Genomic insights into key genes and QTLs involved in cattle reproduction

From an economic standpoint, reproductive characteristics are fundamental for sustainable production, particularly for monotocous livestock like cattle. A longer inter-calving interval is indicative of low reproductive capacity. This issue changes the dynamics of current and future lactations since it necessitates more inseminations, veterinary care, and hormone interventions. Various reproductive phenotypes, including ovulation, mating, fertility, pregnancy, embryonic growth, and calving-related traits, are observed in dairy cattle, and these traits have been associated with several QTLs. Calving ease, age at puberty, scrotal circumference, and inseminations per conception have been associated with 4437, 10623, 10498, and 2476 Quantitative Trait Loci (QTLs), respectively. This data offers valuable insights into enhancing and comprehending reproductive traits in livestock breeding. Studying QTLs associated with reproductive traits has far-reaching implications across various fields, from agriculture and animal husbandry to human health, evolutionary biology, and conservation. It provides the foundation for informed breeding practices, advances in biotechnology, and a deeper understanding of the genetic underpinnings of reproduction.

Geographic and socioeconomic inequalities in the coverage of contraception in Uttar Pradesh, India

BACKGROUND

Uttar Pradesh (UP) is the most populous state in India, with a historically lower level of family planning coverage than the national average. In recent decades, family planning coverage in UP has significantly increased, yet there are considerable geographic and socio-economic inequalities.

METHODS

The data used for the study is derived from a cross-sectional quantitative survey of 12,200 currently married women conducted during December 2020-February 2021 in UP by the Technical Support Unit. Univariate and bivariate analyses were performed and equiplots were used to make visualizing inequalities easy.

RESULTS

The findings of the study reveal significant variation in family planning coverage indicators amongst currently married women in reproductive ages by administrative divisions in UP. For instance, in the Jhansi division, it was 72.4%, while in Faizabad, it was 39.3%. Jhansi division experienced the highest modern contraceptive coverage with the lowest inequity compared to other divisions. However, the range of coverage within the division by Accredited Social Health Activist (ASHA) areas is 25% to 75%. In fact, for some ASHA areas in the Jhansi division, the family planning demand satisfied for modern contraception ranged from more than 85% to less than 22%. On the other hand, the Gonda division with the lowest coverage and lowest inequity for demand satisfied for modern contraception has some ASHA areas with less than 5% and some with more than 36%. The study also revealed intersectionality of education, wealth, place of residence and geographic divisions in identifying inequity patterns. For instance, in case of Mirzapur and Varanasi, the demand satisfied among the illiterates was 69% and the corresponding percentage for literates was 49%. With respect to place of residence, Basti division, where the coverage for modern contraception is extremely low, demand satisfied for modern contraceptive methods is 16.3% among rural residents compared to 57.9% in the case of urban residents.

CONCLUSIONS

The findings showed inequality in the modern family planning methods coverage in UP in both best and worst performing divisions. The inequalities exist even in extremely small geographies such as ASHA areas. Within the geographies as well, the socio-economic inequalities persisted. These inequalities at multiple levels are important to consider for effective resource allocation and utilization.

Core-Shell Structure of Photopolymer-Grafted Polyurethane as a Controlled Drug Delivery Vehicle for Biomedical Application

Functionalized ultraviolet photocurable bisphenol A-glycerolate dimethacrylates with tailorable size have been synthesized as the core, which have further been grafted using the diisocyanate chain end of polyurethane (PU) as the shell to create a core-shell structure of tunable size for a controlled drug delivery vehicle. The core-shell structure has been elucidated through spectroscopic techniques like 1H NMR, FTIR, and UV-vis and their relative shape and size through TEM and AFM morphology. The greater cross-link density of the core is reflected in the higher glass transition temperature, and the improved thermal stability of the graft copolymer is proven from its thermogravimetric analyses. The flow behavior and enhanced strength of the graft copolymers have been revealed from rheological measurements. The graft copolymer exhibits sustained release of the drug, as compared to pure polyurethane and photopolymer, arising from its core-shell structure and strong interaction between the copolymer and drug, as observed through a significant shifting of absorption peaks in FTIR and UV-vis measurements. Biocompatibility has been tested for the real application of the novel graft copolymer in medical fields, as revealed from MTT assay, cell imaging, and cell adhesion studies. The efficacy of controlled release from a graft copolymer has been verified from the gradual cell killing and ∼70% killing in 3 days vs meager cell killing of ∼25% very quickly in 1 day, followed by the increased cell viability of the system treated with the pure drug. The mechanism of slow and controlled drug release from the core-shell structure has been explored. The fluorescence images support the higher cell-killing efficiency as opposed to a pure drug or a drug embedded in polyurethane. Cells seeded on 3D scaffolds have been developed by embedding a graft copolymer, and fluorescence imaging confirms the successful growth of cells within the scaffold, realizing the potential of the core-shell graft copolymer in the biomedical arena.

Efficacy of ShotBlocker device versus vapocoolant spray for spinal needle pain relief during spinal anaesthesia in elective caesarean section - A randomised controlled trial

Background and Aims

Apprehension of pain due to a spinal needle is often a cause of anxiety and refusal. ShotBlocker provides non-painful physical stimulation, inhibiting pain perception. The vapocoolant spray contains ethyl chloride vapours, rapidly raising the skin temperature and hampering the transmission of noxious stimuli. The present study compared the effectiveness of the ShotBlocker device and the vapocoolant spray in reducing spinal needle-associated pain in primigravida women undergoing elective lower-segment caesarean section (LSCS).

Methods

We enroled 144 primigravida women undergoing elective LSCS and were randomised to Group SB (the ShotBlocker device was firmly pressed over the skin, and the spinal needle was inserted through its slit), Group V (the vapocoolant spray was applied at the puncture site before spinal needle insertion), and Group C (received local infiltration before spinal anaesthesia (SA)). The groups were compared for needle-associated pain and patient satisfaction using a 10-point visual analogue scale (VAS) and a 3-point Likert scale.

Results

The mean (standard deviation) [95% confidence interval (CI)] VAS scores of Group SB 3.85 (0.74) [3.64, 4.07] and Group V 3.04 (0.74) [2.83, 3.26] were significantly lower than that of Group C 5.19 (0.92) [3.28, 3.62]). On the Likert scale, the maximum number of patients in the vapocoolant group (64.6%) responded satisfactorily, while in the control group, the majority (62.5%) of participants responded dissatisfied (P < 0.001).

Conclusion

Both the ShotBlocker and vapocoolant spray reduce needle puncture-associated pain before SA in primigravida patients undergoing elective LSCS. However, the vapocoolant spray is more beneficial in reducing spinal needle-associated pain than the ShotBlocker device.

Comparison of Magnesium Pre-treatment With Two Different Doses of Rocuronium in Rapid Sequence Intubation: A Randomized Controlled Trial

Introduction Magnesium is recognized for its ability to reduce the onset time of rocuronium while simultaneously extending its duration of action. This study aims to assess the efficacy of magnesium pre-treatment in decreasing the onset time with two different doses of rocuronium in patients undergoing rapid sequence intubation. Materials and methods This randomized prospective double-blind clinical study involved 50 patients classified as American Society Of Anesthesiologists (ASA) I/II, with no preoperative indications of difficult intubation, undergoing elective surgery under general anesthesia. The patients were divided into two groups: group A received 60 mg/kg of magnesium 15 minutes before intubation with 1.2 mg/kg of rocuronium, and group B received 60 mg/kg of magnesium before 0.6 mg/kg of rocuronium. Intubating conditions were assessed and graded at loss of last twitch after administration in both groups, considering ease of intubation, vocal cord position, and response to the insertion of the tracheal tube. Simultaneously, hemodynamic variations were recorded just before intubation, at one minute and five minutes post-intubation. Results Intubating conditions with 0.6 mg/kg of rocuronium were comparable or equally good compared to 1.2 mg/kg of rocuronium with magnesium pre-treatment. Conclusions Magnesium pre-treatment enhances the neuromuscular blocking effect of rocuronium, reducing its onset time without clinically significant prolongation of the duration of the block.

Post-spinal Anesthesia Low Back Pain in Obese Female Patients: Comparison of the Median Versus Paramedian Approach

BACKGROUND

A side effect of spinal anesthesia is post-dural puncture backache (PDPB), which is characterized by ongoing discomfort at the location of the spinal puncture without any radicular pain. This study aims to compare the incidence and severity of post-dural puncture back pain following spinal anesthesia by median versus paramedian technique in obese female patients.

METHODS

 A prospective randomized comparative study on 120 female patients, aged 20-50 years with a BMI of 30-40 kg/m2 and American Society of Anesthesiologists physical status II, scheduled for elective surgery under spinal anesthesia, was included in the study. Patients were randomly divided into two groups, with 60 patients in each group. Group P uses the paramedian approach for spinal anesthesia, and group M uses the midline approach for spinal anesthesia.

