Preparedness of Healthcare Facilities of Manipur in the Management of Noncommunicable Diseases: A Cross-Sectional Study

Background: India is experiencing a rapid health transition with a rising burden of noncommunicable diseases (NCDs), causing significant morbidity and mortality. Cost?effective interventions for comprehensive NCD management can only be designed after assessing the readiness of various health facilities. Objectives: This study aimed to assess the preparedness of healthcare facilities of Manipur in the management of NCDs and to assess the knowledge of doctors regarding NCDs. Methods: A cross?sectional study was conducted in 21 public healthcare facilities in seven districts of Manipur during October 2021. Readiness of these facilities was assessed through observation and interview of doctors and nurses using a checklist adapted from the WHO Package of Essential NCDs. Knowledge of 153 doctors was also assessed using a self?administered, structured questionnaire. Data were entered in SPSS?26 and expressed using descriptive statistics. Results: General readiness index of primary health centers(PHCs), community health centers(CHCs), district hospitals(DHs), and tertiary care centers(TCCs) was 47%, 66.3%, 73.2%, and 70%, respectively. CHCs were ready in the domains of patient care services (80%), human resources (75%), and advocacy (91.7%). DHs and TCCs were ready in terms of patient care services, human resources, record maintenance, referral system, and advocacy. PHCs were not ready in any of the nine domains. Majority of the doctors (88%) had inadequate knowledge regarding NCDs. Conclusion: PHCs and CHCs were not adequately prepared, but DHs and TCCs were ready to manage NCDs. More than four?fifth of the doctors had inadequate knowledge. Strengthening PHCs and CHCs and training of healthcare workers are needed for integrated NCD management.

Lagophthalmos: An etiological lookout to frame the decision for management

Purpose: To describe the etiology, clinical profile, duration of lagophthalmos cases and thereby, framing a decision for the management based on the severity of Exposure keratitis (EK), Facial palsy (FP) with each etiology and to describe the outcome of the management options. Methods: The method was a prospective review of 120 lagophthalmos cases treated at a single tertiary center from January 2018 to January 2019. The main outcome measures were analysing the association between age, etiology, duration and management of lagophthalmos. Results: Of the 120 patients studied, paralytic etiology was noted in 86 and eyelid etiology in 34 patients. The percentage of various lagophthalmos etiology documented were Bell’s palsy (35.83%), lagophthalmos in ICU patients (15%), traumatic facial palsy(FP) (10.80%), stroke associated FP (6.67%), infection associated FP (6.67%), iatrogenic FP, cicatricial lagophthalmos (5%), lagophthalmos post eyelid surgeries (5%), neoplastic FP(3.33%), congenital FP (1.67%), proptosis induced lagophthalmos (1.67%), floppy eyelid syndrome induced lagophthalmos (0.83%) and lid coloboma associated lagophthalmos (0.83%). A statistically significant correlation was noted between exposure keratitis and age, with an increased prevalence age advances. The management showed significant variation with individual etiology, with some etiologies unquestionably requiring surgical management. Surgical management is crucial as the duration of lagophthalmos increases more than 6 weeks, EK involving pupillary axis and poor FP recovery. Conclusion: This study concludes that the conservative management was sufficient in all cases when the duration is less than 1 week, Exposure keratitis not involving the pupillary axis (EK< Grade II) and FP with good functional recovery ( FP < Grade III). The predominant causes being Bell’s palsy, lagophthalmos in ICU patients and vascular FP. Whereas, cases with poor functional recovery of facial palsy(FP) and permanent eyelid deformation require definitive surgical management like Traumatic FP & cicatricial lagophthalmos

An open-label, exploratory documentation of proving-symptoms of CVN01 (Coronavirus nosode from the clinical sample) in healthy volunteers

Homeopathic Pathogenetic Trials (Proving) are human studies to examine the pathogenetic effects of investigational drugs in high dilution on healthy volunteers. As a part of the new coronavirus nosode development process for prophylactic use, the phase 1 study was conducted. The documentation of proving symptoms for a fast-track nosode development for a pandemic condition was the objectives of this study. An open-label trial to evaluate the safety and proving symptoms of Coronavirus nosode given orally to 10 volunteers (18-65 years age and of both the genders). Volunteers were administered 6 doses of nosode as 6 pills twice daily for 3 consecutive days. Pre and post examinations (physical), vital signs, and laboratory investigations, were done at day 0, 17, 34. Symptoms experienced by the volunteers were recorded. RESULTS Symptoms reported by volunteers were analyzed. The symptoms reported were mild to severe but reversible and matching with the symptoms produced by the viral infection. There were no serious/fatal adverse events during the study. The basic biochemistry and Liver Function tests were not affected by the Nosode. New nosode developed during a pandemic condition produced certain symptoms in the homeopathic pathogenetic trial as a part of the Phase 1 study.

