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Introduction: Adequate knowledge and positive attitude among nurses are essential for successful pain management as a fundamental aspect of patients' rights. This study aimed to assess the knowledge, attitude and perceived barriers of nurses regarding acute pain management in emergency department., Methods: In this cross-sectional study, participating nurses were selected using a consecutive sampling technique within a medical university. Data were collected using 4 questionnaires, which consisted of demographic information checklist, Pain Management Principles Assessment Tool (PMPAT), Nurses' Attitude Survey (NAS), and Nurses' practice checklist. The correlation between knowledge, attitude, and barriers with each other and with baseline characteristics of participates were studied., Results: 400 nurses with the mean age of 38.26±10.39 years were studied (63% male). The average knowledge score of studied nurses was 7.38 ± 2.16 (range: 1 -14). All 400 (100%) nurses exhibited a low level of knowledge. The mean attitude score of participants was 58.47± 22.08 (range:26-100). 214 (53.5%) cases had low attitude, 44 (11.0 %) average attitude, and 142 (35.5%) cases exhibited a high attitude score. The mean score of barriers about pain management was 36.48 ± 23.52 (range: 0 - 80). 23 (5.8%) participants answered the perceived barriers as never, 113 (28.3%) as seldom, 71 (17.8%) as sometimes, 133 (33.3%) as often, and 60 (15.0%) as routine. There was an reverse relationship between the knowledge score and perceived barriers of pain management (r=-0.164, p<0.001). No significant relationship was found between the average knowledge score and nurses' attitudes (r = 0.092; p > 0.065)., Conclusions: The findings of this study highlight the need for ongoing training and the organization of workshops for nurses due to their low levels of knowledge and attitude. These training sessions should focus on the concept of pain, assessment methods, pain relief, as well as pharmacology and the physiology of pain., Competing Interests: The authors declare that there are no competing interests.

In this research, parboiling was carried out at different times (5 and 15 min) on germinated paddy rice (GPR) from various basmati and non-basmati varieties. The results showed that as the parboiling time increased from 5 to 15 min, Δ $\Delta $ E, ash content, total dietary fiber, mineral content, cooking time, and textural properties increased while L*, lipid content, total starch, gruel solid loss, water absorption, oil absorption, foaming capacity, sugar profile, and total phenolic and flavonoid content decreased as compared to GPR. All pasting properties of GPR increased except breakdown as the parboiling time increased from 5 to 15 min. Parboiling altered the properties of GPR due to starch gelatinization. Total essential amino acid and gamma-aminobutyric acid decreased as the parboiling time (5 to 15 min) increased. The germinated parboiled brown rice could create a highly nutritious alternative to regular brown rice as it offers improved texture and cooking qualities., (© 2024 Institute of Food Technologists.)

Optoelectronic chromatic dispersion (OED) is a significant source of effective chromatic dispersion in photodiodes. We present an experimental and theoretical study of OED in PN-type Si photodiodes and photovoltaic cells and report on a very large effective chromatic dispersion in these devices. As measured with the modulation phase-shift technique at a frequency of 4 kHz for these slow devices, the OED spectral sensitivity for a commercial Si photodiode is approx. 0.02 deg/nm in the 720-850 nm wavelength band and increases to 0.25 deg/nm at λ = 1µm. For a Si photovoltaic cell, the OED is approx. 0.09 deg/nm in this spectral region. These values translate into an effective chromatic dispersion parameter of approx. 10 12 ps/( n m × k m ) for these sub-millimeter device lengths, which is over eight orders of magnitude larger than high-dispersion materials such as chalcogenide glass. The enormous dispersion in these sub-millimeter sized silicon-based devices can be utilized for on-chip optoelectronic sensors such as wavelength monitoring and spectroscopy. The substantial OED of photovoltaic cells can be utilized for the characterization and optimization and new applications for optical sensing with these self-powered devices.

