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New-fangled water mediated and air stable thorium complex of molecular formula (AgunH) 2 [Th(dip) 3 ].H 2 O have been prepared by reacting thorium(IV) nitrate, dipicolinic acid (H 2 dip) and aminoguanidine bicarbonate (AgunH.HCO 3) at appropriate molar ratio via., template method. The complex has been systematically characterized by chemical analysis, elemental, spectral, thermal and single crystal studies including luminescence and antioxidant properties. The IR spectrum of the resulting complex infers that the carboxylate anion behaves as a monodentate and facilitates to form a monomeric rather than polymeric environment. This is further confirmed by single crystal X-ray diffraction studies. Thermal stability of the title compound undergoes step-wise decomposition to endure ThO(CO 3) as the end residue. The single crystal X-ray study reveals that the thorium complex crystallizes in the triclinic crystal system with centric space group (P-1) of Z = 2. Each dipicolinate anion (dip2−) exhibits tridentate coordination modes through a nitrogen atom of pyridine ring and oxygen atoms of the carboxylate groups to form nine coordination with tri-capped trigonal prismatic geometry. Further, the anionic complex is neutralized by two aminoguanidinium (AgunH+) cations and stabilized along with a lattice water molecule. This material shows enhanced luminescent properties, this is due to the crucial role of dipicolinate anion not for aminoguanidinium moiety. Whereas, the aminoguanidinium species is promote to act as a secondary antioxidant. [Display omitted] • Thorium complex of (AgunH) 2 [Th(dip) 3 ].H 2 O has been investigated. • The synthesized compound has been analyzed by X-ray diffractions and Thermal analysis. • The antioxidant and luminescent properties of the free acid, free base and its complex were also studied. [ABSTRACT FROM AUTHOR]

Cyclic voltammetric and differential pulse voltammetric technique were used to investigate the oxidation behavior of nimesulide in these studies. An effort was made to use TiO 2 nanoparticles to modify the electrode surface to accentuate an effective technique for the determination of nimesulide. XRD and SEM investigation were carried out to understand the morphology of TiO 2 nanoparticles. Electro-oxidation studies for bare glassy carbon electrode and TiO 2 modified glassy carbon electrode shows an enhanced sensitivity for nanostructure-modified electrode. The electrode prepared was used to develop a sensible method for the trace determination of nimesulide. A wide linear range between 40 μM–100 μM with LOD and LOQ 3.37 nM and 11.2 nM were observed respectively. Further, it was observed that, two protons and two electrons were involved in the reaction mechanism with an irreversible and diffusion controlled electrode process at pH 2. In addition, charge transfer coefficient, heterogeneous rate constant, were calculated. [ABSTRACT FROM AUTHOR]

The formation of black plasma electrolytic oxidation (PEO) coating on aluminium alloy using vanadyl sulphate as additive in a silicate-based electrolyte is investigated. A brief discussion on the mechanism of incorporation of vanadium in PEO coating starting with a cationic species of vanadium (i.e., VO2+) in solution is attempted. The coating formation with respect to morphology and composition is systematically studied as a function of process time. With increase in process time, incorporation of vanadium ions in the coating increases and the formation of black colour is attributed to the presence of V3+ and V4+ species in the coating. A 55 ± 5 μm thick flat absorber black coating with high solar absorptance (0.92) and high infrared emittance (0.88) is obtained with a process time of 10 min. • Vanadyl sulphate is used as an additive to develop black PEO coating. • Novelty in using a cationic source of vanadium (VO2+) in solution. • Mechanism of incorporation of vanadium starting from VO2+ cation is discussed. • A flat absorber coating with absorptance (0.92) and emittance (0.88) is obtained. • SEM reveals interesting morphological variations with respect to process time. [ABSTRACT FROM AUTHOR]

A compact design of microstrip patch antenna is presented to realize wideband characteristics. An annular metal-ring has been used as a superstrate as well as an inductive load to the rectangular patch. Robust analytical technique is applied to choose the dimensions of the ring and the patch where they resonate very close to each other. This strategic approach ensures a wide matching bandwidth with a broadside radiation pattern. An additional enhancement of bandwidth has been achieved by employing a unique design strategy. A set of antenna prototype has been fabricated for experimental validation. As much as 34% matching bandwidth has been revealed experimentally using a compact antenna (~λ × λ). The boresight gain is maintained about 10 dBi over the operating frequency band. The cross-polarized isolation in E- and H-planes are maintained above 40 dB and 30 dB respectively over the operating bandwidth. The back-radiation of the antenna is also maintained below −20 dB over the wide matching bandwidth. [ABSTRACT FROM AUTHOR]

