Application of Otoform to Study Variations of Sinus Tympani: A Novel Technique.

The sinus tympani is a deep pocket of varying dimensions situated in the retrotympanum. It lies medial to the facial nerve thereby making surgical access difficult. It is this area which is frequently involved in chronic otitis media attico-antral type. Removal of disease from sinus tympani is cumbersome and expedites Cholesteatoma Recidivism. In India, very limited studies have been conducted describing the variations of Sinus tympani. Hence, this study is dedicated to estimating it's variations in volume. This is a one-year Observational Cross-sectional study conducted between January 2020 to December 2020 in Temporal Bone Dissection Lab of Department of Otorhinolaryngology and Head and Neck Surgery, J. N. Medical College, KAHER, Belgaum. 40 Human temporal bone (both left and right) have been dissected. The middle ear cavity was filled carefully with a moulding material i.e. Otoform. Once set, a 3-dimensional model of the middle ear cavity was made, which was removed carefully without causing any damage. The volume of the middle ear cavity was calculated. The other contents and parameters were measured using a measuring probe. Forty bones were dissected. The volume of the sinus tympani was measured to be 8.77 cubic mm with a range of 6.5 cubic mm to. 10.9 cubic mm hence showing that sinus tympani show a larger variability in terms of size, shape and volume. The ponticulus was Complete in 65% of the cases (26 bones) and incomplete in 35% of the cases (14 bones). The ponticulus and subiculum were found to be complete in a well pneumatized mastoid bone. The volume of the middle ear cavity was measured to be 1.17 cubic cm. The sinus tympani volume was calculated in this study employing a novel technique called the Otoform mould in cadaveric temporal bones, enabling for accurate measurement. The study concluded that sinus tympani showed a wide range in volume thus owing that it is the structure which has highest variability in terms of size and shape in the middle ear.

Comparing Efficiency Epley and Semont Manoeuvre with Videonystagmography.

Videonystagmography (VNG) is useful and reliable in diagnosing vertigo. Benign Paroxysmal Positional Vertigo (BPPV) is the most common peripheral vestibular disorder in adults, and posterior canal is the commonest canalinvolved. The treatment of choice for posterior canal BPPV is repositioning manoeuvres. Epley and Semontmanoeuvres are the two most commonly used treatment manoeuvres for the management of posterior canalBPPV. In this study, we use VNG to compare the two. Epley Repositioning Manoeuvre was found to be moreeffective than Semont Liberatory Manoeuvre. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03901-3.

Rapid and reliable assaying of Tc-99 in sediment samples with novel MTPN polymeric resin.

The paper describes a new method for the rapid determination of Technetium (Tc) in sediment samples using solid-phase extraction chromatography (SPEC) with a novel methyl triphenyl phosphoniumnitrate (MTPN) resin. The effectiveness of the resin in selectively recovering Tc was evaluated in both batch and column mode and exploited for rapid analysis of 'Tc'. The procedure involves the acid digestion of samples, pre-concentration of fission products in supernatant and co-precipitation of actinides with Fe(OH)3, followed by selective recovery of Tc by SPEC using a column filled with MTPN resin. The recovered Tc was then radiometrically assayed using beta counting. The method was validated using IAEA certified reference materials and was found to provide reliable and reproducible results for the activity concentration of Tc-99 in sediment samples within 24 h.

Comparison of fracture resistance of endodontically treated teeth restored with different aesthetic post and core systems under all ceramic restoration luted with two types of cements.

