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G-quadruplex structure forming motifs are among the most studied evolutionarily conserved drug targets that are present throughout the genome of different organisms and susceptible to influencing various biological processes. Here we report highly conserved potential G-quadruplex motifs (PGQs) in three essential genes (espK, espB, and cyp51) among 160 strains of the Mycobacterium tuberculosis genome. Products of these genes are involved in pathways that are responsible for virulence determination of bacteria inside the host cell and its survival by maintaining membrane fluidity. The espK and espB genes are essential players that prevent the formation of mature phagolysosome and antigen presentation by host macrophages. The cyp51 is another PGQ-possessing gene involved in sterol biosynthesis pathway and membrane formation. In the present study, we revealed the formation of stable intramolecular parallel G-quadruplex structures by Mycobacterium PGQs using a combination of techniques (NMR, circular dichroism [CD], and gel electrophoresis). Next, isothermal titration calorimetry (ITC) and CD melting analysis demonstrated that a well-known G-quadruplex ligand, TMPyP4, binds to and stabilizes these PGQ motifs. Finally, polymerase inhibition and qRT-PCR assays highlight the biological relevance of PGQ-possessing genes in this pathogen and demonstrate that G-quadruplexes are potential drug targets for the development of effective anti-tuberculosis therapeutics. Keywords: G-quadruplex, Mycobacterium tuberculosis, drug targets, anti-tuberculosis compounds, G-quadruplex mediated inhibition, G-quadruplex binder

Coal mine activities lead to the release of potentially toxic elements (PTEs) to the surrounding areas. The present study concerns the health risk caused due to the exposure of PTEs (Hg, As, Cd, Cr, and Pb) in the children residing in the areas around coal mines. The PTEs content and bioaccumulation coefficient (BAC) in the plant, viz., Albizia lebbeck and Madhuca longifolia growing on the nearby soils of the coal mine affected areas were also estimated. The results demonstrated that the hazard quotient (HQ) for Cr (0.211) in the roadside soil (RSS) was higher than other PTEs. The hazard index (HI) was also at the maximum in the RSS (0.553) followed by the core zone soil (0.541). In RSS, Cr contributed the maximum for the HI value (38%) which elucidated that Cr might cause health problem in the long term. The Cr concentration (5.49 mg kg−1) was also higher than other PTEs in the plant leaves of M. longifolia and was two-fold higher than A. lebbeck. Except Cd, the accumulation of other PTEs in the leaves of both the species were low, which could be due to their low availability in soils. The BAC for Cr in M longifolia was comparatively higher than A. lebbeck and was found at the maximum for Cd (0.29) in M longifolia. The outcomes of the study elucidated that although there is no severe health risk in children, the data indicated that the prolonged exposure to PTEs might lead to serious health issues.

Anthropogenic land use change (LUC) affects soil quality and the global carbon (C) pool. Such LUC is a potential threat for forest ecosystems because it can alter soil biome and increases the emission of greenhouse gasses (GHGs). Here, we investigated the changes in soil quality and CO2 emission following afforestation of reclaimed coal mine land and agriculture land created in a tropical dry deciduous forest of Jharkhand, India. Soil samples were collected from afforested mined soil (AMS), agriculture soils (AGS), and the natural forest soils (NFS) and analyzed for physicochemical and biological properties. Soil infiltration rate and CO2 efflux were recorded in situ, and C balance and emission coefficient (Ci) were calculated to determine soil C dynamics.Our results demonstrated significant alteration in soil quality parameters (decreases/increases based on the individual parameter) in converted land use. Compared to NFS, soil organic carbon (SOC) stocks decreased by 84% in AMS and 50% in AGS, soil CO2 efflux increased by 35% in AGS and decreased by 43% in AMS, attributed to differences in vegetation and microbial activities among sites. Principal component analysis showed soil infiltration rate, total nitrogen, and clay content were highly influenced by the LUC and explicitly indicate soil quality. The 4-year old AMS was C negative and had a greater Ci value than AGS and NFS, probably due to the lesser vegetation cover and adverse soil properties. We concluded that the conversion of tropical forests to different lands altered soil quality that can be assessed using indicator parameters like soil infiltration rate, total nitrogen, and clay content. Such LUC tends to switch the forest from a sink to a source of CO2 whether the end use is afforestation or agriculture. However, land degradation due to surface mining activities had a greater impact on soil quality and C sequestration potential than agriculture.

In the current study, for the first time, we study mitophagy enhancer urolithin A and a combination of urolithin A+green tea extract EGCG against human Aβ peptide-induced mitochondrial and synaptic, dendritic, inflammatory toxicities and behavioral changes in humanized homozygous amyloid beta knockin (hAbKI) mice of late-onset Alzheimer’s disease (AD). Our findings reveal significantly increased positive effects of urolithin A and a combination treatment of urolithin A+EGCG in hAbKI mice for phenotypic behavioral changes including motor coordination, locomotion/exploratory activity, spatial learning and working memory. mRNA and protein levels of mitochondrial fusion, synaptic, mitophagy and autophagy genes were upregulated, and mitochondrial fission genes are downregulated in urolithin A and combine treatment in hAbKI mice; however, the effect is stronger in combined treatment. Immunofluorescence analysis of hippocampal brain sections shows similar findings of mRNA and protein levels. Mitochondrial dysfunction is significantly reduced in both treatment groups, but a stronger reduction is observed in combined treatment. Dendritic spines and lengths are significantly increased in both treatment groups, but the effect is stronger in combined treatment. The fragmented number of mitochondria is reduced, and mitochondrial length is increased, and mitophagosomal formations are increased in both the groups, but the effect is stronger in the combined treatment. The levels of amyloid beta (Aβ) 40 and Aβ42 are reduced in both treatments, however, the reduction is higher for combined treatment. These observations suggest that urolithin A is protective against human Aβ peptide-induced toxicities; however, combined treatment of urolithin A+EGCG is effective and stronger, indicating that combined therapy is promising to treat late-onset AD patients.

This paper reviews research on phytoremediation (2002–2021), particularly for the estimation of plant efficiency and soil pollution indices, examining the extraction of metals from soil and plants growing under both artificial (spiked with specific metal) and natural conditions. From the analysis of >200 published experimental results, it was found that contamination factor and geo-accumulation index as well as translocation and bioconcentration factors are the most important soil pollution and plant efficiency metrices, respectively, which are gaining importance to assess the level of metal pollution and its transfer from soil to plant to find a better metal clean-up strategy for phytoremediation. To access the metal concentration, it was found that the most widely accepted extractants to dissolve and extract the metals from the soil and plant were HNO3 and HClO4 (mainly in 5:1; v/v or 4:1; v/v), which are used both in natural and artificial metal contamination studies. Moreover, plants such as Pteris vittata, Monochoria korsakowi, Lolium perenne, Festuca rubra, Poa pratensis, Ricinus communis, and Siegesbeckia orientalis can act as hyperaccumulators under both natural and artificial experiments and can be directly implemented into the fields without checking their further efficiency in phytoremediation.

