Molecular morphology & interactions, functional properties, rheology and in vitro digestibility of ultrasonically modified pearl millet and sorghum starches

The present research investigated to study the effect of ultrasound treatment on isolated pearl millet starch (PMS) and sorghum starch (SS). Ultrasonication was applied to PMS and SS for 10, 15, and 20 min. Ultrasonically modified pearl millet and sorghum starches evaluated for their techno-functionality, pasting profile, morphology, in vitro starch digestibility, XRD, and molecular interactions. Ultrasound treatment increased water and oil absorption capacity, swelling power, and solubility with treatment time. For ultrasonicated PMS and SS, a significant increase (p < 0.05) in paste clarity (PC) (70.05 % and 67.23 %), freeze-thawing stability (FTS), gel consistency (GC) (25.05 mm and 32.95 mm), and in vitro starch digestibility were observed (57.70 g/100 g and 50.29 g/100 g), whereas no significant changes were recorded for the color values after the ultrasound treatment. Variations in pasting property were also observed in ultrasonicated starches with treatment duration. SEM images confirmed ultrasonication mainly forms pores and indentations on starch granule surface. FTIR spectra and X-ray diffractogram for ultrasonicated starches revealed a slight decrease in the peak intensity and A-type X-ray pattern with lower relative crystallinity (RC) than the native starches. G' > G″ value, indicating the elastic behavior and lower tan δ value, depicting viscous behavior and high gel strength.

Using a mobile phone-based application as an adjunct to facilitate oral hygiene practices in children with Attention Deficit Hyperactivity Disorder (ADHD)

AIM

To evaluate the efficacy of a mobile phone application to facilitate oral hygiene practices in children with ADHD.

METHODS

This was a randomized controlled study that included 54 ADHD children after obtaining informed parental consent. The children were randomly divided into 2 groups; Group 1 (conventional) participants were instructed verbally as well as demonstrated the brushing technique on models. Group 2 (mobile phone application) participants were made to download and use the 'BRUSH DJ' app developed by Ben Underwood. At baseline, the oral hygiene index-simplified (OHI-S) [Greene and Vermillion, 1964] of each child was evaluated clinically and the parents were asked to fill a questionnaire regarding the oral hygiene practices followed by their child every day. At the end of the second, sixth, and twelfth week, the parents were asked to fill the same questionnaire in addition to the evaluation of the OHI-S index.

RESULTS

A significant difference was found in the brushing time, brushing frequency, and OHI-S index between group 1 and group 2 at the end of 12 weeks. (unpaired t-test, p<0.05)

CONCLUSION

The mobile phone application proved to be an effective tool in captivating the attention of these children and thus improving their oral health.

Genetic and molecular analysis of leaf blast resistance in Tetep derived line RIL4 and its relationship to genes at Pita/Pita2 locus

The Vietnamese indica landrace 'Tetep' is known worldwide for its durable and broad spectrum-resistance to blast. We performed genetic and molecular analyses of leaf blast resistance in a Tetep derived recombinant inbred line 'RIL4' which is resistant to both leaf and neck blast. Phenotypic analysis of segregating F2 progenies suggested that leaf blast resistance in RIL4 was controlled by a dominant gene tentatively designated as Pi-l(t). The gene was mapped to a 2.4 cm region close to the centromere of chromosome 12. The search for the gene content in the equivalent genomic region of reference cv. Nipponbare revealed the presence of five NBS-LRR genes, two of which corresponded to the alleles of Pita and Pi67 genes previously identified from Tetep. The two other genes, LOC_Os12g17090, and LOC_Os12g17490 represented the homologs of stripe rust resistance gene Yr10. The allelic tests with Pita2 and Pi67 lines suggested that the leaf blast resistance gene in RIL4 is either allelic or tightly linked to these genes. The genomic position of the leaf blast resistance gene in RIL4 perfectly coincided with the genomic position of a neck blast resistance gene Pb2 previously identified from this line suggesting that the same gene confers resistance to leaf and neck blast. The present results were discussed in juxtaposition with past studies on the genes of Pita/Pita2 resistance gene complex.

