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Background: This study describes the surgical technique of thoracoscopic resection of posterior mediastinal neurogenic tumours and reporting the surgical outcomes. Methods: This is a retrospective analysis of 21 patients operated over 7 years in a dedicated thoracic surgery centre. The demographic and post-operative parameters along with complications were recorded and analysed. Results: Twelve patients had right-sided tumours, while 9 had left-sided lesions, and 9 were on the left side. The most common diagnosis was schwannoma (n = 15, 71.42%), followed by neurofibroma (n = 4, 19.04%). The average surgery duration was 104 min (85–135 min), and the mean blood loss was 120 ml (25 ml–250 ml). The average lesion size was 4.8 cm (2 cm–7 cm). Conversion to open procedure was required in one patient. Two patients (14.2%) developed complications. One patient developed Horner's Syndrome and the other developed post-operative lung atelectasis. The median follow-up was 36 months (6–90 months). No recurrence was observed during the follow-up period. Conclusions: Thoracoscopic approach to posterior mediastinal neurogenic tumours is feasible and allows for low morbidity, short hospital stay and superior cosmesis.

Psychological distress associated with surgery is an emerging issue. The study was conducted to assess the impact of structured patient education viz-a-viz routine patient education on anxiety and depression levels in patients undergoing elective chest surgery. It is a prospective, double-blind randomized study, conducted from February 2019 to February 2020 at a tertiary care center in India, on patients who underwent elective chest surgeries. A total of 300 patients were randomized using a computer-generated randomization sequence, into 2 equal groups (150 subjects each). Study group included patients who underwent structured patient education (Group A), whereas control group included patients who underwent routine patient education (Group B). The 2 groups were compared for anxiety and depression levels at admission as well as discharge using Hospital Anxiety and Depression Scale. Also, at the time of discharge, the groups were compared for the effectiveness of patient education using a validated Questionnaire B. In comparison to routine education, patients receiving structured education showed significantly lesser scores for anxiety and depression at discharge ( P

Introduction--: Even today, open lobectomy involves significant morbidity. Video-assisted thoracic surgery (VATS) lobectomy results in lesser blood loss, pain, and hospital stay compared to lobectomy by thoracotomy. Despite being an excellent procedure in expert hands, VATS lobectomy is associated with a longer learning curve because of its inherent basic limitations. The da Vinci surgical system was developed essentially to overcome these limitations. In this study, we report our initial experience with robotic pulmonary resections using the Completely Portal approach with four arms. To the best of our knowledge this is the first series of robotic lobectomy reported from India. Material and Methods: Data on patient characteristics, operative details, complications, and postoperative recovery were collected in a prospective manner for patients who underwent Robotic Lung resection at our institution between March 2012 and April 2014 for various indications including both benign and malignant cases. Results: Between March 2012 to April 2014, a total of 13 patients were taken up for Robotic Lobectomy with a median age of 57 years. The median operative time was 210 min with a blood loss of 33 ml. R0 clearance was achieved in all patients with malignant disease. The median lymph node yield in nine patients with malignant disease was 19 (range 11-40). There was one intra-operative complication and two postoperative complications. The median hospital stay was 7 days with median duration to chest tube removal being 3 days. Conclusion: Robotic lobectomy is feasible and safe. It appears to be oncologically sound surgical treatment for early-stage lung cancer. Comparable benefits over VATS needs to be further evaluated by long-term studies.

Abstract Objective Therapeutic translation is challenging in spinal cord injury (SCI) and large animal models with high clinical relevance may accelerate therapeutic development. Pigs have important anatomical and physiological similarities to humans. Intraspinal inflammation mediates SCI pathophysiology. The purpose of this study was to evaluate the effect of sex on inflammation and outcomes in a pig thoracic contusion/compression SCI model. Methods Adult (gonad-intact) male and female Yucatan miniature swine were subjected to either SCI or sham (laminectomy-only) injury. Results SCI caused locomotor dysfunction (measured with the Porcine Thoracic Injury Behavior Score) with some recovery over 6 weeks and limited tissue sparing at 6 weeks with no difference between sexes. Immunohistological evaluations of spinal cord tissue at 2 days and 6 weeks post-injury revealed intraspinal microglia/macrophage (IBA-1, CD68) and lymphocyte responses (T-cells (CD3) and B-cells (CD79a)) consistent with observations in rodents and humans. Astrocyte (GFAP) immunoreactivity was observed within the lesion core at 6 weeks in contrast to observations in rodents. No differences were seen for astrocytes, microglia, macrophages, B-cells, and neutrophil infiltration between males and females. Intraspinal CD3 + T-cell counts and T-cell microclusters were significantly higher in females compared to males 6 weeks post-injury. Interestingly, we observed a similar significant increase in intraspinal CD3 + T-cell accumulation in female vs. male mice at 6 weeks post-thoracic contusion SCI. Interpretation Our observations indicate that sex is a potential biological variable for T-cell infiltration and may contribute to sex-based differences in SCI pathophysiology and recovery outcomes.