Coronavirus Disease-2019 (COVID-19) is one of the worst pandemics in the history of the world. It is the third coronavirus disease that has afflicted humans in a short span of time. The world appears to be recovering from the grasp of this deadly pandemic; still, its post-disease health effects are not clearly understood. It is evident that the vast majority of COVID-19 patients usually recovered over time; however, disease manifestation is reported to still exist in some patients even after complete recovery. The disease is known to have left irreversible damage(s) among some patients and these damages are expected to cause mild or severe degrees of health effects. Apart from the apparent damage to the lungs caused by SARS-CoV-1, MERS-CoV, and SARS-CoV-2 infection, COVID-19-surviving patients display a wide spectrum of dysfunctions in different organ systems that is similar to what occurs with SARS-CoV-1 and MERS diseases. The major long COVID-19 manifestations include the following aspects: (1) central nervous system, (2) cardiovascular, (3) pulmonary, (4) gastrointestinal, (5) hematologic, (6) renal and (7) psycho-social systems. COVID-19 has a disease display manifestation in these organs and its related systems amongst a large number of recovered cases. Our study highlights the expected bodily consequences of the pandemic caused by SARS-CoV-2 infection based on the understanding of the long-term effects of SARS-CoV-1 and MERS-CoV.

In the last six decades, the consumption of reactive nitrogen (Nr) in the form of fertilizer in India has been growing rapidly, whilst the nitrogen use efficiency (NUE) of cropping systems has been decreasing. These trends have led to increasing environmental losses of Nr, threatening the quality of air, soils, and fresh waters, and thereby endangering climate-stability, ecosystems, and human-health. Since it has been suggested that the fertilizer consumption of India may double by 2050, there is an urgent need for scientific research to support better nitrogen management in Indian agriculture. In order to share knowledge and to develop a joint vision, experts from the UK and India came together for a conference and workshop on “Challenges and Opportunities for Agricultural Nitrogen Science in India.” The meeting concluded with three core messages: (1) Soil stewardship is essential and legumes need to be planted in rotation with cereals to increase nitrogen fixation in areas of limited Nr availability. Synthetic symbioses and plastidic nitrogen fixation are possibly disruptive technologies, but their potential and implications must be considered. (2) Genetic diversity of crops and new technologies need to be shared and exploited to reduce N losses and support productive, sustainable agriculture livelihoods. (3) The use of leaf color sensing shows great potential to reduce nitrogen fertilizer use (by 10–15%). This, together with the usage of urease inhibitors in neem-coated urea, and better management of manure, urine, and crop residues, could result in a 20–25% improvement in NUE of India by 2030.

Anaerobic digestion of kitchen waste faces the challenge of frequent composition variation and rapid digester acidification due to its highly degradable nature. Considering this challenge, one year long pilot scale anaerobic digestion study was conducted in the anaerobic digester of 25 ​m3/day capacity with seasonal kitchen waste (fruits and vegetable waste). The seasonal variation in kitchen waste content was studied by dividing a year into six seasons (each season comprising 60 days), namely, spring, summer, monsoon, autumn, early winter, and prevernal winter. Considering all the properties of kitchen waste, the anaerobic digestion experiment was conducted with the organic loading rate (OLR) of 0.60–0.72 ​kg VS/m3/day. The specific biogas production for all the seasons was found to be 0.56–0.68 ​m3/kg VS, with the volumetric methane content of 54.3–62.8%. The average seasonal specific methane production was observed in the range of 0.30–0.41 ​m3/kg VS. The anaerobic digestion conversion efficiency of 55.3–67.0% was found for the anaerobic digestion of the wastes. The problem of the rapid acidification of kitchen waste has been rectified with the addition of protein-rich de-oiled pongamia cake in place of alkali chemicals. The economic analysis of kitchen waste based anaerobic digestion showed the maximum economic benefits of biogas production as INR 30,783 for its utilization as LPG and INR 37,777 for its utilization as electricity for the summer season compared to all other seasons. The extra economic benefits earned by the utilization of the digested slurry as organic manure, as it contains a good amount of nitrogen (N) 2.3–2.6%, phosphorus (P) 0.6–0.9%, and potassium (K) 0.7–1.1%.

The present study was carried out to screen six promising varieties of chrysanthemum (Chrysanthemum morifolium Ramat.), viz. Pusa Chitraksha, Lalit, Pusa Aditya, Basanti, Himanshu, and Pusa Sona in MS (Murashige and Skoog) media supplemented with 0, 50, 100 and 150 mM/NaCl. As the concentration of NaCl increased, there was a corresponding decrease in shoot length, fresh weight, number of leaves and rooting percentage. Number of shoots per plant exhibited not much significant difference. Maximum reduction in plant growth was recorded in the variety Pusa Sona (60.60%) while minimum reduction was observed in variety Pusa Aditya (35.60%). The highest fresh weight was recorded in variety Pusa Aditya and lowest in the varieties Himanshu and Pusa Sona, when the medium was supplemented with 150 mM NaCl. Variety Pusa Sona (57.00%) had the maximum reduction in the number of leaves per plant and minimum was found in the variety Lalit (29.10%). Increasing salt stress had an adverse effect on rooting abilities of all the varieties. Under the control with no added NaCl, the rooting percentage was 100% among all the varieties. In medium supplemented with 150 mM/l NaCl, the maximum rooting was recorded in the variety Pusa Aditya (63.80%)) and Basanti (63.80%), whereas least was observed in the varieties Pusa Sona and Himanshu (22.00% and 41.80%, respectively).

Resistance in modern wheat cultivars for stripe rust is not long lasting due to the narrow genetic base and periodical evolution of new pathogenic races. Though nearly 83 Yr genes conferring resistance to stripe rust have been cataloged so far, few of them have been mapped and utilized in breeding programs. Characterization of wheat germplasm for novel sources of resistance and their incorporation into elite cultivars is required to achieve durable resistance and thus to minimize the yield losses. Here, a genome-wide association study (GWAS) was performed on a set of 391 germplasm lines with the aim to identify quantitative trait loci (QTL) using 35K Axiom® array. Phenotypic evaluation disease severity against four stripe rust pathotypes, i.e., 46S119, 110S119, 238S119, and 47S103 (T) at the seedling stage in a greenhouse providing optimal conditions was carried out consecutively for 2 years (2018 and 2019 winter season). We identified, a total of 17 promising QTl which passed FDR criteria. Moreover these 17 QTL identified in the current study were mapped at different genomic locations i.e. 1B, 2A, 2B, 2D, 3A, 3B, 3D, 4B, 5B and 6B. These 17 QTLs identified in the present study might play a key role in marker-assisted breeding for developing stripe rust resistant wheat cultivars.

Intestinal duplications are rare congenital anomaly found in pediatric age group. Although, ileum is the most common site, there are cases of colonic duplications even in the adult. We report a case of 43 years woman presented with chronic constipation, intermittent colicky abdomen pain and a cystic lump in left abdomen diagnosed as tubular duplication cyst of descending colon. Colonoscopy is a good investigation tool for diagnosis of colonic duplications; however, it may not be true in all cases. She was managed with left hemicolectomy and excision of cyst with uneventful post-operative days. This case has been reported because of rarity of this condition.

