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Candidemia ranks the 4th most prevalence cause of bloodstream infections and stands out as the primary cause of invasive fungal infections among hospitalized patients. Its incidence varies globally from 0.33 to 6.51 episodes per 1000 admissions, representing a major public health burden due to its increasing incidence and high mortality rates. The present research work has been conducted to identify the distribution of Candida species among septicemic patients and to determine the patterns of antifungal susceptibility of Candida species isolates from them in a tertiary care center in South India. Among the 88 Candida isolates, 13 (14.8%) were speciated and identified as C. albicans and 75 (85.2%) were Candida non-albicans. Of them, C. tropicalis (42%) ranks more prevalent. The distribution of virulence factors among 88 Candida isolates revealed that 49 isolates (55.7%) exhibited phospholipase activity, hemolysin production was detected in 68.2% of isolates, biofilm production was demonstrated in 73.9% isolates and coagulase activity was observed in 46.7% isolates. In the present study, Candida species were most sensitive to Amphotericin B (94.3%), which is followed by Caspofungin (93.2%), Voriconazole (92%), Micafungin (90.9%), and the least was observed with Flucytosine (78.4%) and Fluconazole (71.5%). Thus, in order to improve treatment responses, the insights acquired from this research will aid in clinical management and the development of antifungal stewardship recommendations.

Aim: Present study was done to understand the dimerization of HER2/ERBB2 in normal and cancer cells using in-silico study. Methods: Pathway analysis was done using Reactome. Structure of HER2/ERBB2 protein was obtained from PDB database, and using Schrödinger software protein structure was analysed and dimerization was done. Results: In normal cells, HER2/ERBB2 is present at low levels and forms a stable complex with HSP90 (heat shock protein 90), CDC37 (cell division cycle 37), and ERBIN (an adaptor protein of the HER2/ERBB2 receptor). HER2/ERBB2 lacks a ligand-binding site, so it cannot bind ligands to activate HER2/ERBB2 signaling directly. Instead, it heterodimerizes with other EGFR family members, using their ligand-binding sites to activate cell proliferation signaling cascades. In cancer, overexpression of HER2/ERBB2 leads to ligand-independent activation of signaling through dimerization. During this process, HER2/ERBB2 dissociates from the HSP90 complex. Normally, HSP90 helps to correct misfolded and aggregated proteins, but it fails to correct mutated HER2/ERBB2 in cancer cells. Conclusions: This discussion focuses on the structural changes that HER2/ERBB2 undergoes, particularly in the form of homodimers, under normal and cancerous conditions. This analysis highlights the mutated state of HER2/ERBB2 and the role of HSP90 in this context. Notably, a single-point mutation outside a protein’s active site can significantly alter its structure. This is a critical consideration in drug discovery, underscoring the need to evaluate the entire protein conformation during simulations.

Abstract Type II innate lymphoid cells (ILC2s) maintain homeostasis and barrier integrity in mucosal tissues. In both mice and humans, ILC2s poorly reconstitute after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Determining the mechanisms involved in their impaired reconstitution could improve transplant outcomes. By integrating single-cell chromatin and transcriptomic analyses of transplanted ILC2s, we identify a previously unreported population of converted ILC1-like cells in the mouse small intestine post-transplant. Exposure of ILC2s to proinflammatory cytokines resulted in a mixed ILC1-ILC2 phenotype but was able to convert only a small population of ILC2s to ILC1s, which were found post-transplant. Whereas ILC2s protected against acute graft-versus-host disease (aGVHD) mediated mortality, infusion of proinflammatory cytokine-exposed ILC2s accelerated aGvHD. Interestingly, murine ILC2 reconstitution post-HSCT is decreased in the presence of alloreactive T cells. Finally, peripheral blood cells from human patients with aGvHD have an altered ILC2-associated chromatin landscape compared to transplanted controls. These data demonstrate that following transplantation ILC2s convert to a pro-pathogenic population with an ILC1-like chromatin state and provide insights into the contribution of ILC plasticity to the impaired reconstitution of ILC2 cells, which is one of several potential mechanisms for the poor reconstitution of these important cells after allo-HSCT.

During the pandemic of COVID-19, a novel atypical set of clinical findings was seen among several children with recent or current exposure to the virus. It was termed the “multisystem inflammatory syndrome in children” (MIS-C). Our study used the 2021 National Inpatient Sample to study the associations of sex, race, and age with the incidence of MIS-C among COVID-19-positive children. Out of 69,440 COVID-19-positive children, 2,790 (4.0%) reported MIS-C. The incidence of MIS-C was highest among those aged 8 years old (17,130 MIS-C cases per 100,000 COVID-19 patients), Asian or Pacific Islanders (API) (5,346 MIS-C per 100,000 COVID-19 cases), and males (4,734 cases per 100,000 COVID-19 cases). Furthermore, 7.9% of MIS-C cases met the classification of Kawasaki disease.