Childbirth fear is a prevalent concern among pregnant women, and its measurement is crucial for effective clinical intervention. This article presents a comprehensive review of existing tools for assessing childbirth fear, aiming to assist researchers and health-care professionals in selecting appropriate instruments for their work. A systematic search was conducted across multiple electronic databases, resulting in the identification of twenty tools specifically developed for assessing childbirth fear. The characteristics and psychometric properties of each tool were analyzed. Most tools were Likert scale based, with some employing visual analog tools and dichotomous tools. The identified tools were employed in diverse research designs, including experimental studies and observational studies. Among the tools reviewed, the Wijma Delivery Expectancy Questionnaire emerged as a frequently used and well-validated instrument. It demonstrated good psychometric properties, assessing fear of childbirth through women's expectations and experiences. Other notable tools included the Fear of Birth Scale, Childbirth Experience Questionnaire, and Tokophobia Severity Scale, each addressing specific aspects of childbirth fear. However, some tools lacked thorough testing for validity and reliability, indicating the need for further refinement and evaluation. Researchers can utilize this comprehensive overview to select appropriate tools for their investigations. Clinicians and health-care professionals working with pregnant women can benefit from the identified tools to assess and monitor childbirth fear, aiding in early detection and timely intervention. In conclusion, this review emphasizes the need for well-validated and culturally sensitive tools, facilitating a better understanding of this complex phenomenon and ultimately contributing to improved care for pregnant women., (Copyright © 2024 Copyright: © 2024 WHO South-East Asia Journal of Public Health.)

