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The wild species of rice, Oryza rufipogon, is a source of genetic variation for yield-enhancing traits and blast resistance. With the objective to genetically enhance the elite rice cultivar, ‘Samba Mahsuri’, a set of 192 BC2F2 and BC2F3 lines developed from O. rufipogon was characterized for yield-enhancing traits and blast resistance. The study revealed the presence of significant genetic variability and transgressive segregation for productive tillers, spikelets per panicle, and grain yield per plant. The study also identified several introgression lines superior to the recurrent parent for yield enhancing traits and blast resistance. Molecular characterization of 26 blast resistant lines identified multiple blast resistance genes in IL-136 [Pib, Pi9 (t), Pi54, Pi38, Pitp and Pi20(t)], IL-3 [Pib, Pi54, Pi38, Pitp and Pi20(t)], and IL-140 [Pib, Pi9(t), Pi54, Pi38, and Pitp]. Based on the performance of yield-enhancing traits and blast resistance, seven lines (IL-27, IL-28, IL-29, IL-72, IL-139, IL-158 and IL-171) showed merit. Estimation of the recovery of the recurrent parental genome by using 117 polymorphic SSR markers revealed that recurrent-parental genome recovery varied from 54.0 (IL-158) to 92.3% (IL-27). These promising, high-yielding introgression lines with multiple blast-resistance genes can serve as important genetic resources for yield and blast resistance improvement in rice, especially for the southern India.

Numerous studies have documented the adverse effects of high-dose radiation on hearing in patients. On the other hand, radiographers are exposed to a low dose of ionizing radiation, and the effect of a low dose of radiation on hearing is quite abstruse. Therefore, the present systematic review aimed to elucidate the effect of low-dose ionizing radiation on hearing. Two authors independently carried out a comprehensive data search in three electronic databases, including PUBMED/MEDLINE, CINAHL, and SCOPUS. Eligible articles were independently assessed for quality by two authors. Cochrane Risk of Bias tool was used assess quality of the included studies. Two articles met the low-dose radiation exposure criteria given by Atomic Energy Regulatory Board (AERB) and National Council on Radiation Protection (NCRP) guidelines. Both studies observed the behavioral symptoms, pure-tone hearing sensitivity at the standard, extended high frequencies, and the middle ear functioning in low-dose radiation-exposed individuals and compared with age and gender-matched controls. One study assessed the cochlear function using transient-evoked otoacoustic emissions (TEOAE). Both studies reported that behavioral symptoms of auditory dysfunction and hearing thresholds at extended high frequencies were higher in radiation-exposed individuals than in the controls. The current systematic review concludes that the low-dose ionizing radiation may affect the hearing adversely. Nevertheless, further studies with robust research design are required to explicate the cause and effect relationship between the occupational low-dose ionizing radiation exposure and hearing.

Introduction: Anemia is very common in Indian subcontinent. In India, according to National Health and Family Survey (NHFS-4), the prevalence of anaemia in India among adolescent girls, 15-19 years is 54.1%. Women during pregnancy are more vulnerable for anemia not only because of the synergistic effects of physiological increase in plasma volume (hemodilution) but also because of increased demand and poor bioavailability of iron in the food. Objective: To find out the impact of health educational intervention on anaemia among pregnant and lactating women. Materials and Methods: A non-randomized interventional trial without control study was conducted in the Rural field practice area of Department of Community Medicine, S.N. Medical college, Bagalkot with the Sample size for pregnant and lactating women is 153, for the period of one year (March 2018- June 2019). Results: There is increase in level of knowledge among pregnant and lactating women regarding anemia after health education intervention and was found to be statistically significant by paired t-test. Conclusion: Health education is one of the cost-effective method in improving the knowledge among pregnant and lactating mothers. Keywords: Pregnant and lactating women, Health education, Anemia.

Introduction Heart failure (HF) is a heterogeneous clinical syndrome and affects millions of people all over the world. HF occurs when the cardiac overload and injury, which is a worldwide complaint. The aim of this study was to screen and verify hub genes involved in developmental HF as well as to explore active drug molecules. Methods The expression profiling by high throughput sequencing of GSE141910 dataset was downloaded from the Gene Expression Omnibus (GEO) database, which contained 366 samples, including 200 heart failure samples and 166 non heart failure samples. The raw data was integrated to find differentially expressed genes (DEGs) and were further analyzed with bioinformatics analysis. Gene ontology (GO) and REACTOME enrichment analyses were performed via ToppGene; protein–protein interaction (PPI) networks of the DEGs was constructed based on data from the HiPPIE interactome database; modules analysis was performed; target gene—miRNA regulatory network and target gene—TF regulatory network were constructed and analyzed; hub genes were validated; molecular docking studies was performed. Results A total of 881 DEGs, including 442 up regulated genes and 439 down regulated genes were observed. Most of the DEGs were significantly enriched in biological adhesion, extracellular matrix, signaling receptor binding, secretion, intrinsic component of plasma membrane, signaling receptor activity, extracellular matrix organization and neutrophil degranulation. The top hub genes ESR1, PYHIN1, PPP2R2B, LCK, TP63, PCLAF, CFTR, TK1, ECT2 and FKBP5 were identified from the PPI network. Module analysis revealed that HF was associated with adaptive immune system and neutrophil degranulation. The target genes, miRNAs and TFs were identified from the target gene—miRNA regulatory network and target gene—TF regulatory network. Furthermore, receiver operating characteristic (ROC) curve analysis and RT-PCR analysis revealed that ESR1, PYHIN1, PPP2R2B, LCK, TP63, PCLAF, CFTR, TK1, ECT2 and FKBP5 might serve as prognostic, diagnostic biomarkers and therapeutic target for HF. The predicted targets of these active molecules were then confirmed. Conclusion The current investigation identified a series of key genes and pathways that might be involved in the progression of HF, providing a new understanding of the underlying molecular mechanisms of HF.

Observing the origin, varied branching configurations of superior thyroid artery (STA) and evaluating morphometric details with its surrounding relations was aimed at in this cadaveric neck dissection study to avoid surgical mishaps and its repercussions. This observational study was conducted on 40 fresh frozen embalmed and colored latex infused cadavers in the Department of Otorhinolaryngology and Head and Neck Surgery in collaboration with Department of Anatomy of our institute, which involved systematic evaluative dissection of both sides of neck especially focusing on superior thyroid artery, its branching variations and morphometric details with its surrounding relations. Details were measured using digital caliper. The collected data was statistically analyzed by applying chi-square test and significance was set at 5% level (p

BACKGROUND Diabetes mellitus is a metabolic disorder precipitating micro vascular, macro vascular complications and peripheral vascular diseases. Pulmonary complications of diabetes mellitus have been poorly characterised. Glycaemic status has shown varied impact on lung functions. In type-2 diabetes there is resistance to insulin action and also inadequate insulin secretion. Diabetes mellitus is associated with morphological and functional abnormalities. Several studies have shown that diabetes is associated with impaired pulmonary function. Pulmonary complications of diabetes mellitus (DM) have been poorly characterised. Some authors have reported normal pulmonary functions and even concluded that spirometry is not at all necessary in diabetic patients. We wanted to highlight the evidence-based significance of spirometry. METHODS This cross-sectional study was done for a period of 1 year from September 2017 to July 2018. The study sample consisted of 50 type-2 diabetes patients and 50 controls. RESULTS A total of 100 subjects were included in the present study; 50 of them were diabetics and the other 50 were non-diabetic controls matched by age, sex and body mass index (BMI). The range of forced vital capacity (FVC) in diabetic group was from 1.36 litres, which is lesser than range in controls (2.06 litres). Forced expiratory volume (FEV1) / FVC ranged from 0.59 in diabetics compared to 0.84 in controls. Mean FVC value was higher in diabetics with a duration of diabetes of less than 5 years (2.72) as compared to those with diabetes of more than 5 years (2.03) with a P value of 0.0004 which is statistically significant. CONCLUSIONS Type 2 diabetes mellitus is associated with restrictive pattern of respiratory abnormality. As the duration of diabetes increases the restrictive profile was more prominent. There was inverse relation between glycaemic status and spirometric indices FEV1 and FVC. Thus, an intensive glycaemic management may reduce the risk of death through an improved ventilator function which is independent of the other beneficial effects. KEY WORDS Pulmonary Function Test, Type 2 Diabetes Mellitus, Glycaemic Status

