinical success and procedure time is longer with nasocystic irrigation.

Background: Heart failure (HF), which is an emerging public health issue, adversely affects the strained health system in India. Additionally, the adverse impact of HF on the economic well-being of affected individuals and their families has been narrated in various anecdotal reports, with affected individuals and their dependents pushed into poverty. However, there is limited research quantifying how HF impacts the economic well-being of households from low- and middle-income countries. Methods: We describe the methods of a detailed economic impact assessment of HF at the household level in India. The study will be initiated across 20 hospitals in India. The selected centres represent different regions in India stratified based on the prevailing stages of epidemiological transition levels (ETLs). We will collect data from 1800 patients with acute decompensated HF and within 6-15 months follow-up from the time of initial admission. The data that we intend to collect will consist of a) household healthcare expenditure including out-of-pocket expenditure, b) financing mechanisms used by households and (c) the impoverishing effects of health expenditures including distress financing and catastrophic health expenditure. Trained staff at each centre will collect relevant data by using a validated and structured interview schedule. The study will have 80% power to detect an 8% difference in the proportion of households experiencing catastrophic health expenditures between two ETL groups. After considering a non-response rate of 5%, the target sample size is approximately 600 patients from each group and the total sample size is 1800 patients with heart failure. Impact: The results from our study will help policy makers in understanding the micro-economic impact of HF in India and aid in allocation of appropriate resources for prevention and control of HF.

Aim: The aim of this study is to assess the pattern and mode of thoracoabdominal trauma and anatomical organ involvement, type of management employed, and overall outcomes in the pediatric population. Materials and Methods: A retrospective study conducted at a tertiary hospital over a period of 38 months with a total of 198 pediatric patients

Renal myopericytoma is an extremely rare entity with just 11 cases reported in the literature. We report the case of a 57 year old Caucasian man who was found to have a renal myopericytoma following nephrectomy for suspected renal cell carcinoma. Renal myopericytoma has a distinct morphological overlap with other pericytic tumours and significant histological variation has been noted between cases reported to date. Further characterising this novel tumour is vital to identify subtypes within this spectrum, understand its behaviour and to identify imaging trends which may lead to pre-operative diagnosis in order to potentially avoid radical treatment.

The present study analysed the molecular and agro-morphological diversity in a set of 92 diverse cauliflower genotypes and two each of cabbage and broccoli. Field evaluation of the genotypes was done in randomized block design (RBD) at two locations (i.e. IARI, New Delhi and ICAR-RC-NEH Region, Barapani) during Rabi2019-20. Genotypes showed variation for all the eight observed traits at both locations and, the differences in early and snowball groups were distinct. Pusa Meghna, DC-33-8, Pusa Kartiki and CC-14 were earliest for curd initiation. Genotypes showed higher values for curd traits at Delhi. Molecular diversity was detected with 90 polymorphic simple sequence repeats (SSR). Number of alleles ranged from 1 to 9 with mean value of 2.16 and the highest polymorphic information content (PIC) value was observed for primer BoGMS0742 (0.68) with a mean value of 0.18. Cluster analysis using agro-morphological traits substantiated classification of the genotypes for maturity groups. However, SSR analysis revealed four clusters and with a composite pattern of genotype distribution. STRUCTURE analysis also supported the admixture and four subpopulations. The studyindicates for introgression of genetic fragments across the maturity groups, thereby, potential for use in further genetic improvement and heterosis breeding.

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by the symptoms of motor deficits and cognitive decline. There are a number of therapeutics available for the treatment of PD, but most of them suffer from serious side effects such as bradykinesia, dyskinesia and on-off effect. Therefore, despite the availability of these pharmacological agents, PD patients continue to have an inferior quality of life. This has warranted a need to look for alternate strategies and molecular targets. Recent evidence suggests the Transient Receptor Potential (TRP) channels could be a potential target for the management of motor and non-motor symptoms of PD. Though still in the preclinical stages, agents targeting these channels have shown immense potential in the attenuation of behavioral deficits and signaling pathways. In addition, these channels are known to be involved in the regulation of ionic homeostasis, which is disrupted in PD. Moreover, activation or inhibition of many of the TRP channels by calcium and oxidative stress has also raised the possibility of their paramount involvement in affecting the other molecular mechanisms associated with PD pathology. However, due to the paucity of information available and lack of specificity, none of these agents have gone into clinical trials for PD treatment. Considering their interaction with oxidative stress, apoptosis and excitotoxicity, TRP channels could be considered as a potential future target for the treatment of PD.

