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Cobblestone lissencephaly (C-LIS) (TYPE II) is a rare and severe neuronal migration disorder characterized by a smooth brain surface with overmigrated neurons and abnormal formation of cerebral convolutions or gyri during fetal development, resulting in a cobblestone appearance. C-LIS is associated with eye anomalies and muscular dystrophy. This case report presents a detailed clinical and neuroimaging analysis of a patient diagnosed with cobblestone lissencephaly (Type II). It reviews pertinent literature to enhance our understanding of this complex condition. We report a case of a 6-year-old female child with cobblestone lissencephaly (C-LIS) (Type II) severe developmental delays, hypotonia, and recurrent intractable seizures. Magnetic resonance imaging (MRI) revealed a characteristic cobblestone appearance on the brain surface, indicative of abnormal neuronal migration. In addition to the classic findings of Type II Cobblestone lissencephaly, the patient displayed ventriculomegaly and cerebellar hypoplasia, contributing to the overall neurological impairment observed. The literature review highlights the genetic basis of cobblestone lissencephaly, emphasizing the involvement of genes associated with glycosylation processes and basement membrane integrity. Neuroimaging findings, including MRI and computed tomography scans, are crucial for accurate diagnosis and prognostication. Early identification of cobblestone lissencephaly allows for appropriate counseling and management strategies. However, the prognosis remains guarded, and interventions primarily focus on supportive care and seizure management. This case report contributes to the knowledge of cobblestone lissencephaly, shedding light on the clinical spectrum and neuroimaging features associated with this rare disorder. To clarify the underlying genetic mechanisms and possible therapeutic pathways for better patient outcomes, more investigation is necessary.

Objective: To identify the clinical, laboratory, and radiological markers that could predict a positive GeneXpert result in patients suspected of tuberculous meningitis. Methods: In this prospective, observational study, patients with tuberculous meningitis were systematically evaluated. Various clinical, laboratory [including cerebrospinal fluid (CSF) microscopy, culture, and GeneXpert], and neuroimaging factors were examined. All participants were administered anti-tuberculous treatment and corticosteroids. A six-month follow-up was done to evaluate the outcome. Results: Of the 116 patients studied, 54 (46.6%) tested positive for GeneXpert, while 62 (53.4%) were negative. Third cranial nerve involvement (OR 3.71, 95% CI 1.052-13.09, P=0.04) and the presence of basal exudates on neuroimaging (OR 5.22, 95% CI 2.03-13.42, P=0.001) emerged as independent predictive factors for a positive GeneXpert result. A positive CSF GeneXpert result (P=0.002) and drug resistance (P=0.004) were significantly linked to adverse outcomes. Additionally, a high score on the Medical Research Council stage III (OR 5.64, 95% CI 1.18-26.87, P=0.03) and elevated CSF cell counts (OR 1.002, 95% CI 1.00-1.001, P=0.03) were identified as independent predictors of poor prognosis. Conclusions: Third cranial nerve involvement and the presence of basal exudates were significant indicators of a positive GeneXpert result. MRC stage III disability and elevated CSF cell counts predicted poor outcomes.

Ovarian lymphangiomas are rare benign neoplasms characterized by the proliferation of lymphatic vessels within the ovarian tissue. While lymphangiomas can manifest in various anatomical locations, their occurrence within the ovaries is exceptionally uncommon, posing diagnostic and therapeutic challenges for clinicians. The aetiology of ovarian lymphangiomas remains elusive, with theories suggesting congenital malformations, lymphatic obstruction, or acquired lymphatic proliferation as potential contributing factors. The clinical presentation of ovarian lymphangiomas often includes nonspecific symptoms such as abdominal pain, swelling, or discomfort, leading to difficulties in early detection and diagnosis. Radiological imaging, particularly Ultrasound, CT (computed tomography) and MRI (magnetic resonance imaging), plays a crucial role in identifying these lesions and guiding subsequent management strategies. Despite their generally benign nature, ovarian lymphangiomas can attain significant sizes, causing complications such as torsion, rupture, or compression of adjacent structures. Surgical intervention, typically in cystectomy or oophorectomy, is frequently pursued to alleviate symptoms and prevent potential complications. This paper aims to comprehensively review the existing literature on ovarian lymphangiomas, addressing their clinical presentation, diagnostic challenges, and management strategies. By synthesizing available data, we seek to enhance our understanding of this rare entity, providing valuable insights for clinicians encountering similar cases. Improved awareness and knowledge of ovarian lymphangiomas are essential for timely diagnosis and optimal patient outcomes.

Parry-Romberg syndrome (PRS) is a rare neurocutaneous and craniofacial disorder characterized by progressive hemifacial wasting and atrophy that predominantly affects children and young adults, with an estimated prevalence of 1 in 700,000 individuals. Despite its rarity, PRS poses significant challenges for patients, their families, and healthcare providers due to its unpredictable course and potential functional and aesthetic impairments. The main aim is to provide a comprehensive overview of PRS, encompassing its clinical features, pathogenesis, and management techniques. We present a case of PRS in a 9-year-old female with pronounced facial asymmetry, with marked wasting and atrophy involving the entire right side of the face. CT scan revealed right sided hypoplasia of maxilla, mandible, and zygomatic arch with enophthalmos of right eye. MRI showed right temporalis, medial and lateral pterygoid, masseter, risorius, buccinator, zygomaticus major and minor, levator labii superioris, levatorangulioris and orbicularis oris muscles atrophy. The clinical presentation of PRS typically involves progressive facial atrophy, predominantly affecting the subcutaneous tissues, muscles and bones. Patients may experience various symptoms as the condition advances, including facial asymmetry, hemifacial pain, dental and ocular abnormalities and neurological manifestations. The exact etiology of PRS remains unknown, although autoimmune, genetic and vascular factors are likely contributors. Treatment of PRS needs a multidisciplinary approach involving dermatologists, plastic surgeons, neurologists, ophthalmologists, and dental specialists. Treatment options aim to alleviate symptoms, improve function and address cosmetic concerns. Surgical interventions such as autologous fat grafting, facial reconstructive procedures and orthognathic surgery have restored facial symmetry and function. Additionally, nonsurgical modalities, including botulinum toxin injections, prosthetic devices and dental interventions, may offer symptomatic relief and enhance overall quality of life.

Introduction: Acute viral encephalitis syndrome including dengue encephalitis (DE) is an important tropical illness with a guarded prognosis. The cerebral blood flow may be affected in acute viral encephalitis. Transcranial Doppler (TCD) sonography can quantitatively determine intracranial vascular flow dynamics in acute viral encephalitis. Aim: We aimed to investigate the intracranial blood flow characteristics in patients with DE and compare with nondengue acute viral encephalitis patients. Materials and Methods: In this prospective study, all the cases of acute viral encephalitis including dengue were enrolled over 18 months and followed up at 3 months. TCD was performed to determine the mean velocity pulsatility index (PI) and resistive index (RI) across the middle cerebral artery, anterior cerebral artery, posterior cerebral artery (PCA), vertebral artery, and basilar artery and compared it among dengue versus nondengue group as well as outcome at 3 months. Results: Out of 39 patients, 19 were diagnosed with DE, whereas 20 patients suffered from the nondengue group. The elevated PI and RI in the left PCA were found to statistically significant (P = 0.001 and 0.008, respectively) in the DE group. There was no significant difference in any other TCD indices in any other vessel among both the groups. In addition, an initial low Glasgow Outcome Scale (GOS) and higher brain imaging abnormality were significantly associated with poor GOS of

The proliferation of flexible electronics has entirely transformed the field of antenna design and paved the door for cutting-edge uses in communication, sensing, and other areas. The present research lends a succinct overview of the intriguing advancements in flexible antenna technology, with specific emphasis on the implementation of polymer substrates. As we refer to poly-flex antennas in this article, they stand for the incorporation of polymer substrates in antenna design. Polymer substrates are the optimum candidate for flexible antenna applications as they have specific advantages, including being lightweight, conformable, and inexpensive. The main features of poly-flex antennas, such as their design concepts, fabrication processes, and performance characteristics, are being explored in this proposed article. We delve into the wide variety of polymer substrates that are appropriate for antennas, taking into account their dielectric characteristics, flexibility, and environmental resistance. Their dielectric characterization, bending effects, challenges, and future prospects of this burgeoning field are also addressed. We conclude by emphasizing the immense potential of poly-flex-antennas to shape the future of wireless communication and sensing systems, and how the adoption of polymer substrates is driving innovation in antenna engineering.