Three viruses belonging to different plant virus genera were found associated with Phalaenopsis plants showing symptoms of mild chlorotic spots, mild mosaic and dark green islands with light green depressions. Symptomatic and non-symptomatic plant samples were collected from the experimental farm of National Research Centre of Orchids, Pakyong Sikkim, India. Electron microscopy revealed the presence of virus particles with enveloped quasi-spherical, flexuous and rod-shaped particles morphologies measuring 80–110 nm, 480 × 13 nm and 300 × 18 nm respectively. In DAC-ELISA the symptomatic Phalaenopsis sample reacted with the antibodies raised previously to groundnut bud necrosis orthotospovirus (GBNV), cymbidium mosaic virus (CymMV) and odontoglossum ringspot virus (ORSV). Sequence information generated from the cloned RT-PCR amplified products, followed by sequence identity and phylogeny analyses, further confirmed the identity of the three different viruses as GBNV, CymMV and ORSV. Upon mechanical sap transmission on the N. benthamiana test plants, the phalaenopsis sample with mixed infection could induce a range of mixed symptoms such as systemic symptoms with blotching, mosaic, mottling and green-islands on the leaves, unlike those indicative of the symptoms known for the single infection by CymMV or GBNV or ORSV. The virus transmission and symptomatology revealed that the mixed infection by these three viruses masked the known symptoms of respective viruses induced individually. The present investigation describes the mixed infection by GBNV, CymMV and ORSV on Phalaenopsis for the first time in the world.

To observe and evaluate the intricrate relationship of recurrent laryngeal nerve (RLN) and external branch of superior laryngeal nerve (EBSLN) to various anatomical structures in the neck like the inferior thyroid artery (ITA), Berry’s ligament (LB), Zuckerkandl's tubercle (ZT) and with the superior thyroid artery (STA) for the knowledge of surgical cruciality during surgeries for thyroid gland diseases. This cadaveric observational study was conducted in the department of Otorhinolaryngology and Head and Neck Surgery with logistic support from Department of Anatomy. Total of 40 fresh frozen latex injected cadavers neck dissection was performed to study anatomical variations of thyroid gland and its related vessels and nerves. All measurements were recorded using digital caliper sensitive to 0.01 mm and photographs were documented. Topography of RLN was studied in relation to ITA, LB and ZT. The RLN was predominantly a posterior relation of the ITA in 86.25%, was deep to LB in 46.25% and was related posterior to ZT in 80% of cadaver dissected. The EBSLN has a variable relation with STA which was observed to lie at a distance of 0.05). The awareness and appreciation of the intricate topographical relations and its variations reinforce the surgeons to be careful when performing surgical procedures in the central compartment of the neck which avoid complications.

Background: Risk factors can lead to clinical conditions, like metabolic syndrome, that predisposes the development of cardiovascular diseases. Objective: The goal of this population-based, prospective and non-randomised cohort study was to study the association between patients with metabolic syndrome and other various factors defining metabolic syndrome. Methods: All the patients referred to the department of Medicine, Al-Ameen Medical college hospital and District Hospital, Vijayapur, Karnataka, India over a period of twenty-two months extending from December 2013 to September 2015 were considered in this study. Results: In the current study, out of 100 patients, 62.9% patients had metabolic syndrome with positive family history of hypertension, diabetes mellitus. 70.8% patients had metabolic syndrome with positive history of smoking. 64.3% patients had metabolic syndrome with positive history of alcohol .73.9% patients had metabolic syndrome with positive history of IHD. 87% of the patients with metabolic syndrome had SBP> 130 mmHg, and 78.85% patients had DBP>85 mmHg. And metabolic syndrome was observed in 71.8% patients on anti hypertensive drugs. The mean level of total cholesterol, LDL cholesterol, triglyceride is increased whereas the mean level of anti-atherogenic HDL cholesterol is low in subjects with MS. At least one lipid abnormality was present in > 95 % of cases. Around 81% subjects with BMI 25(out of 62) had metabolic syndrome. Conclusion: All the components defining the metabolic syndrome correlated positively with the abdominal obesity. Systolic blood pressure values were significantly higher than diastolic blood pressure in subjects with abdominal obesity. Metabolic syndrome has multiple risk factors determined by various aspects like the race, the life style, geographical factors larger study is needed to understand the correlation between various components defining it. A healthy lifestyle, that includes avoiding tobacco exposure and proper weight control, must be encouraged in this high-risk population. Keywords: Cardiovascular diseases; Overweight; Risk factors; Smoking.

Background Obesity associated type 2 diabetes mellitus is a metabolic disorder ; however, the etiology of obesity associated type 2 diabetes mellitus remains largely unknown. There is an urgent need to further broaden the understanding of the molecular mechanism associated in obesity associated type 2 diabetes mellitus. Methods To screen the differentially expressed genes (DEGs) that might play essential roles in obesity associated type 2 diabetes mellitus, the publicly available expression profiling by high throughput sequencing data (GSE143319) was downloaded and screened for DEGs. Then, Gene Ontology (GO) and REACTOME pathway enrichment analysis were performed. The protein - protein interaction network, miRNA - target genes regulatory network and TF-target gene regulatory network were constructed and analyzed for identification of hub and target genes. The hub genes were validated by receiver operating characteristic (ROC) curve analysis and RT- PCR analysis. Finally, a molecular docking study was performed on over expressed proteins to predict the target small drug molecules. Results A total of 820 DEGs were identified between healthy obese and metabolically unhealthy obese, among 409 up regulated and 411 down regulated genes. The GO enrichment analysis results showed that these DEGs were significantly enriched in ion transmembrane transport, intrinsic component of plasma membrane, transferase activity, transferring phosphorus-containing groups, cell adhesion, integral component of plasma membrane and signaling receptor binding, whereas, the REACTOME pathway enrichment analysis results showed that these DEGs were significantly enriched in integration of energy metabolism and extracellular matrix organization. The hub genes CEBPD, TP73, ESR2, TAB1, MAP 3K5, FN1, UBD, RUNX1, PIK3R2 and TNF, which might play an essential role in obesity associated type 2 diabetes mellitus was further screened. Conclusions The present study could deepen the understanding of the molecular mechanism of obesity associated type 2 diabetes mellitus, which could be useful in developing therapeutic targets for obesity associated type 2 diabetes mellitus.

Major Depressive disorder (MDD) is a chronic, episodic disorder which manifests with disturbance in mood, interest, cognition and vegetative symptoms. It has major impact on the quality of life of the patients, by affecting their physical, mental, personal, social, and spiritual wellbeing. Vishada and avasada represents minor depressive episodes and MDD can be equated to Kaphaja Unmada. Current case presented with sadness, worthlessness, helplessness, death wishes, disturbed sleep and was diagnosed as MDD as per DSM V criteria. Ayurveda diagnosis was Kaphaja Unmada involving kapha-dominant vata and tama dosha. Mental examination revealed derangement of mana (mind), buddhi (intellect), smruti (memory), bhakti (desire), sheela (temperament), chesta (psychomotor activity) and achara (conduct) components. Patient was Avara Satwa. Management was planned with integrative treatment comprising of Yukti vypasharaya (pharmacological), Satwawajaya (counselling) and daiwivyapashraya (spiritual-based techniques). Management was with snehapana (internal oleation), virechana (gut cleansing), sarvanga abhyanga (massage of whole body with medicated oil) followed by bashpa sweda (steam therapy to whole body), shirodhara (dripping of medicated oil on fore head), shiropichu (transcranial drug administration by placing cotton pad dipped in medicated oil), katibasti (holding of medicated oil in well-prepared from dough), satwavajaya chikitsa, and daiwi vyapashraya chikitsa. Conventional psychopharmacological interventions taken since last year were tapered and discontinued. Treatment continued for 352 days which included 13 days of hospitalized treatment and follow-ups. Intervention outcome showed reduction in Hamilton depression Rating scores from 31 to 6. Patient's self-assessed worry reduced from 16 h/day to 2 h/day, self-assessed daily relaxed state improved from ½ hour/day to 14 h/day. Patient showed complete remission by 180th day of intervention. Improvements sustained even during the non-interventional observation period. Thus, the Ayurvedic integrative management showed efficacy in management of MDD.