RESULTS

Low back pain incidence was lower in group P than in group M at seven days, but at one month and after, its incidence remained the same in both groups. No difference in the severity of pain was observed.

CONCLUSIONS

The occurrence of back pain in the first seven days of surgery was significantly more frequent with the median approach. The pain severity decreased as the time passed from day seven to three months of follow-up. There is no difference in the severity of pain with either approach at different intervals.

Evaluation of 10 current image reconstruction algorithms for linear array photoacoustic imaging

Various reconstruction algorithms have been implemented for linear array photoacoustic imaging systems with the goal of accurately reconstructing the strength absorbers within the tissue being imaged. Since the existing algorithms have been introduced by different research groups and the context of performance evaluation was not consistent, it is difficult to make a fair comparison between them. In this study, we systematically compared the performance of 10 published image reconstruction algorithms (DAS, UBP, pDAS, DMAS, MV, EIGMV, SLSC, GSC, TR, and FD) using in-vitro phantom data. Evaluations were conducted based on lateral resolution of the reconstructed images, computational time, target detectability, and noise sensitivity. We anticipate the outcome of this study will assist researchers in selecting appropriate algorithms for their linear array PA imaging applications.

A Surface Imprinted Polymer EIS Sensor for Detecting Alpha-Synuclein, a Parkinson's Disease Biomarker

Parkinson's Disease (PD) is a debilitating neurodegenerative disease, causing loss of motor function and, in some instances, cognitive decline and dementia in those affected. The quality of life can be improved, and disease progression delayed through early interventions. However, current methods of confirming a PD diagnosis are extremely invasive. This prevents their use as a screening tool for the early onset stages of PD. We propose a surface imprinted polymer (SIP) electroimpedance spectroscopy (EIS) biosensor for detecting α-Synuclein (αSyn) and its aggregates, a biomarker that appears in saliva and blood during the early stages of PD as the blood-brain barrier degrades. The surface imprinted polymer stamp is fabricated by low-temperature melt stamping polycaprolactone (PCL) on interdigitated EIS electrodes. The result is a low-cost, small-footprint biosensor that is highly suitable for non-invasive monitoring of the disease biomarker. The sensors were tested with αSyn dilutions in deionized water and in constant ionic concentration matrix solutions with decreasing concentrations of αSyn to remove the background effects of concentration. The device response confirmed the specificity of these devices to the target protein of monomeric αSyn. The sensor limit of detection was measured to be 5 pg/L, and its linear detection range was 5 pg/L-5 µg/L. This covers the physiological range of αSyn in saliva and makes this a highly promising method of quantifying αSyn monomers for PD patients in the future. The SIP surface was regenerated, and the sensor was reused to demonstrate its capability for repeat sensing as a potential continuous monitoring tool for the disease biomarker.

MCC950 reduces autophagy and improves cognitive function by inhibiting NLRP3-dependent neuroinflammation in a rat model of Alzheimer's disease

Alzheimer's disease (AD) is the seventh most common cause of mortality and one of the major causes of disability and vulnerability in the elderly. AD is characterized by gradual cognitive deterioration, the buildup of misfolded amyloid beta (Aβ) peptide, and the generation of neurofibrillary tangles. Despite enormous scientific progress, there is no effective cure for AD. Thus, exploring new treatment options to stop AD or at least slow down its progress is important. In this study, we investigated the potential therapeutic effects of MCC950 on NLRP3-mediated inflammasome-driven inflammation and autophagy in AD. Rats treated with streptozotocin (STZ) exhibited simultaneous activation of the NLRP3 inflammasome and autophagy, as confirmed by Western blot, immunofluorescence, and co-immunoprecipitation analyses. MCC950, a specific NLRP3 inhibitor, was intraperitoneally administered (50 mg/kg body weight) to rats with AD-like symptoms induced by intracerebroventricular STZ injections (3 mg/kg body weight). MCC950 effectively suppressed STZ-induced cognitive impairment and anxiety by inhibiting NLRP3-dependent neuroinflammation. Moreover, our findings indicate that MCC950 exerts neuroprotective effects by attenuating autophagy in neuronal cells. The inhibiting effects of MCC950 on inflammasome activation and autophagy were reproduced in vitro, provding further mechansistic insights into MCC950 therapeutic action. Our findings suggest that MCC950 impedes the progression of AD and may also improve cognitive function through the mitigation of autophagy and NLRP3 inflammasome inhibition.

Bone Fracture-healing Properties and UPLC-MS Analysis of an Enriched Flavonoid Fraction from Oxystelma esculentum

Oxystelma esculentum has been used as a folk medicine to treat jaundice, throat infections, and skin problems. In the current study, the bone fracture-healing properties of a flavonoid-enriched fraction (Oxy50-60F) of O. esculentum were investigated in Swiss mice using a drill-hole injury model. Oxy50-60F (1 mg/kg/day, 5 mg/kg/day, and 10 mg/kg/day) was administered orally (from the next day) after a 0.6 mm drill-hole injury in mice femur mid-diaphysis for 7 days and 14 days. Parathyroid hormone (40 µg/kg; 5 times/week) was given subcutaneously as the positive control. Confocal imaging for bone regeneration, micro-architecture of femur bones, ex vivo mineralization, hematoxyline and eosin staining, measurement of reactive oxygen species, and gene expression of osteogenic and anti-inflammatory genes were studied. Quercetin, kaempferol, and isorhamnetin glycosides were identified in the active fraction using mass spectrometry techniques. Our results confirm that Oxy50-60F treatment promotes fracture healing and callus formation at drill-hole sites and stimulates osteogenic and anti-inflammatory genes. Oxy50-60F administration to fractured mice exhibited significantly better micro-CT parameters in a dose-dependent manner and promoted nodule mineralization at days 7 and 14 post-injury. Oxy50-60F also prevents ROS generation by increasing expression of the SOD2 enzyme. Overall, this study reveals that Oxy50-60F has bone regeneration potential in a cortical bone defect model, which supports its use in delayed-union and non-union fracture cases.

A blinded study using laser induced endogenous fluorescence spectroscopy to differentiate ex vivo spine tumor, healthy muscle, and healthy bone

Ten patients undergoing surgical resection for spinal tumors were selected. Samples of tumor, muscle, and bone were resected, de-identified by the treating surgeon, and then scanned with the TumorID technology ex vivo. This study investigates whether TumorID technology is able to differentiate three different human clinical fresh tissue specimens: spine tumor, normal muscle, and normal bone. The TumorID technology utilizes a 405 nm excitation laser to target endogenous fluorophores, thereby allowing for the detection of tissue based on emission spectra. Metabolic profiles of tumor and healthy tissue vary, namely NADH (bound and free emission peak, respectively: 487 nm, 501 nm) and FAD (emission peak: 544) are endogenous fluorophores with distinct concentrations in tumor and healthy tissue. Emission spectra analyzed consisted of 74 scans of spine tumor, 150 scans of healthy normal bone, and 111 scans of healthy normal muscle. An excitation wavelength of 405 nm was used to obtain emission spectra from tissue as previously described. Emission spectra consisted of approximately 1400 wavelength intensity pairs between 450 and 750 nm. Kruskal-Wallis tests were conducted comparing AUC distributions for each treatment group, α = 0.05. Spectral signatures varied amongst the three different tissue types. All pairwise comparisons among tissues for Free NADH were statistically significant (Tumor vs. Muscle: p = 0.0006, Tumor vs. Bone: p < 0.0001, Bone vs. Muscle: p = 0.0357). The overall comparison of tissues for FAD (506.5-581.5 nm) was also statistically significant (p < 0.0001), with two pairwise comparisons being statistically significant (Tumor vs. Muscle: p < 0.0001, Tumor vs. Bone: p = 0.0045, Bone vs. Muscle: p = 0.249). These statistically significant differences were maintained when stratifying tumor into metastatic carcinoma (N = 57) and meningioma (N = 17). TumorID differentiates tumor tissue from normal bone and normal muscle providing further clinical evidence of its efficacy as a tissue identification tool. Future studies should evaluate TumorID's ability to serve as an adjunctive tool for intraoperative assessment of surgical margins and surgical decision-making.

Association of age and sex at onset with Glenohumeral Osteoarthritis: A systematic review and meta-analysis

OBJECTIVE

The aim of the present systematic review is to synthesize existing evidence (qualitative and quantitative) regarding age- and sex-specific differences with glenohumeral osteoarthritis (GH OA).

DESIGN

The electronic databases PubMed, Medline and Web of Science were searched up to March 15, 2023. Articles reporting on the association of risk factors (age and sex) with GH OA were considered. We used Newcastle-Ottawa scale to assess study quality. Meta-analysis was conducted to quantitatively summarize the association of age and sex with GH OA.

RESULTS

A total of 24 articles were retrieved for full-text review. Out of twenty-four articles, 8 articles reporting age-specific and 5 articles reporting sex-specific associations with GH OA were included. The odds ratio (OR) for the age [OR-3.18; 95% confidence interval (CI)-1.10-15.92] and female sex [OR-1.78; 95%CI-0.95-3.42] were increased and observed statistically significant.

