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Statement of the Problem: It is essential to address caries risk at an early stage for the prevention of dental caries. Mobile application CaRisk is designed in a particular way to self-assess the dental caries risk by the individual’s themselves.Purpose: The current study aimed to assess the dental caries risk among age groups 5-6 and 35-44 using self-assessment caries risk mobile application CaRisk and compare it with the deft and DMFT values.Materials and Method: This cross-sectional study was conducted in Chennai, India; to evaluate the risk of dental caries in children aged 5 to 6 and adults aged 35 to 44. The scores of the mobile application CaRisk and the decayed- extracted- filled teeth (deft)/ decayed-missing-filled-teeth (DMFT) caries risk assessment were evaluated. Descriptive statistics were performed. The risk category was determined by frequency. Chi-square analysis was done to determine whether the DMFT scores and the CaRisk mobile app were associated. The correlation was performed between the CaRisk mobile application and DMFT scores.Results: Association was found between the caries risk assessment score of the mobile application CaRisk and the DMFT and deft scores of the adults and children for both the age groups 5-6 and 35-44 years respectively and it indicates that it was found to be statistically significant. Pearson’s correlation was performed to assess the strength of association and R-values obtained for the age group 5-6 and 35-44 years respectively, which was statistically significant (0.892 and 0.840).Conclusion: This CaRisk mobile application scores correlate with the deft and DMFT scores and it is an effective self-diagnosis tool for assessing dental caries risk assessment. Further, it is suggested that the mobile application CaRisk should be tested among a huge population.

In this work we present the synthesis of benzimidazole-quinoline hybrids series (9a-c and 10a-f), characterized using spectroscopy studies (FT-IR, 1H NMR, and mass spectroscopy). The precursor for the hybrid compounds consists of two schemes: i. synthesis of substituted quinoline-4-carboxylic acids (3a-b) with various acetophenones. ii. The key intermediates (8a-c) were obtained initially from the benzimidazole-5-carboxylates (7a-c), were efficiently synthesized by ‘one pot’ nitro reductive cyclization reaction between ethyl 3-nitro-4-(substituted amino) benzoates 6a-c and 5-bromothiophene-2-carbaldehyde. iii. Further, the benzimidazole esters (7a-c) were converted into the corresponding hydrazides (8a-c) and then finally obtained the benzimidazole-quinoline hybrids series (9a-c and 10a-f). Compounds 7a and 7b were crystallized and their molecular structures were determined using a single crystal X-ray diffraction method. The resultant compounds from the synthesis were screened (in-silico and in-vitro) for their anti-cancer activities (human melanoma cell line (A375) and human breast cancer cell line (MDA-MB-231)). The p53 receptor protein was used for the molecular docking analysis and compound (name) 10b binds the target site with four hydrogen bonds (−6.25 Kcal/mol). The antioxidant activity revealed compounds 9a (IC50 = 604.8 μg/mL) and 9b (IC50 = 604.8 μg/mL 683.7 μg/mL) to exhibit the highest percentage of inhibition and lowest IC50 value. In addition, compounds 10a and 10b showed high scavenging activity. The compounds 9a (A375: IC50 = 34.7 ± 0.9 µg/mL and MDA-MB-231: IC50 = 20.4 ± 1.1 µg/mL), 10a (A375: IC50 = 19.6 ± 1.3 µg/mL and MDA-MB-231: IC50 = 37.0 ± 1.3 µg/mL) and 10b (A375: IC50 = 16.5 ± 1.5 µg/mL and MDA-MB-231: IC50 = 13.4 ± 1.5 µg/mL) showed the significant cytotoxicity against these human cancer cell lines (melanoma and breast cancer) and can be potential anti-cancer molecules.

