Association between Usage of Prophylactic AYUSH Medicines and Disease Severity in COVID-19 Patients: A Retrospective Cohort Study.

BACKGROUND: Prior vaccination is often studied for its impact on individuals' post-infection prognosis. Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) medicines, advised by the Government of India as prophylaxis during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, were consumed by the masses in 2020. A study was therefore undertaken to observe any association between the prior usage of AYUSH prophylactic medicines and post-infection severity as reported by recovered COVID-19 individuals. METHODS: This was a retrospective, multi-centre, cohort study conducted in 21 cities of India from 5th August to 30th November 2020. Data from recovered COVID-19 patients, of either sex or any age, captured information about AYUSH prophylactic medicines intake prior to infection, disease severity, symptomatology, duration of complaints, etc. The study participants were grouped into AYUSH intake and non-intake. Primary composite outcome was the disease clinical course. Secondary clinical outcomes were the rate of and time to clinical recovery. RESULTS: Data of 5,023 persons were analysed. Ayurveda or homeopathic prophylactic medicines were consumed by more than half of the study participants: that is, 56.85% (n = 1,556) and 56.81% (n = 1,555) respectively. The overall adjusted protective effect (PE) of AYUSH prophylactic intake against moderate/severe forms of COVID-19 disease was 56.7% (95% confidence interval [CI], 48.7 to 63.50; p < 0.001). Adjusted PE for homeopathy and Siddha was 52.9% (95% CI, 42.30 to 61.50; p < 0.001) and 59.8% (95% CI, 37.80 to 74.10; p < 0.001), respectively. A statistically significant association was found between AYUSH prophylactic medicine intake and clinical recovery more frequently by the 3rd day of illness (χ2 = 9.01; p = 0.002). Time to resolution of symptoms in the AYUSH intake group was on average 0.3 days earlier than in the non-intake group (p = 0.002). CONCLUSION: AYUSH prophylactics were associated with statistically significant levels of protection against COVID-19 disease severity. Amongst these, previous intake of homeopathy or Siddha medicines was associated with some protection against moderate/severe illness and with a somewhat quicker clinical recovery. Prospective studies with experimental research design are needed to validate the findings of this study. STUDY REGISTRATION: Clinical Trials Registry-India (CTRI/2020/08/027000).

Microbiological assessment of ready-to-eat foods and drinking water sources as a potential vehicle of bacterial pathogens in northern India.

Foodborne illnesses caused by the consumption of contaminated foods have frequent occurrences in developing countries. The incorporation of contaminated water in food processes, preparation, and serving is directly linked to several gastrointestinal infections. Keeping in view, this study was conducted to assess the microbial quality of both drinking water sources and commonly consumed fresh ready-to-eat (RTE) foods in the region. The drinking water samples from water sources and consumer points, as well as food samples from canteens, cafes, hotels, and restaurants, were collected for the microbiological analysis. Fifty-five percent (n = 286) of water samples were found to be positive for total coliforms with MPN counts ranging from 3 to 2600 (100 ml) -1. E. coli was detected in nearly 30% of the total water samples. Overall, 65% tap water samples were found unsatisfactory, followed by submersible (53%), filter (40%), and WTP (30%) sources. Furthermore, the examination of RTE foods (n = 80) found that 60% were of unsatisfactory microbial quality with high aerobic plate counts. The salads were the most contaminated category with highest mean APC 8.3 log CFU/g followed by pani puri, chats, and chutneys. Presence of coliforms and common enteropathogens was observed in both water and food samples. The detected isolates from the samples were identified as Enterobacter spp., Klebsiella spp., Pseudomonas aeruginosa, Salmonella spp., Shigella spp., and Staphylococcus spp. Based on these findings, microbiological quality was found compromised and this may pose hazard to public health. This exploratory study in the Punjab region also suggests that poor microbiological quality of water sources can be an important source of contamination for fresh uncooked RTE foods, thus transferring pathogens to the food chain. Therefore, only safe potable drinking water post-treatment should be used at all stages.

Relation of Mandibular Canal Discontinuity and IAN Paresthesia in Operated Cases of Mandibular Fracture.