ABSTRACT The membrane-anchored spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a pivotal role in directing the fusion of the virus particle mediated by the host cell receptor angiotensin-converting enzyme 2 (ACE-2). The fusion peptide region of the S protein S2 domain provides SARS-CoV-2 with the biological machinery needed for direct fusion to the host lipid membrane. In our present study, computer-aided drug design strategies were used for the identification of FDA-approved small molecules using the optimal structure of the S2 domain, which exhibits optimal interaction ratios, structural features, and energy variables, which were evaluated based on their performances in molecular docking, molecular dynamics simulations, molecular mechanics/generalized Born model and solvent accessibility binding free energy calculations of molecular dynamics trajectories, and statistical inferences. Among the 2,625 FDA-approved small molecules, chloramphenicol succinate, imipenem, and imidurea turned out to be the molecules that bound the best at the fusion peptide hydrophobic pocket. The principal interactions of the selected molecules suggest that the potential binding site at the fusion peptide region is centralized amid the Lys790, Thr791, Lys795, Asp808, and Gln872 residues. IMPORTANCE The present study provides the structural identification of the viable binding residues of the SARS-CoV-2 S2 fusion peptide region, which holds prime importance in the virus’s host cell fusion and entry mechanism. The classical molecular mechanics simulations were set on values that mimic physiological standards for a good approximation of the dynamic behavior of selected drugs in biological systems. The drug molecules screened and analyzed here have relevant antiviral properties, which are reported here and which might hint toward their utilization in the coronavirus disease 2019 (COVID-19) pandemic owing to their attributes of binding to the fusion protein binding region shown in this study.

Introduction: India struggles with poor quality of medical education, incompetent medical workforces, and insignificant research contribution to the world. Aim: Teaching-learning methods form an integral part of any curriculum hence, we aim to review the application of technology in teaching-learning methods at medical institutions across the world. Materials and Methods: An online search for articles and abstracts published from 2000 to 2020 on PubMed Central, Medline, Scopus, Google scholar using the MeSH terms like medical, education, innovative teaching, three dimensional, curriculum, etc., was conducted. A total of 49 articles were shortlisted by applying inclusion and exclusion criteria. A total of 38 articles were finally selected after thorough reading and were analysed and summarised. Results: Four themes emerged from this review: understanding learner characteristics; innovative newer techniques with the incorporation of advanced technology; cast models and plastination; and future trends for medical education. The more specific findings can be further divided into: online digital learning module; flip classroom; 3D printed models; 3D virtual reality-based technology; simulation techniques; real patient learning practical’s; medical student collaborative clinics; student-driven undergraduate research committee; patientfamily interactive programs; death-and-dying discussions and community-based service project. Conclusion: Amendment in the curriculum and selection of teaching-learning methods should be considered after understanding the student characteristics. Modern technology should be used rationally in teaching-learning methods thereby, restricting its negative impact on the students.

India leads the world in the number of registered medical institutions and produces the largest number of medical doctors in the world. Notwithstanding this, India struggles for the concerns of poor quality of medical education, incompetent medical workforces, and insignificant research contribution to the world which is due to the malfunctioning of Indian regulatory bodies. Many Authors (domestic and foreign) have written extensively on the prevailing deficiencies of the medical education system of India in the last decade but essentially failed in offering effective and realistic solutions for the deficiencies cited by them. The present study undertakes a detailed review of the articles published in the last decade that critically analyses the various aspects of the medical education system of India. The objective of this article is to present the deficiencies in the medical education system in the country supported by statistical facts and figures to provide a framework to enable a better understanding of the complexity of the medical education system in India. This article also attempts to present effective solutions for the same as publicised by the regulatory and governing bodies of medical education and health care system of India thereby providing insight into the future directions in revolutionising it.

To counteract the deadly pathogens, i.e., Y. pestis, Y. enetrocolitica, and Y. pseudotuberculosis, we prepared a recombinant DNA construct lcrV-hsp70 encoding the bivalent fusion protein LcrV-HSP70. The lcrV gene of Y. pestis and hsp70 domain II DNA fragment of M. tuberculosis were amplified by PCR. The lcrV amplicon was first ligated in the pET vector using NcoI and BamHI restriction sites. Just downstream to the lcrV gene, the hsp70 domain II was ligated using BamHI and Hind III restriction sites. The in-frame and the orientation of cloned lcrV-hsp70 were checked by restriction analysis and nucleotide sequencing. The recombinant bivalent fusion protein LcrV-HSP70 was expressed in E. coli and purified by affinity chromatography. The vaccine potential of LcrV-HSP70 fusion protein was evaluated in formulation with alum. BALB/c mice were vaccinated, and the humoral and cellular immune responses were studied. The fusion protein LcrV-HSP70 induced a strong and significant humoral immune response in comparison to control animals. We also observed a significant difference in the expression levels of IFN-γ and TNF-α in LcrV–HSP70-immunized mice in comparison to control, HSP70, and LcrV groups. To test the protective efficacy of the LcrV–HSP70 fusion protein against plague and Yersiniosis, the vaccinated mice were challenged with Y. pestis, Y. enterocolitica, and Y. pseudotuberculosis separately. The bivalent fusion protein LcrV–HSP70 imparted 100% protection against the plague. In the case of Yersiniosis, on day 2 post challenge, there was a significant reduction in the number of CFU of Y. enterocolitica and Y. pseudotuberculosis in the blood (CFU/ml) and the spleen (CFU/g) of vaccinated animals in comparison to the LcrV, HSP70, and control group animals.

An opportunistic pathogen, Klebsiella pneumoniae is known to cause life-threating nosocomial infection with a high rate of morbidity and mortality. Evolutions of multi-drug-resistant and hyper-virulent strains of K. pneumoniae make the situation worse. Currently, there is no incisive drug molecule available for drug-resistant hyper-virulent K. pneumoniae infection that emphasizes the need for identification of novel and more promising drug targets in K. pneumoniae. Recently, various non-canonical structures of nucleic acids especially G-quadruplex (G4) motifs have been identified as potential therapeutic targets against several human pathogenic bacteria and viruses including Mycobacterium tuberculosis, Streptococcus pneumoniae, human immunodeficiency virus (HIV), Ebola, and Nipah. Therefore, in present study we screened the K. pneumoniae genomes for identification of evolutionary conserved G4 structure-forming motifs as promising anti-bacterial drug targets. Bioinformatics analysis revealed the presence of six highly conserved G4 motifs in the promoter region of five essential genes that play a critical role in nutrient transport and metabolism. Biophysical studies showed the formation of G4 structure by these conserved motifs. Circular Dichroism melting analysis showed the stabilization of these G4 motifs by a well-known G4-stabilizing agent, BRACO-19. The stabilization of these motifs by BRACO-19 was also able to stop the primer extension process, which is an essential phenomenon for expression of the G4-harboring gene. The addition of G4-specific ligand at low micromolar range was observed to be lethal for the growth of this bacteria and negatively controlled the expression of the G4-harboring genes via G4 structure stabilization. These observations strengthen the formation of G4 structures by the predicted G4 motif in vivo, which can be stabilized by G4 ligands like BRACO-19. This stabilization of G4 structures can attenuate the expression of G4-harboring essential genes and thus play a critical role in the regulation of gene expression. Thus, taking all given result in consideration, for the first time, this study showed the new therapeutic avenue for combating K. pneumoniae infection by characterizing the conserved G4 motifs as promising therapeutic targets.