Objective: Childbirth is a complex process with various dimensions including physical, psychological, emotional, social, and cultural aspects. The study intended to assess the effectiveness of Nurse led FALCI (Fear and Apprehension related to Labour or Childbirth Improving) Intervention in reducing childbirth fear among pregnant women., Materials and Methods: A quasi-experimental study was conducted among 115 pregnant women (selected through purposive sampling) at antenatal OPD of tertiary care hospital of Bhopal. Data was collected using Wijma Delivery Expectancy Questionnaire (DEQ) and self-structured questionnaire on socio-demographic and clinical variables. The intervention (FALCI) was carried out in two phases, each lasting for 30 minutes conducted at week 3-4 and week 5-6 and information booklet was provided for reinforcement. The data was analysed using two-way repeated measures mixed ANOVA (within group and between groups)., Results: Findings revealed that most of the pregnant women in both experimental (68.5%) and control (90.2%) group had high level of childbirth fear. Post-intervention data revealed mean of pretest, posttest 1 and posttest 2 were 73.85, 46.94 and 37.90 in experimental group and the mean of pretest, posttest 1 and posttest 2 were 75.49, 72.59 and 72.67 in control group respectively and found that there is significant difference in childbirth fear (within group, F value=114.69, p<0.001 in experimental group and F =0.575, p=0.564 in control group) and between groups (F value= 81.52, p value <0.001). However, no significant association was found between childbirth fear and sociodemographic/clinical variables., Conclusion: The study findings revealed that Nurse led FALCI intervention was effective in reducing childbirth fear among the pregnant women and it is recommended that such intervention must be planned at all levels and implemented as routine protocol in maternity services., Competing Interests: Conflict of Interests Authors declare no conflict of interests., (Copyright © 2023 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Lalatendu Moharana The Anaplastic lymphoma kinase inhibitors (ALKi) represent the standard of care for metastatic non-small cell lung cancer (NSCLC) patients with EML4-ALK rearrangements. Various ALKi agents are available; however, not all eligible patients receive treatment with them due to various reasons. Given the limited real-world data available in our country, we aimed to assess treatment outcomes through a multicenter collaboration. This retrospective, multi-institutional study was conducted under the Network of Oncology Clinical Trials India and included a total of 67 ALK-positive metastatic lung cancer patients from 10 institutes across India, with a median follow-up of 23 months. In the first line setting, the objective response rate (ORR) with ALKi was 63.6% (crizotinib: 60.7%, ceritinib: 70%, alectinib: 66.6%, p  = 0.508), while with chemotherapy, it was 26.1%. The median progression-free survival (mPFS) for the first line ALKi group was significantly higher than that for chemotherapy (19 vs. 9 months, p  = 0.00, hazard ratio [HR] = 0.30, 95% confidence interval [CI]: 0.17-0.54). The mPFS for crizotinib, alectinib, and ceritinib was 17, 22, and 19 months, respectively ( p  = 0.48). Patients who received ALKi upfront or after 1 to 3 cycles of chemotherapy or after 4 or more cycles of chemotherapy had mPFS of 16, 22, and 23 months, respectively ( p  = 0.47). ALKi showed superior mPFS compared to chemotherapy in the second line (14 vs. 5 months; p  = 0.002) and the third line (20 vs. 4 months; p  = 0.009). The median overall survival (OS) was significantly better in patients who received ALKi in any line of therapy (44 vs. 14 months, p  < 0.001, HR = 0.10, 95% CI: 0.04-0.23). Brain progression was higher among those who did not receive ALKi (69.2 vs. 31.5%). In conclusion, the use of ALKi as first line treatment for ALK-positive metastatic NSCLC patients resulted in improved PFS. PFS and ORR did not significantly differ between patients who received ALKi upfront or after initiating chemotherapy. Notably, patients who received ALKi in second or later lines demonstrated significantly better outcomes compared to those receiving chemotherapy. The use of ALKi in any line of therapy was associated with significantly prolonged OS., Competing Interests: Conflict of Interest None declared., (MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Background: There are multiple genes that are co-amplified along with human epidermal growth factor receptor 2 (HER2) in chromosome 17. GRB7 and PGAP3 are two such genes. We hypothesize that the protein products of these genes may serve as immunohistochemistry (IHC) markers for detecting HER2 amplification in breast cancer., Methods: Tissue sections from one hundred and thirty-five primary breast carcinoma cases were subjected to immunohistochemical staining for antibodies against HER2, GRB7, and PGAP3 and graded on a scale of 1 to 3. Both membranous staining and cytoplasmic staining were assessed for GRB7 and PGAP3. For equivocal HER2 IHC positivity, fluorescent in situ hybridization was performed to get the final HER2 status., Results: IHC staining for GRB7 and PGAP 3 was a moderate to strong predictor for HER2 status (area under the curve (AUC) of 0.768, 0.868,0.754, and 0.790 for GRB7 membranous staining, GRB7 cytoplasmic staining, PGAP3 membranous staining, and PGAP3 cytoplasmic staining respectively). A combination of GRB7 cytoplasmic and PGAP3 membranous staining resulted in an AUC of 0.905 (95% CI 0.855-0.954), while a combination of GRB7 and PGAP3 cytoplasmic staining resulted in an AUC of 0.902 (95% CI 0.851-0.953)., Conclusion: The point estimates for the AUC of GRB7 and combined GRB7 and PGAP3 in predicting the AUC suggest a strong predictive ability of these markers to predict HER2. With further refinement in technique, cytoplasmic staining and membranous IHC staining for GRB7 and PGAP3 have potential to serve as surrogate markers for HER2 status. The strategy of using protein products of co-amplified genes of HER2 is likely to be successful in technical validation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mudgal et al.)

Background: Very few studies provide direct comparisons between aortic root enlargement and sutureless valve implantation in patients with a small aortic annulus who underwent aortic valve replacement. This study aims to provide comparative outcomes between the two in such a subset of patients, through a systematic review and pool analysis., Methods: The PubMed, Scopus and Embase databases were searched using the appropriate terms. The data from original articles mentioning aortic root enlargement and sutureless valves in a single or comparative study with another group of patients with a small aortic annulus were pooled and analyzed using descriptive statistics., Results: Both cardiopulmonary bypass (68.4 vs. 125.03 min, p  < 0.001) and aortic cross-clamp times were significantly shorter in the sutureless valve group, along with a concomitantly higher number of minimally invasive surgeries. The incidence of permanent pacemaker implantation (9.76% vs. 3.16%, p  < 0.00001), patient prosthesis mis-match and paravalvular leak was significantly higher in the sutureless valve group. In comparison, the incidence of re-exploration for bleeding was higher in the aortic root enlargement group (5.27% vs. 3.16%, p  < 0.02). The two groups had no differences in the duration of hospital stays or mortality., Conclusions: Sutureless valves demonstrated a comparable hemodynamic outcome with aortic root enlargement in patients with a small aortic annulus. In addition to this, it greatly facilitated minimally invasive surgery. However, the high incidence of pacemaker implantation is still a concern for the widespread recommendation of sutureless valves, especially in young patients with a small aortic annulus.

