LSD1 inhibition circumvents glucocorticoid-induced muscle wasting of male mice

Synthetic glucocorticoids (GC), such as dexamethasone, are extensively used to treat chronic inflammation and autoimmune disorders. However, long-term treatments are limited by various side effects, including muscle atrophy. GC activities are mediated by the glucocorticoid receptor (GR), that regulates target gene expression in various tissues in association with cell-specific co-regulators. Here we show that GR and the lysine-specific demethylase 1 (LSD1) interact in myofibers of male mice, and that LSD1 connects GR-bound enhancers with NRF1-associated promoters to stimulate target gene expression. In addition, we unravel that LSD1 demethylase activity is required for triggering starvation- and dexamethasone-induced skeletal muscle proteolysis in collaboration with GR. Importantly, inhibition of LSD1 circumvents muscle wasting induced by pharmacological levels of dexamethasone, without affecting their anti-inflammatory activities. Thus, our findings provide mechanistic insights into the muscle-specific GC activities, and highlight the therapeutic potential of targeting GR co-regulators to limit corticotherapy-induced side effects.

A conserved nutrient responsive axis mediates autophagic degradation of miRNA-mRNA hybrids in blood cell progenitors

In animals, microRNAs are amongst the primary non-coding RNAs involved in regulating the gene expression of a cell. Most mRNAs in a cell are targeted by one or many miRNAs. Although several mechanisms can be attributed to the degradation of miRNA and mRNA within a cell, but the involvement of autophagy in the clearance of miRNA and its target mRNA is not known. We discover a leucine-responsive axis in blood cell progenitors that can mediate an autophagy-directed degradation of miRNA-bound mRNA in Drosophila melanogaster and Homo sapiens. This previously unknown miRNA clearance axis is activated upon amino acid deprivation that can traffic miRNA-mRNA-loaded Argonaute for autophagic degradation in a p62-dependent manner. Thus, our research not only reports a novel axis that can address the turnover of a catalytically active miRISC but also elucidates a slicer-independent mechanism through which autophagy can selectively initiate the clearance of target mRNA.

Study of the association of the known prognostic variables with EGFR expression in head and neck squamous cell carcinomas

Context

: Head and neck squamous cell carcinomas (HNSCCs) are the sixth most frequent malignancy in the world. Epidermal growth factor receptors (EGFRs) are members of Erb B family of receptors. EGFR is known to act as a driver of tumorigenesis in various carcinomas. Over expression of EGFR in HNSCC is associated with poor prognosis and resistance to radiotherapy. It is a useful prognostic marker, marker for response to therapy, and also a therapeutic target.

Aim

To study the association of the known prognostic variables with EGFR expression in HNSCCs and to correlate it with the clinical outcome.

Settings and Design

Cross-sectional observational study.

Materials and Methods

A total of 170 patients of HNSCC were evaluated for EGFR expression and followed up for at least two years, with correlation of EGFR expression with various histopathological factors and their clinical outcome.

Statistical Analysis Used

: Chi-square test.

Results

The expression of EGFR in HNSCC in this study population was 88.82%. Statistical significance was noted between EGFR reactivity and age of the patient, its histological grade and perineural invasion. Statistical significance was also noted between EGFR reactivity and recurrence of malignancy as well as the site of recurrence.

Conclusion

EGFR expression in patients with HNSCC is a poor prognostic biomarker and has a comparatively lower survival outcome as compared to non-EGFR expressing HNSCC cases. Hence, it will be helpful for all those patients diagnosed with HNSCC to ideally undergo an additional EGFR immunohistochemical evaluation, which, in turn, will help the oncologists in management of the tumor with anti-EGFR therapy combined with radiotherapy, to obtain a better response and a survival outcome.

Phenothiazine-Based Cu(II)-Selective Fluorescent Sensor: GHK-Cu Sensing Applications

Sensing important metals in different environments is an important area and involves the development of a wide variety of metal-sensing materials. The employment of fluorescent sensors in metal sensing has been one of the most widely applied methodologies, and the identification of selective metal sensors is important. We herein report a phenothiazine-based Cu(II) fluorescent sensor that is highly selective to Cu(II) ions compared with other transition metal salts. The Lewis acidity of the Cu(II) salt certainly was found to be a factor for obtaining an enhanced sensing response in MeOH as the solvent, while a ratio of 1:1 was calculated to be the most optimum for getting the desired response.

An overview on androgen-mediated actions in skeletal muscle and adipose tissue

Androgens are a class of steroid hormones primarily associated with male sexual development and physiology, but exert pleiotropic effects in either sex. They have a crucial role in various physiological processes, including the regulation of skeletal muscle and adipose tissue homeostasis. The effects of androgens are mainly mediated through the androgen receptor (AR), a ligand-activated nuclear receptor expressed in both tissues. In skeletal muscle, androgens via AR exert a multitude of effects, ranging from increased muscle mass and strength, to the regulation of muscle fiber type composition, contraction and metabolic functions. In adipose tissue, androgens influence several processes including proliferation, fat distribution, and metabolism but they display depot-specific and organism-specific effects which differ in certain context. This review further explores the potential mechanisms underlying androgen-AR signaling in skeletal muscle and adipose tissue. Understanding the roles of androgens and their receptor in skeletal muscle and adipose tissue is essential for elucidating their contributions to physiological processes, disease conditions, and potential therapeutic interventions.