Aims: The workers aim to review disinfection practices in public places in India and USA Main text: Sanitization of Public Places in India: One percent sodium hypochlorite or phenolic disinfectants must be used for mopping of all indoor areas such as entrance lobbies, corridors and staircases, escalators, elevators, security guard booths, ofce rooms, meeting rooms, cafeteria. Frequently touched surfaces should be cleaned twice daily by mopping with a linen/absorbable cloth soaked in 1% sodium hypochlorite. Sanitization of Public Places in USA: Surfaces and objects which are not frequently touched should be cleaned as a routine. They do not require additional disinfection. Gloves and PPE appropriate for the chemicals being used must be worn by the workers for routine cleaning and disinfecting. Notwithstanding Government and WHO guidelines, there are media reports of use of disinfection tunnels in various public places in India. Appropriate disinfectants against SARS-CoV2: EPA's registered antimicrobial products are expected to be effective against SARS-CoV-2 based on data for viruses which are harder to kill. Conclusion:Disinfection for the SARS-CoV-2 is quite similar to disinfection which is carried out for other viruses, like the u or a common cold.

To add a enhance understanding of polycystic ovary syndrome (PCOS) at the molecular level, this investigation aimed to find the genes and crucial pathways linked with PCOS by using integrated bioinformatics analysis. Based on the expression profiling by high throughput sequencing data GSE84958 derived from the Gene Expression Omnibus, the differentially expressed genes (DEGs) between PCOS samples and normal controls were identified. With DEGs, we performed a series of functional enrichment analyses. Then, a protein–protein interaction (PPI) network, miRNA - target genes and TF - target gene networks were constructed and visualized, with which the hub gene nodes were screened out. Finally, validation of hub genes was performed by using receiver operating characteristic (ROC) and RT-PCR. Molecular docking studies performed. A total of 739 DEGs were screened out, among which 360 genes were up regulated and 379 genes were down regulated. GO enrichment analysis indicated that up regulated genes were mainly involved in peptide metabolic process, organelle envelope and RNA binding and the down regulated genes were significantly enriched in plasma membrane bounded cell projection organization, neuron projection and DNA-binding transcription factor activity, RNA polymerase II-specific. REACTOME pathway enrichment analysis showed that the up regulated genes were mainly enriched in translation and respiratory electron transport and the down regulated genes were mainly enriched in generic transcription pathway and transmembrane transport of small molecules. The top 10 hub genes in the constructed PPI network, miRNA - target gene network and TF - target gene network were SAA1, ADCY6, POLR2K, RPS15, RPS15A, CTNND1, ESR1, NEDD4L, KNTC1 and NGFR. The modules analysis showed that genes in the top 2 significant modules of PPI network were mainly associated with respiratory electron transport and signalling by NGF, respectively. We find a series of crucial genes along with the pathways that were most closely related with PCOS initiation and advancement. Our investigations provide a more detailed molecular mechanism for the progression of PCOS, detail information on the potential biomarkers and therapeutic targets.

Background Species belonging to the genus Trichoderma are considered as one of the most potential biocontrol agents which can be readily collected from soil and found effective against various fungal and bacterial diseases. In rice-growing areas, the major fungal pathogens affecting rice production include Rhizoctonia solani causing sheath blight and Sclerotium oryzae causing stem rot disease of rice. Due to the lack of resistant varieties and detrimental effects of chemicals, biocontrol gives a good opportunity to manage the diseases efficiently in a sustainable manner. Main body Trichoderma spp. from native rice rhizosphere soil were examined for their antagonistic efficiency to supress the two soil-borne rice pathogens, viz., R. solani and S. oryzae. Morphological, biochemical and molecular characterisation of the isolates led to the identification of species as T. asperellum. The isolates of Trichoderma spp. were found to be positive to IAA release and phosphate solubilisation and were screened against R. solani and S. oryzae in vitro and in vivo in pots under glass house conditions. Regression analysis indicated a positive correlation between the amount of chlamydospores produced by T. asperellum and their antagonistic potential against the two pathogens. Exposure to external stimuli, viz., light, injury and nitrogen sources in culture media triggered increased conidiation in Trichoderma isolates. Among the four isolates studied, Trichoderma asperellum IIRRCK1 (TAIK-1) was found to be the most effective in improving plant growth in rice and highly antagonistic against R. solani and S. oryzae. Sorghum grain was found to be the most suitable among different organic substrates studied to provide better growth and viability of TAIK-1 and improved the efficiency of the seed treatment and soil application. External stimuli in the form of near UV blue light, mechanical injury to the colonies and nitrogen source added to the culture media help in faster conidiation of Trichoderma. Conclusion Strain TAIK-1 showed strong competitive and antagonistic activities against fungal soil-borne pathogens, in addition with promoting healthy growth and development of rice plants. This can be a suitable and safe alternative to chemical management in the rice fields for long-term scenario.

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. OBJECTIVES The study sought to assess COVID-19`s impact on global cardiovascular diagnostic procedural volumes and safety practices. METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. RESULTS Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoradc echocardiography decreased by 59%, transesophageat echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). hi multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower-middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and teteheatth. CONCLUSIONS COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19-related changes in care delivery is warranted. (C) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

Non Alcoholic Steatohepatitis (NASH) is the most severe histological form of non-alcoholic fatty liver disease (NAFLD). It progress to cirrhosis in 20% population and 40% will have death due to liver pathology. Still consensus on pharmacotherapy is yet to be evolved and till date there is no US FDA approved drug for NASH. Ayurveda formulation Katukyadi churna is explored in the possible management of NASH. Study is a single arm with pre and post test design. Sonologically diagnosed patients of fatty liver (n = 30) were screened. 11 patients meeting elastoghraphic criteria (6.4–11.7 kPa) were enrolled in the study. K. churna was administered in the dose of 6 g twice a day with water at the middle of the meal for a period of 6 months. Subjective parameters were Aruchi (Anorexia), Agnimandhya (loss of appetite), Ajeerna (indigestion), Gouravata. Follow up assessments were done on every 30th day. Study showed that K. churna produced significant improvement in various parameters. Significant decrease in weight, (p

Non-communicable diseases (NCDs) are no longer confined to urban and rich persons. They impose a great risk in the low-income nations due to epidemiological and demographic transition. Adherence to medication is key factor in improving the quality of life and preventing complications of NCDs. This study was carried out to study the prevalence of medication adherence and factors determining non-adherence in elderly population with chronic diseases. A community based cross sectional study was conducted with 400 elderly aged 60 years and above. Data was collected by using a pretested questionnaire, which included socio-demographic variables, co-morbidities and details of their medication. Therapeutic adherence was assessed by modified Morisky-Green test, level of cognitive impairment by Pfeiffer’s short portable mental status questionnaire and functional dependence in activities of daily living by Katz Index. Statistical analysis was done using chi-square test. In our study, out of 400 participants, male participants were 184 (48%) and female participants were 216 (52%). 58.5% of them were adherent to their respective treatment medication. Male gender, low level of education, lower socio-economic status and cognitive impairment were the factors associated with therapeutic non-adherence. Therapeutic non-adherence is highly prevalent among elderly persons and is multi-factorial in origin. Interventions to increase adherence among elderly might effective if they are provided with proper guidance and education on the indications of individual treatments, their adverse effects, importance of adherence to medications and various consequences of non-adherence to the therapy.

Introduction: After the birth of the baby if the placenta is not expulsed within 30 minutes of the delivery, it is termed as retained placenta. The incidence of retained placenta is 2% of deliveries world-wide and is an important cause for maternal mortality and morbidity. Nitroglycerine (NTG) is an organic nitrate that relaxes smooth muscles and produces a generalized vasodilatation. As it relaxes the smooth muscle, it is also used as a uterine relaxant for manual placental removal. Aims and Objectives: To know the efficacy and safety of intravenous NTG in manual removal of placenta and to know the hemodynamic effects during the procedure. Materials and Methods: Total number of patients included in this study were 40. Patients were divided in two groups, each group having 20 patients each. Group 1 patients were administered with 100 microgm of NTG and group 2 patients with 150 microgm of NTG. Clinical parameters and complications were studied and compared between the two groups. Placenta was observed for separation and graded as easily separated, separated with assistance, difficult to separate, failed to separate. The clinical parameters like hypotension, tachycardia, headache after awakening, palpitation after awakening were compared between the two groups. Results: In group 1, we observed that placenta was easily separatedin 12 patients (60%), separated with assistance in 3 patients (15%), difficult to separate in 3 patients (15%) and in 2 patients (10%) placenta was not separated. In group 2, we observed that, placenta was easily separated in 14 patients (70%), separated with assistance in 2 patients (10%), difficult to separate in 2 patients (10%) and in 2 patients (10%) placenta was not separated. Conclusion: Intravenous NTG is an effective and safe method for manual removal of placenta with a dose of 100 microgram. Keywords: Intravenous, Nitroglycerinr, Retained placenta.

