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Background: Supraclavicular brachial plexus block (BPB) is being utilized extensively for upper limb surgeries. To improve block quality, several adjuvants have been used successfully. Fentanyl and dexmedetomidine has been evaluated as adjuvants for such block done using ropivacaine. However, block qualities have been modified to a variable extent with use of such adjuvants. Aims and Objectives: Hence, the study was designed to compare fentanyl and dexmedetomidine as adjuvants during ropivacaine-induced supraclavicular BPB. Materials and Methods: Sixty adults undergoing upper limb surgeries were randomly divided in to two groups to receive either fentanyl or dexmedetomidine as adjuvants to ropivacaine for supraclavicular BPB. The onset of sensory block was the primary outcome measure. Duration of sensory bloc, motor block characteristics, and adverse events were also evaluated. Results: Considerably faster onset of sensory and motor blockade was found with the use of fentanyl as adjuvant over dexmedetomidine (sensory, 8.2±1.19 vs. 12.07±0.96, P

Background: Although proper placement of nasogastric tube (NGT) is a simple procedure, it can turn into a tedious task in an anesthetized intubated patient due to the absence of propulsive movement of swallowing. Different techniques of NGT placement are in vogue in clinical practice with varying success rates. The effect of endotracheal tube (ETT) cuff deflation on the success rate of NGT placement has been evaluated only in one study, and the first-attempt success rate was reported to be not high (55%). Aims and Objectives: This interventional study primarily aimed at comparing the success rates of proper placement of NGT in the first attempt between the ETT cuff inflated and deflated states. Materials and Methods: The present study was carried out on 244 adults scheduled for abdominal surgeries requiring NGT insertion. Patients received NGT placement with either an ETT cuff inflated (Group A, n=122) or ETT cuff deflated (Group B, n=122). The success rate of correct placement of NGT in the first attempt was the primary outcome. Procedure time and adverse events were also evaluated. Results: Considerably higher success rate of correct placement of NGT in the first attempt was noted with ETT cuff deflated over-inflated state (85.2% vs. 55.7%, P

Background: Laryngoscopy and intubation lead to unfavorable hemodynamic responses. Many studies have already compared direct laryngoscope (DL) and different types of video laryngoscopes (VLs). While some of those reported favorable response with use of VL, others have depicted an unfavorable response with VL. Aims and Objectives: Hence, the present study was carried out to compare the hemodynamic response to laryngoscopy between use of Macintosh DL and Tuoren VL in controlled hypertensive patients during elective surgery. Materials and Methods: A total of 122 patients were recruited for this interventional study. Patients were allocated into two groups to have their intubation with Tuoren VL (Group V, n=61) or Macintosh DL (Group D, n=61). The mean arterial pressure (MAP) at 1 min after intubation was the primary outcome. Other outcome measures were to compare heart rate (HR) at different time points, procedure time (glottis exposure time and intubation time), and number of attempts. Results: The use of DL led to considerably higher MAP at 1, 3, and 5 min after laryngoscopy and intubation compared with VL. However, comparable HRs were found between the two groups at such time points. Glottis visualization time and intubation time were considerably higher using VL compared with DL. The mean total procedure time was considerably lesser with DL over VL (mean, 29.5 vs. 38.5 s, respectively,

Background: Although the proper placement of nasogastric tube (NGT) is usually a simple procedure, it may be challenging one in case of its placement in anesthetized intubated patients. At times, it may be tiresome even for the expert anesthesiologist. Different techniques have varying success rates. Many novel techniques are entering the avenue to be tested. Combinations of different techniques are showing improved success rates over individual techniques. Aims and Objectives: This interventional study primarily aimed at comparing the success rates of proper placement of NGT in the first attempt between the “combined lateral position with throat pack in situ” and “lateral position alone.” Materials and Methods: The present study was performed on 180 adults (≥18 years), posted for abdominal surgeries requiring NGT insertion. Patients received NGT placement using the “combined lateral position with throat pack in situ” technique (Group A, n=80) or lateral position alone (Group B, n=80). The proportion of patients in whom correct placement of NGT was possible in the first attempt using either of the techniques (primary outcome), the procedure time for successful placement of NGT, and the incidence of adverse events were compared between the groups. Results: Correct placement of NGT in the first attempt was possible in considerably higher proportions of patients using the combined technique over lateral position alone (87.5% vs. 68.75%, P=0.007). The procedure time was comparable in both groups (23.7±6.6 vs. 25.2±5.2, combined vs. lateral position alone, P=0.093). Coiling was found to be considerably reduced in the combined method compared with the “lateral position alone” (8.75% vs.17.5%, P=0.03). Conclusion: Combined lateral position with throat pack in situ technique can be a better alternative to “lateral position alone” for NGT insertion in anesthetized, intubated adult patients.