INTRODUCTION: Mandibular fractures are common in maxillofacial trauma, often requiring surgical intervention for optimal recovery. One critical concern during such procedures is the potential for nerve damage, specifically involving the mandibular canal. This study aims to investigate whether the presence of postoperative mandibular canal discontinuity is associated with an increased risk of nerve damage. METHODOLOGY: A retrospective analysis was conducted on a cohort of 72 postoperative mandibular fracture patients. In total, 58 patients had entire mandibular canal continuity, while 14 showed discontinuity. Clinical records and follow-up data were examined to assess the occurrence of nerve injury. Statistical analysis was performed to determine the significance of any correlation. RESULTS: Of the 14 patients with mandibular canal discontinuity, 9 (64.28%) exhibited paresthesia. In patients where mandibular canal continuity was maintained, 5 (8.62%) patients reported paresthesia. These results suggest a higher incidence of paresthesia in patients with mandibular canal discontinuity, albeit with a small sample size. Notably, only 3 patients in the discontinuity group did not show any sign of improvement, while the remaining patients in both groups demonstrated complete recovery in 6 months of follow-up period. DISCUSSION: The findings suggest a potential link between mandibular canal discontinuity and an increased risk of paresthesia in postoperative mandibular fracture patients. It is hypothesized that discontinuity may lead to nerve compression, irritation, or direct damage during healing. The observed complete recovery in most patients, including those with paresthesia, highlights the potential for the nervous system to repair itself over a period of time. However, further studies with larger sample sizes are warranted to establish a more definitive correlation. CONCLUSION: This study provides preliminary evidence that mandibular canal discontinuity may contribute to a higher incidence of paresthesia in postoperative mandibular fracture patients. Clinicians should be cautious when addressing mandibular fractures to minimize the risk of nerve damage, particularly in cases involving canal discontinuity. The encouraging trend of complete recovery among the majority of patients suggests a positive prognosis for nerve healing.

Modelling the emergence of social-bird biological controls to mitigate invasions of the spotted lanternfly and similar invasive pests.

The spotted lanternfly is an emerging global invasive insect pest. Due to a lack of natural enemies where it is invasive, human intervention is required. Extensive management has been applied but the spread continues. Recently, the idea of bird-based biological controls has re-emerged and shown effective in studies. However, it is questionable, if birds are able to effectively control unfamiliar and occasionally toxic invasive pests in short timeframes. Unless, perhaps, the birds are effective social learners and toxicity of the invaders is rare. Here, we introduce a mathematical model for social learning in a great tit-like bird to investigate conditions for the emergence of a collective biological control of a pest that is occasionally toxic, like the lanternfly. We find that the social observation rate relative to the proportion of toxic lanternfly dictate when collective biological controls will emerge. We also implement the social learning model into a model of collective motion in bird-like animals, and find that it produces results consistent with the mathematical model. Our work suggests that social birds may be useful in managing the spotted lanternfly, and that removing the toxicity-inducing preferred host of the lanternfly should be a priority to facilitate this.

Histopathological Interpretation of TMJ Osteophyte: Report and Review.

Introduction: Osteophytes are osseocartilaginous structures which are commonly found in common degenerative joint diseases. It can be free or attached to nature. There is a paucity of information in the literature regarding the histopathological interpretation of osteophytes in Temporomandibular Joint (TMJ). Purpose: To report the incidental finding of osteophytes in cases of chronic protracted TMJ dislocation. Material and Method: To present case of an elderly 72-year-old female and a 35-year-old male with chronic protracted TMJ dislocation who were treated surgically for their condition with an incidental finding of an osteophyte in TMJ intraoperatively. Result: The histopathological examination revealed fibrocartilaginous core tissue surrounded by bone formation due to dystrophic calcification. Conclusion: The microscopic examination is mandatory in order to study and understand the pathophysiology of an osteophyte. This study presents rare histopathological evidence of an osteophyte. It reflects the process of its formation and the possibilities of fate of an osteophyte in TMJ.

Incidence and Management of Tooth Root Fracture in Mandibular Fracture Line - A Retrospective Study.

Introduction: In cases of trauma, the most common fractures of the facial region are the nasal bone fractures followed by mandibular fractures. About 60% of mandible fractures are associated with teeth in the fracture line; however conversely, the dentulous mandible has a higher susceptibility of fracture in any impact. Whenever a tooth is involved in the fracture line, it is not unlikely that the tooth root fracture will be associated with it. The prognosis and treatment of such a tooth persistent in a fracture line depends upon the level of tooth root fracture. Materials and Methods: This retrospective study was conducted in the Department of Oral and Maxillofacial Surgery in a Meerut hospital. The eligibility criteria were based on the cases involving fracture line passing through the teeth bearing area of mandible. Total of 56 cases of mandibular fracture treated from January 2021 till December 2022 by open reduction and fixation were included in the study. Results: A total of 56 patients (66 fracture lines) with mandibular fractures were selected, out of which 18 (32%) patients had fracture of the root of the tooth in the fracture line. Third molar root fracture were present in 12 cases (66.6%), first premolars in 4 cases (22.2%), and first molars in 2 cases (11.1%). There were 14 multi rooted teeth (77.7%) and 4 single rooted teeth (22.2%) involvement. All the multi rooted teeth fracture were treated by extraction during open reduction and fracture fixation. The single rooted teeth were successfully treated by endodontic treatment postoperatively. Discussion: The fracture line passing through the dentate segment may fracture the tooth crown and/or root or propagate through the socket without any injury to the root. Root fracture at cervical and middle third is constantly exposed to oral fluids. The affected tooth may be mobile and lose vitality. Teeth in the line of fracture must be removed when they preclude the correct reduction of the segments or if they represent a risk for infection. If the tooth or root does not cause any hindrance during reduction or it is not infected, the tooth can be salvaged by endodontic therapy. The incidence of root fracture was seen in 32% of cases. Fracture of the third molar roots was the single largest group (66.6%). No root fracture was observed in the anterior segment.