Background: Scrub typhus is a vector-borne infection caused by the obligate intracellular organism Orientia tsutsugamushi. In some cases, scrub typhus can result in severe complications, multiorgan failure and death., Objective: To study the clinical and laboratory profiles of patients who succumbed to scrub typhus., Methods: A prospective cohort study was conducted from August 2019 through April 2023 on scrub typhus patients admitted to our hospital. Clinical and laboratory parameters of all the patients were recorded, and blood samples were drawn. To confirm scrub typhus, a nested polymerase chain reaction (nPCR) was performed in collected samples. Viable amplicons were sequenced, and phylogenetic analyses were performed to identify infecting genotypes., Results: A total of 261 patients were enrolled. Of these, nine (3.45%) patients succumbed at a median (Interquartile Range) duration of 5 (1.5, 10.5) days after admission. Sepsis with septic shock (9, 100%) and acute kidney injury (AKI) (6, 66%) were noted among the succumbed patients. All the succumbed patients (100%) required intensive care admission, inotropic and ventilatory support. While 5 (55%) patients required dialysis, two (22%) required blood transfusion. Three (33%) patient samples were co-positive for Leptospira IgM, and four (44%) patients had superinfection with Candida tropicalis , multi-drug-resistant (MDR) E. Coli sepsis, pan drug-resistant (PDR) Acinetobacter Baumanii , and Klebsiella pneumoniae . Phylogenetic analysis revealed Orientia tsutsugamushi Japanese Gilliam-variant (JG-v) like (50%), Karp-like (37.5%), and Japanese Gilliam (JG) like (12.5%) strains among succumbed patients., Conclusion: Delay in scrub typhus diagnosis can result in severe complications, septic shock, and multisystem organ failure, culminating in death.

Scrub typhus is a vector borne disease which in a proportion of patients causes multiorgan involvement and death if untreated. Infecting genotype and virulence factors play a role in severity of infection and outcome. The current prospective cohort study was undertaken to elucidate the severity of illness in scrub typhus patients and to identify the circulating genotypes in Karnataka, India. A total of 214 patients of either gender from 9 districts of Karnataka and one patient each from Andhra Pradesh and Kerala, India were enrolled in the study. With a predefined severity criterion, 132 patients were segregated to the severe group. Multi organ involvement was seen in 59 (44.69%) patients. Phylogenetic analysis revealed JG-v like (48.97%), Karp-like (26.53%), JG-like (22.44%), and Kato-like (2.04%) strains in Karnataka. Patients infected with Orientia tsutsugamushi Karp-like strains had respiratory involvement (69.2%), cardiovascular involvement (46.2%) and thrombocytopenia (23.1%) and required higher hospital resource utilization., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Chunduru et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims: Hyposmia and hypogeusia are one of the symptoms of COVID-19. Occurrence and course of these symptoms and their relationship with severity of COVID-19 disease are studied., Materials and Methods: This was a prospective cohort study, including consenting adult SARS CoV-2 positive patients of both genders, admitted to a Covid Hospital in Puducherry, India. This questionnaire- based study was conducted for a period 4 months from 1st October 2020 to 31st January 2021, and collected data was analyzed using SPSS version 24.0 software., Results: Out of 639 participants, 412 (64.5%) were males, 227 (35.5%) were females. Total cases of new onset hyposmia were 167 (26.1%), and total patients with new onset hypogeusia were 172 (26.91%). 216 (33.80%) had either hyposmia/hypogeusia. First symptom as hyposmia was noted in 49 (7.67%) patients, and as hypogeusia in 20 (3.13%) patients before development of any other symptoms. 216 (33.80%) patients had either smell or taste disturbance as one of their symptoms. By the end of 5 weeks of illness, 96.41% of hyposmic patients, and 97.67% of hypogeusic patients recovered fully. There was no statistically significant difference between presence or absence of hyposmia/hypogeusia and severity of COVID-19 disease ( p value = 0.95)., Conclusion: The occurrence of hyposmia and hypogeusia among Indian COVID-19 patients is more than 26%. Presence or absence of hyposmia/hypogeusia is not a predictor of severity of COVID-19 disease. More than 96% of the patients fully recovered their sense of smell and taste sensation by the end of 5 weeks., Competing Interests: Conflict of interestThe authors have no conflict of interest to declare that are relevant to the content of this article., (© Association of Otolaryngologists of India 2021.)

The increasing trend of industrialization leads to tremendous release of industrial effluents. Waste water treatment is one of the important sectors to focus in order to overcome the most threatening issue of waste disposal and to ensure sustainability. Sustainable and energy efficient treatment methods are the attractive technologies for their current implementation of waste management. Even though the existing technologies are effective, unsustainability makes them unfit for their extended applications. Conventional and advanced technologies have been extensively implemented for the treatment of wide spectrum of effluents. Hybrid technologies including chemical and biological methods also emerging as promising technologies but secondary sludge generation is still unaddressed. Even though effectiveness of biochar varies over type of contaminants, cost-effectiveness and eco-friendly nature extended their applications in waste management. Nanotechnology and membrane technology are the promising and emerging areas of interest due to their widespread applications in waste water treatment. Carbon nano structures, nano filters, graphene, nano magnets modified with activated carbon are the potential candidates for the treatment. The present review demonstrates the emerging treatment technologies with special focus to nano based waste water treatment methods., (Copyright © 2022. Published by Elsevier Ltd.)

Osteoarthritis (OA) is the most commonly occurring disease of middle and elderly population, which is characterized by focal loss of joint articular cartilage, osteophyte formation and sub chondral bone remodeling. Classical risk factors of OA include age, gender, weight, joint injury, trauma, however hereditary component is one of the main crucial factors. Several genome wide association studies and candidate gene approaches have identified genetic variants involved in the influence and association of OA. In the current study influence of Methylene tetra hydro folate reductase MTHFR C677T (rs1801133) gene with early primary knee OA was evaluated. In this study 400 samples were included (200 cases & 200 controls). DNA was extracted & processed for PCR- RFLP evaluation and genotype analysis. Statistical analysis was performed & results indicated a lack of association between MTHFR gene polymorphism and early primary KOA. The stratification was done based on age & gender and also both. Individual's i.e females below the age of 40 years are more prone to the disease when compared with males. MTHFR gene polymorphism showed a lack of association with early primary knee osteoarthritis. To the best of our knowledge this is the first study from south India., (© 2022 Poornima S et al.)