Abstract Net heat flux (Qnet) and its components from four reanalysis (NCEP‐2, CFSR, ERA5, and MERRA) and two blended products (OAFlux & TropFlux) are compared with in situ observation (two Research Moored Array for African‐Asian‐Australian Monsoon Analysis and Prediction buoys and one Woods Hole Oceanographic Institution buoy) over the north Indian Ocean to quantify their uncertainties in daily, seasonal, and annual scales. These comparisons provide the present status of Qnet error in most state of the art reanalysis/blended products. The root‐mean‐square error (RMSE) remains similar to the RMSE a decade earlier, despite more observation and improved models and reanalysis methods. However, there is a clear separation of flux quality from the older generation of reanalysis (NCEP‐2) to the newer production of reanalysis (MERRA, CFSR, and ERA5). While individually ERA5 provides the best estimate, the ensemble mean (i.e., average of ERA5, CFSR, MERRA, TropFlux, and OAFlux) is very close to ERA5 both in terms of correlations and RMSE and provides the most reliable estimate by virtue of removal of some of the uncertainties in estimation of flux by each of the flux products. A significant reduction of RMSE in Qnet estimates from 100 W/m2 (in NCEP‐2) to 45 W/m2 (in the ensemble mean) is considerable progress. It is noteworthy that all the recent flux products estimate the increasing trend of Qnet in the north Bay of Bengal and subseasonal fluctuations with significant fidelity. Also, in the south of equator location vigorous subseasonal fluctuations in boreal winter are well captured. We believe that this is significant progress in the estimation of Qnet over the Indian Ocean.

Wheat is a major food crop and an important component of human diet throughout the world. There are two major types of cultivated wheat; one is tetraploid durum (pasta) wheat and another one is hexaploid bread wheat. Wheat grain is the reservoir of two major dietary components – carbohydrate and protein, which get accumulated during seed maturation and directly affects yield and quality. Hexaploid, having 6 copies of each chromosome differs to a great extent from tetraploid having 4 copies of each chromosome. Studying the gene expression pattern in developing grain would help in understanding the difference in metabolic process as well as involvement of the genes in these two types of wheat. A transcriptional comparison of developing grains was carried out between the two wheat genotypes; tetraploid (AABB:PDW233) and hexaploid (AABBDD:PBW343) using RNA-seq. Approximately 194 million raw reads were obtained from both libraries. After removal of contaminations, a huge proportion (>99%), of high quality reads were obtained, were aligned to reference genome. A total of 2324 up-regulated and 522 down-regulated genes were identified as differentially expressed between PDW233 vs PBW343. Gene ontology annotation and enrichment analysis gave further information about differentially expressed genes between durum and bread wheat. This information will help in understanding process grain reserve in tetraploid and hexaploid wheat in relation to their nutritional quality. Keywords: Hexaploid bread wheat, Tetraploid durum wheat, Transcriptome, Grain development

Introduction: An absent ear lobule may be congenital or the result of trauma, infection, etc. Many procedures have been described for reconstruction. Aim: To present our experience with the Zenteno Alanis and the Gavello techniques. Materials and Methods: The lobule was reconstructed in four patients. Reconstruction of the lobule in the first patient was done by Zenteno Alanis technique and in the next three patients, it was done by Gavello's technique. Results: Results were satisfactory with both techniques. Division and inset were needed in Zenteno Alanis technique to correct the bunched skin behind the lobule at the base of the flap. The scar was inferior and visible. In Gavello's technique, the surgery was single-staged and the scar was retroauricular. Conclusions: Zenteno Alanis technique needed “division and inset” and the scar was visible. Gavello's single-staged reconstruction resulted in a scar, which could be concealed.

Background: Acute poisoning in geriatric age group is a clinical challenge due to multiple comorbidities and complications in this age group. There are very few studies done in the past, which have addressed this issue. Materials and Methods: This retrospective observational study was a carried out in the Department of Emergency Medicine of a tertiary care hospital of Uttarakhand over a period of 1 year from November 2017 to October 2018. Detailed demographic data and clinical history of patients with alleged history of acute poisoning was obtained from the hospital record section. Results: During the period of 1 year, 156 patients of acute poisoning attended the medical emergency department, of which 53 (33.9%) patients belonged to geriatric age group (>60 years). Maximum number of patients belonged to the age group of 71–80 years (n = 26, 16.6%). Males outnumbered female patients. The most common toxidrome in geriatric age group was alcohol intoxication followed by pesticide (organophosphorus) poisoning. Unintentional exposure of toxin in the form of drug over dosage encompassed more than one-third of poisonings in geriatric population. Nine (16.9%) geriatric patients succumbed to poisoning. Complications such as acute renal failure, shock, respiratory distress, acute liver injury, and need for ventilator support were more common in nonsurvivors as compared with survivors. Conclusion: The study demonstrated mortality of 16.9% (n = 9) among geriatric patients with alleged history of acute poisoning. The risk factors attributing to mortality were shock, aspiration pneumonia, and acute liver injury. Although cases of suicidal exposure outnumbered cases of unintentional exposure, the latter group comprised of a considerable number. Clearly, more attention is needed while managing a case of acute poisoning of geriatric age group as their pattern of presentation and complications differ from that of younger age group.

Tuberculosis is an infectious disease caused by mycobacterium tuberculosis. It is one of the deadliest disease and a major burden on the healthcare system in India. India, a second most populous country in the world, has a very high global annual incidence of tuberculosis. Multiple hematological changes have been reported in patients with tuberculosis such as iron deficiency anemia, folate deficiency, and sideroblastic anemia. Aims and Objectives: The present study was planned to find the prevalence and characteristics of anemia in the new cases of pulmonary tuberculosis. The secondary objective was to assess the predictors of anemia in new cases of pulmonary tuberculosis. Methods: The retrospective study was carried out at a tertiary care hospital of Uttarakhand and included all the new cases of tuberculosis aged more than 18 years attending medicine outpatient and inpatient departments over a period of 1 year. Detailed demographic, clinical, and biochemical data were obtained from the hospital record section and tabulated. Results: Most patients with tuberculosis and anemia were more than 50 years of age. Clearly, males outnumbered females. Approximately, 80% patients were illiterates. A majority (71, 39.2%) of the patients had BMI within the range of 18.5 to 24.9 kg/m2. The most common symptoms of tubercular patients with and without anemia were cough, fever, breathlessness, and hemoptysis. However, pallor was the most common sign. Clearly, hematological indices were lower in patients with anemia. In total, 112 (60%) patients had mild anemia and 103 (56.9%) patients had normocytic normochromic anemia. Significant association was found between Body Mass Index (BMI) and anemia in patients with pulmonary tuberculosis. Similarly, severity of anemia co-related significantly with BMI of patients with pulmonary tuberculosis. BMI showed a significant correlation with hemoglobin, packed cell volume, mean corpuscular cell volume, and red cell distribution width (RDW). In addition, age showed a significant correlation with hemoglobin and RDW.Conclusion: Normocytic normochromic anemia is a common hematological abnormality in patients with pulmonary tuberculosis. Thus, it warrants frequent screening for anemia in all the cases of pulmonary tuberculosis to improve morbidity and mortality in these patients.

