Comparison of Diabetes in Pregnancy Study Group India (DIPSI) and WHO criteria for diagnosis of gestational diabetes by assessment of fetomaternal outcomes

OBJECTIVE

To evaluate fetomaternal outcomes in women who are normoglycemic by Diabetes in Pregnancy Study Group India (DIPSI) but have gestational diabetes mellitus (GDM) by WHO criteria versus those who are normoglycemic by both DIPSI and WHO criteria.

METHODS

This was a prospective, cohort study. A total of 635 women participated. They underwent a 2-h non-fasting oral glucose tolerance test (OGTT) and results were interpreted by DIPSI. Out of 635 women, 52 were lost to follow up and 33 were diagnosed as GDM by DIPSI and excluded from the study. The remaining 550 women, after 72 h from the first test, underwent a 75-g fasting-OGTT and results were interpreted using WHO 2013 criteria. Results of the second test were blinded till delivery. The 550 women were followed for fetomaternal outcomes. Participants with normal DIPSI and normal WHO 2013 OGTT were labeled group 1. Participants with normal DIPSI but abnormal WHO 2013 OGTT were labeled group 2. Fetomaternal outcomes were compared between these groups.

RESULTS

Occurrence of GDM by DIPSI was 5.1%, by WHO 2013 criteria it was 10.5%. Composite fetomaternal outcomes occurred more commonly in women with a normal DIPSI but an abnormal WHO 2013 test. Out of 550 women, 492 had normal DIPSI and normal WHO 2013 test. Out of this 492, 116 (23.6%) women had adverse fetomaternal outcomes. Fifty-eight women out of 550 had a normal DIPSI but an abnormal WHO 2013 test. Thirty-seven (63.8%) women out of 58 had adverse fetomaternal outcomes. We found statistically significant association between adverse fetomaternal outcome and GDM by WHO 2013 test (with normal DIPSI test).

CONCLUSION

WHO 2013 has superior diagnostic value compared with DIPSI criteria for diagnosis of GDM.

Procalcitonin levels in maternal serum and cord blood as marker for diagnosis of early onset neonatal sepsis

Objectives

To assess the diagnostic accuracy of Procalcitonin in maternal serum and umbilical cord blood samples to predict Early onset neonatal sepsis (EONS).

Study Design

It was a Prospective analytical cohort study. Pregnant women ≥ 34 weeks gestation in active labour, with risk factors for EONS were included in the study. Maternal blood samples at recruitment and umbilical cord blood samples after delivery were taken for Total leucocyte count (TLC), high sensitivity C-Reactive Protein (hs-CRP) and Procalcitonin. Newborns were classified into non-infected, suspected and proven infection. Sensitivity, specificity and diagnostic accuracy of maternal and cord blood procalcitonin, TLC and hs-CRP were calculated.

Results

A total of 200 women were recruited. Maternal procalcitonin had a superior diagnostic accuracy of 99% compared to maternal TLC and maternal hs-CRP. Also, cord blood procalcitonin had a diagnostic accuracy of 95%.

Conclusion

Procalcitonin in both maternal as well as cord blood is a promising biomarker to detect EONS with high diagnostic accuracy.

Repurposing of known drugs for COVID-19 using molecular docking and simulation analysis

We selected fifty one drugs already known for their potential disease treatment roles in various studies and subjected to docking and molecular docking simulation (MDS) analyses. Five of them showed promising features that are discussed and suggested as potential candidates for repurposing for COVID-19. These top five compounds were boswellic acid, pimecrolimus, GYY-4137, BMS-345541 and triamcinolone hexacetonide that interacted with the chosen receptors 1R42, 4G3D, 6VW1, 6VXX and 7MEQ, respectively with binding energies of -9.2 kcal/mol, -9.1 kcal/mol, -10.3 kcal/mol, -10.1 kcal/mol and -8.7 kcal/mol, respectively. The MDS studies for the top 5 best complexes revealed binding features for the chosen receptor, human NF-kappa B transcription factor as an important drug target in COVID-19-based drug development strategies.

To Evaluate Correlation of Serum Copeptin with Severity of Liver Cirrhosis

INTRODUCTION

Cirrhosis is defined as a diffuse process in the liver characterized by the development of extensive Fibrosis and replacement of the normal hepatic architecture by structurally abnormal nodules of fibrotic tissue. Because of its key role in circulatory homeostasis and its systemic vasoconstrictor effects AVP might be particularly interesting as a marker of circulatory dysfunction and prognosis in cirrhosis. Copeptin is secreted with AVP in equimolar amounts and strongly correlates with AVP over a wide range of osmolalities. These properties make copeptin an interesting surrogate marker of AVP in clinical practice. So, we evaluated the correlation of serum copeptin with the severity of liver cirrhosis.

MATERIALS

We collected data from 80 patients with cirrhosis and divided them into CTP Class A, B, and C. Serum Copeptin levels were measured by a Human Copeptin ELISA Kit. The levels of Serum Copeptin were compared between the CTP Class A, B, and C.

RESULT

The mean (SD) Serum Copeptin(pmol/L) in CTP Class A, B and C is 11 (0.29), 14.20 (0.40) and 23.98 (7.64) respectively. The findings of our study show that there is a significant difference in serum Copeptin levels (pmol/L) (p = <0.001) between the 3 groups as per CTP Class.