Context: Adolescent phase is a very crucial period in one’s life, much emotional and psychological support is needed for an adolescent to bloom into a responsible adult. But unfortunately adolescents do not get the support or they fail to seek support due to lack of awareness. Government of India, to address this issue has established dedicated adolescent friendly health services (AFHS). This study estimates the utilisation of adolescent friendly health clinics in a rural area of Maharashtra. Aims: Aim is to the study the utilisation of adolescent friendly health services and its various determinants in a rural area of Maharashtra. Objectives: Objectives of this study were to assess the sociodemographic profile of study participants, to study the utilisation of adolescent friendly health services among them and to determine the factors associated with utilisation of adolescent friendly health services. Settings and Design: A community based cross-sectional study was conducted among 290 late adolescents from a rural area of Maharashtra from October 2022 to December 2022. Methods and Material: With the help of data from Gram panchayat about residing adolescents in the rural field practice area of tertiary care hospital, all late adolescents were included in this study after obtaining informed consent. Data was collected with and Statistical analysis was done using ‘Open Epi Info’ software. Results: Out of 290 adolescents, 35% (102) were aware of adolescent friendly health clinics (AFHS), 20% (58) utilised AFHS, the significant sociodemographic components for utilisation were found to be females (AOR: 2.161,95% CI: 1.088-4.295), Bauddha religion (AOR: 2.465,95% CI: 0.585-10.383), socioeconomic class I and II- B.G Prasad classification (AOR: 1.544,95% CI: 0.786-3.030), higher secondary education (AOR: 8.025,95% CI: 1.434-44.916) and Government schooling (AOR:0.389,95% CI: 0.080-1.889). Conclusions: Though initiatives are taken from the Government to lend a helping hand to the adolescents, awareness and utilisation seems to be minimal.

BackgroundTo overcome disruptive behavior of children, pediatric dentists rely on various behavior management techniques. When dental therapy is pertinent and nonaversive techniques like tell-show-do, voice control, and positive reinforcement are ineffective; the role of advanced behavior guidance techniques like physical restraints and protective stabilization is of paramount importance. AimThe study was carried out to elicit parents’ opinion and record their response to their children’s experience who underwent dental treatment with an extra assistant for protective stabilization. Materials and MethodsResponse was elicited to a questionnaire from 50 parents of children lacking cooperative ability and were exposed to an extra assistant for protective stabilization during various dental procedures. ResultsThe dental assistant was most preferred as the extra assistant to provide active stabilization. An overwhelming 98% of the parents agreed to protective stabilization with an extra assistant as advantageous and a good 88% of the parents recommended its use for further appointments of their children. ConclusionMajority of the parents approved protective stabilization with an extra assistant in future appointments of their children.

The prevalence of Dermatophytosis is similar in several continents of the Asian country. The varied state of weather is favourable for mycosis that may lead to various clinical symptoms and infection spreads speedily if left untreated with time. The aim of the present study is to determine the clinical and mycological pattern of dermatophyte infections in patients arriving at our dermatology outpatient department and also to correlate the formal clinical diagnosis with KOH positivity and culture positivity. This descriptive observational study was conducted among 300 patients presenting with dermatophyte infections who came to the dermatology outpatient Department of SRM Medical College and research centre, Kattankulathur, Chengalpattu. The clinical specimens were put through direct microscopy by Potassium Hydroxide (KOH) mount and with the culture on Sabouraud’s Dextrose Agar (SDA). The study showed males were affected mostly and most of the participants were students. The common symptoms observed were Itching, Scaling and Discolouration. Commonly, patients had a primary diagnosis of Tinea corporis infection followed by T. cruris. Trichophyton mentagrophytes were the commonly isolated organism followed by Trichophyton rubrum and Trichophyton violaceum. This study indicates the need for personal hygiene and the disadvantage of as only few participants had zoophilic infections of Tinea species. These methods of diagnosing and identification will further aid in better patients management.

Candida tropicalis is the fourth main infective agent of Candida species in several developing nations and leads to the greatest fatality rate among the non-albicans Candida (NAC) species that cause candidemia. Seventy clinically known Candida isolates are isolated in positively flagged blood samples from BacT/ALERT 3D from various wards. Virulence factors like hemolysin production, coagulase activity, phospholipase activity, and biofilm formation were studied and antifungal susceptibility testing was and Minimum Inhibitory Concentration (MIC) values were interpreted. Of the total 70 clinical Candida isolates, the most predominant organism isolated was found to be C. tropicalis 27 (38.57%) which is succeeded by 19 (27.14%) C. albicans, 13 (18.57%) C. parapsilosis, 6 (8.57%) C. glabrata, and 5 (7.14%) C. krusei respectively. Among the70 Candida isolates, 49 (70%) showed hemolysin production, 43 (61.42%) isolates demonstrated phospholipase activity, 34 (48.57%) showed coagulase activity and 55 (78.57%) isolates showed biofilm production by crystal violet assay. A high level of Fluconazole resistance has been observed in 23 (32.85%) Candida isolates in comparison with other antimicrobials utilized in this study. The higher MIC value of: ≥ 64 µg/mL Fluconazole was shown by 4 (57.14%) isolates of C. tropicalis by broth microdilution method. The interpretation of various virulence factors and antifungal drug resistance were seen mostly among NAC species, thus hence signifying its pivotal role in immunocompromised individual treatment.