Introduction: Psychological distress among older adults in India is a concerning issue due to the aging population, the unique challenges they face, and limited access to mental health resources. Understanding and addressing this concern are crucial for promoting better mental health and overall quality of life. This study aims to estimate the prevalence of psychological distress among older adults in selected subcenters of Budge Budge II block, West Bengal; and to find out the factors associated with psychological distress among the study participants. Methods: A descriptive cross-sectional study was conducted among 180 persons aged ≥60 years from different subcenters of the Budge Budge II block selected by multistage random sampling from May 2023 to July 2023 by face-to-face interview using a predesigned, pretested, structured schedule comprising the Kessler Psychological Distress Scale. Multivariable binary logistic regression was done to identify the sociodemographic factors associated with psychological distress. Results: In this study among 180 elderly individuals, the mean age was 67 (±6.34) years, with 65.5% in the 60–69 age group. Nearly two-thirds (70.5%) had no psychological distress, while 18.9%, 5%, and 5.6% had mild, moderate, and severe distress, respectively. Participants who were belonging to the age group 70–79 years [aOR (95% confidence interval [CI]) = 3.31 (1.27–8.63)], widowed or separated (aOR [95% CI] = 3.53 [1.33–9.31]), functionally dependent (aOR [95% CI]) = (8.89 [1.49–53.23]), and economically dependent (aOR [95% CI] = 7.81 [3.21–19.03]) were statistically significant covariates of psychological distress. Conclusion: Nearly one-third of the elderly were suffering from psychological distress. Preventive measures for psychological disorders should be integrated into public health at the local level by providing specialist outpatient services to diagnose and treat common psychological disorders at the primary health center level.

Background: There is a clear association between ABO blood group status and levels of Von Willebrand factor (vWF). Blood group O is related with lower expression of vWF which leads to relative bleeding tendency. Thus, relationships between Bleeding time (BT), Clotting time (CT) and blood groups are important in certain conditions like epistaxis, surgery, thrombosis etc. Aims and Objectives: i)To determine the blood group, of the students and to determine their relationship with BT and CT. Materials and Methods: Institution based cross-sectional observational study done in Department of Physiology, Tripura Medical College & Dr. BRAM Teaching Hospital. BT and CT were done by Duke’s Method and Capillary glass tube method respectively. Blood groups were determined on basis of presence or absence of agglutination. Qualitative data was expressed in percentage and quantitative data in frequency, mean and standard deviations. Chi-square test was applied. P value of 6 minutes found to be maximum in blood group O (53. 8%).Gender wise distribution showed CT > 6minutes in 39% females as compared to 34 %males (p value: 0.5826). Conclusion: In our study, CT was > 6 minutes and BT was > 4 minutes’ maximum in number in blood group O. Gender-wise BT and CT were higher in females than males. Our study showed that O blood group females are prone to certain diseases like epistaxis bleeding etc.

Introduction: : Geriatric population are most vulnerable population, they suffer from various physical illness, mental issues, inancial crisis etc. WHO report showed that the world's population of people aged 60 years and older will be doubled by 2050 (2.1 billion). According to census 2011report, India has 10.1% elderly population and West Bengal has 11.3%. The purpose of the study is to assess the level of awareness on social security& other government schemes, its utilization and to explore the barrier of utilization. Method: An explanatory sequential mixed methods observational study, cross-sectional in design was conductedin Budge-Budge II block of West Bengal among 150elderly population (≥ 60 years) selected by 30 cluster random sampling from March-May 2023 using a pre-designed, pre-tested, structured schedule by face-toface interview. Quantitative data was analysed by SPSS v25.0, and binary logistic regression was performed. Qualitative data was analyzed thematically with IDI guide. Results: Out of 150 elderly, mean age group of the study population was 67.5±4.24 years, 53% were male, and 87% of the study population had awareness on old age pension scheme. However, 83% showed bad utilization. Socioeconomic status [AOR 5.27 (1.98- 13.97)],current employment status [AOR 6.48 (1.12-37.30)] economic dependency [AOR 7.59 (1.71-33.79)] had statistically signiicant higher odds of adequate awareness in the multivariable model. Current employment status, economic dependency showed signiicant association with good utilization and socio demographic characteristics. Conclusion: Majority of the study population were between 65 to 70 years and were aware of old age pension scheme. Old age pension scheme was maximally utilized schemes.

