Significance of Laboratory Markers in Predicting the Severity of COVID-19 in the Central Reserve Police Force Front-line Workers with a Review of Literature

COVID-19 disease has variable clinical presentations, ranging from asymptomatic to mild symptoms to severe manifestation with pneumonia, acute respiratory distress syndrome, septic shock, disseminated intravascular coagulation, and/or multiple organ failure. The real?time reverse transcription–polymerase chain reaction is gold standard test for severe acute respiratory syndrome?coronavirus?2 detection. In the present study, we aimed to predict the significance of various hematological and biochemical markers for early identification of complications and assessing the severity of the disease. A total of cases were divided into two study groups, namely, severe and nonsevere based on clinical presentation. Out of 210 cases, 186 (88.5%) cases were nonsevere and 24 (11.5%) cases were severe. Among various hematological and biochemical markers studied, hemoglobin, total leukocyte count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, albumin, lactate dehydrogenase, C?reactive protein, ferritin, D?dimer, and interleukin?6 are found to have P < 0.05 and significantly correlated with the severity of disease.

A Study of Autonomic Dysfunction in Elderly Age.

Background: Sympathetic and parasympathetic autonomic nervous system act in opposition to each other which enable us to perform our regular functions and maintain the state of the body. Disorders of the autonomic nervous system may result from disorders of the central and the peripheral nervous system. In the elderly, autonomic neuropathy, orthostatic hypotension is prevalent leading to cognitive slowing, hypo or hyperthermia, loss of sweating etc. Methods: 50 elderly patients with no hypertension, Diabetes mellitus, ischemic heart disease and arrhythmias, without addictions and habituations were studied for autonomic dysfunction based on clinical symptoms and using different tests including HR variability with deep respiration, HR Response to Valsalva maneuver, HR response to standing, BP response to standing and SBP response to Valsalva maneuver. Results: We found that the autonomic dysfunction was more prominent in the age above 60 years and more so in males than females. Postural hypotension such as dizziness, blacking out, loss of consciousness, impaired cognition, Calf Claudication was the most common symptom followed by gastric and urinary tract disturbances. There was a significant decline in the heart rate variability but not so much in the BP response test. The decline in the HRV was equal in both males and females showing no disparity between the sexes. Conclusion: The indices based in the heart rate differences are more suitable for assessment of autonomic disturbances in the elderly than BP response tests.

Socio-economic & demographic determinants of hypertension & knowledge, practices & risk behaviour of tribals in India.

Background & objectives: An increase in prevalence of hypertension has been observed in all ethnic groups in India. The objective of the present study was to estimate prevalence and determinants of hypertension among tribals and their awareness, treatment practices and risk behaviours in nine States of India. Methods: A community based cross-sectional study adopting multistage random sampling procedure was carried out. About 120 Integrated Tribal Development Authority villages were selected randomly from each State. From each village, 40 households were covered randomly. All men and women ≥ 20 yr of age in the selected households were included for various investigations. Results: A total of 21141 men and 26260 women participated in the study. The prevalence of hypertension after age adjustment was 27.1 and 26.4 per cent among men and women, respectively. it was higher in the states of Odisha (50-54.4%) and Kerala (36.7-45%) and lowest in Gujarat (7-11.5%). The risk of hypertension was 6-8 times higher in elderly people and 2-3 times in 35-59 yr compared with 20-34 yr. Only <10 per cent of men and women were known hypertensives and more than half on treatment (55-68%). Men with general and abdominal obesity were at 1.69 (CI: 1.43-2.01) and 2.42 (CI: 2.01-2.91) times higher risk of hypertension, respectively, while it was 2.03 (CI=1.77-2.33) and 2.35 (CI 2.12-2.60) times higher in women. Those using tobacco and consuming alcohol were at a higher risk of hypertension compared with the non users. Interpretation & conclusions: The study revealed high prevalence of hypertension among tribals in India. Age, literacy, physical activity, consumption of tobacco, alcohol and obesity were significantly associated with hypertension. Awareness and knowledge about hypertension and health seeking behaviour were low. Appropriate intervention strategies need to be adopted to increase awareness and treatment practices of hypertension among tribals.