Awareness Regarding Antimicrobial Resistance and Antibiotic Prescribing Behavior among Physicians: Results from a Nationwide Cross-Sectional Survey in India

(1) Background: Understanding the physicians' knowledge, attitudes, and antimicrobial prescribing behavior is a crucial step towards designing strategies for the optimal use of these agents. (2) Methods: A cross-sectional online survey was conducted among clinicians across India between May and July 2022 using a self-administered questionnaire in English comprising 35 questions pertaining to demographic characteristics, knowledge, attitude, and practices domains. (3) Results: A total of 544 responses were received from 710 physicians contacted. Sixty percent of participants were males, with mean age of 34.7 years. Mean ± Standard Deviation scores for knowledge, attitude, and practices domains were 8 ± 1.6, 20.2 ± 3.5, and 15.3 ± 2.1, respectively. Higher scores were associated with basic [odds ratio (95% Confidence Interval), p value: 2.95 (1.21, 7.2), 0.02], medical and allied sciences [2.71 (1.09, 6.67), 0.03], and central zone [3.75 (1.39, 10.12), 0.009]. A substantial proportion of dissatisfactory responses were found regarding hospital antibiograms, antibiotics effective against anaerobes, WHO AWaRe (access, watch, and reserve) classification of antibiotics, and the role of infection prevention and control (IPC) measures in the containment of antimicrobial resistance (AMR). (4) Conclusions: There is a need to sensitize and educate clinicians on various issues related to antimicrobial use, such as antibiograms, double anaerobic cover, IPC practices, and guideline-based recommendations, to curb the AMR pandemic.

Anxiety, depression and harmful use of alcohol in severe chronic plaque psoriasis: A cross-sectional study

Background

Psoriasis is a common, chronic T cell-mediated disease characterised by erythematous, scaly plaques. Psoriasis is associated with depression, anxiety, poor quality of life, harmful use of alcohol and suicidal ideation. We performed this study to find out prevalence of psychological morbidity in our patients with severe psoriasis and to know clinical variables associated with higher risk of psychological morbidity.

Method

This study is a cross-sectional, observational study conducted in a dermatology outpatient department (OPD) of a tertiary care centre. Study population included patients with severe psoriasis area severity index (PASI>10). Clinical and epidemiological data, Patient health questionnaire-9, Generalised anxiety disorder-7, Dermatology life quality index (DLQI) and Alcohol Use Disorders Identification Test questionnaires were recorded. Data were analysed using SPSS, version 24. Chi-square test and Spearman's rank correlation test (ρ) were performed, and p value of <0.05 was considered statistically significant.

Result

A total of 140 patients were included in the study and consisted of 67 men and 73 women. The median age was 44 years, median duration of disease was 10 years and median PASI was 13.6. Scoring revealed moderate-to-severe depression in 69 (49.3%) patients, moderate-to-severe anxiety in 40 (28.6%), severe impairment in quality of life in 98 (70%), harmful use of alcohol in 23 (16.4%) and suicidal ideation in 11 (7.8%) patients. Young age, recent onset, higher PASI and facial involvement show significant association with depression, anxiety and poor quality of life.

Conclusion

Screening for psychological morbidity should be performed in patients with severe psoriasis especially younger patients with recent onset disease. Higher DLQI points to concomitant psychological morbidity and it should be performed in all the patients.

Entangling microwaves with light

Quantum entanglement is a key resource in currently developed quantum technologies. Sharing this fragile property between superconducting microwave circuits and optical or atomic systems would enable new functionalities, but this has been hindered by an energy scale mismatch of >10⁴ and the resulting mutually imposed loss and noise. In this work, we created and verified entanglement between microwave and optical fields in a millikelvin environment. Using an optically pulsed superconducting electro-optical device, we show entanglement between propagating microwave and optical fields in the continuous variable domain. This achievement not only paves the way for entanglement between superconducting circuits and telecom wavelength light, but also has wide-ranging implications for hybrid quantum networks in the context of modularization, scaling, sensing, and cross-platform verification.