CONCLUSION

The result of our study shows that measurement of Serum Copeptin levels can be used as an additional, simple, non invasive, easily accessible, and cost-effective parameter to predict the severity of liver cirrhosis. Chiranth S, Geeta Kampani Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, Delhi, India Introduction: Acute pancreatitis (AP) is a potentially life threatening disease. Early identification of patients at increased risk of severe and fatal disease is crucial to improve prognosis through a prompt medical/endoscopic treatment and admission to a specialized intensive care unit. Due to limitations of the commonly used scoring systems, it is difficult to assess the severity of AP at presentation.

MATERIALS

An observational cross sectional study was conducted on 85 patients admitted at a referral hospital. Patients of AP were divided into 2 groups- mild acute pancreatitis (MAP) and moderately severe/ severe acute pancreatitis (MSAP/SAP)and all necessary investigations were done.

RESULT

Out of 85 patients with AP, 55 had MAP, 17 had MSAP and 13 had SAP. Mean serum calcium was significantly lower in patients with MSAP/SAP than in MAP. Red cell distribution width (RDW) at 0 hr and at 24 hours and RDW/Total serum calcium (TSC) were significantly higher in patients with MSAP/SAP than in MAP. BISAP index followed by Modified Marshall Score were the best predictors of severity followed by RDW/TSC. RDW/TSC was a better predictor of severity of AP when compared to RDW at admission and at 24 hrs. No individual parameter was an independent significant predictor of AP.

CONCLUSION

RDW and RDW/Total serum calcium ratio are comparable to BISAP index as predictors of severity in acute pancreatitis. They are cheap, easily available and can be used to predict the severity of AP at admission, thereby effecting prompt intervention at admission.

Preoperative Serum Albumin Level as a Predictor of Abdominal Wound-Related Complications After Emergency Exploratory Laparotomy

Background Serum albumin is generally considered to be a predictor of patients' nutritional status. Previous studies have used serum albumin to assess postoperative morbidity, mortality, and various other surgical outcomes in cardiac surgeries and elective gastrointestinal surgeries. In this study, we used preoperative serum albumin levels to assess postoperative surgical site wound complications in patients who underwent emergency exploratory laparotomy. Methodology Preoperative serum albumin level was observed in 60 patients who underwent emergency exploratory laparotomy due to various pathological conditions and were divided into those with hypoalbuminemia (serum albumin level <3.5 g/dl and >3.5 g/dL). Postoperative surgical site infections, wound dehiscence, and various complications, such as duration of hospital stay, prolonged ileus, the incidence of enterocutaneous fistula, the incidence of anastomotic leak, and 30-day mortality, were assessed. Results In our study, about 65% of the patients had hypoalbuminemia. Among them, 56.4% of the patients had surgical site infections according to the Southampton grade, with a statistically significant p-value of <0.001. Moreover, 87.2% of the patients had wound dehiscence according to the World Union Wound Healing Societies Surgical Wound Dehiscence wound grading, with a statistically significant p-value of <0.001. In addition, statistical significance was noted between preoperative hypoalbuminemia and increased postoperative hospital stay, with a p-value of <0.001. Conclusions Preoperative serum albumin value is a formidable predictor of postoperative surgical site infections, wound dehiscence, and duration of hospital stay in patients who underwent emergency exploratory laparotomy.

Fibroblast Growth Factor-23 in Pre-Dialysis Chronic Kidney Disease Patients and its Correlation with Carotid Artery Calcification

Introduction

Fibroblast growth factor 23 (FGF-23) is a phosphate metabolism regulator in patients with chronic kidney disease (CKD). The present study is aimed to examine the FGF-23 level in pre-dialysis patients with CKD and its correlation with carotid artery calcification (CAAC).

Methods

This cross-sectional study included patients with CKD and controls. The patients were compared with controls having similar distribution of age and sex to determine serum FGF-23 level in Indian healthy adult population. Detailed medical history, physical examination, and investigations were done for each patient. Atherosclerotic risk factors, cardiovascular comorbidities, and drug history were recorded. Carotid calcification was observed using carotid ultrasound.

Results

In total, 62 patients with a mean age of 50.0 years were enrolled. Majority of the patients had hypertension (66.1%), followed by diabetes (27.4%) and dyslipidemia (3.2%). Mean serum corrected calcium levels were significantly higher in patients with CAAC compared to the patients without CAAC (9.21 ± 1.34 vs. 8.53 ± 0.93 mg/dL; P = 0.014). The FGF-23 levels were significantly higher in patients with CAAC compared to those without CAAC (396.0 vs. 254.0 pg/mL; P = 0.008). CAAC was found to be present in both early and late stages of CKD. Multivariate analysis showed that log FGF-23 and serum corrected calcium remained as independent determinants of CAAC. The prevalence of CAAC increased with the ascending quartiles of FGF23.

Conclusion

In conclusion, FGF-23 was found to be independently associated with CAAC in CKD.

