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Background: COVID-19 is an emerging and rapidly evolving situation globally, and it poses additional burden for emergency health care services especially the transfusion medicine and the need of an hour to safeguard our regular blood donors. Aim and Objectives: The study aims to find out the proportion of COVID-19 infection among blood donors and non-blood donors (NBDs) and to assess their behavioral risk factors that predispose to COVID-19. Materials and Methods: A case-control study was conducted among regular blood donors and non-blood donors at the department of transfusion medicine attached to tertiary care hospital with an objective to find out the proportion of COVID-19 status and the risk factors associated with its occurrence. Results: Total of 834 participants involved in our study. Accordingly, we found the proportion of COVID-19 to be 9% among regular blood donors and 2% among NBDs. A significant association was noted with regular going out, co-morbidities, B positive blood group and perceived stress as the risk factors in regular blood donors. Moreover, among NBDs maintaining social distancing and regular washing of hands/use of sanitizers were significant factors. Conclusions: The novelty of this study helps to remake our policies concerned mainly on the protection of our potentially emergency service providers against COVID-19 infection.

Background: Sickness absenteeism is a potential epidemiological issue leading to loss of productivity in addition to increasing the cost of health care and provides a major tool in enhancing occupational health care preventive strategies. Aim and Objectives: To determine the prevalence of sickness absenteeism and their associated factors among Industrial Workers of Pharmaceutical Manufacturing industries in Hyderabad. Materials and Methods: A cross sectional study was taken up among 160 Workers at two Pharmaceutical Manufacturing companies in Hyderabad using simple random sampling technique. Data included Individual, Occupational and Organizational factors influencing their sickness absenteeism and general health conditions in the past six months through camp based approach. Data was analysed using descriptive statistics and multinomial logistic regression analysis to predict the variables associated with the outcome. Results: The prevalence of sickness absenteeism was found among 19% of the workers. Common causes were due to sickness among 25(84%) and social responsibilities among 5(16%). On multinomial logistic regression analysis- poor superior relationships, poor co-workers relationship and high mental stress were found to be significant. Conclusion: Sickness absenteeism was found to be high which can be reduced by improving relationships with superiors and co-workers and also by reducing mental stress among the workers.

Introduction: Coeliac Disease (CD) is a systemic immune disorder caused by gluten in genetically susceptible individuals. A serological screening assay for CD has been designed to detect Immunoglobulin A (IgA) and IgG anti-tissue Transglutaminase (a-tTG) and IgA and IgG Deamidated Gliadin Peptide antibodies (a-DGP) simultaneously. The seronegative gap can be closed when these two antigens are combined on a single solid phase. This is primarily because untreated CD children who are negative for antibodies of one of the antigens may exhibit a positive result for the other. Aim: To determine the diagnostic parameters {sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV)} of tTG-IgA and htTG-DGP (Coeliac fusion- a combination of IgA and IgG to human tTG and synthetic DGP) for the diagnosis of CD in clinically symptomatic children. Materials and Methods: This cross-sectional study was conducted at the Paediatric Outpatient Department (OPD) of Santokhba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India from April 2023 to November 2023. The study population comprised 45 children (age >6 months and

Background: Wireless Holter monitors can be a great alternative to the traditional wired holter monitoring potentially giving better patient outcomes. However, the technology is new and less explored for the quality of ECG wave forms. Objective: This study was taken up to compare the quality of electrocardiogram (ECG) and arrhythmia detection using a traditional Holter and a wireless ambulatory smart ECG – Vigo SmartHeart (VSH) that functions with a Mobile application. Materials and Methods: The present study was cross-sectional in nature. We enrolled the patients indicated for continuous ECG monitoring. All the enrolled patients were connected to VSH wireless Holter solution and a conventional Holter monitor simultaneously. The ECGs generated were compared through descriptive statistics such as mean, standard deviation, and correlation by Pearson’s correlation method. Results: Seventy-one patients had simultaneous ECG recordings by both systems. The Pearson correlation for P wave, QRS, PR, QT, and ST was measured as 0.93, 0.93, 0.99, 0.36, and 0.98, respectively. The minimum heart rate (HR), maximum HR, RR interval, P wave, QRS complex, PR, and ST segments showed a statistically significant correlation between Smart Heart and Conventional Holter. 17 ECG events were reported, of which 14 were detected by both. The events missed by conventional Holter and detected by VSH were Atrioventricular block (2), Supraventricular tachycardia (1), and Intraventricular conduction delay (1). Conclusions: The quality of the report generated by both the methods was comparable to ECG wave quality, However, arrhythmia was picked up by the SmartHeart with better precision compared to conventional Holter. Thus, VSH can serve as a viable and potential alternative tool to screen and help in reducing the morbidity and mortality related to arrhythmias.