Context: Fracture of endodontically treated teeth is a grave sequela that a clinician should seriously ponder. Suitable selection of restorative materials is a requisite for long-term clinical success. Aims: To compare the fracture resistance of endodontically treated teeth restored with three different posts luted using two different cements under all ceramic crowns. Settings and Design: This in vitro study was conducted in the Department of Prosthodontics, Government Dental College, Kottayam, Kerala, India. Methods and Material: Thirty endodontically treated single-rooted mandibular premolars in which post spaces were prepared and divided into three different groups. Group 1 (n = 10): zirconia post group. Group 2 (n = 10): quartz fibre post group. Group 3 (n = 10): glass fibre post group. Each group is sub-divided into two based on the luting system: resin-modified glass ionomer cement (RMGIC) or dual-cure resin cement (DCRC). The fracture resistance testing was performed in a universal testing machine with a crosshead speed of 0.5 mm/min. Statistical Analysis Used: The mean fracture resistance were analysed using independent sample Student t-test and one-way ANOVA. Results: : Within the zirconia post group, the mean fracture resistance was higher in DCRC sub-group compared to the RMGIC sub-group and the difference was statistically significant (p = 0.017). The difference in fracture resistance between three different post systems was not found to be statistically significant with respect to both the luting systems. Conclusions: It was observed that when zirconia post is used, the mean fracture resistance was higher in dual-cure resin group compared to the resin-modified GIC group.

Sorption behavior studies of Cs and its migration in soil samples around Visakhapatnam, India.

Meeting the requirement of high specific activity of radioisotopes and carrying out comprehensive research and development activities in the nuclear field, different nuclear facilities, including their waste disposal facilities, are going to be operational at Visakhapatnam, India. Due to environmental processes, the engineered disposal modules may lose their structural integrity and may release some radioactivity to the geo-environment. The subsequent migration of radionuclides reaching the geological environment will be governed by the distribution coefficient (Kd). Cs was chosen for the sorption study in two soil samples (soil-29 and 31) and to estimate the Kd in all the 40 soil samples through the laboratory batch method at the new campus of DAE, Visakhapatnam, India. Different soil chemical parameters like pH, organic matter, CaCO3, and cation exchange capacity were determined in 40 soil samples and their effect on Cs sorption was investigated. The effect of solution pH and initial concentration of Cs on sorption was also studied. The results show that the sorption of Cs increases with increasing pH. The Cs sorption was well explained by Freundlich and Dubinin-Radushkevich (D-R) isotherm models. Site-specific distribution coefficients (Kd) were also estimated and the values were found to vary from 75 ± 1 to 540 ± 12 L kg-1. The observed wide variation in Kd could be due to large variations in the physico-chemical properties of collected soil. The competitive ions effect study suggests that K+ has higher interference for Cs+ sorption as compared to Na+. The present study results will help assess the environmental impact due to Cs release in any unforeseen scenario and in planning effective remediation strategies.

Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India.

BACKGROUND: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. METHODS: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. RESULTS: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. CONCLUSIONS: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.

Discovery of Oral Anticancer 1,2-Bis(hydroxymethyl)benzo[g]pyrrolo[2,1-a]phthalazine Hybrids That Inhibit Angiogenesis and Induce DNA Cross-Links.

Designing hybrid molecules with dual functions is one approach to improve the therapeutic efficacy of combination treatment. We have previously conjugated phthalazine and bis(hydroxymethyl)pyrrole pharmacophores to form hybrids bearing antiangiogenesis and DNA interstrand cross-linking activities. To improve the bioavailability, we adopted a benzology approach to design and synthesize a new series of 1,2-bis(hydroxymethyl)benzo[g]pyrrolo[2,1-a]phthalazines. These new hybrids retained the dual functions and could be formulated into vehicles for intravenous and oral administration. Among them, we demonstrated that compound 19a with dimethylamine at the C6 position markedly suppressed the tumor growth of human small cell lung cancer cell line H526, squamous lung cancer cell line H520, and renal cancer cell line 786-O in nude mice, implying that compound 19a is a broad-spectrum anticancer agent. Our results implicated that the conjugation of antiangiogenic and DNA cross-linking is likely to be a helpful approach to improving the efficacy of combination therapy.

Steroid and fatty acid contents from the leaves of Carica papaya.