Introduction. Chest wall tuberculosis is an uncommon manifestation, accounting for 1-2% of musculoskeletal and extrapulmonary tuberculosis cases. The pathophysiology involves hematogenous spread, direct extension from chest wall lymphadenitis, or spread from pulmonary or pleural diseases. Diagnosis is challenging, especially in immunocompromised individuals where TB can mimic various illnesses. Case presentation. A 50-year-old female presented with a painful swelling on the right lower lateral chest over the 9th rib. Clinical examination revealed a warm, painful, enlarging chest swelling with defined borders. Imaging studies (Radiograph, Ultrasonography, CT, and MRI) demonstrated a hypodense collection with suspicious soft tissue density, bony erosion, and involvement of adjacent structures. Conclusion. Primary TB of the chest wall is uncommon, often resembling tumors or pyogenic abscesses. Chest wall TB may affect various structures, and imaging plays a crucial role in diagnosis. Multidetector CT offers superior spatial resolution, aiding in assessing anatomical origin and response to therapy. The recommended treatment includes a six-month ATT regimen, with surgical interventions if necessary.

Introduction. Retroclival hematomas (RCH) are a rare entity presented primarily as a post-traumatic phenomenon in the pediatric population. We present a case of Retroclival interdural hematoma in a 12 y/o female with a previous record of craniocervical trauma. A RCH is identified initially by CT and easily overlooked. MRI cervical spine to evaluate the Tectorial membrane and other craniocervical ligaments integrity. Case report. A 12-year-old female presented with bilateral abducens nerve palsies and a Glasgow Coma Score (GCS) of 13 following a high-speed motor vehicle accident. Initial CT brain revealed an infra-tentorial extra-axial focal hyperdense collection (hemorrhage) along the retroclival region in the interdural space measuring approximately 9 × 29 × 58 mm. Subsequent imaging and evaluations suggested cranio-cervical instability, leading to surgical intervention. Conclusions. Prompt diagnosis of RCH with conservative or surgical management is essential to avoid neurological deficits and mortality. Despite the significant potential for morbidity and mortality, the majority of patients show a benign clinical course with conservative care, underscoring the importance of quick diagnosis and close observation.

Background: Mandibular (Gnathic) osteosarcoma, a rare form of primary bone cancer, presents unique challenges due to its location and the essential functions of the mandible. This review aims to synthesize current knowledge on mandibular osteosarcoma, highlighting its clinical presentation, diagnostic challenges, and treatment strategies. Methods: A comprehensive literature review focused on recent studies and reviews on mandibular osteosarcoma. Epidemiology, clinical presentation, diagnostic methods, and advances in treatment modalities were among the main topics of study. Discussion: Mandibular osteosarcoma typically presents as a painless swelling or a painful mass in the jaw, often leading to a delayed diagnosis due to its nonspecific symptoms. Radiographic imaging plays a crucial role in diagnosis, supplemented by histopathological examination. Treatment primarily involves surgical resection, which can range from limb-sparing surgery to radical resection, depending on tumor size and location. Post-operative reconstruction is essential for restoring function and aesthetics. Chemotherapy is a critical adjunct to surgery, while radiation therapy is reserved for specific cases. The multidisciplinary approach to treatment planning is emphasized for optimal patient outcomes. Conclusion: Early diagnosis and a tailored treatment approach are essential for improving the prognosis of mandibular osteosarcoma. Improvements in adjuvant therapies and surgical procedures have improved the results of treatment. Nonetheless, the illness's rarity highlights the necessity of continued study and teamwork to comprehend and successfully treat this complicated cancer.

Epidermoid cysts of the canal of Nuck are an uncommon surgical cause of female inguinal enlargement when the processus vaginalis fails to close during embryologic development. The canal of Nuck, formed by the processus vaginalis in the inguinal canal, is a homolog of the processus vaginalis in men. The canal of Nuck should be considered in the differential diagnosis when a non reducible groin mass is observed in women and girls. Ultrasonography (USG) is the primary imaging modality that accurately and reliably diagnoses these groin masses. The incidence of pathologies is mainly encountered in young girls and is lower in adults. Various pathologic disorders related to the failure of processus vaginalis obliteration can occur, including the herniation of intra-abdominal structures such as the uterus, fallopian tube, ovary and hydrocoele of the canal of Nuck. Hernias are often suspected in paediatric patients with lumps in the inguinal region. Here the authors, present a case of an epidermoid cyst of the canal of Nuck in a two-year-old female identified by USG and Magnetic Resonance Imaging (MRI). The two-year-old female underwent surgical treatment, and subsequent histopathologic evaluation of the cystic lesion revealed an epidermoid cyst. Due to its rarity, the epidermoid cyst of the canal of Nuck is commonly misdiagnosed as a typical groin mass.

This research illustrates the application of PDMS (polydimethylsiloxane), a silicon-based polymer with loss tangent (tan δεr) and dielectric constant (εr) values of 0.02 and 2.65, as a flexible substrate for antenna (PDMS substrate based flexible antenna – PSFA). In this paper, two flexible antennas having a size of 50.2×40.1×1 mm are presented for wireless body and local area networks. A split ring resonator (CSRR) structure with circular geometry is integrated on the patch in the second proposed antenna as compared to the first antenna with the same dimensions. As a result, this antenna has multiband notched frequency characteristics at 5.12, 5.80, and 6.66 GHz, respectively, with improved performance. It also helped to reduce SAR and backward radiation. Both of the proposed antennas behave well and exhibit significant concordance between simulation and measurement findings when tested in various operational situations, including wet and conformal conditions and demonstrate the suitability of PDMS as a flexible substrate for antenna applications.

Background: Guillain–Barré Syndrome (GBS) is an acute acquired autoimmune inflammatory disorder of peripheral nerves and roots. The pathogenesis is essentially an aberrant post-infectious immune response in a genetically susceptible host milieu. Single nucleotide polymorphisms (SNP) in genes encoding the inflammatory mediators like TNF-α, CD1A and CD1E can influence their expression and level and the susceptibility and clinical course of disease in GBS. Objective: We tried to study the susceptibility of single nucleotide polymorphisms of TNF-α and CD1 genes in Guillain–Barré Syndrome in Indian population and determine the association in terms of genotype, allele and haplotype distribution along with individual subtype, severity and clinical outcome. Methodology: In this case-control study, we investigated the single nucleotide polymorphism pattern in the promoter region of TNF-α (-308 G/A), TNF-α (-863C/A), CD1A and CD1E genes using real-time polymerase chain reaction in 75 GBS patients and analysed in comparison with 75 age and sex-matched healthy controls. Results: The findings revealed that the allelic distribution of TNF-α (-308 G/A) *A allele was associated with GBS (P value 0.04, Odds Ratio 2.03, 95% Confidence Interval 1.01–4.07). There was no association found with genotype, haplotype combination and other allele distribution for GBS in the study. CD1A and CD1E SNPs did not reveal any susceptibility for GBS. The subtype analysis did not reveal any statistical significance, except for CD1A *G allele with AMAN subtype (P value 0.026). The haplotypic combinations and mutant allele of TNF-α (-308 G/A), TNF-α (-863C/A), CD1A and CD1E were significantly associated with severe GBS in the study. However, there was no association of any SNP for mortality and survival of GBS in the study. Conclusion: TNF-α (-308 G/A)*A allele might confer genetic susceptibility for GBS in Indian population. CD1 genetic polymorphism could not be considered for susceptibility to GBS. TNF-α and CD1 genetic polymorphism did not affect mortality in GBS.