Background Family Adoption Programme (FAP) has been introduced in the curriculum for medical students to help them learn empathy while understanding the customs and limitations of the community. Though this would help in attaining universal health coverage, most of its aspects are still unknown. Through this study, challenges faced by the students could be identified and addressed. Objectives This study aimed to identify and explore the challenges faced by undergraduate students of a medical college in Kolkata during family visit under FAP. Materials and Methods A descriptive study, cross-sectional in design, using a mixed-methods approach (convergent parallel) was conducted for 2 months (from February 6, 2023, to April 8, 2023) at a medical college in Kolkata. On obtaining approval from the Institutional Ethics Committee (IEC) and after obtaining informed written consent from the participants, data were collected from the undergraduate medical students using a predesigned, pretested, and semi-structured questionnaire. In-depth interviews (IDIs) were conducted on purposively selected faculties supervising the visit. The quantitative data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25, while the qualitative data were analyzed thematically. Results The study included 170 students and five faculties. The majority (91.8%) of the students faced challenges during the visit. The most commonly encountered challenge was transport related. Other problems faced were lack of supervision during the examination of the family members, difficulty in communicating, and locating allotted family and safety issues. The faculty members identified challenges related to transportation, burden of community expectations, insufficient clinical exposure, communication, and locating allotted families. On juxtaposition of quantitative and qualitative data, transportation issues, difficulty in locating families, and communication barrier were confirmed. Conclusion Almost all the students faced challenges during the family visits. Challenges, such as transportation issues, finding the family, and language barrier, were confirmed.

Introduction Few studies have been conducted regarding Respectful Maternity Care (RMC) globally which revealed prevalence of disrespect and abuse during labor ranged from 15% in Tanzania to 90% in Nigeria and Peru. However, there is a dearth of study in this part of India regarding RMC. Objectives To assess the status of RMC during facility-based childbirth among postnatal mothers in a tertiary health care facility in Kolkata and to determine the factors associated with RMC among them. Materials and Methods An observational cross-sectional study was conducted among 250 postnatal mothers in a tertiary care health facility in Kolkata using a predesigned, pretested structured schedule. Statistical Analysis Data were analyzed using SPSS version 20.0. Results About 62.4% of the study population said to have got RMC and the rest 37.6% faced at least one form of disrespect and abuse. Significant associations were found between RMC and individual factors like age, caste, education, qualification, duration of marriage, number of family members, and per capita family income. Conclusion The provision of RMC is a behavioral change issue in India where some progress has been made. However, much work still needs to be done in this respect. Women’s experiences with maternity providers can empower and comfort the mothers or may cause long-lasting emotional trauma and damage.

Introduction: We assessed the baseline knowledge and the improvement and retention of knowledge after attending diabetes self-management education (DSME) programs with respect to different socioeconomic status (SES). We also looked into the change in body mass index (BMI), blood pressure, and glycemic parameters after attending the DSME sessions. Materials and Methods: This was a retrospective, cohort study carried out via chart review based on data collected from manual or electronic medical records (EMR) and questionnaire responses of 160 adult patients with type 2 diabetes (T2D) who attended two DSME sessions with a gap of at least six months. Results: Baseline knowledge on diabetes was uniform (P = 0.06), irrespective of differences in SES, and DSME sessions significantly improved the knowledge in all socioeconomic classes (P value < 0.05 in each SES group). However, SES did have a significant influence on the finally acquired knowledge of diabetes as was evident from the final score after attending two DSME sessions. A significant number of patients (48.1%) from our cohort either improved or retained their knowledge of diabetes over a mean follow-up of 15.5 months. The BMI of our cohort was significantly reduced from baseline to final follow-up (P = 0.016). Conclusion: DSME sessions were effective in improving knowledge and awareness among T2D patients, irrespective of socioeconomic classes in Eastern India. The acquired knowledge from DSME sessions was retained over a long time.

Background: The interscalene block in shoulder arthroscopy is a well-established procedure. Many drugs have been used as adjuvants to local anesthetics to increase the quality of block in regional anesthesia, with variable results. Aims and Objectives: The present study was designed to evaluate the effect of dexmedetomidine as an adjuvant to bupivacaine during interscalene block in terms of intraoperative hemodynamic changes and postoperative analgesia. Materials and Methods: Thirty patients, aged 20–55 years of either sex, American Society of Anesthesiologists physical status I-II, scheduled for shoulder arthroscopic surgery for

