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This study addresses a tumor–macrophage interaction model to examine the role of the saturated response of M2 macrophages. We find the equilibrium point of the model and analyze local stability at each equilibrium. We show that tumor-free equilibrium is always stable, whereas, under certain conditions, the tumor-dominant and interior equilibrium are asymptotically stable. Moreover, stable and unstable limit cycles and period-doubling bifurcation have been observed at the interior equilibrium point. A remarkable result has been observed: in the presence of a saturated response of M2 macrophages, with a relatively higher activation rate of M2 macrophages due to tumor cells, the disease spreads more quickly in the body. Hence, M1 macrophages cannot stabilize the system, and aperiodic oscillations are observed. Furthermore, we show that a better immune response can reverse that system’s unstable nature. Numerical simulations verify the analytical results.

Abstract Spatio-temporal variation in phytoplankton community dynamics in a temporarily open/closed Swarnamukhi river estuary (SRE), located on the South East coast of India was investigated and correlated to that of the adjacent coastal waters. Understanding the seasonal variability of the phytoplankton community and influencing factors are essential to predicting their impact on fisheries as the river and coastal region serve as the main source of income for the local fishing communities. Downstream before the river meets the sea, an arm of the Buckingham Canal (BC), carrying anthropogenic inputs empties into the Swarnamukhi River (SR1). The impact of anthropogenic effects on the phytoplankton community at BC was compared to other estuarine stations SR2 (upstream), SR1 (downstream), SRM (river mouth) and coastal station (CS). In BC station, harmful algal blooms (HABs) of Chaetoceros decipiens (2940 × 103 cells L−1) and Oscillatoria sp. (1619 × 103 cells L−1) were found during the southwest monsoon and winter monsoon, respectively. These HABs can be linked to the anthropogenic input of increased nutrients and trace metals. The HABs of Oscillatoria sp. were shown to be induced by elevated concentrations of nitrate (10.18 µM) and Ni (3.0 ppm) compared to ambient, while the HABs of C. decipiens were caused by elevated concentrations of silicate (50.35 µM), nitrite (2.1 µM), and phosphate (4.37 µM). Elevated nutrients and metal concentration from the aquaculture farms, and other anthropogenic inputs could be one of the prime reasons for the recorded bloom events at BC station. During this period, observed bloom species density was found low at other estuarine stations and absent at CS. The formation of bloom events during the closure of the river mouth could be a major threat to the coastal ecosystem when it opens. During the Osillatoria sp. bloom, both the Cu and Ni levels were higher at BC. The elevated concentration of nutrients and metals could potentially affect the coastal ecosystem and in turn fisheries sector in the tropical coastal ecosystem.

Diaphragm disease (DD) is a rare condition that is associated with the use of nonsteroidal anti-inflammatory drugs. It is characterized by multiple diaphragm-like septa that cause a narrowing of the small bowel lumen. The diagnosis of this disorder can be challenging due to its rarity and its non-specific symptoms, which often suggest other, more probable diseases. We report the case of a 16-year-old boy who presented with iron-deficiency anemia that did not respond to iron supplementation. Despite undergoing endoscopy and computed tomography (CT) enterography, the cause of his condition could not be identified. Capsule endoscopy was attempted, but due to technical difficulties, images could not be obtained. Two years later, the patient's symptoms persisted, prompting further investigation. CT enterography revealed a foreign body in the distal ileum, which was identified as the previously administered capsule. Diagnostic laparoscopy with intraoperative endoscopy was performed to retrieve the capsule. This procedure also revealed multiple short-segment strictures causing luminal narrowing and ulcerations. These were confirmed by histopathology to be lesions associated with DD.

Commodities and commodity futures are expected to benefit stock and bond portfolio diversification because traditional asset types like equities and bonds have low correlations with commodities. During periods when stocks and bonds may underperform, commodities may provide a hedge against inflation and other economic uncertainties. This study investigates the diversification benefits of adding commodities to a traditional portfolio of stock and bonds from the perspective of an Indian investor. It employs several commonly used asset allocation strategies such as mean-variance, equal risk contribution, most diversified portfolio, and equal weight portfolio on different commodity derivative groups. The performance of various portfolios indicates that not all commodity groups provide substantial diversification benefits to a traditional portfolio. Agricultural commodities enhance performance (with an Omega ratio of 1.654), whereas metal and energy-related commodities do not diversify the traditional portfolio significantly (Omega ratio of 1.087 and 0.945, respectively). Gold and different equity sectors also provide some diversification benefits. This study also supports the hypothesis that the behavior of different commodity groups is quite different. AcknowledgmentThe infrastructural support provided by the FORE School of Management, New Delhi, in completing this paper is gratefully acknowledged.