Background: Rhino cerebral mucormycosis is an uncommon opportunistic infection of the nasal sinuses and brain, and a group of saprophytic fungi causes it. During the second wave of COVID-19, India witnessed an unprecedented number of patients with rhino cerebral mucormycosis. Invasion of the cavernous sinus and occlusion of the internal carotid artery in many cases resulted in a stroke. The study aimed to assess the clinical and neuroimaging predictors of stroke in patients with rhino cerebral mucormycosis. We also evaluated the predictors of death in these patients at 90 days. Methods: A prospective study was performed at a tertiary care centre in India between July 2021 and September 2021. We enrolled consecutive microbiologically confirmed patients of rhino cerebral mucormycosis. All patients underwent neuroimaging of the brain. Treatment comprised of anti-fungal drugs and endoscopic nasal/sinus debridement. We followed the patients for 90 days and assessed the predictors of stroke and mortality Results: Forty-four patients with rhino cerebral mucormycosis were enrolled. At inclusion, in 24 patients, the RT-PCR test for SARS-COV-2 was negative. Diabetes mellitus was the most frequent (72.7 %) underlying risk factor; in most, diabetes mellitus was recently discovered. At inclusion or subsequent follow-up, stroke was seen in 11 (25 %) patients. Only seven patients had hemiparesis. Imaging revealed internal carotid artery occlusion in 17 (38.6 %) patients. Hypertension, corticosteroid use, and cavernous sinus thrombosis were independent predictors of stroke. Nine (20.5 %) died during follow-up, and stroke was an independent predictor of death. Conclusion: Stroke indicated poor prognosis among rhino cerebral mucormycosis patients encountered during the second wave of the COVID-19 epidemic.

The present study reports the synthesis of 2-azidobenzothiazoles from substituted 2-aminobenzothiazoles using sodium nitrite and sodium azide under mild conditions. All the synthesized compounds were examined for their antibacterial activity against Gram (+) bacteria, Staphylococcus aureus (ATCC 25923), Enterococcus faecalis (ATCC 51299), Bacillus cereus (ATCC 10876) and Gram (−) bacteria, Escherichia coli (ATCC 10536), Pseudomonas aeruginosa (ATCC 10145), Klebsiella pneumonia (ATCC BAA-2146)and clinical isolates of Gram (+) Methicillin Resistant S. aureus (MRSA) and Multi Drug Resistant E. coli. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) values by broth dilution method revealed that compound 2d exhibited significant antibacterial potential against E. faecalis and S. aureus with MIC of 8 μg/mL, while other synthesized compounds had only moderate effects against all the tested species. The compound significantly inhibited the biofilm formation of the bacterial strains below its MIC. The selective cytotoxicity of Compound 2d towards bacterial cells was evidenced on extended exposure of Human Embryonic Kidney-293 cell line to higher concentrations of the compound. Hence, the present study confirmed that compound 2d can be a potential drug candidate for future development as an antibacterial drug.

Background: In approximately 25% of peripheral neuropathy cases, diagnosis remains obscure. In India, leprosy continues to remain one of the most frequent causes of peripheral neuropathy. We, in this prospective evaluation, performed nerve biopsies in patients with peripheral neuropathy for early confirmation of the diagnosis. Materials and Methods: A total of 55 consecutive cases of peripheral neuropathy were included in this study. All patients were subjected to clinical and electrophysiological evaluation. Sural nerve biopsies were performed in all the patients. Result: After a nerve biopsy in 29 cases, we were able to identify the underlying cause of peripheral neuropathy. In 26 cases, the diagnosis remained obscure. The most frequent histopathological diagnosis was leprosy, which was seen in 20 cases. Other diagnoses were chronic demyelinating neuropathy (four cases), vasculitis (two cases), and amyloidosis in one case. In two biopsies, the findings were consistent with hereditary neuropathies. The demonstration of lepra bacilli was the most distinctive feature. In addition, foamy macrophages (100%) and granuloma (100%) formation, epineurial (83.3%) and endoneurial infiltration (69%) along with epineurial (87.5%) and perineurial thickening (77.3%) were also noted more frequently in leprosy-associated neuropathy. Conclusion: The nerve biopsies revealed that leprosy was the most common etiology in patients with peripheral neuropathy. In approximately 47% of the cases, even nerve biopsies failed to establish a confirmed diagnosis.

Background: Only a proportion of patients with tuberculosis develop tuberculous meningitis. We hypothesize that inherent abnormalities in the host’s innate or adaptive immune system may affect the outcome in tuberculous meningitis. In this study, we evaluated the proportion of underlying primary immunodeficiency in patients with tuberculous meningitis and its impact on the outcome. Methods: Newly-diagnosed cases with tuberculous meningitis and healthy controls were included. Patients with HIV disease were excluded. Blood specimen were subjected to immunological assessment to detect primary immunodeficiency syndrome/s. We estimated serum levels of IgG, IgA, IgM, IgE and IgD along with complement C3, C4, and C5 assay. Absolute lymphocyte count was obtained from an automated three-part cell counter. Flow cytometry was used to enumerate the following lymphocyte subsets: T Cell (CD3, CD4, CD8), B cell (CD19/CD20), and Natural killer cells (CD16 and CD56). Cases were followed for 6 months. Modified Barthel Index was used as a measure of disability. Results: We included 55 cases with tuberculous meningitis and 30 healthy controls. We notedthat among immune parameters, absolute lymphocyte count and CD4 T-cell count in the tuberculous meningitis group was lower; higher serum IgG levels were noted in the poor outcome group. On multivariate regression analysis, none of the immunological, clinical or radiological features were found to predict a poor outcome. Conclusion: Host’s immune factors contribute to the pathogenesis of tuberculous meningitis. Absolute lymphocyte count and CD4+ T-cell count were lower in tuberculous meningitis cases. Higher serum IgG levels may be associated with a poor outcome. A study with a larger sample size is needed to confirm our findings.

Dunbar syndrome (DS) (or median arcuate ligament [MAL] syndrome) is a rare entity of the vascular compression syndrome, where there is focal proximal coeliac axis compression by MAL. It results in an insufficient supply of blood to the respective organs of the gastrointestinal tract. Multidetector computed tomography is a very convenient, noninvasive modality in diagnosing this condition and helpful in distinguishing it from other conditions, such as atherosclerotic disease. DS can further be treated disorder surgically by relieving the compression and sometimes may need vascular reconstruction. We present five cases of the DS.

In the modern era, endoscopic retrograde cholangiopancreatography (ERCP) and therapeutic endoscopic ultrasound (EUS) are increasingly being performed in day-care settings. The safety of these procedures in elderly admitted patients has been established in previous studies, but evidence for the safety of day-care ERCP/therapeutic EUS is limited. We retrospectively analyzed the outcomes of day-care ERCP/EUS in patients more than 80 years of age. All procedures were done under total intravenous anesthesia (ketamine- and propofol-based) and the intra-procedural and immediate postprocedural complications (within 6 hours) were noted. Thirty patients (24 male and 6 female) were enrolled. The most common indication for the procedure was choledocholithiasis (46.6%), followed by malignant stenosis (30.0%) and benign strictures (20.0%). One patient had transient desaturation during the procedure and two patients had hypotension. The dreaded complications of bleeding, perforation, or pancreatitis did not occur in any patients, and none required admission. In conclusion, day-care therapeutic ERCP/EUS is safe and cost-effective in the oldest old patients.

