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Background: Mitochondria are semiautonomous cell organelles having its own nucleic acid. Mitochondrial DNA (Mt-DNA) remain in hypomethylated (CpG) state and impose an immunogenic response by binding to the toll-like receptor (TLR-9) through the NF-kB pathway. Innate immune cells recognize the hypomethylated pattern of mt-DNA and quickly trigger the innate immune response. The immunomodulatory effects of urinary mt-DNA derived from renal transplant recipients with COVID-19-associated acute kidney injury (AKI) have not been studied. Materials and Methods: Healthy donor peripheral blood mononuclear cell (PBMC) was cultured with the urinary Mt-DNA derived from the renal transplant recipients, who previously developed SARS-CoV-2 infection associated AKI. Cell activation was measured by the flow cytometry. In cell pellets, interleukin IL-6, IL-10, and Myd88, TLR-9 mRNA transcript expression was measured by the reverse transcription polymerase chain reaction. The IL-6 and IL-10 cytokine levels were measured by the enzyme-linked immunosorbent assay in culture supernatants. Results: The urinary mitochondrial DNA (umt-DNA) significantly induces the activation of > 75% of PBMCs. The m-RNA transcript expression of the inflammatory gene in control versus umt-DNA treated PBMCs was for IL-6 (0.99 ± 0.05 vs. 2.18 ± 1.15 au; P = 0.004), MYD88 was (1.00 ± 0.05 vs. 1.55 ± 0.31; P < 0.001), TLR-9 (1.00 ± 0.05 vs. 3.33 ± 1.37 au; P < 0.001) was upregulated, and the IL-10 (1.00 ± 0.13 vs. −1.73 ± 0.58; P < 0.001) level was downregulated. However, in PBMC culture supernatants, IL-6 level in control versus umt-DNA-treated groups were (37.50 ± 13.79 vs. 186.9 ± 15.50 pg/mL; P < 0.001), which was significantly higher in umt-DNA-treated groups and the IL-10 (8.80 ± 2.16 vs. 7.60 ± 3.12 pg/mL; P = 0.32) level was similar between the control- and umt-DNA-treated groups. Conclusions: Urinary Mt-DNA significantly induces the inflammatory cytokine IL-6 secretion from the PBMCs through the Myd88-dependent pathway.

Introduction: In India pleural effusion is a common entity, routinely pleural effusion encountered are tuberculous pleural effusion (TPE) and parapneumonic pleural effusion (PPE). Various aetiologies of pleural effusion impart specific characteristics to the pleural fluid that back the clinical diagnosis. Investigations of patients with pleural effusion helps us to reduce morbidity and mortality through timely and accurate management of these patients. Therefore, this study aimed to evaluate the various attributes of pleural fluid of TPE and PPE and to compare both. Methodology: A hospital-based cross-sectional study was conducted on patients of confirmed TPE (n = 65) and PPE (n = 65) to discuss the demographic profile like the distribution of pleural effusion with respect to age, gender, side of lung involvement, comparison of ESR, pleural fluid adenosine deaminase (ADA), and lactate dehydrogenase (LDH) with their significance. Results: Patients of TPE had lesser mean age compared to patients of PPE. The values of ESR (78.23 v/s 41.37), pleural fluid LDH (617 IU/L v/s 355 IU/L), and ADA were (66 IU/L v/s 20 IU/L) higher in PPE subgroups as compared to TPE study group. Conclusion: The higher values of pleural fluid ADA along with ESR and pleural fluid LDH aids high diagnostic utility in performing these combined investigations to differentiate PPE and TPE.

Background Biliary plastic stent (PS) mandates timely removal or replacement. The coronavirus disease 2019 (COVID-19) pandemic had affected the accessibility to medical therapy resulting in delay. We evaluated the burden of retained biliary PS, clinical profile, and impact of COVID-19 pandemic on stent retention.

Abstract IL-22 is critical for ameliorating obesity-induced metabolic disorders. However, it is unknown where IL-22 acts to mediate these outcomes. Here we examine the importance of tissue-specific IL-22RA1 signaling in mediating long-term high fat diet (HFD) driven metabolic disorders. To do so, we generated intestinal epithelium-, liver-, and white adipose tissue (WAT)-specific Il22ra1 knockout and littermate control mice. Intestinal epithelium- and liver-specific IL-22RA1 signaling upregulated systemic glucose metabolism. Intestinal IL-22RA1 signaling also mediated liver and WAT metabolism in a microbiota-dependent manner. We identified an association between Oscillibacter and elevated WAT inflammation, likely induced by Mmp12 expressing macrophages. Mechanistically, transcription of intestinal lipid metabolism genes is regulated by IL-22 and potentially IL-22-induced IL-18. Lastly, we show that Paneth cell-specific IL-22RA1 signaling, in part, mediates systemic glucose metabolism after HFD. Overall, these results elucidate a key role of intestinal epithelium-specific IL-22RA1 signaling in regulating intestinal metabolism and alleviating systemic obesity-associated disorders.

Abstract Due to the low cost, natural origin, higher safety margins, and little to negligible adverse effects of herbal medications, the use of plants and plant derivatives in medicine is becoming increasingly widespread. Terminalia chebula is among the most significant medicinal plants in ayurvedic, siddha, unani, and homeopathic remedies. It is ranked first in Ayurvedic material medicine. T. chebula has been shown to have established effects against various bacterial and fungal infections, including dental caries pathogens. In recent years, there has been a rise in interest in dentistry and medicine related to Enterococcus faecalis. The research aimed to assess the antibacterial effectiveness of different concentrations of T. chebula ethanolic fruit extract (10%, 40%, and 100%) in opposition to E. faecalis and compare it with 2% chlorhexidine. For the study, T. chebula ethanolic fruit extracts were obtained and prepared with Group I: −10% concentration, Group II: −40% concentration, Group III: −100% concentration, and Group IV: −2% chlorhexidine. Colonies of E. faecalis were cultivated in brain heart infusion (BHI) broth at 37°C and were inoculated in 16 BHI agar plates. Then, on the petri dishes, four wells were created (8 mm diameter) using a metal borer. The Agar well diffusion method was used to examine the antibacterial activity, and the zones of inhibition around the wells were noted. The obtained data were statistically analyzed using one‐way ANOVA and post‐hoc tests. The result shows that as the concentration increases, there is an increase in the efficacy of the antibacterial property of the extract before it reaches the saturation point. The decreasing order of antibacterial was chlorhexidine >100% T. chebula >40% T. chebula >10% T. chebula. The production of contemporary pharmaceuticals from T. chebula was addressed, as the global scenario is currently evolving toward using nontoxic plant products with traditional medicinal benefits.