Deep sea bacterial communities demonstrate remarkable adaptability to high-pressure environments coupled with low temperatures which has sparked curiosity about their diversity and exceptional metabolic pathways. Additionally, bacteria in the deep sea exert a substantial influence over various biogeochemical processes. To date, we have relatively very little information about the deep-sea bacterial communities and, they remain largely unexplored. We investigated the variability in the physicochemical conditions, heavy metals and their influence on deep-sea bacterial community structure across three different depths in the Bay of Bengal. The structural and metabolic diversity of deep-sea sediment microbial communities were examined through culture-based sequencing of 16S rRNA genes, ecto-enzymatic studies, and community-level physiological profiling. Bacillota was the most dominant phylum representing 61% of the cultured bacterial isolates, while the remaining belonged to Actinomycetota and Pseudomonodata. Five potential novel species belonging to the genera Fictibacillus, Lysinibacillus, Salinicola, Robertmurraya and Blastococcus were identified. The extracellular enzymatic activity was positive for >50% of the bacterial isolates, wherein the genera Bacillus and Micromonospora exhibited versatile profiles. High metabolic diversity was recorded through the carbon substrate utilization profiles indicating that microbial communities are active participants in biogeochemical cycles in the deep sea. The most prominently utilized carbon substrates were α-cyclodextrin, glucose-1-phosphate, D-xylose, glycogen, and 2-hydroxy benzoic acid which serve as organic substrates for microbial metabolism, facilitating the decomposition of organic matter and, recycling carbon in deep-sea ecosystems. Multivariate statistical analyses confirmed that the environmental variables had a profound influence on the bacterial community. The findings shed light on spatial variability in the bacterial community structure, enzyme activity and metabolic profiles, and enhance our understanding of Bay of Bengal deep-sea sedimentary microbial ecology.

This study employs advanced geospatial analytical techniques to evaluate the vulnerability of Nigeria’s coastal states and their constituent local government areas to flood hazards, which represent a critical and escalating risk within the coastal hazard paradigm intensified by climate change phenomena. The study’s objective is to utilize geospatial data to delineate and quantify the intensity and distribution of flood susceptibility, thus establishing a foundational framework for developing comprehensive disaster management strategies in response to the challenges posed by climate variability. The research uses satellite imagery and geographic information system (GIS)-based hydrological modeling to delineate regions susceptible to flooding, synthesizing topographical and hydrological data to stratify areas into discrete flood susceptibility categories. The findings indicate that the Delta coastal State of Nigeria contains extensive medium to high-risk flood zones spanning 8304.57 km2. While the Bayelsa coastal State of Nigeria presents critical areas at high to very high flood risk, encompassing 5506.61 km2 at high risk and 1826.88 km2 at very high risk, this highlights the urgent necessity for immediate and strategic mitigation measures. This research highlights the critical importance of geospatial technology in shaping disaster management and enhancing community resilience against increasing flood frequencies. As Nigeria’s coastal regions face escalating flood susceptibility, advanced geospatial methods are vital for assessing and mitigating these climate-induced threats, contributing to climate-resilient planning and aligning with Sustainable Development Goal 13: Climate Action. The study’s geospatial approach delivers precise flood risk evaluations and guides targeted mitigation efforts, marking significant progress in managing coastal hazards in a changing climate.

Coastal waters are dynamic because of anthropogenic activities that contribute nutrients and contaminants. These changes have the potential to alter patterns of primary production and thus pelagic food webs. Here, we investigated the spatial variation of the phytoplankton community and its response to changing environmental variables at 84 stations along the five coastal districts of Tamil Nadu (TN). During the present study, 85 phytoplankton species were recorded, such as diatoms (64), dinoflagellates (18), silicoflagellates (1), and Cyanophyceae (2). The maximum phytoplankton abundance was recorded on the Thanjavur coast and gradually decreased towards the south coast of Tamil Nadu. Among the phytoplankton community, 50% was dominated by pennate diatoms, attributed to higher NO3− concentrations in the coastal waters due to agricultural discharge. Cluster analysis revealed that Ramanathapuram and Tirunelveli formed a closed cluster, whereas Thanjavur and Pudukottai formed a separate closed cluster associated with higher nutrient and metal concentrations, highlighting the difference in physicochemical parameters between the northern and southern districts of the TN coast. Relatively high nutrient concentrations in the coastal waters of northern districts are of greater concern, which could impact the coastal ecosystem. Coastal eutrophication is becoming a widespread phenomenon, causing disruption in the food chain and ecosystem balances and hence requiring regular monitoring and management.

Civil Engineering structures are constantly subjected to environmental forces and changes around the surroundings hence a strong need for assessment of the interaction and predictive measures that lead to pro-active actions towards the structural safety and health monitoring. Significant damage is caused to buildings and port infrastructure when soil is subjected to dynamic loadings and high-frequency vibrations as in earthquakes and events that involve the interaction of soil structures. Dynamic loadings, cause significant displacements and tilting in soil-supported structures. Sands, gravels, and other granular materials that support buildings, bridges, port infrastructure, and retaining structures have to withstand the impact of dynamic loadings, with the requirement of serious considerations, to account for liquefaction risk in the soil. Hence there is a need for careful assessments of soil under dynamic loadings. Data from the laboratory for cyclic triaxial experiments and cyclic direct shear experiments from LEAP-2020 (Liquefaction Experiment and Analysis Project) have been used to assess soil fatigue by comparing cyclic triaxial and direct shear strength data. CSR (Cyclic Stress ratio) had correlations with cycle count, axial strain, axial stress, load in KPa, void ratio. In this paper, machine learning (decision tree, extra tree, knn, random forest) and deep learning (artificial neural networks) techniques are applied to the laboratory dataset and results include prediction of the cyclic stress ratio of soil corresponding to the standard input parameters as per ASTM D 3999–91 and ASTM D 6528–07. This study predicts the CSR of soil that can be used for the predictive assessment of the soil. Additionally, CSR (cyclic stress ratio) is a crucial element in determining soil liquefaction

