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Introduction: Quality of Life (QoL) has recently become a focus of research in haemophilia, as children with haemophilia miss out on opportunities to reach their full potential during school and later in life. This leads to emotional and behavioural problems, family issues, and a decrease in Health-related Quality of Life (HRQoL). There is very limited data from the state of Madhya Pradesh, India, to assess the QoL in haemophilia patients. Aim: To study the clinical profile of haemophilic children and assess their QoL. Materials and Methods: The present hospital-based cross-sectional study was conducted in the Department of Paediatrics, Gandhi Medical College, Bhopal, Madhya Pradesh, India, from January 2019 to December 2019. A total of 49 children (Institutional incidence), aged from 4-12 years, with factor VIII/IX deficiency who presented in the Paediatric ward of the study Institution for factor transfusion, were included in the study. The study population was divided into two groups with children aged (group ) and children aged 8-12 years (group II). A detailed clinical history was obtained from the accompanying parent/guardian, and QoL was measured using the Haemophilia QoL (Haemo-QoL) questionnaire. Scores achieved in each dimension, as well as, the total score were combined on a scale ranging from 0 to 100. High values indicate high impairment in QoL. The meanings of different scales like Standardised and Transformed Scale Scores (TSS) of Haemo-QoL were analysed using the student’s t-test. Results: In the present study, haemophilia A was more common than haemophilia B. All patients who attended the paediatric ward for factor transfusion were males, with a mean age of 8.37±2.56 years. It was also observed that the proportion of patients who were diagnosed early was significantly higher in the 4-7 years age group compared to the 8-12 years age group of patients (p-value

Methicillin-resistant Staphylococcus aureus (MRSA) is a prominent pathogenic, antibiotic-resistant microorganism that contains a variety of virulent characteristics having the capacity to develop tolerance to several major classes of antibiotics. The ongoing creation of clones enhances this potential, transforming S. aureus into an “Anti-Infective.” MRSA has started to rise as a Hospital-Acquired MRSA, but due to evolution, new strains of MRSA have been discovered throughout the past several years. The new strains of MRSA as Community-Acquired MRSA, and Livestock-Associated MRSA are infecting the patients despite preexisting medical conditions, being as susceptible to any treatment. The continuous expansion of MRSA is still ongoing. The main goal of this article is to improve reading comprehension of MRSA by studying the prominent classes of antibiotics and their mechanism of resistance which are now susceptible or getting susceptible to the MRSA.

Background: The most significant medications in dentistry are local anesthetics, and intraoral local anesthesia is arguably the most used dental procedure. However, complications have also been reported. Aim: Evaluation of ocular complications in intraoral anesthesia. Materials and Methods: It was a prospective study involving 2,400 patients undergoing different dental procedures that were performed under intraoral local anesthesia over a 12-month period. There was a thorough ocular evaluation of all patients by ophthalmologist before and after the administration of intraoral local anesthesia. Results: There were different types of ocular complications reported including accommodation disturbance, amaurosis, diplopia, enophthalmos, miosis, mydriasis, ophthalmoplegia, and ptosis. The most common ocular complication was diplopia contributing 40.1% of all ocular complications. It was followed by ptosis (16.9%), mydriasis (14.9%), and amaourosis (13.2%). Conclusion: The most common ocular complication in intraoral local anesthesia was diplopia.

Quantitative structure activity relationship (QSAR) is a widely used tool in rational drug design that establishes relationships between the physicochemical and topological descriptors of ligands and their biological activities. Obtained QSAR models help identify descriptors that play pivotal roles in the biological activity of ligands. This not only helps the prediction of new compounds with desirable biological activities but also helps with the design of new compounds with better activities and low toxicities. QSAR commonly uses lipophilicity (logP), hydrophobicity (logD), water solubility (logS), the acid–base dissociation constant (pKa), the dipole moment, the highest occupied molecular orbital (HOMO), the lowest unoccupied molecular orbital (LUMO), molecular weight (MW), molar volume (MV), molar refractivity (MR), and the kappa index as physicochemical parameters. Some commonly used topological indices in QSAR are the Wiener index, Platt index, Hosoya index, Zagreb indices, Balaban index, and E-state index. This review presents a brief description of the significance of the most extensively used physicochemical and topological parameters in drug design.

The emergence of resistance against antimalarials and insecticides poses a significant threat to malaria elimination strategies. It is crucial to explore potential risk factors for malaria to identify new targets and alternative therapies. Malnutrition is a well-established risk factor for malaria. Deficiencies of micronutrients such as vitamin A, zinc, iron, folic acid, and phenotypic measures of malnutrition, such as stunting and wasting, have been studied extensively in the context of malaria. Vitamin B2, also known as riboflavin, is a micronutrient involved in maintaining cellular homeostasis. Riboflavin deficiency has been shown to have an inverse correlation with malarial parasitaemia. This article reviews the role of riboflavin in maintaining redox homeostasis and probes how riboflavin deficiency could alter malaria pathogenesis by disrupting the balance between oxidants and antioxidants. Though riboflavin analogues have been explored as antimalarials, new in vivo and patient-based research is required to target riboflavin-associated pathways for antimalarial therapy.

Abstract A new technology that is gaining popularity today is the Wireless Sensor Network. Smart sensors are being used in a variety of wireless network applications, including intruder detection, transportation, the Internet of Things, smart cities, the military, industrial, agricultural, and health monitoring, as a result of their rapid expansion. Sensor network technologies improve social advancement and life quality while having little to no negative impact on the environment or natural resources of the planet are examined in sensor networks for sustainable development. Real-world applications face challenges ensuring Quality of Service (QoS) due to dynamic network topology changes, resource constraints, and heterogeneous traffic flow. By enhancing its properties, such as maintainability, packet error ratio, reliability, scalability, availability, latency, jitter, throughput, priority, periodicity, deadline, security, and packet loss ratio, the optimized QoS may be attained. Real-world high performance is difficult to attain since sensors are spread out in a hostile environment. The performance parameters are divided into four categories: network-specific, deployment phase, layered WSN architecture, and measurability. Integrity, secrecy, safety, and security are among the privacy and security levels. This article leads emphasis on the trustworthiness of the routes as well as the nodes involved in those routes from where the data has to pass from source to destination. First of all, the nodes are deployed and cluster head selection is done by considering the total number of nodes and the distance from the base station. The proposed work uses AODV architecture for computing QoS parameters that are throughput, PDR and delay. K-means clustering algorithm is used to divide the aggregated data into three possible segments viz. good, moderate and bad as this process does not involve the labelling of aggregated data due to its supervised behavior. The proposed trust model works in two phases. In first phase, data is divided into 3 segments and labelling is done. In second phase, uses generated class objects are to be applied viz. the route records to publicize the rank of the routes followed by the rank of nodes. The proposed technique employed the statistical machine learning and swarm intelligence strategy with dragon fly algorithm in order to address the issues related effective rank generation of nodes and improving the network lifetime. Deep learning concepts can be combined with fuzzy logics approach for resolving issues like secure data transmission, trustworthiness of ranking nodes and efficient route discovery.