Viral variant is one known risk factor associated with post-acute sequelae of COVID-19 (PASC), yet the pathogenesis is largely unknown. Here, we studied SARS-CoV-2 Delta variant-induced PASC in K18-hACE2 mice. The virus replicated productively, induced robust inflammatory responses in lung and brain tissues, and caused weight loss and mortality during the acute infection. Longitudinal behavior studies in surviving mice up to 4 months post-acute infection revealed persistent abnormalities in neuropsychiatric state and motor behaviors, while reflex and sensory functions recovered over time. In the brain, no detectable viral RNA and minimal residential immune cell activation was observed in the surviving mice post-acute infection. Transcriptome analysis revealed persistent activation of immune pathways, including humoral responses, complement, and phagocytosis, and gene expression levels associated with ataxia telangiectasia, impaired cognitive function and memory recall, and neuronal dysfunction and degeneration. Furthermore, surviving mice maintained potent systemic T helper 1 prone cellular immune responses and strong sera neutralizing antibodies against Delta and Omicron variants months post-acute infection. Overall, our findings suggest that infection in K18-hACE2 mice recapitulates the persistent clinical symptoms reported in long-COVID patients and provides new insights into the role of systemic and brain residential immune factors in PASC pathogenesis.

Abstract An attenuated SARS-CoV-2 virus with modified viral transcriptional regulatory sequences and deletion of open-reading frames 3, 6, 7 and 8 (∆3678) was previously reported to protect hamsters from SARS-CoV-2 infection and transmission. Here we report that a single-dose intranasal vaccination of ∆3678 protects K18-hACE2 mice from wild-type or variant SARS-CoV-2 challenge. Compared with wild-type virus infection, the ∆3678 vaccination induces equivalent or higher levels of lung and systemic T cell, B cell, IgA, and IgG responses. The results suggest ∆3678 as an attractive mucosal vaccine candidate to boost pulmonary immunity against SARS-CoV-2.

Purpose: Comparison of diagnostic capability of macular ganglion cell complex thickness vs. retinal nerve fiber layer (RNFL) thickness in patients of primary open-angle glaucoma (POAG). Settings and Design: This cross-sectional observational study was carried out between June 2021 and October 2022 at a tertiary care hospital in North India. Methods: A total of 118 eyes were included in the study with 30 control and the rest 88 eyes with POAG were divided into three groups based on visual field loss Group 1 (30 eyes): early field loss with mean deviation (MD) < −6 dB; Group 2 (30 eyes): moderate field loss with MD −6 to −12 dB; and Group 3 (28 eyes): severe field loss with MD > −12 dB. Optical coherence tomography (OCT) scans to measure RNFL loss and ganglion cell inferior plexiform layer (GCIPL) loss were taken for each patient. Statistical Analysis Used: Categorical variables were analyzed using either the Chi-square test or Fisher’s exact test. A receiver operating characteristics analysis was calculated to determine optimal cut-off values of superior, inferior, and average GCIPL and RNFL for determining the severity of field loss as compared to controls (30 normal eyes). Results: In the mild field loss group the sensitivity of superior, inferior, and average GCIPL was 86.7, 96.7, and 96.7%, respectively. Similarly, the specificity was 96.7, 93.3, and 100%, respectively. In the same group, the sensitivity of superior, inferior, and average RNFL was 70, 93, and 66%, respectively. Similarly, the specificity was 46.7, 83.3, and 70%, respectively. In the moderate and severe groups, the results were comparable. Conclusion: The sensitivity and specificity of GCIPL loss are significantly better than that of RNFL parameters in the mild field loss group.

Consumers are concerned about employing green processing technologies and natural ingredients in different manufacturing sectors to achieve a “clean label” standard for products and minimize the hazardous impact of chemical ingredients on human health and the environment. In this study, we investigated the effects of gelatinized starch dispersions (GSDs) prepared from six plant sources (indica and japonica rice, wheat, corn, potatoes, and sweet potatoes) on the formulation and stability of oil-in-water (O/W) emulsions. The effect of gelatinization temperature and time conditions of 85–90 °C for 20 min on the interfacial tension of the two phases was observed. Emulsification was performed using a primary homogenization condition of 10,000 rpm for 5 min, followed by high-pressure homogenization at 100 MPa for five cycles. The effects of higher oil weight fractions (15–25% w/w) and storage stability at different temperatures for four weeks were also evaluated. The interfacial tension of all starch GSDs with soybean oil decreased compared with the interfacial tension between soybean oil and water as a control. The largest interfacial tension reduction was observed for the GSD from indica rice. Microstructural analysis indicated that the GSDs stabilized the O/W emulsion by coating oil droplets. Emulsions formulated using a GSD from indica rice were stable during four weeks of storage with a volume mean diameter (d4,3) of ~1 µm, minimal viscosity change, and a negative ζ-potential.

Alzheimer’s disease (AD), which affects around twenty-seven million people globally, is an aging-related neurodegenerative condition characterized by the extracellular deposition of misfolded amyloid-β (Aβ) peptides and the intracellular production of neurofibrillary tangles (NFTs) AD results from the death of certain groups of neurons in the brain while appearing to have no impact on neighboring neurons. It is progressive and incurable. Therefore, the pathophysiology of afflicted populations and the development of intervention measures to stop neuronal cell death have been the main areas of attention for delineating therapeutic options. Proinflammatory cytokines are responsible for the stimulation of inflammatory responses and are mostly generated by activated macrophages in the brain. This review discusses how glial cells and innate and adaptive immune responses have a critical role in AD. It also provides information about microglial activation through the cluster of differentiation 40 (CD40) ligation and CD40L. CD40L ligation of microglial CD40 results in a large increase in tumor necrosis factor-α (TNF-α) production. Cultured cortical neuronal injury is caused when microglia are activated by CD40 ligation in the presence of interferon-γ (IFN-γ). This injury is significantly reduced by blocking the CD40 pathway or neutralising TNF-α. The management of AD would require integrating all available information about the innate and adaptive immune response affecting AD-related neuronal death.

Determining cause and manner of death in medico legal cases is of paramount importance in forensic practice. A 29 year old woman was brought by the police for medico legal autopsy with history of assault by her boyfriend. As per the initial police investigation and crime scene visit by the police, the case was registered as culpable homicide amounting to murder. Autopsy revealed that the deceased had acute on chronic meningitis, a natural disease incompatible with life if left untreated. It was also observed that there was a faint ligature mark around neck and multiple contusions at places over the body. There were no features suggestive of asphyxia or other findings which could alone cause death. The deceased was alive for some time after the assault. Considering these facts, cause of death was attributed to meningitis and further it was opined that the assault could have expedited the death.

The gut microbiome has an impact on cancer immune surveillance and immunotherapy, with recent studies showing categorical differences between immunotherapy-sensitive and immunotherapy-resistant cancer patient cohorts. Although probiotics are traditionally being supplemented to promote treatments or sustain therapeutic benefits; the FDA has not approved any for use with immunotherapy. The first step in developing probiotics for immunotherapy is identifying helpful or harmful bacteria down to the strain level. The gut microbiome’s heterogeneity before and during treatment is also being investigated to determine microbial strains that are important for immunotherapy. Moreover, Dietary fiber intake, prebiotic supplementation and fecal microbiota transplantation (FMT) were found to enhance intratumoral CD8+ T cell to T-reg ratio in the clinics. The possibility of probiotic immunotherapy as a “living adjuvant” to CAR treatment and checkpoint blockade resistance is actively being investigated.