Factor X activation by the intrinsic Xase complex, composed of factor IXa bound to factor VIIIa on membranes, is essential for the amplified blood coagulation response. The biological significance of this step is evident from bleeding arising from deficiencies in factors VIIIa or IXa in hemophilia. Here, we assess the mechanism(s) that enforce the distinctive specificity of intrinsic Xase for its biological substrate. Active-site function of IXa was assessed with a tripeptidyl substrate (PF-3688). The reversible S1 site binder, 4-aminobenzamidine (pAB), acted as a classical competitive inhibitor of PF-3688 cleavage by Xase. In contrast, pAB acted as a noncompetitive inhibitor of factor X activation. This disconnect between peptidyl substrate and protein substrate cleavage indicates a major role for interactions between factor X and extended sites on Xase in determining substrate affinity. Accordingly, an uncleavable factor X variant, not predicted to engage the active site of IXa within Xase, acted as a classical competitive inhibitor of factor X activation. Fluorescence studies confirmed the binding of factor X to Xase assembled with IXa with a covalently blocked active site. Our findings suggest that the recognition of factor X by the intrinsic Xase complex occurs through a multistep "dock-and-lock" pathway in which the initial interaction between factor X and intrinsic Xase occurs at exosites distant from the active site, followed by active-site docking and bond cleavage.

Background CanAssist Breast (CAB) is a prognostic test for early stage hormone receptor‐positive (HR+), human epidermal growth factor receptor 2 negative (HER2−) breast cancer patients, validated on Indian and Caucasian patients. The 21‐gene signature Oncotype DX (ODX) is the most widely used commercially available breast cancer prognostic test. In the current study, risk stratification of CAB is compared with that done with ODX along with the respective outcomes of these patients. Methods A cohort of 109 early stage breast cancer patients who had previously taken the ODX test were retested with CAB, and the results respectively compared with old cut‐offs of ODX as well as cut‐offs suggested by TAILORx, a prospective randomized trial of ODX. Distant metastasis‐free survival after 5 years was taken as the end point. Results CanAssist Breast stratified 83.5% of the cohort into low‐risk and 16.5% into high‐risk. With the TAILORx cut‐offs, ODX stratified the cohort into 89.9% low‐risk and 10.1% into high‐risk. The low, intermediate, and high‐risk groups with ODX old cut‐offs were 62.4%, 31.2%, and 6.4%, respectively. The overall concordance of CAB with ODX using both cut‐offs is 75%‐76%, with ~82%‐83% concordance in the low‐risk category of these tests. The NPV of the low‐risk category of CAB was 93.4%, and of ODX with TAILORx cut‐offs was 91.8% and 89.7% with old cut‐offs. Conclusions Compared to the concordance reported for other tests, CAB shows high concordance with ODX, and in addition shows comparable performance in the patient outcomes in this cohort. CAB is thus an excellent and cost‐effective alternative to ODX., Risk stratifications and outcomes of hormone receptor‐positive/human epidermal growth factor receptor 2 negative breast cancer prognostic tests CanAssist Breast (CAB) and Oncotype DX (ODX) were compared in a cohort of 109 patients who had previously taken the ODX test. Using old cut‐offs of ODX as well as those suggested by the TAILORx study, the overall concordance of CAB with ODX was 75%‐76%, with ~82%‐83% concordance in the low‐risk category. The NPV of the low‐risk category of CAB was 93.4% and of ODX was 89.7%‐91.8%. CAB is thus an excellent and cost‐effective alternative to ODX.

Background In patients with bronchiectasis, airway clearance techniques (ACTs) are important management strategies. Research Question What are the differences in patients with bronchiectasis and a productive cough who used ACTs and those who did not? What was the assessment of bronchiectasis exacerbation frequency and change in pulmonary function at 1-year follow up? Study Design and Methods Adult patients with bronchiectasis and a productive cough in the United States Bronchiectasis and NTM Research Registry were included in the analyses. ACTs included the use of instrumental devices and manual techniques. Stratified analyses of demographic and clinical characteristics were performed by use of ACTs at baseline and follow up. The association between ACT use and clinical outcomes was assessed with the use of unadjusted and adjusted multinomial logistic regression models. Results Of the overall study population (n = 905), 59% used ACTs at baseline. A greater proportion of patients who used ACTs at baseline and follow up continuously had Pseudomonas aeruginosa (47% vs 36%; P = .021) and experienced an exacerbation (81% vs 59%; P Interpretation In patients with bronchiectasis and a productive cough, ACTs are used more often if the patients have experienced a prior exacerbation, hospitalization for pulmonary illness, or had P aeruginosa. There is a significant reduction in the use of ACTs at 1-year follow up. The odds of the development of a bronchiectasis exacerbation are higher in those patients who use ACTs continuously, which suggests more frequent use in an ill bronchiectasis population.

With growing interest in polymers of natural origin, innumerable polysaccharides have gained attention for their biomedical application. Pullulan, one of the FDA approved nutraceuticals, possesses multiple unique properties which make them highly advantageous for biomedical applications. This present review encompasses the sources, production, properties and applications of pullulan. It highlights various pullulan based stimuli-responsive systems (temperature, pH, ultrasound, magnetic), subcellular targeted systems (mitochondria, Golgi apparatus/endoplasmic reticulum, lysosome, endosome), lipid-vesicular systems (solid-lipid nanoparticles, liposomes), polymeric nanofibres, micelles, inorganic (SPIONs, gold and silver nanoparticles), carbon-based nanoplatforms (carbon nanotubes, fullerenes, nanodiamonds) and quantum dots. This article also gives insight into different biomedical, therapeutic and diagnostic applications of pullulan viz., imaging, tumor targeting, stem cell therapy, gene therapy, vaccine delivery, cosmetic applications, protein delivery, tissue engineering, photodynamic therapy and chaperone-like activities. The review also includes the toxicological profile of pullulan which is helpful for the development of suitable delivery systems for clinical applications.

In the scenario of global warming and climate change, an outbreak of new pests and pathogens has become a serious concern owing to the rapid emergence of arms races, their epidemic infection, and the ability to break down host resistance, etc. Fusarium head blight (FHB) is one such evidence that depredates major cereals throughout the world. The symptomatological perplexity and aetiological complexity make this disease very severe, engendering significant losses in the yield. Apart from qualitative and quantitative losses, mycotoxin production solemnly deteriorates the grain quality in addition to life endangerment of humans and animals after consumption of toxified grains above the permissible limit. To minimize this risk, we must be very strategic in designing sustainable management practices constituting cultural, biological, chemical, and host resistance approaches. Even though genetic resistance is the most effective and environmentally safe strategy, a huge genetic variation and unstable resistance response limit the holistic deployment of resistance genes in FHB management. Thus, the focus must shift towards the editing of susceptible (S) host proteins that are soft targets of newly evolving effector molecules, which ultimately could be exploited to repress the disease development process. Hence, we must understand the pathological, biochemical, and molecular insight of disease development in a nutshell. In the present time, the availability of functional genomics, proteomics, and metabolomics information on host-pathogen interaction in FHB have constructed various networks which helped in understanding the pathogenesis and coherent host response(s). So now translation of this information for designing of host defense in the form of desirable resistant variety/ genotype is the next step. The insights collected and presented in this review will be aiding in the understanding of the disease and apprise a solution to the multi-faceted problems which are related to FHB resistance in wheat and other cereals to ensure global food safety and food security.