Background Leprosy is primarily a disease of peripheral nerves. Some isolated case reports and case series have communicated imaging changes in the central nervous system (CNS) and brachial plexus in patients with leprosy. Objectives To study the neuroimaging abnormalities in patients with lepra bacilli-positive neuropathy in the context of CNS, spinal root ganglion, and brachial plexus. Design Prospective observational study Methods We screened newly-diagnosed patients with multibacillary leprosy presenting with neuropathy. Patients with bacilli-positive sural nerve biopsies were included in the study and subjected to magnetic resonance imaging (MRI) of the brain and spinal cord. Results A total of 54 patients with bacteriologically confirmed multibacillary leprosy were screened; Mycobacterium leprae was demonstrated in the sural nerve biopsies of 29 patients. Five patients (5/29; 17.24%) had MRI abnormalities in CNS, spinal root ganglion, and/or brachial plexus. Three patients had MRI changes suggestive of either myelitis or ganglionitis. One patient had T2/FLAIR hyperintensity in the middle cerebellar peduncle while 1 had T2/FLAIR hyperintensity in the brachial plexus. Conclusion CNS, spinal root ganglion, and brachial plexus are involved in patients with leprous neuropathy. Immunological reaction against M leprae antigen might be a plausible pathogenetic mechanism for brachial plexus and CNS imaging abnormalities.

Various clinical reports indicate prolonged exposure to general anesthetic-induced neurotoxicity (in vitro and in vivo). Behavior changes (memory and cognition) are compilations commonly cited with general anesthetics. The ability of miRNAs to modulate gene expression, thereby selectively altering cellular functions, remains one of the emerging techniques in the recent decade. Importantly, engineered miRNAs (which are of the two categories, i.e., agomir and antagomir) to an extent found to mitigate neurotoxicity. Utilizing pre-designed synthetic miRNA oligos would be an ideal analeptic approach for intervention based on indicative parameters. This review demonstrates engineered miRNA’s potential as prophylactics and/or therapeutics minimizing the general anesthetics-induced neurotoxicity. Furthermore, we share our thoughts regarding the current challenges and feasibility of using miRNAs as therapeutic agents to counteract the adverse neurological effects. Moreover, we discuss the scientific status and updates on the novel neuro-miRNAs related to therapy against neurotoxicity induced by amyloid beta (Aβ) and Parkinson’s disease (PD).

Objective: Disseminated tuberculosis is characterized with involvement of two or more non-contiguous sites. In this work we evaluated patients of tuberculous meningitis for possible extra-central nervous system tuberculosis. Method: This prospective observational study was performed at a tertiary care institute in Northern India. We included consecutive HIV-uninfected cases of TBM. Patients were evaluated for extra-central nervous system (CNS) tuberculosis. We focussed on peripheral lymph nodes, chest, abdomen, and spinal involvement. All patients were subjected to MRI brain and spine. Patients were also subjected to CT thorax and abdomen. Enlarged lymph nodes, if present, were biopsied. Ascitic and pleural fluid were subjected to biochemical, cellular analysis as well as cartridge-based nucleic acid amplification test (CBNAAT) for detection of Mycobacterium tuberculosis and rifampicin resistance. Results: We enrolled 110 patients of TBM. After cerebrospinal fluid examination alone, 14 (12.7%) patients had microbiologically-confirmed TBM. After planned work-up for extra CNS tuberculosis, 5 additional cases were microbiologically confirmed. Similarly, before work-up for extra CNS tuberculosis, 29 (26.4%) patients were categorized as probable TBM. The number of probable cases increased to 72 (65.5%) (P

Background Modeling studies estimated severe impacts of potential service delivery disruptions due to COVID-19 pandemic on maternal and child nutrition outcomes. Although anecdotal evidence exists on disruptions, little is known about the actual state of service delivery at scale. We studied disruptions and restorations, challenges and adaptations in health and nutrition service delivery by frontline workers (FLWs) in India during COVID-19 in 2020. Methods We conducted phone surveys with 5500 FLWs (among them 3118 Anganwadi Workers) in seven states between August–October 2020, asking about service delivery during April 2020 (T1) and in August-October (T2), and analyzed changes between T1 and T2. We also analyzed health systems administrative data from 704 districts on disruptions and restoration of services between pre-pandemic (December 2019, T0), T1 and T2. Results In April 2020 (T1), village centers, fixed day events, child growth monitoring, and immunization were provided by Conclusions Services to mothers and children were disrupted during stringent lockdown but restored thereafter, albeit not to pre-pandemic levels. Rapid policy guidance and adaptations by FLWs enabled restoration but little remains known about uptake by client populations. As COVID-19 continues to surge in India, focused attention to ensuring essential services is critical to mitigate these major indirect impacts of the pandemic.

To demonstrate that the silicone-based polymer polydimethylsiloxane (PDMS) is suitable as a substrate for flexible/wearable antennae and sensors, an investigation of its various properties was carried out. The substrate was first developed in compliance with the requirements, and then its anisotropy was investigated using an experimental bi-resonator approach. This material exhibited modest but discernible anisotropy, with values of ~6.2/25 % for the dielectric constant and loss tangent, respectively. Its anisotropic behavior was confirmed by a parallel dielectric constant (εpar) ~2.717 and an evaluated perpendicular dielectric constant (εperp) ~2.570—εpar > εperp by 5.7%. Temperature affected PDMS’s dielectric properties. Lastly, the simultaneous impact of bending and anisotropy of the flexible substrate PDMS on the resonance properties of planar structures was also addressed, and these had diametrically opposed effects. PDMS appears to be a good contender as a substrate for flexible/wearable antennae and sensors based on all experimental evaluations conducted for this research.

Recent studies indicate that surfactants are a relatively new and effective class of corrosion inhibitors that almost entirely meet the criteria for a chemical to be used as an aqueous phase corrosion inhibitor. They possess the ideal hydrophilicity to hydrophobicity ratio, which is crucial for effective interfacial interactions. In this study, a coconut-based non-ionic surfactant, namely, coco monoethanolamide (CMEA), was investigated for corrosion inhibition behaviour against mild steel (MS) in 1 M HCl employing the experimental and computational techniques. The surface morphology was studied employing the scanning electron microscope (SEM), atomic force microscope (AFM), and contact measurements. The critical micelle concentration (CMC) was evaluated to be 0.556 mM and the surface tension corresponding to the CMC was 65.28 mN/m. CMEA manifests the best inhibition efficiency (η%) of 99.01% at 0.6163 mM (at 60 °C). CMEA performs as a mixed-type inhibitor and its adsorption at the MS/1 M HCl interface followed the Langmuir isotherm. The theoretical findings from density functional theory (DFT), Monte Carlo (MC), and molecular dynamics (MD) simulations accorded with the experimental findings. The MC simulation’s assessment of CMEA’s high adsorption energy (−185 Kcal/mol) proved that the CMEA efficiently and spontaneously adsorbs at the interface.