Abstract Spinal cord injury (SCI) leads to permanent motor and sensory loss that is exacerbated by intraspinal inflammation and persists months to years after injury. After SCI, monocyte-derived macrophages (MDMs) infiltrate the lesion to aid in myelin-rich debris clearance. During debris clearance, MDMs adopt a proinflammatory phenotype that exacerbates neurodegeneration and hinders recovery. The underlying cause of the lipid-mediated MDM phenotype shift is unclear. Our previous work suggests that cytosolic phospholipase A2 (cPLA2) plays a role in the proinflammatory potentiating effect of myelin on macrophages in vitro. Cytosolic phospholipase A2 (cPLA2) frees arachidonic acid from phospholipids, generating eicosanoids that play an important role in inflammation, immunity, and host defense. cPLA2 is expressed in macrophages along with multiple other cell types after SCI, and cPLA2 inhibition has been reported to both reduce and exacerbate secondary injury pathology recovery. The role of cPLA2 in MDMs after SCI is not fully understood. We hypothesize that cPLA2 activation in MDMs after SCI contributes to secondary injury. Here, we report that cPLA2 plays an important role in the myelin-induced inflammatory macrophage phenotype in vitro using macrophages derived from cPLA2 knockout bone marrow. Furthermore, to investigate the role of cPLA2 in MDMs after SCI, we generated female bone marrow chimeras using cPLA2 knock-out donors and assessed locomotor recovery using the Basso Mouse Scale (BMS), CatWalk gait analysis system, and horizontal ladder task over six weeks. We also evaluated tissue sparing and intralesional axon density six weeks after injury. cPLA2 KO chimeras did not display altered locomotor recovery or tissue pathology after SCI compared to WT chimera controls. These data suggest that although cPLA2 plays a critical role in myelin-mediated potentiation of proinflammatory macrophage activation in vitro, it may not contribute to secondary injury pathology in vivo after SCI.

Bowen’s disease (BD) is a benign epidermal premalignant tumor histopathologically characterized by the presence of dysplastic cells limited to the epidermis. Subungual BD is a less commonly described entity and involvement of toenails is even rarer probably because of less cosmetic concern, especially in elderly males. As clinical characteristics of subungual BD are not clearly defined, creating diagnostic dilemma with various benign and malignant diseases such as fungal infections with nail pigmentation and subungual melanoma, respectively. The patient is often misdiagnosed to be having benign and malignant diseases such as fungal infections and warts, leading to delay in diagnosis. We report a case of subungual BD simulating melanoma in a 75-year-old male.

Background: Intellectual disability is a non-communicable health disorder that has become a public health concern worldwide, with a marked impairment in communication, academic, and social skills. It is important to identify the level of psychological stress among parents of these children. Hence, this study was designed to assess the level of psychological stress among parents having intellectually disabled children. Materials and Methods: The study was conducted in the Physical Medicine and Rehabilitation outpatient department (OPD) at Kalawati Saran Children’s Hospital, New Delhi. Data were collected to analyze the psychological stress in families. Parental Stress Scale (PSS) was used as the tool to measure stress in parents. Results: A total of 170 mothers were enrolled in the study. In total, 14 different variables were considered plausible contributing factors to the mother’s stress. Four variables demonstrated a clear linear association between variable values and PSS. These variables were a) per-capita monthly family income, b) socioeconomic status, c) study subjects’ occupation, and d) duration of disability. The overall mean PSS for the entire cohort was found to be 47.14 ± 2.93. The reference criteria for low stress was 19–45, and it was 45–90 for high stress. Conclusion: The study suggests that mothers of children with intellectual disability experience high stress. Raising a child with special care needs is overwhelming for mothers. Appropriate clinical services should be provided to support parents of children with disabilities and offer resources to educate and enable mothers to manage their children’s disabilities and needs.

In this paper, we define strong deferred summability and deferred statistical summability in intuitionistic fuzzy \(n\)-normed linear spaces (briefly called IF-\(n\)-NLS) and study some of their properties. We also define deferred statistical Cauchy sequence deferred statistical completeness and characterize deferred statistical summability in such spaces. Finally, we will compare deferred statistical summability for different pairs of sequences $\alpha(\ell)$, $\gamma(\ell)$,$u(\ell)$ and $v(\ell)$ satisfying $\alpha(\ell) \leq u(\ell) < v(\ell) \leq \gamma(\ell)$.

Practical reason is the use of reason to decide how to act and perform in a social reality. When someone deliberates about what to do, one puts all the reasons for the action, and then all the reasons against the action will determine the outcome of the action. In that situation, we can describe that practical action with reason because we will determine reason with the weight of different reasons not on the weighing reasons. In this paper, we analyze that reasons have weight against the theory that weights of reasons have no role in a theory of reasoning, and defend that reasons have weight with the evidence of practical reasons. The aim of this paper is to argue that weight of reasons has a role in the process of reasoning. In every situation of life, we can use have reason and weight of reason according to the practical situation of life.