Plant-microbe interactions can be either beneficial or harmful depending on the nature of the interaction. Multifaceted benefits of plant-associated microbes in crops are well documented. Specifically, the management of plant diseases using beneficial microbes is considered to be eco-friendly and the best alternative for sustainable agriculture. Diseases caused by various phytopathogens are responsible for a significant reduction in crop yield and cause substantial economic losses globally. In an ecosystem, there is always an equally daunting challenge for the establishment of disease and development of resistance by pathogens and plants, respectively. In particular, comprehending the complete view of the complex biological systems of plant-pathogen interactions, co-evolution and plant growth promotions (PGP) at both genetic and molecular levels requires novel approaches to decipher the function of genes involved in their interaction. The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/Cas9 (CRISPR-associated protein 9) is a fast, emerging, precise, ecofriendly and efficient tool to address the challenges in agriculture and decipher plant-microbe interaction in crops. Nowadays, the CRISPR/Cas9 approach is receiving major attention in the field of functional genomics and crop improvement. Consequently, the present review updates the prevailing knowledge in the deployment of CRISPR/Cas9 techniques to understand plant-microbe interactions, genes edited for the development of fungal, bacterial and viral disease resistance, to elucidate the nodulation processes, plant growth promotion, and future implications in agriculture. Further, CRISPR/Cas9 would be a new tool for the management of plant diseases and increasing productivity for climate resilience farming.

Background Anti-Androgen Receptor (AR) therapy holds promise for a subset of AR expressing triple-negative breast cancer (TNBC) patients. However, current AR assays are suboptimal in detecting the dynamic range of AR expression, contributing to its controversial role in TNBC disease prognosis. This study is aimed at evaluating the feasibility of qRT-PCR to sensitively and robustly detect AR mRNA levels for prognostication. Methods mRNA expression profiling was performed on FFPE blocks from a retrospective cohort of 101 TNBC patients using qRT-PCR and compared with AR protein expression by immunohistochemistry . Statistical analyses included Spearman’s rank correlation, Chi-square and Kaplan-Meier analyses. Distant Metastasis Free Survival was used as the end point in survival analysis. Results AR mRNA expression was observed in 34/101 patients (34%) whereas 12/80 cases (15%) were positive by IHC. qRT-PCR could thus detect more AR positive patients as compared to IHC, with 75% (9/12) concordance between the two methods. Co-expression of GATA3 and FOXA1 mRNA was observed in 85 and 88% of AR mRNA positive tumors, respectively. AR mRNA positivity was significantly correlated with age at disease onset (p = 0.02), high FOXA1/GATA3 (p p = 0.002). DMFS dropped further to 26% (p = 0.006) in AR (+)/high FOXA1/GATA3 patients. AR mRNA expression together with node positivity had the worst DMFS (23%; p p = 0.001) compared to patients expressing low Ki67 with no AR mRNA expression. Conclusion qRT-PCR was more sensitive and reliable in detecting the dynamic expression levels of AR compared to IHC and this variation could be explained by the higher sensitivity of the former method. High AR mRNA expression was strongly associated with expression of AR protein, high FOXA1/GATA3 mRNA, and with poor prognosis. qRT-PCR was more efficient in detecting the AR positive cases compared to IHC. A distinct signature involving high GATA3/FOXA1, low Ki67, and node positivity in AR mRNA positive tumors correlated with poor prognosis. Thus, AR mRNA screening can serve as an effective prognostic marker along with offering potential targeted therapy options for TNBC.

Cucumber mosaic virus (CMV) has been recorded worldwide, infecting more than 1200 plant species including weeds. In this study, 23 samples of bell pepper, squash, tomato, ornamental (calla lily, French hydrangea, spider lily) and weeds (Arrowleaf dock, Spanish needle) hosts originating from Himachal Pradesh were examined. 20 of 23 samples were identified CMV positive based on electron microscopy, bio-assay, RT-PCR assay and sequence analyses of coat protein (CP) gene. The CMV-CP gene sequences from eight isolates cloned and sequenced in this study shared 96–100% amino acid sequence identities with CMV Subgroup I isolates. This study forms the first report of the natural occurrence of CMV on squash and a weed host, Arrowleaf dock (Rumex hastatus), in India as well as the occurrence of CMV Subgroup I in the cooler hilly regions of India. These findings suggest the expansion of the host range as well as ecological niche of CMV.

Symptoms of severe stunting, little leaf, yellowing and axillary shoot proliferation were recorded on chickpea plants in three northern states of India (New Delhi, Uttar Pradesh and Rajasthan) during January–March, 2017–2018 with disease incidences of 6–56%. Nested PCR assays with phytoplasma-specific universal primer pairs (P1/P7 and 3Far/3Rev) and 16S rRNA gene sequence analysis confirmed the association of ‘Candidatus Phytoplasma trifolii’ in the symptomatic chickpea variety Pusa Bheema at New Delhi. The in silico RFLP and phylogeny analyses of 16S rRNA sequence of the chickpea stunt (CpS) affected samples confirmed the association of 16SrVI-D subgroup phytoplasma. Similar phytoplasma strain (16SrVI-D subgroup) was detected in the leafhopper species, Hishimonus phycitis collected from symptomatic chickpea fields at New Delhi. Association of icosahedral virus particles of ~25–30 nm diameters were seen under electron microscope in CpS affected samples as well as in the aphids, Myzus persicae (Sulzer) collected from the symptomatic CpS samples at New Delhi. Both the plant and aphid samples were tested positive with the polyclonal antibodies (pAbs) of cucumber mosaic virus (CMV) in DAS-ELISA and ISEM tests. PCR assays using coat protein (CP) gene specific primers for CMV and the resultant sequence comparison also confirmed the association of CMV with the CpS affected symptomatic chickpea plants and M. persicae. The CpS affected samples collected from all the three states were further tested positive with chickpea chlorotic dwarf virus (chickpea chlorotic dwarf virus, CpCDV) CP gene specific primers in PCR assays. The 2.7 kb DNA sequence resulted from the rolling circle amplification (RCA) from the CpS affected chickpea samples of New Delhi revealed a highest sequence similarity of 99% with the CpCDV isolate from Pakistan. These results suggested a wider occurrence of CpCDV in chickpea crops in all the three states and a mixed infection of phytoplasma [‘Ca. P. trifolii’ (16SrVI-D subgroup)] and two plant viruses (CMV and CpCDV) associated with CpS disease at New Delhi.

Background: The drug resistant tuberculosis has emerged as an important public health problem. Some epidemiological factors are known to influence the emergence multi drug resistant tuberculosis. This study was undertaken to study the epidemiological factors and clinical factors in emergence of multi drug resistant tuberculosis. Material and Methods: A cases control study was undertaken in the department of Chest and tuberculosis of a tertiary care hospital. A total of 30 cases confirmed as Multidrug resistant tuberculosis patients constituted the cases. About 60 age and sex matched controls were taken in to the study. A detailed history was taken with the help of a standardised proforma for both cases and controls. Results: Most of the multidrug resistant tuberculosis cases belonged to earning age group and males outnumbered females. Cough was the common symptom in cases followed by shortness of breath, expectoration, fever, haemoptysis, chest pain and wheezing. Controls had symptoms in lesser extent than cases in this study. The diabetes mellitus and HIV were the common comorbidities among the cases. About 50% of the cases were former smokers and 40% were alcoholics and 16.7% were tobacco chewers in this study. The treatment was regular in 30% and missed doses were more than 40 in 46.3% of the cases. About 60% of the cases were compliant with the drugs. Conclusions: This study had shown that, epidemiological factors play key role in emergence of multi drug resistant tuberculosis and early screening can help in prevention of emergence of multi drug resistant tuberculosis. Keywords: Multi drug resistant tuberculosis, Epidemiology, Symptomatology, Comorbidity, Treatment.

Background: Pleural effusion is a common disease entity and therapeutic thoracocentesis is a common procedure to tap the pleural fluid. The routine method of pleural tapping is associated with some complications. This study was taken up to assess the rate of complications between the routine procedure and a unique procedure. Materials and Methods: A randomized controlled trial was conducted in the department of Chest and TB in a tertiary care centre. About 30 patients had undergone therapeutic pleural tapping by the routine procedure and 30 patients had undergone tapping by unique procedure where the pleural fluid was allowed to flow through tube passively with gravity. The complications were compared between the two procedures. Results: About 40% of the study subjects in routine procedure belonged to 31 – 40 years age group. About 60% of the patients in routine and 53.3% in the unique group were females. There was no difference in chest pain in both the groups. Dyspnea, cough and reduced blood pressure was higher in the routine procedure group than the Unique procedure group. The signs of reexpansion pulmonary edema were higher in the unique group. But these were statistically not significant for 0 – 30 minutes. After one hour of the procedure, dyspneoa, signs of reexpansion pulmonary edema, cough hematoma were higher in the routine group. After 48 hours of the procedure, chest pain was noted in 3.3% of the routine cases, dyspnoea in 3.3% of the cases and fever in 3.3% of the cases. Conclusions: This study had shown that the needle catheter method was shown to be superior to the routine thoracocentesis. Keywords: Complications, Catheter, Gravity, Therapeutic thoracocentesis, Unique procedure.