Introduction: Even though there have been few studies on coronary artery bypass grafting (CABG), data on patients with coronavirus disease-2019 (COVID-19) infection show that cardiac surgery has poor outcomes in this subset. From the available studies in the literature, we conducted a systematic review with the aim of determining the outcome of COVID-19 patients who underwent CABG., Methods: Between December 2019 and October 2022, searches were conducted in PubMed, the Directory of Open Access Journals, and Google Scholar to find studies reporting results of COVID-19 patients undergoing CABG. We extracted data on the clinical profile and outcomes of the patients from the eligible studies. The quality of the studies was assessed using a standardised tool., Results: The total sample size across the 12 included studies was 99 patients who underwent CABG in active disease or within 30 days of COVID-19 infection. The median and interquartile range (IQR) for the length of time spent on a mechanical ventilator, stay in the intensive care unit (ICU), and the total hospital stay were 0.9 (0.47-2), 4.5 (2.5-8), and 12.5 (8.5-22.5) days respectively. Seventy-six patients developed postoperative complications, and there were eleven deaths., Conclusion: The findings of the present study indicate that mortality risk goes down when the time between COVID-19 diagnosis and surgery increases. When compared to data from other high-risk urgent or emergent CABG patients around the world who were not infected with COVID-19, patients who underwent CABG in the COVID-19 subgroup had similar postoperative outcomes., Supplementary Information: The online version contains supplementary material available at 10.1007/s12055-023-01495-7., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Indian Association of Cardiovascular-Thoracic Surgeons 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Cancer incidence and mortality are rapidly growing worldwide. Cancer affects the overall quality of life of cancer patients. Yoga has its origin in the ancient times. This ancient practice has been used for holistic well-being for ages. Yoga as an alternative therapy might be beneficial for cancer patients too. This study was conducted to assess knowledge, attitudes, and yoga practices among cancer patients., Materials and Methods: For this cross-sectional survey, a self-designed questionnaire was validated and distributed among 25 cancer patients for a pilot study. Then, a full-fledged study was conducted based on the interviews of 1000 cancer patients at a tertiary care oncology unit and the data were analyzed using R 3.6., Results: A total of 1000 participants were enrolled in this cross-sectional survey. Out of 1000 participants, 91 were excluded as they responded that they were not familiar with the term "Yoga" in the first question of the questionnaire. Of 919 participants, 238 strongly agreed and 395 agreed with the question that people who practice yoga are less prone to diseases, showing that 68.87% of cancer patients have a positive attitude toward yoga. However, only 145 (15.77%) of the participants practice yoga regularly. Lack of time was the most common reason for not practicing yoga, and the other reasons were the lack of interest and insufficient facilities., Conclusion: The present study on 1000 patients from the yoga capital of the world, Rishikesh, highlights the fact that the majority of cancer patients are aware of yoga practice's benefits and if given the opportunity to learn appropriate techniques, yoga can further improve the outcome in such patients. There is a need to design the effective yoga programs for cancer patients to promote suitable yoga practices in this population., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 International Journal of Yoga.)