Targeted inCITE-Seq Analysis Identifies the Loss of Nuclear TDP-43 in Endothelium as a Mediator of Blood Brain Barrier Signaling Pathway Dysfunction in Neurodegeneration.

Despite the importance of the endothelium in the regulation of the blood brain barrier (BBB) in aging and neurodegenerative disease, difficulties in extracting endothelial cell (EC) nuclei have limited analysis of these cells. In addition, nearly all Amyotrophic Lateral Sclerosis (ALS) and Frontotemporal Degeneration (FTD), and a large portion of Alzheimer's Disease (AD) exhibit neuronal TDP-43 aggregation, leading to loss of nuclear function, but whether TDP-43 is similarly altered in human BBB ECs is unknown. Here we utilize a novel technique for the enrichment of endothelial and microglial nuclei from human cortical brain tissues, combined with inCITE-seq, to analyze nuclear proteins and RNA transcripts in a large cohort of healthy and diseased donors. Our findings reveal a unique transcriptional signature in nearly half of the capillary endothelial cells across neurodegenerative states, characterized by reduced levels of nuclear ß-Catenin and canonical downstream genes, and an increase in TNF/NF-kB target genes. We demonstrate that this does not correlate with increased nuclear p65/NF-kB, but rather a specific loss of nuclear TDP-43 in these disease associated ECs. Comparative analysis in animal models with targeted disruption of TDP-43 shows that this is sufficient to drive these transcriptional alterations. This work reveals that TDP-43 is a critical governor of the transcriptional output from nuclear p65/NF-kB, which has paradoxical roles in barrier maintenance and also barrier compromising inflammatory responses, and suggests that disease specific loss in ECs contributes to BBB defects observed in the progression of AD, ALS and FTD.

Homoeopathic Medicine Arsenicum album 30 C for Covid-19 in 2020: A Retrospective Analysis from Mass-level Data.

Background and Objective: Homoeopathy has played a notable role in managing epidemics in the past. The Ministry of Ayush, Government of India, declared Arsenicum album 30 C as a prophylactic for Covid-19, which was followed by the distribution of the medicine across India. The Central Council for Research in Homoeopathy (CCRH) collected post-prophylactic consumption data of individuals from various colleges over months, which created a data pool. Considering the importance of these mass-level data and their possible impact on public healthcare decisions, the information gathered from this heterogeneous population cohort was subjected to a retrospective data analysis to observe the incidence of Covid-19 in the community. Methods: Data from 50 colleges from February-August 2020 showed that 10.6 million people in 13 states of India received prophylactic medicine during the study period. The data was collected from individuals three weeks following prophylactic consumption for a retrospective analysis. The incidence of Covid-19 was assessed. Results: The data of 584 980 individuals who met the study criteria were included in the analysis. The incidence of Covid-19 in the population cohort was 13.58 per 10 000-person weeks (95% CI, 13.04 to 14.14), which remained near-constant over time despite the increasing disease burden in the country (12.87 to 14.52 per 10 000-person weeks). Consumption of the prophylactic significantly reduced the risk of contracting Covid-19 in high-risk groups as compared to their counterparts. Conclusion: The study concludes that Arsenicum album 30 C has a potential prophylactic effect against Covid-19. Further controlled studies are recommended to establish a causal relation.

Surveillance of Stability Under Different Stress Conditions in Desloratadine and Study of Degradation Kinetics.