Background: Disorders involving the musculoskeletal system are often identified with short stature and a range of orthopedic problems. The clinical and genetic heterogeneity of these diseases along with several characteristic overlaps makes definitive diagnosis difficult for clinicians. Hence, using molecular testing in addition to conventional tests becomes essential for appropriate diagnosis and management., Methods: Comprehensive clinical examination, detailed pretest and posttest counseling, molecular diagnosis with next-generation sequencing (NGS), genotype-phenotype correlation and Sanger sequencing for targeted variant analysis., Results: This manuscript reports a molecular spectrum of variants in 34 orthopedic cases referred to a single genetic unit attached to a tertiary care hospital. The diagnostic yield of NGS-based tests coupled with genetic counseling and segregation analysis was 79% which included 7 novel variants. In about 53% (i.e. 18/34 cases), molecular testing outcome was actionable since 8 of the 18 underwent prenatal diagnosis, as they were either in their early gestation or had planned a pregnancy subsequent to molecular testing, while ten cases were premaritally/prenatally counseled for the families to take informed decisions as they were in the reproductive age., Conclusions: The report highlights the importance of NGS-based tests even in a low resource setting as it helps patients, families and healthcare providers in reducing the economic, social and emotional burden of these disorders., (© 2022. The Author(s).)

Microalgal omega-3 fatty acids are considered as an efficient alternative for fish-based omega-3 fatty acids. Ethyl esters derived from omega-3 fatty acids are being considered as the drug for hypertriglyceridemia. In this study, omega-3 fatty acids rich Chlorella sp. was utilized for the transesterification for the ethyl ester production using a potassium carbonate alkaline catalyst. At the optimized conditions of transesterification, 86.2% ethyl ester yield was achieved with solvent to algae ratio (20 mL/g), water addition (45 %), catalyst (4 %), temperature (75°C), and reaction time (60 min). Additionally, the acid-hydrolysed spent biomass was used for the production of ɛ-polylysine by fermentation using Streptomyces sp. as fermentative organism. The maximum yield of 1.78 g/L was achieved after 90 h fermentation. This study established a biorefinery approach where two highly valuable compounds could be produced from the Chlorella sp. by transesterification followed by fermentation., Competing Interests: The authors declare that they have no competing interests., (© 2021 Published by Elsevier B.V.)

Microbial production of xylanase is gaining the commercial importance, due to its wide range of applications from paper and pulp to food and feed industries. Streptomyces geysiriensis was used for the production of extracellular xylanase from lignocellulosic substrates such as rice bran and saw dust, under solid-state fermentation. The influence of pH, temperature and incubation period for the maximum production of xylanase was investigated with 1:2 (w/v) of substrate to moisture ratio at 100 rpm shaking conditions. The maximum production was recorded after 5 days of fermentation with pH 8.0 at 40 °C. The scale-up was done based on the results of optimized parameters using 3 L Applikon autoclavable bioreactor with maximum yield of 186 U/ml after 4 days of fermentation. Extracellular xylanase was separated by partitioning in aqueous two-phase system consisting of 20% polyethylene glycol 6000 and 12% K 2 HPO 4 with maximum yield of 93.97%. The investigation of the effect of pH and temperature and its incubation time showed that xylanase was retained its activity in a pH range of 6.5-8.5, with thermal stability from 20 °C to 60 °C up to 180 min. The presence of metal ions was found to inhibit the activity of xylanase especially Cu 2+ and Zn 2+ . Xylanase was stable both at 4 °C and room temperature (35 °C) for 30 and 9 days respectively. The kinetic parameters K m (0.48 mg/ml) and V max (8.33 U/mg) were determined using birchwood xylan as substrate., (Copyright © 2020 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.)

Background: World Health Organization estimates that 60-80 million couple worldwide currently suffer from infertility. Recurrent pregnancy loss (RPL) is also another major concern. Chromosomal rearrangements play a crucial role in primary and secondary infertility and RPL. Underlying genetic abnormalities like chromosomal abnormalities contribute to 5-10% of the reproductive failures. The aim of the study was to evaluate the chromosomal abnormalities in infertility and RPL cases to help obstetrician/fertility experts to carry out risk assessment and provide appropriate assisted reproductive techniques for better management of the problem., Methods: Karyotyping was performed for 414 cases with the history of infertility and RPL over a period of one year. Samples were processed according to procedures of AGT cytogenetic laboratory manual., Results: Chromosomal abnormalities were observed in 15% of cases. Robertsonian translocation, reciprocal translocation, inversion, derivatives, marker chromosomes, mosaics, aneuploidy and polymorphic variants each contributed 2%, 3%, 3%, 13%, 2%, 10%, 6% and 61%, respectively., Conclusion: Evaluation of chromosomal abnormalities in couple is warranted prior to planning pregnancy especially for assisted reproductive management cases. Chromosomal analysis can be used as one of the diagnostic tools by OBG/IVF specialists in association with geneticist/genetic counselor for proper reproductive counseling and management., Competing Interests: Conflict of Interest There is no conflict of interest., (Copyright© 2020, Avicenna Research Institute.)