A Comprehensive Analysis of Deep Learning-Based Approaches for Prediction and Prognosis of Infectious Diseases

Artificial intelligence is the most powerful and promising tool for the present analytic technologies. It can provide real-time insights into disease spread and predict new pandemic epicenters by processing massive amount of data. The main aim of the paper is to detect and classify multiple infectious diseases using deep learning models. The work is conducted by using 29,252 images of COVID-19, Middle East Respiratory Syndrome Coronavirus, Pneumonia, normal, Severe Acute Respiratory Syndrome, tuberculosis, viral pneumonia, and lung opacity which has been collected from various disease datasets. These datasets are used to train the deep learning models such as EfficientNetB0, EfficientNetB1, EfficientNetB2, EfficientNetB3, NASNetLarge, DenseNet169, ResNet152V2, and InceptionResNetV2. The images have been initially graphically represented using exploratory data analysis to study the pixel intensity and find anomalies by extracting the color channels in an RGB histogram. Later, the dataset has been pre-processed to remove noisy signals using image augmentation and contrast enhancement techniques. Further, feature extraction techniques such as morphological values of contour features and Otsu thresholding have been applied to extract the feature. The models have been evaluated on the basis of various parameters, and it has been discovered that during the testing phase, the InceptionResNetV2 model generated the highest accuracy of 88%, best loss value of 0.399, and root mean square error of 0.63.

Stress in Caregivers of Stroke Patients During Rehabilitation: An Observational Study

INTRODUCTION

Stroke causes a high burden of death and disability all over the world. The majority of stroke survivors continue to have difficulties, and their families must shoulder a considerable portion of the expenditures of ongoing rehabilitation and long-term care. In India, stroke rehabilitation is still underachieved due to various reasons leading to delay or incomplete recovery of the patients thus adding up more burden on the caregivers. Thus, studying the caregiver burden of stroke rehabilitation will help policymakers tackle this issue faced by our lower economically challenged citizens.

OBJECTIVES

The objective is to measure the perceived burden on caregivers during stroke rehabilitation.

METHODS AND MATERIALS

The observational study was conducted by interviewing the stroke survivors' caregivers and visiting the physiotherapy OPD using the caregiver burden scale/questionnaire.

RESULTS

The study had 76 caregivers, 51.32% were women and 48.68% were men. The average age for caregivers was 42 years and 55 years for patients. The average duration of giving care was six months. The perceived caregiver burden score was low (mean-19.61) suggesting that not all assistance is associated with stress. The correlation of each burden measure with Modified Rankin Scale for disability is significantly correlated (r=0.7, P<0.0001). Further investigation revealed that caregivers had considerably higher levels of stress when the patient needed to exercise, walk or use the restroom. A low yearly income, a higher secondary education, and a small number of family members were shown to be connected with individuals who scored the highest on stress.

CONCLUSION

Based on this study, we conclude that people with low income residing in nuclear families require more support for caregiving during rehabilitation. We recommend that health and welfare policy measures be developed to lessen caregiver burden in order to improve caregivers' post-stroke experiences.

People's Perspective on Out-of-Pocket Expenditure for Healthcare: A Qualitative Study From Pune, India

Background Out-Of-Pocket Expenditure (OOPE) directly reflects the burden of health expenses that households bear. Despite the availability of social security schemes providing healthcare benefits, a high proportion of Indian households are still incurring OOPE. In order to recognize the reasons behind OOPE, a comprehensive understanding of people's attitudes and behavior is needed. Methodology By purposive sampling, 16 in-depth interviews were conducted using an interview guide in the catchment area of urban and rural health centers of a tertiary healthcare hospital. Interviews were conducted in Marathi and Hindi and were audio tape-recorded after taking informed consent. The interviews were transcribed and translated into English, followed by a thematic analysis. Results Although most participants knew that government hospitals provide facilities and experienced doctors, inconvenience and unsatisfactory quality deter them from utilizing government facilities. A few had experiences with government schemes; almost all concur that the formality and procedure of claiming insurance are cumbersome and all have had bad experiences. Cost of medications and consultation accounted for the majority of the healthcare expenditures. While some participants had benefitted from insurance, few regretted not enrolling in one. Conclusion The awareness regarding government schemes was derisory. Government-financed health insurance schemes and their utilization are crucial to reducing OOPE. Efforts should be made to increase accessibility to public healthcare services. Nevertheless, there is potential to redress the barriers to improve scheme utilization.