Abstract Structure of metallic glasses fascinates as the generic amorphous structural template for ubiquitous systems. Its specification necessitates determination of the complete hierarchical structure, starting from short-range-order (SRO) → medium-range-order (MRO) → bulk structure and free volume (FV) distribution. This link has largely remained elusive since previous investigations adopted one-technique-at-a-time approach, focusing on limited aspects of any one domain. Reconstruction of structure from experimental data inversion is non-unique for many of these techniques. As a result, complete and precise structural understanding of glass has not emerged yet. In this work, we demonstrate the first experimental pathway for reconstruction of the integrated structure, for $${\text{Zr}}_{{{67}}} {\text{Ni}}_{{{33}}}$$ Zr 67 Ni 33 and $${\text{Zr}}_{{{52}}} {\text{Ti}}_{{6}} {\text{Al}}_{{{10}}} {\text{Cu}}_{{{18}}} {\text{Ni}}_{{{14}}}$$ Zr 52 Ti 6 Al 10 Cu 18 Ni 14 glasses. Our strategy engages diverse (× 7) multi-scale techniques [XAFS, 3D-APT, ABED/NBED, FEM, XRD, PAS, FHREM] on the same glass. This strategy complemented mutual limitations of techniques and corroborated common parameters to generate complete, self-consistent and precise parameters. Further, MRO domain size and inter-void separation were correlated to identify the presence of FV at MRO boundaries. This enabled the first experimental reconstruction of hierarchical subset: SRO → MRO → FV → bulk structure. The first ever image of intermediate region between MRO domains emerged from this link. We clarify that determination of all subsets is not our objective; the essence and novelty of this work lies in directing the pathway towards finite solution, in the most logical and unambiguous way.

Background: Nowadays, increasing use of smart phone has led to smart phone addiction. Even medical students are inadvertently using these devices for non-academic purposes. Excessive smart phone use can impact mindfulness, which, in turn, can hamper patient care. Aims and Objectives: The objective of this study was to assess the smart phone usage and mindfulness among Undergraduate Medical Students of a Medical College, Kolkata. Materials and Methods: An observational study and cross-sectional in design was conducted from October 01, 2022, to December 12, 2022, among 423 undergraduate medical students of a medical college in Kolkata selected by simple random sampling technique using a pre-designed pre-tested structured questionnaire (containing mindful attention awareness scale). Besides, assessment of Digital Wellbeing and Parental Control application was done. Data were analyzed using Microsoft Office Excel 2019 and SPSSv25. Descriptive and inferential statistics were used to represent the data. Results: Over 80% participants were using their smart phones excessively and 52.5% students were unmindful. YouTube (26.9%) was the maximally used application. The participants spent 360 min/day on smart phone on an average. Being a male had a higher odd of excessive smart phone usage. Hostel residents were more mindful than others. Duration of smart phone use had a positive relation with mindfulness (Spearman’s rho 0.108, P=0.026). Conclusion: The participants spent a major portion of the day in front of smart phone screens. Smartphone use had a positive impact on mindfulness. By setting boundaries, that is, limiting daily usage in websites and apps, smart phone use can be reduced.

Background: Nowadays, anesthesiologists are evaluating several analgesic adjuncts to minimize opioid use during craniotomy. Some studies have evaluated the analgesic-sparing effect of intravenous infusion of dexmedetomidine and lidocaine on intraoperative hemodynamics and post-operative analgesia. There is a paucity of studies focussing on the intraoperative analgesic requirement. Aims and Objectives: The present study compared dexmedetomidine and lidocaine infusion primarily for their effects on intraoperative fentanyl requirements during craniotomy. Materials and Methods: This study was done on 70 patients aged 18–80 years, the American Society of Anesthesiologists physical status I–II, having Glasgow Coma Scale 15, undergoing craniotomies. Patients were randomly allocated to receive either dexmedetomidine (group A, n=35) at a dose of 0.6 mcg/kg bolus over 10 min followed by 0.6 mcg/kg/h infusion or lidocaine (group B, n=35) at a dose of 1.5 mg/kg bolus over 10 min, followed by 1.5 mg/kg/h infusion till the end of skin suture, respectively. Study drugs were started 10 min before the start of surgery. Intraoperative total fentanyl and propofol consumption, intraoperative hemodynamics, recovery from hypnosis, and time to extubation were recorded. Results: The use of dexmedetomidine resulted in considerably less total fentanyl requirement (245.1 vs. 300.7 mcg, P

Summary: Cassidine leaf beetles are associated with genome-reduced symbiotic bacteria Stammera involved in pectin digestion. Stammera cells appear to be harbored in paired symbiotic organs located at the foregut-midgut junction either intracellularly or extracellularly, whereas the symbiont is extracellular in the ovary-accessory glands of adult females and during caplet transmission in eggs. However, using fluorescence and electron microscopy, an intracellular symbiotic configuration of Stammera was observed in Notosacantha species. Detailed inspection of other cassidine species revealed fragmented cell membrane and cytoplasm of the symbiotic organs, wherein Stammera cells are in an intermediate status between intracellularity and extracellularity. We also identified a mitochondria-rich region adjacent to the symbiont-filled region and well-developed muscle fibers surrounding the whole symbiotic organ. Based on these observations, we discuss why the Stammera genome has been reduced so drastically and how symbiont-derived pectinases are produced and supplied to the host’s alimentary tract for plant cell wall digestion.