Role of total calcium and corrected calcium in comparisons with computed tomography to predict severity of acute pancreatitis

Background: The objective of the study was to evaluate corrected calcium levels in patient of acute pancreatitis and to evaluate role of corrected calcium as predictor of severity in acute pancreatitis in comparison to computed tomography (CT) scan.Methods: The study was conducted in Department of Biochemistry of G.G.S Medical College in collaboration with the Department of Surgery and Department of Radio diagnosis. 50 patients, with clinical diagnosis of acute pancreatitis, attending the Inpatient Department of Department of Surgery, were taken. 50 patients, of either sex of 18 to 70 age groups suffering from acute pancreatitis were enrolled for the study.Results: On exploring the data, highly significant negative correlation found between CT severity index (CTSI) and serum calcium (p≤0.001; r value=-0.520) whereas the non-significant correlation found between CTSI and amylase (p=0.778; r value=-0.041). The corrected calcium and CTSI shows highly negative significant correlation (p≤0.001; r value=-0.654). Serum albumin with CTSI also shows significant correlation (p=0.006; r value=0.385). But no significant association with lipase (p≥0.05).Conclusions: We observed that corrected calcium and calcium is better and alternative marker for predicating the severity of disease because corrected calcium and calcium is having good positive predictive value to indicate progression of damage and also a highly significant negative predictive value to rule out severity of acute pancreatitis.

IGF-1 Gene Polymorphism in Migratory Gaddi Goats of Western Himalayan Region, India

Goat production is a predominant livestock activity in harsh climatic regions of the country particularly hilly regions. ‘Gaddi’ is a prominent goat breed of Himachal Pradesh constituting 60-65% of total goat population of 11.20 lakh (19th Livestock Census, 2012). The somatotropic axis has a key role in postnatal growth and metabolism. IGF-1 gene encodes the protein that is structurally and functionally similar to insulin and regulates cellular synthesis of DNA as well as cellular growth and development, especially in neurons and also mediates the effect of GH gene. The present study was carried onÊ»Gaddiʼ, a distinct goat breed of high altitude areas of Western Himalayan region, for molecular characterization of IGF-1 gene and further analyse its association with growth traits. Blood samples from 63 genetically unrelated animals of Gaddi goat breed were taken from the migratory flocks under AICRP and Gaddi goat unit of CSKHPKV, Palampur and subjected to DNA isolation. 363 bp amplicon was generated and PCR-RFLP analysis using HaeIII restriction enzyme (RE) revealed two variants (AB and BB) however, no significant association could be established. Allele frequencies for A and B alleles were 0.25 and 0.75. The estimates obtained for Ne, Hobs, Hexp and PIC were 1.61, 0.51, 0.38 and 0.31, respectively. PIC value of 0.31 implies the effectiveness of the marker in population studies and also revealed median level of polymorphism. Sequencing confirmed one nucleotide mutation (C264G), however, no significant association were found at IGF-1 genotype with biometric traits in screened Gaddi goats

Preparation of Coronavirus nosodes sourced from a clinical sample of SARS-Cov-2 positive patient, inactivated strain, and spike glycoprotein

IntroductionNosodes, the homeopathicpreparationssourcedfrom biological materials including clinical samples, cultures of organisms, and diseased tissues have been in use against the source-specific infections as well as other diseases. The nosodes have demonstrated some efficacy in managing epidemics, such as influenza, dengue, and leptospirosis.This article presents the need and process of development ofnosodes from the SARS-CoV-2 to explore its prophylactic and therapeutic potentials against certain related viral diseases.Materials and methodsA clinical sample of SARS-Cov-2 positive patient,based on the cycle threshold (CT) value of the qRT-PCR, heat-inactivated SARS-CoV-2, and spike glycoprotein all were processed for making nosodesas per the method described in Homoeopathy Pharmacopoeia of India.Molecular tests, such as qRT-PCR and sterility tests were performed to establish the live organisms, RNA material, and the absence of contamination.ResultsThree variants of CoronavirusNosodewere developed using a clinical sample,heat-inactivatedSARS-CoV-2, and spike glycoprotein.In potencies 3c and above, no detectableSARS-CoV-2 RNA material was found by PCR.The analytical results for nosodes were reported as compliant for sterility testing as per the IP.ConclusionThree variants of Coronavirus nosodes were preparedwhich need to be evaluated further through pre-clinical and clinical studies.(AU)