Comparison of NGSP Certified Methods and their Cost Analysis for Estimation of HbA1c- A Cross-sectional Study

Introduction: Diabetes Mellitus (DM) is a major non communicable disease that adversely impacts the health of the global community, contributing significantly to mortality. Estimation of glycated haemoglobin (HbA1c) is an integral component of diagnosis, treatment and follow-up of cases of DM as the various protocols have included it for therapy. In order to regularise the estimation of HbA1c, it is mandated by American Diabetes Association (ADA) to perform the test on NGSP certified methods only. Aim: To compare the results of HbA1c analysis by SIEMENS DIMENSION EXL 200 and BIORAD D-10 (NGSP certified methods). Materials and Methods: This was a cross-sectional observational study done in Department of Biochemistry, Armed Forces Medical College, Pune, Maharashtra, a tertiary care center. One hundred and twenty blood samples in EDTA tubes for haemoglobin variant analysis, received from patients with unexplained anaemia or screening for antenatal care were included in the study. The tests for HbA1c were performed by HPLC based BIORAD D10 and enzymatic based method, SIEMENS DIMENSION EXL 200 analyser. Cost analysis of both the methods was also performed. Students paired t-test was done to look for any significant statistical difference. Kappa coefficient was also calculated to analyse for agreement between values. Results: HbA1c estimation by SIEMENS DIMENSION EXL200 and BIORAD D-10 (both NGSP certified) showed marginally different results, but it was not significant enough to make a clinical difference (5.308% on BIORAD D10 and 5.211% on SIEMENS DIMENSION EXL 200). On performing the cost analysis, there was a significant difference observed with a figure of Rs 476.05/- per test on the SIEMENS DIMENSION EXL200, while it was significantly cheaper at Rs 266/- per test on the BIORAD D10. Conclusion: Estimation of HbA1c on SIEMENS DIMENSION EXL200 and BIORAD D10 was not clinically significant. As per cost analysis, BIORAD D10 is a cheaper alternative and suitable for tertiary care or large volume centres.

DNA-Encoded Libraries Via Late-Stage Functionalization Strategies: A Review

Drug discovery has undergone a tremendous change in the past decade as the less efficient nature of the high-throughput screening methods that were previously employed have been slowly replaced in...

PTABS: A Unique Water-Soluble π-Acceptor Caged Phosphine

Caged phosphines have unique structure and provide many advantageous properties that could be fine-tuned to develop efficient catalytic systems. Our research group recently introduced a highly water-soluble caged phosphine PTABS (KapdiPhos), which is a derivatized form of triazaphosphaadamantane and explored its applicability as a strongly π-accepting ligand in combination with metals such as Pd or Cu in a variety of cross-coupling reactions of biologically relevant halonucleosides as well as chloroheteroarenes. This account will detail our journey from ideation to the various catalytic applications of the ligands eventually to its commercialization.

Epidemiological investigation of viral hepatitis E outbreak in two colocated training centers

Background

A high number of jaundice cases were reported from two colocated training centers in North India. This outbreak was investigated to describe the epidemiology, identify risk factors, and recommend preventive and control measures.

Methods

Initial line list was prepared, and case definition was defined as "the presence of icterus or passage of yellow-colored urine with fever/anorexia/vomiting/abdominal pain in a resident of Military Station A between 03/04/2016 to 06/06/2016". Case search was conducted through surveillance. An unmatched 1:1 case-control study was conducted to evaluate the associated risk factors. All cases were tested for hepatitis markers. Environmental investigation of food and water sources was conducted to identify the source of infection.

Results

Of 172 cases, all were males from two co-located military training centers (attack rate, 4.7%). Clinical features included icterus (100%), yellowish discoloration of urine (98.9%), anorexia (97.22%), fever (80%), nausea/vomiting (56%), and abdominal pain (52.77%). Only one case (0.6%) had complication of fulminant hepatitis, and there were no deaths (CFR = 0%). Consumption of juice with ice from juice shops was significantly associated with illness (Odds Ratio-14.3 [95%CI 7.4-27.6]). Of 172 cases, 167 (97.1%) tested anti-HEV-IgM positive. Juice shops in training centers were using ice made from contaminated water with positive coliform test. All other water samples tested satisfactory. No cross-contamination of water pipelines with sewage was observed.

Conclusion

Epidemiological evidence concludes that a large viral hepatitis E outbreak was likely caused by consumption of juice with contaminated ice. Early stoppage of contaminated ice usage led to timely control of the outbreak.

Sweetness and positivity together aren't a happy ending: Case controlled study amongst severe COVID-19 for impact of diabetes mellitus on survival

Background

India is the epicenter of diabetes mellitus (DM). The relationship between COVID and DM in age/gender-matched non-diabetics has not been studied yet. The role of DM in predicting the disease severity and outcome in COVID patients might provide new insight for effective management.

Methods

We conducted a prospective comparative study at a COVID care center from 25th April-31st May 2021. Among 357 severe-COVID patients screened, all consecutive diabetes (n-113) and age/gender-matched non-diabetes (n-113) patients were recruited. All diabetics and non-diabetics at admission were subjected to high resolution computed tomography (HRCT) chest and inflammatory markers (C-reactive protein (CRP), D-dimer, ferritin, interleukin-6 (IL-6), lactate dehydrogenase (LDH), Neutrophil-Lymphocyte Ratio (NLR)) before starting anti- COVID therapy. Statistical analysis was done using JMP 15·0 ver·3·0·0.