Background: Many researches were performed in the past to compare propofol and sevoflurane as sole anesthetics. While some studies have reported the advantages of propofol regarding better recovery profile and post-operative analgesic sparing effect, the contrast reporting does exist. Hence, there is a further need of research to explore recovery characteristics. Whether either of these two as sole anesthetics can yield any benefit regarding intraoperative analgesics consumption has not been evaluated. Aims and Objectives: The study primarily aimed at determining total analgesic consumption in the intraoperative period (primary outcome), between those receiving either sevoflurane or propofol for induction as well as maintenance of anesthesia. In addition, intraoperative hemodynamics (heart rate and mean arterial pressure) and recovery profile were compared. Materials and Methods: Total of 168 patients, aged 18–60 years, the American Society of Anesthesiologists’ physical status I/II, undergoing elective and emergency surgeries under general anesthesia for 2–3 h finally recruited. Patients were randomly allocated to receive either sevoflurane (group S, n=84) or propofol (group P, n=84) for both induction and maintenance. Anesthetics were titrated to achieve bispectral index (BIS) value of 60. For both the groups, additional fentanyl was considered aliquots of 25 mcg whenever the hemodynamics changes occurred despite maintaining BIS value in the above-mentioned range. Results: The total intraoperative analgesic consumption was found comparable in both groups of patients. Induction time (38 vs. 59 s) and emergence time (8 vs. 10 s, P9 was achieved earlier with propofol compared with sevoflurane (8.5 vs. 12 min). Conclusion: Propofol-based shows no advantage over sevoflurane in view of intraoperative consumption of analgesics and intraoperative hemodynamic stability. However, the use of propofol was associated with faster induction as well as quicker emergence from anesthesia.

Background: Laparoscopic cholecystectomy is a commonly performed surgery and stable intraoperative hemodynamic status is desirable during pneumoperitonium. Clonidine and dexmedetomidine (alpha-2 adrenergic agonist) were used in this study to attenuate the stress response of pneumoperitoneum because alpha-2 adrenergic agonists help in the attenuation of neuroendocrine and hemodynamic responses to surgery and anesthesia, due to its sympatholytic action. Aims and Objectives: The aims and objectives of the study are to conduct a comparative evaluation of clonidine and dexmedetomidine as pre-anesthetic medication for the attenuation of hemodynamic changes during laparoscopic cholecystectomy surgeries. Materials and Methods: Eighty patients of either sex, aged 20–50 years, complying to the American Society of Anesthesiologists physical status I-II, scheduled for elective laparoscopic cholecystectomy under general anesthesia were divided into two equal groups to receive either clonidine 1 mg/kg (Group-C, n=40) or dexmedetomidine 1 mg/kg (Group-D, n=40), both injected through intravenous route as 15 mL volume with normal saline. Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and SpO2 were measured before and after giving the study drugs, before and immediately after pneumoperitoneum, and then, at 10, 20, 30, 40, and 50 min of pneumoperitoneum. Results: Statistically significant difference was observed in heart rate in the dexmedetomidine group constantly since giving study drug, immediately after the creation of pneumoperitoneum, and then, 10, 20, 30, 40, and 50 min after pneumoperitoneum. Systolic, diastolic, and mean blood pressures were found to be significantly lower in Group D (except after administering study drug), immediately after creating pneumoperitoneum, and 10, 20, 30, 40, and 50 min after pneumoperitoneum. Conclusion: Dexmedetomidine as pre-medication is more efficacious in attenuating hemodynamic stress responses in laparoscopic cholecystectomy surgeries compared to clonidine as pre-medication.

Abstract Frequent mutation and variable immunological protection against vaccination is a common feature for COVID-19 pandemic. Early detection and confinement remain key to controlling further spread of infection. In response, we have developed an aptamer-based system that possesses both diagnostic and therapeutic potential towards the virus. A random aptamer library (~ 1017 molecules) was screened using systematic evolution of ligands by exponential enrichment (SELEX) and aptamer R was identified as a potent binder for the SARS-CoV-2 spike receptor binding domain (RBD) using in vitro binding assay. Using a pseudotyped viral entry assay we have shown that aptamer R specifically inhibited the entry of a SARS-CoV-2 pseudotyped virus in HEK293T-ACE2 cells but did not inhibit the entry of a Vesicular Stomatitis Virus (VSV) glycoprotein (G) pseudotyped virus, hence establishing its specificity towards SARS-CoV-2 spike protein. The antiviral potential of aptamers R and J (same central sequence as R but lacking flanked primer regions) was tested and showed 95.4% and 82.5% inhibition, respectively, against the SARS-CoV-2 virus. Finally, intermolecular interactions between the aptamers and the RBD domain were analyzed using in silico docking and molecular dynamics simulations that provided additional insight into the binding and inhibitory action of aptamers R and J.