A mechanistic physiologically based model to assess the effect of study design and modified physiology on formulation safe space for virtual bioequivalence of dermatological drug products

Physiologically based pharmacokinetic (PBPK) models are widely accepted tools utilised to describe and predict drug pharmacokinetics (PK). This includes the use of dermal PBPK models at the regulatory level including virtual bioequivalence (VBE) studies. The current work considers the Topicort® Spray formulation, which contains 0.25% desoximetasone (DSM), as an example formulation. Quantitative formulation composition and in vitro permeation testing (IVPT) data were obtained from the public literature to develop a mechanistic model using the multi-phase, multi-layer (MPML) MechDermA IVPT module in the Simcyp Simulator. In vitro-in vivo extrapolation functionality was used to simulate in vivo PK for various scenarios and predict a 'safe space' for formulation bioequivalence using the VBE module. The potential effect of vasoconstriction, impaired barrier function, and various dosing scenarios on the formulation safe space was also assessed. The model predicted 'safe space' for formulation solubility suggesting that a 50% change in solubility may cause bio-in-equivalence, whereas viscosity could deviate by orders of magnitude and the formulation may still remain bioequivalent. Evaporation rate and fraction of volatile components showed some sensitivity, suggesting that large changes in the volume or composition of the volatile fraction could cause bio-in-equivalence. The tested dosing scenarios showed decreased sensitivity for all formulation parameters with a decreased dose. The relative formulation bioequivalence was insensitive to vasoconstriction, but the safe space became wider with decreased barrier function for all parameters, except viscosity that was unaffected.

Spectrum of coronary angiographic findings in patients with ST Elevation Myocardial Infarction (STEMI) undergoing primary PCI in a tertiary care center of Nepal

BACKGROUND

Even in developing countries like Nepal, prevalence of ST-elevation myocardial infarction has been shown to be increased with rise in prevalence of conventional risk factors like diabetes, Hypertension, smoking, dyslipidemia and obesity. Our aim is to retrospectively analyze for various risk factors and angiographic patterns of coronary artery disease in patients with ST-elevation myocardial infarction undergoing Primary Percutaneous Intervention.

RESULTS

During the period of 1 year (January 2019 to December 2019), 816 patients presented to our ER with acute STEMI, among them 437 (53.6%) patients underwent primary PCI strategy and among them 22 (5.3%) patients were died. Thirty-six (4.4%) patients received thrombolysis, among them 5 (13.9%) patients were died while remaining 343 (42.0%) patients were managed conservatively and among them 20 (5.8%) were died. The mean age of patient who underwent primary PCI was 58.5±12.7 years range from 25 years to 99 years. Among them 55-75 years old 217 (49.6%) were highest in number followed by<55 years old 180 (41.2%). Males 318 (72.8%) were predominant. Among those who underwent primary PCI, hypertension 214 (49%) was the most common risk factor, followed by smoking 198 (45.3%), diabetes mellitus 123 (28.1%), dyslipidemia 53 (12.1%) and family history of premature coronary artery disease 18 (4.1%). Among those patients, 292 patients (66.8%) had single vessel disease, 99 patients (22.7%) had double vessel disease, 41 patients (9.3%) had triple vessel disease and 5 patients (1.1%) had non-significant coronary artery stenosis. Left anterior descending (53.3%) was the most frequently found culprit artery, followed by right coronary artery, left circumflex, ramus intermedius and left main artery.