CONCLUSIONS

The present systematic review and meta-analysis suggests the role of increasing age as one of the significant contributors to GH OA. However, association of female sex with GH OA is least convincing. Future studies are required to understand the molecular mechanisms behind the contributory role of increasing age and female sex in the establishment of GH OA.

Comparative Evaluation of Shear Bond Strength of Resin-modified Glass Ionomer Cement with ProRoot MTA and MTA Angelus

AIM

The aim of the present study was to evaluate the shear bond strength of resin-modified glass ionomer cement with two different types of mineral trioxide aggregate at different time intervals.

MATERIALS AND METHODS

A total of 80 cylindrical blocks were prepared using a self-cure acrylic resin with a central cavity of 4 mm internal diameter and 2 mm height. The prepared samples were randomly divided into two groups (n = 40 each) according to the type of MTA cements used (ProRoot MTA and MTA Angelus). Two groups were further sub-divided into four sub-groups of 10 samples each according to the different time intervals. ProRoot MTA and MTA Angelus were placed in the prepared cavity and a wet cotton pellet was placed over the filled cavity. A hollow plastic tube was placed over the MTA surface and resin-modified glass ionomer cement (RMGIC) was placed into the hollow plastic tube and light-cured (Spectrum 800, Dentsply Caulk Milford, DE, USA) according to the time intervals decided. After light curing the plastic tubes were removed carefully and the specimens were stored at 37°C and 100% humidity for 24 hours to encourage setting of MTA. The specimens were mounted in a universal testing machine (ADMET) and a crosshead speed of 0.5 mm/min was applied to each specimen by using a knife-edge blade until the bond between the MTA and RMGIC failed. The data were statistically analyzed using ANOVA, post hoc Tukey's t-test and Fisher's t-test and p-value ≤ 0.5 was considered significant.

RESULTS

For both ProRoot MTA and MTA Angelus there was no statistically significant difference between 45 minutes and 24 hours (p-value ≥ 0.8). For ProRoot MTA, shear bond strength value at 10 minutes were significantly lower than 45 minutes and 24 hours group. However, for MTA Angelus, shear bond strength value at 10 minute was not significantly different from 45 minutes group (p-value ≥ 0.3). For both ProRoot MTA and MTA Angelus shear bond strength value at 0 minute were the least and were significantly lower than 10 minutes, 45 minutes, and 24 hours, respectively (p-value ≥ 0.000).

CONCLUSION

Resin-modified glass ionomer cement can be layered over MTA Angelus after it is allowed to set for 10 minutes. However, ProRoot MTA should be allowed to set for at least 45 minutes before the placement of RMGIC to achieve better shear bond strength.

CLINICAL SIGNIFICANCE

Due to the variety of types of mineral trioxide aggregate cements available in dentistry, it is justifiable to emphasize on different time intervals as it may affect the shear bond strength of restorative cements. Such information is pivotal for the clinicians while using mineral aggregate-based cements that receive forces from the condensation of restorative materials or occlusion, as the compressive strength may be affected due to different time intervals. How to cite this article: Tyagi N, Chaman C, Anand S, et al. Comparative Evaluation of Shear Bond Strength of Resin-modified Glass Ionomer Cement with ProRoot MTA and MTA Angelus. J Contemp Dent Pract 2024;25(1):35-40.

Poly(N-acryloylglycine-acrylamide) Hydrogel Mimics the Cellular Microenvironment and Promotes Neurite Growth with Protection from Oxidative Stress

In this work, the glycine-based acryloyl monomer is polymerized to obtain a neurogenic polymeric hydrogel for regenerative applications. The synthesized poly(N-acryloylglycine-acrylamide) [poly(NAG-b-A)] nanohydrogel exhibits high swelling (∼1500%) and is mechanically very stable, biocompatible, and proliferative in nature. The poly(NAG-b-A) nanohydrogel provides a stable 3D extracellular mimetic environment and promotes healthy neurite growth for primary cortical neurons by facilitating cellular adhesion, proliferation, actin filament stabilization, and neuronal differentiation. Furthermore, the protective role of the poly(NAG-b-A) hydrogel for the neurons in oxidative stress conditions is revealed and it is found that it is a clinically relevant material for neuronal regenerative applications, such as for promoting nerve regeneration via GSK3β inhibition. This hydrogel additionally plays an important role in modulating the biological microenvironment, either as an agonist and antagonist or as an antioxidant. Furthermore, it favors the physiological responses and eases the neurite growth efficiency. Additionally, we found out that the conversion of glycine-based acryloyl monomers into their corresponding polymer modulates the mechanical performance, mimics the cellular microenvironment, and accelerates the self-healing capability due to the responsive behavior towards reactive oxygen species (ROS). Thus, the p(NAG-b-A) hydrogel could be a potential candidate to induce neuronal regeneration since it provides a physical cue and significantly boosts neurite outgrowth and also maintains the microtubule integrity in neuronal cells.

Comparison of clinical performance of Baska mask and Ambu AuraGain in patients undergoing surgery: A single-blinded, randomised comparative trial

Background and Aims

The Baska mask (BM) and the Ambu AuraGain (AAG) have shown promising results in recent trials but have not been compared. Therefore, we aimed to compare the clinical performance of the BM and the AAG for airway management of adult patients.

Methods

In this randomised comparative study, patients aged 18-60 years and with an expected surgical duration of less than 2 h were enroled. Patients were randomly allocated to AAG (Group A, n = 37) and BM (Group B, n = 37) for airway management. After induction of anaesthesia, an allocated supraglottic airway device (SAD) was inserted. Oropharyngeal leak pressure (OLP), time taken to insert SAD, number of insertion attempts, leak fraction (LF), first-attempt success rate, overall success rate, ease of insertion, fiberoptic view of the glottis, and complications were compared. The data were analysed using Student's t-test, Mann-Whitney U test, and Fisher's exact tests.

Results

Baseline and demographic characteristics were comparable. OLP (31.32 ± 2.59 versus 27.54 ± 1.32 cmH2O) was higher (P < 0.001), and LF (6.19% ± 1.20% versus 7.24% ± 1.72%) was lower (P = 0.003) in the BM group. First-attempt and overall success rate, time taken to insert, number of insertion attempts, ease of insertion, and fibreoptic view of glottis through the SADs were statistically similar between groups. However, the incidence of sore throat (P = 0.007) and cough (P = 0.028) was higher with AAG.

Conclusion

Clinical performance of BM was better than AAG as the former had higher OLP, lower LF and complications.

Clinical and Radiographic Evaluation of Various Herbal Products Used with Zinc Oxide as an Obturating Material in Primary Teeth: An In Vivo Study

AIM

To compare the clinical and radiographically mixture of zinc oxide with Aloe vera, Curcumin and neem as an obturating material for pulpectomy.

MATERIALS AND METHODS

The study comprised of age group 4-8 years children requiring endodontic treatment for at least a single primary molar tooth. Sixty primary molar teeth from 43 children were divided equally and randomly into four study groups. The materials used for obturation were zinc oxide powder (ZnO) and Eugenol (ZOE) (group I), ZnO and Aloe vera Gel (group II), ZnO and Curcumin Powder (group III), ZnO and neem extract (group IV). They were evaluated clinically and radiographically at immediate postoperative and then at 1-, 3-, 6-, and 9-month intervals.

RESULTS

At the end of 9 months, the Chi-square test revealed 100% success rate for recovery of pain in group I and III, 66.66% in group II and 93.3% in group IV. The success rates for absence of abscess and for periradicular radiolucency in group I, III, and group IV were 100% and 66.6% for group II. The success rate for periapical radiolucency in group I and group III was 100%, in group II 66.6% and in group IV 93.35%. The success rate for all the groups shows 100% success in terms of pathological root resorption.

CONCLUSION

Zinc oxide eugenol has proven to be the best obturating material. ZnO with Aloe vera showed a success rate which is significantly lower than the other medicaments. ZnO with Curcumin and ZnO with neem had shown promising clinical and radiographical results.

CLINICAL SIGNIFICANCE

ZnO with Curcumin and ZnO with neem can be used as a root canal filling material in primary teeth with further follow-up studies.

Effect of Carbohydrate Loading in Diabetic Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Controlled Trial

INTRODUCTION

Investigations of preoperative oral carbohydrate (CHO) loading have primarily examined benefits among patients without diabetes. Preoperative CHO-rich beverages in general populations have resulted in reductions in insulin resistance after surgery, protein loss, metabolic derangements, and immune dysfunction. The aim of this study was to assess the effect of CHO loading in diabetic patients undergoing laparoscopic cholecystectomy.

METHODS

Diabetic patients controlled on oral hypoglycemic agent were randomly divided into two groups: (1) Group T - this group will be given 50 g of maltodextrin before two hours of surgery; (2) Group C - this group will be kept nil per oral as per standard protocol. Blood sugar, serum insulin, serum cortisol, and insulin requirement were compared in both groups.