Diagnostic accuracy of CT Hounsfield unit in distinguishing Exudative and Transudative Pleural Effusion

Background: Differentiation of exudative and transudative types of pleural effusion is crucial for management of patients. Currently, this differentiation is done with the help of biochemical analysis of the aspirated fluid after thoracentesis, which is an invasive procedure. Objective: To evaluate the utility of CT attenuation values in pleural effusion and define a threshold value to differentiate between exudative and transudative pleural effusion. Materials & Methods: A cross sectional study was done on 130 patients showing pleural effusion on CT thorax, mean attenuation was calculated using nine regions of interest on three slices. Within 48 hours of imaging, biochemical assessment was done to decide exudative or transudative nature of fluid as per Light’s criteria. A Receiver operating characteristic curve was drawn to assess the cut off CT attenuation value for distinguishing between exudative and transudative effusion and evaluate its accuracy. Result: Mean CT attenuation value of 57 exudative effusion cases was 5.9 + 6.48 HU, which was higher than 73 cases with transudative pleural effusion (2.97 + 2.69 HU). The difference was statistically significant (p value < 0.0001). The ROC curve revealed a cut off value of 7.5 HU. When the mean CT attenuation value was > 7.5 HU, the specificity and sensitivity of CT scan for diagnosing exudative effusion was 98.6 % and 59.6% respectively. Area under the curve was 0.79, which revealed moderate accuracy of this threshold value. Conclusion: CT attenuation values have moderate accuracy in differentiating between exudative and transudative pleural effusion.

Adiponectin to Leptin Ratio and its Association with Insulin Resistance in Women with Polycystic Ovarian Syndrome

BACKGROUND

Adiponectin and leptin play a major role in metabolic homeostasis. Adiponectin to Leptin ratio can be used as an indicator of insulin resistance and a marker of polycystic ovarian syndrome (PCOS). The study was planned to compare serum adiponectin, leptin, and adiponectin to leptin ratio in age and BMI matched women with and without PCOS and to find out the association of adiponectin to leptin ratio with Insulin resistance in these women.

METHODS

It was a cross-sectional study done in the Gynecology outpatient clinic in a tertiary care center. A total of 120 women, 60 with PCOS and 60 age and BMI matched women without PCOS, who presented in the clinic after the index cases were enrolled and tested for serum adiponectin, leptin, and insulin sensitivity. The main outcome measures were serum levels of adiponectin, leptin, adiponectin to leptin ratio, oral glucose tolerance test, serum insulin and HOMA-IR.

RESULTS

PCOS women had lower serum Adiponectin, higher serum Leptin level and lower Adiponectin to Leptin ratio compared to non PCOS women, 2.15 ± 3.07 ng/ml vs 10.7 ± 27.91 ng/ml, P < 0.0001; 24.25 ± 16.5 ng/ml vs 13.89 ± 11.19 ng/ml, P = 0.0003 and 0.15 ± 0.24 vs 3.03 ± 15.04, P < 0.0001, respectively. Plasma glucose 2 hours after 75 gm glucose and serum Insulin was significantly increased in PCOS women (108.78 ± 10.22 mg/dl vs 100.18 ± 4.89 mg/dl, P = 0.001 and 5.7 ± 9.53 mU/ml vs 3.02 ± 5.34 mU/ml, P = 0.02, respectively). The mean values of fasting plasma glucose and HOMA-IR were comparable in both groups, P = 0.145, P = 0.719, respectively. There was no significant association of A/L Ratio with BMI, plasma glucose 2 hours after 75 gm glucose, serum Insulin and HOMA-IR, in these women, r = -0.074, P = 0.5754; r = -0.203, P = 0.12; r = -0.018, P = 0.8915; and r = -0.041, P = 0.757, respectively.

CONCLUSION

Adiponectin to leptin ratio is significantly reduced in women with PCOS but has no association with insulin resistance.

Study of Correlation of Serum Calcium Level with Disease Severity in Dengue Patients

Dengue fever is the world's fastest growing vector borne viral disease. Dengue infection has high morbidity and mortality unless managed promptly and appropriately. Calcium regulates many physiological processes such as neuromuscular transmission, heart contractility, hormonal release, blood coagulation and is essential for cell function. Low calcium level is present in almost 80% of dengue cases and is more associated with severe cases. Hypocalcemia enhances the binding of the dengue virus to monocyte macrophages and cells of T cell and B cell lineages in dengue infection. However, there is scarcity of literature on calcium homeostasis in dengue infection, and current guidelines do not address the necessity to monitor or correct blood calcium levels in dengue patients. In present study, we evaluated serum calcium level in dengue patients and correlated it with disease severity.

MATERIAL

The present observational cross-sectional study conducted in the Department of Medicine and Biochemistry, VMMC and Safdarjung Hospital, New Delhi, included 60 patients of dengue infection, satisfying the inclusion and exclusion criteria over a period of 18 months. Inclusion criteria were patients with age above 12 years, any gender, and diagnosed as having dengue infection, either by NS1Ag or by IgM ELISA for dengue antibodies, were clinically classified as Dengue Fever (DF), Dengue Haemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS) as per National Guidelines for Clinical Management of Dengue Fever developed by NVBDCP. Exclusion criteria were patients with diseases like hypertension, diabetes, cardiac disease, liver disease, malabsorption syndrome, renal dysfunction and patients taking drugs causing hypocalcemia and oral calcium and vitamin D supplements. In present study, serum calcium level used was corrected for hypoalbuminemia.