The utilization of medicinal plants for their therapeutic properties has long been a key component of Indian culture. Unique medicinal characteristics can be found in the phytochemicals that are extracted from these plants. Globally, tuberculosis (TB) burden and management are challenged due to the emergence of new resistant strains of Mycobacterium tuberculosis (Mtb). This highlights the importance of new drug molecules from diverse sources as well as their innovative management options. In this context, the present study formulated an Anti Mtb medicinal plant database (AMMPDB Ver. 1.1), a manually curated database of native Indian medicinal plants that reported anti-tubercular (anti-TB) activities and their potential therapeutic phytochemicals. This is the first-ever freely accessible digital repository. The current version of the database provides users, with information regarding 118 native Indian anti-tubercular medicinal plants and their 3374 phytochemicals. The database provides the following information: Taxonomical ID, botanical description, vernacular names, conservation status, geographical distribution maps, IC-50 value, phytochemical details which include - name, Compound ID, Synonyms, location in plant part, 2D, 3D structures (as per the availability), and their medicinal uses reported in the literature. The tools section of the database is equipped with sequentially catalogued and hyperlinked open-access tools utilized for computational drug designing. A case study has been incorporated under the contributors section to validate the tools section and the phytochemicals of the database. AMMPDB Ver 1.1 will be serviceable to research in computational drug designing and discovery with effectiveness and ease.Database URL: https://www.ammpdb.com/

Bitter gourd is an important vegetable crop grown throughout the tropics mainly because of its high nutritional value. Sex expression and identification of gynoecious trait in cucurbitaceous vegetable crops has facilitated the hybrid breeding programme in a great way to improve productivity. In bitter gourd, gynoecious sex expression is poorly reported and detailed molecular pathways involve yet to be studied. The present experiment was conducted to study the inheritance, identify the genomic regions associated with gynoecious sex expression and to reveal possible candidate genes through QTL-seq. Segregation for the gynoecious and monoecious sex forms in the F2 progenies indicated single recessive gene controlling gynoecious sex expression in the genotype, PVGy-201. Gynoecious parent, PVGy-201, Monoecious parent, Pusa Do Mausami (PDM), and two contrasting bulks were constituted for deep-sequencing. A total of 10.56, 23.11, 15.07, and 19.38 Gb of clean reads from PVGy-201, PDM, gynoecious bulk and monoecious bulks were generated. Based on the ΔSNP index, 1.31 Mb regions on the chromosome 1 was identified to be associated with gynoecious sex expression in bitter gourd. In the QTL region 293,467 PVGy-201 unique variants, including SNPs and indels, were identified. In the identified QTL region, a total of 1019 homozygous variants were identified between PVGy1 and PDM genomes and 71 among them were non-synonymous variants (SNPS and INDELs), out of which 11 variants (7 INDELs, 4 SNPs) were classified as high impact variants with frame shift/stop gain effect. In total twelve genes associated with male and female gametophyte development were identified in the QTL-region. Ethylene-responsive transcription factor 12, Auxin response factor 6, Copper-transporting ATPase RAN1, CBL-interacting serine/threonine-protein kinase 23, ABC transporter C family member 2, DEAD-box ATP-dependent RNA helicase 1 isoform X2, Polygalacturonase QRT3-like isoform X2, Protein CHROMATIN REMODELING 4 were identified with possible role in gynoecious sex expression. Promoter region variation in 8 among the 12 genes indicated their role in determining gynoecious sex expression in bitter gourd genotype, DBGy-1. The findings in the study provides insight about sex expression in bitter gourd and will facilitate fine mapping and more precise identification of candidate genes through their functional validation.

Loss-of-function CRISPR-based screens have identified several genes associated with cancer resistance to T cell-induced cytotoxicity. Here the authors perform a genome-scale, gain-of-function CRISPR screen and identify candidate genes, including the poly-N-acetyllactosamine synthase B3GNT2, whose overexpression confers tumor cell resistance to T cell cytotoxicity

Introduction: A multicentric study on the benefits and outcomes of e-learning was lacking during the pandemic. This study aimed to find out the participation, satisfaction, and insights of dental and medical undergraduate learners toward digital learning during the COVID-19 pandemic in various healthcare institutes of India. Material and Methods: A questionnaire-based cross-sectional study was conducted using Google Forms online on e-learning among students from the first to the final year of MBBS and BDS courses in five healthcare institutions. Results: Most participants (72.7%) reported cellular data as their mode of internet connection. Seventy point eight percent of participants stated online classes did not affect health. Eyestrain (54.6%) was the most common, followed by headache and fatigue, whereas only 21.2% chose obesity and disturbed sleep as a consequence of e-learning. Conclusion: Most students had experience in digital learning, in which the use of smart phones with cellular data was the most common mode of digital learning during the pandemic.

Cellular and humoral responses are required for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) eradication. Antigen-presenting cells load SARS-CoV-2 peptides on human leukocyte antigen (HLA) with different avidities and present to T- and B-cells for imposing humoral and cellular responses. Due to immunosuppression, renal transplant recipient (RTR) patients are speculated to poorly form the antibody against the SARS-CoV-2. Therefore, determining the association of specific HLA alleles with anti-SARS-CoV-2 spike protein antibody formation will be helpful in managing the RTR having specific HLA alleles from SARS-CoV-2 infection and vaccination. Materials and Methods: In this study, anti-SARS-CoV-2 spike protein antibody in 161 RTRs was determined by the chemiluminescent microparticle immunoassay methods, and HLA alleles were determined by the polymerase chain reaction-single-strand oligonucleotide methods and analyzed to study the HLA allele association with anti-SARS-CoV-2 spike protein-specific humoral response and severity of COVID-19 symptoms in recently SARS-CoV-2-infected RTRs. Results: The anti-SARS-CoV-2 spike protein specific antibody seroconversion rate in RTRs was 90.06% with a median titer of 751.80 AU/ml. The HLA class I alleles, A*11 in 22.1%, A*24 in 21.37%, A*33 in 20.68%, HLA B*15 in 11%, B*07 in 8.27%, HLA-C*30 in 20.93%, C*70 in 23.25% and HLA Class II alleles, DRB1*07 in 18.62%, DRB1*04 in 13.8%, HLA-DRB1*10 in 14.48%, HLA-DQA1*50 in 32.55% of RTRs were associated with the seroconversion. The mean SARS-CoV-2 clearance time was 18.25 ± 8.14 days. Conclusions: RTRs with SARS-CoV-2 infection developed a robust seroconversion rate of 90.0% and different alleles of HLA-B, DRB1, and DQA1 were significantly associated with the seroconversion.