AIM: To extract and identify the non-polar entities from the leaves of Carica papaya, a plant used for medicinal purpose as folk medicine. MATERIALS AND METHODS: Petroleum ether extract of the Carica papaya leaves was used for this study. Saponification process and methylation process was performed to separate fatty acids and unsaponifiable matters. Phytochemical constituents were separated using chemical process and separated fractions were analyzed by thin layer chromatography (TLC) and gas chromatography coupled with mass spectroscopy (GC-MS). RESULTS: The chemical composition of the steroids, triterpenoids and fatty acid methyl esters (FAMEs) in leaves of Carica papaya, which were analyzed by gas chromatography coupled with mass spectroscopy (GC-MS). A total of 15 fatty acid components were identified in saponifiable matter, from unsaponifiable portion 2 steroids (campesterol, ß- or γ-sitosterol), 1 triterpene (squalene), and 1 diterpene (phytol) were identified. CONCLUSIONS: The results indicate that the extract is rich in non-polar compounds. In this study, GC-MS method is at the central focus for identification of these phytoconstituents. The current method can be used for direct analysis of non-polar entities of plant material.

Protocol for sampling and analysis of food and agricultural produces consequent to a nuclear accident in India.

Nuclear accidents, despite having an extremely low probability of occurrence, could cause uncontrolled release of radioactive elements (fission and activation products) into the environment, and may ultimately lead to contamination of food products. Such a scenario requires extraordinary measures for control of food, which might be contaminated to a level not suitable for human consumption. Agricultural products (which include grain crops, vegetable, fruits, dairy, meat, eggs and poultry) pass through a series of local, district and state level markets to finally reach consumers. An effective intervention at different stages of distribution by targeted sampling and analysis of suspected (contaminated) foodstuffs will substantially reduce the chances of contaminated food to reach the public. At the same time, it will also ensure food security of the people without imposing unreasonable restrictions in market flow. This can also help in getting the farmers adequately compensated. This paper presents a protocol for sampling and analysis suitable for India, considering the diversity with respect to climate, soil type, land use, crop pattern, population density, etc. The paper also provides an estimate of infrastructure requirement to carry out environmental monitoring following the emergency with respect to human resources and instruments. The paper proposes to use the national web portal for collection of data pertaining to crop pattern, land use and market flow. A web-based decision support system (Web-DSS) on a GIS platform, for sampling, analysis and display of data online would enhance the transparency of decision being taken and enable the administrators to effectively monitor the work flow, details of sample collection, analysis and effective use of human and other resources.

Prognostic utility of the assessment of diastolic function in patients undergoing cardiac resynchronization therapy.

Conflicting data exist about the relationship between cardiac resynchronization therapy (CRT) and diastolic function. Aims of the study are to assess diastolic patterns in patients undergoing CRT according to the 2016 recommendations of the American Society of Echocardiography/European Association of Cardiovascular Imaging and to evaluate the prognostic value of diastolic dysfunction (DD) in CRT candidates. METHODS AND RESULTS: One-hundred ninety-three patients (age: 67 ± 11 years, QRS width: 167 ± 21 ms) were included in this multicentre prospective study. Mitral filling pattern, mitral tissue Doppler velocity, tricuspid regurgitation velocity, and indexed left atrial volume were used to classify DD from grade I to III. CRT-response, defined as a reduction of left ventricular (LV) end-systolic volume > 15% at 6-month follow-up (FU), occurred in 132 (68%) patients. The primary endpoint was a composite of heart transplantation, LV assisted device implantation, or all-cause death during FU and occurred in 29 (15%) patients. CRT was associated with a degradation of DD in non-responders. At multivariable analysis corrected for clinical variables, QRS duration, mitral regurgitation, CRT-response and LV dyssynchrony, grade I DD was associated with a better outcome (HR 0.37, 95% CI: 0.14-0.96). Non-responders with grade II-III DD had the worse prognosis (HR 4.36, 95%CI: 2.10-9.06). CONCLUSIONS: The evaluation of DD in CRT candidates allows the prognostic stratification of patients, independently from CRT-response.