ABSTRACT Background: Pre-cytoreduction refers to the administration of initial chemotherapy to reduce tumor burden prior to initiating definitive multi-agent chemotherapy. This study assessed the safety and efficacy of pre-cytoreduction prior to definitive multi-agent chemotherapy in aggressive lymphomas. Methods: A prospective cohort study was done at Ziauddin Hospital, Karachi for six months. Patients of either gender, aged between 18-80 years diagnosed with aggressive lymphoma (Stage II-IV) were included. Patients having stage-I lymphoma, primary CNS lymphoma, HIV-linked Diffuse Large B Cell Lymphoma (DLBCL) transformed lymphoma, and other malignancies were excluded. The pre-cytoreduction group received a low dose of chemotherapeutic drug on the −6th day and prednisolone 100mg daily for 7 days (−6th day to day 0) followed by standard chemotherapy on day 1. Non-pre-cytoreduction group received chemotherapy without pre-cytoreduction. After chemotherapy’s first cycle, follow-up was done for 30 days. Anxiety assessment was done using the Hamilton Anxiety Rating Scale (HAM-A). For data analysis, SPSS v27 was used. Results: From 120 patients, 27(22.5%) were diagnosed with Burkitt Lymphoma while 93(77.5%) with DLBCL. Pre-cytoreduction included prednisone, in 17(14.2%) patients, while 12(10%), 13(11%), and 10(8%) were given Vincristine, Prednisolone (VP), Cyclophosphamide, Prednisolone (CP) and Cyclophosphamide, Vincristine, and Prednisolone (CVP) respectively. There was a significant difference between both groups’ tumor lysis syndrome, bone marrow suppression, ECOG PS (Eastern Cooperative Oncology Group Performance Status), and other post-treatment complications (p

Abstract Focal adhesions (FAs) connect inner workings of cell to the extracellular matrix to control cell adhesion, migration and mechanosensing. Previous studies demonstrated that FAs contain three vertical layers, which connect extracellular matrix to the cytoskeleton. By using super-resolution iPALM microscopy, we identify two additional nanoscale layers within FAs, specified by actin filaments bound to tropomyosin isoforms Tpm1.6 and Tpm3.2. The Tpm1.6-actin filaments, beneath the previously identified α-actinin cross-linked actin filaments, appear critical for adhesion maturation and controlled cell motility, whereas the adjacent Tpm3.2-actin filament layer beneath seems to facilitate adhesion disassembly. Mechanistically, Tpm3.2 stabilizes ACF-7/MACF1 and KANK-family proteins at adhesions, and hence targets microtubule plus-ends to FAs to catalyse their disassembly. Tpm3.2 depletion leads to disorganized microtubule network, abnormally stable FAs, and defects in tail retraction during migration. Thus, FAs are composed of distinct actin filament layers, and each may have specific roles in coupling adhesions to the cytoskeleton, or in controlling adhesion dynamics.

Abstract Familial cardiomyopathy in pediatric stages is a poorly understood presentation of heart disease in children that is attributed to pathogenic mutations. Through exome sequencing, we report a homozygous variant in tropomodulin 1 (TMOD1; c.565C>T, p.R189W) in three individuals from two unrelated families with childhood-onset dilated and restrictive cardiomyopathy. To decipher the mechanism of pathogenicity of the R189W mutation in TMOD1, we utilized a wide array of methods, including protein analyses, biochemistry and cultured cardiomyocytes. Structural modeling revealed potential defects in the local folding of TMOD1R189W and its affinity for actin. Cardiomyocytes expressing GFP-TMOD1R189W demonstrated longer thin filaments than GFP-TMOD1wt-expressing cells, resulting in compromised filament length regulation. Furthermore, TMOD1R189W showed weakened activity in capping actin filament pointed ends, providing direct evidence for the variant’s effect on actin filament length regulation. Our data indicate that the p.R189W variant in TMOD1 has altered biochemical properties and reveals a unique mechanism for childhood-onset cardiomyopathy.

The experiment conducted at Bihar Agricultural University, Sabour, India, during the rabi season of 2020-21 aimed to assess genetic diversity among 35 chickpea genotypes and identify those with traits associated with terminal heat tolerance using phenotypical parameters. Based on D2 analysis, the genotypes were classified into six clusters using the Tocher method. Clusters I and II comprised the majority of the genotypes while Clusters IV, V, and VI: were the least populated. The highest inter-cluster distance was observed between Cluster III and V, followed by Cluster III and IV and Cluster III and VI. This indicated that there was significant diversity between the genotypes belonging to these clusters. In terms of agronomic traits, all clusters showed the highest mean value for grain yield under late sown conditions, indicating their potential for better yield performance. Among the 12 traits studied, 100-seed weight exhibited the highest contribution in the manifestation of genetic divergence. The diverse clusters identified in the study can be valuable for breeding programs. They can be used to develop improved chickpea varieties that are better adapted to late-sown conditions and have enhanced productivity. This could contribute to more resilient chickpea crops, especially in regions where terminal heat stress is a concern.