Background: The reproductive tract infection (RTI) is one of the major health issues associated with menstrual hygiene management which often goes unnoticed and hence remains underdiagnosed and untreated, resulting in devastating health effects on women. It gives way to some common complications like pelvic inflammatory disease (PID), ectopic pregnancy, infertility, adverse outcomes of pregnancy, neonatal morbidity and death (in case of a coexisting grievous disease like Human immune deficiency virus (HIV)). Method: A cross-sectional study was conducted in the rural and urban government schools of Lucknow, using two-stage cluster sampling separately for both urban and rural areas. Two schools (one co-education and one all girls) were chosen from each area. A total of 629 participants were taken for the study, 389 from urban and 240 from rural schools. The study subjects were taken proportionately from each school for an interview-based session using a pre-designed and pretested questionnaire. Descriptive analysis and Chi-square tests were used to analyse the quantitative data. Result: A total of 629 participants were taken for the study, from rural (240) and urban schools (389) of Lucknow. From urban, 50.9% had fair knowledge about RTI. Whereas 71.3% from urban had fair knowledge about RTI. Lower abdominal pain (54.8%) and vaginal discharge (32.6%) were the most common complaint reported by the participants related to RTI. Only 58.1% from urban and 32.6% from rural used sanitary pads as menstrual absorbents. The presence of vaginal discharge showed a significant relation (P value < 0.001) with the type of menstrual absorbent used. Conclusion: The knowledge related to RTI and menstrual hygiene practices has not changed significantly with time. Which is amongst the primary prevention that could be employed to prevent RTI and the consequences arising from a physiological cause.

Purpose: To assess the efficacy and clinical outcome of Tenon's patch graft (TPG) in corneal perforation and descemetocele. Methods: In this retrospective study, medical records of 83 patients (85 eyes) who underwent TPG for corneal perforation (58, 68%) or descemetocele (27, 32%) between July 2018 and October 2021 were reviewed. Clinical examination and anterior segment optical coherence tomography (AS-OCT) were performed on every follow-up visit. Anatomical success was considered as the restoration of the structural integrity with the formation of scar and anterior chamber (AC). Results: The mean size of the corneal lesions (corneal perforation or descemetocele) was 4.20 ± 1.01 mm. The mean follow-up period was 9.2 ± 5.48 months. The common underlying etiologies were infectious keratitis in 48% and autoimmune disorders in 35% of cases. TPG successfully restored the globe integrity in 74 (87%) eyes (83% in perforation and 96% in descemetocele). Anatomical failure occurred in 11 eyes (13%). The failures were due to graft dehiscence (8 eyes), graft ectasia (1 eye), and scarring with flat AC (2 eyes). The median time to epithelialization and scar formation were 3 and 15 weeks, respectively. Logistic regression analysis showed few predictors for a successful outcome: descemetoceles, noninfective causes, viral keratitis in infectious etiology, and paracentral or peripheral lesions. Conclusion: TPG can be considered an effective and inexpensive treatment for restoring the structural integrity in the eyes with perforations and descemetoceles, particularly when the donor tissue is unavailable. AS-OCT is a valuable noninvasive tool for monitoring the graft status.

Purpose: The objective of this survey-based study was to examine the effects of personal protective measures taken at the level of instrument and surgeon during the pandemic on the optics in ophthalmology. Methods: The study involved an online questionnaire of 24 questions which was distributed to ophthalmologists practicing in several hospitals, including residents and fellows undergoing training in ophthalmology in India. The responses were collected through an online data collection tool (Google forms). The participants could choose from multiple options provided to them in each question. Results: A total of 285 participants out of 296 had used modified methods for examining and performing surgical procedures during the pandemic, while 78.7% (265) of the participants acknowledged having encountered difficulty in interpreting the ocular findings of patients while examining in personal protective equipment. Moreover, 58.7% (198) of our study respondents also reported that there was significant worsening of the quality of ophthalmological examination with pandemic-appropriate measures and 84.8% (286) of our study participants also felt that these measures have significantly added to the time of examination, hence increasing the risk of exposure to both patient and doctor. Conclusion: The workplace study has highlighted the crucial aspects of optics in ophthalmology during the pandemic. The protective measures taken during the pandemic have significantly worsened the quality of ophthalmological examination and increased the time taken to perform outpatient department-based and surgical procedures in ophthalmology.

Purpose To elucidate visual outcome of patients after combined Descemet stripping endothelial keratoplasty (DSEK) with scleral fixated intra ocular lens (SFIOL) implantation in patients of endothelial decompensation with coexistent aphakia or lens subluxation. Materials and Methods A prospective interventional study of combined DSEK with sutured SFIOL in the patients who have undergone surgery at our center over 6-month follow-up period. Preoperative visual acuity and slit lamp findings were documented. Postoperative follow-up was done at days 1, 3, and 7 subsequently, months 1 and 3, and thereafter monthly till the sixth month. Results Mean age of the patients was 60.47 years. Six patients had aphakic bullous keratopathy, while 11 patients had pseudophakic bullous keratopathy with subluxated posterior chamber IOL (PCIOL). Preoperative visual acuity ranged from hand movements close to face (LogMar 2.4) with accurate projection of rays to 1/60 (LogMar 2) due to existing corneal edema and aphakia. Postoperatively uncorrected visual acuity at 6 months improved up to 6/36 (LogMar 0.8) in all cases. There was gradual improvement in corneal clarity and compactness during the follow-up. A good donor tissue endothelial count and an adequate IOP control were vital prognostic factors for the successful outcome. Conclusion This novel surgical merger reduces the complications of lenticule dislocation into vitreous and repeated surgeries and shows results akin to when performed in a staged manner.

Background: Modern day's society is engaged in commitment-based and time-bound jobs. This invites tension and mental depression among many people who are not able to cope up with this type of working environment. Cases of mental depression are increasing day by day all over the world. Recently, the onset of the COVID-19 pandemic has added further fuel to the fire. In many countries, the ratio between patients with mental depression and psychiatrists or psychologists is remarkably poor. Under such a situation, the design, and development of an expert system by exploiting the hidden power of various deep learning (DL) and machine learning (ML) techniques can solve the problem up to a greater extent. Methodology: Each deep learning and machine learning technique has got its advantages and disadvantages to handle different classification problems. In this article four neural network-based deep learning architectures namely MLP, CNN, RNN, RNN with LSTM, and two Supervised Machine Learning Techniques such as SVM and LR are implemented to investigate and compare their suitability to track the mental depression from EEG Data. Result: Among Neural Network-Based Deep Learning techniques RNN model has achieved the highest accuracy with 97.50% in Training Set and 96.50% in the Testing set respectively. It has been followed with RNN with LSTM model when there were 40% data in the Testing Set. Whereas both the Supervised Machine Learning Models namely SVM and LR have outperformed with 100.00% accuracies in Training Phase and approximately 97.25% accuracies in Testing Phase respectively. Conclusion: This investigation and comparison-oriented study establish the suitability of RNN, RNN with LSTM, SVM and LR model to track mental depression from EEG data. This type of comparative research using Machine Learning and Deep learning architectures must be framed out on this topic to finalize the design and development of an expert system for the automatic detection of depression from EEG data.