Physicochemical, functional, phenolic and amino acids composition of brown rice (BR) from non-basmati and basmati varieties were evaluated. Higher a*, b*, ash content, dietary fiber, blue value, foaming capacity, oil absorption capacity and total phenolic content (TPC) were observed in BR from basmati varieties than the non-basmati varieties. In addition, higher accumulation of ferulic and p-Coumaric acid in bound form and gallic acid in free form was observed for BR from basmati varieties than non-basmati varieties. BR from basmati varieties contained higher concentration of valine, methionine, phenylalanine, histidine and threonine than BR from non-basmati varieties. Noodles from basmati varieties showed lower gruel solids loss, water uptake and glycemic index but higher storage modulus than from non-basmati varieties. BR from PB1121 had better functional, rheological and noodles making properties amongst all the varieties evaluated., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Adolescents' scholastic and social life has become increasingly reliant on the internet and mobile technology in recent years. Problematic Internet Use (PIU) is a growing problem in Indian adolescents. However, in many cases, this use has become obsessive, causing them to neglect other elements of their lives. Adolescents account for over 35% of internet users in India. The purpose of this study was to evaluate the psychosomatic problems related to internet overuse among school going adolescent students. This cross-sectional survey was conducted among 348 students in selected schools of Aspur block in Dungarpur-district, Rajasthan, India in the month of February 2016. Problematic internet use (PIU) was assessed by Young's twenty question internet addiction test. The Depression, Anxiety, Stress Scale (DASS-42) and self structured questionnaire check list was used to measure psychosomatic problems among adolescents. Approximately 5.17% adolescents showed Problematic internet use (PIU). Adolescents with PIU were associated with age between 14-16 year, males,10th class of study, using internet since more than 3 years, being at home, mobile as a source of internet use, purpose of internet use with online gaming. Compared with normal internet users, there were significant correlation between Problematic Internet Use and Somatic Complaints r=0.3660, p<0.05, Depression r=0.3982, p<0.05. Anxiety r=0.2512, p<0.05 and Stress r=0.2886, p<0.05. Problematic internet use (PIU) is an increasing problem among teenagers and it has been linked to psychosomatic issues. Timely Effective measures are needed to prevent the spread of this problem.

Diabetes mellitus is characterized not only by alteration in glucose insulin axis but marked features described as the diabetic dyslipidemia. The increased lipid level and total cholesterol synthesis during hyperglycemia may contribute to the acceleration of atherosclerosis in diabetes mellitus. Majority of guidelines currently recommend a fasting serum lipid for achieving consistency. It is also because majority of research has been performed using fasting lipids, it was assumed that making comparisons and analyzing risk would be less precise if using non-fasting tests. Fasting requirements are difficult for diabetics due to hypoglycemia and can reduce adherence with testing requests, delay results and place strain on testing facilities as a large influx of patients present for testing each morning., Material: 100 known cases of type-2 diabetes mellitus(as per ADA criteria) were selected after obtaining consent., Exclusion Criteria: Type 1 DM, pregnancy, CKD, CLD, Familial Dyslipidemias, hypothyroidism, hyperthyroidism, malignancies and Patients on Hypolipidemic drugs, beta blockers, thiazides, diuretics, corticosteroids. Lipid profile after 8 hours fasting and Lipid profile 2 hours after major meal was assessed. HDL-C was assessed by the direct assay method, and Friedewald's formula estimated LDL-C., Observation: Out of 100 cases, the majority i.e. 46% were from 61-70 years, 38% from 51-60 years, 8% from 41-50 years and 4% each from 30-40 years and above 70 years. Mean age of the study population was 59.98±9.84 years. 51% were females and 49% were males. Prevalence of dyslipidemia in our study was: elevated TC-16%, elevated TG-63%, elevated LDL-17%, elevated VLDL-63% and reduced HDL-96%. Total cholesterol value was elevated in 16% diabetic patients in fasting status and also in post prandial status. Mean total cholesterol value of diabetic patients in fasting status was 170.78±37.90 and in post prandial status was 168.32±31.79. Difference was statistically insignificant. Triglyceride value was elevated in 63% diabetic patients in fasting status and in 68% of diabetic patients in post prandial status. Mean triglyceride value of diabetic patients in fasting status was 181.24±70.89 and in post prandial status was 184.12±70.24. Difference was statistically insignificant. There no statistically significant difference between LDL, HDL and VLDL in fasting and postprandial states., Conclusion: There is very negligible difference in the mean values of fasting and postprandial lipid profile in our study. We would like to infer that Fasting lipid profile, which is usualy recomemded in view of consistency is neither covenient nor does it reflect the true biological state the person spends most of their time in., (© Journal of the Association of Physicians of India 2011.)