OBSERVATION

The mean age was 27 years with a male and female ratio of approximately 3:2. The present study shows that the mean serum calcium level (mg/dL) of patients in Dengue Fever, Dengue Haemorrhagic Fever and Dengue Shock Syndrome was 8.85, 8.27 and 7.95 respectively(p&lt;0.0001). Serum calcium level was lower in DSS and DHF patients than DF patients. Negative correlation between severity of dengue infection and serum calcium level was found with correlation coefficient of -0.892.

CONCLUSION

The present study revealed significant negative correlation between Serum calcium level and severity of dengue infection. Therefore, it can be considered to use serum calcium level as a potential biomarker in order to identify severe dengue patients and this investigation will help in early identification, diagnosis and management of dengue infection but further studies are required to support this.

Matrix Metalloproteinase-9 Gene Polymorphism and Its Methylation in Stroke Patients

Background

Genetic and environmental factors, along with hypertension, diabetes mellitus and smoking cause accelerated atherosclerosis and, eventually, stroke. Matrix metalloproteinase-9 (MMP-9) are inflammatory mediators of the endoproteinase family, and their polymorphism and methylation are associated with the development of atherosclerosis and stroke. This study explores this association in the Indian population.

Objective

To study the association of MMP gene polymorphism and methylation with the risk of stroke.

Methods

A case-control study was conducted on 100 admitted patients (both genders) diagnosed with ischaemic stroke. Another 100 healthy subjects, not suffering from any chronic illness or stroke, were taken as controls. All participants were genotyped for rs3918242 (MMP-9) by polymerase chain reaction (PCR) and restriction fragment length polymorphism. Methylation of the MMP-9 gene-promoter region was assessed by methylation-specific PCR.

Results

The case (mean age = 61.3 ± 7.36 years old) and control (mean age = 60.68 ± 7.1 years old) groups were age-matched. Among cases, 61 patients were smokers, 55 were diabetic and 53 were hypertensive. A significant risk of ischaemic stroke was associated with the CT genotype (adjusted odds ratio [aOR] = 7.09; P < 0.001), TT genotype (aOR = 19.75; P < 0.001) and T allele (aOR = 10.71; P < 0.001). MMP-9 methylation decreased the risk of stroke (aOR = 0.23; P < 0.001).

Conclusion

MMP-9 gene-1562C/T polymorphism (SNP rs3918242) (single-nucleotide polymorphism [SNP] rs3918242) is a potential marker to predict ischaemic stroke and constitutes a significant proportion of the general population. Its polymorphism predisposes to ischaemic stroke, while its methylation is protective.

Accelerated Epigenetic Aging Mediates the Association between Vitamin D Levels and Knee Pain in Community-Dwelling Individuals

OBJECTIVES

To examine the relationship between Vitamin D status and pain intensity and disability in individuals with and without knee pain, and to examine the role of epigenetics in this relationship.

DESIGN

Cross-sectional analysis of data from the UPLOAD-2 study (Understanding Pain and Limitations in OsteoArthritic Disease-2).

PARTICIPANTS

189 individuals aged 45-65 years and older.

MEASUREMENTS

Serum Vitamin D levels, pain related interference and characteristic pain intensity measures, and the epigenetic clock GrimAge derived from blood analyses.

RESULTS

Lower Vitamin D was associated with advanced epigenetic aging (AgeAccelGrim), greater pain and disability and that (AgeAccelGrim) mediated the relationship between Vitamin D status and self-reported pain (ab = -0.0799; CI [-0.1492, -0.0237]) and disability (ab = -0.0669; CI [-0.1365, -0.0149]) outcomes.

CONCLUSION

These data support the notion that lifestyle factors such as nutrition status play a key role in aging process, as well as the development and maintenance of age-related diseases such as pain. Modifying nutrition status could help promote healthy aging and reduce pain.

Antimicrobial screening to molecular docking of newly synthesized ferrocenyl-substituted pyrazole

OBJECTIVE

Microbial diseases are snowballing at an alarming proportion. Therefore, the intent of this study was to inspect the antimicrobial action of ferrocenyl-substituted pyrazole against various human pathogenic Gram-positive, Gram-negative, and fungal microbial strains. Pyrazoles have been recognized for over a century as a significant and bioactive class of heterocyclic compounds. The association of pyrazoles with a ferrocene moiety may give new class of compounds. The present study was designed to synthesize biological active ferrocenyl-substituted pyrazole through a novel route.

METHODS

The anhydride of ferrocenyl-substituted pyrazole, namely, (S)-(3-(3-(carboxyamino)-3H-pyrazol-4-yl)cyclopenta-1,3-dien-1-yl)(cyclopenta-1,3-dien-1-yl)iron was synthesized using expansion cyclocondensation. FTIR, NMR, and GC-MS were performed to analyze the structure of the synthesized ferrocenyl-substituted pyrazole. Antimicrobial, DNA photo-cleaving, and anti-angiogenic activities of ferrocenyl-substituted compounds were studied.

RESULTS

Anhydride of (S)-(3-(3-(carboxyamino)-3H-pyrazol-4-yl)cyclopenta-1,3-dien-1-yl)(cyclopenta-1,3-dien-1-yl)iron obtained with yield of 87%. Spectral analysis confirmed the formation of anhydride. The synthesized compound was found to be biological active in the range of 85-95 μg/ml.