Background and study aims Pseudoaneurysms are usually associated with high rates of morbidity and mortality. There are limited data in the literature on endoscopic ultrasound (EUS)-guided thrombin injection for pseudoaneurysms. The aim of this study is to assess the efficacy and safety of EUS-guided thrombin injection for pseudoaneurysms. Patients and methods This prospective study was conducted in our department between January and December 2018. All patients with symptomatic visceral artery pseudoaneurysms, who were unable to undergo angioembolization, were enrolled consecutively. Data related to demography, laboratory parameters, radiological imaging, pseudoaneurysms, and endotherapy were analyzed. Results Eight patients with median age 34 years (27–58 years), all men, were studied. The vessel involved was the splenic artery in 5 patients (62.5 %), the left hepatic artery in 2 (25 %), and the gastroduodenal artery in 1 patient (12.5%). The median size of the pseudoaneurysms was 2.9 cm × 2.6 cm (range, 1.8 × 1.9–4 × 5 cm). The median thrombin requirement was 400 IU (range, 200–500 IU) for loss of Doppler flow signals. EUS after 3 months showed obliterated pseudoaneurysms in 7 patients (87.5 %), while recurrence was observed in 1 patient (12.5 %) after 6 weeks. Conclusions EUS-guided thrombin injection may be a new option for the management of pseudoaneurysms.

Although Epigallocatechin gallate (EGCG) is the most available and beneficial catechin found in tea, its auto-oxidation property may lead to toxicity when consumed in large quantities. Thus, there is a need to quantify the EGCG, which enables to study the pharmacological characteristics of the compound. The study aimed to develop and validate a rapid and accurate analytical method for quantitative determination of EGCG. Standard EGCG was used to conduct trials for the optimization of the analytical method using Ultra-High Performance Liquid Chromatography (UHPLC). Tests for validation (specificity, linearity, accuracy, system suitability, method precision, robustness, and ruggedness) were performed. The preliminary trials yielded an analytical method with good peak shape and acceptable system suitability which was further validated. The method was shown to be specific, with a linear correlation coefficient of > 0.9996 and accurate with acceptable recovery rate (99.1% to 100.4%). Acceptable system suitability and method precision were confirmed with a relative standard deviation (less than 2%). Further, robustness and ruggedness experiments also demonstrated the suitability of the present analytical method. The method developed for determination of EGCG was validated as per the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines and thus can be used in routine compliance tests in the laboratory for further studying/characterizing the properties of EGCG.

Background: Capsule endoscopy (CE) has an established role in evaluating obscure gastrointestinal bleeding (OGIB). The aim was to know the diagnostic yield of CE and spectrum of OGIB. Materials and Methods: In this retrospective study, we evaluated all the patients with obscure gastrointestinal bleed using MiroCam capsule endoscope (IntroMedic, Seoul, Korea) between February 2014 and March 2018. Clinical data, ancillary investigations, and response to specific treatment were considered to confirm CE findings. Results: Out of 102 patients included in the study (mean age 54.5 ± 16.1 years, male: female ratio = 1.83:1) OGIB‑overt and OGIB‑occult was present in 46 and 56 patients, respectively. Diagnostic yield of CE was similar in both the groups (overt‑37/46, 80.4% versus occult‑37/56, 66.5%) (P ≥ 0.05), although there was trend to find more lesions in overt group. Overall positive diagnostic yield was 72.5%. Lesions detected were vascular malformations in 21 (20.5%), nonsteroidal anti‑inflammatory drug enteropathy in 13 (12.7%), small bowel ulcerations in 27 (26.4%), which were further divided into three subgroups (a) nonspecific ulcerations 11 (10.7%), (b) tubercular ulcer with/without stricture in 7 (6.8%) and (c) serpiginous ulcers and fissuring with cobble‑stone appearance suggestive of Crohn’s disease in 9 (8.8%), portal hypertensive enteropathy in 5 (4.9%), worm infestation (hookworms in 3, roundworms 1) in 4 (3.9%), and small bowel tumour in 1 (0.98%) patient. Overall, 56.7% patients were having definitive (P2) lesions (Saurin classification). Two patients had retention of capsule, but none developed intestinal obstruction. Capsule was removed with surgical intervention. Conclusion: CE has high diagnostic yield, relative safety and tolerability, and it is an important diagnostic tool for OGIB. Small bowel tuberculosis, Crohn’s disease and Worm infestation continue to be commonly recognized causes of OGIB in developing countries like India.