Association between dietary sodium intake and disease burden and mortality in Koreans between 1998 and 2016: The Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES@#Sodium intake is positively associated with blood pressure, which may increase the risk for cardiovascular disease (CVD). Therefore, we assessed the disease burden of CVD attributable to sodium intakes above 2,000 mg/day and prospectively investigated the association between dietary/urinary sodium levels and the risk of all-cause and CVD-mortality using the Korea National Health and Nutrition Examination Survey (KNHNES). @*SUBJECTS/METHODS@#A total of 68,578 and 33,113 participants were included for comparative risk assessment (CRA) analysis and mortality analysis, respectively, and mean follow-up time for mortality was 5.4 years. CRA analysis was used to quantify attributable incidences of stroke, ischemic heart disease (IHD), and deaths attributable to sodium intake between 1998 and 2016. Cox proportional hazard regression model was used to determine the association between sodium intake and all-cause and CVD-mortality. @*RESULTS@#Mean dietary sodium intake decreased over time, reaching 3,647 mg/day in 2016.Similarly, the population attributable fractions of stroke and IHD, and the number of CVDassociated deaths attributable to high sodium intake/excretion also decreased. In terms of association with mortality, when participants were grouped into quartiles (Q) by energyadjusted sodium intake, those in Q2 had a lower risk of all-cause mortality than those in Q1 with lower intakes. The risk of CVD-associated mortality was higher only in females with high sodium intake in Q4 than those in Q1. @*CONCLUSIONS@#This nationwide data indicates that, in line with previous studies of multiple cohorts, both low and high sodium intakes may be associated with an increased risk of mortality; therefore, the optimal sodium intake for Koreans needs to be revised.

Impact of dietary risk factors on cardiometabolic and cancer mortality burden among Korean adults: results from nationally representative repeated cross-sectional surveys 1998–2016

BACKGROUND/OBJECTIVES@#Dietary factors are important contributors to cardiometabolic and cancer mortality. We examined the secular trends of nine dietary factors (fruits, vegetables, whole grains, nuts and seeds, milk, red meat, processed meat, sugar-sweetened beverages, and calcium) and the associated burdens of cardiometabolic and cancer mortality in Korea using representative cross-sectional survey data from 1998 to 2016. @*SUBJECTS/METHODS@#Using dietary data from Korean adults aged ≥ 25 years in the Korea National Health and Nutrition Examination Survey (KNHANES), we characterized secular trends in intake levels. We performed comparative risk assessment to estimate the population attributable fraction and the number of cardiometabolic and cancer deaths attributable to each dietary factor. @*RESULTS@#A total of 231,148 cardiometabolic and cancer deaths were attributable to nine dietary risk factors in Korea from 1998 to 2016. Suboptimal intakes of fruits and whole grains were the leading contributors. Although the intakes of fruits, vegetables, and whole grains moderately improved over time, the intake levels in 2016 (192.1 g/d, 225.6 g/d, and 10.9 g/d, respectively) remained far below the optimal levels. Deaths attributable to the low intakes of nuts and seeds (4.5 g/d), calcium (440.5 mg/d), and milk (37.1 g/d) and the high intakes of red meat (54.7 g/d), processed meat (4.7 g/d), and sugar-sweetened beverages (33.0 g/d) increased since 1998. Compared with older age groups (≥ 45 years), more unfavorable changes in dietary patterns were observed in the younger population aged 25–44 years, including more sharply increased intakes of processed meat. @*CONCLUSIONS@#We observed improvement in the intakes of fruits, vegetables, and whole grains and unfavorable changes in the intakes of processed meat and sugar-sweetened beverages over the past few decades. Our data suggest that to reduce the chronic disease burden in Korea, more effective nutritional policies and interventions are needed to target these dietary risk factors.