Results

The prevalence of DM among the screened population (n-357) was 38·37%. The mean age of the study population was 61y with male preponderance (57%). There was no statistical difference in the HRCT-score or inflammatory markers in the two groups except for higher NLR (p-0·0283) in diabetics. Diabetics had significantly inferior overall survival (OS) (p-0·0251) with a 15d-OS of diabetics vs. non-diabetics being 58·87%, 72·67%, and 30d-OS of diabetics vs. non-diabetics being 46·76%, 64·61%, respectively. The duration of the hospital stay was not statistically different in the two groups (p-0·2).

Conclusion

The mortality is significantly higher in severe-COVID patients with DM when compared to age/gender-matched non-diabetics. There was no significant difference in most inflammatory markers/CT at admission between the two groups.

Strategies for the Synthesis of Fluorinated Nucleosides, Nucleotides and Oligonucleotides

Fluorinated nucleosides and oligonucleotides are of specific interest as probes for studying nucleic acids interaction, structures, biological transformations, and its biomedical applications. Among various modifications of oligonucleotides, fluorination of preformed nucleoside and/or nucleotides have recently gained attention owing to the unique properties of fluorine atoms imparting medicinal properties with respect to the small size, electronegativity, lipophilicity, and ability for stereochemical control. This review deals with synthetic protocols for selective fluorination either at sugar or base moiety in a preformed nucleosides, nucleotides and nucleic acids using specific fluorinating reagents.

Evaluation of point of entry surveillance for COVID-19 at Mumbai international airport, India, July 2020

India started Point of entry (PoE) surveillance at Mumbai International Airport, screening passengers returning from coronavirus disease (COVID-19)-affected countries using infrared thermometers. We evaluated in July 2020 for March 1-22 with the Centers for Disease Control and Prevention evaluation framework. We conducted key informant interviews, reviewed passenger self-reporting forms (SRFs) (randomly selected) and relevant Airport Health Organization and Integrated Disease Surveillance Programme (IDSP) records. Of screened 165,882 passengers, three suspects were detected and all were reverse transcription-polymerase chain reaction negative. Passengers under-quarantine line-listing not available in paper-based PoE system, eight written complaints: 6/8 SRF filling inconvenience, 3/8 no SRF filling inflight announcements, and standing in long queues for their submission. Outside staff deployed 128/150 (85.3%), and staff: passenger ratio was 1:300. IDSP reported 59 COVID-19 confirmed cases against zero detected at PoE. It was simple, timely, flexible, and useful in providing information to IDSP but missed cases at PoE and had poor stability. We recommended dedicated workforce and data integration with IDSP.

Headache of Wearing PPE; A Survey for Neurological Symptoms with PPE amongst Health Care Workers

BACKGROUND

The COVID-19 pandemic has put the entire medical fraternity into a very challenging and demanding situation. Along with always being at the risk of COVID infection, healthcare workers (HCWs) are also facing neurological problems due to long working hours in personal protective equipment (PPE). These symptoms and their characteristics need to be observed and studied in-depth to understand the problems experienced by HCWs and to design new solutions to overcome such problems.

OBJECTIVES

This study intends to evaluate the various neurological manifestations among the HCWs wearing PPE for prolonged periods.

MATERIALS AND METHODS

We conducted a questionnaire-based cross-sectional study at a Covid care center from western India from April 20 to June 01, 2021 by using a self-administered web-based questionnaire. A total of 256 HCWs were surveyed. The de-identified data were analyzed using JMP 15.0.0.

RESULTS

Among a total of 256 HCWs surveyed for this study, the majority (58.6%) were aged 24-35 years, with a male preponderance (65.62%, n = 168). Participants included doctors (41%), nurses (35%), paramedical staff (22%), and housekeeping staff (1%). The symptoms encountered among the HCWs wearing the PPE were headache, classified further as donning headache in 112 (44.98%), doffing headache in 56 (26.24%), slowed mentation in 48 (21.05%), and excessive sleepiness in 86 (38.74%), which affected their work performance. The age of the HCWs had a significant correlation with all the symptoms.

CONCLUSION

Headache, slowed mentation, and excessive sleepiness was encountered among the HCWs wearing PPE, which depended upon the duration of PPE usage. The most common symptom was headache, which was of moderate to severe intensity.

Effectiveness of ChAdOx1 nCOV-19 Vaccine: Experience of a tertiary care institute

Background

The first dose of the ChAdOx1 nCoV- 19 Corona Virus Vaccine (Covishield) was administered to the eligible beneficiaries of tertiary care institute of Western Maharashtra on 16 Jan 21 and in the past three months almost 97% of the staff has been vaccinated. The present study analyses the incidence of COVID cases in the unvaccinated and vaccinated population of the institute.

Methods

All Covid 19 infections (RT-PCR positive) from 01 February 21 to 25 April 21 were included in the study and analyzed as per their vaccination status. To assess the COVID 19 transmission in contacts, Secondary Attack Rates (SAR) of the pre-vaccination period (Jun–Oct 20) was compared with the present SAR.