Context: Inflammation is a common feature of both peripheral artery disease (PAD) and periodontal disease. Aim: The aim of this study is to evaluate the relationship between PAD and periodontal disease by examining the levels of inflammatory cytokines, pentraxin-3 (PTX-3), and high-sensitive C-reactive protein from serum. Materials and Methods: A total of 50 patients were included in this cross-sectional study. Patients were divided into two groups: those with PAD (test group) and those with the non-PAD group (control group) based on ankle–brachial index values. Periodontal examinations and biochemical analysis for PTX-3 and high-sensitive C-reactive protein were performed to compare the two groups. Statistical Analysis Used: All the obtained data were sent for statistical analyses using SPSS version 18. Results: In the clinical parameters, there is statistically significant difference present between plaque index, clinical attachment loss, and periodontal inflammatory surface area with higher mean values in patients with PAD having periodontitis. There is statistical significant (P < 0.01) difference in all biochemical parameters (P < 0.05) considered in the study between PAD patients and non-PAD patients with higher mean values of total cholesterol (TC), low-density lipoprotein (LDL), high-sensitive C-reactive protein (hs-CRP), and PTX-3. Conclusion: PTX-3 and acute-phase cytokine such as hs-CRP can be regarded as one of the best indicators to show the association between the PAD and periodontitis followed by hs-CRP, TC, very LDL (VLDL), and LDL. However, high-density lipoprotein (HDL) is a poor indicator for its association with chronic periodontitis and PAD.

Context: The commercially available oral solid dosage forms are used to prepare suitable liquid dosage forms extemporaneously by the pharmacists for pediatric, geriatric, and other patients with inability of swallowing tablets or capsules. These extemporaneous preparations are not subjected to tests for quality and stability like commercial products. The stability of extemporaneous preparations should be determined in hospital settings, but the practice is to rely on published information. Unavailability of stability data limits the availability of many medicines for special patients. The extemporaneously prepared omeprazole suspension is regularly used in hospital settings. Aim: This research was taken up to perform the stability study of extemporaneous omeprazole oral suspension frequently used in a referral hospital to determine the shelf life. Materials and Methods: Stability studies were performed by keeping the freshly constituted preparations in small containers at 2°C–8°C and 25°C ± 5°C; samples were withdrawn at 0, 7, 14, 21, and 28 days and assayed by spectrophotometric method at 301 nm. The percent degradation or stability was calculated for each preparation, and data were extrapolated to find out the shelf life. Results: It was found that the shelf life (t90%) of omeprazole oral suspension, prepared extemporaneously, is 32 days at room temperature (25°C ± 5°C) and 54 days in refrigerator (2°C–8°C). Conclusion: Study outcomes shall help the hospital pharmacist to improve pharmaceutical services by dispensing the extemporaneous preparations with the knowledge of their stability and storage condition.

Objectives: Studies have reported changes in leptin and adiponectin levels in the gingival crevicular fluid, saliva, and blood serum of obese patients with periodontal disease. The aim of the study is to evaluate serum leptin and adiponectin levels in obese and nonobese individuals with chronic periodontitis and to deduce a relationship between the clinical parameters and the inflammatory biochemical parameters. Materials and Methods: In this case–control study, a total of fifty individuals were selected based on the body mass index (BMI): Group I of obese individuals with chronic periodontitis and Group II of nonobese individuals with chronic periodontitis. Periodontal parameters used in this study were plaque index, gingival index, probing pocket depth, and clinical attachment level. The effects of obesity and periodontal status on serum leptin and adiponectin levels of both groups were statistically analyzed using an independent t- test. Results: Statistical analysis showed that the effect of BMI on serum leptin and adiponectin levels was statistically significant (P < 0.01), and the effect of chronic periodontitis on the serum leptin and adiponectin levels was also statistically significant compared to nonobese individuals (P < 0.0001). However, there is no statistically significant correlation between serum leptin and adiponectin, which indicates that both are independent to each other. Conclusions: In obese individuals with chronic periodontitis, serum leptin levels were significantly high compared to nonobese individuals and serum adiponectin levels were significantly lower in obese individuals compared to nonobese individuals with periodontitis, though both the parameters were independent of each other.