Introduction: Osteoarthritis (OA) is a multifactorial disease with genetic factors playing a crucial role, and it has been associated with a family history of obesity. G595C polymorphism in the sterol regulatory element-binding protein 2 ( SREBP2 ) gene has demonstrated an association with knee osteoarthritis (KOA) patients. However, this polymorphism has been never explored in an Indian population. Hence, the current study aimed to examine whether G595C (rs2228314) polymorphism in SREBP2 gene was associated with KOA susceptibility in the South Indian Hyderabad population., Methods: G595C polymorphism was genotyped with 200 KOA cases and 200 healthy controls using polymerase chain reaction-restriction fragment length polymorphism analysis., Results: A significant association was observed between age, body mass index (BMI), and family histories in KOA cases and controls (p < 0.05). The current allele (C vs G; OR-2.8 [95%CI = 2.1-3.7]; p < 0.0001) and genotype analysis confirms the significant association with (GC + CC vs GG; OR-3.5 [95%CI = 2.3-5.3]; p < 0.0001 & GC vs GG + CC; OR-1.7 [95%CI = 1.0-2.9]; p = 0.02) KOA vs. control subjects. On stratification analysis, genotype CC and C allele were associated with KOA. Gender association failed to demonstrate positive genotype frequencies (p > 0.05). Multifactor-dimensionality reduction (MDR) analysis showed a positive association with BMI and G595C genotypes (p < 0.05); 51% of the homozygous variant CC genotypes were present in obesity subjects., Conclusion: In conclusion, our findings suggest that G595C polymorphism in SREBP2 gene is associated with KOA in the South Indian Hyderabad population and presents scope for further investigation of the gene's function in KOA.

Introduction: A large proportion of the population suffers from disturbed sleep and a majority of these present to clinicians with the complaint of insomnia. Many of these people possibly suffer from other primary sleep disorders such as sleep apnea; however, insomnia disorder also remains an extremely common condition directly impacting the quality of life and work efficiency of affected people. While a number of approaches are used for treatment by many clinicians, a much smaller percentage can seek help from specialty sleep clinics. Since very little data are available regarding the effectiveness of treatment offered, this retrospective study aims at examining the outcome of chronic insomnia patients attending to a quaternary care specialty sleep center., Methods: Consecutive patients with the presenting complaint of and diagnosis of insomnia, during a study period of 2 years between 2013 and 2015, were identified and analyzed. Patients were classified based on the comorbidity and types of treatment received. Life stressors were also identified and analyzed. Outcomes were reviewed for those who had follow-up data available., Results: Based on the defined inclusion criteria, 102 patients could be analyzed. Among these, at least 3-month follow-up was available for 48 patients. It was observed that among patients for whom at least 3-month follow-up was available, 91.4% (43/48) showed a good response to treatment with physician-administered cognitive behavioral therapy for insomnia along with treatment for comorbid conditions., Conclusion: With correct diagnostic classification, as well as appropriate and easily available treatment strategies, excellent treatment outcomes are observed at specialty sleep clinics., Competing Interests: There are no conflicts of interest.

We aimed to evaluate the effect of sleep quality on memory, executive function, and language performance in patients with refractory focal epilepsy and controlled epilepsy and compare these with healthy individuals. We prospectively enrolled 37 adolescent and adult patients with refractory focal epilepsy (Group 1) and controlled epilepsy (Group 2) in each group. History pertaining to epilepsy and sleep were recorded, and all patients underwent overnight polysomnography. Language, memory, and executive function assessments were done using Western Aphasia Battery, Post Graduate Institute (PGI) memory scale, and battery of four executive function tests (Trail Making Test A & B, Digit symbol test, Stroop Task, and Verbal Fluency Test), respectively. Forty age- and sex-matched controls were also included in the study. Significant differences were noted in both objective and subjective sleep parameters among all the groups. On polysomnography, parameters like total sleep time, sleep efficiency, sleep latency, and rapid eye movement (REM) latency were found to be significantly worse in Group 1 as compared with Group 2. Cognitive and executive parameters were significantly impaired in Group 1. Shorter total sleep time, poorer sleep efficiency, and prolonged sleep latencies were observed to be associated with poor memory and executive function in patients with refractory epilepsy. Our study strongly suggests that sleep disturbances, mainly shorter total sleep time, poor sleep efficiency, and prolonged sleep latencies, are associated with impaired memory and executive function in patients with refractory focal epilepsy and to a lesser extent, among those with medically controlled epilepsy., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Stigma is an important factor that determines whether individuals seek treatment for mental illnesses. Studies assessing public perceptions regarding mental illnesses are scarce in India. This study documents the stigma perceived by a rural population toward patients with mental illness and their families., Materials and Methods: A cross-sectional pilot study was done in five villages, selected by simple random sampling, from a rural block in Vellore, Tamil Nadu. Households in each village were selected by systematic random sampling. From the selected households, 150 subjects aged 18-65 years, without known mental disorders, were chosen by convenience sampling, based on availability. Stigma was assessed using the Devaluation of Consumers Scale (DCS) and Devaluation of Consumer's Families Scale (DCFS)., Results: The proportion with high perceptions of stigma associated with mentally ill persons was 63.8%, among the 150 interviewed rural respondents (women: 112, median age: 37 years). The proportion which perceived that there was public stigma toward families of those with mental illnesses was 43.4%. Older respondents (>37 years) had higher perceptions of stigma (odds ratio: 2.07; 95% confidence interval: 1.02-4.20) than others., Conclusion: The high perception of stigma associated with persons who are mentally ill as well as their families needs to be kept in mind while planning interventions to decrease the treatment gap for psychiatric morbidity, especially in rural areas., Competing Interests: There are no conflicts of interest.