Results

A total of 113 cases occurred in the study period (01 Feb to 25 Apr 21). Lower number of infections were observed among the fully vaccinated as compared to partially vaccinated and non-vaccinated. The overall vaccine effectiveness was found to be 88.6% (81.55–92.37) and 44.1% (4.55–67.3) in completely and partially vaccinated individuals respectively. Hazard Ratios for getting infected dropped significantly after 28 days of the second dose. The SAR in high risk contacts (HRCs) was found to be 4.25%, which was lower than SAR (20.6%) of pre-vaccination period.

Conclusion

This is one of the earliest studies in India to report the impact of COVID-19 vaccination. The results indicate that the vaccine provides effective protection against COVID-19 infection. However, given the complex dynamics of vaccination, the role of NPIs and implementation of COVID appropriate behavior cannot be undermined.

Precision medicine: Concept and tools

Precision medicine is the new age medicine and refers to tailoring treatments to a subpopulation who have a common susceptibility to a particular disease or similar response to a particular drug. Although the concept existed even during the times of Sir William Osler, it was given a shot in the arm with the Precision Medicine Initiative launched by Barack Obama in 2015. The main tools of precision medicine are Big data, artificial intelligence, the various omics, pharmaco-omics, environmental and social factors and the integration of these with preventive and population medicine. Big data can be acquired from electronic health records of patients and includes various biomarkers (clinical and omics based), laboratory and radiological investigations and these can be analysed through machine learning by various complex flowcharts setting up an algorithm for the management of specific subpopulations. So, there is a move away from the traditional "one size fits all" treatment to precision-based medicine. Research in "omics" has increased in leaps and bounds and advancements have included the fields of genomics, epigenomics, proteomics, transcriptomics, metabolomics and microbiomics. Pharmaco-omics has also come to the forefront with development of new drugs and suiting a particular drug to a particular subpopulation, thus avoiding their prescription to non-responders, preventing unwanted adverse effects and proving economical in the long run. Environmental, social and behavioural factors are as important or in fact more important than genetic factors in most complex diseases and managing these factors form an important part of precision medicine. Finally integrating precision with preventive and public health makes "precision medicine" a complete final product which will change the way medicine will be practised in future.

Seroconversion among COVID-19 patients admitted in a dedicated COVID hospital: A longitudinal prospective study of 1000 patients

BACKGROUND

The immune response after SARS-CoV-2 is complex and may be affected by severity of the disease, race, etc. The present study was conducted to assess the serial antibody response among the COVID-19 patients admitted in the hospital.

METHODS

The study was conducted between July and October 2020 in a dedicated COVID-19 hospital. All consented patients underwent serial testing of antibodies using a rapid chromatographic immunoassay-based qualitative IgG/IgM kit every third day until their discharge or death. The data about age, sex, severity of disease, length of stay, onset of symptoms, date of molecular testing were also collected. Appropriate statistical tests were used.

RESULTS

The mean age of 1000 COVID-19 patients was 47.5 ± 17.9 years. Out of the total, 687 (68.7%) were males. With respect to severity, 682 (68.2%) were asymptomatic/mild, 200 (20%) were moderate and 118 (11.8%) were severe cases. The seroconversion percentage increased from 12.8% to 97.9% and 16.3% to 80.9% for IgG and IgM respectively in 21 days. The median time for seroconversion was 10 days (IQR:6-12 days) for IgG and eight days (IQR: 6-11 days) for IgM. At the time of discharge (median nine days), detectable IgG and IgM antibodies were present in 502 (52.46%) and 414 (43.26%) participants respectively. Seroconversion was associated with days after the symptoms, increasing severity of the disease and the presence of co-morbidity.

CONCLUSION

Seroconversion increased during the period of observation. The severe/moderate cases of COVID-19 tend to have an early seroconversion as compared to the asymptomatic/mild cases. Only half of the patients were seroconverted at discharge.

Development and Validation of Chromatographic Method for the Standardization of Homeopathic Formulation of Syzygium Cumini

BACKGROUND

 Syzygium cumini (Lam.), family Myrtaceae, has a long history of use in folk and traditional systems of indigenous medicine. Many homeopathic formulations of Jamun seeds are available in the market for their crucial usage as an anti-diabetic. Despite the popularity of homeopathic products, a lack of standard quality is a significant impediment in their acceptance. The present study aimed to develop and validate a chromatographic method for the standardization of the homeopathic formulation of Syzygium cumini.

METHODS

 The seeds of Syzygium cumini were studied for physicochemical evaluation and preliminary phytochemical screening. Also, the in-house standard and marketed homeopathic formulations of Syzigium cumini were standardized for pH, total fatty content, total phenolic and flavonoid content, with quantitative high-performance liquid chromatography- photodiode array detector (HPLC-PDA) analysis by using ellagic acid as a marker.