Background: Healthcare at people’s doorstep called Makkalai Thedi Maruthuvam (MTM) scheme was launched by Tamil Nadu Government in 2021 to further improve the access to NCD care by ensuring door step blood sugar & blood pressure screening, drug delivery by designated trained manpower called Women Health Volunteers (WHV). Assessing the programme awareness and its utilization at this juncture is the need of the hour. Hence, the present study was conducted. Objectives: 1. To assess the awareness about MTM scheme among adults >30 years in the field practice area, Madurai district 2. To determine the factors influencing awareness and utilization of MTM services Methodology: A community based cross-sectional study was done among 165 adults of >30 years in field practice area of our department in October 2023. By cluster sampling, participants were interviewed using a pre-structured validated questionnaire containing socio-demographic details and data to assess awareness and factors influencing awareness and utilization of MTM services. Data were entered in MS Excel and analysed using SPSS. Results: Mean age was 54±13.60 years. 60% were females, 83% were literates,63% were employed.80% were aware about the scheme and 74% awareness was through healthcare workers,98% preferred door to door services. Awareness regarding lifestyle modifications, breast, cervix and oral cancer screening were 56%,40%,39% and 20% respectively. There is statistically significant association between MTM awareness and age, occupation, blood sugar and blood pressure check-up in the last one year. By multiple logistic regression, awareness among those 50 yrs. Those with awareness had 2.62 times odds of utilization of services as compared to those without awareness. Conclusion: There is a good awareness and utilization of MTM services. To sustain this, IEC activities can be done at regular intervals with special emphasis on cancer screening.

Background and Objectives: Coronavirus disease 2019 (COVID-19) caused several cardiovascular complications, including acute myocardial infarction (AMI), in infected patients. This study aims to understand the overall trends of AMI among COVID-19 patients during the first two years of the pandemic and the disparities and outcomes between the first and second years. Materials and Methods: The retrospective analysis was conducted via the 2020 and 2021 National Inpatient Sample (NIS) database for hospitalizations between April 2020 and December 2021 being analyzed for adults with a primary diagnosis of COVID-19 who experienced events of AMI. A comparison of month-to-month events of AMI and mortality of AMI patients with concomitant COVID-19 was made alongside their respective patient characteristics. Results: Out of 2,541,992 COVID-19 hospitalized patients, 3.55% experienced AMI. The highest rate of AMI was in December 2021 (4.35%). No statistical differences in trends of AMI mortality were noted over the 21 months. AMI cases in 2021 had higher odds of undergoing PCI (aOR 1.627, p < 0.01). They experienced higher risks of acute kidney injury (aOR 1.078, p < 0.01), acute ischemic stroke (aOR 1.215, p < 0.01), cardiac arrest (aOR 1.106, p < 0.01), need for mechanical ventilation (aOR 1.133, p < 0.01), and all-cause mortality (aOR 1.032, 95% CI 1.001–1.064, p = 0.043). Conclusions: The incidence of AMI among COVID-19 patients fluctuated over the 21 months of this study, with a peak in December 2021. COVID-19 patients reporting AMI in 2021 experienced higher overall odds of multiple complications, which could relate to the exhaustive burden of the pandemic in 2021 on healthcare, the changing impact of the virus variants, and the hesitancy of infected patients to seek care.

Candidemia is caused by healthcare-associated bloodstream infections ranking as a fifth cause especially in the United States as well as in European countries among intensive care units (ICUs). Despite ongoing advances in diagnostics and medical interventions, it remains associated with high mortality rates, along with the prolonged duration of hospitalization and elevated health care costs. The aim of the study is to characterize Candida species and to investigate the antifungal resistance pattern from blood samples in a Tertiary Care centre. 53 known Candida isolates from blood samples of various wards and ICUs were collected. All isolates are processed and speciated by the conventional identification method demonstrating its various virulence factors phenotypically and AFST patterns were studied. In the present study, among 53 Candida isolates, 25 (47.16%) C. tropicalis is a predominant pathogen followed by 11 (20.75%) C. parapsilosis, 9 (16.98%) C. albicans, 4 (7.54%) C. glabrata and 4 (7.54%) C. krusei. Phospholipase activity was observed in 30 (56.60%) isolates, 36 (67.92%) showed hemolysin production. AFST showed 15 (28.30%) isolates being resistant to Fluconazole and 2 (3.77%) showed resistance to Amphotericin B. The prevalence of candidemia was high, the fatality rate was alarming and non-albicans Candida species were predominant and fluconazole was the least effective drug owing to the high level of resistance.

Unsustainable energy utilization is negatively affecting the planet’s atmosphere, eco-capacities, and present (just as future) prosperity around the globe. With such a great amount of work to be done, overseas environmental associations having some expertise in sustainable energy source every now and again need international volunteers to join their group. International energy conservation in sustainable energy source offers you the chance to gain up hands-on experience working with environmental people and have an immediate effect in the field of sustainability for Smart cities development. Regardless of whether it’s chipping away at hydropower frameworks in landlocked nations, helping spread the reception of Solar powered energy generators in nations that do not have the foundation for power or helping an organization on the cutting edge of another innovation, the open doors are astonishing and about perpetual. This research is much focused on the overseas Dimensional array based heuristic Fuzzy classification systems (DA-HFCS) science and technology guidance system which aims for sustainable energy source volunteer projects will offer one of kind social viewpoints that will upgrade and illuminate present growing perspective. The case studies have been evaluated and statistical analysis shows prominent outcomes.