The present study investigated the phytoplankton assemblage and diversity with physicochemical parameters of Diu coastal waters in different seasons during 2018–19. During the study period, 61 phytoplankton species comprising diatoms (50 sp.), dinoflagellates (8 sp.), and cyanophyceae (3 sp.) were recorded. Diatom was found to be a major community and contributed 79 to 99% of total phytoplankton abundance. Reduction in dinoflagellate and dominance of pennate-diatoms were observed during the monsoon. Chlorophyll-a concentration also showed a similar trend and decreased during the monsoon. However, the phytoplankton abundance was low particularly during the monsoon which might be due to the elevated total suspended solids (TSS) load. Canonical correspondence analysis revealed that diatoms were able to survive in high TSS with the support of high nutrients; while dinoflagellates were limited due to those conditions. Overall, the reduction in phytoplankton abundance, diversity, and biomass was recorded due to the elevated TSS input along the coastal waters of Diu.

Background: Snakebite is a common occupational hazard in tropical countries such as India. India has the highest number of snakebites and accounts for nearly 50% of global snakebite deaths. Jharkhand is a state with abundant flora and fauna, with a large rural population, prone to snakebite deaths. We aimed to study various clinical and laboratory parameters in snakebite patients and their association with mortality. Material and Methods: This study was an analytical cross-sectional study conducted from October 2019 to April 2021. Snake-bitten individuals admitted in the in-patient department (General Medicine) of a tertiary care centre of Jharkhand state were included in this study. Information regarding gender, species of the snake, site of bite, symptoms (neurological and haematological), signs, reaction to ASVS, procedures performed (haemodialysis), general examinations, systemic examinations, and investigations were collected and analysed to predict mortality. Results: Out of 60 snakebite patients, 39 (65%) were males and 21 (35%) were females. Snakebite in 41.67% patients was because of unknown species, snakebite in 26.67% patients was because of Russell's viper, snakebite in 21.67% was because of krait, and snakebite in 10% was because of cobra. 41.67% of individuals sustained bites over the right leg, 23.33% over the left leg, 18.33% over the right arm, and 15% over the left arm. Mortality was seen in 8 (13.33%) patients. Haemorrhagic manifestations including haematuria and haemoptysis were seen in 10 (16.66%) and 3 (5%) patients, respectively. Neurological symptoms were present in 27 (45%) patients. In laboratory examination, the total leucocyte count, international normalised ratio, d-dimer, urea, creatinine, and amylase were significantly high in the non-survivor group (all P values < 0.05). In this study, mortality was significantly associated with increased requirement of haemodialysis because of renal failure and an increase in duration of hospital stay (P value < 0.05). The duration of hospital stay independently predicts mortality with an odds ratio of 0.514 (95% confidence interval 0.328 to 0.805; P = 0.004). Conclusion: Early evaluation of clinical and laboratory parameters is needed to identify various complications (haematological and neurological) as they may prolong the hospital stay, leading to an increase in mortality.

Video endoscopy is an important modality for the diagnosis and treatment of various gastrointestinal diseases. Most endoscopic procedures are performed as outpatient basis, sometimes requiring sedation and deeper levels of anesthesia. Moreover, advances in endoscopic techniques have allowed invasion into the third space and the performance of technically difficult procedures that require the utmost precision. Hence, formulating strategies for the discharge of patients requiring endoscopy is clinically and legally challenging. In this review, we have discussed the various criteria and scores for the discharge of patients who have undergone endoscopic procedures with and without anesthesia.

Background: Ovarian cancer is one of the most common malignancies in female patients. In recent years, immunohistochemistry (IHC) has emerged as an important tool in the diagnosis of ovarian tumors. The study aimed to assess estrogen receptors (ERs), progesterone receptors (PRs), Her-2-neu, and Ki-67 by IHC in surface epithelial ovarian tumors and to correlate the findings with different variables. Materials and Methods: It was a cross-sectional study. Oophorectomy/salpingo-oophorectomy/cystectomy specimens were included in this study. IHC was done on 10% neutral buffer formalin-fixed paraffin-embedded tissue sections by using Dako FLEX Ready to use mouse monoclonal antibodies and DakoEnvisionTM FLEX/HRP detection reagent. Results: The study includes 81 cases of surface epithelial ovarian tumors (a benign serous tumor [20], a benign mucinous tumor [18], a borderline mucinous tumor [5], low-grade serous carcinoma [8], high-grade serous carcinoma [19], mucinous carcinoma [7], endometrioid carcinoma [2], borderline Brenner tumor [1], and malignant Brenner tumor [1]. ER had higher expression in malignant cases (51.33%) than in benign cases (15.8%). PR had higher expression in malignant tumors (54.05%) incomparable to benign (18.42%) and borderline tumors (16.66%). PR had higher expression in high grade. Expression of Her-2-neu positivity was found to be 29.7% out of the total 81 cases. Her-2-neu was found in 11 high-grade tumors among 31 malignant cases. CA-125 levels were significantly higher in malignant ovarian tumors (P = 0.0143). Proliferation activity was considered low if proliferation index (PI) 10%. The study showed high PI in malignant tumors. Conclusion: Expression of these marks in adjunct to H&E diagnosis may prove beneficial in differentiating benign, borderline, and malignant cases, in which a diagnosis of borderline cases based on sole H & E is doubtful.