RESULTS

Blood sugar levels of Group C were found to be significantly higher than that of Group T at six hours and 24 hours. In Group T, a rise in baseline serum insulin (8.94 ± 3.43 mIU/l) was observed at 24 hours (13.23 ± 5.71 mIU/l). A change of 4.29 ± 3.00 mIU/l in serum insulin level was observed. The change in baseline serum insulin levels was 47.99%. In Group C too, a rise in baseline serum insulin (6.27 ± 1.74 mIU/l) was observed at 24 hours (18.00 ± 5.34 mIU/l). A change of 11.73 ± 4.97 mIU/l in serum insulin level was observed. The change in baseline HOMA-IR (homeostatic model assessment for insulin resistance) levels in Group T was 53.66%. A rise (4.39 ± 1.63) in baseline HOMA-IR of Group C (1.65 ± 0.45) was observed at 24 hours (6.04 ± 1.76). The change in baseline HOMA-IR levels in Group C was 266.06%.

CONCLUSIONS

CHO loading is observed to be beneficial in diabetic patients undergoing laparoscopic cholecystectomy. No adverse effects or an increased risk of aspiration were observed in the intervention group during the study period.

Non-invasive Monitoring of α-Synuclein in Saliva for Parkinson's Disease Using Organic Electrolyte-Gated FET Aptasensor

Parkinson's disease (PD) currently affects more than 1 million people in the US alone, with nearly 8.5 million suffering from the disease worldwide, as per the World Health Organization. However, there remains no fast, pain-free, and effective method of screening for the disease in the ageing population, which also happens to be the most susceptible to this neurodegenerative disease. αSynuclein (αSyn) is a promising PD biomarker, demonstrating clear delineations between levels of the αSyn monomer and the extent of αSyn aggregation in the saliva of PD patients and healthy controls. In this work, we have demonstrated a laboratory prototype of a soft fluidics integrated organic electrolyte-gated field-effect transistor (OEGFET) aptasensor platform capable of quantifying levels of αSyn aggregation in saliva. The aptasensor relies on a recently reported synthetic aptamer which selectively binds to αSyn monomer as the bio-recognition molecule within the integrated fluidic channel of the biosensor. The produced saliva sensor is label-free, fast, and reusable, demonstrating good selectivity only to the target molecule in its monomer form. The novelty of these devices is the fully isolated organic semiconductor, which extends the shelf life, and the novel fully integrated soft microfluidic channels, which simplify saliva loading and testing. The OEGFET aptasensor has a limit of detection of 10 fg/L for the αSyn monomer in spiked saliva supernatant solutions, with a linear range of 100 fg/L to 10 μg/L. The linear range covers the physiological range of the αSyn monomer in the saliva of PD patients. Our biosensors demonstrate a desirably low limit of detection, an extended linear range, and fully integrated microchannels for saliva sample handling, making them a promising platform for non-invasive point-of-care testing of PD.

Boys' perspectives on girls' marriage and school dropout: a qualitative study revisiting a structural intervention in Southern India

Girls' education has for many decades been central to the global development agenda, due to its positive impact on girls' health and wellbeing. In this paper, the authors revisit boys' attitudes, behaviours and norms related to girls' education, following the Samata intervention to prevent girls' school dropouts in Northern-Karnataka, South India. Data were collected from 20 boys in intervention villages before and after the intervention, and analysis was undertaken using a thematic-framework approach. Findings suggest that while boys did hold some attitudes and beliefs that supported girls' education and delayed-marriage, these remained within the framework of gender-inequitable norms concerning girls' marriageability, respectability/family-honour. Participants criticised peers who sought to jeopardise girls' respectability by teasing and community gossip about girls-boys' communication in public. Boys who rejected prevailing norms of masculinity were subjected to gossip, ridicule and violence by the community. Boys' attitudes and beliefs supported girls' education but were conditional on the maintenance of gendered hierarchies at household and interpersonal levels. Social norms concerning girls' honour, respectability and the role of boys as protectors/aggressors appeared to influence boys' response to girls' school dropouts. Future interventions aiming to address girls' education and marriage must invest time and resources to ensure that intervention components targeting boys are relevant, appropriate and effective.

A life cycle assessment of coal-fired thermal power plants with post-combustion control techniques: an India scenario

In recent years, there has been a focus on clean power generation, and it is critical to assess the environmental impact of novel technologies used in pollution control in power generation. The study uses life cycle assessment (LCA) to assess the environmental impacts of coal-fired thermal power plants with different emission control techniques in an Indian scenario. As there are no such studies available in the Indian context, this work might provide a holistic view of the impacts of energy generation. A supercritical coal-fired plant with a capacity of 660 MW is considered in this study. The system boundary included coal extraction, transportation, power plant operation, and transmission losses of electricity with a functional unit of 1 kWh. It was observed that there was an energy penalty due to the power consumed in emission control devices, but the maximum energy penalty was due to the power used in the carbon capture system. The LCA is done from "cradle to gate", with impact indicators at the mid-point evaluated using the RECIPE (H) 2016 LCIA method. LCA results showed that power plant operation is the most significant contributor to environmental impact. Initially, in cases 1 and 2, climate change (CC) potential was a major impact category, but CC potential was reduced with carbon capture and storage, 0.27 kg CO2 eq. in case 3 with ESP, FGD, SCR, and carbon capture and storage (CCS) and 0.263 kg CO2 eq. in case 4 with ESP and CCS. But there was a considerable increase in the majority of the impact categories in case 4. Freshwater consumption potential increased from 3.98 E-03 m3 in base case 1 to 4.98 E-03 m3 in case 3 due to the amount of water used in chemical production during CCS, as CC potential is a major concern in power generation, However, compared to case 1, the potential for climate change increased in case 2, whilst in case 4, the potential for climate change is lower but has resulted in an increase in the majority of impact categories. Case 3 shows an optimal approach to reducing CO2 emissions compared to other cases. The combination of ESP, FGD, SCR, and CCS is favourable for cleaner energy generation.

A Miniaturized System for Rapid, Isothermal Detection of SARS-CoV-2 in Human and Environmental Samples

We report a small-footprint cost-effective isothermal rapid DNA amplification system, with integrated microfluidics for automated sample analysis and detection of SARS-CoV-2 in human and environmental samples. Our system measures low-level fluorescent signals in real-time during amplification, while maintaining the desired assay temperature on a low power, portable system footprint. A unique soft microfluidic chip design was implemented to mitigate thermocapillary effects and facilitate optical alignment for automated image capture and signal analysis. The system-on-board prototype, coupled with the LAMP primers designed by BioCoS, was sensitive enough to detect large variations in viral loads of SARS-CoV-2 corresponding to a threshold cycle range of 16 to 39. Furthermore, tested samples consisted of a broad range of viral strains and lineages identified in Canada during 2021-2022. Clinical specimens were collected and tested at the Kingston Health Science Centre using a clinically validated PCR assay, and variants were determined using whole genome sequencing.

Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial

Background

Preoperative anxiety plays a critical role in post-operative pain response and other outcomes. Melatonin is a naturally secreted hormone which has anxiolytic, sedative, and analgesic properties. Pregabalin, analogue of gabapentin which has property of anxiolytic and analgesic effects.

Materials and Methods

Total 96 patients undergoing total hip arthroplasty, divided into 3 groups of 32 each and were given placebo (group I), melatonin 6 mg (group II), and pregabalin 150 mg (group III). Anxiety level, postoperative pain score, sedation level and duration as well as characteristics of spinal anaesthesia were assessed with other vital parameters.

Results

Group I showed an increment in the anxiety score from baseline whereas in group II and group III, there was a decline in pre-operative anxiety score from baseline at all the periods of observation and more significantly in group III. Visual analogue scale (VAS) score and total dose of rescue analgesia were highest in group I, but group II and group III were comparable to each other. However, the durations of spinal anaesthesia and motor blockade showed a statistically significant difference with maximum duration in group III followed by II and then I. The level of sedation among the three groups were comparable at all the periods of observation.

Conclusions

Pregabalin was found better for perioperative anxiolysis, post-operative analgesia and for prolongation of duration of spinal anaesthesia when compared to melatonin.

Neuropsychiatric Outcomes in Intensive Care Unit Survivors

BACKGROUND

Over the last two decades, there has been phenomenal advancement in critical care medicine and patient management. Many patients recover from life-threatening illnesses that they might not have survived a decade ago. Despite a decrease in mortality, these survivors endure long-lasting sequelae like physical, mental, and emotional symptoms.