Mucormycosis is an opportunistic, aggressive, and angioinvasive fungal infection associated with a high mortality rate as it disseminates and infects the whole body if not treated early. Most conventional diagnostic methods require time and may also generate false-negative reports due to the several lacunae associated. On the other hand, molecular methods are rapid, reliable, and can be applied to different biological samples, such as fresh tissue, formalin-fixed paraffin-embedded blocks, serum, and urine. Mucorales are angio-invasive, and many studies have found the circulating fungal DNA (a non-invasive form of DNA) in the blood and urine of the patient. In addition, with the increase in the usage of steroid drugs in this COVID scenario, the rate of mucormycosis infection has taken a sudden rise. In light of this situation, there is an imperative need to diagnose these infections at the earliest., Competing Interests: The authors declare that they have no conflict of interest regarding the publication of the present study., (Copyright: © 2021, Published by Mazandaran University of Medical Sciences on behalf of Iranian Society of Medical Mycology and Invasive Fungi Research Center.)

Cyclic dinucleotides are second messengers that are present in all the three domains of life, bacteria, archaea, and eukaryotes. These dinucleotides have important physiological and pathophysiological roles in bacteria. Cyclic di-AMP (cdA) is one of the recently discovered cyclic dinucleotides present predominantly in gram-positive bacteria. cdA is synthesized through diadenylate cyclase (DAC) activity from ATP in a two-step process and hydrolyzed to linear dinucleotide pApA (and to 5' AMP in certain cases) by specific phosphodiesterases. cdA regulates various physiological processes like K + transport and osmotic balance, DNA repair, cell wall homeostasis, drug resistance, central metabolism either by binding directly to the target protein or regulating its expression. It also participates in host-pathogen interaction by binding to host immune receptors ERAdP, RECON, and STING., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The physicochemical and functional properties of grains, flour and protein isolates (QPI) from different quinoa lines were evaluated. Quinoa flour and protein isolates were characterised by high protein (14.1-15.4% and 78.7-86%, respectively) and phenolic content (419 to 655 mg GAE/100 g). Water and oil absorption capacity of QPI (2.0-3.6 g/g and 2.71-3.32 g/g, respectively) was significantly higher than quinoa flour (1.22 and 2.17 gand 0.9 and1.54 g, respectively). QPI showed desirable functional properties in terms of high foaming capacity (50.8 to 60.2%), foam stability (38.5 to 50.4%), protein solubility (30 and 53.3%), and emulsification index (EAI- 19.2-26.1 m 2 /g and ESI- 96.7-149.8 min, respectively). Digestibility of QPI ranged between 70.8 and 77.8% and was negatively correlated to random coils. Quinoa lines with higher grain density (GD) showed higher total phenol content (TPC) and WAC and lower FRSA and OAC. QPI with higher proportions of β-structure and random coils had enhanced protein surface activities leading to improved emulsification and foaming capabilities. Among the highly conserved polypeptides (PPs), variations were observed in accumulation of 53, 59 and 32 kDa PPs for grains and 33 and 21-24 kDa PPs for QPI., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Research Background: Diabetes is a chronic multi-system disease having long term consequences to the health of people suffering from it. This study investigates the role of finger millet ( Eleusine coracana )-enriched probiotic fermented milk in alleviating the diabetic complications in streptozotocin-induced diabetic rats., Experimental Approach: The probiotic strain used in the study was Lactobacillus helveticus MTCC 5463. Study comprised six groups each containing 6 Sprague Dawley rats: two controls (nondiabetic and diabetic), and four diabetic groups fed finger millet-enriched probiotic fermented milk, probiotic fermented milk, finger millet flour or metformin (standard drug). Samples were administered orally for four weeks, and parameters associated with diabetic disorders were studied., Results and Conclusions: Oral administration of finger millet-enriched milk significantly (p<0.001) decreased (64.26%) the fasting blood glucose level of diabetic rats compared to metformin (56.43%) and diabetic groups receiving the probiotic fermented milk (18.88%) and finger millet flour (47.14%) after four weeks of treatment. The finger millet-enriched milk significantly ameliorated the diabetic symptoms polyphagia and polydipsia and improved body mass. In diabetic control group, body mass was reduced up to 15.60% at the end of experiment, while in the group receiving the probiotic fermented milk, body mass significantly (p<0.0001) increased by about 5-30%. Significant (p<0.0001) reduction in total cholesterol, triglyceride levels in the groups treated with finger millet flour, finger millet-enriched probiotic fermented milk and probiotic fermented milk was observed compared to diabetic control rats. The probiotic fermented milk enriched with finger millet caused significant (p<0.05) decrease in low-density lipoprotein and very-low-density lipoprotein levels (p<0.0001) and insignificant increase in high-density lipoprotein level. A reversal of altered activities of hepatic marker enzymes aspartate transaminase and alanine transaminase was observed in the group receiving the probiotic milk enriched with finger millet. Histological observations of pancreatic tissues and liver showed that the enriched milk prevents more severe changes in the acinar cells and ameliorated the inflammation and alteration in the liver structure to some extent. Therefore, the finger millet-enriched probiotic fermented milk can be a potential functional food in the management of diabetes., Novelty and Scientific Contribution: This is the only paper reporting about the antidiabetic potential of finger millet-enriched milk fermented using probiotic Lactobacillus helveticus MTCC 5463 and Streptococcus thermophilus MTCC 5460. It also shows the synergistic antidiabetic effect of milk and finger millet used in combination, thus offering a novel functional food., Competing Interests: CONFLICT OF INTEREST: The authors declare no conflict of interest.