CONCLUSION

This study described the novel method for the synthesis of biologically active anhydride of ferrocenyl-substituted pyrazole. The study demonstrations that synthesized ferrocenyl-substituted pyrazole in today's situation is the encouraging antimicrobial mediator against the human pathogens. In addition, it may open new doors to initiate research against drug resistance bacteria with possible biomedical applications.

Molecular characterization of a novel mutation in the E1 flowering gene induced by gamma irradiation in soybean

Soybean is a typical short-day (SD) plant. It undergoes reproductive growth only when the day length becomes shorter than a critical length. Fourteen major genes/loci affecting soybean flowering and maturity period have been mapped to date. These are E1 and E7 on chr6, E1La, E1Lb, E6, E8, and J on chr4, E2 on chr10, E3 on chr19, E4 on chr20, E9 on chr6, E10 on chr8, Dt1 on chr19, and GmAGL1 on chr14. The functional allele of all these genes, except E6, E9, J, and GmAGL1, delay flowering, while the non-functional counterpart accelerates flowering and maturity. The contribution of the E1 gene in delaying flowering is highest. Four non-functional/dysfunctional allelic variants of the E1 gene are already known, which accelerates the flowering by 20-25 days and are being used in development of early maturing soybean varieties in many parts of the world. In this study, seeds of the late maturing Indian variety NRC 37 were irradiated with gamma rays to develop an early maturing variety. One early maturing variant was obtained. Molecular characterization of the gene responsible for early flowering proved it to be a non-functional variant of the E1 gene with major deletion.

Gall Bladder Calculus in reproductive age group females attending the ultrasound clinic at a tertiary care hospital: A comparative Cross-sectional study

Background: Pregnant females are at risk for cholelithiasis' progress, and the obstruction in the bile duct produced by gallstones is responsible for jaundice and abdominal pain. Objective: The objectives of the present study were to see the burden of gall stones, relation with parity, and trimester among reproductive age group females. Methodology: A cross-sectional study was conducted on 467 females of age between 15 to 45 years. The gall bladder was thoroughly examined by an ultrasound probe of frequency 2-5 MHz in all planes. Results: In most females who had gallstones, single (68.8 percent) gall stone was common as compared to multiple (31.2 percent). More nonpregnant women had gall bladder stones than pregnant women (p-value <0.005). Among the current nonpregnant group, the percentage of presence of gallbladder stones was greater in the female having parity of two or more (27.4 percent) than the females having parity of less than two (8.2 percent) with p-value <0.05. Conclusion: Since Gallstones can further complicate the situation in the form of gallbladder carcinoma, and females with higher parity have more chances of developing gallstones. Therefore, it becomes necessary to know the trimester of gallstone formation and its role in the progression of symptoms.

Signaling Pathways and Downstream Effectors of Host Innate Immunity in Plants

Phytopathogens, such as biotrophs, hemibiotrophs and necrotrophs, pose serious stress on the development of their host plants, compromising their yields. Plants are in constant interaction with such phytopathogens and hence are vulnerable to their attack. In order to counter these attacks, plants need to develop immunity against them. Consequently, plants have developed strategies of recognizing and countering pathogenesis through pattern-triggered immunity (PTI) and effector-triggered immunity (ETI). Pathogen perception and surveillance is mediated through receptor proteins that trigger signal transduction, initiated in the cytoplasm or at the plasma membrane (PM) surfaces. Plant hosts possess microbe-associated molecular patterns (P/MAMPs), which trigger a complex set of mechanisms through the pattern recognition receptors (PRRs) and resistance (R) genes. These interactions lead to the stimulation of cytoplasmic kinases by many phosphorylating proteins that may also be transcription factors. Furthermore, phytohormones, such as salicylic acid, jasmonic acid and ethylene, are also effective in triggering defense responses. Closure of stomata, limiting the transfer of nutrients through apoplast and symplastic movements, production of antimicrobial compounds, programmed cell death (PCD) are some of the primary defense-related mechanisms. The current article highlights the molecular processes involved in plant innate immunity (PII) and discusses the most recent and plausible scientific interventions that could be useful in augmenting PII.

Histological changes at the commissure of the lip on approaching from its cutaneous to the mucosa region in males

Introduction:

The morphology of the epithelium of the oral lips comprised keratinized external epithelium (anteriorly) and nonkeratinized or sometimes parakeratinized mucous membrane epithelium (posteriorly). Knowledge of morphometry of the lip lining helps in deciding the best site for choosing graft for its better uptake during several dermal grafting procedures following trauma or tumor excision following craniofacial cancers or cosmetic procedures.

Materials and Methods:

Ten human male cadavers were procured at the Department of Anatomy King George's Medical University, Lucknow, Uttar Pradesh. The rectangle-shaped skin specimen through the right commissure of the lip which included the skin, mucocutaneous junction, and mucosa was stained with hematoxylin and eosin stain. A total of 30 slides were prepared. Thus, the readings were obtained for three regions, respectively, with the help of CAT-CAM E-series HD cameras which were installed in a light microscope.