Background: The spleen is most the commonly injured solid organ in abdominal trauma. Operative management (OM) has been challenged by several studies favoring successful non-OM (NOM) aided by modern era interventional radiology. The results of these studies are confounded by associated injuries impacting outcome. The aim of this study is to compare NOM and OM for isolated splenic injury in an Indian Level 1 Trauma Center. Materials and Methods: This is a retrospective analysis of prospective database. Results: A total of 1496 patients were admitted with abdominal injuries. One hundred and twenty-nine patients admitted with diagnosis of isolated splenic injury from January 2009 to December 2016 were included in the study. RTIs, followed by falls from height, were the most common mechanisms of injury. Ninety-two (71.3%) patients with isolated splenic trauma were successfully managed nonoperatively. Thirty-seven (28.7%) required surgery, of which three were due to the failure of NOM. Three patients in the nonoperative group underwent splenectomy later, giving an overall success rate of 96.8% for NOM. Patients with isolated splenic trauma requiring OM had higher grade splenic injury (Grade 4/5), higher blood transfusion requirements (P < 0.001), and prolonged Intensive Care Unit and hospital stay in comparison to patients in the nonoperative group. No patient died in the NOM group; two patients died in the splenectomy group due to hemorrhagic shock and acute respiratory distress syndrome, respectively. Conclusion: Although NOM is successful in most patients with blunt isolated splenic injuries, careful selection is the most important factor dictating the success of NOM.

A biological is a substance which either comprises, contains, or is derived from human cells or human tissues. The use of biological products is associated with the risk of infection transmission, allergic reactions, and other adverse events (AEs). The science and activities relating to the detection, assessment, understanding, and prevention of AEs or any other problems related to biological products (blood, cells, tissues, organs, and vaccine in international perspective) are termed as biovigilance. With more and more biologicals being marketed and the rapid revolutionary changes in transplant-related services, the importance of biovigilance is increasing day by day. Although specific types of vigilance systems (pharmacovigilance and materiovigilance) exist, activities related to “biovigilance” are still in an infancy stage. Many developed countries such as the USA, Europe, and Australia have implemented nationwide biovigilance programs. In India, the National Institute of Biologicals, in collaboration with the Indian Pharmacopoeia Commission, has launched the Biovigilance Programme of India. In this article, the biovigilance systems of different countries across the globe have been reviewed along with highlights of the current biovigilance needs.

Introduction: Classification of chronic obstructive pulmonary (COPD) disease has changed from being solely based on spirometric variables to combined assessment including symptom scores and history of exacerbations/ hospitalizations. There is both lack of awareness regarding change in its assessment as well as underutilization due to time constraints and seeming complexity. Moreover, treatment of COPD needs to be tailored according to the new combined assessment. Aims: Current study was planned to look at current stratification of patients according to new revised combined assessment (Global Initiative for Chronic Obstructive Lung Disease GOLD 2017) in comparison to old(GOLD 2011) as well as its incorporation in clinical practice. Co-relation between revised combined assessment and spirometric staging was also assessed. Methods: 418 consecutive COPD patients were enrolled, their dyspnea scores in terms of modified medical research council scale (mMRC), preceding history of hospitalization/ exacerbation over preceding one year and spirometric variables were recorded. Their stratification according to old and new classification recorded. Their past treatment records were reviewed and combined assessment if done recorded. Results: Substantial shift of categories is seen from C and D respectively to stage A and B on applying the new classification compared to old i.e more severe to less severe. Secondly, revised combined assessment is still highly underutilized. Revised combined assessment has positive co-relation with spirometry and post bronchodilator forced expiratory volume in 1 second(FEV1). Conclusions: Management of substantial number of stable COPD patients may need to be stepped down in accordance with revised combined assessment. There is a need to disseminate information regarding change in COPD classification and stress on its incorporation in our day-to day clinical practice. Revised combined assessment has positive co-relation with spirometry, stressing its utility even in peripheral centers without spirometry facilities.

Introduction: Trauma systems vary in performance during different time periods and may affect the patient outcomes, especially in resource-limited settings. The present study was undertaken to study the pattern, epidemiological profile, processes of care variations of trauma victims presenting during-hours and after-hours in a level 1 trauma Center of a lower middle-income country. Methodology: Retrospective analyses of prospectively collected data registry at a single tertiary care center. Data collected from 2013 to 2015 were analyzed. Patients with a history of trauma and admission to the center or death between arrival and admission were included. Isolated limb injury and patients dead on arrival were excluded. Results: Of 4692, 1789 (38.1%) patients arrived and were admitted during-hours and 2903 (61.9%) after-hours. The overall in-hospital mortality was 14.9% in the cohort. Moreover, it was 16.10% during after-hours in comparison to 13.0% during-hours. The Revised Trauma Score was statistically different during-hours and after-hours suggesting patients with greater physiological derangement after-hours. The Kaplan–Meier survival curves for 7 days were comparable in two groups with the log-rank test of 078. The proportion of initial radiological investigations (chest X-ray, focused assessment sonography in trauma [FAST], and computerized tomography [CT] scans) was ranged from 84.9% for CT scans in the cohort to 99.3% for FAST. Conclusions: Processes of care do not differ significantly for the patients admitted at a level 1 trauma center irrespective of time of the day. Although survival probability for the initial 7 days of follow-up is comparable between two groups; however, for 30 and 90 days of follow-up they are significantly different between during-hours and after-hours, likely due to injury severity.

Background: Incidence of road traffic injuries (RTIs) is increasing and accounting for country's 3% gross domestic product. It is crucial to perform a cost analysis of trauma systems to allocate resources judiciously. Aim and Objectives: To study the economic burden of trauma care on the patient attending a level I trauma center including stratification of costs according to injury. Materials and Methods: This is a prospective study, with patients of polytrauma (Injury Severity Score >16) admitted in the center. Cost analysis (cost descriptive study) was done by calculating direct costs to hospital by bottom-up microcosting considering fixed and recurrent costs including reference unit prices (RUPs). According to the anatomical site of injuries, major injury groups (MIGs) costs were also analyzed. Results: The demographics including mode of injury were similar to other studies. The RUP's and MIG's were defined which represented majority of the sample size. Due to highly subsidized nature of services in this Government institute, the cost to patient is less compared to other countries. Still, the total expenditure incurred by the low-income group was higher than the minimum wages at that time. The creation of plausible RUP's and the grouping of MIG's can help in reducing the costs by targeting and implementing strategic cost reduction measures. Conclusion: The study has shown that microcosting is feasible. Considering the low-income population demanding trauma services, further efforts are required to reduce costs substantially.