Social media is a technology that supports the sharing of content, multimedia, and information through virtual networks and communities. The aim of this study was to determine the role of Twitter in oral health information and promotion. This systematic review was carried out using a transparent methodology in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An extensive literature search was carried out in PubMed, Trip database, and Google Scholar database from the year 2006 to 2023. The search generated 1901 articles. Five articles were selected for this review. The majority of the articles in this review demonstrated a positive association between Twitter and the promotion of oral health by assessing oral health campaign tweets and emotional experiences shared regarding people's dental health.

Plant diseases, mainly caused by bacteria and fungi, affect crop yield and quality. Detecting disease symptoms at an early stage and promptly is a significant obstacle in safeguarding crops. In developing nations, experts and agronomists commonly opt for visual identification of diseases on vast farms, which incurs both time and monetary expenses. Scientists have suggested diverse deep neural network architectures for recognizing plant ailments. Nevertheless, deep learning algorithms necessitate a vast amount of parameters, which extends the training duration but yields commendable precision. While deep learning and Densenet are widely used in pesticide recommendations. Researchers have suggested diverse deep-learning architectures for detecting agricultural ailments and recommend appropriate pesticides. Test images were diagnosed using an automated Densenet model and the results were verified by plant pathologists. An accuracy of over 92% was achieved in identifying the disease. Our solution is an innovative, scalable and accessible tool for disease management of various crops that can be implemented as a cloud service for farmers and professionals involved sustainable agricultural production.

ABSTRACTObjectives The objectives of this paper are to (a) explore stakeholders’ opinions regarding Nepal’s existing medicines pricing practices/situation and (b) build and present a set of medicines pricing policies for Nepal.Methods A review of the literature and field visits to community retail pharmacies, hospital pharmacies, wholesalers, and distributor outlets in Kathmandu were conducted to assess the medicines pricing situation. Following the literature review, preliminary meetings with stakeholders and field visits were held and a draft interview guide was prepared. Consultative sessions subsequently were undertaken in Kathmandu, Nepal, in January 2023 with representatives from the Department of Drug Administration, Ministry of Health and Population, Association of Pharmaceutical Producers of Nepal, consumer groups, Transparency International, Medicines Importers Association of Nepal/ Pharmaceutical Distributors Association of Nepal, Nepal Chemist and Druggist Association, and Nepal Pharmaceutical Association. Notes were taken during these meetings regarding issues and concerns raised as well as experiences and recommendations for the future, as outlined in the interview guide.Results The stakeholders in general stated that they do not have any objection to price regulation; however, they believe such regulation should be subject to periodic review. Both the importers and the Ministry of Health and Population have the view that an independent body/authority should be charged with regulating the prices of medicines. A set of policy options to be considered for use in Nepal include cost-plus pricing, external price referencing, internal reference pricing, and mark-up regulations.Conclusion Key issues related to pricing were identified and suggest that a set of pricing policies and updated regulations need to be considered to establish changes that are transparent, rational, and acceptable to the related stakeholders. Hence, suggestions made in this paper could be useful to inform a rational and fair pricing structure and to improve access to medicines.

Rice false smut, which is caused by the soil-borne fungal pathogen Ustilaginoidea virens (U. virens), is one of the most threatening diseases in most of the rice-growing countries including India that causes 0.5–75% yield loss, low seed germination, and a reduction in seed quality. The assessment of yield loss helps to understand the relevance of disease severity and facilitates the implementation of appropriate management strategies. This study aimed to mitigate biotic stress in rice by employing a rhizobacterial-based bioformulation, which possesses diverse capabilities as both a plant growth promoter and a biocontrol agent against U. virens. Rhizobacteria were isolated from the soil of the rice rhizospheres from the healthy plant of the false smut affected zone. Furthermore, they were identified as Bacillus strains: B. subtilis (BR_4), B. licheniformis (BU_7), B. licheniformis (BU_8), and B. vallismortis (KU_7) via sequencing. Isolates were screened for their biocontrol potential against U. virens under in vitro conditions. The antagonistic study revealed that B. vallismortis (KU_7) inhibited U. virens the most (44.6%), followed by B. subtilis BR_4 (41.4%), B. licheniformis BU_7 (39.8%), and B. licheniformis BU_8 (43.5%). Various biochemical and plant growth promoting attributes, such as phosphate and Zn solubilization, IAA, ammonium, siderophore, and chitinase production, were also investigated for all the selected isolates. Furthermore, the potential of the isolates was tested in both in vitro and field conditions by employing talc-based bioformulation through bio-priming and root treatment. The application of bioformulation revealed a 20% decrease in disease incidence in plants treated with B. vallismortis (KU_7), a 60.5% increase in the biological yield, and a 45% increase in the grain yield. This eco-friendly approach not only controlled the disease but also improved the grain quality and reduced the chaffiness.