The title compound, [Mn 2 (C 4 H 5 N 2 O 4 ) 2 (NCS) 2 (H 2 O) 4 ]·4H 2 O (I), exists as a centrosymmetric dimer. Each dimeric unit consists of tridentate ( O , O , N )-chelating Schiff bases with symmetry-maintained μ- O -bridged carboxyl-ate anions, terminally bound thio-cyanate anions, and ligated and solvated water mol-ecules. The complex exhibits a distorted octa-hedron geometry and the centrosymmetric μ- O -bridged carboxyl-ate anions connect the two manganese atoms to form an M 2 O 2 strong N-H⋯O and O-H⋯O hydrogen-bonding contacts and weak O-H⋯S inter-molecular inter-actions, forming a three-dimensional mol-ecular network.via strong N-H⋯O and O-H⋯O hydrogen-bonding contacts and weak O-H⋯S inter-molecular inter-actions, forming a three-dimensional mol-ecular network.

Study Objectives: Obstructive sleep apnea (OSA) is an independent risk factor for stroke. The objective of this study was to assess the effect of continuous positive airway pressure (CPAP) treatment on prevention of new vascular events among patients with stroke and OSA., Methods: Consecutive conscious patients presenting with first imaging-confirmed arterial stroke were included, 6 weeks or more after ictus. All patients underwent clinical and polysomnography (PSG) testing. Patients with an apnea-hypopnea index (AHI) of > 15 events/h were randomized to posttitration nightly CPAP treatment and non-CPAP (received best medical treatment) groups. On follow-up at 3, 6, and 12 months from randomization, evaluation was carried out for any new vascular events as the primary outcome measure, and for clinical stroke outcomes (using the Barthel Index and modified Rankin scale) and neuropsychological parameters as the secondary outcome measures., Results: Among the 679 patients with stroke who were screened, 116 reported for PSG, 83 had AHI > 15 events/h, and 70 (34 in CPAP and 36 in non-CPAP) were randomized. Thirteen patients could not be randomized because of a lack of CPAP devices. Four patients crossed over from the CPAP to the non-CPAP group. Age (mean age 53.41 ± 9.85 in CPAP versus 52.69 ± 13.23 years in non-CPAP, P = .81) and sex distribution (24 males in CPAP versus 33 males in non-CPAP, P = .79) were similar in both groups. At 12-month follow-up, there was 1 vascular event (3.33%) in the CPAP group and 6 events (15%) in the non-CPAP group ( P = .23). Modified Rankin scale score improvement by ≥ 1 at 12-month follow-up was found in significantly more patients in the CPAP group than in the non-CPAP group (53% versus 27%)., Conclusions: These findings suggest significantly better stroke outcomes and statistically nonsignificant favorable outcomes in terms of recurrence of vascular events for patients with stroke and OSA who use CPAP treatment., Clinical Trial Registration: Registry: Clinical Trials Registry - India, CTRI Registration No: CTRI/2016/07.007104, Title: Sleep Disordered Breathing in stroke patients: Effect of treatment trial, URL: http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=8682&EncHid=&userName=sleep%20disordered%20breathing., (© 2018 American Academy of Sleep Medicine.)

Cervical carcinoma is a frequent malignancy in developing countries despite being a preventable disease. For the first time, four screening tests were used simultaneously for identifying women with a risk of developing cervical cancer, to help clinicians and policy makers to implement the best strategy for reducing the burden of this disease. Women visiting a hospital in India were enrolled after institutional ethics clearance and informed consent. Visual inspection using acetic acid and Pap smear tests were performed on 2683 women, and 104 had abnormal cytology: atypical squamous cells of undetermined significance (n = 29), low-grade squamous intraepithelial lesion (n = 41), high-grade squamous intraepithelial lesion (n = 17), and squamous cell carcinoma (n = 17). These and 96 samples, with normal cytology, were subjected to high-risk human papilloma virus testing and fluorescent in situ hybridization evaluation. Women with abnormal cytology were followed for 5 years and evaluated with colposcopy-guided biopsy. Three accepted methods of screening and one novel fluorescent in situ hybridization assay were carried out in 200 cases. Cutoffs for fluorescent in situ hybridization were established. The screening methods had 88%-96% negative predictive value, while positive predictive value was low (20%) for visual inspection using acetic acid, 47% for fluorescent in situ hybridization, 56% for high-risk human papilloma virus, and 73% for combined high-risk human papilloma virus and fluorescent in situ hybridization. Combined high-risk human papilloma virus and fluorescent in situ hybridization had 94% sensitivity, specificity, and negative predictive value, suggesting that simultaneous screening with these two tests is appropriate for identifying women progressing to cervical cancer and not visual inspection using acetic acid, which has low positive predictive value and Pap cytology which requires to be repeated. Policy makers and clinicians can assess feasibility of incorporating this screening strategy to prevent cervical cancer.