Introduction: Malnutrition leads to poor outcomes in surgical patients, leading to negative impact during the postoperative period. Nutrition Risk Screening (NRS) 2002 and Subjective Global Assessment (SGA) are novel tools to assess nutrition risk which have the potential to predict the postoperative complications in surgical patients. Aim: This study was carried out to determine the efficiency of the NRS 2002 and SGA in predicting postoperative complications. Materials and Methods: A prospective cohort study was conducted to assess the nutritional risk of patients aged 18 years and above who underwent elective abdominal surgery. NRS 2002 and SGA were used for nutritional screening. Univariate analysis was carried out to determine the relative risk (RR) of complications for each variable. Receiver operating characteristic (ROC) and area under curve (AUC) were plotted for NRS 2002 and SGA to identify the score for the former and grade for the latter that predicted complications postoperatively. The correlation of malnutrition with surgical outcomes was performed to determine their association. Results: A total of 320 patients were included in the study. Among the patients who underwent elective abdominal surgeries, 39.4% of the total number developed postoperative complications. The most prevalent were Grade 2 complications, which accounted for 69.1% of all such events. Postoperative complications were recorded in 75.5% of the patients identified as at risk by NRS 2002, with a RR of 5.3 (95% confidence interval [CI]: 3.7–7.6; P < 0.001). Complications were found among 68.3% of those who were malnourished by SGA, with a RR of 4.2 (95% CI: 3.0–6.0; P < 0.001). The ROC curve for NRS 2002 to determine the complications had an AUC of 0.80. A score of 3 was the optimal cutoff of NRS 2002 for predicting complications with a maximum sensitivity of 93.6%. Similarly, the ROC curve for SGA grades to determine complications had an AUC of 0.79. Grade B was the best cutoff, with a sensitivity of 77.0%. Conclusion: Patients with NRS 2002 scores higher than or equal to 3 and SGA Grades B and above had a higher incidence of postoperative complications in patients undergoing elective abdominal surgeries. Hence, NRS 2002 and SGA are reliable nutrition risk assessment tools for predicting postoperative outcomes.

Background: Globally, the prevalence of overweight and obesity has dramatically increased in the recent years. In India, more than 10% of schoolchildren are overweight or obese. Schools play a major role in the modification of behavior. The aim of this study was to assess the effectiveness of after-school physical activity intervention on body mass index (BMI) and waist circumference/height ratio as primary outcomes. Materials and Methods: A randomized controlled trial was adopted where the schools were randomized. Each group, i.e., study and control groups, had 140 overweight adolescents. BMI and waist circumference/height ratio were measured. After-school physical activity intervention was carried out for a period of 9 months by the study group. The posttests were carried out at an interval of 3 months up till 9 months. Results: There was a statistically significant difference in BMI between the study and control groups during the 6th and 9th months (t = 1.256, P < 0.001 and t = 0.920, P < 0.001), respectively. The repeated measures analysis of variance did not show a significant reduction in BMI and waist circumference/height ratio over a period of time. Conclusion: School-based physical activity interventions are effective in prevention of childhood overweight/obesity and are a very cost-effective measure that can be easily implemented in schools.

Background: Chronic kidney disease is an emerging major noncommunicable health problem globally. The hemodialysis procedure results with increase in lipid peroxidation and decrease in antioxidant enzymes such as superoxide dismutase with change in serum antioxidant activity. The aim of the study is to formulate an antioxidant-rich peridialytic granola bar to supplement hemodialysis patients. Methods: The recipe was formulated using oats, ground nuts, dehydrated papaya, flax seeds, almonds, honey, and vegetable oil. To make the supplement antioxidant-rich, dehydrated papaya, honey, and vegetable oil have been selected. Results: The amount of antioxidant in the analyzed peridialytic granola bar has been compared with the recommended dietary allowance (RDA) for the hemodialysis patients and the quantity for supplementation has been finalized. The 80 g of peridialytic granola bar provides around 3369.6 μg of antioxidant, 15 g of protein, and 346.4 kcal of energy to meet the two-third of the recommended antioxidants and one-fourth of the protein and energy. Conclusion: The composition of the developed bar was standardized through organoleptic evaluation. The antioxidant content of the developed product was analyzed and compared with RDA. Eighty grams, i.e., 2 numbers of peridialytic granola bar, will provide roughly around 3369.6 μg of antioxidant, 15 g of protein, and 346.4 kcal of energy. This nutritional value is equivalent to approximately 1 serving of standard commercial formulas of 50 g. The formulated antioxidant-rich peridialytic granola bar can be considered for supplementation for 4 weeks to the subjects undergoing hemodialysis to reduce their oxidative stress.