The 2004 Indian Ocean earthquake and tsunami significantly impacted the coastal shoreline of the Andaman and Nicobar Islands, causing widespread destruction of infrastructure and ecological damage. This study aims to analyze the short- and long-term shoreline changes in South Andaman, focusing on 2004–2005 (pre- and post-tsunami) and 1990–2023 (to assess periodic changes). Using remote sensing techniques and geospatial tools such as the Digital Shoreline Analysis System (DSAS), shoreline change rates were calculated in four zones, revealing the extent of the tsunami’s impact. During the pre- and post-tsunami periods, the maximum coastal erosion rate was −410.55 m/year, while the maximum accretion was 359.07 m/year in zone A, the island’s east side. For the 1990–2023 period, the most significant coastal shoreline erosion rate was also recorded in zone A, which was recorded at −2.3 m/year. After analyzing the result, it can be seen that the tsunami severely affected the island’s east side. To validate the coastal shoreline measurements, the root mean square error (RMSE) of Landsat-7 and Google Earth was 18.53 m, enabling comparisons of the accuracy of different models on the same dataset. The results demonstrate the extensive impact of the 2004 Indian Ocean Tsunami on South Andaman’s coastal shoreline and the value of analyzing shoreline changes to understand the short- and long-term consequences of such events on coastal ecosystems. This information can inform conservation efforts, management strategies, and disaster response plans to mitigate future damage and allocate resources more efficiently. By better understanding the impact of tsunamis on coastal shorelines, emergency responders, government agencies, and conservationists can develop more effective strategies to protect these fragile ecosystems and the communities that rely on them.

A planned artificial reef (AR) deployment program as part of a fisheries enhancement might be a useful tool for managers to supplement traditional ways to utilize available space and augment local productivity. Several AR deployment initiatives have been carried out globally, but they are rarely subjected to a rigorous site selection process. We created a site selection procedure in this study that includes systematic stages including exclusion mapping, underwater visual transect, benthic composition, seawater quality, and comparative visual mapping. This research focused on restoring the fishing grounds for artisanal fishermen by deploying AR along the southeast coast of India. The results of each stage in the procedure enabled us to choose suitable locations at a target depth with low wave action, no slope, and a good substrate capable of supporting an AR. Analysis of variance (ANOVA-one way) showed significant (p < 0.05) spatial variation for depth, slope, seawater current, salinity, chlorophyll-a, benthic density, and diversity. The geographical information system (GIS) based model output showed space allocation for AR deployment. The GIS methodology for site selection was developed to be easily adaptable to the demands of diverse artificial reef programs. The integrated strategy has proven to be a successful regulatory intervention for AR deployment practices in order to facilitate coastal restoration and management.

Abstract Background Periodontitis is a microbial disease that leads to inflammation in the tooth-supporting tissues of the oral cavity that is common among the elderly. It is initiated by oral inflammation induced by bacterial dysbiosis. Choosing an appropriate antimicrobial agent with the right course of drug administration is the key to successful periodontal therapy. In recent times, with more biomarkers and the development of new technologies, several point-of-care testing (POCT) platforms have been developed for the diagnosis and monitoring of periodontitis. This review focuses on oral microbiology and the pathogenesis of periodontitis as well as recent insights into the in situ gel system for periodontitis. Design An exhaustive search was conducted in the following scientific databases Science Direct, Springer, Pub Med, and Google Scholar to review all relevant literatures. This is a comprehensive narrative review of the literature, summarizing the perspectives of the authors. Results Novel in situ forming gel is introduced at the site that shows a promising potential to overcome one of the main practical obstacles associated with the treatment of local periodontitis: partial adhesion to the surrounding tissue, causing in the accidental expulsion of at least parts of the implants from patient’s pockets. This results in a large residence time of the system at the site of action and uncertainty of the final exposure to the drug. Conclusion From the reviewed literature, it is concluded that experimental evidence suggests that the in situ gel-forming systems can be useful in treating several common diseases of the oral cavity. Future research should focus on clinical studies to be performed for the in situ gel to make a significant contribution to periodontitis. Graphical abstract

Osteoporosis is a progressive and chronic bone disorder characterized by low bone mass and microarchitectural deterioration of skeletal tissues. Osteoporosis leads to alteration in bone mineral content resulting in decreased bone strength with elevated fracture risks frequently associated with greater morbidity. The latest research in the area of photomedicine had sparked interest in harnessing the active components from plants in both disease control and management across the globe. We in the present review have taken a comprehensive approach to identify forty known plants and their phytoconstituents, which encompasses (i) the genetic diversity of various plants, (ii) their active components and (iii) their osteoprotective role in osteoporosis. Thus, the present review is an attempt for the first time to collectively document the therapeutic properties of valuable medicinal plants in preventing and treating bone loss in osteoporosis.