CONTEXT: The therapeutic role of D2 lymphadenectomy in the management of gastric cancer is an ongoing controversy. AIMS: To examine the morbidity and oncological outcomes of D2 lymph node dissection for gastric cancer patients treated in a stand-alone cancer center in rural India and to compare it with international data. SETTINGS AND DESIGN: Retrospective study on patients treated for gastric cancer from June 2009 to December 2014. METHODS AND MATERIAL: All patients underwent subtotal or total gastrectomy with modified D2 lymph node dissection preserving spleen and pancreas. The Clavien-Dindo model was used to stratify the severity of morbidity. STATISTICAL ANALYSIS: Descriptive statistics was used for data exploration. Chi-square test was used to compare the association of various factors with survival. Kaplan-Meier method was used to calculate the survival rates (RFS and DFS). Log-rank test was used to compare the survival of different subgroups. RESULTS: Fifty-four patients (41 males and 13 females) were included in the study. Four (7.4%) patients had significant postoperative morbidity. The 5-year OS and DFS respectively were 34.9% and 37.6%. Female sex was associated with poorer survival. Lymph node ratio of more than 0.2 and advanced stage at presentation showed strong tendency towards lower OS and DFS. CONCLUSIONS: An R0 resection with D2 lymphadenectomy for gastric cancer carries acceptable morbidity and mortality in Indian patients with survival rates comparable with the western studies. Lymph node ratio more than 0.2 and female gender and advanced stage were associated with poorer oncological outcomes.

Background The occurrence of adverse drug reactions with chemotherapy among cancer patients is a well-documented phenomenon. However, the understanding of contributoring factors and their influence on the severity of adverse drug reactions is incomplete without the psychosocial factors affecting them. Objective The present study was done to understand if factors like Health literacy and cognition levels have an association with the severity of adverse drug reactions of cancer chemotherapy. Setting This study was done in the Department of Medical Oncology in a tertiary care hospital in India. Method Two hundred and twenty-four patients meeting the study inclusion and exclusion criteria took part in the study. Details of adverse drug reactions were collected as per the central drugs standard control organization format and severity of adverse drug reactions assessed with National Cancer Institute common terminology criteria of adverse events, version 5.0. Health Literacy and Cognition Levels of patients were assessed using standardized questionnaires, i.e., Short test of functional health literacy in adults and short portable mental status questionnaire, respectively. Data were anonymized and analyzed using Statistical Package for Social Sciences version 16.0 software. Pearson’s Chi square test (p value ≤ 0.05 was considered statistically significant) was used to study the associations. Main outcome measure The associations of Health Literacy and Cognition Levels with the severity of adverse drug reactions. Result We found that both Health Literacy and Cognition Levels had a statistically significant association with Grade 3 and above adverse drug reactions in cancer patients receiving chemotherapy. Conclusion An initial assessment of Health Literacy and Cognition Levels in cancer patients by cancer care providers can help identify patients at high risk of developing severe adverse drug reactions. Interventional measures for improving Health Literacy by healthcare providers can help reduce the overall burden of disease on the patient due to adverse drug reactions.

PURPOSE: Metformin is the most commonly prescribed drug in the management of metabolic disorders such as polycystic ovarian syndrome (PCOS) and gestational diabetes in women of reproductive age. Insulin-sensitizing effect of metformin helps in improving from PCOS features such as hyperandrogenism, anovulation, and infertility. However, its ability to cross placental barrier raises concern about safety of the drug on early embryonic development. In this study, we evaluated the effect of metformin on the ovarian function and embryo development. METHODS: Adult Swiss albino female mice were administered with metformin (0, 50, 100, and 200 mg/kg body weight) for 4 weeks and assessed for reproductive function and preimplantation embryo development. Further, effect of metformin (0, 10, 25, 50, 100, 250, and 500 μg/mL) exposure to 2-cell-stage embryos was tested under in vitro conditions. RESULTS: Metformin did not alter the body weight, blood glucose, ovarian weight, and follicular reserve. However, the early embryo development was significantly affected in mice treated with metformin in vivo at highest dose. Moreover, embryos which were exposed to metformin in vitro showed dose-dependent decline in blastocyst rate and hatching rate. Furthermore, at highest concentration of metformin (500 μg/mL), all the embryos were arrested at compaction stage. CONCLUSION: The study revealed that metformin affects the early embryonic development and raises concern about its use during conception. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10815-020-01709-6) contains supplementary material, which is available to authorized users.

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-U.S. institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection.

Subacute in-stent thrombosis is a rare but potentially fatal condition that can occur after treatment for intracranial aneurysms or stenosis. While immediate and late thromboembolic post-stent complications are well-described, subacute (2–30 days post-intervention) thrombosis is unusual. The administration of peri-operative dual anti-platelet therapy (DAPT) has significantly reduced the risk for thrombosis, but questions remain as to the choice of agents and treatment of thromboembolic complications in this setting. We present our acute endovascular management strategies for three patients who suffered thromboembolic complications.

Iron deficiency chlorosis is an important abiotic stress affecting groundnut production worldwide in calcareous and alkaline soils with a pH of 7.5–8.5. To identify genomic regions controlling iron deficiency chlorosis resistance in groundnut, the recombinant inbred line population from the cross TAG 24 × ICGV 86031 was evaluated for associated traits like visual chlorosis rating and SPAD chlorophyll meter reading across three crop growth stages for two consecutive years. Thirty-two QTLs were identified for visual chlorosis rating (3.9%–31.8% phenotypic variance explained [PVE]) and SPAD chlorophyll meter reading [3.8%–11% PVE] across three stages over 2 years. This is the first report of identification of QTLs for iron deficiency chlorosis resistance- associated traits in groundnut. Three major QTLs (>10% PVE) were identified at severe stage, while majority of other QTLs were having small effects. Interestingly, two major QTLs for visual chlorosis rating at 60 days (2013) and 90 days (2014) were located at same position on LG AhXIII. The identified QTLs/markers after validation across diverse genetic material could be used in genomics-assisted breeding.

The human gut pathogen, Salmonella Typhimurium (S. Typhimurium) not only survives but also replicates inside the phagocytic cells. Bacterial proteins are the primary targets of phagocyte generated oxidants. Because of the different amino acid composition, some proteins are more prone to oxidation than others. Many oxidant induced modifications to amino acids have been described. Introduction of carbonyl group is one of such modifications, which takes place quite early following exposure of proteins to oxidants and is quite stable. Therefore, carbonyl groups can be exploited to identify oxidant susceptible proteins. Hypochlorous acid (HOCl) is one of the most potent oxidants produced by phagocytes. Incubation of S. Typhimurium with 3 mM HOCl resulted in more than 150 folds loss of bacterial viability. Proteins extracted from HOCl exposed S. Typhimurium cells showed about 60 folds (p

Background. Active case finding (ACF) for tuberculosis (TB) is a promising tool to enhance early case detection among marginalized populations. As opposed to passive case finding, it involves systematically searching for TB in individuals who would not spontaneously present for care. The National TB Program (NTP) of India has initiated ACF for TB through the existing general health system since the end of 2017. However, prior to scale-up, there is need for exploring the implementation challenges and solutions to improve the efficiency of this program. Objectives. (1) To explore the enablers and challenges in the implementation of ACF for TB by NTP in the Bengaluru rural district of Karnataka, South India, and (2) to explore the perceived solutions to improve the efficiency of ACF activity. Methods. A qualitative descriptive study was conducted in the Bengaluru rural district during July 2018. In-depth interviews using purposively selected health care providers involved in active case finding (n=9) and presumptive TB patients (n=8) were conducted. Manual content analysis was conducted by two independent researchers to generate categories and themes. Results. The challenges in conduct of ACF were as follows: inadequate training of health care workers, shortage of staff, indifferent attitude of community due to stigma, lack of awareness about TB, illiteracy, inability to convince patients for sputum test, and delay in getting CBNAAT results. The field staff recommended the installation of mobile CBNAAT machine, involvement of general health staff in activity, training of health workers on counseling of patients, and issue of identity cards for community health workers/volunteers so that people recognize them. Conclusion. The health system challenges in conduct of ACF need to be addressed by training the health staff involved in activity and also improving the access to TB diagnostics.