Context: The aim is to awaken our colleagues to these reversible conditions. These are live saving if understood properly are life saving for patients. That is the purpose of this article and discussed in introduction. Aim: The aim of this study is to identify possible treatable causes in patients who present with progressive cognitive decline. These patients can be identified only by high degree of suspicion, thorough clinical examination and appropriate choosing of case-based investigations. This will be highly rewarding to the patients, their family, and to the treating physician. In this article, we are sharing our experience with the treatable dementias identified which were masquerading as degenerative. Settings and Design: Retrospective study. Subjects and Methods: Retrospective study of patients seen by the authors in the past 5 years who had all the mandatory recommended investigation done was included. Patients who qualified for pseudo-dementia and small vessel disease were not included in the analysis. Statistical Analysis Used: Basic statistical elements only were used as cases in each category are small. Results: Of 1105 patients, 92 had confirmed reversible cause. Among the treatable group immune-mediated dementia formed the largest and constituted about 45.6% followed by infections 19.5%, nutritional 15.2%, and rest were by rare conditions such as Whipple's disease, cerebrotendinious xanthamatosis, mitochondrial disorders, primary demyelination, central nervous system (CNS) lymphoma, surgical conditions such as normal pressure hydrocephalus and subdural hematoma. Conclusion: About 12.1% percentage of patients with memory complaint has a reversible cause which when detected early, the quality of life of both the patient and caregiver are significantly improved. Apart from protocol-based categorization of the patients, individualized thorough clinical examinations are mandatory to identify these patients.

Introduction: A neurological consultation is needed in nearly 45% of patients suffering from cancer. The present study was planned to evaluate the clinical, radiological and histopathological spectrum of patients with an underlying malignancy and presenting with a neurological complaint. Materials and Methods: We prospectively evaluated all patients provisionally diagnosed either with a primary or secondary malignancy of the brain on the basis of clinical, radiological and/or histopathological features. Results: A total of 155 patients were enrolled from a total of 4893 admissions done from January 2015 to July 2016. The common presenting symptoms were headache, back pain and paraparesis. Around 26% of patients presented with an altered sensorium, 19.4% with seizures and 21% had at least one cranial nerve involvement. The most common site of involvement was the brain noted in 49.7% of patients. Primary malignancies constituted 78 cases (50.7%) while secondary malignancies included 77 cases (49.3%). Magnetic resonance imaging (MRI) revealed 92 (59.4%) intra-axial lesions and 59 (38.1%) extra-axial lesions, with five cases having both. The most common diagnoses were intra-cerebral metastases and glioblastoma (intra-axial), and vertebral metastases and meningioma (extra-axial). Histopathological confirmation was obtained in 59 patients (38.1%) with 12 primary and 47 secondary lesions. Ten (6.45%) patients had an unknown primary with secondary metastases. The three most common histopathologically confirmed diagnoses were adenocarcinoma lung, plasma cell dyscrasia and adenocarcinoma prostate. Conclusion: Primary neurological consultations with an unknown primary are common hence a high index of suspicion can prevent an inadvertent delay in the diagnosis and appropriate treatment of a malignant lesion. Developing a neuro-oncology register may help us in gaining more insight into such situations.

Objectives The COVID-19 pandemic has profound negative impacts on people’s lives, but little is known on its effect on household food insecurity (HFI) in poor setting resources. This study assessed changes in HFI during the pandemic and examined the interlinkages between HFI with child feeding practices and coping strategies.Design A longitudinal survey in December 2019 (in-person) and August 2020 (by phone).Setting Community-based individuals from 26 blocks in 2 districts in Uttar Pradesh, India.Participants Mothers with children

Type 2 Diabetes (T2D), whose main cause is hyperglycemia, affects the central nervous system, leading to impairment of cognitive functions, which is a major hallmark of certain neurodegenerative disorders in human. These days, zebrafish (Danio rerio) has gained an increasing popularity as a promising model organism for experimental studies of learning and memory. The aim of this study was to investigate the effects of high sucrose induced hyperglycemia or T2D on learning and memory of zebrafish. Hyperglycemia was induced in adult zebrafish by immersion in 83.25 mM sucrose solution for 14 days after performing the study for survival in sucrose solutions. The animals were divided into 2 groups in replicates: control and sucrose-treated hyperglycemic groups. Afterwards, the learning and memory performance was evaluated in both the groups using T-plus maze test and spatial learning test, where zebrafish was required to either associate a visible cue with food reward irrespective of the location of this pairing or associate the spatial location of food reward irrespective of intra-maze cues respectively in two tests. High-sucrose induced hyperglycemic group produced diminished cognitive functions i.e. simple associative and spatial learning abilities by showing less time spent in target arm or zone, lower frequency of target arm or zone visits and total number of arm visits in the experimental apparatus. Overall, our results confirm that an unfamiliar environment of high-sucrose induced hyperglycemia in the zebrafishes are affecting their cognitive abilities. These results further strengthen the view that this complex cognitive ability may be further analyzed using the available genetic tool set for this simple vertebrate.

Background: Acute myopathy is a common cause of acute motor quadriparesis which has various etiologies with different courses of illness and prognosis depending on the cause. Understanding this diversity helps us in proper approach toward diagnosis, predicting the prognosis, and possible complications and in improving the treatments that are being provided. This study was planned to study the clinical, electrophysiological, and etiological profile of patients presenting with acute myopathy. We also studied how dengue-related acute myopathy differs from other causes and also difference between myopathy due to myositis and hypokalemia in cases of dengue. Materials and Methods: This was a prospective, observational study involving all clinically suspected cases of acute myopathy of not more than 4 weeks duration with raised serum creatine kinase (CK) level. They were subjected to detailed clinical evaluation along with hematological, biochemical, microbiological, and electrophysiological studies and followed-up for outcome at 1 and 3 months. Muscle biopsy and histopathological examination were done in selected patients after taking informed consent. Statistical analysis was performed by appropriate methods using SPSS version 16.0 (Chicago, IL, USA). Results: We evaluated thirty patients of acute myopathy with raised CK level. Seventeen patients had fever, 11 had myalgia, and 5 had skin lesions. All presented with symmetric weakness, 17 (56.7%) patients having predominantly proximal weakness, neck or truncal weakness in 6 (20%), hyporeflexia in 12 (40%), with mean Medical Research Council (MRC) sum score of 46.67 ± 6.0. Eight (mean modified Barthel index [MBI] at presentation - 15 ± 3.7) patients had poor functional status according to MBI and 15 according to modified Rankin scale (MRS) (mean MRS score - 2.5 ± 1.2). Etiology was dengue viral infection in 14 patients; hypokalemia due to various causes other than dengue in 8; pyomyositis in 3; dermatomyositis, polymyositis, thyrotoxicosis, systemic lupus erythematosus, and unknown etiology in one each. Only eight patients had abnormal electrophysiology and seven among nine biopsies done were abnormal. At 1 month, 24 (80.0%) and 23 (76.7%) patients had achieved normal MBI and MRS scores with 28 (93.3) and 27 (90%) patients, respectively, at 3 months. Dengue with hypokalemia had less myalgia, more of hyporeflexia, and lower serum CK compared to those without hypokalemia. Conclusion: Dengue infection and hypokalemia due to various causes are the most common causes of acute myopathy and are associated with rapid and complete recovery within 1 month. Shorter duration of illness, higher MRC sum score, better disability status at presentation, lower serum CK correlate with better outcome. Biopsy was decisive in

The simultaneous influences of the substrate anisotropy and substrate bending are numerically and experimentally investigated in this paper for planar resonators on flexible textile and polymer substrates. The pure bending effect has been examined by the help of well-selected flexible isotropic substrates. The origin of the anisotropy (direction-depended dielectric constant) of the woven textile fabrics has been numerically and then experimentally verified by two authorship methods described in the paper. The effect of the anisotropy has been numerically divided from the effect of bending and for the first time it was shown that both effects have almost comparable but opposite influences on the resonance characteristics of planar resonators. After the selection of several anisotropic textile fabrics, polymers, and flexible reinforced substrates with measured anisotropy, the opposite influence of both effects, anisotropy and bending, has been experimentally demonstrated for rectangular resonators. The separated impacts of the considered effects are numerically investigated for more sophisticated resonance structures—with different types of slots, with defected grounds and in fractal resonators for the first three fractal iterations. The bending effect is stronger for the slotted structures, while the effect of anisotropy predominates in the fractal structures. Finally, useful conclusions are formulated and the needs for future research are discussed considering effects in metamaterial wearable patches and antennas.