Summary: Background: Globally, most of the randomised trials with hypofractionation in patients with breast cancer have used 3-dimensional conformal radiotherapy technique (3D-CRT). As facilities for 3D-CRT technique may not be available in low-resource settings, there is a need to see if hypofractionation is feasible and safe with 2-dimensional (2-D) technique. In this study, we compared a 3-week radiation schedule with a 2-week schedule of hypofractionated radiotherapy in patients with breast cancer with 2-D technique. Methods: The current study was an open-label, randomised, phase 3 trial. Patients with breast cancer, stage I-III, post mastectomy or after breast conservative surgery who needed adjuvant locoregional radiotherapy were randomised in the Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India; to 34Gy in 10 fractions over 2 weeks (2-week arm) or 35Gy in 15 fractions over 3 weeks to the chest wall and 40Gy/15#/3wks to breast and supraclavicular fossa (3-week arm). Boost dose when indicated was 8–10Gy/2–4#/2–4 days in both the arms. Patients were planned on a 2-dimensional (2D) simulator with 2 tangential fields to breast/chest wall and incident supraclavicular fossa field. Acute toxicity was assessed using the Radiation Therapy Oncology Group (RTOG) grading scale. Assessments were carried out weekly during radiotherapy and at 4 weeks after treatment by the physician. Cosmetic outcome was assessed using the Harvard/National Surgical Adjuvant Breast and Bowel Project (NSABP)/RTOG scale. The toxicity rates between the two arms were compared using Fisher's exact tests. The trial was approved by institutional ethics committee and registered with ClinicalTrials.gov, number NCT04075058. Findings: This study included 1121 eligible patients from June 2015 to December 2020. Median follow-up was 35 months (6–84 months). Mean age was 48 years (24–75 years). The patient characteristics were comparable between the two arms except for more mastectomies in the 3-week arm and more node-positive patients in the 2-week arm. There were more oestrogen receptor-positive tumors in the 3-week arm. Acute skin toxicities were comparable between the two arms. Grade 2 and 3 skin toxicity was 100 (18%) and 82 (15%); and 16 (3%) and 12 (2%) in the 3-week and 2-week arm (p = 0.21), respectively. Cosmetic outcome was assessed as Excellent or Good for 89% of patients in the 3-week arm as compared to 94% in the 2-week arm (p = 0.004). Interpretation: The two radiation schedules were comparable in terms of acute skin toxicity. The cosmetic outcome was better with the 2-week schedule. The preliminary findings indicate 2-week radiotherapy schedule with 2-D technique was better than the 3-week schedule in patients with breast cancer. However, disease outcomes and late-term toxicities need to be further checked. Funding: This study was funded by Science and Engineering Research Board (SERB), India.

Objective: To compare two different treatment planning systems (TPSs) for plan quality and to check the feasibility of VMAT TBI on the Elekta linear accelerator ‘Versa HD’. Methods: Ten clinical VMAT TBI plans were replanned in Monaco TPS version 5 for retrospective dosimetric analysis and to check the feasibility of treatment delivery in Elekta Versa HD. A dose of 12 Gy in 6 fractions was prescribed to cover 95% PTV. The OARs were the lungs, kidneys, heart, liver, and brain. Dosimetric optimization and calculation were performed in Monaco TPS with a statistical uncertainty of 1%, 2 mm grid. The chosen criterion for plan evaluation and comparison was based on plan quality, dosimetric indices like conformity and homogeneity index, and OAR doses. The comparison of time for optimization, monitor units, and beam on time was also analyzed. Pre-treatment verification using Octavious phantom and gamma analysis using Low’s method with a dose difference of 3% and distance to agreement 3mm criteria was done. The dosimetry of 2 VMAT TBI plans were compared using Wilcoxon signed rank test. Result: The calculated average maximum and mean doses of the PTV were 14.3321Gy and 12.235Gy for eclipse; and 14.428Gy and 12.198Gy for the Monaco system, respectively. The planning time in Monaco was approx. 4.5–6hrs compared to 14–18hrs for Eclipse TPS. Statistically significant difference was observed between the results of 2 TPSs in terms of monitor units, mean doses to lungs, kidneys, heart, and liver and planning time (P < 0.05). However, calculated p values for HI, CI, and brain for both VMAT TBI plans were not statistically different. Conclusion: The study showed the feasibility of VMAT TBI for VERSA HD as it offers faster, better optimization in a single target compared to the Eclipse.