Introduction: Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication in cirrhotic patients with ascites. SBP is generally diagnosed based on an increased number of polymorphonuclear neutrophils in the ascitic fluid (>250/mm3) and positive culture. Usually fluid analysis and culture take time and precious hours are lost in starting therapy. Leukocyte Esterase Reagent Strips (LERS) have consistently given a high negative predictive value (>95% in the majority of the studies). Aims and Objectives: Aim was to evaluate the diagnostic utility of leukocyte esterase reagent strip for rapid diagnosis of SBP in patients who underwent abdominal paracentesis and to calculate the sensitivity, specificity, positive, and negative predictive values. Methodology: The study was carried out on 64 patients with ascites. Cell count of AF as determined by colorimetric scale of Multistix 10 SG reagent strip was compared with counting chamber method (PMNL count ≥250 cells/mm3 was considered positive). Results: Of the 64 patients SBP was diagnosed in 17 patients, 47 patients were negative for SBP by manual cell count. At cut off of 2+; sensitivity to diagnose SBP was 100%; specificity of 94%; PPV being 57% and NPV of 94%. at the cut off level of 3+; sensitivity decreased down to 76%; specificity increased to 100%; PPV of 100% and NPV of 93.75%. Overall accuracy at 2 + and 3 + was respectively 94.5% and 93.75%. Conclusion: In this study we have found good sensitivity and specificity for the prompt detection of elevated polymorphonuclear neutrophil count. A negative test result excludes SBP with a high degree of certainty. Thus, it represents a convenient, inexpensive, simple bedside screening tool for SBP diagnosis.

Background and Aims: Esophageal carcinoma is a common gastrointestinal malignancy. There is a paucity of literature about the time trends from India. The aim of the study was to evaluate the time trends over 20 years and observe how they differ from the West. Material and Methods: We retrospectively evaluated the data of 552 patients from the gastroenterology database (single department, single-center) over a period of 20 years from 1996 to 2015. The study period was split into two groups, namely, Group A (1996 to 2005) and Group B (2006 to 2015). Results: There were 263 patients in Group A and 289 patients in Group B. The mean age was 54.83 years (range 25–89 years). There were 345 males and 207 females, with the ratio being 1.67. The most common histological type was squamous cell carcinoma (SCC) with 443 patients (80.25%). The most common location was mid esophagus with 229 patients (41.48%) followed by 208 patients (37.68%) in the lower esophagus. There was no significant increase in the lower esophageal malignancy. However, there was a significant increase in the gastroesophageal junction (GEJ) and adenocarcinoma (AC). There were no other time trend changes in gender, location, or histology. Conclusion: SCC is still far more common than AC in India. The mid esophagus is the most common site. There is no evidence of an increase in the lower esophageal malignancy in our study for over 20 years. However, the rates of GEJ-AC were found to be increasing.

Mitochondria fulfill the cell’s energy demand and affect the intracellular calcium (Ca2+) dynamics via direct Ca2+ exchange, the redox effect of reactive oxygen species (ROS) on Ca2+ handling proteins, and other signaling pathways. Recent experimental evidence indicates that mitochondrial depolarization promotes arrhythmogenic delayed afterdepolarizations (DADs) in cardiac myocytes. However, the nonlinear interactions among the Ca2+ signaling pathways, ROS, and oxidized Ca2+/calmodulin-dependent protein kinase II (CaMKII) pathways make it difficult to reveal the mechanisms. Here, we use a recently developed spatiotemporal ventricular myocyte computer model, which consists of a 3-dimensional network of Ca2+ release units (CRUs) intertwined with mitochondria and integrates mitochondrial Ca2+ signaling and other complex signaling pathways, to study the mitochondrial regulation of DADs. With a systematic investigation of the synergistic or competing factors that affect the occurrence of Ca2+ waves and DADs during mitochondrial depolarization, we find that the direct redox effect of ROS on ryanodine receptors (RyRs) plays a critical role in promoting Ca2+ waves and DADs under the acute effect of mitochondrial depolarization. Furthermore, the upregulation of mitochondrial Ca2+ uniporter can promote DADs through Ca2+-dependent opening of mitochondrial permeability transition pores (mPTPs). Also, due to much slower dynamics than Ca2+ cycling and ROS, oxidized CaMKII activation and the cytosolic ATP do not appear to significantly impact the genesis of DADs during the acute phase of mitochondrial depolarization. However, under chronic conditions, ATP depletion suppresses and enhanced CaMKII activation promotes Ca2+ waves and DADs.

Novel coronavirus (COVID-19) has been spread in 213 countries and created an emergency situation around the world.A coronavirus is a group of single-stranded RNA enveloped viruses that causes severe respiratory infection in the infected individual. Nowadays, coronavirus has become a leading cause of death in the world. Efficient diagnosis is an essential step before starting the best possible treatment. For the diagnosis of coronavirus mainly 3 methods are reported such as RT-PCR method, RegularLAMP-based methods and Serology based tests. Based on the above methods, various diagnostic kits have been developed by different countries. This review contains the list of diagnostic kits approved by various countries, their working mechanism and time required to give result along with sampling procedure and major precautions which is most important during the diagnosis process. The worldwide R & D (research & development) will definitely lead to find an efficient and rapid diagnostic tool for the treatment of COVID-19.

