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Parth J Rana,1 Himanshu Deshmukh,2 Urmil Shah,3 Vinod Kumar,4 Sanghamitra Kanungo,5 Deepika Singhal,6 Santosh Kumar Mahapatra,7 Ira Vakharia,8 Mukesh Jaiswal,9 Ajitkumar Gondane,10 Pooja Vaidya,10 Vinayaka Shahavi,9 Harish Shandilya,11 Dattatray Pawar,10 Akhilesh Sharma12 1Department of Retina and Trauma Surgery, Netralaya Superspeciallity Hospital, Ahmedabad, Gujarat, India; 2Department of Retina; ‘Daulat’ Deshmukh Eye Hospital, Khaparde Gardens, Amravati, Maharashtra, India; 3Department of Retina, P.N. Desai Eye Hospital, Ahmedabad, Gujarat, 380052, India; 4Department of Ophthalmology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India; 5Department of Retina, Kar Vision Eye Hospital, Bhubaneswar, Odisha, 751007, India; 6Department of Ophthalmology, GMERS Medical College and Civil Hospital, Ahmedabad, Gujarat, India; 7Department of Retina, JPM Rotary Club of Cuttack Eye Hospital and Research Institute, Cuttak, Odisha, 753014, India; 8Department of Retina, Nirmal Hospital Pvt Ltd, Surat, Gujarat, 395002, India; 9Clinical Research Department, Alkem Laboratories Ltd., Lower Parel, Mumbai, India; 10Medical Affairs Department, Alkem Laboratories Ltd., Lower parel, Mumbai, India; 11Global Product Development, IPM & Regulatory Affairs, Enzene Biosciences Ltd., Pune, India; 12Medical Affairs and Clinical Research Department, Alkem Laboratories Ltd., Lower Parel, Mumbai, IndiaCorrespondence: Ajitkumar Gondane, Medical Affairs, ALKEM Laboratories Ltd., ALKEM HOUSE, “Devashish”, Adjacent to Matulya Centre, Senapati Bapat Marg, Lower Parel, Mumbai, 400 013, India, Tel +8983375722, Email ajitkumar.gondane@alkem.comObjective: This study aimed to compare efficacy, safety, and immunogenicity of the biosimilar ranibizumab in comparison with the Innovator Ranibizumab in treatment-naive patients with neovascular (wet) age-related macular degeneration (nAMD or wAMD).Materials and Methods: This comparative, double blind, multicentre, Phase III clinical study randomized eligible patients in a 3:1 ratio to receive either OPTIMAB® (Alkem Laboratories Ltd./ Enzene Biosciences Ltd.) or Innovator Ranibizumab. Intravitreal injections of Innovator Ranibizumab (0.5 mg in 0.05 mL) and OPTIMAB® (0.5 mg in 0.05 mL) were administered every four weeks for 12 weeks (three doses). Primary efficacy endpoints included loss of < 15 letters from baseline, gain of ≥ 15 letters from baseline in visual acuity, mean change in best corrected visual acuity (BCVA) from baseline, and change in central subfoveal thickness (CSFT) from baseline at week 12. Safety was assessed through monitoring of adverse events (AEs) and serious adverse events (SAEs) throughout the study.Results: Overall, of the 152 patients randomized, 141 (92.8%) patients (mean age, 66.6 ± 9.37 years) completed the study. Percentage of patients who lost < 15 letters in BCVA at week 12 from baseline was comparable in both the groups (100.0%, each). On secondary end point analysis, the two groups had comparable mean changes in BCVA (OPTIMAB®, 11.8 ± 9.18; innovator ranibizumab, 12.9 ± 10.29; P = 0.5509); proportion of patients who gained ≥ 15 letters in visual acuity (OPTIMAB®, 32.18%; innovator ranibizumab, 25.74%; P = 0.4785) and mean change in CSFT (OPTIMAB®, − 76.6 ± 89.03; Innovator ranibizumab, − 73.1 ± 92.23 μm; P = 0.8422) at week 12 as compared to baseline. OPTIMAB® and innovator ranibizumab demonstrated comparable safety over the 12-week treatment period and no patient expressed anti-ranibizumab antibody in either group patient.Conclusion: Biosimilar ranibizumab (OPTIMAB®) was non-inferior to innovator ranibizumab in terms of efficacy, safety, and immunogenicity in the patients of nAMD.Keywords: biosimilar ranibizumab, best corrected visual acuity, central subfoveal thickness, nAMD