Introduction: Cleft lip (CL) and/or cleft palate (CP) are the most common visible craniofacial anomalies throughout the world. CL and CP occur due to a failure of the skeletal components of the mid-face to fuse. The affected individual may have an isolated defect or a combination of both. These children can be undernourished due to feeding difficulties after birth. The growth problems of children with clefts have largely been attributed to inadequate nutrition. The aim of the study is to assess the anthropometric status and micronutrient deficiencies in children with cleft lip and palate. Methods: This is a cross-sectional study of 18 months duration conducted at SGT medical college, Gurugram, a tertiary care center in Haryana, India between June 2020 to December 2021 involving the assessment of patients with cleft lip and palate between the age of 3 months to 5 years of either gender who visited pediatric unit for complete evaluation before surgery. A total of 100 patients were enrolled in the study and the following information was recorded: age, gender, hemoglobin, serum vitamin D3 level, serum ferritin, and serum vitamin B12 level. Results: A total of 100 patients were included in the study, of which, 53 (53%) were males and 47 (47%) were females. Anthropometrically, in our study, 83% of patients had moderate to severe wasting, according to WHO classification. Anemia was prevalent in 71.1% of cases in the current study. Vitamin D3 deficiency was seen in 88% of the study population, while 37% of cases had Vitamin B12 deficiency. The correlation between anthropometric assessment and nutritional deficiency suggested that children of cleft lip and palate with severe wasting had significant iron deficiency anemia as well as vitamin B12 deficiency. However, vitamin D deficiency was not statistically significant in severe wasting group. Conclusion: A large number of children with cleft lip and/or palate are not exclusively breastfed due to anatomical deficits. They need supplemental Iron and vitamin D to meet the demands. Macro and micronutrient deficiencies along with recurrent infections, lead to moderate to severe wasting and stunting in these children causing severe malnutrition with complications and failure to thrive.

In this study the authors report that Caldesmon controls force-balance and architecture of stress fibers through dynamic cross-linking of actin and myosin filaments. Caldesmon depletion led to consequent problems in cell morphogenesis, motility and mechanosensing.

Attainment of Sustainable Development Goals (SDGs) is a critical issue for the United Nations in the 21st Century. These 17 SDGs have specific targets to achieve these goals. To achieve a more sustainable future, 193 countries agreed to work on these 17 SDGs by 2030. Out of these 17 SDGs, this paper focuses on attaining SDG 3 through indigenous knowledge. The researchers explored previous studies by other researchers worldwide and global reports related to medical plants. They discussed the role of folk medicine in attaining the third goal of sustainable development (SDG3). Target 3.3 of SDG 3 focuses on eliminating combat hepatitis, waterborne diseases, Malaria, and other communicable diseases, and target 3.4 of SDG 3 focuses on reducing non-communicable diseases through prevention and treatment. Therefore, the focus of the study is to find out the specific plants which can be used for the treatment of various types of diseases through meta-analysis protocol and systematic reviews. Ninety articles are screened by keeping in view the set criteria. The study selected 50 scientific papers after excluding some papers due to the unavailability of full papers and duplicate copies of the articles. The researchers selected those papers whose citation is good. Previous researchers discussed that some plants and their parts—folk medicines— are often used to cure various communicable and non-communicable diseases like diabetes, cancer, Malaria, COVID-19, infections, pain, liver problems, etc., by certain groups and communities due to its lesser price, effortlessness, easy accessibility and affordability.

Abstract Background Fermented foods are the results of metabolic activities of various microorganisms. People have traditionally known how to culture desirable microorganisms, primarily lactic acid bacteria, yeasts, and filamentous molds, for the manufacture of edible foods. Yeast isolated from home-made mango pickle from Hamirpur, Himachal Pradesh, was assessed for probiotic properties and their enzymatic profiling. Results Four yeast isolates were isolated out of which P. kudriavzevii Y33 was selected on the basis of high acid tolerance as well as broadest antimicrobial activity. The selected isolate was observed to have high acid tolerance at pH 2 and show strong antimicrobial activity against all the pathogens examined. P. kudriavzevii Y33 can also withstand high bile concentration and showed high viability index, i.e., 95% at concentration of 2% of bile. The isolate was able to demonstrate high cholesterol assimilation in medium containing ox bile and taurocholate, at 88.58 and 86.83%, respectively. The autoaggregation ability of isolate increases with increasing the time of incubation and showed 87% of autoaggregation after 24 h of incubation. P. kudriavzevii Y33 exhibited resistance towards different antibiotics, found to be positive for exopolysaccharide production and showed no hemolytic activity. The isolate was observed to produce several enzymes such as β-galactosidase, protease, amylase, phytase, and lipase. Conclusions The results of the current study revealed that P. kudriavzevii Y33 has various beneficial qualities that suggest it could be used as probiotics. Enzymes produced by yeast isolate help in improving flavor and mineral availability in the fermented products.