BACKGROUND: A stability-indicating method (SIM) stipulates the testing of the drug product and drug substances under the stressed conditions that will imply a clear notion about the stress conditions that would affect the drug in its finished dosage form. Furthermore, manufactures can clearly define the state at which the drug is unstable and present its storage conditions. OBJECTIVE: The present article deals with the stability testing and degradation kinetic studies of desloratadine (DL). METHOD: The method of analysis was UV visible spectroscopy, which is a most convenient and reliable method for the analyst. A method was developed and validated according to the ICH Q2 guidelines along with the amendment in 2018 (ICH Q14). RESULTS: The study denotes that the drug is extremely unstable in the presence of dry heat and then follows the oxidative and basic degradations. The acidic, neutral, and photolysis did not show notable degradations. CONCLUSIONS: The chemical kinetic studies were carried out to more clearly understand the mechanism of degradation and to present the order of reaction, rate of reaction, and reaction half-time. HIGHLIGHTS: The application of a spectrophotometric method in the development of a SIM and study of degradation kinetics is much handier and cost-effective.

Cerebral creatine deficiency disorders - A clinical, genetic and follow up study from India.

INTRODUCTION: Cerebral creatine deficiency syndromes (CCDS) are a group of potentially treatable neurometabolic disorders. The clinical, genetic profile and follow up outcome of Indian CCDS patients is presented. MATERIALS AND METHODS: This was a retrospective cohort of CCDS patients seen over six-years. Diagnosis was based either on low creatine peak on proton magnetic resonance spectroscopy (MRS) and/or genetic evaluation. RESULTS: Thirteen patients were eligible [8 creatine transporter deficiency (CTD), 4 guanidinoacetate methyltransferase (GAMT) deficiency and 1 could not be classified]. The mean (±SD) age at diagnosis was 7.2(±5.0) years. Clinical manifestations included intellectual disability (ID) with significant expressive speech delay in all. Most had significant behavior issues (8/13) and/or autism (8/13). All had history of convulsive seizures (11/13 had epilepsy; 2 patients only had febrile seizures) and 2/13 had movement disorder. Constipation was the commonest non-neurological manifestation (5/13 patients). Cranial MRI was normal in all CTD patients but showed globus pallidus hyperintensity in all four with GAMT deficiency. MRS performed in 11/13 patients, revealed abnormally low creatine peak. A causative genetic variant (novel mutation in nine) was identified in 12 patients. Three GAMT deficiency and one CTD patient reported neurodevelopmental improvement and good seizure control after creatine supplementation. CONCLUSION: Intellectual disability, disproportionate speech delay, autism, and epilepsy, were common in our CCDS patients. A normal structural neuroimaging with easily controlled febrile and/or afebrile seizures differentiated CTD from GAMT deficiency patients who had abnormal neuroimaging and often difficult to control epilepsy and movement disorder.

Modeling the life cycle of the spotted lanternfly (Lycorma delicatula) with management implications.

The spotted lanternfly (SLF) is an invasive pest that emerged in the US less than a decade ago. With few natural enemies and an ability to feed on a wide variety of readily available plants the population has grown rapidly. It is causing damage to a wide range of natural and economically important farmed plants and at present there is no known way to stop the growth and spread of the population. However, a number of control measures have been proposed to limit the growth and the effectiveness of some of these have been assessed via empirical studies. Studies to estimate the natural mortality rate of the lanternfly's different life stages and other properties of its life cycle are also available. However, no attempt to integrate this empirical information to estimate population level characteristics such as the population growth rate and the potential effects of proposed control measures can be found in the literature. Here, we introduce a simple population dynamics model parameterized using available information in the literature to obtain estimates of this type. Our model suggests that the annual growth rate of the SLF population in the US is 5.47, that only three out of six proposed control measures considered here have the potential to decrease the population even if we can find and treat each SLF in every stage, and that even with a combined strategy involving the most effective proposed control measures about 35% of all SLF in the relevant stages must be found and treated to turn the current population growth into decline. Suggesting that eradication of the spotted lanternfly over larger geographical areas in the US will be challenging, and we believe that the modeling framework presented here may be useful in providing estimates to inform feasibility assessment of proposed management efforts.

Delays in Diagnosis of Pulmonary Lymphangitic Carcinomatosis due to Benign Presentation.

The diagnosis of lymphangitic carcinomatosis is challenging due to the manifestation of nonspecific symptoms and radiographic abnormalities that bear similarity to those of interstitial lung disease. Herein, we report the case of a 53-year-old woman diagnosed with lymphangitic carcinomatosis from metastatic gastric adenocarcinoma, 3 months after her initial presentation.

Effect of Tb substitution in naturally layered LaMn2Si2: magnetic, magnetocaloric, magnetoresistance and neutron diffraction study.