METHODS

Patients after intensive care unit (ICU) discharge were assessed in a follow-up outpatient department (OPD) clinic for anxiety, stress, and depression. Patients were asked to fill out the questionnaires Depression, Anxiety and Stress Scale-21 (DASS-21) and Short Form-36 (SF-36) for assessment of health-related quality of life (HRQOL) at 4th, 6th, and 8th months after discharge. ICU data were recorded, including patients' demographics, severity of illness and length of stay, and duration of mechanical ventilation. Patients who failed to follow-up in OPD on designated dates were assessed telephonically.

RESULTS

Depression showed a positive, strong, and moderate correlation between length of stay and mechanical ventilation duration. A positive correlation was found between stress and length of stay and duration of mechanical ventilation. A positive strong correlation was found between anxiety and length of ICU stay, and a moderate positive correlation was found between anxiety and duration of mechanical ventilation. A weak correlation was found between age and neuropsychiatric outcomes.

CONCLUSION

The severity of depression, anxiety, and stress was significantly higher at four months compared to six months. Severity decreased with time. Prolonged ICU stay increased levels of anxiety, depression, and stress. HRQOL improved from four to six months.

NLRP3 Inflammasome-Targeting Nanomicelles for Preventing Ischemia-Reperfusion-Induced Inflammatory Injury

Ischemia-reperfusion (I/R) injury is a disease process that affects several vital organs. There is widespread agreement that the NLRP3 inflammasome pathway plays a crucial role in the development of I/R injury. We have developed transferrin-conjugated, pH-responsive nanomicelles for the entrapment of MCC950 drug. These nanomicelles specifically bind to the transferrin receptor 1 (TFR1) expressed on the cells of the blood-brain barrier (BBB) and thus help the cargo to cross the BBB. Furthermore, the therapeutic potential of nanomicelles was assessed using in vitro, in ovo, and in vivo models of I/R injury. Nanomicelles were injected into the common carotid artery (CCA) of a middle cerebral artery occlusion (MCAO) rat model to achieve maximum accretion of nanomicelles into the brain as blood flows toward the brain in the CCA. The current study reveals that the treatment with nanomicelles significantly alleviates the levels of NLRP3 inflammasome biomarkers which were found to be increased in oxygen-glucose deprivation (OGD)-treated SH-SY5Y cells, the I/R-damaged right vitelline artery (RVA) of chick embryos, and the MCAO rat model. The supplementation with nanomicelles significantly enhanced the overall survival of MCAO rats. Overall, nanomicelles exerted therapeutic effects against I/R injury, which might be due to the suppression of the activation of the NLRP3 inflammasome.

A Randomized Comparison of Intravenous Versus Nebulized Routes for Administering Dexmedetomidine and Ketamine Combination to Facilitate Awake Fibreoptic Intubation

Introduction Awake fibreoptic intubation is a technique used to secure the airway of patients who are having predicted difficult intubation. We compared two routes, intravenous and nebulized, for administering a combination of ketamine and dexmedetomidine to patients requiring sedation for fibreoptic intubation. Methods and materials After approval of the institutional ethics committee, 64 patients between 18 and 60 years belonging to the American Society of Anesthesiologists physical status I or II and having predicted difficult airway were randomized to receive study medications through either intravenous (group I, n = 32) or nebulized (group N, n = 32) routes. Group I patients were given a combination of ketamine and dexmedetomidine through intravenous route. Group N patients were nebulized with a combination of ketamine and dexmedetomidine. The time required for awake fiberoptic intubation was the primary outcome variable. In addition, sedation score, cough severity, patient tolerance, intubating condition, hemodynamic changes, recall of events and discomfort during intubation, and any adverse events in the perioperative period were also compared. Results Compared to group N, the time needed to intubate the patients was significantly less in group I (75.69 ± 10.83 versus 49.19 ± 3.60 seconds, p < 0.001). Observer assessment sedation/alertness score (p < 0.001), cough severity (p < 0.001), patient tolerance (p < 0.001), and intubating condition (p = 0.001) were statistically significant, all conditions being better in group I. Patient discomfort and recall of the procedure were statistically similar between the groups. Conclusions The efficacy of a combination of dexmedetomidine and ketamine through the intravenous route is better than the nebulized route for patients undergoing awake fibreoptic intubation.

Adolescent Girls and Their Family Members' Attitudes Around Gendered Power Inequity and Associations with Future Aspirations in Karnataka, India

Intergenerational differences in inequitable gender attitudes may influence developmental outcomes, including education. In rural Karnataka, India, we examined the extent of intergenerational (adolescent girls [AGs] vs. older generation family members) dis/agreement to attitudes around gendered power inequities, including gender roles and violence against women (VAW). Unadjusted and adjusted logistic regression examined associations between intergenerational dis/agreement to attitude statements and AGs' future educational and career aspirations. Of 2,457 AGs, 90.9% had a matched family member (55% mothers). While traditional gender roles were promoted intergenerationally, more AGs supported VAW than family members. In adjusted models, discordant promotion of traditional gender roles and concordant disapproval of VAW were associated with greater aspirations. Results highlight the need for family-level programming promoting positive modeling of gender-equitable attitudes.

Brain-Mimicking Phantom for Photoablation and Visualization

While the use of tissue-mimicking (TM) phantoms has been ubiquitous in surgical robotics, the translation of technology from laboratory experiments to equivalent intraoperative tissue conditions has been a challenge. The increasing use of lasers for surgical tumor resection has introduced the need to develop a modular, low-cost, functionally relevant TM phantom to model the complex laser-tissue interaction. In this paper, a TM phantom with mechanically and thermally similar properties as human brain tissue suited for photoablation studies and subsequent visualization is developed. The proposed study demonstrates the tuned phantom response to laser ablation for fixed laser power, time, and angle. Additionally, the ablated crater profile is visualized using optical coherence tomography (OCT), enabling high-resolution surface profile generation.

High-Flow Nasal Cannula as an Alternate Weaning Strategy: A Randomized Controlled Trial

Background Extubation failure is associated with increased morbidity and poor outcomes. This study aimed to ascertain the effectiveness of a high-flow nasal cannula (HFNC) as a weaning method compared to conventional weaning. Methodology A total of 60 mechanically ventilated patients, aged 18-65 years, who were ventilated for 48 hours and whose underlying pathology had either resolved or was improving, were enrolled in this study. They were randomized in a 1:1 ratio to participate in the HFNC weaning method or receive conventional weaning. Patients in Group A were extubated and oxygen was provided via HFNC. Group B patients were given a spontaneous breathing trial (SBT) per the standard protocol and extubated after a successful SBT. Results Weaning failure was found in five patients and was higher in the conventional group (three patients in the conventional group and two patients in the HFNC group). The duration of stay of patients in intensive care units was significantly higher in the conventional group than in the HFNC group. Conclusions HFNC is a better alternative to conventional weaning through SBT.

MCC950 Regulates Stem Cells Destiny Through Modulating SIRT3-NLRP3 Inflammasome Dynamics During Oxygen Glucose Deprivation

Ischemic stroke is the major cause of death and morbidity worldwide. Stem cell treatment is at the forefront of ischemic therapeutic interventions. However, the fate of these cells following transplantation is mostly unknown. The current study examines the influence of oxidative and inflammatory pathological events associated with experimental ischemic stroke (oxygen glucose deprivation (OGD)) on the stem cell population (human Dental Pulp Stem Cells, and human Mesenchymal Stem Cells) through the involvement of the NLRP3 inflammasome. We explored the destiny of the above-mentioned stem cells in the stressed micro (-environment) and the ability of MCC950 to reverse the magnitudes. An enhanced expression of NLRP3, ASC, cleaved caspase1, active IL-1β and active IL-18 in OGD-treated DPSC and MSC was observed. The MCC950 significantly reduced NLRP3 inflammasome activation in the aforementioned cells. Further, in OGD groups, oxidative stress markers were shown to be alleviated in the stem cells under stress, which was effectively relieved by MCC950 supplementation. Interestingly, whereas OGD increased NLRP3 expression, it decreased SIRT3 levels, implying that these two processes are intertwined. In brief, we discovered that MCC950 inhibits NLRP3-mediated inflammation by inhibiting the NLRP3 inflammasome and increasing SIRT3. To conclude, according to our findings, inhibiting NLRP3 activation while enhancing SIRT3 levels with MCC950 reduces oxidative and inflammatory stress in stem cells under OGD-induced stress. These findings shed light on the causes of hDPSC and hMSC demise following transplantation and point to strategies to lessen therapeutic cell loss under ischemic-reperfusion stress.

Understanding the rise in traditional contraceptive methods use in Uttar Pradesh, India

BACKGROUND

The sustainable development goals (SDG) aim at satisfying three-fourths of family planning needs through modern contraceptive methods by 2030. However, the traditional methods (TM) of family planning use are on the rise, along with modern contraception in Uttar Pradesh (UP), the most populous Indian state. This study attempts to explore the dynamics of rising TM use in the state.