Global burden of breast cancer is expected to increase to >2 million new cases every year by 2030 and 10% of these are likely to have hereditary breast and ovarian cancer syndrome. Identifying these individuals by pedigree and BRCA1/2 mutation analyses will enable us to offer targeted mutation testing and appropriate counseling. This study from a tertiary care hospital showed that of the 127 breast cancer patients on treatment during 2014-2015, 24 of them fulfilled the criteria of hereditary breast and ovarian cancer syndrome after detailed verbal autopsy and pedigree analysis, and BRCA1 and 2 next-generation sequencing done after pre-test counseling revealed mutations in 13 cases (54%), these included 9 BRCA1 mutations (69%) and 4 BRCA2 mutation (31%). Subsequent post-test counseling recommended targeted mutation analysis for 64 high-risk members in these 13 families with pathogenic mutations, which will help in surveillance for early detection, appropriate management, and prevention of the disease by decreasing the burden to both family and nation. Results from this preliminary study highlight the importance of genetic counseling, pedigree analysis, and genetic testing. It can be recommended that all oncology units should have a genetic counseling service for providing appropriate support to oncologists, patients, and families to prevent unnecessary testing; however, breast cancer screening program is incomplete without evaluating for hereditary breast and ovarian cancer syndrome.

Purpose: Levetiracetam (LEV) is often chosen early in the treatment of refractory epilepsy; however, its adverse effects have largely been studied as part of clinical trials. Oxcarbazepine and valproate (VPA) are the other commonly used AEDs and, hence, serve as good comparators. This study was conducted to evaluate behavioral abnormalities and somnolence among patients with epilepsy being treated with LEV and/or OXC compared with those receiving VPA., Method: Data of consecutive patients attending our intractable epilepsy clinic over a 2 1/2-year period were reviewed, and patients with at least one seizure a month, who had been initiated on either or a combination of LEV, VPA, or OXC, were included for analysis. Data regarding behavioral adverse effects, daytime somnolence (EDS), and weight changes were collected apart from those regarding any major effect necessitating dose reduction or discontinuation of the AED., Results: Among a total of 445 patients screened, 292 (93 F, median age: 21years [range: 8-54]; 237 focal and 55 generalized epilepsy) fulfilled inclusion criteria. Median epilepsy duration was 11years. Levetiracetam had been introduced in 114 patients, VPA in 134, and OXC in 151 during the study period. Twenty-three were on LEV+OXC, 27 on LEV+VPA, and 33 on VPA+OXC. Behavioral disturbances (irritability, obsessive manifestations, aggressiveness, and frank psychosis) were observed in 43 patients; 23 on introduction of LEV (20.2%); LEV was discontinued in 10 (9%). Daytime somnolence was reported by 28 patients, 15 on OXC (10%); 8 received oral modafinil for the same, while none discontinued this AED. Only one patient on LEV and 3 on VPA reported EDS. Menstrual disturbances were reported by 9, weight gain by 3, and severe hair loss by 2 females on VPA., Conclusion: Behavioral disturbances with levetiracetam are common among patients with refractory epilepsy while somnolence is common with oxcarbazepine. Antiepileptic drugs should be selected with this in perspective., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Introduction: Angiotensin I converting enzyme (ACE) insertion and deletion (I/D) polymorphism has been implicated in the pathogenesis of osteoarthritis (OA). In recent years, numerous genetic factors have been identified and implicated in OA. In this Asian Indian population-based study, we aimed to evaluate the relationship between ACE (I28005D) gene polymorphism and primary OA. We performed a case-control association study to identify and explore the correlation between clinically, radiologically diagnosed individuals with primary knee OA and the ACE I/D polymorphism., Methods: Genomic DNA was isolated from 200 samples, including 100 OA cases and 100 healthy volunteers. DNA was amplified by polymerase chain reaction (PCR) using I and D allele-specific primers. PCR products were assessed via UV visualization of products electrophoresed on 2% agarose gels., Results: The groups differed significantly in genotype distributions (p < 0.05). The primary knee OA group showed a considerably higher incidence of the DD genotype and the D allele compared to the control group (OR = 2.14, 95% CI: 1.10-4.15, p = 0.02 and OR = 2.08, 95% CI: 1.39-3.10, p = 0.0003)., Conclusion: The ACE gene polymorphism I28005D was found to be associated with primary knee OA in Asian Indian populations. This is the first study in India to report that the ACE gene polymorphism is a risk factor for early onset primary knee OA., (© The Author(s) 2014.)

Background: Degenerated disc disease (DDD) is a common disorder responsible for increased morbidity in a productive age group. Its etiology is multifactorial and genetic factors have been predominantly implicated. Disc prolapse results due to tear in the annulus, which is a fibrous structure composed largely of type I collagen. Functional polymorphism at the Sp1 site of the collagen I alpha 1 (COL1A1) gene has shown a positive association with DDD in Dutch and Greek populations. The purpose of this study was to assess COL1A1 Sp1 gene polymorphism in the Indian population., Materials and Methods: Fifty clinically and radiologically proven patients with disc prolapse requiring surgery were included as cases and 50 healthy, age-matched volunteers served as controls. After isolating DNA from their blood sample, genotyping for COL1A1 polymorphism (rs1800012) was performed and identified as GG, GT, and TT., Results: The mean age and body mass index in cases and controls were similar. 76% of the patients were males. The most common site of disc degeneration was L4-L5 (36%), followed by L5-S1 (34%). Homozygous-GG, heterozygous GT, and homozygous TT genotypes were seen in 38 (76%), 10 (20%) and 2 (4%) cases respectively, controls had similar percentage of genotypes as well. The alleles in cases and the control group showed no significant difference (P = 0.6744) and followed the Hardy-Weinberg Equilibrium in the study population., Conclusion: The COL1A1 (rs1800012) is in Hardy-Weinberg equilibrium in the present subset of Indian population. But taken as a single factor, it was not found to be associated with DDD in this preliminary study. Disc degeneration is multifactorial and also anticipated to be a result of multiple genes involvement and gene-gene interaction.