Benign on cytology, malignant on histopathology: Coexistence of Hashimoto’s thyroiditis with Papillary carcinoma of thyroid.

Papillary thyroid carcinoma (PTC) and Hashimoto’s thyroiditis (HT) are common diseases in clinical practice. Hashimoto’s thyroiditis is the most common autoimmune thyroid disease and the most common cause of hypothyroidism. It is characterized by diffuse lymphocyte infiltration, fibrosis, and parenchymal atrophy. Papillary thyroid carcinoma is the most common malignant neoplasm of the thyroid. There is a high prevalence of association between HT and PTC FNAB is useful for diagnosing PTC in patients with HT associated thyroid lesions. The presence of HT in patients with PTC was associated with disease presentation at an earlier stage, less aggressive clinical course and better outcome. Here we have presented a case of hashimoto's thyroiditis with papillary thyroid carcinoma in a 37 years old female who came with complaints of swelling in front of neck. Cytology and radiology showed features of HT but, on histopathology it was diagnosed as HT with PTC.

Lactating adenoma of the breast: A case report.

Lactating adenomas are rare benign tumors of breast, frequently associated with pregnency and lactation. They are common in the third trimester of pregnancy during second and third decade. They present similarly as other benign lesions of breast and differentiation from them preoperatively is difficult both clinically and radiologically. it is characterised by typical changes of secretory epithelium leading to formation of a well-diffrentiated benign tumor. Cytology and histopathology remains the definitive tests for confirming the diagnosis. Surgery is the treatment of choice. They tend to regress spontaneously and prognosis is generally good. Here we have presennted such a rare case of lactating adenoma arising from 28 years old lactating women.

Incidentally detected carcinoma in situ in a fibroadenoma of breast in a postmenopausal woman: A case report.

Fibroadenomas are the most common benign tumor of the breast. it can occur in women of any age but the peak incidence seen in young adolescent women during the second and third decades of life, Fibroadenoma is a biphasic tumor, composed of an epithelial and a stromal component. Even though they are solitary lesions, multiple fibroadenomas can also occur especially in the older age group. Breast fibroadenomas seemed to display a wide spectrum of proliferative and non-proliferative histologic changes. Of all these changes, carcinoma arising from fibroadenoma is a rare occurrence. Here, we have presented such a rare case of carcinoma in situ arising from the long standing multiple fibroadenoma in a postmenopausal women. Clinical and radiological features are not helpful in identifying carcinoma arising from fibroadenoma. Histopathological examination of the excised specimen should be done for the confirmation of the diagnosis.

Malignant gastrointestinal stromal tumors (GISTs) of the duodenum – A rare occurrence: Case report.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal (GI) tract. Most of the cases are located in the stomach followed by the small intestine. They arise from the interstitial cells of cajal, which are located in the wall of the intestine. Malignant GISTs are rare type of tumors in GIT. Small intestine GIST is more likely to be malignant compared to stomach. Here we reported such a rare case of malignant GIST in a 54 years old female patient who came to the hospital with complaints of pain and mass in abdomen. Ultrasound revealed a mass originating from the duodenum. Provisional clinical diagnosis of duodenal carcinoma was considered preoperatively. Patient underwent complete surgical excision of the tumor. Histopathological examination confirmed the diagnosis of malignant GIST. As the recurrence rate for malignant GIST is high, patient was kept on follow up.

Adenosquamous carcinoma of stomach: A rare entity – Case report.

Primary gastric adenosquamous carcinomas are rare and constitute less than 0.5% of all gastric malignancies. They are common in males and seen in sixth decade of life. These tumors are composed of both adenocarcinoma and squamous cell carcinoma in varied proportions. Here we have presented such a rare case in a 47 years old male patient who presented with complaints of abdominal pain and bleeding. Routine investigations were normal except for mild anemia. Upper gastrointestinal endoscopy revealed ulcerartive lesion in the pyloric antrum. Histopathological examination confirmed the diagnosis of adenosquamous carcinoma. They are aggressive tumors and have worse prognosis compared to adenocarcinomas hence, follow up is necessary.

Surgery -First Approach in Orthognathic Surgery- A Case Report.