Background: Digital reporting of adverse events remains the most important tool to improve pharmacovigilance information related to drugs introduced in the market with good efficacy and limited safety knowledge perceived from clinical trials.Aim of the Study: The study aimed to identify the knowledge and awareness of digital reporting of adverse drug events among healthcare professionals working at a tertiary care hospital in India.Materials and Methods: A cross-sectional descriptive questionnaire-based study was conducted with Physicians, Pharmacists, Technicians and Nurses. The questionnaire comprised items regarding awareness of pharmacovigilance and digital reporting of ADRs and perception and attitudes of healthcare professionals in digital reporting of adverse drug events. Descriptive statistics were used to analyse the data.Results: Healthcare professionals received 200 questionnaires in total, and 200 participants responded, yielding a 100% response rate among which 108 were male and 92 were female. 98 doctors, 32 pharmacists, 11 technicians, and 59 nurses comprised the group of healthcare professionals. 72% of healthcare professionals were familiar with the phrase "pharmacovigilance." Nearly 73% of healthcare professionals did not know the method of digital reporting of ADR and their nearby pharmacovigilance centers. In addition, 88% agreed that ADRs need to be reported digitally because it is easy and convenient and 92% agreed that it is their professional responsibility.Conclusion: Our study shows that awareness of pharmaco-vigilance and digital ADR reporting among healthcare professionals is relatively low.

Several bacterial taxa enriched in inflammatory bowel diseases and colorectal cancer (CRC) are found in the oral cavity. We conducted a pilot study nested within a six-week aspirin intervention in a randomized placebo-controlled trial to test their response to aspirin intervention. Fifty healthy subjects, 50–75 years old, were randomized to receive 325 mg aspirin (n = 30) or placebo (n = 20) orally once daily for six weeks. Oral tongue swabs were collected at baseline and week six. We estimated the association between aspirin use and the temporal changes in the relative abundance of pre-specified genus level taxa from pre- to post-treatment. The temporal change in relative abundance differed for eight genus level taxa between the aspirin and placebo groups. In the aspirin group, there were significant increases in the relative abundances of Neisseria, Streptococcus, Actinomyces, and Rothia and significant decreases in Prevotella, Veillonella, Fusobacterium, and Porphyromonas relative to placebo. The log ratio of Neisseria to Fusobacterium declined more in the aspirin group than placebo, signaling a potential marker associated with aspirin intervention. These preliminary findings should be validated using metagenomic sequencing and may guide future studies on the role of aspirin on taxa in various oral ecological niches.

Factors driving accelerated biological age (BA), an important predictor of chronic diseases, remain poorly understood. This study focuses on the impact of diet and gut microbiome on accelerated BA. Accelerated Klemera–Doubal biological age (KDM-BA) was estimated as the difference between KDM-BA and chronological age. We assessed the cross-sectional association between accelerated KDM-BA and diet/gut microbiome in 117 adult participants from the 10,000 Families Study. 16S rRNA sequencing was used to estimate the abundances of gut bacterial genera. Multivariable linear mixed models evaluated the associations between accelerated KDM-BA and diet/gut microbiome after adjusting for family relatedness, diet, age, sex, smoking status, alcohol intake, and BMI. One standard deviation (SD) increase in processed meat was associated with a 1.91-year increase in accelerated KDM-BA (p = 0.04), while one SD increase in fiber intake was associated with a 0.70-year decrease in accelerated KDM-BA (p = 0.01). Accelerated KDM-BA was positively associated with Streptococcus and negatively associated with Subdoligranulum, unclassified Bacteroidetes, and Burkholderiales. Adjustment for gut microbiome did not change the association between dietary fiber and accelerated KDM-BA, but the association with processed meat intake became nonsignificant. These cross-sectional associations between higher meat intake, lower fiber intake, and accelerated BA need validation in longitudinal studies.

Objectives: Postconcussion syndrome (PCS) results from an injury to the head, leading to loss of consciousness. It includes symptoms like fatigue, headache, dizziness, and difficult concentration. PCS is frequently seen among athletes, and its treatment is still controversial. This systematic review aims to study the impact of manual therapies on recovery from postconcussion syndrome. Methods: A systematic search was performed using three databases (PubMed, Google Scholar, and Research Gate) from 2011 to 2021. GRADE approach (grading of recommendations assessment, development, and evaluation) was utilized to evaluate and appraise the quality of studies deemed eligible for this study. Results: A total of 5489 articles were identified. After undergoing the process of screening and review, only 7 articles were used in the systematic review. Data were extracted from these 7 articles (GRADE rating very low to low). Discussion: Manual therapy is an intervention for treating postconcussion symptoms. More studies especially controlled trials with randomization with greater sample sizes, are required to confirm the existing findings.

The demand for high‐performance materials in thermoelectric (TE) technology has driven continuous efforts to enhance the performance of commercialized Bi2Te3‐based thermoelectric materials. Here, we report success in achieving significant performance improvements in n‐type Bi2Te2.8Se0.2S0.01 through the implementation of a hot extrusion manufacturing process. This tailored manufacturing process has yielded a desired microstructure characterized by grain growth and preferred orientations. The resulting enlarged grain‐based microstructure exhibits reduced dislocations and defects that originated from plastic deformation during extrusion and post annealing. As such, the charge carrier mobility is significantly enhanced, leading to an ultrahigh power factor of approximately 51 μW cm−1 K−2 at ambient temperature. Consequently, a maximum figure of merit (zT) of 1.12 is achieved at 348 K in the combination of extrusion and annealing procedures. Using the synthesized n‐type Bi2Te2.8Se0.2S0.01 material, full‐scale cooling modules have been fabricated. These modules demonstrate record cooling performance, with a maximum temperature difference (ΔT) of 73.9 K at a hot‐side temperature of 300 K and a maximum cooling power density of 2.2 W cm−2. The cooling performance of these TE devices surpasses that of commercially available devices, establishing their potential for next‐generation TE cooling applications.

Abstract Background: The COVID-19 pandemic amplified known challenges associated with the conduct of inpatient clinical trials, while also introducing new ones that needed to be addressed. Methods: Stakeholders based in the United States who participated in the conduct of inpatient therapeutic trials for the treatment of COVID-19 as part of the Accelerating COVID-19 Therapeutic Interventions and Vaccines program identified challenges experienced in the conduct of these trials through a series of meeting to discuss and identify common themes. In addition, innovations developed to address these challenges and other potential solutions that may be utilized in future pandemics were highlighted. Results: Six thematic challenges including infection control considerations, the interplay between provision of clinical care and research, competing clinical trials, arduous consenting procedures, onerous procedural requirements, and participant recruitment including achieving representation of diverse populations were identified and are discussed here. Conclusions: Consideration of the lessons learned and recommendation outlined here may allow for more efficient conduct of inpatient clinical trials in future pandemics.

Integrated disease management is the best and most environmentally friendly technique for managing of a plant disease. Among the nine fungicides tested in vitro against Botrytis cinerea, which causes grey mould in Gladiolus, hexaconazole and a combination of iprodione+carbendazim exhibited complete inhibition of the mycelia growth at all the tested concentrations. In the evaluation of 15 different plant oils against B. cinerea, oils of Mentha piperita, Cymbopogon martini, Pelargonium graveolens, Cymbopogon sp., and Oreganum vulgare resulted in 100% mycelial growth inhibition of B. cinerea at all concentrations ranging from 200 to 1000 ppm. Aqueous extract of cloves of Allium sativum resulted best among the different botanicals and bioproducts tested in vitro with a maximum average mycelial growth inhibition of 57.39%, followed by the leaves of Azadirachta indica (45.47%) at 20, 50, 75, and 100 ppm. In integrated management of the grey mould of gladiolus under in vivo conditions, the combination of quintal + A. sativum + neem oil exhibited the maximum reduction in disease (94.40 %), followed by the combination of contaf + A.sativum + neem oil, which showed 93.19% disease reduction. The treatments viz., quintal +A.sativum + neem oil also resulted in the most superior treatment in enhancing growth and yield parameters of gladiolus with significantly improved plant height (70.34 cm), yield of corms (38.00), spike length (53.17 cm), number of florets (15.65), and number of flowers (32.67). These results indicate that the integrated management approach by using fungicides, botanicals and essential oils could be used for the control of grey mould diseases caused by Botrytis pathogens.