Digital psychiatry and COVID-19: the Big Bang effect for the NHS?

The COVID-19 pandemic has brought untold tragedies. However, one outcome has been the dramatically rapid replacement of face-to-face consultations and other meetings, including clinical multidisciplinary team meetings, with telephone calls or videoconferencing. By and large this form of remote consultation has received a warm welcome from both patients and clinicians. To date, human, technological and institutional barriers may have held back the integration of such approaches in routine clinical practice, particularly in the UK. As we move into the post-pandemic phase, it is vital that academic, educational and clinical leadership builds on this positive legacy of the COVID crisis. Telepsychiatry may be but one component of 'digital psychiatry' but its seismic evolution in the pandemic offers a possible opportunity to embrace and develop 'digital psychiatry' as a whole.

Design, synthesis and antitumour evaluation of pyrrolo[1,2-f]-phenanthridine and dibenzo[f,h]pyrrolo[1,2-b]isoquinoline derivatives.

A series of 1,2-bis(hydroxymethyl)pyrrolo[1,2-f]phenanthridine derivatives and their alkyl (ethyl and isopropyl) carbamates and 12,13-bis(hydroxymethyl)-9,14-dihydro-dibenzo[f,h]pyrrolo[1,2-b]isoquinoline derivatives were synthesized for antiproliferative evaluation. The preliminary antitumour studies revealed that these two types of bis(hydroxymethyl) derivatives showed significant antitumour activities and were able to inhibit the growth of various human tumour cell lines in vitro. Several of the derivatives were demonstrated to cause DNA interstrand cross-links by an alkaline agarose gel shifting assay. These conjugates were cytotoxic to a variety of cancer cell lines by inducing DNA damage, delaying cell cycle progression in the G2/M phase and triggering apoptosis. Compound 21a, dissolved in a vehicle suitable for intravenous administration, was selected for antitumour studies in animal models. We demonstrated that at a dose that did not cause body weight loss in mice, compound 21a could significantly suppress the growth of tumour xenografts of human lung cancer H460 and colorectal cancer HCT-116 cells in nude mice. Our present results confirm the antitumour activities of these conjugates.

Design and Synthesis of 1,2-Bis(hydroxymethyl)pyrrolo[2,1- a]phthalazine Hybrids as Potent Anticancer Agents that Inhibit Angiogenesis and Induce DNA Interstrand Cross-links.

Hybrid molecules are composed of two pharmacophores with different biological activities. Here, we conjugated phthalazine moieties (antiangiogenetic pharmacophore) and bis(hydroxymethyl)pyrrole moieties (DNA cross-linking agent) to form a series of bis(hydroxymethyl)pyrrolo[2,1- a]phthalazine hybrids. These conjugates were cytotoxic to a variety of cancer cell lines by inducing DNA damage, arresting cell cycle progression at the G2/M phase, triggering apoptosis, and inhibiting vascular endothelial growth factor receptor 2 (VEGFR-2) in endothelial cells. Among them, compound 29d encapsulated in a liposomal formulation (e.g., 29dL) significantly suppressed the growth of small-cell lung cancer cell (H526) xenografts in mice. Based on immunohistochemical staining, the tumor xenografts in mice treated with 29dL showed time-dependent decreases in the intensity of CD31, a marker of blood vessels, whereas the intensity of γ-H2AX, a marker of DNA damage, increased. The present data revealed that the conjugation of antiangiogenic and DNA-damaging agents can generate potential hybrid agents for cancer treatment.

Repeated social stress leads to contrasting patterns of structural plasticity in the amygdala and hippocampus.