Background: Although curcumin's effect on head and neck cancer has been studied in vitro and in vivo, to the authors' knowledge its efficacy is limited by poor systemic absorption from oral administration. APG-157 is a botanical drug containing multiple polyphenols, including curcumin, developed under the US Food and Drug Administration's Botanical Drug Development, that delivers the active components to oromucosal tissues near the tumor target., Methods: A double-blind, randomized, placebo-controlled, phase 1 clinical trial was conducted with APG-157 in 13 normal subjects and 12 patients with oral cancer. Two doses, 100 mg or 200 mg, were delivered transorally every hour for 3 hours. Blood and saliva were collected before and 1 hour, 2 hours, 3 hours, and 24 hours after treatment. Electrocardiograms and blood tests did not demonstrate any toxicity., Results: Treatment with APG-157 resulted in circulating concentrations of curcumin and analogs peaking at 3 hours with reduced IL-1β, IL-6, and IL-8 concentrations in the salivary supernatant fluid of patients with cancer. Salivary microbial flora analysis showed a reduction in Bacteroidetes species in cancer subjects. RNA and immunofluorescence analyses of tumor tissues of a subject demonstrated increased expression of genes associated with differentiation and T-cell recruitment to the tumor microenvironment., Conclusions: The results of the current study suggested that APG-157 could serve as a therapeutic drug in combination with immunotherapy., Lay Summary: Curcumin has been shown to suppress tumor cells because of its antioxidant and anti-inflammatory properties. However, its effectiveness has been limited by poor absorption when delivered orally. Subjects with oral cancer were given oral APG-157, a botanical drug containing multiple polyphenols, including curcumin. Curcumin was found in the blood and in tumor tissues. Inflammatory markers and Bacteroides species were found to be decreased in the saliva, and immune T cells were increased in the tumor tissue. APG-157 is absorbed well, reduces inflammation, and attracts T cells to the tumor, suggesting its potential use in combination with immunotherapy drugs., (© 2020 American Cancer Society.)