The growth of reduced graphene oxide (rGO) based semiconductor nanohybrids through simple, scalable, additive-free and cost-effective route has fascinated significant attention of researchers for both fundamental research areas and its commercial applications. In the present work, cadmium sulphide/reduced graphene oxide (CdS/rGO) films were sequentially or layer-by-layer (LBL) deposited by spin coating method. The samples were characterized by using x-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), UV-visible spectroscopy, Raman spectra and Hall measurements. The cubic phase of the CdS and formation of rGO was confirmed by XRD measurements. The FESEM micrographs elucidate a change in morphological features with rGO content in CdS/rGO nanohybrid films. The Raman spectra indicate the characteristic features for nanostructured CdS and rGO in these samples. Optical transmission is found to increase along with a decrease in optical gap with rGO content. Hall measurements showed the change in the majority carrier concentration with rGO content or the observation of surface charge transfer doping (SCTD) in these nanocomposites. The change in dispersion of refractive index with rGO content for CdS/rGO nanocomposites in terahertz (THz) spectral region has been observed. These results are very important for the development of new functionality of nanohybrid materials for emerging technologies.

The aim of this study was to evaluate the dose optimization in 3D image based gynecological interstitial brachytherapy using Martinez Universal Perineal Interstitial Template (MUPIT). Axial CT image data set of 20 patients of gynecological cancer who underwent external radiotherapy and high dose rate (HDR) interstitial brachytherapy using MUPIT was employed to delineate clinical target volume (CTV) and organs at risk (OARs). Geometrical and graphical optimization were done for optimum CTV coverage and sparing of OARs. Coverage Index (CI), dose homogeneity index (DHI), overdose index (OI), dose non-uniformity ratio (DNR), external volume index (EI), conformity index (COIN) and dose volume parameters recommended by GEC-ESTRO were evaluated. The mean CTV, bladder and rectum volume were 137 ± 47cc, 106 ± 41cc and 50 ± 25cc, respectively. Mean CI, DHI and DNR were 0.86 ± 0.03, 0.69 ± 0.11 and 0.31 ± 0.09, while the mean OI, EI, and COIN were 0.08 ± 0.03, 0.07 ± 0.05 and 0.79 ± 0.05, respectively. The estimated mean CTV D90 was 76 ± 11Gy and D100 was 63 ± 9Gy. The different dosimetric parameters of bladder D2cc, D1cc and D0.1cc were 76 ± 11Gy, 81 ± 14Gy, and 98 ± 21Gy and of rectum/recto-sigmoid were 80 ± 17Gy, 85 ± 13Gy, and 124 ± 37Gy, respectively. Dose optimization yields superior coverage with optimal values of indices. Emerging data on 3D image based brachytherapy with reporting and clinical correlation of DVH parameters outcome is enterprizing and provides definite assistance in improving the quality of brachytherapy implants. DVH parameter for urethra in gynecological implants needs to be defined further.

The effects of applied nitrogen (N) doses on crude protein and amylose accumulation in rice grains on primary and secondary rachis branches and their palatability were examined. The crude protein content of rice grains on both primary (PRB) and secondary rachis branches (SRB) increased with the increase in N supply showing a strong negative correlation with palatability. The correlation coefficient between protein content of the grains on PRB and SRB was –0.92 and –0.98, respectively. Although the amylose content also decreased with increasing N supply, the change was not significant oneither PRB or SRB. However, it showed a good correlation with palatability; i.e., the correlation coefficient on PRB and SRB was 0.93 and 0.84, respectively. Analysis of protein by SDS-PAGE showed that the contents of protein bodies PB-I and PB-II, were correlated with palatability, but the latter had a higher correlation. The grains on PRB showed a higher palatability than those on SRB due to the difference in the accumulation pattern of proteins and amylose. These results suggest that when breeding for varieties with good palatability, the plants with more grains on PRB should be selected and by maintaining the nitrogen level in the field, we can control protein accumulation and thus can improve the palatability of rice crop.

Vibrio cholerae porin OmpU plays a crucial role in the survival of the organism in the human gut. Various observations suggest critical involvement of OmpU in V. cholerae pathogenesis. However, OmpU is poorly characterized in terms of its ability to evoke cellular responses, particularly in the context of host immune system. Therefore, towards characterizing V. cholerae OmpU for its host immunomodulatory functions, we have studied the ability of OmpU to elicit pro-inflammatory responses in a range of immune cells which include, mouse RAW 264.7 macrophages, human THP-1 monocytes and human PBMCs. We have observed that purified OmpU induces pro-inflammatory responses in terms of production of NO, TNFα and IL-6. Interestingly, pre-treatment of the cells with OmpU suppresses the production of NO, TNFα, IL-6 as well as IL-12 upon subsequent activation with LPS. Our results therefore suggest that V. cholerae OmpU may have a differential regulatory role in terms of host immunomodulatory function: it can induce pro-inflammatory responses in target host immune cells, whereas it can also exert suppressive effect on LPS-induced pro-inflammatory responses. In addition, our study indicates that purified OmpU may have the ability to skew the Th1 response towards the Th2 response, presumably via suppression of IL-12 production.

Understanding the requirements for protection against pneumococcal carriage and pneumonia will greatly benefit efforts in controlling these diseases. Several proteins and polysaccharide capsule have recently been implicated in the virulence of and protective immunity against Streptococcus pneumonia. Pneumococcal surface protein A (PspA) is highly conserved among S. pneumonia strains, inhibits complement activation, binds lactoferrin, elicits protective systemic immunity against pneumococcal infection, and is necessary for full pneumococcal virulence. Identification of PspA peptides that optimally bind human leukocyte antigen (HLA) would greatly contribute to global vaccine efforts, but this is hindered by the multitude of HLA polymorphisms. Here, we have used an experimental data set of 54 PspA peptides and in silico methods to predict peptide binding to HLA and murine major histocompatibility complex (MHC) class II. We also characterized spleen- and cervical lymph node (CLN)-derived helper T lymphocyte (HTL) cytokine responses to these peptides after S. pneumonia strain EF3030-challenge in mice. Individual, yet overlapping peptides, 15 amino acids in length revealed residues 199 to 246 of PspA (PspA(199-246)) consistently caused the greatest IFN-gamma, IL-2, IL-5 and proliferation as well as moderate IL-10 and IL-4 responses by ex vivo stimulated splenic and CLN CD4(+) T cells isolated from S. pneumonia strain EF3030-challeged F(1) (B6xBALB/c) mice. IEDB, RANKPEP, SVMHC, MHCPred, and SYFPEITHI in silico analysis tools revealed peptides in PspA(199-246) also interact with a broad range of HLA-DR, -DQ, and -DP allelles. These data suggest that predicted MHC class II-peptide binding affinities do not always correlate with T helper (Th) cytokine or proliferative responses to PspA peptides, but when used together with in vivo validation can be a useful tool to choose candidate pneumococcal HTL epitopes.

Competing Interests: Competing InterestsThe authors declare no competing interests.