Background: Conventional analgesia using non-steroidal anti-inflammatory drugs not only provides inadequate pain relief but also can produce a multitude of systemic adverse effects. During oral and maxillofacial surgeries, inhibition of central sensitization by pre-incision nerve blocks with local anesthetic can reduce postoperative pain, may curtail analgesic requirement, and thereby can provide better patient comfort. Aims and Objectives: This study aimed to evaluate the effectiveness of pre-incisional peripheral nerve block using 0.25% bupivacaine over placebo for postoperative pain relief in patients undergoing oral and maxillofacial surgery under general anesthesia. Materials and Methods: One hundred and twenty patients of 18–35 years of either sex, American Society of Anesthesiologists physical status class I and II had undergone oral and maxillofacial surgeries were divided into two groups to receive bupivacaine 0.25% (Study group, n=60) normal saline (Control group, n=60) for nerve block before surgical incision. Postoperative pain was assessed by Visual Analog Scale (VAS) score and verbal response scale (VRS) score. The number of rescue analgesia was required in the first 24 h and the incidence of any complications associated with this agent was documented. Results: The VAS score was found considerably lower in the bupivacaine group compared with the control group in the first 24 h of postoperative period (P

Starting at 4 weeks of age, male and female C57BL/6J mice were provided with a semi-synthetic diet for a period of one year and then continued on the semi-synthetic diet with or without grape supplementation for the duration of their lives. During the course of the study, no variation of body weights was noted between the groups. At 2.5 years of age, the body-weight-to-tissue-weight ratios did not vary for the liver, colon, muscle, prostate, or ovary. However, relative to the standard diet, the body/kidney weight ratio was significantly lower in the male and female groups with grape-supplemented diets. With the mice provided with the standard diet, the BUN/creatinine ratios were 125 and 152 for males and females, respectively, and reduced to 63.7 and 40.4, respectively, when provided with the grape diet. A histological evaluation suggested that this may be due to enhanced/improved perfusion in the kidney as a preventive/protective effect. In response to the dietary grapes, an RNA seq analysis revealed up-regulation of 21 and 109 genes with male and female mice, respectively, with a corresponding down-regulation of 108 and 65 genes. The downward movement of the FPKM values in the males (alox5, btk, fga, fpr1, hmox1, lox, ltf, lyve1, marco, mmp8, prg4, s100a8/9, serpina3n, and vsig4) and upward movement of the FPKM values in the females (camp, cd300lf, cd72, fcgr4, fgr, fpr2, htra4, il10, lilrb4b, lipg, pilra, and tlr8) suggest beneficial kidney effects. The expression of some genes related to the immunological activity was also modulated by the grape diet, mainly downward in the males and upward in the females. The reactome pathway analysis, KEGG analysis, and GSEA normalized enrichment scores illustrate that several pathways related to immune function, collagenase degradation, extracellular matrix regulation, metabolism of vitamins and cofactors, pancreatic secretion, aging, and mitochondrial function were enriched in both the males and females provided with the grape diet. Overall, these results indicate that the long-term dietary consumption of grapes contributes to renal health and resilience against fibrosis and related pathologies.

Lung adenocarcinoma (LUAD), the most prevalent form of non-small cell lung cancer (NSCLC), remains a leading cause of cancer-related death globally, including in India, with a 5-year survival rate below 10%. Despite these grim statistics, recent advances in the use of next-generation sequencing (NGS) for identifying genetic alterations and the emergence of targeted therapies have opened new possibilities for personalized treatment based on distinct molecular signatures. To understand the molecular pattern of NSCLC, a retrospective study was conducted with 53 Indian LUAD patient samples, using a targeted NGS panel of 46 cancer-relevant oncogenes to identify clinically relevant variants. Pathogenic or likely pathogenic variants were detected in 94% of the 53 cases. Non-synonymous mutations, rearrangements, copy number alterations, insertions, and deletions of functional relevance were observed in 31 out of 46 genes. The most frequently mutated genes included TP53 (52.8%) and EGFR (50.9%), followed by RET, PIK3CA and ERBB2; some patients had multiple alterations in the same gene. Gender-based enrichment analysis indicated that ALK and IDH2 alterations were more prevalent in females, while TP53 and PTEN were more common in males. No significant correlation was found between mutations and other clinicopathological attributes, such as age, stage, and subtype. A higher prevalence of EGFR, RET, PIK3CA, ERBB2 and ALK mutations were observed compared to previous LUAD genetic studies coupled with a lower frequency of KRAS mutations. Clinically actionable variants were annotated using OncoKB and categorized into the four therapeutic levels based on their clinical evidence. Seventy-nine percent of cases had at least one clinically actionable alteration. Most patients (39.6%) had the highest level of actionability (Level 1) wherein an FDA-approved drug is available specifically for the observed mutation in lung cancer patients. EGFR Exon19 in-frame deletions and EGFR L858R were the most frequent among targetable variants (20.7%). These findings emphasize the importance of a selective NGS panel in enabling personalized medicine approaches by identifying actionable molecular alterations and informing the choice of targeted therapy for more effective treatment options in Indian NSCLC patients.