Background: Malnutrition and mineral disparities has become increasingly common in patients with the end-stage renal disease treated with hemodialysis (HD). Lack of nutritional knowledge is one of the most significant reasons for nutritional problems leading to improper practice and causing several complications. The objectives of the study were to asses the nutrition knowledge, attitude, and practice of HD patients regarding renal diet, to counsel the patients on HD dietary guidelines and to determine the association of factors such as income and education level on nutrition management of HD Patients. To assess the nutrition knowledge, attitude, and practice of HD patients regarding renal diet. To counsel the patients on HD dietary guidelines. To determine the association of factors such as income and education level on nutrition management of HD patients. Methods: A total of 120 patients undergoing HD were assessed for the level of nutrition knowledge, attitude, and practice, regarding HD dietary guidelines, using a validated questionnaire. Results: About 60.3% of HD patients had excellent knowledge, 60% had excellent attitude, and 40% had excellent practices. There is a significant positive correlation between knowledge and attitude, as well as knowledge and practice (r < 0.01) of the patients undergoing HD regarding renal diet. There is also a significant association between the knowledge, attitude, and practice scores with the selected demographical variables (education level and income) of patients at the significance level of P < 0.001. Conclusion: Although majority of the patients have excellent knowledge, attitude, and practice, a notable number of patients are unaware about their dietary guidelines and do not adhere to the dietary regime that needs to be followed. Diet counseling by a renal dietitian using a nutrition education module can effectively upgrade the nutrition knowledge, attitude, and practice of HD dietary guidelines by the patients.

Introduction The COVID-19 pandemic significantly impacted the world in 2020. Every country adopted quarantine measures to prevent the transmission of the coronavirus infection. These measures resulted in dramatic changes in the daily lives of most people. In the academic world, students faced a shift from the traditional classroom-based teaching to virtual distance learning platforms. This shift in nursing education posed challenges both to the instructors and students as they were not fully prepared for this transition. Objective The study assessed the nursing students’ satisfaction with the virtual learning experience during the COVID-19 pandemic in selected nursing colleges in India. Methods The study was conducted in four nursing colleges in India. A total of 1,166 Diploma, Post Basic BSc (N), BSN, and MSN nursing students participated in the study. Ethical approval was obtained from all the nursing colleges included in the study. The Google Forms satisfaction survey included student, teacher, course, technology, environmental, and practical dimensions. Results The response rate was 86.31% (n = 1,166). The overall satisfaction with virtual theory and practical classes has a mean and SD score of 67.14 + 11 and 16.21 + 3.46, respectively. The results showed that overall 51% of the students had good satisfaction with virtual theory classes while 48% had moderate satisfaction. In terms of overall satisfaction with virtual practical classes, approximately 39% had good satisfaction, 58% had moderate satisfaction and nearly 3% had poor satisfaction. In addition, the students expressed that they had good satisfaction with Teacher dimension (64.3%), Student dimension (63%), and Course dimension (57.2%). On the contrary, they expressed poor satisfaction in the Technical dimension (11.3%) and Environmental dimension (5.6%). The results showed that the courses, the place of attending class, and health issues were significantly associated with the student's level of satisfaction with virtual learning. Conclusion Although the majority of the students rated their satisfaction level as being “good” in virtual theory classes and “moderate” in virtual practical learning, most of them were dissatisfied with the Technical and Environmental dimensions of virtual learning. This results calls for blended learning strategies to be designed to enhance better learning outcomes and, to ensure deepened level of satisfaction with virtual learning activities.

Purpose: Global trends show a high prevalence of refractive errors among children. The prevalence of vision impairment due to uncorrected refractive errors among school children is increasing and the need for management of other ocular conditions is also reported. This study presents the status of eye health and pattern of daily activities among the school children of a tribal location in Tamil Nadu, South India. Methods: A cross-sectional study was conducted in 13 schools of Karumandurai cluster, Salem district in Tamil Nadu, India. A three-phased comprehensive school screening protocol was conducted to understand the prevalence of vision impairment, refractive error, and other ocular conditions along with a survey about the daily activities of the children at school and home. Results: Among the 3655 children screened, the prevalence of vision impairment was found to be 0.62% (n = 23, 95% confidence interval [CI] 0.42–0.94) and prevalence of refractive error was 0.30% (n = 11, 95%CI 0.17–0.54), among which 0.11% (n = 4) were already wearing spectacles. A total of 44 children (1.20%; 95%CI 0.90–1.61) were found to have other ocular problems and among them, 14 (0.38%) had visual acuity less than 20/30 (6/9). Almost 84% of children required surgical or specialty eye care services. Vision impairment was more in children with other ocular conditions compared to refractive errors (P < 0.001). Conclusion: The prevalence of vision impairment and refractive errors in this tribal area was less. Ocular conditions were more prevalent than refractive errors in this tribal region with the majority of children needing specialty or surgical eye care services. This implies the need for access to secondary or tertiary eye care centers.