Background: The COVID-19 pandemic overburdened the healthcare system and affected the mental health of healthcare workers. Yoga has proven to improve mental health correlates, within diverse population groups, including healthcare workers. Considering the pandemic-imposed restrictions, this trial was designed to study the feasibility and effect of tele-yoga intervention on burnout, sleep quality, depression, anxiety, stress, mindfulness, and immune markers of healthcare workers on COVID-19 duty., Methods: This randomized controlled trial was conducted in a tertiary care hospital. Tele-yoga intervention was delivered five days a week for 8 weeks. Stanford Professional Fulfilment Index (SPFI), Pittsburg Sleep Quality Index (PSQI), Depression Anxiety and Stress Scale (DASS-21), Mindfulness Attention Awareness Scale (MAAS) were used to assess the burnout, sleep quality, depression, anxiety, stress and mindfulness. Blood samples were assessed for TNF-α, IL-6 and serum cortisol levels., Results: A total of 147 healthcare workers were screened to achieve a sample size of 90 (45 each in tele-yoga intervention and control group). Of the 45 subjects in the intervention group, 35 attended at least 50 % of sessions over 8 weeks, at the rate of 3.35 sessions per week. Nearly 37.14 % of subjects among 35 were able to attend more than 70 % of the tele-yoga sessions. At the endline, 35 in the intervention and 37 in the control group completed the outcome questionnaires. On both per protocol (PPA) and intention to treat analyses (ITT) the burnout index, PSQI, anxiety and stress scores and IL-6 and serum cortisol level were significantly lower among the tele-yoga group compared to control group participants (p<0.05) at the endline. The effect size was medium (r=0.3-0.5) favoring intervention group for most of the parameters., Conclusions: Tele-yoga is a feasible and accessible intervention for improving burnout, sleep quality, and reducing anxiety, stress, IL-6, and serum cortisol among healthcare workers in tertiary care hospitals during the COVID-19 pandemic. Being a single-center pilot study in India and with other methodological limitations, the generalizability of the study findings is restricted., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This study explores the synthesis of a novel titanium oxide-cetyltrimethylammonium bromide (TO@CTAB) nanocomposite for the effective removal of malachite green (MG) and methyl orange (MO) dyes. The optimization of the nanocomposite's performance was carried out using response surface methodology (RSM). The adsorption characteristics were further evaluated through isotherm models, kinetic studies and thermodynamic analyses. The mesoporous nature of TO@CTAB was confirmed through BET analysis, revealing a pore diameter of 4.625 nm. The crystalline size of TO@CTAB is 54.78 nm, and its crystalline index is 70.84%. The optimal operating conditions were established based on the results obtained from the ANOVA. The Langmuir isotherm model demonstrates superior adsorption performance compared to the Freundlich isotherm model, with adsorption efficiencies of 317.46 mg/g for MO and 306.748 mg/g for MG. The pseudo-second-order model, with an R 2 value of 0.998 and 0.997 for MO and MG, respectively, provides a more accurate and reliable explanation of the adsorption process compared to the pseudo-first-order model. Furthermore, the high reusability and minimal deterioration of TO@CTAB were observed for up to 5 cycles. The analysis of the adsorption mechanism indicates that the adsorption of MG and MO occurs through H-bonding, electrostatic and π-π interactions. A comprehensive cost analysis of the process was conducted to evaluate the cost-effectiveness; total expenditure incurred during the process was determined to be within acceptable limits. TO@CTAB was assessed using real wastewater samples, demonstrating a decolourization efficiency of 82%. Additionally, it resulted in a reduction of COD, BOD, TSS and TDS., Competing Interests: Declarations Ethics approval Not applicable to the current study. Consent for publication The authors express their consent for the publication of research work. Competing interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Rearrangement involving ZNF384 gene ( ZNF384 -r) is recently being described in acute leukemias. We present the clinic-pathological and immunophenotypic findings in a series of five cases of acute leukemia with ZNF384 -r reported in our Institute between September 2020 to September 2023. Notably, while TCF3::ZNF384 fusion was the most frequently encountered abnormality, the fusion partner was not identified in two patients with ZNF384 -r BCP-ALL. Immunophenotypically, patients presenting as B-cell precursor acute lymphoblastic leukemia (BCP-ALL) had a distinct profile characterized by weak or absent CD10 expression and the presence of myeloid markers such as CD13/CD33. Our findings underscore the importance of recognizing the distinct immunophenotypic features of ZNF384-r leukemias, particularly in cases presenting with atypical BCP-ALL or B/Myeloid mixed phenotype acute leukemia phenotypes. Moreover, these findings highlight the necessity for tailored diagnostic algorithms in clinical laboratories to facilitate the timely and accurate diagnosis of this clinically relevant leukemia subtype., Competing Interests: Conflicts of Interest/Competing InterestsThe authors declare that they have no conflict of interest., (© The Author(s), under exclusive licence to Indian Society of Hematology and Blood Transfusion 2024.)

The COVID-19 pandemic has underscored the critical importance of understanding the intricate relationship between micronutrient levels and disease outcomes. This study explores the impact of Vitamin D, calcium, phosphorus, magnesium, and alkaline phosphatase (ALP) on COVID-19 severity and mortality. The study involves 200 participants (100 COVID-19 patients, 100 controls), we meticulously analyzed micronutrient dynamics. Calcium, phosphorus, magnesium and ALP was measured spectrophotometrically. Vitamin D was measured using Chemiluminescent method. The study reveals that diminished levels of calcium, phosphorus, magnesium, and with elevated ALP, are significantly associated with COVID-19 cases. Whereas the Vitamin D levels in severe group was increased when compared to mild cases but decreased than control group. Disease severity correlated with declining calcium (r = - 0.35, p  < 0.01), phosphorus (r = - 0.26, p  < 0.05), and magnesium (r = - 0.21, p  < 0.05), and increased ALP (r = 0.42, p  < 0.001). Post-discharge, calcium ( p  < 0.05) and phosphorus ( p  < 0.01) showed positive trends, while ALP ( p  < 0.001) decreased. Notably, calcium (OR = 0.63, p  < 0.05) and ALP (OR = 1.87, p  < 0.001) emerged as significant predictors of disease severity. The findings not only illuminate potential therapeutic avenues but also emphasize the need to optimize nutrient levels, including magnesium, for COVID-19 prevention and management. Given the complexities of these relationships, further rigorous exploration, including well-designed trials and understanding underlying mechanisms, is imperative to unravel the dynamics of these nutrient interactions in the context of COVID-19., Supplementary Information: The online version contains supplementary material available at 10.1007/s12291-024-01225-9., (© The Author(s), under exclusive licence to Association of Clinical Biochemists of India 2024. 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.)