Results:

Thickness of skin (epidermis + dermis) of the lip ranged from 756 μm to 1068 μm among males. Epidermal thickness increases on moving from the cutaneous region to the mucosa region of the lip. The lowest contribution of the stratum corneum in thickness of the epidermis was observed in the vermillion region, while the highest contribution was observed in the skin region. It was found to be absent in the mucosa region of the lip. Rete pegs at the dermoepidermal junction was found to be maximum in the vermillion region and minimum in the skin region. Its depth increased as we move from the skin to the mucosa region of the lip. Depth of the dermis was found to be maximum in the skin region, while minimum in the vermillion region. It ranged between 291 μm and 693 μm.

Conclusion:

Care should be taken while using dermal fillers in lip augmentation surgeries, especially in the vermillion region due to its close proximity to musculature in the core of the lip.

Transition from physical to virtual classroom amidst COVID-19 crisis: Analyzing students' perspective to drive improvement in the current online teaching methodology

BACKGROUND

Among the COVID crisis, medical education is forced to shift to the virtual mode, for which neither the students nor the teachers are prepared. Currently, we replaced traditional classroom teaching (CT) by live online classes (LOC), power-point presentations with voiceovers (UPV), or only power point presentations (UP). Uncertainty of this situation necessitates analysis of the experiences of its stakeholders to improve the implemented online teaching methodologies in coming time. The present study aims to analyze and compare the effectiveness of online teaching methodologies among themselves and against traditional CT.

MATERIALS AND METHODS

A cross-sectional, survey based, observational study was conducted on 250 MBBS first year students after 1 month of implementation of online teaching program. Responses were collected on Likert scaling from 1 to 5, and data were analyzed using the Kruskal-Wallis H-test, ANOVA with multiple comparisons post hoc Turkey test, and an independent t-test.

RESULTS

The students perceived that the understanding, convenience for attending class, notes-taking, visibility, audibility, raising queries and overall experience was best in traditional setup. The understanding of the topic and overall experience of the students was not affected by gender. Internet connectivity problem popped up as the major issue that adversely affected the online teaching experience.

CONCLUSIONS

Majority of students perceived that the traditional CT is best, but at the same time, they felt that a combination of live online classes and power point presentations with voice over can replace the traditional online classes.

Effect of Inhalation of Pyrethroid Based Mosquito Vaporisers Fumes on the Body Weight of Male Albino Wistar Rats- An Experimental Study

Introduction: Pyrethroid based mosquito vaporisers are commonly used as Personal Protective Measure (PPM) to avoid mosquito borne diseases. Effective control of mosquito borne diseases with the use of general public health measures are yet to be achieved in our country, so there is increasing use of PPM like mosquito coils, liquid vaporisers, mats, insecticide treated bed nets in Indian population but data regarding the safety profile of PPM is still scarce. Aim: To analyse the change in the body weight of male albino wistar rats exposed to pyrethroid based mosquito vaporiser. Materials and Methods: This was an experimental study on total 12 male albino wistar rats from July 2015 to October 2016. They were randomly divided into group I and II. Each group contained six rats. Group I animals served as control and Group II animals were exposed to mosquito vaporiser, 8 hours/day for six days in a week for 90 days. The data was analysed using Statistical Package for Social Sciences (SPSS) version 21.0. Independent samples t-test was used to compare between group differences. A p-value less than 0.05 were considered to be significant. Results: Pyrethroid exposure results in reduced weight gain in exposed group rats. The mean difference in body weight between the groups at the end of study was 37.32±24.47 gm (p=0.165). Weight gain in both the group rats was almost similar till 8th postexposure week, after that from 9th week onwards decremental trend in weight was seen in group II. Conclusion: The assessment suggests that inhalation of pyrethroid based mosquito vaporisers fumes have toxic effects, reflected as reduced weight gain following subchronic exposure.

Effect of genotype, seed development stages, and processing treatments on Bowman-Birk inhibitor in soybean and its level in commercial soy products

Bowman-Birk inhibitor (BBI) is a protease inhibitor that affects protein digestibility; however, it is increasingly being recognised as anutraceutical and cosmeceutical molecule. In the present study, BBI concentration during soybean seed development, its loss during processing treatments, and the level in commercial soy products were determined. Significant differences for BBI concentration were observed across the genotypes and seed development stages. Genotype × seed development stage interaction was also found to be significant (P<0.05) for BBI concentration. Boiling, autoclaving, microwave irradiation, and sprouting resulted in significant (P<0.05) loss of BBI. Minimum loss was observed in sprouting, while autoclaving for 5 min completely deactivated BBI. Microwave irradiation of the soaked seeds resulted in higher BBI loss than of dry seeds. Among the commercial soy products, BBI concentration was high in soy flour brands, minuscule in ready-to-cook miso soup and undetectable in extruded soy products and roasted soy nuts.

Diffuse alveolar hemorrhage secondary to plastic fume exposure: A case report

A 31-year non-smoker man, working in plastic making industry for 12 years presented with cough and streaking hemoptysis for 2 days. Computed tomography (CT) of chest showed patchy ground glass opacities with interlobular septal thickening in bilateral lung parenchyma. Fiber optic bronchoscopy (FOB) was done. Sequential lavage was taken which showed progressively increasing hemorrhagic fluid. His diffusion capacity for carbon monoxide (DLCO) was 38.08 mL/mmHg/Mi (126%) predicted on day 2 of admission, 32.36 ml/mmHg/Mi (106%) predicted on discharge and 39.63 mL/mmHg/Mi (130%) predicted on going back to work. He was diagnosed with plastic fume exposure related pulmonary alveolar hemorrhage.