METHODS

We used a state representative cross-sectional survey conducted among 12,200 Currently Married Women (CMW) aged 15-49 years during December 2020-February 2021 in UP. Using a multistage sampling technique, 508 primary sampling units (PSU) were selected. These PSU were ASHA areas in rural settings and Census Enumeration Blocks in urban settings. About 27 households from each PSU were randomly selected. All the eligible women within the selected households were interviewed. The survey also included the nearest public health facilities to understand the availability of family planning methods. Univariate and bivariate analyses were conducted. Appropriate sampling weights were applied.

RESULTS

Overall, 33.9% of CMW were using any modern methods and 23.7% any TM (Rhythm and withdrawal) at the time of survey. The results show that while the modern method use has increased by 2.2 percentage points, the TM use increased by 9.9 percentage points compared to NFHS-4 (2015-16). The use of TM was almost same across women of different socio-demographic characteristics. Of 2921 current TM users, 80.7% started with TM and 78.3% expressed to continue with the same in future. No side effects (56.9%), easy to use (41.7%) and no cost incurred (38.0%) were the main reasons for the continuation of TM. TM use increased despite a significant increase (66.1 to 81.3%) in the availability of modern reversible methods and consistent availability of limiting methods (84.0%) in the nearest public health facilities.

CONCLUSION

Initial contraceptive method was found to have significant implications for current contraceptive method choice and future preferences. Program should reach young and zero-parity women with modern method choices by leveraging front-line workers in rural UP. Community and facility platforms can also be engaged in providing modern method choices to women of other parities to increase modern contraceptive use further to achieve the SDG goals.

Chebulinic acid alleviates LPS-induced inflammatory bone loss by targeting the crosstalk between reactive oxygen species/NFκB signaling in osteoblast cells

Chebulinic acid (CA), a plant ellagitannin derived from Triphala, is reported to exhibit both anti-inflammatory & anti-oxidant activity apart from anti-tumour property. However, its role in inflammatory bone loss conditions was unexplored. We hypothesized that CA may prevent the bone loss under inflammatory conditions induced by lipopolysaccharide (LPS) in 10-week-old male C57BL/6J mice. Micro-CT analysis and histomorphometric evaluations were carried out where it was found that CA significantly improved the bone micro-architectures by enhancing trabecular connectivity and strength of the bone. CA also increased the bone regeneration as examined by calcein labelling and ex-vivo mineralisation along with maintaining the bone serum markers. Further, CA ameliorated the reduction in osteoblast cell differentiation, proliferation and viability after LPS stimulation. DCFDA and Mitosox staining revealed that CA presented remarkable protective effects against LPS treatment by attenuating oxidative stress, both at cellular & mitochondrial levels. In addition, CA significantly decreased the production of pro-inflammatory cytokines, and down-regulated the phosphorylation of NFκB and IκBα, indicating that CA could attenuate the inflammatory impairment to primary osteoblast cells by suppressing the NFkB signalling pathway. Taken together, the protective role of CA against LPS-induced bone loss & inhibitory effect on total ROS levels hold promise as a potential novel therapeutic strategy for the inflammatory diseases in bones.

Differential Pharmacokinetic Interplay of Atorvastatin on Lacosamide and Levetiracetam on Experimental Convulsions in Mice

BACKGROUND

The beneficial effects of statins, other than their hypocholesterolemia role, have been well documented, however, their use as an adjuvant drug with other antiseizure drugs, in the treatment of epilepsy is poorly understood.

OBJECTIVE

This study aimed to investigate the symbiotic effect of ATOR along with either lacosamide (LACO) or levetiracetam (LEVE) on experimentally induced epilepsy (Maximal electro-shock-MES or pentylenetetrazol- PTZ) in mice models.

METHODS

Conventional elevated-maze (EPM) and rotarod methods were performed to observe the behavioral effects.

RESULTS

In both the animal models, we found that co-administration of ATOR along with LACO showed a significant reduction in hind-limb extension (HLE) and clonic convulsion (CC) responses, respectively, but not in the ATOR+LEVE treated group. Intriguingly, comparable Straub tail response and myoclonic convulsion as the diazepam (DIA) group were observed only in the ATOR+LACO treated group. Moreover, a significant muscle-grip strength was observed in both groups. Also, pharmacokinetic analysis has indicated that the mean plasma concentration of ATOR peaked at 2nd hr in the presence of LACO but marginally peaked in the presence of LEVE. An Insilico study has revealed that ATOR has a higher binding affinity toward neuronal sodium channels.

CONCLUSION

This study has demonstrated that the plasma concentration of ATOR was potentiated in the presence of LACO, but not in the presence of LEVE and it has provided significant protection against both the electro and chemo-convulsive models in mice. This could be due to the symbiotic pharmacokinetic interplay of ATOR with LACO, and possibly, this interplay may interfere with sodium channel conductance.

Ultrasound-Guided Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Laparoscopic Inguinal Hernia Repair and Appendicectomy Using Ropivacaine With Dexmedetomidine

Background The present study aims to investigate the efficacy of ultrasound-guided quadratus lumborum (QL) block versus transversus abdominis plane (TAP) block for laparoscopic inguinal hernia repair and appendicectomy using ropivacaine with dexmedetomidine for quality and duration of postoperative analgesia. Settings and design This was a prospective, randomized, single-blind study conducted for one year (September 2020-August 2021) in the Department of Anesthesiology and Critical Care, King George's Medical University, Lucknow, after obtaining ethical clearance from the institutional ethics committee. Methods A total of 64 patients of American Society of Anesthesiologists (ASA) grades I-II and ages between 20 and 50 years undergoing laparoscopic inguinal hernia repair and appendicectomy were randomly allocated into two groups of 32 each; group A received ultrasonography (USG)-guided quadratus lumborum block using 0.5% ropivacaine 20 ml with dexmedetomidine 0.5 mcg/kg of body weight, and group B was given USG-guided transversus abdominis plane block using 0.5% ropivacaine 20 ml with dexmedetomidine 0.5 mcg/kg of body weight after the induction of general anesthesia and before surgical incision. Data were analyzed using Student's t-test, Mann-Whitney U test, and chi-square test as applicable. Results The duration of analgesia was statistically higher (P<0.001) in group A (21.00±3.73 hours) as compared to group B (14.44±2.99 hours). Group A had significantly less analgesic (P<0.001) at 12, 18, and 24 hours postoperatively. The visual analog scale (VAS) was significantly decreased in group A at rest and movement. The range of percentage changes in heart rate (HR) was significantly higher in group B as compared to group A at 12, 18, and 24 hours (group A: 7.23%-14.70%; group B: 6.41%-28.01%). The mean blood pressure (MBP) was significantly increased in group B at 12, 18, and 24 hours as compared to group A. The range of changes in baseline MBP in group A was less than in group B (group A: 0.73%-8.34%; group B: 0.73%-18.20%). Conclusion Quadratus lumborum block is effective and better than transversus abdominis plane block for providing postoperative analgesia during laparoscopic inguinal hernia repair and appendicectomy.

Nanoparticle-Mediated PRDX2 Inhibition for Specific Targeting of CHK2-Null Colorectal Cancer

Synthetic lethality is a pragmatic targeted cancer therapy approach in which cancer cells harboring genetic alterations are exploited for the specific killing of cancer cells. Earlier, we have established a synthetic lethal (SL) interaction between two genes that are CHK2 and PRDX2 in colorectal cancer (CRC) cells. The SL interaction between CHK2 and PRDX2 resulted in selective targeting of CHK2-defective CRC cells. N-Carbamoyl alanine (NCA) is a PRDX2 inhibitor and is a peptide-like organic compound, which degrades after oral administration in harsh gastric pH. To overcome the limitations of NCA, a chitosan-based nanocarrier was developed for the entrapment of NCA. In this study, we targeted the SL interaction between PRDX2 and CHK2 using NCA-loaded chitosan nanoparticles (NCA-Chit NPs) to selectively inhibit the CHK2-null HCT116 cells. NCA-Chit NPs were assessed for various physicochemical characterizations such as the hydrodynamic diameter (size), zeta potential, and polydispersity index using a Zetasizer. Additionally, morphological studies for the shape and size of NPs were confirmed by transmission electron microscopy, scanning electron microscopy, and atomic force microscopy. Cellular uptake of NPs was confirmed using confocal microscopy, which exhibited that nanoparticles were able to internalize into the HCT116 cells. Blank Chit NPs were found to be cytocompatible as they did not exert any cytotoxic effects on hTERT, L929, and Caco-2 cells (intestinal epithelial cells). Importantly, NCA-Chit NPs were quite hemocompatible also. In the form of an NCA-chitosan nanoformulation, the efficacy was enhanced by about 8 times compared to free form of NCA towards selective killing of CHK2-null HCT116 cells as compared to HCT116 cells. The chitosan-based nanoformulation for NCA was developed to augment the efficacy of the NCA for enhanced cell death of colorectal cancer cells having CHK2 defects.