Introduction: Genetic and environmental factors play an important role in susceptibility to type 2 diabetes mellitus (T2DM). Several genes have been implicated in the development of T2DM. Genetic variants of candidate genes are, therefore, prime targets for molecular analysis., Aim: In this study, we have selected 3 candidate genes, namely, TCF7L2, SLC30A8, and IGF2, for assessing their association with T2DM in an Indian population., Materials and Methods: Five hundred individuals were enrolled in this case-control study- 250 T2DM patients and 250 healthy control individuals. Clinical characteristics were obtained for all subjects, and genotype analysis was performed by PCR-RFLP analysis., Results: Allele and genotyping frequencies, odds ratios, and 95% confidence intervals were calculated for 3 single nucleotide polymorphisms (SNPs), 1 each from TCF7L2 (rs7903146), SLC30A8 (rs13266634), and IGF2 (rs680) in T2DM patients. The rs7903146 and rs680 polymorphisms were found to be significantly associated with T2DM (p < 0.05), whereas the rs13266634 polymorphism was not (p > 0.05). The multifactor dimensionality reduction method identified the particular polymorphisms associated with an increased risk of disease., Conclusion: The present study indicated that the gene-gene interaction model successfully predicted T2DM risk based on TCF7L2 and SLC30A8 polymorphisms. These results provide strong evidence of independent association between T2DM and the 3 SNPs analysed herein.

Introduction: Cognitive impairment has long been recognized as a co-morbidity or sequel to refractory epilepsy. This study was conducted to evaluate the degree and selectivity of involvement of memory, language and executive functions performance among patients with temporal (TLE) versus extratemporal epilepsy (ETLE)., Methods: We prospectively enrolled adolescent and adult patients with medically refractory focal epilepsy, who had undergone pre-surgical evaluation. Language, memory and executive function assessment was done using Western Aphasia Battery, PGI memory scale and battery of four executive function tests (trail making test A & B, digit symbol test, Stroop Task and verbal fluency test), respectively., Results: Among102 patients enrolled (TLE-59, ETLE-43), mean age of patients 23.0 4± 8.3 years, 83 (82%) had impairment of more than one cognitive domain and 21 (21%) had all three domains involved. Severely impaired memory scores were found in 8.6% patients with MTLE-HS, 8% of the rest of the patients with TLE and 7% patients with ETLE. The differences in the mean scores were also not found statistically significant (p=0.669). Naming impairment was the most common language abnormality, although all aphasia subscores were similar for the ETLE and TLE groups. Executive function impairment was the most common cognitive domain affected. Overall performance on executive function tests was found impaired in almost all patients of both groups without any significant inter-group difference, except on Trail-A test, which revealed better results in patients with mTLE-HS as compared to all other sub-groups., Conclusion: Our study shows that impairment of memory, language and executive function is common among patients with drug refractory epilepsy. The most prevalent impairment is in executive function. There is no significant difference in the degree, prevalence or selectivity of impairment in either of the three domains, between the TLE versus ETLE groups., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Spinocerebellar ataxia is a growing group of hereditary neurodegenerative diseases for which ≥30 different genetic loci have been identified. In this study, we assessed the repeats at eight spinocerebellar ataxia (SCA) loci in 188 clinical SCA patients and 100 individuals without any neurological signs. Results from the present study were able to identify 16/188 (8.5%) clinical ataxia patients with repeat expansions in the pathological range of SCA genes, with the majority having expansion at the SCA1, 2, and 3 loci. The present study further evaluated two mitochondrial mutations associated with ataxia, i.e., T8993G and A8344G. Six patients were identified with A8344G mutation and none had the mutation in ATPase 6 gene; however, G8994A variation was found in three cases. Overall, three cases had triplet repeat expansions as well as mitochondrial (mt) mutations, which indicates potential association of triplet repeat expansions and mitochondrial mutations. Both the molecular analysis of several SCA loci and two relevant mt mutations indicated that the majority of ataxia cases were still undiagnosed; hence, the following hypotheses were proposed and tested based on available data: (i) lower repeats than normal range and (ii) large normal alleles (LNAs) at multiple loci may be an alternative basis for disease pathogenesis.

Aim: To determine the prevalence of oral malodour in Indian children and also to assess the relationship of oral malodour with oral hygiene, gingival health, dental caries, tongue coating, mouth breathing and frequency of tooth brushing., Method: A total number of 900 school children (7-15 years) were included in the study. Children were assessed for the oral malodour, oral hygiene, gingival health, dental caries, tongue coating, mouth breathing and frequency of tooth brushing., Results: The prevalence of oral malodour in Davangere school children was found to be 40.9%. Oral malodour was significantly (p < 0.001) associated with age, mouth breathing, tongue coating, oral hygiene status, gingival status and tooth brushing frequency. Oral malodour was not significantly correlated with gender and caries status., Conclusions: The prevalence of malodour in the population studied was 40.9% and oral health status and oral malodour were associated with one another. The prevalence of oral malodour was considerably high and should not be neglected in children.