Abstract Background Kaposiform Hemangioendothelioma is a rare vascular neoplasm that typically presents in neonates and infancy. Most of the cases of Kaposiform Hemangioendothelioma are reported in neonates (60%) and infancy (93%), and very few cases have been reported prenatally. We describe here a case which was diagnosed prenatally in the 3rd trimester with rapid growth of upper limb and appearance of non-immune hydrops. Case presentation A 25-year-old primigravida, an antenatally booked case, presented for routine third trimester level III scan at 34-week gestation. Level I scan for nasal bone and nuchal translucency at 12 weeks and level II anomaly scan at 20 weeks were normal. Level III ultrasound scan revealed increased echogenicity and hypertrophy of soft tissues of right upper limb and trunk involving both the subcutaneous and muscular compartments. Fetal middle cerebral artery Doppler, echocardiography and magnetic resonance imaging revealed fetal anemia, cardiac failure, and non-immune hydrops. These findings with hemodynamic changes and rapid evolution were suggestive of Kaposiform Hemangioendothelioma with Kasabach–Merritt phenomenon. Conclusion The diagnosis of Kaposiform Hemangioendothelioma should be suspected in prenatal period if there is unilateral hypertrophy of limb which has evolved rapidly over a short interval of time and shows findings suggestive of Kasabach–Merritt Phenomenon. Prenatal presentation is life threatening if it is associated with poor fetal hemodynamics. Prenatal counseling in such cases should include advice on termination of pregnancy with emphasis on neonatal management.

Background: The benign enlargement of the prostate gland is known as benign prostatic hyperplasia (BPH). It refers to stromal and glandular epithelial hyperplasia that develops in the region of the prostate that surrounds the urethra known as the periurethral transition zone. Aims and Objectives: The aim of the study was to perform a survey of urologists over the management of BPH in India. Materials and Methods: A survey questionnaire was e-mailed to a random sample of 57 urologists of India through surveymonkey.com. The enrolled questionnaires were statistically analyzed. Of the 57 questionnaires sent, nine were returned, and 48 of those were included in the final analysis (response rate of 84.21%). Results: Majority of urologists’ opinion is that USG-KUB with uroflowmetry is the most reliable investigation for diagnosis of BPH. Tamsulosin (tamsulosin 0.4 mg) was the most preferred α-1 selective blocker drug in BPH patients across all the age groups, whereas silodosin was the most preferred α-1 selective blocker drug in cardiac patients having BPH. The preferred 5-alpha reductase inhibiting drug and dose was recorded as dutasteride 0.5 mg/day. Solifenacin is the preferred anti-cholinergic drug for urinary urgency and incontinence. The IPSS score of the patient improved usually within 1–6 weeks of treatment with alpha blockers/5-alpha reductase inhibitor. As per Indian urologists, the drug therapy with alpha blockers gave the fastest symptomatic improvement in BPH patients. Conclusion: In our conclusion, there is no uniformity in the treatment of acute urinary retention; however, the overall care must be individualized for the patient. Lack of understanding of the population’s history of BPH hinders advancement in appropriate care.

Objective: Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are associated with risk of euglycemic ketoacidosis. Guidelines recommend withholding SGLT2i prior to surgery and considering procedure delay in the presence of ketosis. Literature to support this in setting of routine outpatient colonoscopy is limited. Our aim was to clarify the incidence and range of ketosis in all individuals presenting for elective colonoscopies to help setting guidelines and threshold for concern. Methods: This single-centre prospective study recruited patients ≥18 of age who underwent routine outpatient colonoscopies in a medium metropolitan hospital in Brisbane, Australia between August and November 2021. SGLT2i were withheld for 48 h prior and blood glucose and capillary ketone concentrations were recorded within 90 minutes before procedure commencement. Results: 315 individuals were consecutively recruited; 179 (56.8%) were female. Sixty-nine (21.9%) had a previous diagnosis of type 2 diabetes mellitus (T2DM) and 17 (5.4%) were taking SGLT2i. The mean age was 57.79 (± 15.21). Significant ketone levels defined as >1.0 mmol/L were noted in 41 individuals (13.0%). Of these, 13 (33%) were diabetic with ketosis ranging from 1.0-4.2mmol/L. The range of significant ketosis in the 28 non-diabetics was 1.0-5.7mmol/L. Only a diagnosis of T2DM and increased fasting times (>45 mins) conferred a greater trend towards ketosis risk. Patients with T2DM as a whole were 2.06 times more likely to develop ketosis with or without SGLT2i. This did not reach statistical significance (p = 0.05). Conclusion: A wide range of periprocedural ketosis commonly occurs in patients undergoing colonoscopies with or without T2DM. This phenomenon is not unique to diabetics or in those on SGLT2i. Hence, previously defined significant ketosis cut-offs are unlikely to be useful in the unique context of colonoscopies. Avoiding procedural delays and early commencement oral intake should be a priority.

Scleral patch grafting is very commonly in use for ophthalmic conditions like scleral melting post pterygium surgery, immune or infection-related scleral melt, localized staphyloma-related scleral thinning, for covering the tubes of Ahmed glaucoma valve implant, for covering the orbital implants post enucleation, etc. A review of literature revealed the use of sclera graft for corneal perforations, but these techniques have become obsolete now due to improvement in eye banking facilities across the country, eye donation awareness leading to easy accessibility to corneal donor tissue. However, under emergency conditions in case of unavailability of corneal donor tissue the technique of scleral patch grafts can be used as a decent alternative to corneal patch grafts. The scleral patch graft is equivalently sturdy and provides tectonic/therapeutic bridging over the perforation to help salvage the eye. In this case series, we have described three cases, two of whom had peripheral corneal perforations due to aggressive corneal ulcerations refractory to medical management. The last case had posterior corneal abscess with thinning which was also refractory to treatment; hence, scleral grafting (unavailability of therapeutic corneal graft) was performed to manage the case.

Acute cerebellar ataxia (ACA) is a self-limited syndrome that is frequently post-infectious, most commonly following Varicella infection having an autoimmune mechanism. ACA is the commonest cause of childhood ataxia. We report a 14-year-old male who presented with acute onset wide-based gait and slurring of speech with dysdiadochokinesia, incoordination of voluntary movements, pendular knee jerk, and intentional tremors. He had worsening transaminitis and rising bilirubin during his hospital course and was subsequently found to be hepatitis A virus (HAV) immunoglobulin-M antibody positive. Thus, we report a case of ACA with HAV infection who developed jaundice after three weeks of onset of ataxia, a rarity that has not been reported so far in medical literature.

Favipiravir, a pyrazine analog, is proposed as providential antiviral agent against the COVID-19 infection during 2020 pandemic emergency. For the first time, a fabric phase sorptive extraction (FPSE) combined with gas chromatography-mass spectrometry (GC-MS) has been developed and applied for the determination of favipiravir (FAV) in biological samples (human plasma, blood and urine), pharmaceutical and forensic samples. The method comprises of extraction of FAV by FPSE followed by its derivatization with N, O-bis (trimethylsilyl) trifluoroacetamide (BSTFA) and GC-MS analysis. Design of experiment-based optimization was performed using Placket-Burman Design (PBD) and Central Composite Design (CCD) for the screening of significant factors of FPSE and their optimization, respectively. Among all tested membranes, sol-gel polyethylene glycol (PEG) has offered the best extraction efficiency for FAV. Under optimum conditions, the proposed method was found to be linear in the range of 0.01–10 µg mL−1 by GC-MS. The LODs and LOQs were as low as 0.001-0.0026 µg mL−1 and 0.003-0.0086 µg mL−1, respectively by GC-MS. Intra-day and inter-day precisions were less than 5 and 10%, respectively, showing good method precision. The proposed method has been successfully applied to detect and quantify FAV in human urine, whole blood and plasma samples along with seized forensic samples. In addition, the proposed method has been evaluated for its green character by ComplexGAPI index.