Background: Methaemoglobinemia is a rare disease complicating pregnancy and often diagnosed for the first time in perioperative or peripartum setting. Aim: To analyse the type of methaemoglobinemia, clinical presentation and pregnancy outcomes in our series of pregnant women with methaemoglobinemia. Methods: This is a single centre retrospective study of patients with methaemoglobinemia admitted between 2003 and 2015. Results: We had six pregnant women with methaemoglobinemia during the study period. Three women had congenital methaemoglobinemia and three of them had acquired methaemoglobinemia. Obstetric and foetal outcomes were good. Conclusion: Congenital methaemoglobinemia is reasonably well tolerated in pregnancy. With proper counselling, follow-up, avoidance of drugs associated with methaemoglobinemia and prompt diagnosis and management especially in cases of acquired methaemoglobinemia, we can achieve good pregnancy outcomes.

Abstract Pulsations of the dorsalis pedis artery are commonly used to evaluate the peripheral arterial diseases like thromboangiitis obliterans (TAO) or Buerger’s disease, in lower limbs. Dorsalis pedis artery is a direct extension from the anterior tibial artery and major vascular supply for the dorsum of the foot. But arterial variations in lower limbs are common due to rich distal anastomoses around the ankle joint. Absence of dorsalis pedis arterial pulse does not indicate peripheral arterial disease always as it is sometimes replaced by the enlarged perforating branch of peroneal artery, it may be absent or very thin, deviate laterally on the dorsum of foot. Aim of the present study is to observe the variations in origin, course and branching pattern of dorsalis pedis artery because of its clinical significance. During routine dissection of lower limbs for undergraduates we came across rare variations in the dorsalis pedis artery in its origin, course and branching pattern. Normal anatomic description was found in 27 limbs. In 13 specimens we noted variations, includes bilateral anomalous origin of dorsalis pedis artery, bilateral lateral deviation of dorsalis pedis artery, double dorsalis pedis artery, trifurcation of dorsalis pedis artery and absence of arcuate artery. Knowledge about the arterial variations around the ankle is important to orthopaedic, vascular surgeons and radiologists to prevent complications during surgical interventions.

Diet and nutritional factors affects oral health in multiple ways. Carbonated beverages have an inherent acidity due to the presence of carbonic acid, phosphoric acid and citric acid that are added to stimulate taste. Dental Erosion is an irreversible loss of dental hard tissues by a chemical process without bacterial involvement. The objective of this systematic review and meta-analysis was to evaluate the association of carbonated beverages with dental erosion. MEDLINE, Science Direct and Google Scholar were searched for articles published between January 2000 to March 2020. Observational studies reporting odds ratios for comparing the risk of dental erosion in patients reporting a frequent consumption of carbonated drink versus those with infrequent consumption were included for review. Studies not reporting odds ratio or with insufficient information to calculate odds ratio were excluded from the study. Newcastle-Ottawa scale was used to assess the quality of the studies. Pooled odds ratios and 95% confidence interval were calculated using a random-effect, generic inverse variance method. A total of 20978 participants from 21 cross sectional studies and 1 cohort study were included in the analysis. The pooled crude odds ratio (19 studies) was found out to be 1.44 (95% CI, 1.23–1.68) and pooled adjusted odd ratio (12 studies) was found out to be 1.86(95% CI, 1.42–2.42). Several clinical and methodological variation among the studies contributed to statistical heterogeneity (I2 = 69%, P ≤ 0.01 for crude odds ratio and I2 = 88%, P ≤ 0.01 for adjusted odds ratio).This systematic review study demonstrates statistically significant associations between consumption of carbonated beverages and dental erosion. Because of the high clinical and methodological heterogeneity estimated pooled effect cannot be relied upon.

Introduction: Diffuse Large B-cell Lymphoma (DLBCL) is the most common type of Non-Hodgkin Lymphoma (NHL) and is categorised into the Germinal Centre B-cell (GCB) and Activated B-cell (ABC/Non GCB) subtypes as per the Cell Of Origin (COO) model with the help of gene expression profiling/immunohistochemistry. The non GCB subtype has been found to associate with the Double Expressor (DE) phenotype (i.e., co-expression of BCL-2 and c-myc by IHC and this association was substantiated and proven to be statistically significant in the present study. Aim: To categorise all DLBCL cases into GCB and Non GCB and further into DE and Non-DE by using Hans and Choi IHC alogrithm. Materials and Methods: A retrospective study of 50 patients was carried out with the help of archival material filed in the Department of Anatomic Pathology at Dharamshila Narayana Superspeciality Hospital, New Delhi, India from 1st January 2019 to 30th June 2020. The study was approved by Instituitional Ethics Committee (IEC). The study cohort was divided into two groups- group A with nodal presentation and group B with extranodal presentation. By using the Hans and Choi IHC algorithms, the cases were categorised into the GCB and non GCB subtypes in both the groups. Chi-square test and Yates correction were used for statistical analysis. Results: The median age at presentation was 49 years (20-81 years) with a male to female ratio of 2.3:1 (35 males and 15 females). Group A with nodal disease included 28 patients and group B with extranodal disease included 22 patients. The DE phenotype was determined in each case by the co-expression of c-myc (>40%) and BCL-2 (>50%) by IHC. By using the statistical chi-square test analysis and Yates correction, the association of DE was found to be statistically significant with non GCB type lymphomas and non DE with GCB lymphomas with p-value being 0.0005 and 0.00168, respectively. Conclusion: Due to the heterogeneity inherent in DLBCL, prediction of the DE phenotype and the COO by IHC is a sensitive tool and helps in the prognostication and therapeutic triage of patients. Hence, in all the cases diagnosed as DLBCL, a detailed morphological and IHC work up is mandatory to determine prognosis and possibly tailor therapy according to COO and DE phenotype.