Background: Due to the limited availability of data related to anemia in hospitalized children, this research was conducted to study the occurrence, morphological patterns, distribution in different age groups, sex, and severity of anemia among children aged 6 months-12 years., Setting: Inpatients in department of pediatrics at a multispecialty hospital, Bangalore., Study Design: Descriptive cross sectional study from Oct, 2011 to Sep, 2012., Materials and Methods: Ethical clearance was obtained from the ethical committee of the hospital as per 1964 Declaration of Helsinki. Unrestricted random sampling method was used to select the study group consisting of 882 children between the age of 6 months and 12 years. After obtaining the consent, data were obtained and statistically analyzed using statistical tools like mean, median, standard deviation, and Chi-square test., Results: Out of 882 children selected, 642 (72.79%) were anemic, out of which a majority of 629 (98%) children suffered from nonhemoglobinopathies and a meagre 13 (2%) suffered from hemoglobinopathies. Children in the age group of 6 months-1 year were most affected with nonhemoglobinopathies (33%). Moderate degree of anemia (hemoglobin = 7-9.9 g/dL) was the commonest grade of anemia (80%), while microcytic hypochromic anemia was commonest morphological type of anemia (48%). Among hemoglobinopathies, thalassemia major was the most common (69%, that is 9 out of 13 patients)., Conclusion: The occurrence of anemia among children aged between 6 months and 12 years is high and nonhemoglobinopathies predominate over the hemoglobinopathies.

Background: The median nerve N20 component constitutes the initial response of the primary somatosensory cortex to somatosensory stimulation of the upper extremity. Knowledge of the underlying generators is important for basic understanding of the initial sequence of cortical activation., Materials and Methods: In the present study, normative data of cortical evoked potentials in particular of N20 wave onset and peak latencies by median nerve stimulation in a group of 100 medical students aged between 18 and 30 years were documented and the effect of physiological variables were studied. Descriptive statistics and Student t-test were used to analyze the healthy subjects and to compare N20 latencies for handedness, respectively. Regression analysis was used to show association between average N20 latencies and physiological variables from which regression formulae were calculated to predict normative values of these parameters., Results: The results of the study indicated that N20 onset and peak latency values are significantly affected by limb length at 95% confidence level. Height is showing as a significant factor affecting N20 onset latencies but it is probably because of high correlation of height with limb length. Age though on linear regression showed some significant correlation with N20 onset and peak latency, multiple regressions showed that it does not affect N20 onset and peak latencies in the presence of other variables. Handedness did not affect both N20 onset and peak latency values., Conclusion: Physiological variables do affect the N20 latencies and these should be standardized before usage for research in basic sciences at all age groups.

Acute organophosphate pesticide poisoning is a common medical emergency with high fatality in agricultural communities of Asia. Organophosphate compounds inhibit acetylcholinesterase and prolonged neuromuscular weakness is a major cause of morbidity and mortality of poisoning. Organophosphate pesticide induced muscle weakness may not only arise from inhibition of acetylcholinesterase but also from non-cholinergic pathomechanisms, particularly mitochondrial dysfunction, affecting the production of sufficient ATP for muscle function. This study examined whether muscle weakness in rats subject to monocrotophos toxicity (0.8LD₅₀) was caused by inhibition of ATP synthesis, by oxidative phosphorylation and glycolysis, in addition to inhibition of muscle acetylcholinesterase. Severe muscle weakness in rats following monocrotophos administration was associated with inhibition of muscle acetylcholinesterase (30-60%) but not with reduced ATP production. The rats rapidly recovered muscle strength with no treatment. The ability of rats to spontaneously reactivate dimethoxy phosphorylated acetylcholinesterase and efficiently detoxify organophosphates may prevent severe inhibition of muscle acetylcholinesterase following acute severe monocrotophos poisoning. This may protect rodents against the development of prolonged muscle weakness induced by organophosphates., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Objective: In an effort to better understand turnover rates in hospitals and the effect of new nurses on them, this study sought to describe the characteristics and attitudes toward work of newly licensed RNs, a population important to both the nursing profession and the health care system., Methods: A survey was mailed to a random sample of new RNs in 35 states and the District of Columbia. A total of 3,266 returned surveys met the inclusion criteria, for a response rate of 56%. RNs who qualified had completed the licensing examination and obtained a first license between August 1, 2004, and July 31, 2005. Data pertaining to four areas were collected: respondent characteristics, work-setting characteristics, respondents' attitudes toward work, and job opportunities. Respondents who were not working were asked to specify why., Results: Of the eligible newly licensed RNs, 58.1% had an associate's degree, 37.6% had a bachelor's degree, and 4.3% had a diploma or a master's or higher degree as their first professional degree. They were generally pleased with their work groups but felt they had only moderate support from supervisors. About 13% had changed principal jobs after one year, and 37% reported that they felt ready to change jobs. More than half of the respondents (51%) worked voluntary overtime, and almost 13% worked mandatory overtime. Also, 25% reported at least one on-the-job needlestick in a year; 39%, at least one strain or sprain; 21%, a cut or laceration; and 46%, a bruise or contusion; 62% reported experiencing verbal abuse. A quarter of them found it "difficult or impossible" to do their jobs at least once per week because of inadequate supplies., Conclusions: This study provides descriptive evidence that a majority of newly licensed RNs are reasonably satisfied and have no plans to change jobs, but the group is not homogeneous. The negative attitudes expressed in response to some survey questions suggest that newly licensed RNs may not remain in the acute care settings where they start out. Investing in better orientation and management may be the key to retaining them in hospitals. The authors will be following these RNs for two years and will develop predictive models of turnover rates.