The dormant phenotype of Mycobacterium tuberculosis that develops during infection poses a major challenge in disease treatment, since these bacilli show tolerance to front-line drugs. An in vitro hypoxia dormancy model was established, which produced phenotypically dormant Mycobacterium smegmatis after prolonged incubation under conditions of low oxygen, low pH, and nutrient limitation. Bacilli in this model displayed the classical dormancy characters, including loss of acid fastness, altered morphology, and, most importantly, tolerance to front-line drugs. The dormant form of M. smegmatis was treated with drugs and phytomolecules. Three phytomolecules exhibited activity against dormant bacilli, as shown by lack of regrowth in solid and liquid media. Further investigation of dormancy-active hits was carried out using in silico approaches to understand the druggable targets of these phytomolecules in dormant bacilli. For this study, molecular docking, molecular dynamics simulations (MDS), and molecular mechanics-generalized born solvent accessibility (MM-GBSA)-based binding energy (ΔGbind) calculations were performed. Five different targets, namely, isocitrate lyase (ICL), GMP synthase, LuxR, DosR, and serine/threonine protein kinase (STPK), from M. smegmatis and M. tuberculosis were studied in details. DosR and STPK were found to be the common targets in both the species that were more prone to the phytomolecules. The standard DosR inhibitor, HC104A, showed a lower dock score and binding energy of −4.27 and −34.50 kcal/mol, respectively, compared to the natural products under study. The phytomolecule, icariin, showed better docking score (dock score = −5.92 kcal/mol with and binding energy ΔGbind= −52.96 kcal/mol) with DosR compared to known DosR inhibitor, HC104A (dock score = −4.27 kcal/mol and binding energy ΔGbind = −34.50 kcal/mol). Similarly, the known STPK inhibitor MRCT67127 showed a lower dock score and binding energy of −4.25 and −29.43 kcal/mol, respectively, compared to the phytomolecule, icariin (dock score = −5.74 kcal/mol and ΔGbind= −43.41 kcal/mol). These compounds might ultimately lead to new therapeutics or may be useful as adjuvants to the first-line drugs to reduce the lengthy anti-TB therapy in the future.

The mammalian intestinal epithelium is a rapidly self-renewing tissue in the body and its homeostasis is tightly controlled by numerous factors at multiple levels. The RNA-binding protein HuR (human antigen R) is intimately involved in many aspects of gut mucosal pathobiology and plays an important role in maintaining integrity of the intestinal epithelium by regulating stability and translation of target mRNAs. Nonetheless, deregulation of HuR expression and altered binding affinity of HuR for target transcripts occur commonly in various gut mucosal disorders. In this review, we highlight the essential role of HuR in the intestinal epithelium homeostasis and discuss recent results that interactions between HuR and noncoding RNAs (ncRNAs), including circular RNAs, long ncRNAs, small vault RNAs, and microRNAs, influence gut mucosal regeneration and regulate barrier function in various pathophysiological conditions. These exciting discoveries advance our knowledge of HuR biological function in the gut mucosa and also create a fundamental basis for developing novel therapies to protect intestinal epithelial integrity in critically ill patients.

Introduction: COVID-19 disease is more prevalent and severe in people who are more likely to be deficient in vitamin D, people with obesity and diabetes mellitus, and people who live in higher latitudes. Materials and methods: The study was an ambispective, analytical, observational study conducted at a tertiary care teaching hospital in New Delhi, India. The study population consisted of adults with a confirmed diagnosis of COVID-19. Results and conclusion: Eighty eight patients diagnosed with COVID-19 between February and July 2021 were enrolled, with mean (SD) age being 40(2) years and there were 55 (62.5%) males. The most common co-morbidities were hypertension, diabetes mellitus, and chronic obstructive pulmonary disease (COPD) and the most common symptoms were fever, cough, and myalgia. Twelve (13.6%) patients had severe disease. Seven (7.9%) patients died. Sixty one (69.3%) patients had vitamin D levels

Objective: The current investigation was aimed to compare the safety, efficacy, adverse effects, and outcome of air pyelogram versus contrast pyelogram for percutaneous nephrolithotomy. Materials and Methods: This was a cross-sectional study conducted from August 2018 to November 2020, which included 400 patients with a clinical diagnosis of renal calculus and randomly (1:1) assigned into Group I (air pyelogram) and Group II (contrast pyelogram). Air was injected in Group I and diatrizoate meglumine 76% was used in Group II for PCS identification. In the case of difficulty in visualization in either group, a mixture of contrast and air was used. The following parameters were assessed: duration of access, total duration of radiation exposure during access, total attempts needed to puncture the desired calyx, failure rate, complications, and outcomes. Results: Both the groups were comparable including renal calculus characteristics. The mean (standard deviation) duration of access was 3.08 (1.21) and 5.23 (1.02) min (P < 0.0001) in Groups I and II, respectively; in 85% and 57.5% of patients (P < 0.0001), respectively, the caliceal puncture was done in a single attempt. The duration of radiation exposure was more in Group II (P < 0.0001). The failure rate (22%) was higher and statistically significant in Group II. The stone clearance rate was not statistically significant between the groups (P = 0.380). No patient had hypoxia, cardiopulmonary complications, and air embolism in perioperative period. Conclusion: Air contrast is effective and safe, and it reduces the duration of caliceal puncture and radiation exposure with lower failure rate. If both air and contrast fail, a combination of both may be effective.

India experienced the second wave of SARS-CoV-2 infection from April 3 to June 10, 2021. During the second wave, Delta variant B.1617.2 emerged as the predominant strain, spiking cases from 12.5 million to 29.3 million (cumulative) by the end of the surge in India. Vaccines against COVID-19 are a potent tool to control and end the pandemic in addition to other control measures. India rolled out its vaccination programme on January 16, 2021, initially with two vaccines that were given emergency authorization-Covaxin (BBV152) and Covishield (ChAdOx1 nCoV- 19). Vaccination was initially started for the elderly (60+) and front-line workers and then gradually opened to different age groups. The second wave hit when vaccination was picking up pace in India. There were instances of vaccinated people (fully and partially) getting infected, and reinfections were also reported. We undertook a survey of staff (front line health care workers and supporting) of 15 medical colleges and research institutes across India to assess the vaccination coverage, incidence of breakthrough infections, and reinfections among them from June 2 to July 10, 2021. A total of 1876 staff participated, and 1484 forms were selected for analysis after removing duplicates and erroneous entries (n = 392). We found that among the respondents at the time of response, 17.6% were unvaccinated, 19.8% were partially vaccinated (received the first dose), and 62.5% were fully vaccinated (received both doses). Incidence of breakthrough infections was 8.7% among the 801 individuals (70/801) tested at least 14 days after the 2nd dose of vaccine. Eight participants reported reinfection in the overall infected group and reinfection incidence rate was 5.1%. Out of (N = 349) infected individuals 243 (69.6%) were unvaccinated and 106 (30.3%) were vaccinated. Our findings reveal the protective effect of vaccination and its role as an essential tool in the struggle against this pandemic.