Fatty liver is the earliest response of the liver to excessive alcohol consumption. Previously we identified that chronic alcohol administration increases levels of stomach-derived hormone, ghrelin, which by reducing circulating insulin levels, ultimately contributes to the development of alcohol-associated liver disease (ALD). In addition, ghrelin directly promotes fat accumulation in hepatocytes by enhancing de novo lipogenesis. Other than promoting ALD, ghrelin is known to increase alcohol craving and intake. In this study, we used a ghrelin receptor (GHSR) knockout (KO) rat model to characterize the specific contribution of ghrelin in the development of ALD with emphasis on energy homeostasis. Male Wistar wild type (WT) and GHSR-KO rats were pair-fed the Lieber-DeCarli control or ethanol diet for 6 weeks. At the end of the feeding period, glucose tolerance test was conducted, and tissue samples were collected. We observed reduced alcohol intake by GHSR-KOs compared to a previous study where WT rats were fed ethanol diet ad libitum. Further, when the WTs were pair-fed to GHSR-KOs, the KO rats exhibited resistance to develop ALD through improving insulin secretion/sensitivity to reduce adipose lipolysis and hepatic fatty acid uptake/synthesis and increase fatty acid oxidation. Furthermore, proteomic data revealed that ethanol-fed KO exhibit less alcohol-induced mitochondrial dysfunction and oxidative stress than WT rats. Proteomic data also confirmed that the ethanol-fed KOs are insulin sensitive and are resistant to hepatic steatosis development compared to WT rats. Together, these data confirm that inhibiting ghrelin action prevent alcohol-induced liver and adipose dysfunction independent of reducing alcohol intake.

Air pollution constitutes a significant global challenge in both public health and the environment, particularly for countries undergoing industrialization and transitioning from low- to middle-income economies. This study aims to investigate the feasibility and effectiveness of a real-time air quality prediction system based on data collected from Internet of Things (IoT) sensors to help people and public institutions track and manage atmospheric pollution. The primary objective of this study was to investigate whether an IoT-based approach can provide accurate and continuous real-time air quality forecasting. The standard dataset provided by the Indian government was analyzed using regression, traditional Long-Short-Term Memory (LTSM), and bidirectional LSTM (BLSTM) models to evaluate their performance on multivariate air quality features. The results show that the proposed BLSTM model outperformed the other models in minimizing RMSE errors and avoiding overfitting.

Recipients of hematopoietic stem cell transplants and solid organ transplants frequently develop pulmonary infiltrates from both infectious and non-infectious etiologies. Differentiation and further characterization of microbiologic etiologies—viral, bacterial, and fungal—can be exceedingly challenging. Pediatric patients face unique challenges as confirmatory evaluations with bronchoscopy or lung biopsy may be limited. A generalizable approach to diagnosing and managing these conditions has not been well established. This paper aims to summarize our initial clinical approach while discussing the relative evidence informing our practices. A pediatric patient with characteristic infiltrates who has undergone HSCT is presented to facilitate the discussion. Generalizable approaches to similar patients are highlighted as appropriate while highlighting considerations based on clinical course and key risk factors.