The surgery-first approach (SFA) or Surgery-first Orthognathic approach (SFOA) without pre-surgical orthodontic treatment, has become favoured in the treatment of dentomaxillofacial deformities. Conventional orthognathic surgery treatment involves orthodontic interventions both before and after orthognathic surgery, making the total treatment period of 3-4 years and temporary worsening of facial profile. Surgery-first approach involves orthognathic surgery being carried out first, followed by orthodontic treatment to align the teeth and occlusion and it takes the advantage of corticotomy- facilitated orthodontics allowing rapid tooth movement thus reducing treatment duration. The purpose of this article is to present a case of skeletal class III malocclusion treated with surgery-first approach with emphasis on selection of case, treatment protocol, indications, advantages and disadvantages of surgery-first approach.

In-vitro and in-vivo anti-inflammatory activity of Andrographis serpyllifolia (Rottl. Ex Vahl.) Wt.

The study was aimed to evaluate the analgesic and anti-inflammatory activity (by both in-vitro and in-vivo) of both chloroform and methanol root extracts of Andrographis serpyllifolia (Rottl. Ex Vahl.) Wt. Methods used for the studies were In-vitro 5-Lipoxygenase inhibition assay and In-vivo measurement of rat paw edema and ear edema in rats, acetic acid induced writhing response and hot plate method in albino mice. Chloroform and methanolic extracts of A. serpyllifolia root have shown moderate potency in inhibiting 5-LOX and shown significant anti-inflammatory activity. Despite the IC50 values are little higher, anti-inflammatory efficacy of these extracts possibly due to other mechanisms apart of 5-LOX inhibition. However, In-vivo anti-inflammatory studies revealed that A. serpyllifolia methanolic extract has shown higher degree of efficacy when compared to the chloroform extract. In terms of analgesic activity in writhing test, methanolic extract has shown more efficacy than chloroform extract. Hence, it is important to isolate the active principles for further testing the anti-inflammatory efficacy.

In-vitro and in-vivo anti-inflammatory activity of Andrographis serpyllifolia (Rottl. Ex Vahl.) Wt.

The study was aimed to evaluate the analgesic and anti-inflammatory activity (by both in-vitro and in-vivo) of both chloroform and methanol root extracts of Andrographis serpyllifolia (Rottl. Ex Vahl.) Wt. Methods used for the studies were In-vitro 5-Lipoxygenase inhibition assay and In-vivo measurement of rat paw edema and ear edema in rats, acetic acid induced writhing response and hot plate method in albino mice. Chloroform and methanolic extracts of A. serpyllifolia root have shown moderate potency in inhibiting 5-LOX and shown significant anti-inflammatory activity. Despite the IC50 values are little higher, anti-inflammatory efficacy of these extracts possibly due to other mechanisms apart of 5-LOX inhibition. However, In-vivo anti-inflammatory studies revealed that A. serpyllifolia methanolic extract has shown higher degree of efficacy when compared to the chloroform extract. In terms of analgesic activity in writhing test, methanolic extract has shown more efficacy than chloroform extract. Hence, it is important to isolate the active principles for further testing the anti-inflammatory efficacy.

Duplex-immunocapture-RT-PCR for detection and discrimination of two distinct potyviruses naturally infecting sugarcane (Saccharum spp. hybrid).

A sensitive duplex-immunocapture-RT-PCR (D-IC-RT-PCR) technique was developed for detection and discrimination of taxonomically distinct Sugarcane streak mosaic virus (SCSMV) and Sugarcane mosaic virus (SCMV) that naturally infect sugarcane. D-IC-RT-PCR was performed using polyclonal antisera for capture of virions. Oligo 5′-d(T)18(AGC)-3′ as a common reverse primer for both viruses and virus specific forward primers, 5′-aagtggttaaacgcctgtgg-3′ and 5′-ATGTC(GA)AAGAA(GA)ATGCGCTTGC-3′ were used for amplifying ~1400 and ~900 bp fragments of SCSMV and SCMV genomes, respectively from their 3′ termini. To assess the applicability of the developed technique, 67 mosaic affected sugarcane samples were initially screened by direct antigen coating-enzyme-linked immunosorbent assay (DAC-ELISA) followed by D-IC-RT-PCR. In DAC-ELISA, ~69 % of tested samples were shown to be positive for presence of SCSMV, ~28 % for SCMV and ~10 % for both viruses. In D-IC-RT-PCR both viruses were detected up to the dilution of 10-4. In D-IC-RT-PCR, ~76 % of tested samples were found to be positive for SCSMV, ~37 % for SCMV and ~16 % for both viruses. The sequence analyses of D-IC-RT-PCR amplicons of 3 isolates of each virus revealed that the designed primers were virus-specific. The developed technique had potential application for sensitive parallel detection of two viruses in sugarcane.