Introduction Malaria and malnutrition are key public health challenges in India. However, the relationship between them is poorly understood. Here, we aimed to elucidate the potential interactions between the two health conditions by identifying the areas of their spatial overlap.Methods We have analysed the district-wise undernutrition and malaria data of 638 districts of India across 28 states and 8 union territories. Data on malnutrition parameters viz. stunting, wasting, underweight and anaemia, sourced from the fourth National Family Health Survey (2015–2016), and malaria Annual Parasite Index (API) data of the same year (i.e, 2015), sourced from National Center of Vector Borne Diseases Control were analysed using local Moran’s I Index and logistic regression.Results Among all the malnutrition parameters, we found underweight in children and anaemia in men to co-occur with malaria in the districts of Chhattisgarh, Jharkhand, Madhya Pradesh and Odisha. Further, districts with more than 36% underweight children (OR (95% CI): 2.31 (1.53 to 3.48)) and/or more than 23.6% male population with anaemia (OR (95% CI): 2.06 (1.37 to 3.11)) had higher odds of being malaria endemic districts (ie, Annual Parasite Index >1).Conclusion Malaria and malnutrition co-occur in the malaria-endemic parts of India. The high prevalence of undernutrition in children and anaemia among men may contribute to malaria endemicity in a particular region. Therefore, future research should be prioritised to generate data on the individual level. Further, malaria control interventions could be tailored to integrate nutrition programmes to disrupt indigenous malaria transmission in endemic districts.

Aspirin (ASA) is a globally used anti-inflammatory drug and salicylic acid (SA) is the biological metabolite of ASA. As an analytical chemist, it's always a challenge to accurately and precisely determine a drug along with its metabolites with a single method. Hence, we aim to develop a simple and low-cost assay based on combination of vortex assisted-dispersive liquid-liquid microextraction (VADLLME) with smartphone based digital image colorimetry (DIC) as a promising platform for simple low-cost analysis of ASA and SA. The method comprises of three simple steps viz. (i) extraction and pre-concentration of ASA/SA by VADLLME, (ii) reaction of ASA/SA with Trinder reagent on a filter paper strip to produce blue colour, and (iii) DIC of developed colour with imageJ software. Design of experiment approach comprising of Plackett-Burman design (PBD) and central composite design (CCD) were used for optimization of parameters affecting the efficiency of the proposed method. Under the optimized conditions, the limits of detection (LOD) and the limit of quantitation (LOQ) were found to be 8.88 and 29.0 µg mL−1, respectively. Calibration plot demonstrated good linearity in the range of 50–400 µg mL−1, with coefficients of determination (R2) higher than 0.993 and standard deviation less than 10%. The proposed method has been successfully applied for the estimation of ASA/SA in pharmaceutical formulations (tablets), cosmetic product and human urine samples, with percent recoveries (%R) ranging from 92.14–99.6%. In addition, the green character of the proposed method from sample collection to final determination has been evaluated by using ComplexGAPI index.

Plant-based heterologous expression systems can be leveraged to produce high-value therapeutics, industrially important proteins, metabolites, and bioproducts. The production can be scaled up, free from pathogen contamination, and offer post-translational modifications to synthesize complex proteins. With advancements in molecular techniques, transgenics, CRISPR/Cas9 system, plant cell, tissue, and organ culture, significant progress has been made to increase the expression of recombinant proteins and important metabolites in plants. Methods are also available to stabilize RNA transcripts, optimize protein translation, engineer proteins for their stability, and target proteins to subcellular locations best suited for their accumulation. This mini-review focuses on recent advancements to enhance the production of high-value metabolites and proteins necessary for therapeutic applications using plants as bio-factories.

Introduction: Sickle Cell Disease (SCD) is an autosomal recessive multisystem disorder, characterised by anaemia, recurrent episodes of pain and chronic organ damage. Hydroxyurea (HU), a disease modifying agent with proven efficacy in reducing painful episodes in SCD patients thereby improving quality of life. Compliance to hydroxyurea therapy is a liming factor in management of SCD. Aim: To compare adherence to HU therapy and frequency of hospital admissions before and after counselling. Materials And Methods: This longitudinal study was conducted in Department of Paediatrics at Gandhi Medical College and associated Hamidia Hospital Bhopal, Madhya Pradesh, India, from 1st January 2020 to 30th June 2021. Patients with SCD, between the age group of 1-14 years, in a study period were recruited for the study. After enrolment, data regarding HU therapy and admissions in the previous one year was recorded for each registered patient. This was followed by detailed counselling sessions, which were repeated at 3 monthly intervals for a period of 1 year. Post-counselling data collection was done to evaluate the response. The effect of counselling was assessed using Chi-square test (for categorical variables) and Analysis of Variance (ANOVA) or paired t-test (for continuous variables). A p-value

Abstract Atherosclerosis, a chronic inflammatory disease of large arteries, is the major contributor to the growing burden of cardiovascular disease-related mortality and morbidity. During early atherogenesis, as a result of inflammation and endothelial dysfunction, monocytes transmigrate into the aortic intimal areas, and differentiate into lipid-laden foam cells, a critical process in atherosclerosis. Numerous natural compounds such as flavonoids and polyphenols are known to have anti-inflammatory and anti-atherogenic properties. Herein, using a fluorometric imaging plate reader-supported Ca2+ influx assay, we report semi high-throughput screening-based identification of ginkgetin, a biflavone, as a novel inhibitor of transient receptor potential vanilloid 4 (TRPV4)-dependent proatherogenic and inflammatory processes in macrophages. We found that ginkgetin (1) blocks TRPV4-elicited Ca2+ influx into macrophages, (2) inhibits oxidized low-density lipoprotein (oxLDL)-induced foam cell formation by suppressing the uptake but not the binding of oxLDL in macrophages, and (3) attenuates oxLDL-induced phosphorylation of JNK2, expression of TRPV4 proteins, and induction of inflammatory mRNAs. Considered all together, the results of this study show that ginkgetin inhibits proatherogenic/inflammatory macrophage function in a TRPV4-dependent manner, thus strengthening the rationale for the use of natural compounds for developing therapeutic and/or chemopreventive molecules.

Reports related to incidences of drug facilitated crimes (DFCs) have notably increased in recently. In such cases, victims report being assaulted or robbed while under the influence of drugs. Lorazepam (LZ) is frequently used in DFCs as it can easily make victims docile owing to its potent numbing effect. Therefore, a straightforward and green analytical method to analyze LZ in spiked food matrices in connection with criminal acts becomes important. The current study reports a simple, green, and high sample throughput analytical method for determining LZ in food and drink matrices commonly encountered in DFCs, based on recently introduced cellulose paper sorptive extraction (CPSE). For the extraction of LZ from food matrices, pristine cellulose paper (CP, commonly used laboratory filter paper) was used as a sorptive medium. Five pieces of CP (1.5″ × 1.5″ each) were dipped into diluted food matrices (cream biscuits and tea) and stirred on a rotary shaker for 30 min at 200 rpm. The CPs were then dried, and the adsorbed LZ was back-extracted into 2 mL of methanol. The extract was then subjected to GC–MS analysis in selected ion monitoring (SIM) mode. Several parameters, including CP size and number, back-extraction solvent type and volume, sample volume, extraction time and stirring speed, pH, ionic strength, elution time and speed, were thoroughly screened and optimized. Under the optimized conditions, the method was found to be linear in the range of 0.2–10 µg·mL−1 (or µg·g−1) with a coefficient of determination (R2) ranging from 0.996–0.998. The limit of detection and limit of quantification for cream biscuits were 0.054 and 0.18 µg·g−1 whereas they were 0.05 and 0.16 µg·mL−1 for tea samples. For all measurements, the relative standard deviations (%RSD) were always below 10%. Two mL of methanol per sample was used during the entire sample preparation process. The greenness of the proposed procedure was evaluated using Analytical Eco-Scale and GAPI greenness assessment tools. Finally, the CPSE–GC–MS method has been applied for the determination of LZ in forensic food samples which were used in DFCs.