As the population ages, the number of older adults experiencing mild cognitive impairment (MCI), Alzheimer's disease, and other forms of dementia will increase dramatically over the next few decades. Unfortunately, cognitive changes associated with these conditions threaten independence and quality of life. To address this, researchers have developed promising cognitive training interventions to help prevent or reverse cognitive decline and cognitive impairment. However, the promise of these interventions will not be realized unless older adults regularly engage with them over the long term, and like many health behaviors, adherence to cognitive training interventions can often be poor. To maximize training benefits, it would be useful to be able to predict when adherence lapses for each individual, so that support systems can be personalized to bolster adherence and intervention engagement at optimal time points. The current research uses data from a technology-based cognitive intervention study to recognize patterns in participants' adherence levels and predict their future adherence to the training program. We leveraged the feature learning capabilities of deep neural networks to predict patterns of adherence for a given participant, based on their past behavior. A separate, personalized model was trained for each participant to capture individualistic features of adherence. We posed the adherence prediction as a binary classification problem and exploited multivariate time series analysis using an adaptive window size for model training. Further, data augmentation techniques were used to overcome the challenge of limited training data and enhance the size of the dataset. To the best of our knowledge, this is the first research effort to use advanced machine learning techniques to predict older adults' daily adherence to cognitive training programs. Experimental evaluations corroborated the promise and potential of deep learning models for adherence prediction, which furnished highest mean F-scores of 75.5, 75.5, and 74.6% for the Convolution Neural Network (CNN), Long Short-Term Memory (LSTM) network, and CNN-LSTM models respectively.

Dental caries is an irreversible, microbial disease of the tooth which is characterised by demineralisation and dissolution of the hard tissues. Conventional methods such as visual and tactile examination, radiography, laser or light induced fluorescence methods help in the diagnosis of dental caries, though they lack sensitivity. Being an irreversible process, it is important to detect the caries process in its incipient stages. Very recently, intraoral scanners have also found their way through to the detection and diagnosis of dental caries, particularly, the incipient lesions. Use of advanced technology for the detection of dental caries in its incipient stages has enabled a change in the paradigm to minimally invasive dentistry which focuses more on a preventive approach to caries management. The present review paper attempts to summarise the available literature on the role of intraoral scanners in caries diagnosis by performing a online search on PubMed, Embase, SCOPUS and MEDLINE databases. Only full text studies authored in English and published in peer reviewed journals between 2010 and 2022 were included in the research. Keywords and terms from both review articles and original research papers were taken. A total of 36 papers were reviewed including full texts and abstracts.

The ongoing COVID-19 pandemic plaguing countries worldwide has created an unprecedented change for the global economy, especially healthcare institutions at the forefront. Acceleration of the online-offline integration is the need of the hour. Massive expansion of home-based care likely will be supplemented with artificial intelligence (AI). One particular sector that has the greatest potential to benefit from tele-health services is the rural sector across all countries. Telemedicine has shown to improve access to healthcare in these populations through a reduction in travel burden and decreased cost of care. Innovative arrangements between the private and the public sectors and digitalization are more crucial now than ever before. The digital media will play a rather more important role in connecting with prospective patients. Thus, as we unravel the mysteries of the ongoing pandemic there are opportunities in the future offering unique learning opportunities for the health care sector. Rationalizing and optimizing available resources with resilience shown on the coronavirus frontline during the crisis are some of the most important lessons learnt during the crisis Keywords: COVID-19, Clinical Practice, Telemedicine.

Abstract Japanese encephalitis (JE) virus is a flavivirus causing encephalitis causing neurological damage. RNA-dependent-RNA-polymerase (RdRp) is responsible for genome replication making it excellent anti-viral target. In this study, the crystal structure of JE RdRp (jRdRp) and bioflavonoids reported in Azadirachta indica were retrieved from specific databases. Structure-based virtual screening was employed using MTiOpenScreen server and top four compounds selected with the most negative docking scores. Conformations were redocked using AutoDock Vina; these complexes showed mechanistic interactions with Arg474, Gly605, Asp668, and Trp800 residues in the active site of jRdRp, i.e., guanosine-5′-triphosphate. Furthermore, 100 ns classical molecular dynamics simulation and binding free energy calculation showed stability of docked bioflavonoids in the active jRdRp pocket and significant contribution of van-der-Waals interactions for docked complex stability during simulation. Therefore, this study predicted the anti-viral activity of Gedunin, Nimbolide, Ohchinin acetate, and Kulactone against jRdRp and can be considered for further antiviral drug development.

Abstract Background Campylobacter jejuni (C. jejuni) is accountable for more than 400 million cases of gastroenteritis each year and is listed as a high-priority gut pathogen by the World Health Organization (WHO). Although the acute infection of C. jejuni (campylobacteriosis) is commonly treated with macrolides and fluoroquinolones, the emergence of antibiotic resistance among C. jejuni warrants the need for an alternative approach to control campylobacteriosis in humans. To this end, vaccines remain a safe, effective, and widely accepted strategy for controlling emerging and re-emerging infectious diseases. In search of a suitable vaccine against campylobacteriosis, recently, we demonstrated the potential of recombinant Haemolysin co-regulated protein (Hcp) of C. jejuni Type VI secretion system (T6SS) in imparting significant immune-protection against cecal colonization of C. jejuni; however, in the avian model. Since clinical features of human campylobacteriosis are more complicated than the avians, we explored the potential of Hcp as a T6SS targeted vaccine in a murine model as a more reliable and reproducible experimental host to study vaccine-induced immune-protection against C. jejuni. Because C. jejuni primarily utilizes the mucosal route for host pathogenesis, we analyzed the immunogenicity of a mucosally deliverable bioengineered Lactic acid bacteria (LAB), Lactococcus lactis (L. lactis), expressing Hcp. Considering the role of Hcp in both structural (membrane-bound) and functional (effector protein) exhibition of C. jejuni T6SS, a head-to-head comparison of two different forms of recombinant LAB vectors (cell wall anchored and secreted form of Hcp) were tested and assessed for the immune phenotypes of each modality in BALB/c mice. Results We show that regardless of the Hcp protein localization, mucosal delivery of bioengineered LAB vector expressing Hcp induced high-level production of antigen-specific neutralizing antibody (sIgA) in the gut with the potential to reduce the cecal load of C. jejuni in mice. Conclusion Together with the non-commensal nature of L. lactis, short gut transit time in humans, and the ability to express the heterologous protein in the gut, the present study highlights the benefits of bioengineered LAB vectors based mucosal vaccine modality against C. jejuni without the risk of immunotolerance.

Cytokinin dehydrogenase (CKX; EC.1.5.99.12) regulates the level of cytokinin (CK) in plants and is involved in CK regulatory activities. In different plants, a small gene family encodes CKX proteins with varied numbers of members. These genes are expanded in the genome mainly due to segmental duplication events. Despite their biological importance, CKX genes in Triticum aestivum have yet to be studied in depth. A total of 11 CKX subfamilies were identified with similar gene structures, motifs, domains, cis-acting elements, and an average signal peptide of 25 amino acid length was found. Introns, ranging from one to four, were present in the coding regions at a similar interval in major CKX genes. Putative cis-elements such as abscisic acid, auxin, salicylic acid, and low-temperature-, drought-, and light-responsive cis-regulatory elements were found in the promoter region of majority CKX genes. Variation in the expression pattern of CKX genes were identified across different tissues in Triticum. Phylogenetic analysis shows that the same subfamily of CKX clustered into a similar clade that reflects their evolutionary relationship. We performed a genome-wide identification of CKX family members in the Triticum aestivum genome to get their chromosomal location, gene structure, cis-element, phylogeny, synteny, and tissue- and stage-specific expression along with gene ontology. This study has also elaborately described the tissue- and stage-specific expression and is the resource for further analysis of CKX in the regulation of biotic and abiotic stress resistance, growth, and development in Triticum and other cereals to endeavor for higher production and proper management.