Previous studies have demonstrated that repeated immobilization and restraint stress cause contrasting patterns of dendritic reorganization as well as alterations in spine density in amygdalar and hippocampal neurons. Whether social and ethologically relevant stressors can induce similar patterns of morphological plasticity remains largely unexplored. Hence, we assessed the effects of repeated social defeat stress on neuronal morphology in basolateral amygdala (BLA), hippocampal CA1 and infralimbic medial prefrontal cortex (mPFC). Male Wistar rats experienced social defeat stress on 5 consecutive days during confrontation in the resident-intruder paradigm with larger and aggressive Wild-type Groningen rats. This resulted in clear social avoidance behavior one day after the last confrontation. To assess the morphological consequences of repeated social defeat, 2 weeks after the last defeat, animals were sacrificed and brains were stained using a Golgi-Cox procedure. Morphometric analyses revealed that, compared to controls, defeated Wistar rats showed apical dendritic decrease in spine density on CA1 but not BLA. Sholl analysis demonstrated a significant dendritic atrophy of CA1 basal dendrites in defeated animals. In contrast, basal dendrites of BLA pyramidal neurons exhibited enhanced dendritic arborization in defeated animals. Social stress failed to induce lasting structural changes in mPFC neurons. Our findings demonstrate for the first time that social defeat stress elicits divergent patterns of structural plasticity in the hippocampus versus amygdala, similar to what has previously been reported with repeated physical stressors. Therefore, brain region specific variations may be a universal feature of stress-induced plasticity that is shared by both physical and social stressors.

Triterpenoid and Fatty Acid Contents from the Stem Bark of Cordia dichotoma (Forst f.).

AIM: To isolate and determine the chemical constituents of the stem bark of Cordia dichotoma (Forst f.), a plant used for medicinal purpose in folk medicine. MATERIALS AND METHODS: Petroleum ether extract of the stem bark was used for this study. Saponification process was performed to separate fatty acid and unsaponifiable matter. RESULTS: One triterpenoids, α-amyrin was isolated from the bark by using isocratic elution. The chemical compounds isolated, for the first time, were analyzed by GC/MS, IR, and UV. The chemical composition of the fatty acids methyl esters (FAMEs) in bark of Cordia dichotoma were also analyzed by gas chromatography-mass spectrometry. After methyl-esterification, 17 components were identified in the bark. The derivatization conditions were investigated in order to validate this method. CONCLUSION: The present analysis revealed that Cordia dichotoma stem bark contains 17 fatty acid. The principal themes of the review highlight the development and application of chromatographic techniques for the separation, isolation and detection of the compounds.

Study of liquid scintillation alpha spectral properties.

Alpha spectra were acquired with Quantulus 1220 liquid Scintillation Counter (LSC) and correlations among parameters, such as alpha particle energy, sample quenching, peak's centroid and resolution were established. The effect of quenching and factors such as types of counting vials, extractive reagents and composition of extractive scintillation cocktail on alpha spectral resolution, was experimentally studied.

Comparison of accuracies of an intraoral spectrophotometer and conventional visual method for shade matching using two shade guide systems.

BACKGROUND AND OBJECTIVES: This in vitro study compared the shade matching abilities of an intraoral spectrophotometer and the conventional visual method using two shade guides. The results of previous investigations between color perceived by human observers and color assessed by instruments have been inconclusive. The objectives were to determine accuracies and interrater agreement of both methods and effectiveness of two shade guides with either method. METHODS: In the visual method, 10 examiners with normal color vision matched target control shade tabs taken from the two shade guides (VITAPAN Classical™ and VITAPAN 3D Master™) with other full sets of the respective shade guides. Each tab was matched 3 times to determine repeatability of visual examiners. The spectrophotometric shade matching was performed by two independent examiners using an intraoral spectrophotometer (VITA Easyshade™) with five repetitions for each tab. RESULTS: Results revealed that visual method had greater accuracy than the spectrophotometer. The spectrophotometer; however, exhibited significantly better interrater agreement as compared to the visual method. While VITAPAN Classical shade guide was more accurate with the spectrophotometer, VITAPAN 3D Master shade guide proved better with visual method. CONCLUSION: This in vitro study clearly delineates the advantages and limitations of both methods. There were significant differences between the methods with the visual method producing more accurate results than the spectrophotometric method. The spectrophotometer showed far better interrater agreement scores irrespective of the shade guide used. Even though visual shade matching is subjective, it is not inferior and should not be underrated. Judicious combination of both techniques is imperative to attain a successful and esthetic outcome.