Introduction:Allergic rhinitis (AR), clinically compatible with Vataja pratisyaya, is a highly prevalent global health issue that has a substantial negative effect on quality of life, especially children. In the text Basavarajiyam, Shatyadhi churna is mentioned in the treatment of Pratisyaya (~rhinitis) to be taken along with Ghrita and Guda. The study was undertaken with the objective to evaluate the efficacy of Shatyadhi churna in Vataja pratisyaya w. r. t AR among children of 6–16 year age in comparison with syrup Levocetirizine (LCZ).Methods:Ethically approved trial was two-arm, randomized, open-labeled, controlled, parallel, interventional study with allocation ratio 1:1, conducted at All India Institute of Ayurveda (AIIA), New Delhi on outpatient department basis.Results:In the present study, out of total 30 enrolled participants, 16 patients were assigned to intervention group, Shatyadhi churna (trial period of 4 weeks) and 14 others were assigned to control group, Syrup LCZ (trial period of 2 weeks). Treatment with the trial drug significantly reduced the clinical features, immunoglobulin E level and improved the health-related quality of life among the participants.Conclusion:The anti-inflammatory, antihistamine, analgesic, antioxidant properties and Dipana (digestion enhancer), Ama pachana (metabolism enhancer), Anulomana (regularizing physiological movement), Srotoshodhaka (cleansing of functional channels) and Rasayana (rejuvenation) attributes of each individual drugs are responsible for Doshapratyanika (treatment specified to regulatory functional factors of body) as well as Vyadhipratyanika chikitsa (disease specific treatment) of Shatyadhi churna in the management of Vataja pratisyaya w. r. t AR.

Senescent cells are characterized by multiple features such as increased expression of senescence-associated β-galactosidase activity (SA β-gal) and cell cycle inhibitors such as p21 or p16. They accumulate with tissue damage and dysregulate tissue homeostasis. In the context of skeletal muscle, it is known that agents used for chemotherapy such as Doxorubicin (Doxo) cause buildup of senescent cells, leading to the inhibition of tissue regeneration. Senescent cells influence the neighboring cells via numerous secreted factors which form the senescence-associated secreted phenotype (SASP). Lipids are emerging as a key component of SASP that can control tissue homeostasis. Arachidonic acid-derived lipids have been shown to accumulate within senescent cells, specifically 15d-PGJ2, which is an electrophilic lipid produced by the non-enzymatic dehydration of the prostaglandin PGD2. This study shows that 15d-PGJ2 is also released by Doxo-induced senescent cells as an SASP factor. Treatment of skeletal muscle myoblasts with the conditioned medium from these senescent cells inhibits myoblast fusion during differentiation. Inhibition of L-PTGDS, the enzyme that synthesizes PGD2, diminishes the release of 15d-PGJ2 by senescent cells and restores muscle differentiation. We further show that this lipid post-translationally modifies Cys184 of HRas in C2C12 mouse skeletal myoblasts, causing a reduction in the localization of HRas to the Golgi, increased HRas binding to Ras Binding Domain (RBD) of RAF Kinase (RAF-RBD), and activation of cellular Mitogen Activated Protein (MAP) kinase–Extracellular Signal Regulated Kinase (Erk) signaling (but not the Akt signaling). Mutating C184 of HRas prevents the ability of 15d-PGJ2 to inhibit the differentiation of muscle cells and control the activity of HRas. This work shows that 15d-PGJ2 released from senescent cells could be targeted to restore muscle homeostasis after chemotherapy.

The most significant accomplishment of dentists is the early detection of oral dysplasia or the rapid diagnosis of potentially malignant lesions. An additional test that assists in the diagnosis of numerous oral illnesses is exfoliative cytology. This study was conducted among dental professionals in the city of Bhubaneswar to assess their exfoliative cytology knowledge, attitudes, and practices. Fifty-eight dental interns participated in a cross-sectional, descriptive, Web-based questionnaire study. The findings reveal that while some interns were knowledgeable about some components of exfoliative cytology in oral cancer (OC) screening, they lacked a thorough understanding of other crucial elements. To enhance early diagnosis and lessen the prevalence of OC, it is critical that dental practitioners increase their understanding of and use of exfoliative cytology. To address the misconcepts found in the study, it draws attention to the necessity of patient education and public awareness campaigns. The study recommends more awareness and education among dental practitioners and emphasizes the need of tackling OC through preventive measures and appropriate diagnostic techniques such as exfoliative cytology.