Institutional support for planning, production and marketing of products produced by women entrepreneurs.

The results of the study indicated that majority of the women entrepreneurs were seeking support from District Industries Centre, Khadi and Village Industries Board and Janasikshna Seva Samastan. Among planning, production and marketing support, TBMPP and NIRD was providing maximum planning support followed by K&VIB and DIC was providing maximum production support and K&VIB and ALEAP was providing maximum marketing support to the women entrepreneurs. Among all the institutions, K&VIB, ALEAP and DIC were providing maximum overall support to the women entrepreneurs.

INDeGenIUS, a new method for high-throughput identifi cation of specialized functional islands in completely sequenced organisms.

Genomic islands (GIs) are regions in the genome which are believed to have been acquired via horizontal gene transfer events and are thus likely to be compositionally distinct from the rest of the genome. Majority of the genes located in a GI encode a particular function. Depending on the genes they encode, GIs can be classifi ed into various categories, such as ‘metabolic islands’, ‘symbiotic islands’, ‘resistance islands’, ‘pathogenicity islands’, etc. The computational process for GI detection is known and many algorithms for the same are available. We present a new method termed as Improved N-mer based Detection of Genomic Islands Using Sequence-clustering (INDeGenIUS) for the identifi cation of GIs. This method was applied to 400 completely sequenced species belonging to proteobacteria. Based on the genes encoded in the identifi ed GIs, the GIs were grouped into 6 categories: metabolic islands, symbiotic islands, resistance islands, secretion islands, pathogenicity islands and motility islands. Several new islands of interest which had previously been missed out by earlier algorithms were picked up as GIs by INDeGenIUS. The present algorithm has potential application in the identifi cation of functionally relevant GIs in the large number of genomes that are being sequenced. Investigation of the predicted GIs in pathogens may lead to identifi cation of potential drug/vaccine candidates.

Assembly of recombinant coat protein of sugarcane streak mosaic virus into potyvirus-like particles.

Coat protein (CP) gene of sugarcane streak mosaic virus-AP isolate (SCSMV-AP) was expressed in E. coli and recombinant CP (SCSMV-AP rCP) was purified by linear sucrose density gradient centrifugation. Observation of purified SCSMV-AP rCP under electron microscope revealed the presence of potyvirus-like particles (PVLPs). The assembled particles were shown to encapsidate CP gene transcripts by slot-blot hybridization.

Studies on exhaust emissions of catalytic coated spark ignition engine with adulterated gasoline.

Adulteration of automotive fuels, especially, gasoline with cheaper fuels is widespread throughout south Asia. Some adulterants decrease the performance and life of the engine and increase the emission of harmful pollutants causing environmental and health problems. The present investigation is carried out to study the exhaust emissions from a single cylinder spark ignition (SI) engine with kerosene blended gasoline with different versions of the engine, such as conventional engine and catalytic coated engine with different proportions of the kerosene ranging from 0% to 40% by volume in steps of 10% in the kerosene-gasoline blend. The catalytic coated engine used in the study has copper coating of thickness 400 microns on piston and inner surface of the cylinder head. The pollutants in the exhaust, carbon monoxide (CO) and unburnt hydrocarbons (UBHC) are measured with Netel Chromatograph CO and HC analyzer at peak load operation of the engine. The engine is provided with catalytic converter with sponge iron as a catalyst to control the pollutants from the exhaust of the engine. An air injection is also provided to the catalytic converter to further reduce the pollutants. The pollutants found to increase drastically with adulterated gasoline. Copper-coated engine with catalytic converter significantly reduced pollutants, when compared to conventional engine.