A novel, simple, precise and accurate method developed for the estimation of Lamivudine and tenofovir disoproxil fumarate (TDF) in bulk drug form has been established. Lamivudine and tenofovir are well known drugs and used in treatment of HIV- Ⅰ. The method was performed by using C18 column, ODS Hypersil column with UV detection at 262nm by using Acetonitrile and water in ratio 55:45. The retention time was found to be 2.8 and 6.8 min for Lamivudine and tenofovir disoproxil fumarate (TDF). The linearity was found in range of 6- 14µg/ml for Lamivudine and 10- 50µg/ml for Tenofovir disoproxil fumarate with flow rate 1ml/min. the method was validated for linearity, accuracy, precision and robustness as per ICH guidelines. This method is suitable for simultaneous analysis for both the nucleoside analog reverse- transcriptase inhibitors

Morphine (MO), a prime constituent of opium, is highly toxic and can alter various immune functions as well as disruption in the central nervous system. In this context, the present work focuses on the development of an electrochemical sensor based on thiourea (N and S atom) doped graphene for MO detection. The doping of nitrogen and sulphur (N and S) atoms effectively increases the active sites on graphene surface along with an increase in the electroactive surface area, causing faster electron transfer process. Various spectroscopic and microscopic characterization techniques such as Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), field emission scanning electron microscopy-energy dispersive X-ray (FESEM-EDX) spectroscopy, Raman spectroscopy, X-ray photoelectron spectroscopy (XPS) endorsed the successful formation of N and S doped graphene (NSG). The electrochemical features of NSG modified glassy carbon electrode (NSG 4/GCE) were investigated through electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV). Further, differential pulse voltammetry (DPV) measurements of NSG 4/GCE in the presence of MO were carried out to record the concentration dependent change in the redox current responses. The constructed sensor exhibited a dose dependent increase in DPV anodic peak current with a dynamic concentration range of 0.57 ​μgmL−1 to 294 ​μgmL−1 (at a potential of 0.37 ​V) and a detection limit of 0.26 ​μgmL−1. Finally, the practical ability of the proposed electrochemical sensor for the determination of trace amount of morphine were evaluated in real samples such as soft and hard drinks. Therefore, the present electrochemical sensor based on NSG material as electrochemical interfaces could be a potential candidate for morphine detection in clinical settings and for forensic purpose.

Activated carbon is a carbonaceous material with highly porous structure. Different functionalities can be introduced to its surface by various physical and chemical treatments. Various precursors can be used for the synthesis of activated carbon such as fossil fuels, agricultural wastes, and lignocellulosic wastes, etc. Number of papers have been reported in literature devoted to the synthesis, characterization, and various applications of activated carbon. Herein, in this review, special attention has been paid to the basic properties of activated carbon and its surface chemistry originated due to physical and chemical treatment. In addition, a general introduction to adsorption process, various adsorption isotherms, and adsorption kinetics is also included. A brief description of mechanism of adsorption onto activated carbon is also presented. At last, most probable applications of activated carbon such as adsorption of pollutants (e.g., dyes, heavy metal ions, pesticides, pharmaceutical waste products, and volatile organic organic), as catalyst support, anduse in food and pharmaceutical industries is also presented.

Favipiravir (FAV) has become a promising antiviral agent for the treatment of COVID-19. Herein, a green, fast, high-sample-throughput, non-instrumental, and affordable analytical method is proposed based on surfactant-assisted dispersive liquid–liquid microextraction (SA-DLLME) combined with thin-layer chromatography–digital image colourimetry (TLC-DIC) for determining favipiravir in biological and pharmaceutical samples. Triton X-100 and dichloromethane (DCM) were used as the disperser and extraction solvents, respectively. The extract obtained after DLLME procedure was spotted on a TLC plate and allowed to develop with a mobile phase of chloroform:methanol (8:2, v/v). The developed plate was photographed using a smartphone under UV irradiation at 254 nm. The quantification of FAV was performed by analysing the digital images’ spots with open-source ImageJ software. Multivariate optimisation using Plackett–Burman design (PBD) and central composite design (CCD) was performed for the screening and optimisation of significant factors. Under the optimised conditions, the method was found to be linear, ranging from 5 to 100 µg/spot, with a correlation coefficient (R2) ranging from 0.991 to 0.994. The limit of detection (LOD) and limit of quantification (LOQ) were in the ranges of 1.2–1.5 µg/spot and 3.96–4.29 µg/spot, respectively. The developed approach was successfully applied for the determination of FAV in biological (i.e., human urine and plasma) and pharmaceutical samples. The results obtained using the proposed methodology were compared to those obtained using HPLC-UV analysis and found to be in close agreement with one another. Additionally, the green character of the developed method with previously reported protocols was evaluated using the ComplexGAPI, AGREE, and Eco-Scale greenness assessment tools. The proposed method is green in nature and does not require any sophisticated high-end analytical instruments, and it can therefore be routinely applied for the analysis of FAV in various resource-limited laboratories during the COVID-19 pandemic.

During shoot apex development, the plants undergo a very complex transition phase of flowering for successful reproduction, seed/cone setting and fruit development. The conversion of vegetative shoot meristems to floral meristems depends upon numerous endogenous, exogenous factors and flowering genes for the development of floral parts. The perennial crops suffer from the limitation of the innate ability to keep some meristems in the vegetative state for the polycarpic growth habit leading to the long juvenile phase. Conventional breeding approaches viz. selection of early flowering parental lines, flower thinning and grafting are time-consuming requiring more time for the release of a new cultivar which is undesirable for rapid crop improvement. The best way to accelerate the perennial plant breeding improvement programs and to reduce the long juvenile phase is the induction of early flowering through the utilization of biotechnological approaches. The ability to allow the transmission of an early flowering gene to the progeny in a Mendelian fashion is the major advantage of biotechnological interventions. The introgression of early flowering traits from non-commercial germplasm or sexually compatible species to perennial species through the biotechnological aspects will act as a boon for crop improvement in future studies. The present review gives an overview of various flowering genes in perennial crops accompanying the implementation of biotechnological approaches including overexpression studies, RNA interference, Virus-induced flowering and CRISPR-Cas approaches that will help in reducing the period for induction of flowering in perennial crops.

Fabric phase sorptive extraction (FPSE) has become a popular sorptive-based microextraction technique for the rapid analysis of a wide variety of analytes in complex matrices. The present study describes a simple and green analytical protocol based on in-matrix methyl chloroformate (MCF) derivatization of non-steroidal anti-inflammatory (NSAID) drugs in urine samples followed by FPSE and gas chromatography-mass spectrometry (GC-MS) analysis. Use of MCF as derivatizing reagent saves substantial amounts of time, reagent and energy, and can be directly performed in aqueous samples without any sample pre-treatment. The derivatized analytes were extracted using sol–gel Carbowax 20M coated FPSE membrane and eluted in 0.5 mL of MeOH for GC-MS analysis. A chemometric design of experiment-based approach was utilized comprising a Placket–Burman design (PBD) and central composite design (CCD) for screening and optimization of significant variables of derivatization and FPSE protocol, respectively. Under optimized conditions, the proposed FPSE-GC-MS method exhibited good linearity in the range of 0.1–10 µg mL−1 with coefficients of determination (R2) in the range of 0.998–0.999. The intra-day and inter-day precisions for the proposed method were lower than

The mathematical construct of dimension is one of the fundamental ideas for developing a sound understanding of two-dimensional (2D) and three-dimensional (3D) shapes. Yet, research in mathematics education has rarely explored children's understanding of dimension in primary education. This paper explores how year 5/6 (9 to 11 years old) children construct and negotiate their meanings about dimension while engaging in classroom interactions about 2D and 3D shapes during geometry lessons in a New Zealand (NZ) English-medium multilingual primary classroom. Transcribed data of two key moments selected from six audiovisually recorded geometry lessons are presented. The findings suggest that children may use different discursive constructions--"another world", "different ways to go", and "flat vs fat"--to display their meanings about dimension. The findings also suggest that children and teacher participants may use prosodic features of their languages to interactionally construct the meanings of these discursive constructions. The paper discusses these findings in light of current research literature and offers a few implications for curriculum development and future research.