Introduction: Truck drivers, though forming an integral part of a vital trade link for the Indian population, lack basic life insurance and health care benefits offered by other organized sectors in Indian Industries. This paper aims to present the initial findings of the “VaaiGanam” program which proposes to identify tobacco use and the prevalence of Oral potentially malignant disorders (OPMDs) among truck drivers who are stationed or passing via Chennai and provide cessation services by behavioral therapy. Methods: This cross-sectional study was conducted by a dental screening team who were involved in data collection and screening of the 747 truck drivers who fulfilled the inclusion and exclusion criteria between Jan to Oct 2022. After data collection, oral examinations were done and suspicious lesions were sought for expert opinion. A standard punch biopsy was taken from those lesions requiring confirmation. Results: Among the 747 subjects who participated in this program, 704 (94.2%) were current users of various tobacco products, with 235 (31.4%) preferring smoking and the rest 469(62.8%) using smokeless tobacco products. Oral mucosal lesions were recorded in 49 (6.5%) of the study population, mostly among tobacco users. Punch/incisional biopsies were taken among 17 of the 49 subjects and oral dysplasia was histopathologically confirmed in 9 (mild epithelial dysplasia = 5; moderate epithelial dysplasia = 4) subjects. Conclusion: Truck drivers with tobacco and substance abuse are at high risk of developing oral cancer and hence this study emphasizes the importance of periodic oral cancer screening programs for this vulnerable population to identify potentially malignant oral lesions at an early stage.

BackgroundThere is a high incidence of oral cancer and oral potential malignant disorder observed in southeast Asian countries such as India. Our study aimed to assess the correlation between screening and histopathological diagnosis and to predict the specificity and sensitivity of chair-side/field-based assessment of the oral lesion.Materials and methodsA total of 40,852 subjects aged between 20 and 60 years were screened in the 1st phase of the study, suspected lesions were stained with toluidine blue (Manufactured by Otto Chemicals private limited, India) at two time points, those who stained positively during the two points were taken up for biopsy. Provisional diagnosis was later correlated with histopathological diagnosis.ResultsSubjects who underwent biopsy had a mean age of (49.01 ± 9.8 years), Leukoplakia (1.5%) was the most common lesion observed among tobacco users, interestingly it had the least correlation (39.6%) in diagnosis, Overall sensitivity (88%) and a positive predictive value (80%) was high for clinical diagnosis of OPMD in our study.ConclusionCorrelation of clinical and histopathological diagnosis observed in our study confirms higher yield of true positives while screening in remote and vulnerable populations, which would assure a better quality of life for these subjects.

Abstract Raffinose family oligosaccharides (RFOs) are known to have important physiological functions in plants. However, the presence of RFOs in legumes causes flatulence, hence are considered antinutrients. To reduce the RFOs content to a desirable limit without compromising normal plant development and functioning, the identification of important regulatory genes associated with the biosynthetic pathway is a prerequisite. In the present study, through comparative RNA sequencing in contrasting genotypes for seed RFOs content at different seed maturity stages, differentially expressed genes (DEGs) associated with the pathway were identified. The DEGs exhibited spatio-temporal expression patterns with high RFOs variety showing early induction of RFOs biosynthetic genes and low RFOs variety showing a late expression at seed maturity. Selective and seed-specific differential expression of raffinose synthase genes (AhRS14 and AhRS6) suggested their regulatory role in RFOs accumulation in peanut seeds, thereby serving as promising targets in low RFOs peanut breeding programs. Despite stachyose being the major seed RFOs fraction, differential expression of raffinose synthase genes indicated the complex metabolic regulation of this pathway. The transcriptomic resource and the genes identified in this study could be studied further to develop low RFOs varieties, thus improving the overall nutritional quality of peanuts.