Various formulae had been derived to calculate the LDL-C from other lipid profile parameters to supplant the need for direct estimation. Martin's, Sampson's, and Cordova's formulae are recently derived formulae for calculating LDL-C. However, no study has been undertaken till now to verify the newer formulae viz. Martins's and Sampson's in Indian population. The retrospective cross-sectional study was carried out after obtaining approval from the Institutional Ethics Committee on human subject research. The lipid profile data were collected for a period of 17 months from January 2020 to May 2021. The formulae proposed by Friedewald, Cordova, Anandaraja, Martin, and Sampson were used to assess calculated LDL-C. Intraclass correlations were performed to assess the effectiveness of each formula when compared with direct estimation. In our study, we observed that LDL-C calculated using Martin was observed to be closer to that of direct estimation. The bias observed was lowest for Martin's formulae, followed by Sampson's. Intraclass correlation analysis for absolute agreement demonstrated Cordova, Martin, and Sampson to have an average ICC > 0.9, with Martin, and Sampson having a p value < 0.05. Martin fared superior to other formulae in intraclass correlation in patients with LDL > 70. In patients with TG below 200 mg/dL, Martin, and Sampson had a significant correlation with comparable average ICC. However, in patients with TG > 300 mg/dL, Cordova appears to fare better than all other formulae. Our study demonstrated a distinctly superior performance of Martin's formula over Friedewald's formula in the Indian patient population., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Author(s), under exclusive licence to Association of Clinical Biochemists of India 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: To diagnose diseases, track the effectiveness of treatments and make well-informed clinical decisions, doctors rely on results from laboratories. Accurate and precise results minimize the necessity for additional testing, saving time and money while enhancing patient satisfaction.. Internal quality control and an external quality assurance scheme(EQAS) are metrics used to evaluate a clinical laboratory's performance. One of the numerous quality indicators that can be used to gauge the amount of errors is sigma metrics. To calculate the sigma scores bias%, CV%, and Total Error Allowable (TEa) are needed. Total Error allowable(TEa) is a crucial benchmark that establishes allowed limits on the degree of deviation from the target value for a certain analyte. Nevertheless, a proper consensus for establishing a TEa goal has not been reached and the impact of this limiting factor in standard laboratory practice and sigma calculation has not been sufficiently established. Choosing the right Total Error allowable(TEa) goal is one of the greatest challenges when employing sigma metrics as depending on the source, several measurands of TEa values may exhibit alteration., Material and Methods: Our study aims to determine the sigma scores of 20 routine chemistry parameters using six different TEa sources: Clinical Laboratory Improvement Amendment (CLIA 88'), CLIA(Clinical Laboratory Improvement Amendment) 24, BDV (Biological Variation Desirable), RCPA(Royal College of Pathologists of Australasia), RiliBak(Guideline of the German Medical Association for Quality Assurance of Laboratory Medical Examinations), and EMC/Spain(Measurement and Control Scheme) over a 12-month period using the bias percent from the External Quality Assessment Scheme (EQAS) and coefficient of variation (CV) from the Internal Quality Control (IQC). Detection system was automated, multi-channel, selective analyzer, the Beckman Coulter AU680 which works on the principle of spectrophotometry. To compute the Sigma metrics, formula used was Sigma = (TEa - Bias%) / CV%. By comparing the sigma values from the different TEa sources, TEa variance on the evaluation of the sigma metric was ascertained after which an internal quality control plan and QGI(Quality Goal Index) for underperforming parameters were devised., Results: The study discovered that the sigma values of common chemical parameters varied significantly based on the TEa sources used. Maximum parameters in the above three-sigma zone were TBil, HDL, CK, ALP, amylase and uric acid in CLIA'88 while RCPA and Biological variation were determined to be the most severe, with the highest performing parameters falling below three sigma zones. Rilibaek was the most liberal, with only sodium in the lower three sigma zones along with CLIA'88. The findings indicate that there is the substantial influence of various Total Error Allowable (TEa) sources on the sigma metric evaluation. A quality control plan was devised depending on different sigma scores of the analytes using biorad unity 2.0 software(westgard sigma multirules). The origins of errors that resulted in low sigma ratings liked enhanced cleaning of electrodes, electrode replacement, ageing of reagents, instrument maintainence were pinpointed and addressed., Conclusion: The study highlights the necessity of harmonizing and standardizing sigma metrics, stressing the significance of choosing suitable total error allowable goals (TEa). The creation of worldwide standards and recommendations for total error allowable (TEa) can lead to its harmonization. Establishing a consensus on the acceptable levels of error for various laboratory tests would necessitate the cooperation of specialists from many nations and organizations in order to set such guidelines and standards., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, is increasing globally. Noninvasive methods, such as bioelectrical impedance analysis (BIA), which measures body composition, including visceral fat, are gaining interest in evaluating MASLD patients. Our study aimed to identify factors associated with significant liver fibrosis, compare noninvasive scores, and highlight the importance of visceral fat measurement using BIA., Methods: MASLD patients seen in our out-patient department underwent comprehensive evaluations, including liver stiffness using transient elastography, body composition analysis using BIA, and metabolic measurements. Significant fibrosis was defined as a liver stiffness measurement of ≥8.2 kPa. Using multivariate analysis, we identified factors associated with significant liver fibrosis and compared four noninvasive scores with a novel diabetes-visceral fat 15 (DVF15) score., Results: We analyzed data from 609 MASLD patients seen between February 2022 and March 2023. The median age was 43 years (81% male). Among these, 78 (13%) had significant fibrosis. Patients with significant fibrosis had higher rates of type 2 diabetes (41% vs 21%, P < 0.001) and elevated levels of aspartate aminotransferase, alanine aminotransferase, hemoglobin A1c, Fibosis-4, aspartate-aminotransferase-to platelet-ratio index, and NAFLD fibrosis scores. They also exhibited higher visceral and subcutaneous fat. Binary logistic regression revealed type 2 diabetes and a visceral fat level of >15% as associated with significant liver fibrosis. Additionally, the DVF15 score, combining these factors, showed a modest area under the receiver operating characteristic curve of 0.664 ( P < 0.001)., Conclusion: Our study identified diabetes and high visceral fat as factors associated with significant liver fibrosis in MASLD patients. We recommend that visceral fat measurement using BIA be an essential part of MASLD evaluation. The presence of either diabetes or a visceral fat level of >15% should prompt clinicians to check for significant fibrosis in MASLD patients. Further research is warranted to validate our findings and evaluate the utility of the DVF15 score in larger cohorts and diverse populations., (© 2024 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Response to BH3 mimetics in multiple myeloma (MM) correlates with CCND1-rearrangement or expression of anti-apoptotic molecules, particularly Bcl-2 and Mcl-1. Our study investigates the relationship between cytogenetic abnormalities (CGAs) and intracellular Bcl-2 and Mcl-1 expression in myeloma plasma cells (MPCs) using flow cytometry (FCM). We measured median fluorescence intensity (MFI) of Bcl-2 and Mcl-1 in 163 bone marrow samples (143 MM, 20 controls) across various cell types. Both Bcl-2MFI and Mcl-1MFI were significantly higher in MPCs compared to other cells, with Bcl-2 MFI exceeding Mcl-1 MFI in MPCs. Bcl-2 expression peaked in CCND1-rearranged cases, while Mcl-1 expression was highest in cases with 1q21 gain/amplification. Notably, 65-74% of cases with other CGAs exhibited moderate to strong Bcl-2 or Mcl-1 expression, indicating potential utility of BH3 mimetics in this group, while 25% showed dim to absent expression of one or both markers, suggesting potential futility in these patients. Our study highlights FCM's potential for rapid Bcl-2 and Mcl-1 quantification, surpassing traditional methods. We propose that direct measurement of Bcl-2 and Mcl-1 expression in PCs by FCM, combined with cytogenetic characterization, could improve therapeutic decision-making regarding the use of BH3 mimetics in MM, potentially enhancing outcomes and overcoming resistance., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Ten-eleven translocases (TETs) are enzymes responsible for demethylation processes, playing a crucial role in maintaining the body's methylation balance. Dysregulation of TET expression can lead to abnormal methylation levels. Isocitrate dehydrogenases (IDH) are upstream genes involved in Kreb cycle responsible for production of α-ketoglutarate (α-KG). α-KG and vitamin C are cofactors of TET3 enzyme. There is limited data on the relationship between TET3 and its cofactor Vitamin C in head and neck carcinoma (H&NC)., Methods and Results: In this study, we have investigated the expression of the TET3 gene along with IDH1/2 genes involved in the Krebs cycle in the peripheral blood of 32 H&NC patients compared to 32 healthy controls. We estimated serum levels of TET3 protein and vitamin C and 5-hydroxymethylcytosine (5-hmC) percentage in DNA isolated from EDTA blood samples. Our findings revealed that TET3 and IDH1/2 were downregulated in H&NC patients compared to healthy controls. Serum levels of TET3 and Vitamin C were low in H&NC patients compared to healthy controls. Diminished levels of percentage 5-hmC were detected in EDTA blood samples of H&NC patients compared to controls. Spearman correlation analysis revealed a significant positive correlation between TET3 levels, vitamin C levels and 5-hmC percentage., Conclusion: The low levels of Vitamin C are believed to contribute to decreased activity of the TET3 gene and less conversion of 5-methylcytosine (5-mC) to 5-hmC. Dietary supplementation of Vitamin C may increase TET3 activity., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)