Allergy is a conundrum lacking satisfactory answers despite its global prevalence. Traditional systems of medicine may contain sustainable and effective solutions for the same. For mainstreaming them, an evaluation based on the system's own methods is inevitable rather than symptom-based correlations. Atopy is a novel entity in Ayurveda, but the methods of tripartite delineation (disease pattern, disease targets and influencing factors) of novel diseases and multifactorial approach to diagnosis and management in Ayurveda can bring about comprehensiveness in collection and categorization of data regarding the entity. This in turn can make the prediction, prevention and management of the same more precise, effective and sustainable. The article provides a template for the application of Ayurvedic biological framework in the diagnosis and management of novel diseases, with special reference to childhood allergic disorders.

Sushree Sarathi,1 Bijayini Behera,1 Ashoka Mahapatra,1 Sarita Mohapatra,2 Jayanti Jena,1 Saurav Nayak3 1Department of Microbiology, All India Institute of Medical Sciences [AIIMS], Bhubaneswar, Odisha, 751019, India; 2Department of Microbiology, All India Institute of Medical Sciences [AIIMS], New Delhi, 110608, India; 3Department of Biochemistry, All India Institute of Medical Sciences [AIIMS], Bhubaneswar, Odisha, 751019, IndiaCorrespondence: Ashoka Mahapatra, Department of Microbiology, All India Institute of Medical Sciences [AIIMS], Bhubaneswar, Odisha, 751019, India, Tel +919437302030, Email meetasoka@yahoo.co.inPurpose: Elizabethkingia is an emerging non-fermenting Gram-negative bacillus (NFGNB) causing bloodstream infections (BSI) associated with high mortality. It demonstrates a unique antimicrobial profile in showing susceptibility to antimicrobials effective against Gram-positive bacteria. This study was undertaken to determine the overall frequency of Elizabethkingia BSI, associated risk factors, microbiological susceptibility, and clonal relationship of Elizabethkingia isolates using Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR).Patients and Methods: Elizabethkingia isolates obtained from the blood culture of admitted patients (August 2020–December 2021) were identified by the VITEK 2 system and subjected to an antimicrobial susceptibility test by standard procedures. Demographics, co-morbidities, risk factors for survival, and outcome were summarized and analyzed by Chi-square test, Kaplan–Meier curve, and Cox regression. Clonal relatedness between Elizabethkingia isolates was analyzed using ERIC‑PCR fingerprinting with the “PAST: Paleontological statistics software package”.Results: Of 13,747 blood samples received during the study period, 13.59% were culture positive, and 14.60% were NFGNBs. The frequency of Elizabethkingia spp. among all NFGNBs in BSI was 29.30%, and the overall prevalence in BSI was 4.21%. In patients with Elizabethkingia BSI, Foley’s catheter was present in 81.25% of the cases. 100% susceptibility was observed to linezolid, followed by vancomycin (98.75%) and chloramphenicol (89.5%). The 30-day mortality rate in the patients of Elizabethkingia BSI was 26.25%. The Presence of COVID-19, pneumonia, diabetes mellitus (DM), mechanical ventilation (MV), and prior antibiotics were significantly different (p< 0.05) between the survival and death groups. ERIC-PCR profile dendrogram of Elizabethkingia isolates showed ten major clusters indicating high genetic diversity.Conclusion: Elizabethkingia was responsible for one-third of NFGNB BSI in a single-center study, with approximately 26% of 30-day all-cause mortality. Most isolates were susceptible to linezolid, vancomycin, and chloramphenicol. COVID-19 was the most significant risk factor associated with mortality. ERIC-PCR of Elizabethkingia isolates exhibited high genetic diversity.Keywords: Elizabethkingia, bloodstream infection, risk factor, ERIC PCR typing