Evolution of physical and magnetic properties of La rich La1-x Tb x Mn2Si2 (x = 0, 0.1 and 0.225) compounds is studied using temperature and field dependent dc magnetization, electrical transport, and heat capacity measurements. LaMn2Si2 undergoes a paramagnetic to antiferromagnetic ordering at T N ~ 400 K and a long range ferromagnetic ordering below T C ~ 308 K. However, the substitution of Tb at La site results in the contraction of unit cell as well as decrease in the Mn-Mn spacing, which leads to an additional antiferromagnetic phase below T N ~ 87 K and 257 K for La0.9Tb0.1Mn2Si2 and La0.775Tb0.225Mn2Si2, respectively. Using magnetization isotherm results, we have constructed an H-T phase diagram for x = 0.225 and have found the coexistence of this additional antiferromagnetic phase with ferromagnetic phase. The phase coexistence at x ~ 0.225 is further analysed using magnetoresistance (MR) and magnetocaloric effect (MCE) studies and a reasonable correlation is established between MCE and MR. In order to analyse the nature of the magnetic transition at T C, a universal master curve is constructed by rescaling the magnetic entropy curves. Low temperature neutron diffraction measurements performed on the polycrystalline samples revealed a canted ferromagnetic structure for x ~ 0.1 and a canted antiferromagnetic structure for x ~ 0.225.

Report of Another Mutation Proven Case of Carbonic Anhydrase II Deficiency.

Carbonic anhydrase (CA) II deficiency results in an uncommon type of autosomal recessive sclerosing bone dysplasia with renal tubular acidosis and intracerebral calcification. We report a classic case of CA II-associated osteopetrosis with a previously reported homozygous frameshift mutation. Child was evaluated for short stature and failure to thrive. He was diagnosed as osteopetrosis in view of the presence of hepatosplenomegaly and increased bone density though hematological parameters were normal. Further evaluation showed presence of associated distal renal tubular acidosis raising a possibility of CA II deficiency. Mutation analysis revealed a previously reported homozygous frameshift mutation c.143-146delCTGT (p.Ser48Phefs*9) in CA2. Child has normal growth after initiation of alkali therapy.

Prevalence and treatment gap in childhood epilepsy in a north Indian city: a community-based study.

BACKGROUND: Epilepsy is one of the most common neurological disorders prevalent in childhood period. There is scarcity of epidemiological data, required to plan services in resource constrained developing nations. OBJECTIVE: To study the prevalence and treatment gap in childhood epilepsy in north Indian city, in the age group of 1-18 years. METHODS: A two stage stratified cluster sampling; probability proportionate to size (PPS) was employed. A ten question screening questionnaire was employed to identify the presence of epilepsy. Definitions provided by International League against Epilepsy (ILAE) were used to classify screen positive subjects as epilepsy and to calculate the treatment gap. RESULTS: The prevalence rate for epilepsy was 6.24/1000 population. Febrile seizures and neurocysticercosis were most common causes of symptomatic seizures in childhood. CONCLUSION: This study of epidemiology of epilepsy provides valuable aid in optimizing effective community approach, thereby improving outcomes of childhood epilepsy.

The effect of glial glutamine synthetase inhibition on recognition and temporal memories in the rat.

The glutamate neurotransmitter is intrinsically involved in learning and memory. Glial glutamine synthetase enzyme synthesizes glutamine, which helps maintain the optimal neuronal glutamate level. However, the role of glutamine synthetase in learning and memory remains unclear. Using associative trace learning task, we investigated the effects of methionine sulfoximine (MSO) (glutamine synthetase inhibitor) on recognition and temporal memories. MSO and vehicle were injected (i.p.) three hours before training in separate groups of male Wistar rats (n=11). Animals were trained to obtain fruit juice after following a set of sequential events. Initially, house-light was presented for 15s followed by 5s trace interval. Thereafter, juice was given for 20s followed by 20s inter-presentation interval. A total of 75 presentations were made over five sessions during the training and testing periods. The average number of head entries to obtain juice per session and during individual phases at different time intervals was accounted as an outcome measure of recognition and temporal memories. The total head entries in MSO and vehicle treated animals were comparable on training and testing days. However, it was 174.90% (p=0.08), 270.61% (p<0.05), 143.20% (p<0.05) more on training day and 270.33% (p<0.05), 157.94% (p<0.05), 170.42% (p<0.05) more on testing day, during the house-light, trace-interval and inter-presentation interval phases in MSO animals. Glutamine synthetase inhibition did not induce recognition memory deficit, while temporal memory was altered, suggesting that glutamine synthetase modulates some aspects of mnemonic processes.