Duplication of the oesophagus has ranges from complete duplication which is very rare to a partial cystic duplication (also known as duplication cyst). The oesophagus is the second most common site after the ileum to be involved with gastrointestinal duplication. It commonly manifests in neonates and children. The adults are usually asymptomatic. In this report, we describe a case of an adult male presenting with dysphagia because of a lower oesophageal duplication cyst. The diagnostic features and treatment options are discussed.

We study the magnetic properties and emergence of superconductivity in YBa$_2$Cu$_3$O$_7$ (YBCO)/ La$_{0.67}$Sr$_{0.33}$MnO$_3$ (LSMO) heterostructures. Bilayer films of superconducting layer, YBCO, and ferromagnetic layer, LSMO were grown on SrTiO$_{3}$ (STO) (001) substrate using ultrahigh vacuum Pulsed Laser Deposition system. Magnetization data at 100 K as a function of applied magnetic field shows ferromagnetic behaviour due to the LSMO layer. Cooling below 100 K leads to superconductivity in this material; the onset of superconductivity occurs at a temperature, $T_{c,SC},$ of 86 K for $H_{ext}\perp c$ (in-plane) \& 84 K for $H_{ext}||c$ (out-of-plane) under 100 Oe applied field. In-plane magnetic measurements show significant suppression of diamagnetic behaviour as compared to the out-of-plane measurements. The susceptibility signals are higher for out-of-plane direction. Such strong anisotropy in magnetism and the transition temperatures reveal complex interplay of magnetism and superconductivity in this system and calls for further study in this direction.

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global public health safety and the economy. Multiple antiviral drugs have been developed, and some have received regulatory approval and/or authorization. The use of nutraceuticals can be beneficial for preventing and treating COVID-19 complications. AHCC is a standardized, cultured extract of an edible mushroom Lentinula edodes of the Basidiomycete family of fungi that is enriched in acylated α-1,4-glucans. Here, we evaluated the effects of the oral administration of AHCC on the host response to SARS-CoV-2 infection in two murine models, K18-hACE2 transgenic mice and immunocompetent BALB/c mice. Oral administration of AHCC every other day for one week before and one day post SARS-CoV-2 infection in both strains of mice decreased the viral load and attenuated inflammation in the lungs. AHCC treatment also significantly reduced SARS-CoV-2-induced lethality in the K18-hACE2 mice. AHCC administration enhanced the expansion of γδ T cells in the spleen and lungs before and after viral infection and promoted T helper 1-prone mucosal and systemic T cell responses in both models. In AHCC-fed BALB/c mice, SARS-CoV-2 specific IgG responses were also enhanced. In summary, AHCC supplementation enhances host resistance against mild and severe COVID-19 infection primarily via the promotion of innate and adaptive T cell immune responses in mice.

BackgroundHemophagocytic lymphohistiocytosis (HLH) is characterized by uncontrolled and excessive inflammation leading to high mortality. Aetiology of HLH can be primarily due to genetic causes or secondarily due to infections or rheumatological illness. However, rarely T-cell deficiencies like severe combined immunodeficiency (SCID) can develop HLH.ObjectiveTo describe clinical and laboratory features of SCID cases who developed HLH.MethodsWe collected clinical, laboratory, and molecular details of patients with SCID who developed HLH at our center at Chandigarh, North India.ResultsOf the 94 cases with SCID, 6 were noted to have developed HLH-like manifestations. Male-female ratio was 5:1. Median (inter-quartile range) age of onset of clinical symptoms was 4.25 months (2-5 months). Median (inter-quartile range) delay in diagnosis was 1 month (1-3.5 months). Family history of deaths was seen in 4 cases. Molecular defects in IL2RG were seen in 5 out of 6 cases. Documented infections include disseminated bacillus calmette-guerin (BCG) infection (n=2), blood stream infections (n=3) with Staphylococcal aureus (n=1), Klebsiella pneumonia (n=1), and Pseudomonas aeruginosa (n=1), pneumonia (influenza H1N1 strain, and K. pneumoniae (n=1).ConclusionChildren with SCID can present with HLH-like manifestations secondary to fulminant infections. A high index of suspicion of SCID is needed in infants who present with HLH who have an associated infection or a suggestive family history. Occurrence of HLH-like manifestations in SCID suggests that T-lymphocytes may not have a significant role in immunopathogenesis of HLH.

IntroductionVaccination is an effective strategy for preventing SARS-CoV-2 infection and associated mortality. Renal Transplant Recipients (RTRs) are vulnerable to acquiring infection and high mortality due to their immunocompromised state. Varying responses to the different vaccines, depending on types of vaccines and population, have been reported. Vaccines supply is also limited. The current study evaluated the seroconversion rate after SARS-CoV-2 infection and 2 doses of either COVAXIN™ or COVISHIELD™ vaccination in RTR.MethodsThe serum anti-SARS-CoV-2 spike protein neutralizing antibody titer was measured in 370 RTRs who acquired SARS-CoV-2 infection (n=172), yet not vaccinated; and those vaccinated with COVAXIN™ (n=78), and COVISHIELD™ (n=120) by chemiluminescence microparticle immunoassay methods from serum.ResultOverall, the seroconversion rate either after vaccination or infection was 85.13% (315/370). The vaccine-associated seroconversion was 80.30% (159/198). SARS-CoV-2 infection-associated seroconversion was 90.69% (156/172), COVISHIELD™ associated seroconversion was 79.2% (95/120), and COVAXIN™ associated seroconversion was 82.05% (64/78). The median IgG titer in the SARS-CoV-2 infection group was 646.50 AU/ml (IQR: 232.52-1717.42), in the COVAXIN™ group was 1449.75 AU/ml (IQR: 400.0-3068.55), and the COVISHIELD™ vaccination group was 1500.51 AU/ml (IQR: 379.47-4938.50). The seroconversion rate and antibody titers were similar irrespective of the place of sampling. Patient’s age-associated seroconversion in 60 years was 58.3% (7/12).ConclusionsBoth infection and vaccination induce robust antibody formation in RTRs. The seroconversion rate after SARS-CoV-2 infection was higher but with a lower antibody titer than vaccines. The vaccines, COVAXIN™ and COVISHIELD™, induce more elevated antibody titers than natural infection. The seroconversion rate and antibody titer in Indian RTRs appears to be better than in the western population, irrespective of their vaccination status.