Universal Health Coverage (UHC) is instrumental for achieving sustainable development goals (SDGs) and its agenda of leaving no one behind (LNOB). For resource poor setting, the frictions between free health services, priority programs and health insurance schemes are not unlikely. Asynchronous safety nets - free health services, subsidized or targeted free programs, with existing health insurance schemes fail to protect the population from catastrophic out of pocket expenditure in health. Multiple scientific publications and media narratives have declared health insurance to be failing in Nepal, they either recommend or report government of Nepal (GoN) to restructure health insurance program. The answers on how to restructure are catered in the scope of coverage of health insurance schemes, application of contextual evidence for ethical priority setting and appropriate packaging of safety nets. Evidences clearly show that uptake of insurance schemes have multiple supply and demand side factors and they are contextual, thus one size fit for all approach will not be effective. It is high time government reconsiders rigorous and ethical priority setting for packaging of safety nets synchronous with health insurance program, committed and transparent governance, vigilant civil societies and commitment of political leadership for paving path towards universal health coverage.

Access to health facilities alone, without quality services, does more harm than the benefit to the people’s health. Nepal has invested more than two decades in expansion of number of health facilities and the journey is still on to balance level of health facilities based on the federal structure. Institutionalization of Minimum Service Standards (MSS) for health facilities in Nepal implemented by Ministry of Health and Population is an exemplary Plan-Do-Study-Act (PDSA) cycle for health facilities readiness and service availability for quality improvement. From its design, development, stakeholders’ engagement, implementation to development of action plan makes MSS lively and outcome oriented tool. MSS for health facilities in Nepal is an effort of government to prepare foundation of readiness and service availability to move ahead with effective quality service utilization. Digitalization of the all sets of MSS, development of MSS to cover the existing type of the health facilities currently present in the country and access of data set for researchers is the way forward. Developing standards for national accreditation system and international collaboration is the next step to embrace. Furthermore, MSS gradually reported through self assessment of the health facilities with occasional monitoring by the local, provincial and federal government and gap fulfillment through routine annual work plan and budgeting is the future direction. It is high time MoHP moves ahead with service specific quality improvement tools integrated with MSS assessment prepare them for high quality health systems that can adapt to changing health needs and health shocks.

The liver is a major metabolic organ that performs many essential biological functions such as detoxification and the synthesis of proteins and biochemicals necessary for digestion and growth. Any disruption in normal liver function can lead to the development of more severe liver disorders. Overall, about 3 million Americans have some type of liver disease and 5.5 million people have progressive liver disease or cirrhosis, in which scar tissue replaces the healthy liver tissue. An estimated 20% to 30% of adults have excess fat in their livers, a condition called steatosis. The most common etiologies for steatosis development are (1) high caloric intake that causes non-alcoholic fatty liver disease (NAFLD) and (2) excessive alcohol consumption, which results in alcohol-associated liver disease (ALD). NAFLD is now termed “metabolic-dysfunction-associated steatotic liver disease” (MASLD), which reflects its association with the metabolic syndrome and conditions including diabetes, high blood pressure, high cholesterol and obesity. ALD represents a spectrum of liver injury that ranges from hepatic steatosis to more advanced liver pathologies, including alcoholic hepatitis (AH), alcohol-associated cirrhosis (AC) and acute AH, presenting as acute-on-chronic liver failure. The predominant liver cells, hepatocytes, comprise more than 70% of the total liver mass in human adults and are the basic metabolic cells. Mitochondria are intracellular organelles that are the principal sources of energy in hepatocytes and play a major role in oxidative metabolism and sustaining liver cell energy needs. In addition to regulating cellular energy homeostasis, mitochondria perform other key physiologic and metabolic activities, including ion homeostasis, reactive oxygen species (ROS) generation, redox signaling and participation in cell injury/death. Here, we discuss the main mechanism of mitochondrial dysfunction in chronic liver disease and some treatment strategies available for targeting mitochondria.