Context: Improvement in perioperative care can reduce anesthesia-related morbidity. Noncompliance to protocols and poor working practices can compromise patient safety. Aims: The objective was to survey the working practices of anesthesiologists in India and find out the most commonly overlooked aspects in perioperative period. Setting and Design: Prospective cross-sectional survey involving practicing anesthesiologists in India, conducted over a period of 2 months. Methods: An online questionnaire, including questions pertaining to pre-, intra- and post-operative phases during conduct of anesthesia was mailed to anesthesiologists (members of the Indian Society of Anesthesiologists) over a period of 2 months through the online survey builder SurveyMonkey. The questionnaire was delivered to 13,700 anesthesiologists, of which 2055 responded. Results are expressed as numbers or percentages. Results: Checklist compliance, equipment check, and perioperative record-keeping are the most commonly overlooked aspects by anesthesiologists in perioperative period. The survey also highlights the shortage of postanesthesia care units across the country. Conclusions: Checklist compliance, equipment check, and record-keeping are potential areas for improvement. Professional societies should promote better practices, monitoring standards and should also formulate minimum standards for different setups where anesthesia can be delivered safely.

Introduction: Type 2 diabetes mellitus is a heterogeneous group of metabolic disorders of disturbance of carbohydrate, fat, and protein metabolism causing macrovascular (like coronary artery disease) and microvascular (kidney damage) complications. Microalbuminuria is the first manifestation of injury to glomerular filtration barrier and carotid intima-media thickness (IMT) of common carotid artery serves as an excellent marker for early lesion of atherosclerosis. Method: A cross-sectional observational study was carried out over a period of 1.5 years in PGIMER, DR. RML Hospital, New Delhi. Patients with type 2 diabetes mellitus, aged between 35 and 60 years, were investigated for uric acid (UA), urine albumin levels, and common carotid IMT during this period. Patients on drugs that affect serum UA level, patients with acute illness, patients with serum creatinine >1.5 mg/dL, or with coronary artery disease were excluded from study. Result: Prevalence of hyperuricemia was found to be high (46%) in type 2 diabetic patients. It was also higher in females (73.7%) than males (25.8%). There was positive correlation between serum UA concentrations with logarithm of urine albumin excretion (P < 0.023) and carotid intima-media thickness (IMT) (P < 0.027). Plaque index also showed a positive correlation with UA (P < 0.019). However, there was no positive correlation with UA and other variable such as age, duration of diabetes, systolic blood pressure, diastolic blood pressure, HbA1c, lipid profiles, urea, and creatinine. Conclusion: Serum UA concentration thus serves as an early marker of renal dysfunction and cardiovascular diseases in type 2 diabetic patients.

Purpose: To evaluate and compare the positional and angular accuracy of virtual implant positions planned on cone-beam computed tomography and final implant positions achieved using a universal open guide system. Materials and Methods: A dual scan of a partially edentulous jaw model along with prosthesis was done, and virtual implant planning was performed. Three implant positions in relation to 35, 36, and 37 were simulated (Group A). In total, 24 implants were placed in eight replaceable bone blocks (Group B) in the same region on the model using an open stereolithographic template. The linear positions and angulation of the placed implants were determined using Vision Measuring Machine. Deviations between virtually planned and surgically placed implants were analyzed in terms of linear and angular measurements. Data were analyzed with the independent-sample t-test with differences P ≤ 0.05 being considered statistically significant. Results: The linear distance (mean ± standard deviation [SD]) in mesiodistal direction between implants in relation to 35 and 36, 36 and 37, 35 and 37 in Group A was 8.79 ± 0 mm, 8.71 ± 0 mm, and 17.50 ± 0 mm, respectively, and in Group B was 7.70 ± 0.58 mm, 8.11 ± 0.30 mm, and 15.80 ± 0.48 mm. All these above values were found to be statistically significant (P ≤ 0.05). The linear distance (mean ± SD) in the vertical direction (mesial) for implants placed in the region of 35, 36, 37 for Group A was 1.51 ± 0 mm, 1.51 ± 0 mm, and 2.47 ± 0 mm, respectively, and for Group B was 1.37 ± 0.32 mm, 1.65 ± 0.48 mm, and 1.79 ± 0.36 mm, respectively. The linear distance (mean ± SD) in the vertical direction (distal) for implants placed in the region of 35, 36, 37 for Group A was 3.37 ± 0 mm, 1.51 ± 0 mm, and 1.51 ± 0 mm, respectively, and for Group B was 1.86 ± 0.48 mm (P ≤ 0.05), 1.56 ± 0.23 mm, and 1.29 ± 0.39 mm (P ≤ 0.05), respectively. The angular deviation (perpendicularity) values for virtually planned implants (Group A) were 90.00° ± 0° and for implants placed in the region of 35, 36, and 37 (Group B) were 84.52° ± 5.4°, 83.57° ± 1.52°, and 80.41° ± 2.37°, respectively, which are highly significant (P ≤ 0.05). Conclusions: The stereolithographic universal open guide used in the study may be considered accurate for placement of implants in mesiodistal position and also in terms of perpendicularity but not in the vertical position. Stereolithographic open guide may be recommended for more accurate implant position, especially for the placement of multiple implants.

Fragile X-associated tremor ataxia syndrome is an untreatable neurological and neuromuscular disorder caused by unstable expansion of 55–200 CGG nucleotide repeats in 5′ UTR of Fragile X intellectual disability 1 (FMR1) gene. The expansion of CGG repeats in the FMR1 mRNA elicits neuronal cell toxicity through two main pathogenic mechanisms. First, mRNA with CGG expanded repeats sequester specific RNA regulatory proteins resulting in splicing alterations and formation of ribonuclear inclusions. Second, repeat-associated non-canonical translation (RANT) of the CGG expansion produces a toxic homopolymeric protein, FMRpolyG. Very few small molecules are known to modulate these pathogenic events, limiting the therapeutic possibilities for FXTAS. Here, we found that a naturally available biologically active small molecule, Curcumin, selectively binds to CGG RNA repeats. Interestingly, Curcumin improves FXTAS associated alternative splicing defects and decreases the production and accumulation of FMRpolyG protein inclusion. Furthermore, Curcumin decreases cell cytotoxicity promptly by expression of CGG RNA in FXTAS cell models. In conclusion, our data suggest that small molecules like Curcumin and its derivatives may be explored as a potential therapeutic strategy against the debilitating repeats associated neurodegenerative disorders.

A general term N95 Mask has been widely used by all including the health care personnel. It has been use incorrectly by all and it should be replaced with the term filtering facepiece respirator. There are two types of respirators being used in the world. One is the industrial type whereas the other one is the medical surgical one. The medical surgical masks are an intermediate product between the industrial and the triple layer medical mask. Many other equivalent products like KN95 masks are also available in the market. There is an urgent need of certification because this is the only way quality face masks can be provided to the public in these difficult times of COVID-19. This is essential because of the entry of many counterfeit and uncertified respirators have entered the market.

Foreign body (FB) aspiration into the tracheobronchial tree is a fairly common occurrence in the pediatric age group. The most common FBs aspirated are organic materials. However, aspiration of iatrogenic FB is rare and infrequently reported. It is a challenge to retrieve a sharp and pointed FB without further injuring the tracheobronchial tree. We report an unusual case of sharp and pointed dental instrument aspiration in a 4-year-old boy, which was safely removed by a flexible fiberoptic bronchoscope and sequestering the FB within the endotracheal tube without injuring the tracheobronchial mucosa.