Introduction: Newer coexisting conditions should be identified in order to modify newer risk factors. Aim was to identify patients with non-classical or less common coexisting conditions in patients infected of COVID 19. Method: Single centred study from June 2020 to May 2021 at a tertiary centre in North India. A preformed questionnaire was used to record clinical and laboratory parameters and to identify cases which are in addition to CDC list and Indian data. Results: 0.67% (46) cases out of 6832 patients were identified to have non-classical coexisting illness. It was divided into 2 groups-infections A (60.1%) and non-infections B (39.9%). Group A included-tuberculosis- pulmonary (14.3%) & extra pulmonary (32.9%), bacterial (25.0%) viral infections [dengue, hepatitis B & C] (14.3%), HIV disease (10.7%) and malaria (3.6%). Group B included- organ transplant (27.8%), autoimmune [myasthenia gravis, polymyositis, psoriasis] (22.6%), haematologic [Haemophilia, ITP, Aplastic anaemia, APML, CML] (27.8%), uncommon malignancies [disseminated sacral chordoma and GTN] (11.1%) and snakebite (11.1%). Serum Procalcitonin was not helpful for diagnosis of bacterial infection in COVID-19 disease. Group A had significantly longer duration of illness, hepatitis and elevated CRP. The mortality in group A & B were 32.1% and 43.8% respectively. Death in non-severe COVID cases was in tetanus and snakebite. 30.7% death among tuberculosis patients. More than 70% of deaths were attributable to COVID 19 in both the groups. Conclusion: In Indian settings, comorbidities like tuberculosis and bacterial infections can precipitate severe COVID 19 unlike other parts of the world where tuberculosis is relatively uncommon.

Introduction: Dental fear and anxiety pose a significant problem for the practice of dentistry, especially in children. Therefore, it is necessary to identify and quantify this anxiety, to implement, and to monitor the effectiveness of treatment interventions. Materials and Methods: A cross-sectional study was conducted on children in the age group of 3–14 years. The children who had sound health and visited outpatient department of a Dental College, Lucknow, India with their parents for dental care were considered for study purposes. Children’s dental fear and anxiety were measured by using three scales. Result: Out of the total 220 respondents, 118 (53.6%) were males and 102 (46.4%) females. The outcome of the study showed that the dental fear among children was 13.3%, 22.9%, 7.8%, respectively, in existence measured by the three scales, viz., (a) facial image scale (FIS), (b) dental fear scale (DFS), and (c) children’s fear survey schedule-dental subscale (CFSS-DS). About 70.2% of the children showed Frankl’s behavior rating of 3, i.e. positive. Conclusion: Dental fear and anxiety are the most common problems of children and because of this, they are afraid of undergoing any dental treatment. By using the above scale, we can know about those factors which can enhance their fear so that we can modify our treatment approach. Altering in a treatment modality not only leads the children to get the treatment done easily but also removes the fear for dental treatment in the future.

Purpose: To assess the stress-related physiological parameters of ophthalmic surgeons during complicated cataract surgery and compare them with uncomplicated routine cataract surgery. Methods: In this cross-sectional observational study, 110 patients of various types of cataract were divided into two groups: Group 1 included 55 patients with simple cataract (Grade ≤3) with no ocular or systemic comorbidities, whereas Group 2 included 55 patients with complicated cataracts (Grade >3) and ocular/systemic comorbidities. All patients underwent phacoemulsification with intraocular lens implantation in the right eye only. The outcome measures were systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and saturation of peripheral oxygen (SpO2). Results: The average SBP, DBP, MAP, and HR were significantly higher in the surgeon operating Group 2 (complicated cataract) compared with Group 1 (uncomplicated cataract; P < 0.05). The average SBP of the surgeon while operating Group 1 patients preoperatively and postoperatively was 125.42 ± 2.49 mmHg and 122.45 ± 2.10 mmHg, respectively, whereas in Group 2, the average SBP of the surgeon taken preoperatively and postoperatively was 145.98 ± 3.80 mmHg and 137.44 ± 3.45 mmHg, respectively (P < 0.05). The surgeon's SpO2 showed no significant difference between the two groups. Conclusion: There is a significant level of increase in stress-related parameters of operating surgeons while doing complicated cataract surgery.

Background: Studies have reported that dental procedures may serve as a portal of entry for bacteria into the blood circulation, commonly termed as bacteremia which may inhabitate the heart and joints subjected to repair and replacement by prosthesis and may lead to complications in immunocompromised patients. Dental procedure may play a pivotal role in the development of infective endocarditis and infection around the prosthetic joint. Antibiotic use is suggested for all dental procedures requiring gingival manipulation or of the periapical region of teeth or mucosal incision in these patients. Objective: The present study has been conducted to inspect the antibiotic prescribing practices of general dentists among 250 dental practitioners. Methods: The study was conducted on 250 dental surgeons practicing in the urban Indian population of various parts of the country. A validated questionnaire was developed by a multidisciplinary dental and medical team and was circulated on the subject of the basic knowledge and awareness about antibiotic prophylaxis in susceptible patients. The data from the participants were collected, collated, and statistically analyzed. Results: The present study comprised 250 dental surgeons; 178 out of 250 were male, whereas 72 were female. Antibiotic prophylaxis guidelines were followed by 169 practitioners (67.60%), whereas 81 (32.40%) dentists did not follow any guidelines. Out of 169, 67 followed the American Academy of Orthopaedic Surgeons (AAOS) guidelines (39.64%), 58 followed American Heart Association (AHA) guidelines (34.30%), whereas 44 followed general physician's guidelines (26.03%). On screening the underlying conditions for which antibiotic cover was prescribed, it was shown that majority of the dental surgeons did the same for patients with cardiac valve repair or replacement (230; 92%), followed by infective endocarditis (212; 84.80%); organ transplant (212; 84.405); diabetes (189; 75.60%); prosthetic joint replacement (150; 60%); and congenital heart defect (110; 44%). Conclusion: Patients should then be trained to perform meticulous oral hygiene and advised to schedule regular dental checkups to maintain optimal dental health. Dentists should use antibiotic prophylaxis in only conditions associated with a valid scientific basis and should follow the standard protocols recommended by the American Dental Association, AHA, or AAOS.

Purpose: This study aimed to determine the various innovative surgical training techniques prevalent among ophthalmology residents in India during the COVID-19 pandemic. Methods: This was a prospective cross-sectional study. An online survey questionnaire was completed by ophthalmology residents from different parts of the country. The survey consisted of questions related to the impact of the pandemic on training, innovative training techniques adapted during the pandemic and their effectiveness, and COVID-19 duty-related information. Results: A total of 147 responses were obtained. The mean age was 29.3 years (range: 24–40 years, SD: ±3.82). Of which, 87 (59.2%) respondents were females. A total of 61 (41.5%) respondents reported practicing steps of ocular surgeries on goat eye, 69 (46.9%) on model eye/vegetables/fruits, 30 (20.4%) on surgical simulators, and 26 (17.7%) utilized 3-D virtual images and videos. In addition, 22 (15%) respondents reported never using any such techniques. Furthermore, 130 (88.4%) respondents reported practicing steps of cataract surgery, 52 (35.4%) practiced steps of open globe repair, and steps of trabeculectomy were reported by 24 (16.3%). The steps that were reported to be practiced most are incision or tunnel construction by 108 (73.5%), suturing by 92 (62.6%), capsulorrhexis by 91 (61.9%), primary wound repair by 82 (55.8%), and conjunctival peritomy by 75 (51%). Conclusion: The present study demonstrates that residents across the country are adapting to the present scenario by utilizing several innovative methods to sharpen their surgical acumen. The current pandemic situation can serve as an impetus to emphasize upon the institutes and medical regulatory bodies to appropriately remodel the residency curriculum.