The kinetics of NKG2C+ adaptive natural killer (ANK) cells and NKG2A+inhibitory NK (iNK) cells with respect to the incidence of SARS-CoV-2 infection were studied for 6 months in a cohort of healthcare workers following the administration of the heat-killed Mycobacterium w (Mw group) in comparison to a control group. In both groups, corona virus disease 2019 (COVID-19) correlated with lower NKG2C+ANK cells at baseline. There was a significant upregulation of NKG2C expression and IFN-γ release in the Mw group (p=0.0009), particularly in those with a lower baseline NKG2C expression, along with the downregulation of iNK cells (p

Introduction: Radiation-induced oral mucositis (RIOM) is considered the most severe non-haematological complication affecting almost every head and neck cancer patient during the course of radiotherapy (RT). Curcumin, a herbal agent present in Indian spice 'Turmeric' has anti-inflammatory, immunomodulation and wound healing properties. The objective of this pilot randomised controlled clinical trial was to compare the effectiveness and safety of 0.1% curcumin (freshly prepared using nanoparticles) and 0.15% benzydamine mouthwash on RIOM among 74 head and neck cancer patients scheduled to receive RT. Materials and Methods: Assessment of RIOM was carried out using WHO criteria once in a week for 6 weeks. Both modified intention to treat (MIT) and per protocol (PP) analysis were carried out to test the null hypothesis of equal effectiveness on prevention and severity of RIOM. Results: As far as the onset of RIOM is concerned, MIT analysis showed that the instantaneous risk of getting the onset of RIOM was 50% lower (hazard ratio 0.5) in curcumin. Onset of RIOM was also significantly delayed (mean = 19.56, median = 21) in the test group by 2 weeks. But in 'PP' analysis, no significant difference was observed between two preparations and almost all patients experienced the onset. Both the mouthwashes were equally effective in preventing the occurrence of severe form of RIOM in PP analysis after dichotomisation of severity score (≥3 and ≤2). Conclusion: Though both the mouthwashes were not able to completely prevent the onset of RIOM and reduce the severity of RIOM, use of 0.1% curcumin mouthwash was able to significantly delay the onset of RIOM (Clinical trial registration no. CTRI/2018/04/013362).

Oral candidiasis is caused by an unregulated overgrowth of candidal species which remains in saprophytic form under healthy conditions. Probiotics can be a biologically acceptable alternative in promoting beneficial microbial flora. This review aims to provide a potential evidence for an effect of probiotic supplementation on oral candidal count as assessed by laboratory culture in randomized controlled trials (RCTs) conducted in human. PubMed (1975 to till date), Cochrane Central Register of Controlled Trials (CENTRAL, Till August 2016, Issue– 8) and Google Scholar were searched. Randomized controlled clinical trials which compared the probiotics used as single or mixture of strains, any dosage regimen, and by any form of edible or palatable vehicle either with a placebo or other controls were selected to assess the change in oral candidal count. All the in vitro studies, animal experiments, and clinical trials which had no control group/groups in the parallel arm were excluded from our final review. We screened titles and abstracts, obtained full reports of relevant trials and independently appraised them for eligibility. A total number of nine studies were included in this review and JADAD scale was used for quality assessment. In all the included studies, oral candidal count was measured by counting the CFUs after culturing the candidal colonies on selective culture mediums. Overall, this review demonstrated that there is a lack of evidence for effects of probiotics on oral Candida in lower age group but has consistent results in elderly individuals reducing high candidal count compared to any control group.

Mycobacterium-w (Mw) was shown to boost adaptive natural killer (ANK) cells and protect against COVID-19 during the first wave of the pandemic. As a follow-up of the trial, 50 healthcare workers (HCW) who had received Mw in September 2020 and subsequently received at least one dose of ChAdOx1 nCoV-19 vaccine (Mw + ChAdOx1 group) were monitored for symptomatic COVID-19 during a major outbreak with the delta variant of SARS-CoV-2 (April–June 2021), along with 201 HCW receiving both doses of the vaccine without Mw (ChAdOx1 group). Despite 48% having received just a single dose of the vaccine in the Mw + ChAdOx1 group, only two had mild COVID-19, compared to 36 infections in the ChAdOx1 group (HR-0.46, p = 0.009). Transcriptomic studies revealed an enhanced adaptive NK cell-dependent ADCC in the Mw + ChAdOx1 group, along with downregulation of the TLR2-MYD88 pathway and concomitant attenuation of downstream inflammatory pathways. This might have resulted in robust protection during the pandemic with the delta variant.