Introduction: Long COVID is commonly encountered by many individuals during the coronavirus 2019 pandemic. It is best diagnosed by a history consistent with acute coronavirus disease 2019 (COVID-19) followed by a prolonged recovery. An attempt has been made to enlist the sequel of long COVID clinically and to assess their risk factors. Materials and Methods: Confirmed COVID-19 patients admitted to our hospital were enquired about their persistent symptoms following infection after 3– 12 weeks for acute symptoms and after 12 weeks for chronic symptoms through the predesigned questionnaire schedule about their manifestations and followed up every month for 6 months. Results: A total of 152 patients were included in our study and found acute long COVID symptoms related to neurological (72.2%), respiratory (64.7%), and musculoskeletal (61.4%) system being most commonly affected. Chronic symptoms were comprised predominantly musculoskeletal (63.1%) followed by fatigue (43.4%) and neurological (29.6) manifestations. Risk factors estimate of postacute COVID-19 symptoms showed that females had increased risk with odds ratio (OR) (and 95% confidence intervals) (OR) of 2.412 (1.239–4.692), sedentary lifestyle OR 1.775 (1.345–2.762), body mass index (BMI) >23 OR 3.877 (1.613–6.144), and presence of comorbidities OR 2.526 (1.277–4.997). Similarly, risk factor estimate of Postchronic COVID-19 symptoms showed that females had increased risk with OR 1.879 (0.952–3.709), sedentary lifestyle OR 5.091 (2.853–9.085), BMI >23 OR 2.082 (1.005–4.134), and presence of comorbidities OR 1.851 (0.925–3.705). Conclusions: Long COVID symptoms noted were mainly related to musculoskeletal disorders, neurological, respiratory, and fatigue. This enumeration will help us to bring the further pathway to include this long COVID entity for preventive strategies in our regular setup at the primary care level.

Introduction: The aim of the study was to evaluate the feasibility and outcome of laparoscopic surgery in complicated choledochal cyst (CDC) with previous interventions (laparotomy or biliary drainage). Patients and Methods: Patients with CDC who underwent surgery from July 2014 to July 2019 were evaluated. CDC without previous interventions (Group A) was compared with CDC that had previous interventions (Group B) to assess the feasibility and outcome of laparoscopic surgery. Results: In 5 years' period, 38 patients were operated for CDC. The mean age was similar in both groups (3.78 ± 2.27 in Group A and 4.08 ± 2.73 in Group B). Out of six CDC with previous intervention (Group B), five patients were previously managed at other institutions as follows: (1) Laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) stenting. (2) Laparotomy for biliary peritonitis and ERCP. (3) Percutaneous drainage of the large cyst. (4) Laparoscopic cholecystectomy. (5) ERCP stenting. (6) Percutaneous drainage for biliary ascites. All patients underwent laparoscopic CDC excision and hepatico-duodenostomy. The mean duration of surgery was 160.3 ± 17.22 in Group A and 169.2 ± 17.5 in Group B (P = 0.258). None required intraoperative blood transfusion. None had a bile leak. Drain was removed at 4.47 ± 0.98 in Group A, while at 4.17 ± 0.75 days in Group B (P = 0.481). There was statistically no significant difference in feed starting time or length of stay. In follow-up of 6 months–3 years, all patients are asymptomatic. Conclusions: Laparoscopy in complicated CDC with previous intervention is technically tedious but is feasible. The procedure is safe and delivers a good outcome.

The complex of methyltransferase-like proteins 3 and 14 (METTL3-14) is the major enzyme that deposits N6-methyladenosine (m6A) modifications on messenger RNA (mRNA) in humans. METTL3-14 plays key roles in various biological processes through its methyltransferase (MTase) activity. However, little is known about its substrate recognition and methyl transfer mechanism from its cofactor and methyl donor S-adenosylmethionine (SAM). Here, we study the MTase mechanism of METTL3-14 by a combined experimental and multiscale simulation approach using bisubstrate analogues (BAs), conjugates of a SAM-like moiety connected to the N6-atom of adenosine. Molecular dynamics simulations based on crystal structures of METTL3-14 with BAs suggest that the Y406 side chain of METTL3 is involved in the recruitment of adenosine and release of m6A. A crystal structure with a BA representing the transition state of methyl transfer shows a direct involvement of the METTL3 side chains E481 and K513 in adenosine binding which is supported by mutational analysis. Quantum mechanics/molecular mechanics (QM/MM) free energy calculations indicate that methyl transfer occurs without prior deprotonation of adenosine-N6. Furthermore, the QM/MM calculations provide further support for the role of electrostatic contributions of E481 and K513 to catalysis. The multidisciplinary approach used here sheds light on the (co)substrate binding mechanism, catalytic step, and (co)product release, and suggests that the latter step is rate-limiting for METTL3. The atomistic information on the substrate binding and methyl transfer reaction of METTL3 can be useful for understanding the mechanisms of other RNA MTases and for the design of transition state analogues as their inhibitors.