Abstract Background Arthropods gradually change their forms through repeated molting events during postembryonic development. Anamorphosis, i.e., segment addition during postembryonic development, is seen in some arthropod lineages. In all millipede species (Myriapoda, Diplopoda), for example, postembryonic processes go through anamorphosis. Jean-Henri Fabre proposed 168 years ago the “law of anamorphosis”, that is, “new rings appear between the penultimate ring and the telson” and “all apodous rings in a given stadium become podous rings in the next stadium”, but the developmental process at the anamorphic molt remains largely unknown. In this study, therefore, by observing the morphological and histological changes at the time of molting, the detailed processes of leg- and ring-addition during anamorphosis were characterized in a millipede, Niponia nodulosa (Polydesmida, Cryptodesmidae). Results In the preparatory period, a few days before molting, scanning electron microscopy, confocal laser scanning microscopy, and histological observations revealed that two pairs of wrinkled leg primordia were present under the cuticle of each apodous ring. In the rigidation period, just prior to molt, observations of external morphology showed that a transparent protrusion was observed on the median line of the ventral surface on each apodous ring. Confocal laser scanning microscopy and histological observations revealed that the transparent protrusion covered by an arthrodial membrane contained a leg bundle consisting of two pairs of legs. On the other hand, ring primordia were observed anterior to the telson just before molts. Conclusions Preceding the anamorphic molt in which two pairs of legs are added on an apodous ring, a transparent protrusion containing the leg pairs (a leg bundle) appears on each apodous ring. The morphogenetic process of the rapid protrusion of leg bundles, that is enabled by thin and elastic cuticle, suggested that millipedes have acquired a resting period and unique morphogenesis to efficiently add new legs and rings.

Background: Correct placement of nasogastric tube (NGT) placement often becomes difficult in anesthetized, intubated adult patients due to lack of cooperation from patient and the propensity of the tube to travel the same course of path. Preexisting throat pack is supposed to resist the normal passage of the NGT as per common belief. Only one study has evaluated this in pediatric population and the result is encouraging. Aims and Objectives: Hence, the present study has been carried out in adult population to compare the success rate of correct placement of NGT in anesthetized intubated adult patients with the pharyngeal (throat) pack in its position in comparison with no throat pack. This is to examine the effect of preexisting throat pack whether it assists or resists the normal passage of the NGT. Materials and Methods: One hundred and eighty patients were recruited for this interventional and single-blind study. After induction of anesthesia and intubation, the patients were randomized to receive NGT insertion following either blind insertion of the NGT without a pharyngeal pack (group A, n=90) or receive the NGT placement in the same technique but after placement of a pharyngeal pack. The success rate of correct placement of NGT in the first attempt (primary outcome), the procedure time, and adverse events was recorded. Results: Successful insertion of NGT in first attempt was considerably higher in throat pack in situ group compared to blind insertion without a throat pack 81 (90%) versus 63 (70%), respectively (P=0.001). The procedure time for successful placement of NGT was found comparable between the two groups. Significant decrease in coiling is seen in “throat pack in situ” group compared with blind insertion technique (P=0.003). Conclusion: In view of considerable higher success rate and reduced adverse events, it can be concluded that the pre-existing appropriately placed throat pack can facilitate the placement of NGT instead of putting any hindrance.

Background: A cross-sectional observational study conducted in the outpatient registration counter among people seeking registration ticket in a government Medical College. Sample size was 214 with equal representation of each sex. Aims and Objectives: (1) The study’s aims at assessing the knowledge quotient about the occurrence, site presenting symptoms risk factors and outcome of various cancers. (2) Sex specific cancer screening program self-breast examination, mammography, pap smear awareness, and usage among females of study population have been investigated. Materials and Methods: A cross-sectional observational study. Predesigned pretested questionnaire was administered to consenting participants among those registering for outpatient tickets at Calcutta National Medical college Hospital. Statistical analysis Used: Descriptive statistics was used with MS Excel. Results: Awareness was 69.8% with 69% stating gastrointestinal tract to be the most common site, Of the population 70% stated pain was to be the most common presenting symptom, tobacco was said to be the most common causative agent by 72% and 70% stated it to be non-treatable. Among sex specific cancers 40% women identified breast as site of cancer presenting with nipple discharge and 34% stated the presenting feature to be lump. Screening method of self-breast examination and PAP smear was said by 5% and 2%, respectively. Conclusion: The awareness regarding site cardinal signs outcome and risk factors was not good among study population. Much effort is to be given to address the state of things.