BACKGROUND: Dentists are often overlooked resources in the workforce for disaster management (DM). To determine the knowledge, attitudes, willingness, and self-perceived effectiveness to participate in DM among general dental practitioners (GDPs) of Eastern India. MATERIALS AND METHODS: A web-based online survey was conducted among 256 Dental Council of India registered GDPs of Cuttack district, Odisha. The 45-item survey comprised closed-ended questions on the demographic data of the participants, years of practice, previous experience in DM, and willingness to participate. Other domains assessed were the participants' objective knowledge of DM, attitude, and self-perceived effectiveness toward participation during disasters. Data were analyzed descriptively, and the Chi-square and Mann–Whitney U tests were used for statistical analysis, with a significance threshold of P < 0.05. RESULT: A total of 154 responses were analyzed, giving a response rate of 60.16%. The average age was ≤35 years, 59.1% were BDS dentists and 78.6% had less than 10 years of practice. Only 18% of them had previous experience with DM, and merely 3.2% were formerly trained; however, 95.5% of the dentists were willing to participate in DM. The mean DM knowledge and attitude scores were 16.12 (CI = 15.4–16.8) and 5.79 (5.45–6.13), respectively. Knowledge and attitude showed a significant correlation. About 56% indicated that they would be able to respond effectively to a disastrous event. Significant associations were observed between age group (P = 0.008), years of clinical practice (P = 0.001), qualification (P = 0.012), previous participation (P = 0.029), and self-perceived effectiveness. CONCLUSION: The knowledge regarding DM among respondents was at an average level. However, the majority of them were found to have a positive attitude toward participation in DM. Thus, including DM in dental curricula and drills for dental professionals might prove beneficial as almost all GDPs were showing greater self-perceived effectiveness and willingness to participate in disasters.

Locating potholes and repairing them is essential, but it has always been a time consuming task for the authorities. This paper presents a way that can help the authorities speed up the pothole detection process by the use of a camera-enabled Unmanned Aerial Vehicle drone. The system is further enabled with a geo-tag and reports the presence of a pothole to the central database which is accessible by the relevant authorities and the common road users. The potholes are located on an open-source map, through which the users using the road can take caution. This increases public safety and helps the concerned authorities take action faster. The model is trained with YOLOv3 algorithm to even detect potholes filled with water, and distinguish potholes from dark road patches, and etc. The results show good accuracy of 85% in detecting the potholes with a low false-negative and false-positive rate.

The theoretical (Freebase, Cationic species) and experimental investigations on the molecular structural, spectroscopic characterization, and electronic properties of N2M5MB are reported. The most stable structure of the N2M5MB was analysed by employing Density Functional Theory (DFT) at different functional such as B3LYP, PBEPBE, TPSSTPSS and IEF-PCM (Freebase) and Cationic (B3LYP, IEF-PCM)/ 6–311++G (d,p) basis set level. The Potential Energy Scan (PES) analysis has been employed to investigate the conformational preference of the title molecule. The optimized molecular geometry, vibrational assignments (FT-IR, FT-Raman) of wavenumbers have been performed for freebase, cationic species (Gas, PCM) for the individual modes of vibration. The experimental UV-Vis absorption spectrum was obtained and compared with the simulated (Freebase, Cationic species) Time-Dependent (TD-DFT-M062X) method. The FMO's, electron-hole distributions, HOMA, FLU, Hirshfeld surface analysis, Electrostatic potential surface (ESP), Fukui functions, and topological parameters were discussed. Molecular docking studies were performed for the N2M5MB (ligand) into the active site of targeted proteins (1H22, 4DTL, 5OV9) which belong to AChE inhibitors with the minimum binding energy was detected.

Introduction: Arterial supply of hand is by two arterial anastomotic arches formed by radial and ulnar arteries and their branches. The anastomoses between the branches of radial and ulnar arteries such as palmar carpal and dorsal carpal arches at the wrist and superficial and deep palmar arches in the palm, maintain a rich arterial supply to the wrist and palm. Effective collateral circulation in palm is essential in peripheral arterial diseases such as Raynaud’s disease and in harvesting radial artery or the ulnar artery for Coronary Artery Bypass Graft (CABG) surgery. Aim: To observe the variations in the formation of superficial palmar arch. Materials and Methods: A descriptive study was performed on 45 formalin fixed upper limbs of both sex in the Department of Anatomy, JSS Medical College, Mysuru, Karnataka, India. The study was conducted during routine dissection of upper limbs for undergraduates as per the Cunningham’s manual for practical anatomy. Few rare variations in the formation of superficial palmar arch and the arterial pattern of hand were noticed. The variations found were classified according to Coleman and Anson classification. Results: Out of 45 limbs, complete arch was found in 36 limbs and incomplete arch in nine limbs. In complete arch type, we found an arterial arcade, bifurcation of ulnar artery and in incomplete arch type, radial-radial anastomosis. Another rare findings of highly tortuous ulnar artery in forearm and in the palm. Conclusion: The findings in the variations of superficial palmar arch are essential in microvascular surgery, forearm fasciocutaneous flap, radial artery and ulnar artery harvesting in coronary artery bypass graft procedure.