RESULTS

 The physicochemical characteristics of crude material were found to be within pharmacopeial limits. The phytochemical screening showed the presence of various secondary metabolites. The total phenolic and flavonoid content was higher in the in-house standard than in marketed formulations. A validated quantitative HPLC-PDA analysis showed variations of ellagic acid content in different homeopathic formulations.

CONCLUSION

 Physicochemical analysis and the HPLC method for quantitative estimation of ellagic acid can be used to standardize a homeopathic formulation of Syzygium cumini.

Utility of glomerular morphometry in diagnosing pediatric renal disease

BACKGROUND

Morphometry has now become a useful adjunct to the diagnostic armamentarium of light, immunofluorescence, and electron microscopy, as it provides a deep insight into quantitative parameters of nephropathies. There has been a limited study on its utility especially in diagnosing pediatric renal diseases. This study is probably the first in India to assess the contribution of this diagnostic modality in pediatric renal disease to the best of authors' knowledge.

METHODS

It's a retrospective cross-sectional study covering a period of 05 years at a tertiary care hospital. The study includes 28 cases of pediatric (age till 14 years) nephropathies. The diseases were divided into two groups-nephrotic presentation and nephritic presentation. Glomerular morphometry was performed and mean was calculated for Bowman's capsule area, glomerular capillary tuft area, and Bowman's space area; for the three groups, respectively. Renal parameters serum creatinine, blood urea, 24 h urine protein were studied along with hemoglobin and serum cholesterol for the cases. Data were analyzed using SPSS software, version 25, for one-way ANOVA comparing mean in the three groups.

RESULTS

We found a positive and significant correlation between Bowman's capsule area with proteinuria, blood urea, and serum creatinine. There was positive and significant correlation between glomerular capillary tuft area and serum creatinine and Bowman's space area and proteinuria in both the groups.

CONCLUSION

Glomerular morphometry may contribute to the diagnosis of some glomerulopathies and the association between glomerular morphometric parameters and laboratory data may promote better understanding of the prognosis of these patients.

Acute gastroenteritis outbreak in a school associated with religious ceremony in Mirzapur District, Uttar Pradesh, India

Background

A suspected food-poisoning outbreak occurred in a residential school in Mirzapur, India, in February, 2017.

Objective

We investigated the outbreak to find out the epidemiology and to identify the risk factors.

Methods

A descriptive study followed by retrospective-cohort study was done to investigate the outbreak. Cases (defined as ≥3 or more loose stools in 24 h, abdominal pain, or vomiting with onset between February 1 and 4, 2017) were searched by reviewing sick/patient registers from school and nearby health facilities. Cases were also searched through active surveillance by visiting school hostels. Stool samples were sent for microbiological testing. Food sources and food handlers were also assessed.

Results

Among 468 students, 204 cases were identified (44% attack rate) without any mortality. The median age was found to be 14 years (range: 10-18 years) and 59% were male. Relative risk with consumption of curd, apple, and panjiri (sweetened wheat flour) was found to be 15.4, 2.5, and 3.7, respectively. All these three food items were served as prasad, a religious offering. Only consumption of sweetened curd (adjusted odds ratio = 36.1, 95% confidence interval = 12.1-107.8) was significantly associated with gastroenteritis. No microorganism was isolated from two tested stool samples. Curd from the vendor was prepared from nonpasteurized milk. There were no illnesses among food-handlers.

Conclusions

This outbreak of acute gastroenteritis in a residential school was associated with consumption of curd, likely contaminated with preformed toxins. We recommend implementation of the food safety and standards authority of India regulations.

A Cross-sectional Comparative Study of hs-CRP Levels between Non Diabetic and Diabetic Patients of Chronic Obstructive Pulmonary Disease

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is characterised by persistent airflow limitation and is a global health issue with high social and economic burden. Type 2 Diabetes Mellitus (T2DM) is a major global metabolic disorder affecting approximately 300 million individuals worldwide. Accordingly, chronic low grade systemic inflammation is probably one of the common denominators between COPD and T2DM. Aim: To evaluate the status of systemic inflammation in COPD patient with/without T2DM, using quantitative serum high sensitivity C-Reactive Protein (hs-CRP) and Total Leucocyte Count (TLC). Materials and Methods: This cross-sectional study was conducted for a period of one year from May 2019 to April 2020 on 100 patients of COPD patients attending outpatient department. Either known patients of COPD or patients with complains of chronic cough was evaluated with chest x-ray and pulmonary function test (spirometry) after thorough history and physical examination. Global Initiative for Chronic Obstructive Lung Disease-GOLD guidelines a grading system for COPD was used for assessing severity. For assessing diabetes, criteria adopted from American Diabetes Association (ADA) i.e., symptoms of diabetes plus random plasma glucose >200 mg/dL (11.1 mMol/L). Venous blood samples were obtained to perform quantitative hs-CRP estimation by immune turbidimetry method as a marker of systemic inflammation. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 26.0 of International Business Machines (IBM) Corporation, California, United States of America (USA). Results: The T2DM was present in 40% COPD patients. The frequencies of T2DM in patients with GOLD stages I, II, III, and IV were 16%, 45%, 28%, and 11%, respectively. The mean hs-CRP levels for diabetic group was 5.45±1.07 mg/L, which was significantly higher (p<0.05) than 2.26±0.69 mg/L that of non diabetic group. Conclusion: Present study concluded that the inflammatory process is a definite pathophysiological factor that has a significant link between COPD and T2DM and can be evaluated using a marker like hs-CRP level and TLC.