Total antioxidant status in type 2 diabetes mellitus with diabetic nephropathy

Background: Diabetes mellitus has emerged as one of the most common health hazard all over the world. Diabetic nephropathy is the most challenging long term complication of Type 2 Diabetes mellitus and microalbuminuria is the earliest marker of diabetic nephropathy. In diabetes, chronic hyperglycemia and deranged lipid profile lead to excess generation of free radicals. The increased oxidative stress plays a major role in pathogenesis of diabetic complications, including diabetic nephropathy. There are many naturally occurring antioxidant enzymes in our body. Diabetes has multiple effects on protein levels and activity of these antioxidant enzymes. This further augments the oxidative stress. There are many non-enzymatic antioxidants in our body which include vitamins A, C, E and trace minerals like copper, zinc, manganese and selenium.Methods: The study was done on a total of 150 subjects. Group A comprised of 60 Type 2 diabetic patients with diabetic nephropathy, Group B comprised of 60 Type 2 diabetic patients without diabetic nephropathy and Group C comprised 30 healthy controls. Total antioxidant status, microalbuminuria and glycosylated haemoglobin were measured.Results: In present study, authors found that total antioxidant status is drastically reduced in all diabetic patients, and it was found to be further low in patients with diabetic nephropathy. This decrease was found to be directly proportional to the degree of diabetic nephropathy, as measured by the levels of microalbuminuria.Conclusions: Timely institution of antioxidant supplementation therapy may emerge as a promising measure in delaying the onset and progression of diabetic complications, especially diabetic nephropathy.

Hotdog in bun: a recent technique for oophoropexy

Ovarian torsion is an acute gynaecological emergency. It may present at any age group, however it is more common in the reproductive years. The patient may present with a myriad of clinical features which are often non-specific posing a diagnostic dilemma. Ultrasonography is the best initial modality of imaging. Once diagnosed a surgical approach is the mainstay of treatment. Preservation of ovaries and preventing recurrence in young patients is crucial. We present a case of a young adolescent girl diagnosed with an ovarian torsion who was managed laparoscopically. Oophoropexy was done to avoid future recurrence by an emerging method called the “Hotdog in bun” technique.

Preparation of Cancer Nosodes from specific cancer tissues

Nosodes are ultra-dilute preparations made from diseased tissues or organisms used in homeopathy since 1830, more frequently used since 1880. Carcinosin is a commonly used nosode prepared over 100 years ago from cancer tissues in the last part of the nineteenth century, of which the exact scientific information on the histopathological characterization of the source material is not available. The current therapeutic indications of Carcinosin have been largely empirical and clinically derived. In such a scenario, understanding the paramount importance of the Cancer nosode, it's revamping in the light of current scientific knowledge has been identified by the author. Specific cancerous tissue samples were sourced for nosode preparation. Identified pieces of tissue were histopathologically diagnosed, thoroughly washed, quantified and triturated with powder of Saccharum lactis to prepare decimal potencies, as per standard method suggested in the Homoeopathy Pharmacopoeia of India. Centesimal potencies were prepared using electromechanical potentizer, documenting the force parameters. The Cancer nosodes from specific cancer tissues were prepared in a systematic manner, which could be used for research as well as in clinical practice. The author has attempted scientific preparation of new Cancer nosodes making them available to the profession. On similar lines, more of cancer tissues could be explored for making other nosodes. (AU)

A Rare Case Of Accessory Nerve To Mylohyoid Communucating With Lingual Nerve And Its Clinical Implications

Nerve to mylohyoid is a branch of inferior alveolar nerve given just before it enters the mandibular foramen. Itcourses inferior to the origin of mylohyoid and supplies both mylohyoid and anterior belly of digastric along itssuperficial surface. An accessory branch from inferior alveolar nerve was discovered during routine dissection.The nerve was found only on the left side. Additionally, a communicating branch was seen between lingual nerveand accesoory nerve to mylohyoid. Knowledge of the variations of the mandibular nerve, its branches andcommunications are clinically important especially for attaining adequate local anaesthesia during routineoral and dental procedures.

Formulation of Insecticidal Nematode

Insecticidal nematodes or entomopathogenic nematodes (EPNs) in the genera Heterorhabditis and Steinernema are lethal obligate parasites of insect pests. These nematodes carry specific pathogenic bacteria which are released into the insect hemocoel after penetration of the insect host. The economic importance of entomopathogenic nematodes (EPNs) is increasing as the nematodes are amenable for mass production, formulation, handling and application on a large scale and is currently marketed worldwide for use. The objective of the review is to discuss the principles of formulation and quality control, latest development and future perspectives of the EPNs formulation for the successful use of EPNs as bio insecticides.