CONCLUSION

Fifty percent of patients presented with acute ST-elevation myocardial infarction and underwent primary PCI were between 55-75 years of age. Hypertension and smoking were the most common risk factors present in those patients. Single vessel disease was most prevalent with left anterior descending found to be the most commonly involved coronary artery followed by right coronary artery and left circumflex.

Artificial intelligence-based classification of schizophrenia: A high density electroencephalographic and support vector machine study

BACKGROUND

Interview-based schizophrenia (SCZ) diagnostic methods are not completely valid. Moreover, SCZ-the disease entity is very heterogeneous. Supervised-Machine-Learning (sML) application of Artificial-Intelligence holds a tremendous promise in solving these issues.

AIMS

To sML-based discriminating validity of resting-state electroencephalographic (EEG) quantitative features in classifying SCZ from healthy and, positive (PS) and negative symptom (NS) subgroups, using a high-density recording.

SETTINGS AND DESIGN

Data collected at a tertiary care mental-health institute using a cross-sectional study design and analyzed at a premier Engineering Institute.

MATERIALS AND METHODS

Data of 38-SCZ patients and 20-healthy controls were retrieved. The positive-negative subgroup classification was done using Positive and Negative Syndrome Scale operational-criteria. EEG was recorded using 256-channel high-density equipment. Eight priori regions-of-interest were selected. Six-level wavelet decomposition and Kernel-Support Vector Machine (SVM) method were used for feature extraction and data classification.

STATISTICAL ANALYSIS

Mann-Whitney test was used for comparison of machine learning-features. Accuracy, sensitivity, specificity, and area under receiver operating characteristics-curve were measured as discriminatory indices of classifications.

RESULTS

Accuracy of classifying SCZ from healthy and PS from NS SCZ, were 78.95% and 89.29%, respectively. While beta and gamma frequency related features most accurately classified SCZ from healthy controls, delta and theta frequency related features most accurately classified positive from negative SCZ. Inferior frontal gyrus features most accurately contributed to both the classificatory instances.

CONCLUSIONS

SVM-based classification and sub-classification of SCZ using EEG data is optimal and might help in improving the "validity" and reducing the "heterogeneity" in the diagnosis of SCZ. These results might only be generalized to acute and moderately ill male SCZ patients.

An ovarian spheroid based tumor model that represents vascularized tumors and enables the investigation of nanomedicine therapeutics

The failure of cancer therapies in clinical settings is often attributed to the lack of a relevant tumor model and pathological heterogeneity across tumor types in the clinic. The objective of this study was to develop a robust in vivo tumor model that better represents clinical tumors for the evaluation of anti-cancer therapies. We successfully developed a simple mouse tumor model based on 3D cell culture by injecting a single spheroid and compared it to a tumor model routinely used by injecting cell suspension from 2D monolayer cell culture. We further characterized both tumors with cellular markers for the presence of myofibroblasts, pericytes, endothelial cells and extracellular matrix to understand the role of the tumor microenvironment. We further investigated the effect of chemotherapy (doxorubicin), nanomedicine (Doxil®), biological therapy (Avastin®) and their combination. Our results showed that the substantial blood vasculature in the 3D spheroid model enhances the delivery of Doxil® by 2.5-fold as compared to the 2D model. Taken together, our data suggest that the 3D tumors created by simple subcutaneous spheroid injection represents a robust and more vascular murine tumor model which is a clinically relevant platform to test anti-cancer therapy in solid tumors.

The effects of process technology on the physicochemical properties of peony seed oil

Peony seed oils (PSOs) were prepared using supercritical CO2 (SC) and compared with soxhlet extraction (SE) and mechanical screw press extraction (SPE) methods. The fatty acid compositions of the oils were determined, and the physicochemical properties of the oils, including free radical-scavenging activity, α-amylase and α-glucosidase inhibition, thermal and rheological properties were evaluated. The unsaturated fatty acids in the SE oils were higher than SC and SPE oils due to the higher percentage of olefinic, allylic methylene and allylic methine protons in the SE oils. The SPE oils also displayed the highest DPPH and ABTS+ radical scavenging activity at the tested concentrations. However, the SE oils showed stronger inhibitory effects on α-amylase and α-glucosidase enzymes under in vitro conditions when compared with the other oil samples. The three oils had similar melting and crystalline point due to similar contents of fatty acids (FAs). The SC oils had a lower Ea than the others.