Sustainable dyeing of wool fabric with Talaromyces purpurogenus

Natural dyes had been used by human being since ancient times for colouring of various materials including textiles. These were replaced completely by synthetic dyes, continuous use of which created the problem of pollution and environmental degradation. With the development of green technology and increased awareness of sustainability, the use of non-allergic, non-toxic and eco-friendly natural dyes on textiles has become a matter of significant importance. Among the natural sources of colourants, microorganisms such as bacteria and fungi have gained interest in the field of textile coloration.  In the present study, the pigment solution yielded from growth of Talaromyces purpurogenus sp. on organic waste was used for dyeing of wool fabric. Under the dyeing conditions i.e. 1:30 M:L ratio, pH 5, 80º C temperature and 45 minutes dyeing time, the percent absorption could reach 57 %, 32%, 36% and 49% respectively. The wool fabric samples dyed with the fungal dye exhibited very good to excellent washing and rubbing fastness properties. The colour pigment obtained from fungal thus offered an opportunity to reduce impact on plant resources for dye source exploration. So it can be concluded from the study that a natural fungal dye could help to sustain the environment and to minimize the over exploitation of natural resources.

Association of Childhood Attention Deficit Hyperactivity Disorder Symptoms with Academic and Psychopathological Outcomes in Indian College Students: a Retrospective Survey

OBJECTIVE

To survey the prevalence of retrospectively recalled clinically significant symptoms of attention deficit hyperactivity disorder (ADHD) in childhood and determine the association of ADHD symptoms in childhood with current academic achievement and psychopathological outcomes among college students in the state of Kerala, India.

METHODS

A self-administered questionnaire was distributed to 5784 students from 58 colleges selected by cluster random sampling. The Barkley Adult ADHD Rating Scale-IV was used for recollection of childhood ADHD symptoms; a total score of ≥60 (indicating the 99 percentile) was taken as the cut-off for clinically significant ADHD symptoms in childhood. The Alcohol, Smoking and Substance Involvement Screening Test was used to assess lifetime use of alcohol and tobacco. The Kessler Psychological Distress Scale was used to assess non-specific psychological distress. Lifetime suicidality and exposure to sexual abuse were assessed by asking relevant questions. Students who recalled having clinically significant ADHD symptoms in childhood were compared with those who did not.

RESULTS

Of 5784 students, 639 (11.5%) did not complete the questionnaire. Of the remaining 5145 students, 1750 (34.8%) were men and 3395 (65.2%) were women, with a mean age of 19.4 years. 143 (2.8%) students reported clinically significant ADHD symptoms in childhood. Childhood ADHD symptoms were significantly more common in men and in those living in urban areas. In the bivariate analysis, those with clinically significant ADHD symptoms in childhood had significantly higher odds of poorer academic performance, alcohol use, tobacco use, psychological distress, suicidal thoughts, suicidal attempts, and contact and non-contact sexual abuse, after adjusting for sex and residence.

CONCLUSIONS

Clinical evaluation and appropriate management may be warranted for adults who retrospectively recall clinically significant ADHD symptoms in childhood.

Proficiency Test for Chemical Laboratories for the Analysis of a Pesticide in a Formulated Product: Interlaboratory Study

A multilaboratory proficiency testing program was conducted by the National Accreditation Board for Testing and Calibration Laboratories (India) and coordinated by the Institute of Pesticide Formulation Technology. This program was conducted to compare the performance of individual laboratories in the area of pesticide formulation (Chlorpyrifos 20 EC) analysis. A total of 24 laboratories in India participated. Analysis of 2 parameters (i.e., estimation of the active ingredient and the acidity) of 2 samples of Chlorpyrifos 20 EC was the objective of this program. Homogeneity tests were performed before sample distribution. Performance of the participating laboratories was evaluated by using new robust statistics given in the guidelines of the National Association of Testing Authorities, Australia. Results were collated and statistically computed to calculate the value of 2 types of Z-scores (Zwi and Zbi). In addition to the statistical analysis, a graphical representation such as the Youden plot was also generated to evaluate the performance of participating laboratories.

Mirror finger patterns of apparent monozygotic twins and sib pairs with Schizophrenia

BACKGROUND

Although mirror images are noted in some twins, no such reports are available for twins and subjects with schizophrenia.

AIM

The study was to assess the occurrence of mirror image finger patterns in apparent monozygotic twins with schizophrenia. Another objective was to elucidate these characteristics among sib pairs with schizophrenia for comparison with those of the twins.

MATERIALS AND METHODS

Eight apparent monozygotic twin pairs and eight sib pairs with schizophrenia were investigated. The frequency of identical patterns in the right side finger of one twin and the corresponding left side finger of the other twin was assessed, and similarly on other sides. Similar assessment was made in sib pairs with schizophrenia and normal sib pairs.