Background: Pinus roxburghii has been used in the Himalayan region as folkloric remedy while nothing is yet known about its immunomodulatory potential. Methods: The crude extracts of green and fallen pine needles were subjected to sequential fractionation to get partially purified fractions. Human peripheral blood lymphocytes (PBL)were used to analyze immunoenhancing potential of these fractions. Microcytotoxicity assay was employed to investigate improved cancer cells killing capabilities of PBL against various cancer cell lines. GC-MS was carried out to identify the major compounds in the bioactive fractions. Results: The lymphocyte proliferation assay depicted the immunoenhancing potential of extractsand fractions of fallen and green needles of P. roxburghii. The ethyl acetate fractions of both fallen and green needles displayed highest mitogenic activity on human PBL. Both fractions heightened the expression of cell surface markers (CD3, CD8, and CD56) and significantly increased the production of cytokines (IL-2, IFN-γ and TNF-α). The enhanced intracellular granulysin (immunomarker for activated CTLs and NK cells) expression also confirmed immune stimulatory potential of these fractions on human lymphocytes. The ethyl acetate fractions of pine needles enhanced the cytotoxicity of PBL towards various cancer cells (HCT-116, HeLa, PC-3 and A549) as compared to untreated PBL. GC-MS analysis showed presence of major compounds like 3-α-mannobiose, octakis (trimethylsilyl) ether, methyloxime in ethyl acetate fraction of the green needles and cyclodecasiloxane, eicosamethyl in ethyl acetate fraction of the fallen needles. Conclusion: The bioactive fractions of the fallen and green needles of P. roxburghii stimulate cancer cells killing potential of human lymphocytes.

To achieve wideband circular polarization (CP) characteristics, a new structure with a single feeding technique has been proposed. In the proposed CP structure, to excite the cylindrical dielectric resonator (CDR) four asymmetrical rectangular slots are etched on the ground plane, each rectangular slot is rotated by an angle of ( $\theta = 30^{\circ }$ ) with respect to its adjacent slots. The electric fields at each slot are separated by 30° in space with respect to its adjacent slot to create 90° angular separations between the E-field components. Two orthogonal broadside modes ( ${HE}_{11\delta }$ ) are excited inside the cylindrical dielectric resonator antenna (CDRA) independently to obtained CP characteristics. To compare the simulated outcomes with the experimental results, fabrication of the proposed antenna prototype has been done. The measured percentage of bandwidth achieved by the proposed radiator for $\vert \text{S}_{11}\vert $ and CP is 26.73% and 23.59%, respectively, and the whole usable axial ratio (AR) frequency bands overlap the impedance passband of the presented CP structure. The proposed radiator has achieved the maximum gain and radiation efficiency of 3.4 dB and 95% over the operating frequency range of the designed antenna, respectively. The proposed CP DRA has been configured for the WLAN band application.

Introduction: Premenstrual dysphoric disorder is a severe form of premenstrual syndrome that impairs quality of life and carries an increased risk of suicidal attempts. Hormonal changes may underlie these symptoms. The present study was conducted to find out the prevalence of premenstrual dysphoric disorder among female students of a medical college in Nepal. Methods: This descriptive cross-sectional study was conducted among 266 healthy young females in a medical college of Nepal from 21st June 2021 to 31st August 2021 with approval from the Institutional Review Committee 51/2021. Convenience sampling was done. Self-rated questionnaire of premenstrual symptoms screening tool was used to evaluate premenstrual dysphoric disorder. The Premenstrual Symptoms Screening Tool reflects and ‘translates’ categorical Diagnostic and Statistical Manual of Mental Disorders-IV criteria into a rating scale with degrees of severity. Data were analyzed using the Statistical Package for Social Sciences version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for the binary data. Results: Out of 266 female students, we found that the prevalence of premenstrual dysphoric disorder was 10 (3.8%) (1.50-6.10 at 95% Confidence Interval). Conclusions: The prevalence of premenstrual dysphoric disorder in our study was found to be higher when compared to other similar studies.

Venous malformations (VMs) are congenital slow flow vascular malformations that are usually present at birth. They grow proportionate with the age and do not regress with time differentiating them from hemangiomas. VM presents as bluish discoloration of skin/mucosa or as soft subcutaneous masses. It may affect any organ, including viscera-like gastrointestinal tract or brain. VM is generally slowly progressive and asymptomatic as they grow slowly with age. We report the case of asymptomatic giant VM over the tongue for which the patient presented due to herpetic stomatitis.

To estimate epistasis and components of genetic variance a study was carried out during 2016 and 2017 at Experimental Research Farm of Department of Vegetable Science, Dr YSP UH & F Nauni, Solan, (HP) and data were recorded for different qualitative and quantitative traits using triple test cross (TTC) analysis of an inter-varietal cross LC-1-1 × K-75 of cucumber (Cucumis sativus L.). Three testers of cucumber named LC-1-1, K-75 and their F1 (LC-1-1 × K-75) were crossed to 15 inbred lines for detecting the additive, dominance and epistatic components of genetic variance. Good quantum of genetic variability has been generated through triple test cross progenies with respect to different traits studied as revealed by the significant analysis of variance. TTC analysis revealed that overall epistasis and j+l type component were found to be significant for majority of the traits except fruit breadth and total soluble solids. Further, experimental results showed that (i) type of epistasis were also significant for majority of the traits under study. The components of genetic variance were estimated using analysis of variance for sums and differences revealed the importance of both additive (D) as well as dominance (H) components of genetic variance in controlling various traits and showed partial dominance except over dominance for fruit breadth and severity of downy mildew. Therefore, kind of genetic variance revealed from triple test cross can be exploited by intermating selected individuals in early segregating generations with delayed selection in later generations, or recurrent selection followed by pedigree method to exploit both additive and non-additive components along with epistasis in cucumber.