Bacteriological profile and antibiotic sensitivity pattern of neonatal septicaemia in a rural tertiary care hospital in North India

BACKGROUND

There is not much published literature on neonatal septicemia available for the Sub-Himalayan region of North India. Hence, we undertook this study to find out the bacteriological profile and antibiotic sensitivity pattern of neonatal septicemia in the neonatal Intensive Care Unit.

MATERIAL AND METHODS

Blood cultures were performed for all clinically suspected neonatal septicemia cases for 1-year. Identification of all pathogenic isolates was followed by antibiotic sensitivity testing.

RESULTS

We did blood cultures for 450 neonates and 42% were culture positive. Early onset sepsis were 92 (49%) and 96 (51%) were late onset sepsis. Gram-positive isolates were 60% and 40% were Gram-negative. Staphylococcus aureus (40%), coagulase negative Staphylococcus species (16%), non-fermenter group of organisms (NFGOs) (15%), and Klebsiella pneumoniae (10%) were the main isolates. Nasal cannula 101 (54%), birth asphyxia 91 (48%), and prematurity 73 (38%) were the prominent risk factors associated with septicemia. Gram-positive organisms were highly resistant to penicillin (87%) whereas Gram-negative isolates showed high resistance to third generation cephalosporins (53-89%) and aminoglycosides (50-67%). The S. aureus isolates were methicillin-resistant in 41% whereas extended spectrum beta lactamase production was seen in 48% Gram-negative isolates.

CONCLUSION

Our study highlights the recent emergence of Gram-positive organisms as predominant cause of neonatal septicemia in this part of Sub-Himalayan region, along with the review of literature which shows similar results from North India and rest of the world too. Though Gram-negative bacteria still remain the main cause of mortality in neonatal septicemia, we want to dispel the common notion among practitioners that they are the predominant isolates in neonatal septicemia.

Pediatric tuberculous meningitis: Model-based approach to determining optimal doses of the anti-tuberculosis drugs rifampin and levofloxacin for children

Pediatric tuberculous meningitis (TBM) is a highly morbid, often fatal disease. Standard treatment includes isoniazid, rifampin, pyrazinamide, and ethambutol. Current rifampin dosing achieves low cerebrospinal fluid (CSF) concentrations, and CSF penetration of ethambutol is poor. In adult trials, higher-dose rifampin and/or a fluoroquinolone reduced mortality and disability. To estimate optimal dosing of rifampin and levofloxacin for children, we compiled plasma and CSF pharmacokinetic (PK) and outcomes data from adult TBM trials plus plasma PK data from children. A population PK/pharmacodynamic (PD) model using adult data defined rifampin target exposures (plasma area under the curve (AUC)0-24 = 92 mg*h/L). Levofloxacin targets and rifampin pediatric drug disposition information were literature-derived. To attain target rifampin exposures, children require daily doses of at least 30 mg/kg orally or 15 mg/kg intravenously (i.v.). From our pediatric population PK model, oral levofloxacin doses needed to attain exposure targets were 19-33 mg/kg. Our results provide data-driven guidance to maximize pediatric TBM treatment while we await definitive trial results.

Meningitis caused by Rhodotorula rubra in an human immunodeficiency virus infected patient

Rhodotorula spp. are common saprophytes but may be responsible for systemic infections in immunocompromised patients. Meningitis caused by Rhodotorula spp. in human immunodeficiency virus (HIV) infected patients has been reported only rarely. We present a case of meningitis caused by Rhodotorula rubra in HIV infected patient. The presumptive diagnosis of cryptococcal meningitis was made on the basis of India ink preparation, Gram staining and latex agglutination test (LAT) for cryptococcal antigen. The final diagnosis was confirmed by isolation of Rhodotorula rubra from cerebrospinal fluid on culture. LAT was considered false positive. Amphotericin B and 5-fluorocytosine were administered but the patient succumbed to his illness.