Burdens of Cardiometabolic Diseases Attributable to Dietary and Metabolic Risks in Korean Adults 2012–2013

PURPOSE: In line with epidemiological and sociocultural changes in Korea over the past decades, reliable estimation of diseases as a result of dietary and metabolic risks is required. In this study, we aimed to evaluate the contributions of dietary and metabolic factors to cardiometabolic diseases (CMDs) in Korean adults (25–64 years old) during 2012–2013. MATERIALS AND METHODS: Distribution of risk factors and cause-specific mortality by gender and age per year was obtained from the Korea National Health and Nutrition Examination Survey and Statistics Korea, respectively. The association between the two was obtained from published meta-analyses. The population-attributable fraction attributable to the risk factors was calculated across gender and age strata (male and female, age groups 25–34, 35–44, 45–54, and 55–64) in 2012 and 2013. RESULTS: The results showed that during the period studied, high body mass index [5628 deaths; uncertainty intervals (UIs): 5473–5781] and blood pressure (4202 deaths; UIs: 3992–4410) were major metabolic risks for CMD deaths, followed by dietary risks such as low intake of whole grain (4107 deaths; UIs: 3275–4870) and fruits (3886 deaths; UIs: 3227–4508), as well as high intake of sodium (2911 deaths, UIs: 2406–3425). Also, males and the younger population were seen more prone to be exposed to harmful dietary risk than their female and older counterparts. CONCLUSION: The findings provide the necessary information to develop targeted government interventions to improve cardiometabolic health at the population level.

In silico structural and functional analysis of protein encoded by wheat early salt-stress response gene (WESR3).

Salt stress is one of the major abiotic stresses limiting grain yield in wheat (Triticum aestivum L.). Wheat early salt-stress response gene (WESR3) is one of the major salt stress genes, which is affected in the first phase of salt stress. In this study, sequence and structural analysis of protein coded by WESR3 gene was carried out using various bioinformatics tools. Sequence analysis of WESR3 protein revealed the presence of highly conserved regions of Mlo gene family. Three-dimensional modeling was carried out to elucidate its structure and its active site. The sequence analysis revealed that WESR3 protein might be involved in fungal pathogen attack pathway. Thus, in addition to its involvement in abiotic stresses, it also seemed to play an important part in biotic stress pathways. Out of the three modeled protein structures obtained from I-TASSER, HHPred and QUARK, the I-TASSER protein model was the best model based on high confidence score and lesser number of bad contacts. The Ramchandran plot analysis also showed that all amino acid residues of I-TASSER model lie in the allowed region and thus indicating towards the overall good quality of the predicted model. Seventeen active sites were predicted in the protein bearing resemblance to the Mlo family conserved regions. In conclusion, a detailed analysis of WESR3 protein suggested an important role of WESR3 in biotic and abiotic stress. These results aid to the experimental data and help to build up a complete view of WESR3 proteins and their role in plant stress response.

Variation in the insertion of the palmaris longus tendon

The palmaris longus is harvested as a tendon graft in various surgical procedures. We herein report the variations in the insertion of the palmaris longus tendon. During a routine dissection, a rare variation in the insertion of the palmaris longus tendon was observed. In the left forearm, the palmaris longus tendon bifurcated, while in the right forearm, the palmaris longus tendon trifurcated, giving rise to an accessory muscle, which passed superficial to the ulnar artery and ulnar nerve. The accessory muscle was supplied by a deep branch of the ulnar nerve, and the ulnar artery was observed to be tortuous. During reconstructive surgeries, surgeons should bear in mind the accessory muscle. Also, since the palmaris longus muscle provides a very useful graft in tendon surgery, every surgeon should be aware of the variations in the insertion of the palmaris longus tendon.

Morphological traits association with fodder and seed yield in Vigna unguiculata (L.).

In cowpea, dual purpose plant types are more preferable for cultivation. Therefore, exotic and indigenous cowpea germplasm lines were evaluated in augmented design to study estimates of the correlation coefficients and path analysis of morphological as well as fodder and grain yield attributes. The present study showed a high impact of direct effects of correlation (0.9714**) and suggested that going for plant types with higher biomass per plant (0.8856**), dry weight per plant (0.4598), stem girth (0.2336) number of secondary branches (0.2788), leaves per plant (0.3251), pods per plant (0.9059) and pod clusters per plant (0.7718) would be effective for improving both fodder and seed yield in cowpea.

Diversity of airborne pollen grains over rice field.

The diversity of airborne pollen grains was studied over Sonapur Rice Field, Kamrup district, Assam. The Burkard personal sampler was used to carry out the aeropalynological survey for the period of two consecutive years from March’08 to February’10. A total of 31 pollen types were reported during the study period. In the present study total number of spores recorded from March’08 to February’09 were 3658 pollen/m3 and from March’09 to February’10 were 4149.58 pollen/m3. The dominant pollen types recorded were, Poaceae, Amaranthaceae/ Chenopodiaceae, Asteraceae and Mimosa pudica. Some allergenically significant pollen types recorded were Amaranthaceae/ Chenopodiaceae, Argemone mexicana Linn., Mangifera indica Linn., Poaceae, Terminalia cuneata Roth. It was observed that entomophilous pollen ranked first in order of dominance.