To evaluate the adhesion of Streptococcus mutans to preformed zirconia and stainless steel crowns and compare plaque accumulation and gingival inflammation over a period of 1 year. Thirty children between 6 to 9 years with pulpectomised bilateral mandibular primary second molars were randomly divided into zirconia/stainless steel groups. Plaque was collected from the crowns using swabs at 3, 6, 9, and 12 months. Gingival and plaque index were recorded at all follow-ups. S. mutans was cultured on tryptone-yeast-cysteine-sucrose-bacitracin agar, and organisms were expressed as colony-forming units. Within-group analysis was performed using repeated measures ANOVA and between-groups using the independent T test. S. mutans were found in significantly higher numbers on the stainless steel crowns as compared with zirconia crowns at all the follow-ups. Gingival inflammation and plaque index scores were also significantly higher around the stainless steel crowns as compared with zirconia at the end of 12 months follow-up. Adhesion of S. mutans to stainless steel crowns was significantly greater when compared with zirconia, and minimal gingival inflammation and plaque accumulation was found in the tooth restored with zirconia crowns as compared with stainless steel crowns. Preformed zirconia crowns prevents adhesion of S. mutans onto its surface, and reduces plaque accumulation around the crown, inflammation of surrounding gingiva compared to conventional stainless-steel crowns. Pediatric zirconia crowns could help in reducing the overall microbial density and prevalence in the oral cavity, thus reducing the caries risk in the long term.

Purpose: The impact of gamma radiation on the reproductive biology of the spotted pod borer, Maruca vitrata (Fabr.) (Lepidoptera: Crambidae) was ascertained to explore the potential of the radio-ge...

Background: In India, tuberculosis (TB) is a major public health problem, and the advent of drug resistance TB (DR-TB) has worsened the situation. The Revised National TB Control Programme (RNTCP) has introduced universal drug susceptibility testing (UDST) for all diagnosed TB cases in 2018. We conducted this study to know the advantage of implementing UDST when compared to selective testing existent in 2017 on key diagnostic cascade parameters and to identify the challenges in the implementation of UDST. Methods: The study was conducted in two districts of Karnataka, India during January 2017-December 2018. The quantitative part consisted of before-and-after design and the qualitative part consisted of descriptive design. Results: In 2017 (during selective testing/“before” period) out of the 2440 TB patients, 80 (3%) were diagnosed with Isoniazid and Rifampicin resistance patients; in contrast in 2018 (during UDST/“after” period) of the 5129 TB patients 258 (5%) were diagnosed with Isoniazid and Rifampicin resistance. However, the proportion of eligible patients tested for rifampicin resistance during the “after” period was 60% when compared to 100% during the “before” period and median turnaround time for testing was also longer during the “after” period when compared to the “before” period (32.5 days vs 27.5 days). Major reasons for these two gaps were found to be difficulties in collecting sputum specimens and transportation. Conclusion: The rollout of UDST has led to a three-fold increase in a number of DR-TB cases detected in the region. There is a need for the programme to increase the proportion tested for DST by increasing the laboratory capacity and address the challenges in sputum collection and transportation.

Background: Pregnancy is not a disease, but a normal physiological process; still it is associated with certain risk to the health and survival of both the mother and the child. Oral health is an essential component of the overall health status of a pregnant woman. Aim: This study aims to assess the knowledge and attitude about the association between periodontitis and its adverse obstetric outcomes among pregnant women in Modinagar, North India. Materials and Methods: A hospital-based study was conducted, which comprised of pregnant women visiting for Antenatal checkup at a public health care (Community Health Care) system in Modinagar, a North Indian city. A self-administered validated questionnaire in local language (Hindi) was used. This 30-item closed ended questionnaire consisted of different domains of oral hygiene practices, importance of periodontitis obstetric outcomes and demographic information. A 5 – point Likert scale was used to assess the attitudes of pregnant women. Statistical analysis was carried out using the Statistical Package for Social Sciences (SPSS) 21.0 (SPSS Inc., Chicago, IL, USA). Mean, Standard deviation, and Independent t-test were used to compare the knowledge and attitude about the association of maternal periodontitis and its adverse obstetric outcomes between the two groups of women: Prima gravida and Multi gravida. P ≤ 0.05 was considered statistically significant. Results: Two hundred pregnant women participated in the study (50% each of Prima gravida and Multi gravida). The mean age of participants was found to be 32.88 ± 0.86 years. Most of the study population had poor knowledge (33%) and attitude (18.4%) about the association between maternal periodontitis and its adverse obstetric outcomes. For knowledge, a mean difference of 0.23 (P ≤ 0.05) between the two groups, which was found to be significant regarding whether visiting a dentist during pregnancy is necessary. First time pregnant (Prima gravida) has less knowledge compared with Multi gravida women regarding poor oral health which can lead to any complications during pregnancy. Conclusions: There is a knowledge deficit about pregnancy-induced periodontitis symptoms, prevention of complications and about the impact of obstetric outcomes among the mothers. Health-care providers should implement the focused health education programs during antenatal visit.

Guillain-Barre syndrome (GBS) is a severe acute paralytic neuropathy with rapid progression usually occurring post infections. Inspite of the active medications it is associated with severe weakness, incomplete recovery and pain. Long disease course can cause autonomic dysfunction or deterioration in general health and life threatening complications like respiratory failures. Current case was diagnosed as GBS with motor, sensory & sphincter disturbance. Ayurveda diagnosis of Sarvangavata was made and customized treatment strategy was planned. First part of Kapha pitta samrushtavata (Vatadosha associated with Kapha and Pitta dosha) and then vatahara chikitsa were followed. Treatments were Koshta shodhana (gut cleansing), Abhyanga (massage of whole body with medicated oil), Ksheera parisheka (dripping of medicated milk over body), Shastikashali panda sweda (Rubbing of medicated rice poultice over body), Anna lepa (application of medicated rice over the body), Shirotalam (trans cranial drug administration by applying medicines over scalp), Basti (trans rectal administration of medicines) and Oral medicaments. Panchakarma treatments were for 14 days followed by oral medications for next 151 days. Intervention period of 165 days showed complete recovery of all the motor, sensory & sphincter deficits however follow up of the patient was maintained for 437 days looking in to the sustainability of the outcomes. Keywords: Guillain-barre syndrome, Ayurveda, Sarvangavata, Vatavyadhi

Introduction: Stainless steel crowns are the most successful restoration for multisurface carious lesions in primary molars. The esthetics has been poorly accepted which led to the introduction of zirconia crowns. Objectives: The aim of the study was to evaluate and compare the clinical success, parental satisfaction, and child satisfaction of stainless steel and zirconia crowns in primary molars. Methods: Thirty healthy patients aged 6–8 years bilateral pulp therapy treated primary molars were randomly divided into two equal groups of stainless steel and zirconia crowns. Tooth preparation was done according to the manufacturers' recommendations depending upon the crown each patient would receive. All crowns were cemented with Type I GIC luting cement. Patients were evaluated at 6 months, 12 months, 18 months, 24 months, and 36 months. Results: Clinical success for stainless steel crowns and zirconia crowns were similar with no statistical difference between them. Zirconia accumulated less plaque than stainless steel crowns (P = 0.047). The parental satisfaction was high with both crowns. A highly significant statistical difference existed between the 2 groups in relation to the acceptance of color (P < 0.001) and child's satisfaction (P < 0.001). Conclusion: Zirconia can be considered as an esthetic alternative in the future.