Background: COVID-19 pandemic has affected mankind globally. After the three waves since March 2020, the threat continues instilling fear in the minds. Vital parameter monitoring through remote health monitoring system (RHMS) becomes critical for effective disease management and manpower safety and confidence. In a low resource setting like India, a comprehensive, wearable, and remotely operable device that is economical was required to be introduced for COVID-19 care. Present study validated the remote health monitoring device named COVIDBEEP with gold standard equipment. Materials and Methods: Six parameters, namely heart rate, SpO2, respiratory rate, temperature, blood pressure, and ECG were acquired in the supine position using the devices. Result: Analysis was performed using Graph Pad Prism. Intraclass correlation coefficients were used to measure concurrent validity. Bland–Altman graphs were plotted to know the agreement for each vital parameter. Confidence limits were set at 95%. All the parameters recorded from the devices showed a significant correlation with an “r” value between 0.5 and 0.9 with P value between 0.001 and 0.0002. Bland–Altman plots showed a minimum bias of 0.033 for heart rate and maximum of 3.5 for systolic blood pressure and respiratory rate. Conclusion: The association between the parameters recorded by the devices strengthened as the time of collection of data increased. Agreement between the two methods in 95% confidence interval was also proven to be significant for the parameters. Therefore, the indigenously developed COVIDBEEP has shown good validity in comparison to standard monitoring device.

Aluminum phosphide (ALP) poisoning is one of the most common and lethal poisonings with no antidote available till now. Inhalation or ingestion of ALP leads to the production of phosphine gas when exposed to moisture. We here report an adolescent female with alleged consumption of ALP available as celphos tablet, followed by severe metabolic acidosis and cardiogenic shock. Rapid timely initiation of venoarterial extracorporeal membrane oxygenation leads to intact neurological outcome and survival. Timely referral to higher center with extracorporeal life support facility is a key.

Cor triatriatum is a rare congenital heart disease (0.1% of all congenital cardiac defects). Most patients are identified shortly after birth with the evaluation of a distressed or cyanotic neonate. However, when the presentation is delayed, primary symptoms may mimic reactive airway disease. We present an 11-year-old adolescent male who presented with obstructive sleep apnea-like features initially, on further evaluation showed features of severe pneumonia. There was clinical and radiological dissociation with the findings.

Background: The different ambient temperatures of the upper and lower respiratory tract could influence the replication kinetics of the virus. Objective: This study is aimed to evaluate the effect of steam inhalation on clinical progression of COVID-19 and its subsequent impact on viral load that was evaluated in patients. Materials and Methods: A randomized control trial in mildly infected COVID-19 was undertaken. The participants were randomized either to standard treatment plus steam inhalation (test, n = 22) or standard treatment alone (control, n = 22). Steam inhalation was continued for 20 min thrice daily for 10 days. The first reverse transcription polymerase chain reaction swab was collected on day 1 before steam inhalation and the second swab was obtained after its completion on the fourth day. In the control group, the swabs were collected at the matched time-points. The clinical progression of disease and the need of oxygen therapy were observed for 10 days. Reductions in cycle-threshold levels were assessed at the completion of 4 days of steam treatment. Results: Only one patient from the test group and six patients from the control group progressed to moderate disease. No patient from the steam group required oxygen therapy, whereas three patients from the control group needed it. The median cycle-threshold levels pertaining to N-gene, E-gene, and RNA-dependent RNA polymerase, respectively, were nonsignificant. All the patients showed clinical recovery. Conclusions: The clinical trends support the use of steam therapy as add on over standard treatment in mildly infected COVID-19 patients.

Misuse of organophosphate insecticides, even in case of domestic application, can be life threatening. We report a case of accidental consumption of organophosphorus substance by a 3-year-old female child presented to us with unconsciousness and nicotinic manifestation of organophosphate poisoning unlike classical toxidrome of muscarinic manifestation.

We report new chemical entities for disrupting the interactions between N6-methyladenosine (m6A) mRNA and its reader YT521-B homology-domain-containing protein 1 (YTHDC1). High-throughput docking was used to screen commercially available databases of small molecules, and molecular dynamics simulations were employed to evaluate the binding stability of m6A nucleotide analogues. The poses of 25 fragment-like new binders were confirmed by X-ray crystallography. The structure-based merging of two weak fragments resulted in a ligand-efficient binder (compound 6) which shows an equilibrium dissociation constant of 1.7 ​μM in isothermal titration calorimetry measurements and a ligand efficiency value of 0.66 ​kcal ​mol−1 nHA−1.