Prosthetic management of posttraumatic external auditory canal atresia: A rare cause of conductive hearing loss.

Acquired external auditory canal (EAC) atresia is an infrequent entity which can originate from a number of different causes including trauma, infection, neoplasia, inflammation, and radiotherapy. Posttraumatic atresias are exceptionally rare, only 10% of atresias are attributed to trauma in most of the series. The management of stenosis of the EAC is challenging as it is associated with residual hearing loss and late recurrence. Traditional stents often occlude the EAC, resulting in a temporary conductive hearing loss. This case report describes the technique of fabrication of a wide-bored acrylic stent which attained additional retention from the folds of the auricle. The customized earmold stent effectively prevented restenosis, while the large bore provided ventilation and improved hearing subjectively during the stenting period.

Development and Evaluation of Chitosan Microparticles Based Dry Powder Inhalation Formulations of Rifampicin and Rifabutin.

BACKGROUND: The lung is the primary entry site and target for Mycobacterium tuberculosis; more than 80% of the cases reported worldwide are of pulmonary tuberculosis. Hence, direct delivery of anti-tubercular drugs to the lung would be beneficial in reducing both, the dose required, as well as the duration of therapy for pulmonary tuberculosis. In the present study, microsphere-based dry powder inhalation systems of the anti-tubercular drugs, rifampicin and rifabutin, were developed and evaluated, with a view to achieve localized and targeted delivery of these drugs to the lung. METHODS: The drug-loaded chitosan microparticles were prepared by an ionic gelation method, followed by spray-drying to obtain respirable particles. The microparticles were evaluated for particle size and drug release. The drug-loaded microparticles were then adsorbed onto an inhalable lactose carrier and characterized for in vitro lung deposition on an Andersen Cascade Impactor (ACI) followed by in vitro uptake study in U937 human macrophage cell lines. In vivo toxicity of the developed formulations was evaluated using Sprague Dawley rats. RESULTS: Both rifampicin and rifabutin-loaded microparticles had MMAD close to 5 µm and FPF values of 21.46% and 29.97%, respectively. In vitro release study in simulated lung fluid pH 7.4 showed sustained release for 12 hours for rifampicin microparticles and up to 96 hours for rifabutin microparticles, the release being dependent on both swelling of the polymer and solubility of the drugs in the dissolution medium. In vitro uptake studies in U937 human macrophage cell line suggested that microparticles were internalized within the macrophages. In vivo acute toxicity study of the microparticles in Sprague Dawley rats revealed no significant evidence for local adverse effects. CONCLUSION: Thus, spray-dried microparticles of the anti-tubercular drugs, rifampicin and rifabutin, could prove to be an improved, targeted, and efficient system for treatment of tuberculosis.

Application of spectrum shifting methodology to restore NaI(Tl)-recorded gamma spectra, shifted due to temperature variations in the environment.

A method has been standardized for restoring a shifted differential pulse height spectrum from a scintillator based gamma ray spectrometer recorded at measurement temperature, to the position of a desired spectrum, recorded at a reference temperature. The method is based on the assumption that the spectrum obtained at measurement temperature represents the same statistical distribution as that at reference temperature but with different energy scales. A computer program has been developed for calculation of the transformation between the energy scales and for the restoration of the shifted spectrum. The method developed has been successfully applied for the restoration of gamma spectra measured at different temperatures.