Priorities and preferences for school-based mental health services in India: a multi-stakeholder study with adolescents, parents, school staff, and mental health providers

BACKGROUND

Schools are important settings for increasing reach and uptake of adolescent mental health interventions. There is limited consensus on the focus and content of school-based mental health services (SBMHSs), particularly in low-resource settings. This study elicited the views of diverse stakeholders in two urban settings in India about their priorities and preferences for SBMHSs.

METHODS

We completed semi-structured interviews and focus group discussions with adolescents (n  =  191), parents (n  =  9), teachers (n  =  78), school counsellors (n  =  15), clinical psychologists/psychiatrists (n  =  7) in two urban sites in India (Delhi and Goa). Qualitative data were obtained on prioritized outcomes, preferred content and delivery methods, and indicated barriers.

RESULTS

All stakeholders indicated the need for and acceptability of SBMHSs. Adolescents prioritized resolution of life problems and exhibited a preference for practical guidance. Parents and teachers emphasized functional outcomes and preferred to be involved in interventions. In contrast, adolescents' favored limited involvement from parents and teachers, was related to widespread concerns about confidentiality. Face-to-face counselling was deemed to be the most acceptable delivery format; self-help was less frequently endorsed but was relatively more acceptable if blended with guidance or delivered using digital technology. Structured sensitization was recommended to promote adolescent's engagement. Providers endorsed a stepped care approach to address different levels of mental health need among adolescents.

CONCLUSION

SBMHSs are desired by adolescents and adult stakeholders in this setting where few such services exist. Sensitization activities are required to support implementation. School counsellors have an important role in identifying and treating adolescents with different levels of mental health needs, and a suite of interventions is needed to target these needs effectively and efficiently.

Risk Factors Associated with Tuberculosis Infection Among Household Children Contacts of Sputum Smear Positive Tuberculosis Cases

Background: India has highest burden of tuberculosis (TB) globally. The source of infection for children is usually an adult in their household with active TB. Only few studies have been carried out among household children contacts of active TB patients in India to assess the risk factors of infection among children. Aim and Objective: To study the risk factors of TB infection among household children contacts of sputum positive patients. Material and Methods: We conducted study on 200 household children contacts (1-15 years) of sputum positive patients registered at DOTS centers in Lucknow district, Uttar Pradesh. Stratified sampling was done. A semi structured questionnaire was administered to collect the information. Infection in children was assessed by TST (Mantoux test). Results: TST positivity in children of TST positivity was associated with female index case (p=0.027), lower socioeconomic status (p=0.011), overcrowding (0.008) and duration of symptoms before treatment (p<0.001). Among the factors of children, age >6 years, duration of stay with index case >10 hours/day and malnutrition were significantly associated. Conclusion: The study concludes that TB infection among children is significantly associated with various factors related to index case, susceptible host and environment, which can be intervened to prevent TB infection in children.

Congenital paediatric atlantoaxial dislocation: clinico-radiological profile and surgical outcome

INTRODUCTION

Congenital atlantoaxial dislocation (AAD) is the most common bony abnormality affecting the craniovertebral junction. The paediatric population has specific problems like preoperative diagnostic difficulties, precise neurological examination, radiological diagnosis, surgical problems including physical fitness to tolerate surgery (including problems of anaesthesia), technical difficulties in surgery and problems related to immobilization.

MATERIAL AND METHODS

A total of 229 consecutive paediatric (≤18 years) patients of AAD visited our centre from the period of January 1997 to August 2011. Twenty-nine cases were excluded from the study as these cases were diagnosed as CVJ tuberculosis, 31 cases were excluded as they were traumatic and the remaining 169 cases were retrospectively analysed. These patients were operated by a single experienced surgeon (the senior author) at the Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow. The preoperative and the postoperative clinical evaluation of the patient was done by the Kumar and Kalra myelopathic scoring system. The score was recorded in the preoperative period, at the time of discharge, at 3 months follow-up and at 6 months follow-up.

RESULTS

Ninety-four were males and 75 were females. The age range was 4 to 18 years with mean age 9.96±3.78 years. The follow-up ranged from 3 to 120 months with mean follow-up being 39.03±13.38 months. One hundred five cases were of fixed/irreducible AAD, and 64 were cases of mobile/reducible AAD. Majority of these cases presented with features of pyramidal tract involvement, and 108 cases had compromised pulmonary function test. One hundred thirty-seven cases had improved outcome, and 18 cases were in the same grade in the postoperative period with only 14 cases either deteriorated or died.