Introduction and aim: Considered as a healthcare quality indicator, hospital readmissions in decompensated cirrhosis predispose the patients and the society to physical, social and economic distresses. Few studies involving North American cohorts have identified different predictors. The aim of this study was to determine and validate the predictors of 1-month and 3-months readmission in an Asian cohort. Material and methods.: We prospectively studied 281 hospitalised patients with decompensated cirrhosis at a large tertiary care public hospital in India between August 2014 and August 2016 and followed them for 3 months. Data regarding demographic, laboratory and disease related risk factors were compiled. We used multivariate logistic regression to determine predictors of readmission at 1-month and 3-months and receiver operating curves (ROC) for significant predictors to obtain the best cut-offs. Results: 1-month and 3-months readmission rates in our study were 27.8% and 42.3%, respectively. Model for End stage Liver Disease (MELD) score at discharge (OR:1.24, p < 0.001) and serum sodium (OR:0.94, p-0.039) independently predicted 1-month and MELD score (OR:1.11, p-0.003), serum sodium (OR:0.94, p-0.027) and male gender (OR:2.19, p-0.008) independently predicted 3-months readmissions. Neither aetiology nor complications of cirrhosis emerged as risk factors. MELD score >14 at discharge and serum sodium < 133 mEq/L best predicted readmissions; MELD score being a better predictor than serum sodium (p - 0.0001). Conclusions: High rates of early and late readmissions were found in our study. Further, this study validated readmission predictors in Asian patients. Structured interventions targeting this risk factors may diminish readmissions in decompensated cirrhosis.

Background: Splenic vein thrombosis (SVT) is most commonly caused by acute and chronic pancreatitis (CP). Variceal gastrointestinal (GI) bleeding is a potentially life-threatening event in such patients. The aim of this study was to determine the prevalence of SVT in CP patients and the risk of variceal GI bleeding. Materials and Methods: A total of 187 consecutive patients with a diagnosis of CP were assessed for the presence of SVT at the gastroenterology department of a tertiary care hospital. Thirty seven patients had evidence of SVT. Patients with portal vein thrombosis or cirrhosis were excluded. Potential factors associated with SVT were assessed. Results: Of the 187 CP patients assessed, 37 patients (19.8%) (male 33; female 4; mean age 41.9 years) had evidence of SVT. Among patients with SVT, most common etiology of CP was alcohol abuse (70.3%). Seven patients (18.9%) with SVT presented with clinically significant upper GI bleeding. The source of GI bleeding was gastric varices in three patients (8.1%) and non-variceal source in four patients (10.8%). All three patients with gastric varices were managed by splenectomy. There were no new variceal bleeding episodes in other 33 patients (89.2%) during mean follow-up of 16.4 months. On comparison of patients with and without SVT, the factors associated with significantly higher incidence of SVT were smoking (P = 0.019, odds ratio 3.021, 95% confidence interval 1.195–7.633) and presence of pseudocyst (P = 0.008, odds ratio 3.743, 95% confidence interval 1.403–9.983). Complete resolution of SVT was seen in three patients (8.1%) after resolution of underlying pseudocyst. Conclusion: SVT is a common complication of CP, particularly in patients with pseudocysts and history of smoking. Most patients remain asymptomatic and the risk of variceal bleeding is low. Splenectomy is the treatment of choice in patients with variceal bleeding. Conservative approach is preferred in other patients. Resolution of pseudocysts may lead to resolution of SVT in some patients.

Phytochemicals encompass a wide and diverse range of products and processes. Ferulic acid, a phenolic compound, is extensively found in plants. Various studies on ferulic acid have been documented. In different experimental models, ferulic acid has shown antidiabetic, hepatoprotective, anticancer, anti-apoptotic and antiaging properties. Present work was designed to evaluate the antiulcer activity of alcoholic extract of ferulic acid. As per previous studies, ferulic acid in the dose of 10, 20, and 40 mg/kg of body weight was used in the study. In the present study, the ferulic was tested for antiulcer activity against pyloric ligation model, ethanol induced ulcers, aspirin induced ulcers and histamine induced ulcers. In vitro and in silico activity against gastric H+-K+ATPase enzyme was also studied. Ferulic acid inhibited gastric acid secretion as evident by reduction in ulcer index and lipid peroxidation, Treatment with ferulic acid caused increment in gartric pH, total acidity and free acidity. In vitro and in silico activity against gastric H+-K+ATPase enzyme confirmed inhibitory effect of ferulic acid over this enzyme. From these studies, it is established ferulic acid has ulcer healing property as revealed by in vivo, in silico and in vitro studies. Therefore, the present study confirms anti ulcer potential of ferulic acid. Keywords: Cytoprotective, Gastric lesions, Polyphenols, Docking