Background: Exposure to tobacco at a young age leads to a subsequent smoking habit in large proportions of the population in adulthood. Social and mass media have both positive and negative effects on adolescents’ behavior and social skills and therefore play vital roles in driving this behavior. Objectives: The purpose of this study was to assess the influence of film stars on smoking initiation and tobacco use among male adolescents aged 13–15 years in Chennai city, Tamil Nadu, India. Methods: The study adopted a cross-sectional design. In total, 200 students from schools that serve low-income households participated in the study. All the students completed a 20-item questionnaire on the perceived severity of smoking, perceived barriers to quitting, and factors affecting quitting. Results: None of the participants had a history of smoking. One (0.5%) participant stated that he smoked daily. All the participants agreed that exposure to media images of smoking behavior among their favorite film stars would not encourage them to smoke. In terms of peer pressure, one (0.5%) participant stated that he would accept a cigarette if offered one by a friend. Only descriptive information of the collected data was tabulated as the aim of the study was to collect the baseline data and not to test any prespecified hypothesis. Conclusion: In our study, peer pressure seemed to play more influence on the smoking initiation by adolescents than the film stars on mass media. Though all of them agreed that they would not be provoked by media images of film stars smoking, one participant was likely to initiate the habit on being offered by his friend. Hence, the evidence suggests the need for reorientation of research modalities to better identify early initiators of smoking.

Oral cancer constitutes around 2.1% and it is the sixth-most common malignancy worldwide and the third-most common type of malignancy in India. The purpose of this systematic review is to find the prediction of survival rate among oral cancer patients using artificial intelligence (AI) and its forms like machine learning. Suitable articles were identified by searching PubMed, Trip database, Cochrane, and Google Scholar host databases. The search was done with the help of PIO analysis where the population stands for oral cancer patients, the intervention given here were AI and its subsets and the outcome were diagnosis and survival prediction of oral cancer. The screening of the titles and abstracts was done, and only those articles that fulfilled the eligibility criteria were selected. The search resulted in 451 articles, of which only six articles that fulfilled the criteria were included. The studies showed that AI models were able to predict the 5-year survival rate among oral cancer patients. The accuracy of the decision tree classifier, logistic regression, and boosted decision tree models were 76%, 60%, and 88.7%, respectively. Modern age diagnosed people tend to have a longer survival rate than those diagnosed in the past. The limitation was that these studies were created using retrospective cohorts, but for validation, they must be compared with prospective cohorts. These studies are important for identification and survival prediction, which will contribute to future advancements, change in the treatment plan, and reduce health-care problems.

The detailed investigation of post-oxidation phenomena based on gas emissions, PM and gas temperature were performed on a turbocharged DISI engine. In post-oxidation phenomena, rich air-fuel mixture is used inside cylinder and this rich excursion gives rise to the production of CO, THC, PM and H2 emissions. Then the scavenged O2 and emitted H2 play a key role for post-oxidation reaction (exothermic) with CO, THC and PM in exhaust manifold and in-turn can aid in increasing the temperature along with overcoming of decrease in temperature by heat absorption reaction. The actuation time delay of reaction was also investigated with emissions and temperature with fast response devices in transient mode.

Binge drinking is the most common form of excessive alcohol use. Repeated episodes of binge drinking cause multiple organ injuries, including liver damage. We previously demonstrated that chronic ethanol administration causes a decline in the intrahepatic ratio of S-adenosylmethionine (SAM) to S-adenosylhomocysteine (SAH). This decline causes impairments in essential methylation reactions that result in alcohol-induced fatty liver (steatosis) and other features of alcohol-associated liver disease (ALD). Co-treatment with betaine during chronic ethanol feeding, normalizes hepatocellular SAM:SAH ratio and alleviates many features of liver damage including steatosis. Here, we sought to examine whether betaine treatment similarly protects against liver injury in an alcohol binge-drinking model. We hypothesized that ethanol binge with prior or simultaneous betaine administration would prevent or attenuate acute alcohol-induced liver damage. Male C57Bl/6 mice were gavaged twice, 12 h apart, with either 6 g ethanol/kg BW or with an equal volume/kg BW of 0.9% NaCl. Two separate groups of mice (n = 5/group) were gavaged with 4 g betaine/kg BW, either 2 h before or simultaneously with the ethanol or saline gavages. All mice were sacrificed 8 h after the last gavage and serum and liver parameters were quantified. Ethanol binges caused a 50% decrease in hepatic SAM:SAH ratio and a >3-fold rise in liver triglycerides (p ≤ 0.05). These latter changes were accompanied by elevated serum AST and ALT activities and blood alcohol concentrations (BAC) that were ∼three-times higher than the legal limit of intoxication in humans. Mice that were treated with betaine 2 h before or simultaneously with the ethanol binges exhibited similar BAC as in mice given ethanol-alone. Both betaine treatments significantly elevated hepatic SAM levels thereby normalizing the SAM:SAH ratio and attenuating hepatic steatosis and other injury parameters, compared with mice given ethanol alone. Simultaneous betaine co-administration with ethanol was more effective in preventing or attenuating liver injury than betaine given before ethanol gavage. Our findings confirm the potential therapeutic value of betaine administration in preventing liver injury after binge drinking in an animal model.