Diaphragmatic hernia (DH) is a common condition following blunt trauma to upper abdomen and is also a commonly missed diagnosis. Its early anticipation in post-traumatic setting is very important to avoid any further life-threatening sequelae. X-ray chest with a nasogastric tube is a simpler way to diagnose this condition. CT scan is a gold standard tool to confirm diagnosis. Due to wide availability of ultrasound (US) in emergency room (ER), this tool will decide the correct way of further evaluation avoiding unnecessary delays in management. We present a case of a diaphragmatic hernia followed by blunt injury abdomen with multiple herniated abdominal contents successfully managed by early intervention.

Intestinal tuberculosis has varied clinical presentations and often requires high index of suspicion for clinching the diagnosis. We report a case of an 18-year-old male who presented with abrupt onset of massive lower gastrointestinal bleeding and was diagnosed to have ileocecal tuberculosis. This case signifies the need to consider the possibility of intestinal tuberculosis as a cause of severe hematochezia among other etiologies to prevent mortality and morbidity.

Onosma bracteata Wall. is an important medicinal and immunity-enhancing herbs. This plant is commonly used in the preparation of traditional Ayurvedic drugs to treat numerous diseases. Inspired by the medicinal properties of this plant, the present study aimed to investigate the antiproliferative potential and the primary molecular mechanisms of the apoptotic induction against human osteosarcoma (MG-63) cells. Among all the fractions isolated from O. bracteata, ethyl acetate fraction (Obea) showed good antioxidant activity in superoxide radical scavenging assay and lipid peroxidation assay with an EC50 value of 95.12 and 80.67 µg/mL, respectively. Silica gel column chromatography of ethyl acetate (Obea) fraction of O. bracteata yielded a pure compound, which was characterized by NMR, FTIR, and HR-MS analysis and was identified as 1,2-benzene dicarboxylic acid, bis (2-methyl propyl) ester (BDCe fraction). BDCe fraction was evaluated for the antiproliferative potential against human osteosarcoma MG-63, human neuroblastoma IMR-32, and human lung carcinoma A549 cell lines by MTT assay and exhibited GI50 values of 37.53 μM, 56.05 μM, and 47.12 μM, respectively. In MG-63 cells, the BDCe fraction increased the level of ROS and simultaneously decreased the mitochondria membrane potential (MMP) potential by arresting cells at the G0/G1 phase, suggesting the initiation of apoptosis. Western blotting analysis revealed the upregulation of p53, caspase3, and caspase9 while the expressions of p-NF-κB, p-Akt and Bcl-xl were decreased. RT-qPCR studies also showed upregulation in the expression of p53 and caspase3 and downregulation in the expression of CDK2, Bcl-2 and Cyclin E genes. Molecular docking analysis displayed the interaction between BDCe fraction with p53 (−151.13 kcal/mol) and CDK1 (−133.96 kcal/mol). The results of the present work suggest that the BDCe fraction has chemopreventive properties against osteosarcoma (MG-63) cells through the induction of cell cycle arrest and apoptosis via Akt/NF-κB/p53 pathways. This study contributes to the understanding of the utilization of BDCe fraction in osteosarcoma treatment.

The entry and survival of Mycobacterium tuberculosis (Mtb) within host cells is orchestrated partly by an essential histone-like protein HupB (Rv2986c). Despite being an essential drug target, the lack of structural information has impeded the development of inhibitors targeting the indispensable and multifunctional C-terminal domain (CTD) of HupB. To bypass the requirement for structural information in the classical drug discovery route, we generated a panel of DNA aptamers against HupB protein through systemic evolution of ligands by exponential (SELEX) enrichment. Two G-quadruplex-forming high-affinity aptamers (HupB-4T and HupB-13T) were identified, each of which bound two distinct sites on full-length HupB, with an estimated KD of ∼1.72 μM and ∼0.17 μM, respectively, for the high-affinity sites. While HupB-4T robustly inhibited DNA-binding activity of HupB in vitro, both the aptamers recognized surface-located HupB and significantly blocked Mtb entry into THP-1 monocytic cells (p

The purpose of our study is to investigate early cellular, molecular, morphological and behavioral changes in humanized amyloid-beta-knock-in (hAbKI) mice. Using seven-month-old homozygous hAbKI mice, we studied behavioral phenotype parameters, including spatial learning and memory (Morris Water Maze), locomotor activity (open field), working memory (Y-maze) and motor coordination (rotarod); mRNA abundance, protein levels, soluble amyloid-beta 40 and 42 levels and regional immunoreactivities of key markers of mitochondrial dynamics, mitochondrial biogenesis, synaptic health, mitophagy and autophagy; mitochondrial function and using transmission electron microscopy & Golgi–Cox staining, we assessed mitochondrial morphology and dendritic spines. Our extensive behavioral analysis revealed that seven-month-old hAbKI mice showed impairments in motor coordination, reduced locomotor and exploration activities, impairments in working memory and spatial learning and memory. Our mRNA and protein analyses revealed the increased expression of mitochondrial-fission genes and reduced expression of mitochondrial-fusion, mitochondrial-biogenesis, synaptic, autophagy and mitophagy genes in seven-month-old hAbKI mice. An immunofluorescence analysis revealed altered immunoreactivities and agreed with the immunoblot results. Transmission-electron-microscopy data revealed increased mitochondrial fragmentation and reduced mitochondrial length in both hippocampal and cortical tissues of seven-month-old hAbKI mice and mitochondrial function defective. A Golgi–Cox-staining analysis revealed reduced dendritic spines in both cerebral cortices and hippocampi of hAbKI mice. Soluble amyloid-beta (1–40 and 1–42) were detected in three-month-old hAbKI mice and progressively increased in seven-month-old mice. These observations suggest that the human amyloid-beta peptide is sufficient to cause behavioral, mitochondrial, synaptic and ultrastructural changes in seven-month-old hAbKI mice. Our study findings also suggest that hAbKI mice might serve as a model for preclinical studies of preventive therapies.

The presence of an abnormal amount of Cu2+ in the human body causes various health issues. In the current study, we synthesized a new naphthoquinolinedione-based probe (probe 1) to monitor Cu2+ in different water systems, such as tap water, lakes, and drain water. Two triazole units were introduced into the probe via a click reaction to increase the binding affinity to a metal ion. In day-light, probe 1 dissolved in a mixed solvent system (HEPES: EtOH = 1:4) showed a vivid color change from light greenish-yellow to pink in the presence of only Cu2+ among various metal ions. In addition, the green luminescence and fluorescence emission of the probe were effectively bleached out immediately after Cu2+ addition. The limit of detection (LOD) of the probe was 0.5 µM when a ratio-metric method was used for metal ion detection. The fluorescence titration data of the probe with Cu2+ showed a calculated LOD of 41.5 pM. Hence, probe 1 possesses the following dual response toward Cu2+ detection: color change and fluorescence quenching. Probe 1 was also useful for detecting Cu2+ spiked in tap/lake water as well as the cytoplasm of live HeLa cells. The current system was investigated using ultraviolet-visible and fluorescence spectroscopy as well as density functional theory calculations (DFT).

Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2–10) years were managed. Mechanism of injury was road traffic accident, fall from height and other accidental injury in 2, 3 and 1 patient respectively. The presentation was respiratory distress and quadriplegia, exposed heart, penetrating injury in neck, dysphagia and dyspnea, and swelling over the chest wall in 1, 1, 1, 2 and 1 cases respectively. Injuries included lung laceration, open chest wall, vascular injury of the neck, tracheoesophageal fistula (2), and chest wall posttraumatic pyomyositis. One patient had a flare of miliary tuberculosis. Immediate management included chest wall repair; neck exploration and repair, esophagostomy, gastroesophageal stapling, and feeding jejunostomy (followed by gastric pull-up 8 months later). Chest tube insertion and total parenteral nutrition was required in one each. 2 and 4 patients required tracheostomy and mechanical ventilation. The patient with gastric pull-up developed a stricture of the esophagogastric anastomosis that was revised at 26-month follow-up. At follow-up of 40–61 months, five patients are well. One patient with penetrating neck injury suffered from blindness due to massive hemorrhage from the vascular injury in the neck and brain ischemia with only peripheral vision recovery. Conclusion: Successful management of neck and chest wall trauma requires timely appropriate decisions with a team effort.

Introduction: Emergency department (ED) overcrowding with critically ill trauma patients has been a major concern globally. It has been shown that longer stays in the hospital before Intensive Care Unit (ICU) admission have a higher mortality rate. Objective: The objective of this study was to find whether the delay in ICU admission from ED is associated with significant mortality in a trauma patient. Methods: A prospective trauma registry data of 232 patients collected from the ED of JPNATC trauma center between September 2015 and March 2016 were used in the study. The study participants were all admitted trauma patients. Dead-on-arrival patients were excluded from the study. Results: All included patients had a blunt injury at the time of arrival. Of 232 patients, 66 died during treatment and 166 were discharged. Of these, 196 (84.5%) were male and 36 (15.5%) were female. Most of the patients among 66 who died were referred from different hospitals; however, most survivors arrived directly at JPNATC as compared to another group (P < 0.001). Waiting time in ED was calculated by the difference between arrival time and ED disposition time. There was statistically significant difference found in ED waiting time in both the groups (P = 0.015); however, the odds ratio is closer to 1, that is, 0.998. Similarly, age, gender, oxygen saturation, Glasgow Coma Scale, ICU stay days, heart rate, referring status, and injury severity score were found to be significant at the level of 25% under univariate analysis. Conclusion: The ED delay is not associated with adverse outcome in terms of mortality. Other factors may play a much greater role in determining the prognosis.

Background: Postmortem examination is indispensable to ascertain the cause of an unnatural death and as such is mandatory by the law. From ages, traditional autopsy (TA) has proved its worth in establishing the cause of death in the deceased despite some inherent difficulties and challenges and has enjoyed an insurmountable status. The increasing use of application of the modern-day radiology for postmortem examination has however opened a new arena overcoming some of the difficulties of the TA. There are conflicting reports in the published literature regarding superiority of one modality of the postmortem over the other. Objective: The objective of this study was to compare the findings of postmortem computed tomography (CT) scan and TA in the victims of traumatic deaths and to analyze whether postmortem CT can be used to replace TA. Materials and Methods: All patients with a history of trauma that were declared brought dead on arrival in the emergency department were subjected to full-body CT scan. An experienced radiologist reported the findings of CT scan. Subsequently, a forensic expert subjected the patients to TA. The physician who performed autopsy was blinded to the findings of CT scan and vice versa. An individual who was not part of the radiology or forensic team then entered the findings of CT scan and autopsy in a predesigned Pro forma. An unbiased assessor finally compared the findings of the two modalities and analyzed the results. McNemar's test was used to ascertain the level of significance between the findings reported by these two modalities considering P = 0.05 as statistically significant. The agreement or disagreement on cause of death reported by these two modalities was also assessed. Results: About 95% of the deceased were males. The mean age of the corpses was 35 years (range 16–67 years). CT was found superior in picking up most of the bony injuries, air-containing lesions, hemothorax, and hemoperitoneum. However, autopsy was found more sensitive for soft-tissue and solid visceral injuries. Both modalities were equally helpful in identifying extremity fractures. Statistically significant agreement (>95%) on cause of death by both modalities was not achieved in any patient of trauma. Conclusion: Postmortem CT scan is promising in reporting injuries in traumatic deaths and can significantly complement the conventional autopsy. However, at present, it cannot be considered as a replacement for TA.

Open cast coal mining causes complete loss of carbon sink due to the destruction of vegetation and soil structure. In order to offset the destruction and to increase sequestration of carbon, afforestation is widely used to restore these mine spoils. The current field study was conducted to assess the ecosystem status, soil quality and C pool in an 8 years old reclaimed mine spoil (RMS), compared to a reference forest (RF) site and unamended mine spoil (UMS). Biochar (BC) prepared from invasive weed Calotropis procera was applied in this 8 year RMS at 30 t ha−1 (BC30) and 60 t ha−1 (BC60) to study its impact on RMS properties and C pool. Carbon fractionation was also conducted to estimate inorganic, coal and biogenic carbon pools. The C stock of 8 year old RMS was 30.98 Mg C ha−1 and sequestered 113.69 Mg C ha−1 CO2. BC30 and BC60 improved the C-stock of RMS by 31% and 45%, respectively, and increased the recalcitrant carbon by 65% (BC30) and 67% (BC60). Spoil physio-chemical properties such as pH, cation exchange capacity, moisture content and bulk density were improved by biochar application. The total soil carbon at BC30 (36.3 g C kg−1) and BC60 (40 g C kg−1) was found to be significantly high compared to RMS (21 g C kg−1) and comparable to RF (33 g C kg−1). Thus, eco-restoration of coal mine spoil and biochar application can be effective tools for coal mine reclamation and can help in achieving the UN sustainable development goal 13 (climate action) by increasing carbon sequestration and 15 (biodiversity protection) by promoting ecosystem development.

Two series of glasses were synthesized by conventional rapid melt-quench method for different glass systems 55[(PbxBi1-x).TiO3]-44[2SiO2B2O3] and 65[(PbxBi1-x).TiO3]-34[2SiO2B2O3] doped with 1 mole percent of La2O3. X-ray diffraction study of synthesized glass sample shows amorphous nature while the glass ceramic sample revealed a cubic crystal structure due to devitrification of the glass as major crystalline phase of bismuth titanium oxide. X-ray absorption spectroscopy measurements in transmission mode were carried out and confirm the maximum value of absorption coefficient, 3.05 at energy 13450 eV for lead free glass ceramic sample. Scanning electron microscopy and contact angle measurements were also performed to explain the surface morphology. Energy dispersive X-ray analysis confirmed the presence of grains of bismuth titanium oxide and its elemental analysis with O, Ti, Si, Bi nanoparticles. The inclusions of La2O3 results in development of well interconnected crystallites were formed as major phase of bismuth titanium oxide.