Background: Chronic blood disorders such as beta-thalassaemia major require continuous blood transfusions, which results in complications such as transfusion-transmitted infections (TTIs), iron overload, skeletal deformities, endocrinal and cardiac and hepatic disorders. This study aimed at assessing proportion of TTIs, other complications and factors associated with their occurrence amongst children with beta-thalassaemia major. Methods: This cross-sectional study was conducted amongst children with beta-thalassaemia majo attending a tertiary care institution in Kolkata One hundred and ninety two children were selected amongst participants who fulfilled the inclusion criteria. Parents of study participants were interviewed using pre-designed, pre-tested, semi-structured schedule. Results: TTIs were evident in 8.3% of the study participants. Amongst them, hepatitis C, malaria and hepatitis B were present amongst 3.6%, 2.6% and 2.1%, respectively. No cases of human immunodeficiency virus infection and syphilis were found. Elevated serum ferritin levels (53.6%), Chipmunk facies (5.2%), hypothyroidism (2.1%), cardiomyopathy and diabetes mellitus (0.5% each) were noted. A significant association was observed between iron chelation therapy and serum ferritin level amongst these children (P = 0.042). Conclusions: Various transfusion-related complications are still prevalent amongst children suffering from beta-thalassaemia major.

Background: Horticulture or working in plant nursery is one of the main occupations in few areas of the southern part of West Bengal. It is considered as a hazardous health sector worldwide as it possesses several physical, chemical, and biological risks. Objectives: The present study aimed to estimate the occupational health hazards and morbidity profile among the nurserymen living in a rural area of West Bengal and to determine the factors associated with occupational health hazards and morbidity of the participants. Materials and Methods: An observational descriptive, cross-sectional study was conducted from September 2021 to November 2021among 132 nurserymen in a subcenter of South 24 Parganas district of West Bengal through interview using a predesigned, pretested, and structured schedule. Data were analyzed using the SPSS version 25.0. Bivariate and multivariate logistic regression was used to determine the factors associated with health hazards and morbidity. Results: Different types of occupational hazards experienced by the participants were physical (100%), biological (91.6%), ergonomical (91%), chemical (85.6%), and psychological (31.8%). Most common occupation-related morbidity reported was skin rash (82.6%) followed by headache (78%), neck pain (78%), and low back pain (59.8%). Multivariate logistic regression revealed that age ≥60 years, daily working hours of ≥7 h and presence of chronic disease were statistically significant covariates of hazards. Female gender and working span of >10 years were significant covariates of “high morbidity” (P < 0.05). Conclusion: One or more types of occupational hazards were experienced by the respondents. Future interventions to address hazards and morbidities of the workers along with the development of preventive measures are the need of the hour.

Toll like receptor 4 (TLR4), a pathogen-associated molecular pattern (PAMP) receptor, is known to exert inflammation in various cases of microbial infection, cancer and autoimmune disorders. However, any such involvement of TLR4 in Chikungunya virus (CHIKV) infection is yet to be explored. Accordingly, the role of TLR4 was investigated towards CHIKV infection and modulation of host immune responses in the current study using mice macrophage cell line RAW264.7, primary macrophage cells of different origins and in vivo mice model. The findings suggest that TLR4 inhibition using TAK-242 (a specific pharmacological inhibitor) reduces viral copy number as well as reduces the CHIKV-E2 protein level significantly using p38 and JNK-MAPK pathways. Moreover, this led to reduced expression of macrophage activation markers like CD14, CD86, MHC-II and pro-inflammatory cytokines (TNF, IL-6, MCP-1) significantly in both the mouse primary macrophages and RAW264.7 cell line, in vitro. Additionally, TAK-242-directed TLR4 inhibition demonstrated a significant reduction of percent E2-positive cells, viral titre and TNF expression in hPBMC-derived macrophages, in vitro. These observations were further validated in TLR4-knockout (KO) RAW cells. Furthermore, the interaction between CHIKV-E2 and TLR4 was demonstrated by immuno-precipitation studies, in vitro and supported by molecular docking analysis, in silico. TLR4-dependent viral entry was further validated by an anti-TLR4 antibody-mediated blocking experiment. It was noticed that TLR4 is necessary for the early events of viral infection, especially during the attachment and entry stages. Interestingly, it was also observed that TLR4 is not involved in the post-entry stages of CHIKV infection in host macrophages. The administration of TAK-242 decreased CHIKV infection significantly by reducing disease manifestations, improving survivability (around 75%) and reducing inflammation in mice model. Collectively, for the first time, this study reports TLR4 as one of the novel receptors to facilitate the attachment and entry of CHIKV in host macrophages, the TLR4-CHIKV-E2 interactions are essential for efficient viral entry and modulation of infection-induced pro-inflammatory responses in host macrophages, which might have translational implication for designing future therapeutics to regulate the CHIKV infection.