Abstract Introduction The prevalence of depression and suicidality is high among men who have sex with men (MSM) and transgender women (TGW) worldwide. Stigma and discrimination are likely contributing factors. More research is needed in low-income, non-English speaking countries to assess the effects of social and structural factors on depression and suicidality among MSM and TGW. Methods Nepalese MSM and TGW (n = 340) were recruited using a respondent-driven sampling design and filled out a survey questionnaire. The outcomes were depression and suicidality. Data was analyzed using bivariate and multivariable logistic regression. Results More than half of the participants (59%) suffered from depression. Severe depression was more common among TGW compared to MSM (41 and 20%, respectively). When it comes to suicidality, TGW had higher lifetime prevalence of suicidal thoughts compared to MSM (32 and 5%, respectively). Depression was positively associated with sex work both for MSM (AOR: 7.9; 95% CI 3.4–18.2) and TGW (AOR: 6.5; 95% CI: 2.3–18.2). MSM who were evicted by family had high odds of suicidal thoughts (AOR: 6.2; 95% CI: 1.3–28.8). For TGW, suicidality was associated with being cheated and threatened (AOR: 3.9; 95% CI: 1.2–12.5) and having forced to marry a female (AOR: 2.2; 95% CI 1.1–5.1). Conclusions Nepalese MSM and TGW suffer from a high degree of mental and psychosocial health issues. Future studies should focus on intervention research and on collecting data from a larger variety of gender and sexual minorities.

Abstract It has been previously shown that chronic ethanol administration-induced increase in adipose tissue lipolysis and reduction in the secretion of protective adipokines collectively contribute to alcohol-associated liver disease (ALD) pathogenesis. Further studies have revealed that increased adipose S-adenosylhomocysteine (SAH) levels generate methylation defects that promote lipolysis. Here, we hypothesized that increased intracellular SAH alone causes additional related pathological changes in adipose tissue as seen with alcohol administration. To test this, we used 3-deazaadenosine (DZA), which selectively elevates intracellular SAH levels by blocking its hydrolysis. Fully differentiated 3T3-L1 adipocytes were treated in vitro for 48 h with DZA and analysed for lipolysis, adipokine release and differentiation status. DZA treatment enhanced adipocyte lipolysis, as judged by lower levels of intracellular triglycerides, reduced lipid droplet sizes and higher levels of glycerol and free fatty acids released into the culture medium. These findings coincided with activation of both adipose triglyceride lipase and hormone sensitive lipase. DZA treatment also significantly reduced adipocyte differentiation factors, impaired adiponectin and leptin secretion but increased release of pro-inflammatory cytokines, IL-6, TNF and MCP-1. Together, our results demonstrate that elevation of intracellular SAH alone by DZA treatment of 3T3-L1 adipocytes induces lipolysis and dysregulates adipokine secretion. Selective elevation of intracellular SAH by DZA treatment mimics ethanol’s effects and induces adipose dysfunction. We conclude that alcohol-induced elevations in adipose SAH levels contribute to the pathogenesis and progression of ALD.