Caffeic Acid Modified Nanomicelles Inhibit Articular Cartilage Deterioration and Reduce Disease Severity in Experimental Inflammatory Arthritis

Inflammation plays an important role in the development of rheumatoid arthritis (RA). NR4A1 is an anti-inflammatory orphan nuclear receptor involved in protection from inflammatory stimuli in RA. In this study we have explored the anti-inflammatory potential of the FDA-approved drug 9-aminoacridine (9AA) and the natural compound caffeic acid (CA) conjugated to nanomicelles for the treatment of RA. We have synthesized methoxy polyethylene glycol polycaprolactone block copolymer (mPEG-b-PCL) by ring opening polymerization of ε-caprolactone. Then, we conjugated the hydrophilic caffeic acid (CA) with mPEG-b-PCL micelles via Steglich esterification and incorporated the 9AA drug. These nanomicelles were formulated by the solvent evaporation method with a size distribution around 190 nm and showed maximum drug loading capacity along with sustained drug release behavior. Furthermore, we tested the therapeutic potential of the formulated 9AA-encapsulated CA-conjugated nanomicelles (9AA-NMs) against an experimental RA model. We observed promising results which showed alleviation of arthritic symptoms by reducing inflammation, joint damage, bone erosion, and swelling. Further, collagen destruction was significantly reduced in articular cartilage, as shown by safranin-O and toluidine blue staining. The protective mechanism might be due to the simultaneous inhibition of NF-κB by 9AA and CA, whereas the activation of NR4A1 by 9AA leads to the suppression of HIF-1α. This combined therapeutic effect of 9AA and CA has enhanced the therapeutic efficacy of 9AA-NM and markedly reduced the severity of inflammatory arthritis. Unlike existing drugs for pain management and with limited efficacy, 9AA-NM exerted a disease-relevant activation/blockade that alleviated inflammation and exhibited marked therapeutic efficacy against RA.

A Comparative Analysis of Voids and Sealing Ability of Different Obturating Techniques Using CBCT

AIM

To evaluate voids and sealing ability using a disposable syringe, endodontic pressure syringe, and Skinni syringe with NaviTip in primary molars with cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

The 15 extracted primary mandibular molars with at least one root ≥8 mm length and an equal number of mesiobuccal canals were divided into three groups, i.e., obturation using a disposable syringe, an endodontic pressure syringe, and a Skinni syringe with NaviTip, respectively. The evaluation of the apical seal was determined as the measurement between the apical end of the filling material and the radiographic apex. The quality of the filling was determined by the size, number, type, and location of voids present. Statistical analysis was done using the Chi-square test and post-hoc test.

RESULTS

The endodontic pressure syringe score was the highest and statistically significant in obtaining apical seal (p = 0.013). Disposable syringe shows highest size of voids (p = 0.01) in which type I-voids (p = 0.04) and type S-voids (p = 0.07) were statistically significant. The location of voids was maximum at the middle third of the root (p = 0.016).

CONCLUSION

The endodontic pressure syringe provided the best root canal obturation of primary molars, whereas the disposable syringe was least effective with the maximum number and size of voids.

CLINICAL SIGNIFICANCE

Comparing the voids and sealing abilities of different obturating techniques with CBCT would help the pediatric practitioners for better outcome of obturation in primary teeth.

Enhanced Antioxidant Effects of Naringenin Nanoparticles Synthesized using the High-Energy Ball Milling Method

Naringenin, one of the flavonoid components, is majorly found in and obtained from grapefruits and oranges. Naringenin also acts as a potent antioxidant, which possesses hypolipidemic as well as anti-inflammatory potential. Naringenin reduces the expressions of several inflammatory mediators, viz., NF-κB, cycloxygenase-2, and other cytokine mediators. In spite of having various biological effects, the clinical application of naringenin is restricted due to its very poor aqueous solubility. In the present study, the high-energy ball milling method was employed for the preparation of naringenin nanoparticles without using any chemical with an aim to enhance the anti-oxidant potential of naringenin. The milled naringenin nanoparticles were characterized for their physicochemical properties using scanning electron microscopy (SEM) and X-ray diffraction. Additionally, the effects of milling time and temperature were further assessed on the solubility of crude and milled naringenin samples. The antioxidant potential of milled naringenin was evaluated with various assays such as DHE, DCFDA, and cleaved caspase-3 using SH-SY5Y human neuroblastoma cells. The nanoparticle size of naringenin after milling was confirmed using SEM analysis. Crystalline peaks for milled and crude samples of naringenin also established that both the naringenin forms were in the crystalline form. The solubility of naringenin was enhanced depending on the milling time and temperature. Moreover, crude and milled naringenin were found to be cytocompatible up to doses of 120 μM each for the duration of 24 and 48 h. It was also observed that milled naringenin at the doses of 1, 2, and 5 μM significantly reduced the levels of reactive oxygen species (ROS) generated by H₂O₂ and exhibited superior ROS scavenging effects as compared to those of crude or un-milled forms of naringenin. Furthermore, milled naringenin at the doses of 1 and 2 μM inhibited H₂O₂-induced cell death, as shown by immunofluorescence staining of cleaved caspase-3 and Annexin-V PI flow cytometry analysis. Conclusively, it could be suggested that the size reduction of naringenin using high-energy ball milling techniques substantially enhanced the antioxidant potential as compared to naïve or crude naringenin, which may be attributed to its enhanced solubility due to reduced size.

A Randomized, Double-Blind, Prospective Study to Evaluate the Effect of Oral Pregabalin in Upper Limb Surgeries Under Brachial Plexus Block

Context

The oral pregabalin administration preoperatively has been reported to reduce acute postoperative pain and prolong the duration of anesthesia produced by single-injection peripheral nerve blockade.

Aim

To study the effect of single dose pregabalin on duration of brachial plexus block

Settings and design

Prospective, randomised, double blind, comparative study

Material and methods

Patients were divided into two groups (groups A and B), with each group having 50 patients. In group A, the patient received a pregabalin capsule of 300 mg orally two hours before surgery with a sip of water. Group B received a placebo (vitamin B complex capsule) orally two hours before surgery. Brachial plexus block was performed, and data was collected.

Statistical analysis

Data analysis was done using SPSS version 21.0 statistical analysis software. Demographic data and clinical variables were compared using the student's t-test, chi-square test, and Mann-Whitney U test.

Results

The requirement of the first dose of analgesia was significantly earlier in group B as compared to group A (4:56±0:20 vs. 8:01±0:30 hours). Group B patients, as compared to group A patients, had significantly higher levels of pain after two hours of surgery (0.32±0.47 vs. 0.00±0.00) and at four hours of surgery (2.42±0.50 vs. 0.34±0.59).

Conclusions

Oral pregabalin prolongs analgesia from brachial plexus block without significant effect on the motor block. In addition, premedication with oral pregabalin increases the sensory block of brachial plexus block.

Programmatic mapping and estimating the population size of female sex workers, men who have sex with men, people who inject drugs and transgender populations in Kenya

Introduction: Effective coverage of Human Immunodeficiency Virus prevention services for Key Populations (KPs) including female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and transgender (TG) people necessitates periodic validation of physical venues and size estimates. Kenya conducted a robust size estimation of KPs in 2012 and a repeat mapping and size estimation exercise was conducted in 2018 to update KP Size Estimates and sub-typologies within each County for calculation of realistic program indicators.  Methods: A prospective mixed methods programmatic mapping approach adopted comprised two steps. The first step involved consolidating and documenting all known venues where KPs congregate while the second step included visiting and validating these venues confirming their active status. Data were collected in 34 out of 47 Counties in Kenya between January and March 2018. Data collected included estimated number of KPs (range), venue typology and timing of operation of each venue.   Results: We estimated a total number of 167,940 (129,271 to 206,609) FSWs; 32,580 (24,704 to 40,455) MSM; 16,063 (12,426 to 19,691) PWIDs; 10,951 (8,160 to 13,742) and 4,305 (2,826 to 5,783) transgender people congregating at 10,250, 1,729, 401 and 1,202 venues respectively. Majority of the venues for FSW (81%), MSM (64%) and transgender people (67%) were bars with and without lodging, PWIDs were mostly found on streets and injecting dens (70%).  Around 9% of FSW and MSM and11% of PWIDs were below the age of 18 years.  Conclusion: This study provided information on young KPs, female PWIDs, MSWs and for the first time, TG people in Kenya. The exercise updated size estimates of KPs by typology and provided new evidence for resource allocation, planning of interventions and targets. Programmatic mapping continues to be a useful approach supporting programs to achieve high levels of coverage and prioritize resources.