CONCLUSIONS

Congenital paediatric AAD are a different subset of abnormalities and have a satisfactory outcome. Preoperative evaluation must also include identification of various syndromes associated with paediatric AAD and respiratory reserve. Cormack-Lehane grade can be helpful in selecting borderline cases for postoperative need of tracheostomy. Majority of the cases have a good outcome, and therefore, surgery should be offered even in severe grade.

Mandibular canal variant: a case report

The mandibular canal transmits the inferior alveolar artery, vein and the inferior alveolar nerve. From an embryological perspective, there might be three inferior dental nerves innervating three groups of mandibular teeth. During rapid prenatal growth and remodeling in the ramus region there is spread of intramembranous ossification that eventually forms the mandibular canal. Occurrence of bifid/trifid mandibular canals in some patients is secondary to incomplete fusion of these three nerves. Various types of bifid mandibular canals have been classified according to anatomical location and configuration. This case report highlights an unusual variant of the mandibular canal.

Bivariate- distribution for transition matrix elements in Breit-Wigner to Gaussian domains of interacting particle systems

Interacting many-particle systems with a mean-field one-body part plus a chaos generating random two-body interaction having strength lambda exhibit Poisson to Gaussian orthogonal ensemble and Breit-Wigner (BW) to Gaussian transitions in level fluctuations and strength functions with transition points marked by lambda = lambda c and lambda = lambda F, respectively; lambda F >> lambda c. For these systems a theory for the matrix elements of one-body transition operators is available, as valid in the Gaussian domain, with lambda > lambda F, in terms of orbital occupation numbers, level densities, and an integral involving a bivariate Gaussian in the initial and final energies. Here we show that, using a bivariate-t distribution, the theory extends below from the Gaussian regime to the BW regime up to lambda = lambda c. This is well tested in numerical calculations for 6 spinless fermions in 12 single-particle states.

Single-particle entropy in (1+2)-body random matrix ensembles

Random matrix ensembles defined by a mean-field one-body plus a chaos generating random two-body interaction (called embedded Gaussian orthogonal ensembles of (1+2)-body interactions[EGOE(1+2)]) predict for the entropy defined by the occupation numbers of single-particle states, in the chaotic domain, an essentially one parameter Gaussian form for their energy dependence. Numerical embedded ensemble calculations are compared with the theory. In addition, it is shown that the single-particle entropy, thermodynamic entropy defined by the state density and information entropy defined by wave functions in the mean-field basis for EGOE(1+2) describe the results known for interacting Fermi systems such as those obtained from nuclear shell model.

Heavy metal pollution of river Yamuna in the industrially developing state of Haryana

Heavy metal concentrations viz. Fe, Ni, Pb, Cd, Co, Zn in the river Yamuna flowing along the state of Haryana through Delhi have been reported selecting 16 stations covering the upstream and downstream stations for major industrial complexes of the state. While Fe, Ni and Co concentrations exceeded the maximum permissible limits prescribed for drinking all along the river, the Cd concentrations crossed the acceptable standards in Delhi downstream. The Pb concentrations declined in the eutrophicated Delhi downstream while Zn concentrations remained within desirable limits throughout. Peak concentrations were recorded in Delhi downstream for Fe and at Sonepat-Gohana downstream for Ni, Co & Zn, which matched with the type of industrial inputs viz. Iron-works and the electroplating, galvanizing & cycle industries, respectively. The status of heavy metal pollution of the river has been discussed with respect to possible impacts on human health and aquatic life.

Structure of wave functions in (1+2)-body random matrix ensembles

Random matrix ensembles defined by a mean-field one body plus a chaos generating random two-body interaction [called embedded ensembles of (1+2)-body interactions] predict for wave functions, in the chaotic domain, an essentially one-parameter Gaussian forms for the energy dependence of the number of principal components (NPC) and the localization length l(H) (defined by information entropy), which are two important measures of chaos in finite interacting many-particle systems. Numerical embedded ensemble calculations and nuclear shell-model results, for NPC and l(H), are compared with the theory. These analyses clearly point out that for realistic finite interacting many-particle systems, in the chaotic domain, wave-function structure is given by (1+2)-body embedded random matrix ensembles.

Theory for matrix elements of one-body transition operators in the quantum chaotic domain of interacting particle systems

Demonstrating the equivalence between the recent theory of Flambaum and collaborators which is based on smoothed strength functions, with the much earlier formulation due to French and collaborators which is based on embedded random matrix ensembles and smoothed transition strength densities, we derive a theory for matrix elements of one-body transition operators in the quantum chaotic domain of isolated finite interacting particle systems with a mean-field and a chaos generating two-body interaction (V). The role of the bivariate correlation coefficient (zeta) arising out of the noncommutability of V and the transition operator (in the theory of Flambaum et al., zeta=0) is tested in numerical embedded ensemble calculations with a one- plus two-body Hamiltonian generating order-chaos transitions.