We illustrate a method that uses bovine serum albumin (BSA) to control the receptor-accessible part of rebaudioside A (Reb A). The critical micelle concentration (CMC) of Reb A was found to be 4.5 mM and 5 mM at pH 3 and 6.7 respectively. NMR studies show that below its CMC, Reb A binds weakly to BSA to generate a Reb A-protein complex ("RPC"), which is only modestly stable under varying conditions of pH (3.0-6.7) and temperature (4-40°C) with its binding affinities determined to be in the range of 5-280 mM. Furthermore, saturation transfer difference (STD) NMR experiments confirm that the RPC has fast exchange of the bitterness-instigating diterpene of Reb A into the binding sites of BSA. Our method can be used to alter the strength of Reb A-receptor interaction, as a result of binding of Reb A to BSA, which may ultimately lead to moderation of its taste., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Kleine-Levin syndrome (KLS) alias sleeping beauty syndrome, is a rare sleep disorder. Clinically presenting as episodes of hypersomnolence, behavioral and cognitive disturbances, hyperphagia and hypersexuality. KLS may have an idiopathic onset or may be precipitated by neurological event or infection. Until date, no definite underlying cause is established and neither there are any definitive management guidelines. It remains a diagnosis of exclusion after other psychiatric and neurological causes have been ruled out. Coloring of presentation with behavioral and mood elements makes it important for a psychiatrist to be well-informed about the condition to avoid the erroneous diagnosis. KLS is a devastating illness, which robs the patient of time, experiences, and relationships. An early diagnosis and effective management can help patient escape from the morbidity caused by this disorder. Armodafinil and oxcarbamazepine have found to be effective in two of the case. The emphasis of this report is to add to the existing clinical knowledge of neurologists, psychiatrists and physicians. In the future, research is needed on genetic etiology and management of this disorder.

Amitriptyline is sometimes used to treat arm pain related to repetitive use, but rigorous evidence of its benefit is lacking. This randomized controlled trial investigated whether amitriptyline provided greater pain relief or improved arm function than a placebo pill in adults with arm pain associated with repetitive use that had persisted for at least 3 months. Participants (N=118) were randomly assigned to receive 25mg of amitriptyline or a placebo pill for 6 weeks. The primary outcome was intensity of pain (10-point numerical rating scale) and secondary outcomes were arm symptoms, arm function, grip strength, mood, and sleep. Assessments were done at baseline, 3 and 6 weeks of treatment, and 1 month after the treatment ended. Changes in arm pain were not statistically significant. However, the amitriptyline group improved more than the placebo group in arm function (p=0.023) and sense of well being (p=0.034). In a longitudinal analysis, the amitriptyline group's arm function score improved 0.45 points per week faster than placebo after adjusting for subject characteristics (p=0.015). At the treatment's midpoint, the amitriptyline group reported more "troublesome side-effects" than the placebo group (52.5% vs. 27.1%, p=0.005), but this difference decreased by the end of the treatment (30.5% vs. 22.0%, p=0.30). The most frequent side effect was drowsiness. In conclusion, this study found that low-dose amitriptyline did not significantly decrease arm pain among these participants but did significantly improve arm function and well being. Future research is needed to explore the effects of higher doses and longer duration of treatment., (Copyright 2010 International Association for the Study of Pain. All rights reserved.)

This study aims to present the functional outcome in patients who sustained paint-gun injuries to the hand with latex paint and review the current trends, recommendations, and pitfalls of surgical treatment in contemporary literature. Five male patients with an average age of 35 years were treated between 2000 and 2003 after sustaining a paint-gun injury with latex paint. All wounds were located volarly on the digits of the nondominant hand. Preoperative radiographs were obtained in every patient. All patients underwent debridement of the affected digit. Despite delayed presentation, more than 24 h post injury, our patients recovered substantial function at an average follow-up of 12 months. Every patient returned to his previous occupation and there were no amputations. Paint-gun injuries with latex paint appear to be associated with an outcome that is superior to the poor outcome traditionally associated with oil-based paints.

This report describes a closed rupture of the entire extensor digitorum communis and extensor indicis proprius.

Dislocations of the metacarpophalangeal joint are uncommon and usually caused by significant trauma. The distinction between subluxations and dislocations is critical. Complex dislocations require surgical reduction. The need for surgical reduction is primarily due to the anatomy of this region, which contributes to the complexity of this injury and to the degree of difficulty in its reduction. This pictorial essay aims to highlight the clinical, radiographic, and surgical features of this uncommon yet complex injury.