Palamu goat forms the part and parcel of the lives of the farmers and tribes of Jharkhand. Palamu goat also known as Medini is named after its distribution area (Palamu, Latehar and Garhwa) in Jharkhand. This small size goat is reared in Jharkhand since time immemorial. Average flock size is 5.36±0.19 and varies from 1 to 31. Twinning is common except in first kidding. Head profile is convex, ears are pendulous, and horns are straight with backward and upward orientation. Muzzle, eyelids and hooves are black, body is cylindrical, udder is small and pendulous and teats are conical shaped. Age at first mating in males is 8.32±0.86 (months) that vary between 7.2– 9.2 months. Corresponding values for female are 7.22±1.35 months varying between 6.7–7.7 months. Diversity status of the population was explored using 25 microsatellite markers. A total of 190 alleles were detected and sufficient polymorphism was evident from the allele frequency data. ILSTS82 showed the highest number of observed alleles per locus (20) while RM4 and ILSTS05 showed the lowest (4) with 9.14±2.0 as mean number of alleles. Expected number of alleles varied from 1.49 (ILSTS065) to 7.55 (ILSTS30) with the mean value of 4.15±0.91. Palamu goat had substantial genetic variation based on its gene diversity in addition to the average number of alleles per locus. The observed and expected heterozygosity values were 0.64±0.14 and 0.69±0.15, respectively. Observed heterozygosity was lower than expected showing a departure from Hardy-Weinberg Equilibrium (HWE) and possibility of inbreeding. Population has heterozygote deficiency to the tune of 9% (FIS value=0.09). Population did not suffer from recent genetic bottleneck (last 40–80 generations). The results suggest existence of a distinct goat population harboring sufficient genetic variation for scientific management.

Introduction: Changes in the lifestyle, food habits, lack of nutritious diet, stress, physical inactivity increases the body mass index among adults. Excess weight gain is an important risk factor for non-communicable diseases such as heart disease, stroke, diabetes, and some cancers (endometrial, breast, colon). Thus, this study aims to find out body mass index of medical students of a medical college in Nepal. Methods: This descriptive cross-sectional study was conducted in the department of physiology of a tertiary care center from August 2019 to February 2020 after taking ethical clearence from Institutional Review Committee (Reference number 192/19). Height and weight were recorded and body mass index was then being calculated. Data entry was done in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 22. Results: Out of 266 medical students, 39 (15%) were overweight and 32 (12%) were underweight with mean body mass index 26.60±1.99kg/m2 and 17.13±1.19kg/m2 respectively. Mean body mass index of males was 21.76±3.06kg/m2 and that of females was 21.70±2.96 kg/m2. Conclusions: Comparing with a similar study done in Nepal previously, we found a higher prevalence of overweight in medical students whereas majority of medical students had normal weight. Factors affecting body mass index in medical students should be explored further.

Allogeneic hematopoietic stem cell transplantation (HSCT) is the solitary therapeutic therapy for many types of hematological cancers. The benefits of this procedure are challenged by graft vs. host disease (GVHD), causing significant morbidity and mortality. Recent advances in the metabolomics field have revolutionized our understanding of complex human diseases, clinical diagnostics and allow to trace the de novo biosynthesis of metabolites. There is growing evidence for metabolomics playing a role in different aspects of GVHD, and therefore metabolomic reprogramming presents a novel tool for this disease. Pre-transplant cytokine profiles and metabolic status of allogeneic transplant recipients is shown to be linked with a threat of acute GVHD. Immune reactions underlying the pathophysiology of GVHD involve higher proliferation and migration of immune cells to the target site, requiring shifts in energy supply and demand. Metabolic changes and reduced availability of oxygen result in tissue and cellular hypoxia which is extensive enough to trigger transcriptional and translational changes. T cells, major players in acute GVHD pathophysiology, show increased glucose uptake and glycolytic activity. Effector T (Teff) cells activated during nutrient limiting conditions in vitro or multiplying during GVHD in vivo, depend more on oxidative phosphorylation (OXPHOS) and fatty acid oxidation (FAO). Dyslipidemia, such as the increase of medium and long chain fatty and polyunsaturated acids in plasma of GVHD patients, has been observed. Sphingolipids associate with inflammatory conditions and cancer. Chronic GVHD (cGVHD) patients show reduced branched-chain amino acids (BCAAs) and increased sulfur-containing metabolites post HSCT. Microbiota-derived metabolites such as aryl hydrocarbon receptor (AhR) ligands, bile acids, plasmalogens and short chain fatty acids vary significantly and affect allogeneic immune responses during acute GVHD. Considering the multitude of possibilities, how altered metabolomics are involved in GVHD biology, multi-timepoints related and multivariable biomarker panels for prognosticating and understanding GVHD are needed. In this review, we will discuss the recent work addressing metabolomics reprogramming to control GVHD in detail.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular tumor which presents as a dermal papule or a nodule over the head-and-neck region. Histopathologically, there is vascular proliferation in the upper dermis and diffuse lymphocytic infiltrate with eosinophilia. Kimura's disease is the closest differential of ALHE, which presents as subcutaneous nodules. We report a case of ALHE presenting with a violaceous papule overlying a subcutaneous nodule, histopathologically; both lesions were diagnosed as ALHE.