RESULTS

The left middle finger pattern of one of the twin pair was found to be the mirror image of the right middle finger of the other twin in all the twin pairs studied and so was in seven of the sib pairs with schizophrenia. These mirror images of sib pairs with schizophrenia was more than those of normal sib pairs. This difference was accentuated with significantly more of these patterns in the twins in comparison to those among normal sib pairs. Notably, no difference emerged between the sib pairs with schizophrenia and the twins in any of their finger pairs.

CONCLUSION

Mirror images that are probably due to factors like abnormal genotypes and L- DNA, appear to be promising tools to study the etiology of schizophrenia.

Gender Linked Metric Analysis of Portal Vein: A Sonographic Appraisal

INTRODUCTION

Portal hypertension is one of the most mystifying and disconcerting abdominal ailment. Ultrasonography (USG) is an effective diagnostic tool for its prompt management. Knowledge of normal calibre of portal vein in a local setting is essential as literature reports contrasting values in different regions. It helps in early diagnosis of portal hypertension even before it is clinically manifested thereby assisting clinicians and interventional radiologists in pertinent management.

AIM

Study was aimed to evaluate the Portal Vein Diameter (PVD) and find its correlation with gender by using USG in North Indian population.

MATERIALS AND METHODS

A total of 300 healthy adults were included in the study. Portal vein diameter was measured in supine position and normal respiration by grey scale USG. The portal vein diameter was correlated with age and gender statistically using independent Student's t-test and ANOVA.

RESULTS

Mean PVD of (9.49±1.03 mm) was observed in the present cross-sectional study. Male showed a significantly higher mean PVD (9.70±1.02 mm) as compared to females (9.10±0.94 mm).

CONCLUSION

Scarcity of information concerning ultrasonographically measured standard portal vein diameter and inconstant values reported in literature necessitates the need for establishing local standard value. In the given subset of population the portal vein diameter was influenced by the gender. The information will be helpful in prompt diagnosis and management of portal hypertension.

Linkage mapping of Mungbean yellow mosaic India virus (MYMIV) resistance gene in soybean

Mungbean Yellow Mosaic India Virus (MYMIV) is one of the most prevalent pathogen that limits soybean production in India. In this study RILs derived from JS335, dominant but MYMIV susceptible variety and PI171443, donor of MYMIV resistance gene in most of the MYMIV resistant varieties released in India and F2 population derived from SL525, a resistant variety released for northern India and NRC101, a susceptible genotype were used to study the inheritance of MYMIV resistance and map the gene responsible for MYMIV resistance. F1s were found to be completely susceptible. F_2:3 and RILs population segregated to fit a ratio of 1:2:1 and 1:1 indicating that a single recessive gene controlled resistance to MYMIV. BSA was performed using 144 polymorphic SSR markers. MYMIV resistance gene was mapped on chr 6 (LG C2) within a 3.5-cM genome region between two SSR markers GMAC7L and Satt322 whose size was estimated to be 77.115 kb (position of 12,259,594-12,336,709 bp). This is the first report on linkage mapping of MYMIV resistance gene in soybean. This will be helpful in breeding soybean varieties for resistance against MYMIV responsible for wide spread damage to soybean crop in India using Marker Assisted Selection.

Study of anemia in nondialysis dependent chronic kidney disease with special reference to serum hepcidin

We studied the role of serum hepcidin in anemia of chronic kidney disease (CKD) in a hospital-based cross-sectional study. Serum hepcidin, ferritin, and high-sensitivity C-reactive protein (hsCRP) levels were evaluated in patients of CKD. Hepcidin levels were increased in patients as compared to healthy adults. Hepcidin levels increased as CKD progressed through stage 3-5 (P trend = 0.015) but did not correlate with estimated glomerular filtration rate. Hepcidin correlated positively with ferritin (P < 0.0001) and transferrin saturation (TSAT) (P = 0.0217) and negatively with erythropoietin (EPO) levels (P = 0.0258) but did not correlate with either hsCRP or estimated glomerular filtration rate. Iron status influenced hepcidin levels of patients. Patients were divided according to iron status on the basis of TSAT and serum ferritin levels. We observed that while absolute iron deficiency (transferrin saturation <20%, ferritin <40 ng/ml) is associated with downregulation of hepcidin, hepcidin is elevated in other two categories of CKD patients (P = 0.0039). Iron status of patients also influenced interaction between hepcidin and hemoglobin (Hb). Hepcidin correlated negatively with Hb in patients with sufficient iron status (r = -0.7452, P < 0.0001) but nearly correlated positively with Hb in patients with absolute iron deficiency (r = 0.9428, P = 0.0572). Almost similar association persisted when cutoff value for serum ferritin was raised to 100 ng/ml as per NKF/KDOQI 2006 clinical practice guidelines except that no association was observed in absolute iron deficiency category. Cutoff value for hepcidin for differentiating absolute iron deficiency from other categories in our study population is ≤ 34 ng/ml (area under curve = 0.836, P < 0.0001). In conclusion, serum hepcidin level is increased in nondialysis CKD patients as compared to healthy adults possibly due to associated inflammation and decreased renal clearance. Furthermore, iron status modifies hepcidin level and its association with Hb. Raised hepcidin can predict the need for parenteral iron therapy and need for higher dose of recombinant human EPO to overcome iron-restricted erythropoiesis.