Bimetallic nanoparticles (BNPs) are formed by the combination of two different metals. Bimetallic nanoparticles have attracted huge attention as compared to monometallic nanoparticles in both technological and scientific view because BNPs shows better properties. Bimetallic nanoparticles can be synthesized in different shape, size and structure. The nanocomposites of BNPs have been prepared by supporting them on the organic or inorganic counterparts. BNPs nanocomposites have improved properties as compared to those of bimetallic nanoparticles. Due to reduction in size and increase in surface area, these are prominently used as catalyst. Application area of bimetallic nanocomposites includes drug delivery, water purification and catalysis etc. Keywords: Nanotechnology, Nanoparticles, Monometallic, Bimetallic, Bimetallic nanocomposites, Catalysts

Context: Cutaneous adverse drug reactions (CADRs) are the most frequent of all manifestations of drug sensitivity that present with varied and diverse morphology and therefore, awareness about them is essential for diagnosis and prevention. Aims: To evaluate the clinical spectrum, morphology, causality, severity and preventability of cutaneous adverse drug reactions in a tertiary care hospital. Setting and Design: Descriptive study for six months in the Dermatology Department of a tertiary care hospital in Kerala. Methods and Materials: All patients of any gender and age who presented with visible skin lesions and were diagnosed or suspected cases of cutaneous adverse drug reactions were included in the study. All the relevant information was recorded using pre-structured proforma and ADR reporting form. Statistical Analysis: Data were analyzed using descriptive statistics. The quantitative variables were expressed as mean ± standard deviation and qualitative variables as frequencies and percentages. Odds ratio (OR) was calculated to assess the risk factors for severe cutaneous adverse drug reactions using SPSS 16. Results: Total 124 cutaneous adverse drug reactions were reported with mean age 39.22 ± 20.47 years, male:female ratio being 1:1.4. Most common cutaneous adverse drug reaction was maculopapular rash. Antibiotics accounted for maximum cases, of which beta-lactams were the most common. About 55.6% cutaneous adverse drug reactions occurred within 24 hours of drug administration. Mean hospital stay duration was 4.89 ± 6.23 days. Most reactions were either mild or moderate. Risk analysis revealed that concomitant use of more than one drug, delayed onset, oral route, more generalized area of involvement and medications prescribed for CNS indications were risk factors for severe cutaneous adverse drug reactions. All reactions were preventable. Majority got fully recovered. No fatality was observed. Conclusion: Identification and reporting of cutaneous adverse drug reactions reduces their future occurrences and encourages rational prescribing. The study emphasizes on having a deeper understanding of risk factors for serious cutaneous adverse drug reactions that may contribute significantly in improving their outcomes.

Introduction: Does metabolic imaging help in better definition of target during radiation treatment planning by bringing about changes in dimensions of the primary tumor in terms of diameter, length, and picking up new skip lesions or nodal stations which in turn prevents geographic misses by including more 18F-fluorodeoxyglucose avid regions not visible on conventional imaging? Materials and Methods: We compared the length and radial dimensions of the primary tumor as well as changes brought about due to addition of new nodal stations, involved structures, and skip lesions in 50 patients of carcinoma esophagus treated between 2011 and 2013, as seen on contrast-enhanced computed tomography (CT) thorax and positron emission tomography (PET)/CT and drew conclusions regarding the technical changes brought about in treatment planning by the additional input of PET/CT. Results and Conclusions: PET-CT tremendously changes treatment plans by expanding the gross tumor volume and including regions which might otherwise have been missed on purely CT-based plans. Of the 50 patients, it changed the contouring and treatment planning of 35 patients and did not impact the remaining 15. Whether this translates into better long-term controls requires further validation by randomized controlled trials, which was not our present objective.

Introduction: Emphysematous Pyelonephritis (EPN) is a serious life threatening, necrotising infection which can affect renal parenchyma, collecting system and nearby tissue with presence of gas within renal system Aim: To check likelihood of kidney salvagibility by minimally invasive approaches in EPN and to see the prognostic factors that support kidney salvagibility in EPN. Materials and Methods: The cross-sectional study was conducted during October 2018 to June 2020 on 30 patients who were admitted in Department of Urology, Srirama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha,India with features of EPN. Thirty patients with clinical and radiological features (Huang Tseng Classification) of EPN were enrolled in the study. All the biochemical parameters, clinical features and outcomes (patient who managed conservatively included in good outcome group while the patients who required nephrectomy were included in poor outcome group) continuous variables were analysed with the Unpaired t-test and categorical variables were analysed with fisher-exact test and multiple logistic regression test. Results were considered statistical significance when p-value was

Summary: Background: The association of air pollution with multiple adverse health outcomes is becoming well established, but its negative economic impact is less well appreciated. It is important to elucidate this impact for the states of India. Methods: We estimated exposure to ambient particulate matter pollution, household air pollution, and ambient ozone pollution, and their attributable deaths and disability-adjusted life-years in every state of India as part of the Global Burden of Disease Study (GBD) 2019. We estimated the economic impact of air pollution as the cost of lost output due to premature deaths and morbidity attributable to air pollution for every state of India, using the cost-of-illness method. Findings: 1·67 million (95% uncertainty interval 1·42–1·92) deaths were attributable to air pollution in India in 2019, accounting for 17·8% (15·8–19·5) of the total deaths in the country. The majority of these deaths were from ambient particulate matter pollution (0·98 million [0·77–1·19]) and household air pollution (0·61 million [0·39–0·86]). The death rate due to household air pollution decreased by 64·2% (52·2–74·2) from 1990 to 2019, while that due to ambient particulate matter pollution increased by 115·3% (28·3–344·4) and that due to ambient ozone pollution increased by 139·2% (96·5–195·8). Lost output from premature deaths and morbidity attributable to air pollution accounted for economic losses of US$28·8 billion (21·4–37·4) and $8·0 billion (5·9–10·3), respectively, in India in 2019. This total loss of $36·8 billion (27·4–47·7) was 1·36% of India's gross domestic product (GDP). The economic loss as a proportion of the state GDP varied 3·2 times between the states, ranging from 0·67% (0·47–0·91) to 2·15% (1·60–2·77), and was highest in the low per-capita GDP states of Uttar Pradesh, Bihar, Rajasthan, Madhya Pradesh, and Chhattisgarh. Delhi had the highest per-capita economic loss due to air pollution, followed by Haryana in 2019, with 5·4 times variation across all states. Interpretation: The high burden of death and disease due to air pollution and its associated substantial adverse economic impact from loss of output could impede India's aspiration to be a $5 trillion economy by 2024. Successful reduction of air pollution in India through state-specific strategies would lead to substantial benefits for both the health of the population and the economy. Funding: UN Environment Programme; Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.