Cranial vault Salmonella osteomyelitis leading to extradural abscess - a case report

A case of rarely encountered Salmonella typhi osteomyelitis of left occipital bone leading to extradural abscess, is reported. The causative organism was not suspected until the culture report was obtained. The patient responded promptly to surgical drainage and antibiotic therapy.

Bacterial indices of drinking water from natural sources

Two hundred forty samples of water from twenty natural sources were subjected to the study for the detection of four bacterial indicators of faecal pollution. The samples were subjected to the detection of coliform, faecal coliform, E. coli, S. faecalis, Cl. welchii and plate count at 37 degrees C and 22 degrees C. All these samples were found unfit for human consumption. MPN for coliforms, E. coli and S. faecalis varied from 3 to 1800 per 100 ml of water, sero to 1800 per 100 ml water and zero to 540 per 100 ml of water respectively. Plate count at 37 degrees C and 22 degrees C varied from 2.5 x 10(3) to > 150 x 10(3) per ml of water. Cl. welchii was detected in 30.4% samples in rainy season and high plate count at 37 degrees C and 22 degrees C was observed during the same period.

Shima drinking water--a bacteriological analysis

300 water samples, 60 from piped supply and 240 from 20 natural sources were analyzed bacteriologically for four important bacterial indicators every month over a period of one year. The MPN of total coliforms, Escherichia coli, Streptococcus faecalis were detected by multiple tube method and Clostridium perfringens was isolated using litmus milk medium. From piped water supply, only one sample was found unfit for human consumption. The plate count at 37 degrees C and 22 degrees C varied from 0.5 x 10(3) to 15 x 10(3) per ml. of water. From natural sources, MPN indices for coliforms, Esch. coli and S. faecalis varied from 3 to > 1800, 0 to > 1800 and 0 to 540 per 100 ml. of water respectively. About 1/3rd of samples showed presence of Cl. perfringens. The plate count varied from 1.0 x 10(3) to > 150 x 10(3) per ml. of water. Salmonella typhi was isolated in 1.25% samples by membrane filtration technique. The water from all the natural sources was unfit for human consumption whereas piped water supply was of good quality in general.

Health awareness and treatment compliance of high blood pressure among women in a peri-urban colony of Chandigarh, India

Health awareness is a central issue in the control of hypertension. In a cross-sectional survey among 1727 women of > 30 years, 2 blood pressure recordings were done in 1686 cases. The prevalence of hypertension was found to be 13.1% (221 out of 1686 cases). A random sub sample of 72 hypertensive women above 30 years of age from a peri-urban colony of Chandigarh was selected to find out health awareness and treatment compliance of hypertension. Sixty-three (87.5%) of the selected women were aware of their high blood pressure. However, only 12 women (16.7%) who were on treatment had achieved control of blood pressure (< 140/90 mm Hg). Main reasons for discontinuing the treatment were ignorance about the need of regular treatment (33.3%), high cost of medicines (19.44%) and non-availability of a family member who can go with the patient to hospital (9.72%). Twenty-six (36.1%) hypertensive women did not know the importance of weight reduction for controlling high blood pressure. Twenty-three (31.9%) hypertensive women were currently smoking. A comprehensive health education approach involving health care professionals, patients and general population should be launched to improve the care of hypertensives in the community.

Use of self-expanding metallic stents in the management of obstruction of the sigmoid colon

OBJECTIVE

The purpose of our study was to evaluate the clinical efficacy of a new self-expanding metallic endoprosthesis in the management of distal colonic obstruction in seven patients. CONCLUSION. The Wallstent enteral endoprosthesis is safe and effective in relieving obstruction in patients with resectable colonic tumors. Once in place, the Wallstent permits planned elective surgery and avoids a temporary stoma. In addition, the Wallstent can palliate patients with obstruction due to advanced colonic neoplasms. The results of our preliminary study are promising and show a low incidence of complications.