Introduction: During the past 50 years, there is a substantial rise in noncommunicable diseases (NCDs) mortality in developing countries. India is also undergoing demographic transitions. Lifestyle which increases the risk of NCDs in younger age group will lead to increase in NCDs burden further in future generation. Objectives: The objective of this study is to determine the association between risk factors of common NCDs and sociodemographic factors in young adult women of Palam Village, New Delhi. Settings and Design: A community-based cross-sectional study was conducted in Palam Village, New Delhi. Materials and Methods: A total of 585 study participants were interviewed using a predesigned, semi-structured questionnaire. Waist circumference, blood pressure (BP), and weight were measured using nonstretchable measuring tape, digital BP apparatus, and digital weighing scale, respectively. Qualitative data are expressed in proportions and Chi-square test is applied. Mean and standard deviation are used for quantitative data. Results: As the socioeconomic status improved, the frequency of consuming adequate amount of fruits and vegetables in a day also increased. This association was statistically significant (P < 0.05). Conclusion: The present study reported varied prevalence of different risk factors with various sociodemographic characteristics and there is an urgent need to implement population, individual, and program wide prevention and control interventions.

Introduction: A toothbrush is the most common oral hygiene aid used, but maintaining and storing the toothbrush hygienically is commonly neglected. In India, people are not aware of the contamination of toothbrushes. Contaminated toothbrushes can act as a vector for the transmission or reinfection of various bacteria, viruses, and fungi. The herbs, which have pharmaceutical properties, can be used as an alternative. The study aimed to compare the antimicrobial efficacy of 3% neem and 3% garlic on Streptococcus mutans and to compare with 0.2% chlorhexidine mouthwash as toothbrush decontaminants. Materials and Methods: A triple-blinded randomized controlled trial was done on 120 subjects. The subjects were divided into four groups: Group I (distilled water), i.e., control, three study groups having 3% neem (Group II), 3% garlic extract (Group III), and 0.2% chlorhexidine gluconate (Group IV). Subjects were provided toothbrushes and toothpaste for both baseline and intervention phases. The toothbrushes were collected after 14 and 28 days for microbial analysis in both phases. The data were analyzed and compared using appropriate t-test and analysis of variance. The level of significance was set at P < 0.05. Results: Garlic (Group III) was most effective at 98%, followed by chlorhexidine (Group IV) 96% and neem (Group II) 88% in reducing the level of S. mutans. Distilled water (Group I) showed only a 3% reduction. Conclusion: Neem and garlic proved to be as effective as chlorhexidine, and these herbal products can be used as an alternative to chlorhexidine as disinfectants for toothbrushes. These are the common ingredients that can be easily found in Indian households. It is herbal, cost-effective, and has no side effects so it can be easily used by every individual as a toothbrush decontaminant.

The Covid pandemic brought a hard time for sexual and reproductive health. Lockdown and covid restrictions made it difficult to maintain healthy sexual life and relationship. Although Covid is not a sexually transmitted disease and but can get a transfer into others by close contact with suspected or confirmed positive partners. Sexual health is essential for couples to maintain trust, intimacy, and love in their relationships. Reportedly sexual practices of couples changed accordingly to avoid any possible risk of transfer of deadly Covid infection. This paper is a review of studies published during past two years of pandemic. Even when people showing high levels of resilience, the negative aspects of pandemic and lockdown could affect their quality of sexual life. We are witnessing a century’s crisis where the whole world is under threat of rapidly spreading the new infection COVID -19 and the overall global impact of this new pandemic is yet uncertain.

Introduction: Individuals who did not have the opportunity to undergo orthodontic treatment due to lack of information or financial resources, find themselves physiologically deprived of aesthetics. So, awareness must be a part of planning oral health problems in every stratum of the society. Aim: To evaluate the awareness and knowledge of Orthodontic treatment among patients from Purvanchal region, Uttar Pradesh. Materials and Methods: This self-designed questionnaire‑based descriptive and cross-sectional study, was conducted from May 2018 to June 2019 at Faculty of Dental Sciences, Unit of Orthodontics, Banaras Hindu University, Uttar Pradesh, India. Four subject expert and one public health dentist formulated 22 bilingual questions. A pilot study was conducted on 200 randomly selected study participants and the internal consistency of the questions were measured statistically (Coefficient of variation ratios, Cronbach’s alpha=0.659, Lawshe’s index= 0.626). The study sample size was then computed using nMaster 1.0 software to be 1748 which was later increased to 2112. Patients were randomly selected and categorised depending on age groups (10-15, 16-20, 21-25, 26-30 years), sex (male/female) and residential area (rural/urban). The questionnaire was distributed among the study group and response were collected on the same day. The data acquired was later subjected to statistical analysis. Chi-square, t-test and Analysis of Variance (ANOVA) were carried out using Statistical Package for the Social Sciences (SPSS) version 20.0 (p-value

Severe Combined Immunodeficiency (SCID) is an inherited group of rare, life-threatening disorders due to the defect in T cell development and function. Clinical manifestations are characterised by recurrent and severe bacterial, viral, and fungal opportunistic infections that start from early infancy period. Haematopoietic stem cell transplantation (HSCT) is the treatment of choice. The pattern of inheritance of SCID may be X-linked or autosomal recessive. Though the diagnosis of SCID is usually established by flow cytometry-based tests, genetic diagnosis is often needed for genetic counselling, prognostication, and modification of pre-transplant chemotherapeutic agents. This review aims to highlight the genetic aspects of SCID. Keywords: Adenosine deaminase, Flow cytometry, Genetics, Newborn screening, Severe combined immunodeficiency

Activated Phosphoinositide 3-kinase δ syndrome (APDS) is a newly recognised primary immunodeficiency disease. It has currently been a hot topic of clinical research and new data are emerging regarding its pathogenesis, clinical manifestations and treatment. Patients with APDS syndrome have significant autoimmune manifestations and lymphoproliferation. It is important to differentiate APDS from the usual polygenic CVID in view of the availability of targeted therapy like mTOR inhibitors such as Rapamycin and selective PI3Kδ inhibitors. We provide a comprehensive review on this interesting disorder focusing light on its etiology, genetic research and emerging therapy. Keywords: Activated phosphoinositide 3-kinase δ syndrome (APDS), Gain of function, Immunodeficiency, Lymphadenopathy, Lymphoproliferation, p110δ-activating mutation causing senescent T cells

Primary immunodeficiency diseases (PIDs) refer to a heterogenous group of disorders characterized clinically by increased susceptibility to infections, autoimmunity and increased risk of malignancies.These group of disorders present with clinical manifestations similar to PIDs with known genetic defects but have either no genetic defect or have a somatic mutation and thus have been labelled as “Phenocopies of PIDs”. These diseases have been further subdivided into those associated with somatic mutations and those associated with presence of auto-antibodies against various cytokines.In this review, we provide an update on clinical manifestations, diagnosis and management of these diseases. Keywords: Anti-cytokine antibodies, Phenocopies, Primary immunodeficiency diseases, Somatic mutations