Maintenance of increased bone mass after PTH withdrawal by sequential medicarpin treatment via augmentation of cAMP-PKA pathway

Osteoporosis is a metabolic bone disorder associated with impaired bone microarchitecture leading to fragility fractures. Long-term usage of parathyroid hormone (PTH) enhances bone resorption and leads to osteosarcoma in rats which limits its exposure to maximum 2 years in human. Notably, the anabolic effects of PTH do not endure in the absence of sustained administration. Studies in our lab identified osteogenic and antiresorptive activity in medicarpin, a phytoestrogen belonging to the pterocarpan class. Considering dual-acting property of medicarpin and limitations of PTH therapy, we envisaged that medicarpin sequential treatment after PTH withdrawal could serve as promising therapeutic approach for osteoporosis treatment. As PTH exerts its bone anabolic effect by increasing osteoblast survival, our study aims to determine whether medicarpin amplifies this effect of PTH. Our results show that PTH withdrawal led to reduced bone mineral density and bone parameters, while sequential treatment of medicarpin after PTH withdrawal significantly enhanced these parameters. Remarkably, these effects were more pronounced than 8-week PTH treatment. Sequential therapy also significantly increased P1NP levels and decreased CTX levels and TRAP positive cells compared to PTH 8W group where CTX levels were quite high due to bone resorptive action of PTH. Protein expression studies revealed that medicarpin along with PTH betters the antiapoptotic potential compared to PTH alone, through augmentation of cyclic adenosine monophosphate-PKA-CREB pathway. These results proclaim that medicarpin sequential treatment prevented the reduction in bone accrual and strength accompanying PTH withdrawal and also aided in antiapoptotic role of PTH. The study points toward the potential use of medicarpin as a replacement therapeutic option postdiscontinuation of PTH.

Dual contraceptives and associated predictors in HIV positive women: a case-control study

Background

People living with the human immune deficiency virus (PLHIV) are an important group to address HIV prevention. Mostly, 90% of the HIV cases in children are usually through mother-to-child transmission. Dual contraception (barrier condoms i.e., male, and female condoms) are one of the most effective ways to avoid HIV transmission. Thus, the present study was carried out to establish the predictors associated with the use of dual contraceptives in sexually active HIV positive women in Hossana, Southern Ethiopia.

Methods

An institution based unmatched case–control study among randomly selected 312 sexually active HIV positive women was conducted from February 2021 to May 2021. The data were collected through structured questionnaire and anti-retroviral treatment (ART) cards considering the case-to-control ratio of 1:3. The information was coded, entered into Epi-Info7.0 and exported to SPSS 20.0 for further analysis. A P-value < 0.25 in bi-variate analysis was further processed for multi-variate analysis and P-value < 0.05 was considered statistically significant.

Results

A response rate of 97.2% was recorded. A significant difference was observed towards the use of dual contraceptives in sexually active HIV positive women living in urban vs rural areas (AOR = 0.28; 95% CI = 0.09–0.84), having sexual intercourse with a regular partner (AOR = 3.77; 95% CI = 1.48–9.55) and taking first initiation to use (AOR = 0.05; 95% CI = 0.02–0.11).

Conclusion

The determinants associated with lower use of dual contraceptives were residing in rural areas, sexual intercourse with a regular partner and low initiation rate at first time for use of dual contraceptives. Therefore, we strongly recommend that open discussion about sexually transmitted infections like HIV and their prevention, providing adequate facilities in rural areas can help to prevent HIV transmission and reduce the disease burden. The health professionals are encouraged to organize awareness campaigns in rural areas for use of dual contraceptives among PLHIV.

HIV/AIDS has become a serious global threat to human beings. People living with HIV are an important group that needs attention. About 90% of the children get HIV infection through their mothers that involved mother-to-child transmission of HIV. Therefore, World Health Organization has focused on the use of condoms to prevent the transmission of sexually transmitted diseases (STDs) and to avoid unwanted pregnancies. Out of these contraceptives, the use of dual contraceptives has been considered the best to prevent the transmission of STDs/HIV. Therefore, the present study tried to identify the use of dual contraceptives (barrier condoms i.e., male, and female condoms) and factors associated with its use in sexually active HIV women in Hossana, SNNPR, Ethiopia. We conducted a case–control study and recruited 312 sexually active HIV positive women that were on antiretroviral therapy and visiting the ART clinics for their follow-ups. The present investigation revealed that women living in rural areas were not aware about the use of dual contraceptives when compared to urban areas. Also, it was observed that women, those involved in sexual activities with multiple partners and had an open discussion with their partners about using dual contraceptives at first were more when compared to others. Although, the use of dual contraceptives among HIV positive women living in Hossana was low. Hence, this needs more focused awareness programs in rural areas and people having sexual intercourse with regular partners.

A System-on-Board Integrated Multi-analyte PoC Biosensor for Combined Analysis of Saliva and Exhaled Breath

The need for oral health monitoring Point of Care (PoC) systems is ever growing. This is effectively highlighted by the ongoing COVID-19 pandemic where the lack of rapid PoC testing has placed an unsustainable burden on centralized laboratory testing. Urgent development has furthered pathogenic nucleic acid and antibody detection in oral samples throat swabs, but without corresponding advancements in biochemical monitoring through oral biosensing. We have recently reported two novel biosensor technologies for detection of high impact hormones: cortisol in saliva by organic electrolyte gated FETs (OEGFETs), and 8-isoprostane in exhaled breath condensate (EBC) using molecularly imprinted electroimpedance spectroscopy biosensors (MIP EIS). In this work, we report a first stage integration of the two biosensors - previously bench-top proven - with a miniaturized semi-hermetically sealed soft-fluidic enclosure, onto a low-power (<300 mW) customized printed circuit board. Our findings established comparable detection thresholds for the miniaturized board-based configuration and a lab-based test setup, and their ability to characterize, calibrate, and operate these small footprint biosensors. Testing with the 8-isoprostane EBC MIP EIS biosensors showed the system-on-board had an effective frequency range of 100-100kHz, comparable to lab bench impedance analyzers. Despite internal impedance increases of 210%, the expected data features are present in the impedance graphs collected with the PCB. The system-on-board experiments using OEGFET aptasensor showed a predictable behavior and comparable sensor detection range and resolution using unadulterated supernatant and serial dilutions of cortisol over a range of 273 μM to 2.73pM. The portable, multi-analyte oral biosensor is a promising prototype for future packaging and clinical validation.

3-PEP promotes bone regeneration by up regulating BCL-2 expression via ERK phosphorylation

Bone healing and regeneration is a complex process that recapitulates embryonic skeletal development and is delayed in diseases like osteoporosis. Bone healing therapies like recombinant bone morphogenetic-2 protein (rhBMP-2) and parathyroid hormone (PTH), an approved bone anabolic therapy reduces fracture risks but are fraught with high cost and several side effects. Thus, there is an unmet need for cost-effective bone healing agents. In this study, we have synthesized 3-piperidinylethoxypterocarpan (3-PEP) which is a hybrid of bone supplement ipriflavone and anti-resorptive drug raloxifene and evaluated its bone regeneration and healing potential. Prior to studies in animal models, the potency of 3-PEP was confirmed in calvarial osteoblast cells. Bromodeoxy uridine cell proliferation and cell viability assay revealed that 3-PEP at 100 pM concentration increased the proliferation and survival of osteoblasts simultaneously inhibiting the apoptosis by involving activation of BCL-2 by phosphorylation at Ser70 site through MEK-ERK pathway. In vivo studies were conducted in estrogen-deficient ovariectomized Balb/c mice and drill hole injury was generated in the mid diaphysis of the femur in all the animals. Treatment with 3-PEP commenced the next day onward and terminated at 7 and 15 days. Micro-CT analysis and calcein labeling of newly generated bone at the drill hole injury site showed that 3-PEP promotes bone healing and new bone formation at a dose of 5 mg/kg at the injury site. These data were also corroborated in non-ovariectomized Balb/c mice cortical defect model. Owing to the side effects associated with rhBMP-2 and PTH, along with the expenses involved, our study proposes an alternative therapeutic option for bone healing.

A cross sectional observational study on the effect of music on the anxiety state of patients admitted for COVID 19 in a tertiary care hospital in New Delhi

Introduction

COVID 19 has led to dramatic changes in the lives of people leading to an increase in stress and anxiety. Music intervention is a non-medicated method for relieving anxiety. This current study aims to understand whether music can be effectively used to alleviate anxiety in admitted COVID-19 patients.

Objectives

To study the effect of music on anxiety in patients admitted for COVID-19 in a tertiary care hospital in New Delhi

Methods

34 patients (17 females &17 males) were randomly divided into two groups, a control (N=17) and a music group (N=17). Vitals of all the patients were noted. Patients of the music group were asked to listen to relaxing instrumental for 30 minutes, while patients of the control group were asked to relax for 30 minutes. Vitals of all the patients were noted again. Patients were asked to fill State Trait Anxiety Inventory (STAI) before and after intervention.

Results

The post-intervention mean scores of STAI after the music session were lower in the music group than the control group [95.06 (SD 8.5)) versus 102.37 (SD 10.3)]. The differences in mean values of pre- to post-intervention changes between both groups after music session were statistically significant.

Conclusions

Our findings suggest that listening to music lowers anxiety. As music is non- invasive and free of side-effects we recommend that music intervention service should be used to improve health care quality.

Disclosure

No significant relationships.