Mitochondria are vital organelles inside the cell and contribute to intracellular calcium (Ca2+) dynamics directly and indirectly via calcium exchange, ATP generation, and production of reactive oxygen species (ROS). Arrhythmogenic Ca2+ alternans in cardiac myocytes has been observed in experiments under abnormal mitochondrial depolarization. However, complex signaling pathways and Ca2+ cycling between mitochondria and cytosol make it difficult in experiments to reveal the underlying mechanisms of Ca2+ alternans under abnormal mitochondrial depolarization. In this study, we use a newly developed spatiotemporal ventricular myocyte computer model that integrates mitochondrial Ca2+ cycling and complex signaling pathways to investigate the mechanisms of Ca2+ alternans during mitochondrial depolarization. We find that elevation of ROS in response to mitochondrial depolarization plays a critical role in promoting Ca2+ alternans. Further examination reveals that the redox effect of ROS on ryanodine receptors and sarco/endoplasmic reticulum Ca2+-ATPase synergistically promote alternans. Upregulation of mitochondrial Ca2+ uniporter promotes Ca2+ alternans via Ca2+-dependent mitochondrial permeability transition pore opening. Due to their relatively slow kinetics, oxidized Ca2+/calmodulin-dependent protein kinase II activation and ATP do not play significant roles acutely in the genesis of Ca2+ alternans after mitochondrial depolarization, but their roles can be significant in the long term, mainly through their effects on sarco/endoplasmic reticulum Ca2+-ATPase activity. In conclusion, mitochondrial depolarization promotes Ca2+ alternans acutely via the redox effect of ROS and chronically by ATP reduction. It suppresses Ca2+ alternans chronically through oxidized Ca2+/calmodulin-dependent protein kinase II activation.

In the present article we provide a detailed account on the occurrence of Wedge Sea Hare Dolabella auricularia, from two different locations (Hut Bay and Burmanallah) of Andaman Islands. This species has been reported by Rao (2003) from Andamans but there is no specific location mentioned. First occurrence of this species was observed in Hut Bay coast of Little Andaman and after a three month interval a group of Wedge Sea Hares were again spotted from Burmanallah, South Andaman. In the present article we have given a detailed account on the occurrence and morphological features with field and laboratory pictures of D. auricularia and its biomedical importance based on literature.

Background/AimsThis study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation).MethodsPatients with body mass index (BMI) less than 18 kg/m2 or more than 30 kg/m2, or who had undergone previous abdominal or pelvic surgeries were randomized to air, carbon dioxide, or water insufflation during colonoscopy. The primary endpoint was cecal intubation with mild pain (less than 5 on visual analogue scale [VAS]), without use of sedation.ResultsThe primary end point was achieved in 32.7%, 43.8%, and 84.9% of cases with air, carbon dioxide and water insufflation (P30 kg/m2.

Background/Aims Endoscopic retrograde cholangiopancreatography (ERCP) is the initial therapy recommended for patients with high likelihood of choledocholithiasis. To determine whether endoscopic ultrasonography (EUS) can prevent diagnostic ERCPs in patients with high probability of choledocholithiasis and inconclusive ultrasonography (US). Methods All patients with high likelihood of choledocholithiasis and negative US underwent EUS. ERCP was performed for the patients who showed a definite stone/sludge on EUS. Patients without choledocholithiasis were followed up for 3 months. The primary outcome was avoidance of diagnostic ERCP. Results We included 78 patients (51 women; 27 men). Of these, 25 and 7 (total 41%) were diagnosed with choledocholithiasis and sludge, respectively; stone/sludge was removed in 96.9% of the patients. EUS ruled out choledocholithiasis in 38 patients (48.7%). Two of them were found to have choledocholithiasis on follow-up. The sensitivity, specificity, positive and negative predictive value of EUS for detecting choledocholithiasis were 93.9%, 97.3%, 96.9%, and 94.7%, respectively. Unnecessary ERCP was avoided in 57.7% of the patients by using the EUS-first approach. Conclusions EUS is a highly accurate and safe procedure. EUS can replace ERCP as the initial investigation in patients with a high probability of choledocholithiasis. It avoids unnecessary ERCP; hence, decreasing related costs and complications.

The present work is aimed at facilitating conservation efforts of a rare species of sea urchin (Colobocentrotus atratus) reported nearly eight decades after its initial description by Bell (1887) and later by Clarke (1925) from the coastal waters of south Andaman Islands. Recently, during a three years study (2011-14) on the macrobenthic epifauna along the south Andaman coast, five live specimens of C. atratus were recorded from Kodiyaghat (11031'532''N; 092043'457'' E), south Andaman Islands. Available information shows that this species has reappeared in the south Andaman Islands seventy nine years after the citation by Sastry (1994) collected in the year 1935. The disappearance of this species from the literature in the intermittent years and a sparse population in coastal reaches of south Andaman Islands at present suggest that this species makes a candidate taxa for inclusion in the list of ‘endangered’ or ‘vulnerable’ Indian marine species following IUCN Red List criteria to Wild species.