Aims of this study Severe acute pancreatitis has been defined recently based on the persistence of organ failure at 48 hours of admission. The bedside index for severity in acute pancreatitis (BISAP) score, a simplified scoring system to predict severity of acute pancreatitis, is proposed to be useful in early risk stratification of acute pancreatitis. Our aim was to prospectively compare BISAP score with the already established acute physiology and chronic health evaluation II (APACHE II) and modified computed tomography severity index (CTSI) scores in predicting the severity of acute pancreatitis. Materials and methods A total of 87 consecutive cases presenting with the first attack of acute pancreatitis were included in the study. Acute physiology and chronic health evaluation II and BISAP scores were calculated from the worst parameters in the first 24 hours, and modified CTSI was reported at 48 hours of admission. Receiver-operating characteristic (ROC) curves were plotted, and predictive accuracy of each score was calculated from the area under the curve. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each score. Results A total of 20 patients (23%) had severe acute pancreatitis with a total of 11 mortalities (12.64%), 10 of them in the severe acute pancreatitis group. Acute physiology and chronic health evaluation II, modified CTSI, and BISAP score all correlated well with each other. Modified CTSI and BISAP score also correlated with duration of hospital stay. Areas under the curve for APACHE II (≥8), modified CTSI (≥8), and BISAP score (≥2) were 0.826, 0.806, and 0.811, respectively, suggesting similar predictive accuracy. Conclusion The BISAP score was similar to APACHE II and modified CTSI in terms of accuracy, sensitivity, specificity, and NPV. It is much easier to calculate and a useful risk stratification tool. It should be used for early triage and referral to a high dependency unit. How to cite this article Chatterjee R, Parab N, Sajjan B, Nagar VS. Comparison of Acute Physiology and Chronic Health Evaluation II, Modified Computed Tomography Severity Index, and Bedside Index for Severity in Acute Pancreatitis Score in Predicting the Severity of Acute Pancreatitis. Indian J Crit Care Med 2020;24(2):99-103.

Objective To analyze a consecutive series of patients with middle cerebral artery (MCA) aneurysms who needed an adjunctive cerebral revascularization procedure to achieve aneurysm occlusion with preservation of flow through all MCA branches. Methods A total of 42 patients with 43 MCA aneurysms underwent 52 bypass procedures over 13 years. The location of the aneurysm were M1 trunk, M1 bifurcation, M2 and beyond. The bypasses performed included intracranial bypasses (resection with end to end anastomosis, end to side implantation, side to side anastomosis, and short interposition graft), extraintracranial bypasses (superficial temporal to middle cerebral artery anastomosis, and radial artery bypass graft, or saphenous vein graft), double bypasses, Y-grafts, and combined techniques. Results Forty-two of 43 aneurysms (98%) had patent bypasses at long-term follow-up. All 43 aneurysms were completely occluded at last follow-up. Six patients (14%) developed strokes related to the surgical treatment. At last follow-up, 36 patients had a modified Rankin score of 0–2, 5 patients had modified Rankin score 3–5, and 1 died. In this series, 31 (73.8%) patients improved, 8 (19%) patients had same functional status, and 3 (7.2%) patients deteriorated, including 1 patient who expired due to sepsis. The mean clinical follow-up duration was 39.3 months (0.4–124 months) and the mean radiological follow-up was 37 months (0.4–134 months). Conclusions Cerebral revascularization is an important adjunct for treating MCA aneurysms and can be done safely. The article provides the insights we gained by rising through the learning curve.

Background: Essential hypertension (EHTN) is emerging as one of the most prevalent disorder with high rate of complications, morbidity and mortality. Brahmi vati, an Ayurvedic medicine is explored for its efficacy in the management of EHTN. Objective: To evaluate the efficacy of Brahmi vati and sarpagandha Ghana vati in the management of EHTN. Methods: Total 68 patients meeting the JNC 7 criteria of EHTN of age group 20 to 60 years of either sex participated in the study. They were randomly divided into two groups, group A received capsule Brahmi vati 500 mg and group B capsule Sarpagandha Ghana vati 500 mg respectively twice a day for 30 days. Assessments were done through various variables like systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), lipid profiles, Hamilton anxiety rating scale, 2 weeks sleep diary, serum creatinine, hemoglobin, total leukocyte count and erythrocyte sedimentation rate. Follow up visit was on every 15th day. Results: Study showed that both Brahmi vati and Sarpagandha Ghana vati produced improvement in most of the variables and were comparable. Improvements were seen in various variables like SBP, DBP, MAP, Hamilton anxiety rating scale, subjective sleep profiles and total cholesterol. However Brahmi vati showed increase in weight and Body Mass Index (BMI). Sarpagandha Ghana vati produced reduction in total cholesterol and LDL. Both groups showed good safety profile evaluated through the assessment of serum creatinine levels. Conclusion: Clinical efficacy of Sarpagandha Ghana vati and Brahmi vati on EHTN showed that both were effective, safe and comparable. Keywords: Essential hypertension, Sleep profiles, Lipid profile, Sarpagandha Ghana vati, Brahmi vati

Depression is a common problem worldwide since the ages. Mostly it is treated with Selective serotonin reuptake inhibitors (SSRI) but they are not effective in each and every patient. Hence other methods for better effective ways to treat depression are needed. This study was divided as acute and chronic study. Each containing five groups control, escitalopram (standard),omega -3 fatty acid (FA),escitalopram + omega -3 FA (2 doses).A 15 min pretest was done followed 24h later by a 5 min test.Various models of depression were used and biochemical analysis was done. In acute study there was no significant potentiation effect seen .In chronic study there was significant potentiation effect of omega 3 FA. Based on the results we conclude omega 3 fatty acid can be considered as a part of therapeutic use along with escitalopram. Further clinical studies may be required to validate the results of this study.

Thrips palmi transmits the tospoviruses watermelon bud necrosis (WBNV) and groundnut bud necrosis virus (GBNV) in persistent propagative way. Little is known about the T. palmi-WBNV and -GBNV relationship. In this study, we report the effects of WBNV and GBNV infection on the life history traits of T. palmi. Both WBNV and GBNV had some negative effects on the adult life span, fecundity and survival of T. palmi as compared to non-exposed T. palmi. Tospovirus exposure favoured a female-biased ratio in the experimental population.

Among 10 proteins encoded by Papaya ringspot virus (PRSV), only coat protein (CP) has been studied extensively from mainly the papaya-originated isolates i.e. PRSV-P. In this study, besides CP, the helper component proteinase (HC-pro) and nuclear inclusion protein-a (NIa-pro) coding regions from 19 PRSV-P and -W isolates originating from different geo-climatic locations and hosts were analyzed. Unlike CP, both HC-pro and NIa-pro did not reveal the variability in their length. HC-pro and NIa-pro sequences revealed less than 10% deduced amino acid (daa) diversity worldwide, the CP was found highly variable (up to 20% daa diversity). Highest variability in CP sequence was noticed among the cucurbit-originating PRSV-P Indian isolates, especially from Warm semi-arid climate, which was attributed to a large number of aa insertions/deletions. However, papaya-originating PRSV-P isolates from the Oceanic climate were less variable (up to 5% daa diversity). In NIa-pro, besides already known host/pathotype-specific switching of aa Lys/Asp27, switching of Lys27 → Arg27 and Asp27 → Glu27 was identified within P and W pathotypes. Additionally, a novel aa switching from Ser/Met134 → Thr134 between P and W pathotypes respectively was identified. The phylogeny of PRSV isolates was largely based on the geo-climatic locations and hosts. Through recombination detection analysis, three recombinant isolates were detected based on both NIa-pro and CP sequences, which possessed cucurbit-originated PRSV (either -P or -W) isolates as one of their parents (either major or minor.) Patterns of codon usage among the three protein coding sequences generated further revealed that the CP gene is under maximum selection pressure (with six sites) followed by NIa-pro gene (with one site). This investigation shows that the genetic recombination between the isolates originating from different hosts and geo-climatic locations as well as mutations are the significant mechanisms playing their role in generating diverse populations of PRSV.

Background: Wilson disease (WD) is a rare autosomal recessive disorder characterized by the accumulation of copper in the liver, brain, cornea, and kidneys. Asymptomatic nature of disease at earlier stages leads to diagnostic enigma. Objective: The objective of this study was to study the clinical, biochemical, and histological profile of WD in children between 1 and 12 years of age. Methodology: It was a hospital-based descriptive study. All children between 1 and 12 years of age who were admitted with symptoms of liver disease and neuropsychiatric symptoms were screened for WD. Low serum ceruloplasmin (