This present study aims to evaluate the peroxidase activity in soybean extract which was obtained through the seeds of the soybean. This enzymatic extract (Soybean Peroxidase-SBP) was then compared with commercially available pure enzyme i.e., horseradish peroxidase (HRP). The effect of the enzyme concentration, substrate concentration, pH temperature were studied to interpret the factors affectingthe rate of the reaction. Therefore, after the studies were carried out, it was detected that the increase in the concentration of the substrate as well as enzyme resulted in the gradual increase of the activity. The rate of the reaction thus became constant when all the enzymes got saturated after a certain range. The optimum pH and temperature of 7 and 40 ​°C was maintained for the decolorization of the synthetic dyes viz., Sunset yellow and Coomassie Brilliant blue dye R-250. The removal of Sunset yellow dye and CBB was around 45 % and 11 %, respectively and results were compared with the degradation with HRP in similar conditions. The effective degradation of Sunset yellow over CBB may be because of the difference in the molecular weight. Furthermore, optimization of reaction mixture and reaction conditions is in progress. The results obtained in this work suggest that peroxidases can be used in a supplementary step to the conventional processes for specific dye removal.

The current monologue reports the facile synthesis of hybrid Patchouli oil (P. cablin) coated silver nanoparticles (P-Ag-NPs) using hyacinth bean (L. purpureus) seed extract as a reducing agent. Design of experiment (DoE) based methodical optimization of the formulation parameters such as metallic salt concentration, and pH resulted in the successful accomplishment of the desired attributes i.e. morphology, and particle size. State of art spectroscopic (UV–Vis, DLS, ATR-FTIR, EDS), and microscopic techniques (HR-TEM, FE-SEM mapping) based characterization of the attained nanoparticles was carried out.The outcome of the respective UV–Vis analysis ascertained the biogenic synthesis, as the absorption maxima of the obtained particles (~415 ​nm) lied within characteristic SPR region of the Ag-NPs. DLS analysis revealed that the fabricated nanoparticles were nanosized (110 ​nm), and possessed a significantly high surface charge (−20.73 ​mV). ATR-FTIR spectra illustrated the presence of varied functional groups which confirmed the imperious role played by the phytoconstituents in reducing and capping of the synthesized P-Ag-NPs. Electron microscopic analysis further strengthened these findings, as no signs of intermittent agglomeration were present, and the P-Ag-NPs were uniformly distributed.HR-TEM also illustrated that the synthesized hybrid metallic nanoparticles were spherical, and encompassed a coating of essential oil on the halo of the as-synthesized NPs. FE-SEM-Mapping confirmed the phase purity of the Ag-NPs and showed that the particles primarily comprised of the elemental silver in nano form. DPPH and antibacterial assay revealed a significantly high antioxidant (i.e. 2.76 fold) and antibacterial (i.e. 3 fold) potential of the P-Ag-NPs as compared to its counterparts, respectively. The present work thus paves a gallant and promising pathway to eradicate the unsurmountable predicament of microbial pathogenesis.

In all Hard IP (HIP) designs, there is a need for signals to travel from its source to destination module. To meet timing, they are flop repeated based on the floorplan of the design. Different signals have unique repetition requirements based on their functionality/timing criticality. Also signals may have single destination or multiple destinations. The flop repeater structure for each signal should be optimized so that it has minimum number of flops and timing is also met, to achieve desired targets for timing, area and power. This paper will show how we are creating optimized treestructure based on mathematical techniques and generating automated RTL for such repeater flop module. This submission presents a new tool ART (Auto Repeater Tool) that completely eliminates the manual effort/time required to generate functional, ready to plug-in RTL.

Summary: Background: Many countries, including India, seek locally constructed disease burden estimates comprising mortality and loss of health to aid priority setting for the prevention and treatment of diseases. We created the National Burden Estimates (NBE) to provide transparent and understandable disease burdens at the national and subnational levels, and to identify gaps in knowledge. Methods: To calculate the NBE for India, we combined 2017 UN death totals with national and subnational mortality rates for 2010–17 and causes of death from 211 166 verbal autopsy interviews in the Indian Million Death Study for 2010–14. We calculated years of life lost (YLLs) and years lived with disability (YLDs) for 2017 using published YLD–YLL ratios from WHO Global Health Estimates. We grouped causes of death into 45 groups, including ill-defined deaths, and summed YLLs and YLDs to calculate disability-adjusted life-years (DALYs) for these causes in eight age groups covering rural and urban areas and 21 major states of India. Findings: In 2017, there were about 9·7 million deaths and 486 million DALYs in India. About three quarters of deaths and DALYs occurred in rural areas. More than a third of national DALYs arose from communicable, maternal, perinatal, and nutritional disorders. DALY rates in rural areas were at least twice those of urban areas for perinatal and nutritional conditions, chronic respiratory diseases, diarrhoea, and fever of unknown origin. DALY rates for ischaemic heart disease were greater in urban areas. Injuries caused 11·4% of DALYs nationally. The top 15 conditions that accounted for the most DALYs were mostly those causing mortality (ischaemic heart disease, perinatal conditions, chronic respiratory diseases, diarrhoea, respiratory infections, cancer, stroke, road traffic accidents, tuberculosis, and liver and alcohol-related conditions), with disability mostly due to a few conditions (nutritional deficiencies, neuropsychiatric conditions, vision and other sensory loss, musculoskeletal disorders, and genitourinary diseases). Every condition that was common in one part of India was uncommon elsewhere, suggesting state-specific priorities for disease control. Interpretation: The NBE method quantifies disease burden using transparent, intuitive, and reproducible methods. It provides a simple, locally operable tool to aid policy makers in priority setting in India and other low-income and middle-income countries. The NBE underlines the need for many more countries to collect nationally representative cause of death data, paired with focused surveys of disability. Funding: Ministry of Health and Family Welfare, Government of India.

Tuberculosis (TB), a common chronic-specific granulomatous disease, has become rare in the developed countries. However, it is still a common cause of morbidity and mortality in India. Although it commonly involves the lungs, its presentation in the oral cavity is quite uncommon. The very rare incidence of primary gingival TB, particularly in the absence of active pulmonary involvement often leads to misdiagnosis. Clinical features of oral lesions may include ulceration, nodules, granulomas, and fissures. TB in pregnant women is a major cause of obstetric complications and increased risk of maternal and child mortality. This report highlights a rare case of primary TB of gingiva, presenting as severe gingival overgrowth in a patient with 4th month of pregnancy. This case strongly suggests the importance of suspecting TB as the differential diagnosis of gingival overgrowth and therefore, playing a critical role in the early detection and treatment. Interdisciplinary collaboration for diagnosis and management resulted in the successful outcome and prevented the obstetric complications in this case.

Introduction: Altered pharmacokinetics of antituberculosis (anti-TB) drugs due to interaction with non-TB medications or concomitant diseases may lead to suboptimal plasma levels of the affected drugs and hence contribute to the emergence of drug resistance in mycobacteria. Yet, few studies have investigated the prevalence of concomitant drug intake or concurrent diseases in patients on anti-TB therapy (ATT). The objective of this study is to study the prevalence of concomitant diseases and intake of non-TB drugs in patients on ATT. Methods: Adult patients who were undergoing treatment for TB at a directly observed treatment short-course (DOTS) center were interviewed to find out any concomitant drug intake and ailments they were suffering from. Data were also collected from the patients' treatment cards. Results: A total of 105 patients were interviewed for the study over a period of 1 month. Among these, 66 (62.9%) patients reported having taken a non-ATT drug in the last 3 months, 61 (58.1%) of which were drugs that may affect the ATT. A comparable number of patients (61 [58.1%]) reported suffering from one or the other concurrent illnesses or symptoms while on DOTS, including one patient with AIDS and eight with diabetes mellitus. Fluoroquinolones had been prescribed to four patients while on DOTS. Conclusion: A large proportion of the patients with TB were found to be on non-TB concomitant medications including drugs with potential for interactions that are capable of affecting ATT outcomes. It is, therefore, important that the patients and prescribing physicians be aware of any possible drug interactions.