Kaposi varicelliform eruption (KVE) is a disseminated vesiculopustular lesion occurring over a preexisting cutaneous lesion. Although initially thought to be caused by herpes virus 1 and 2, other viruses have also been known to provoke the disease. There are no reports of human herpes virus 3 over tinea infections causing KVE.

In this work, the restricted three-body system is studied in the framework of the continuation fractional potential with its application on the Earth–Moon system. With the help of a numerical technique, we obtained thirteen equilibrium points, such that nine of them are collinear while the remaining four are non-collinear points. We found that the collinear points near the smaller primary were shifted outward from the Moon, whereas the points near the bigger primary were shifted towards the Earth as the value of the continuation fractional parameter increased. We analyzed the zero-velocity curves and discussed the perturbation of the continuation fractional potential effect on the possible regions of the motion. We also discussed the linear stability of all the equilibrium points and found that out of thirteen only two were stable. Due to such a prevalence, the continuation fractional potential is a source of significant perturbation, which embodies the lack of sphericity of the body in the restricted three-body problem

Background: One way to improve hospital food provision is certainly by understanding the management of hospital foodservices, but there is limited detailed information about staff roles in food provision in many hospitals around the world. Objective: The hospital meal experience of patients, a part of the services provided by hospitals, is becoming important. Therefore, the role of various hospital staff members was studied through their behavior, attitudes, and practices so as to understand how the foodservice system works to address patients’ food consumption. Methods: This qualitative research used the convenient sampling method. Data was collected by interviewing twenty hospital employees with different job scopes (nurses, doctors, dietitians, foodservice managers, and directors of hospital foodservices) in 6 public hospitals. Results: Themes such as providing familiar food, food as the motivational factor for consumption, empathy shown by staff, and influences of the eating environment were identified using content analysis. Conclusion: The viewpoints and experiences of key stakeholders facilitated the understanding of various factors involved in the provision of hospital food which affect patients’ decisions to accept and consume food.

Lymphedema is extravasation of lymphatic fluid into extracellular spaces and may be primary or secondary. Primary lymphedema may be caused by truncular lymphatic malformation. Long-standing lymphedema may result in various complications due to increased porosity of lymphatics, defective valves, and increased lymphatic pressure. There are few reports of normolipidemic xanthoma in association with lymphedema. We report a case of giant xanthoma associated with primary lymphedema.

Primary cutaneous amyloidosis (PCA) is the deposition of amyloid proteins in the skin without systemic involvement. Amyloidosis cutis dyschromica (ACD) is a rare variant of PCA with onset typically in early childhood or at a prepubertal age. It is more common in the Asian and Southeast Asian people. Clinically it manifests as asymptomatic diffuse hyperpigmentation interspersed with hypopigmented spots without papulation. Histologically, small foci of amyloid closely under the epidermis are seen. There are only few case reports in the literature of this rarer variant. We report a case of a 32-year-old male presenting as dyschromatosis with a prepubertal onset and histopathological evidence of intradermal deposits in the upper dermis which was confirmed on Congo red staining and hence was diagnosed as a case of ACD.

Carcinoma of the oral cavity is one of the most common cancers of the head-and-neck region with frequent metastasis to internal organs, especially the lungs, liver, and bone. However, cutaneous metastasis of head-and-neck squamous cell carcinoma is rarely reported in the literature, with only a few cases reported in the past. Here, we report a case of relapse of squamous cell carcinoma of the tongue which metastasized to the upper trunk region.

Allogeneic hematopoietic stem cell transplant (allo-HSCT) is often used to treat acute leukemia or defects of hematopoiesis. Its widespread use is hampered by graft-vs.-host disease (GVHD), which has high morbidity and mortality in both acute and chronic subtypes. Chronic GVHD (cGVHD) occurs most frequently in skin and often is characterized by pathogenic fibrosis. Mast cells (MCs) are known to be involved in the pathogenesis of other fibrotic diseases. In a murine model of cGVHD after allo-HSCT, C57BL/6J recipients of allogeneic LP/J donor cells develop sclerodermatous dermal cGVHD which is significantly decreased in mast cell-deficient B6.Cg-KitW−sh/HNihrJaeBsmGlliJ recipients. The presence of MCs is associated with fibrosis, chemokine production, and recruitment of GVHD effector cells to the skin. Chemokine production by MCs is blocked by drugs used to treat cGVHD. The importance of MCs in skin cGVHD is mirrored by increased MCs in the skin of patients with dermal cGVHD. We show for the first time a role for MCs in skin cGVHD that may be targetable for preventive and therapeutic intervention in this disease.