Background/AimsTo investigate the various etiologies, yields, and effects of capsule endoscopy (CE) on management and complications, along with follow up of patients with obscure gastrointestinal (GI) bleeding.MethodsThe study group of patients included those having obscure, overt, or occult GI bleeding. The findings were categorized as (A) obvious/definitive, (B) equivocal, or (C) negative. Any significant alteration in patient management post CE in the form of drug or surgical intervention was noted.ResultsTotal patients included in the study were 68 (48 males and 20 females). The ratio of male:female was 2.4:1. The age ranged between 16 years to 77 years. Mean age for males was 62±14 years, for females 58±16 years. The total yield of CE with definitive lesions was in 44/68 (65.0%) of patients. In descending order (A) angiodysplasia 16/68 (23.53%), (B) Crohn's disease 10/68 (14.70%), (C) non-steroidal anti-inflammatory drug enteropathy 8/68 (11.76%), (D) small bowel ulcers 4/68 (5.88%), (E) jejunal and ileal polyps 2/68 (2.94%), (F) intestinal lymphangiectasis 2/68 (2.94%), and (G) ileal hemangiomas 2/68 (2.94%) were followed. Equivocal findings 12/68 (17.65%) and negative study 12/68 (17.65%) was found. Complications in the form of capsule retention in the distal ileum were noted in 2/68 (2.94%) subjects. Statistically, there was a higher probability of finding the etiology if the CE was done during an episode of bleeding.ConclusionsCE plays an important role in diagnosing etiologies of obscure GI bleeding. Its role in influencing the management outcome is vital.

Background/Aim: The study was carried out to compare the efficacy of Vitamin E versus Ursodeoxycholic acid (UDCA) in nondiabetic nonalcoholic fatty liver disease (NAFLD) patients. Patients and Methods: We randomized 250 non cirrhotic and non diabetic NAFLD patients diagnosed on ultrasound, with raised alanine aminotransferase (ALT) level. (>40 IU/L), to receive Vitamin E 400 mg twice a day (Group A) or UDCA 300 mg twice a day (Group B) for 52 weeks. Lifestyle modification to achieve at least 5% weight reduction and subsequent weight control and regular exercise was advised to both groups. The primary study endpoint was normalization of ALT. Secondary endpoints were the proportion of patients with reduction in ALT, relative reduction in the NAFLD Fibrosis score (NFS), symptomatic improvement and tolerability. Results: One hundred and fifty patients received UDCA as compared to 100 patients receiving Vitamin E. The treatment groups were comparable at entry with regard to age (44.1 vs 42.4 years), gender (67% vs 63% female), risk factors for nonalcoholic steatohepatitis, hypochondriac pain, serum liver biochemistries, and NAFLD Fibrosis score. The primary endpoint was achieved in 21 (14%) and 19 (19%) of patients in Group A and Group B, respectively (P = 0.2). The proportion of patients with reduction in ALT (56% vs 63%, P = 0.2), symptomatic improvement (78% vs 67%, P= 0.058), reduction in the NFS (44% vs 47%, P= 0.69), and tolerability (98% vs 95%, P= 0.2) were similar between Group A and Group B, respectively. Conclusion: UDCA is an effective and safe alternative to Vitamin E in nondiabetic–noncirrhotic Indian NAFLD patients.

Pneumatosis intestinalis is a rare condition that affects 0.03% of the population. Pneumatosis cystoides intestinalis (PCI) is characterized by the presence of multiple gas-filled cysts in the intestinal wall and the submucosa and/or intestinal subserosa. It is usually a secondary finding caused by a wide variety of underlying gastrointestinal or extragastrointestinal diseases. Here, we present the case of a 47-year-old man who was referred to our gastroenterology department with a history suggestive of intermittent small bowel obstruction associated with abdominal pain. Abdominal computed tomography demonstrated PCI of the small bowel. The mesentery and branches of the superior mesenteric artery and superior mesenteric vein were twisted with minimal pneumoperitoneum. Exploratory laparotomy was performed, and demonstrated segmental small bowel PCI secondary to hypermobile mesentery. The affected segment of the ileum was resected, and jejunoileal anastomosis was performed. Here, we report a rare case of segmental PCI probably due to repeated twisting of hypermobile mesentery. The clinical and imaging features of this disorder may mimic those of visceral perforation or bowel ischemia. PCI can be a cause of severe abdominal pain that may require surgical intervention.

Pancreaticopleural fistula is an extremely rare complication of chronic pancreatitis. Interestingly it may present without any symptoms of pancreatitis per se. The diagnosis requires a high index of suspicion due to the predominant thoracic symptoms. Cases with massive, rapidly refilling, refractory pleural effusion in the setting of pancreatitis (symptomatic or asymptomatic) should be suspected of having a pancreaticopleural fistula. We report two cases of pancreaticopleural fistula. One of the patient also had pancreatic divisum and to the best of our knowledge this is the first case report of pancreatic divisum with pancreaticopleural fistula in the literature.

Background: Amphotericin B (AmB) is among the gold standard antifungal agents used for the treatment of the wide range of fungal infections. However, the drug has various side- effects. Transdermal approach for the delivery of drug is one of the accepted and convenient modes of drug delivery. Aim: The current work was designed to formulate and to evaluate the AmB emulgel system. Materials and Methods: In the preparation of AmB emulgel, Carbopol 930 was used as a gel in this study. The formulation was evaluated for viscosity, spreadability, drug content, drug release and in vitro and in vivo antifungal testing. Results: AmB emulgel was found to penetrate skin effectively and without any irritation. Further, in vivo studies revealed effective therapeutic potential against Candida albicans induced dermal mycosis. Conclusions: The current work, for the first time, revealed effective delivery of AmB across the skin.