Development and Validation of the Emotion Laden Sentences Toolbox for Emotion Recognition (ELSTER).

Introduction: Emotion recognition plays a crucial role in our social interactions and overall well-being. The present cross-sectional study aimed to develop and validate Emotion Laden Sentences Toolbox for Emotion Recognition (ELSTER), that utilizes emotion-laden sentences as stimuli to assess individuals' ability to perceive and identify emotions conveyed through written language. Methods: In Phase I, a comprehensive set of emotion-laden sentences in English language were validated by 25 (eight males and 17 females) qualified mental health professionals (MHPs). In Phase II, the sentences that received high interrater agreement in Phase I were selected and then a Hindi version of the same sentences was also developed. The English and Hindi database was then validated among 50 healthy individuals (30 males and 20 females). Results: The percentage hit rate for all the emotions after exclusion of contempt was 84.3% with a mean kappa for emotional expression being 0.67 among MHPs. The percentage hit rate of all emotion-laden sentences across the database was 81.43% among healthy lay individuals. The mean hit rate percentage for English sentences was similar to Hindi sentences with a mean kappa for emotional expression being 0.63 for the combined English and Hindi sentences. Conclusion: The ELSTER database would be useful in the Indian context for researching textual emotion recognition. It has been validated among a group of experts as well as healthy lay individuals and was found to have high inter-rater reliability.

Furosemide Stress Test and Renal Resistive Index for Prediction of Severity of Acute Kidney Injury in Sepsis.

Introduction The furosemide stress test (FST) predicts the severity and the need for renal replacement therapy (RRT) in patients with sepsis-associated acute kidney injury (S-AKI). The renal resistive index (RRI) indicates renal vascular resistance. Objectives The primary objective was to find the correlation between FST and RRI in S-AKI. The secondary objectives were to evaluate the role of FST and RRI on the progression of S-AKI. Methods A total of 154 consenting adult patients with S-AKI were administered FST. Renal echography was performed within the first 12 hours of admission, and RRI was calculated. The patients were grouped either into progressors or non-progressors to AKI-KDIGO stage 3. Results Of the patients who had RRI at Day 1 less than 0.73, 60% recovered, 34.3% needed RRT, and 35.5% died, whereas in those who had RRI at Day 1 greater than 0.73, only 22% recovered, 46.6% required RRT, and 51.6% died. RRI value of 0.73 predicted the need for RRT with a sensitivity of 35.1%, specificity of 80.4% and accuracy of 69.1%. The highest number of patients of KDIGO stage 3 (50%), followed by stage 2 (28.1%) and stage 1 (21.9%), presented technical difficulties in measuring the RRI. Conclusion FST is an economical and easily administered test to assess renal tubular function and can predict the occurrence and progression of S-AKI. RRI is a modest marker for predicting the need for RRT or persistent AKI.

Nebulised fentanyl, dexmedetomidine and magnesium sulphate for attenuation of haemodynamic response to laryngoscopy and tracheal intubation: A double-blinded, randomised comparative study.

Background and Aims: Direct laryngoscopy and tracheal intubation cause an increase in heart rate (HR) and blood pressure, called as pressor response. This study aimed to compare nebulised forms of fentanyl, dexmedetomidine and magnesium sulphate to attenuate the haemodynamic response to laryngoscopy and tracheal intubation. Methods: This double-blinded, randomised study was conducted on 90 patients undergoing elective surgery requiring endotracheal intubation. Nebulisation was done with fentanyl 1 µg/kg (Group A), dexmedetomidine 1 µg/kg (Group B) and magnesium sulphate (MgSO4) (40 mg/kg) (Group C). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and HR were recorded before nebulisation (T0), post-nebulisation (T1) and at 2, 5 and 10 min after intubation (T2, T3, T4). The statistical analysis for comparing continuous variables between the groups was performed using analysis of variance (ANOVA), and a P value <0.05 was considered statistically significant. Results: Compared to T0, an increase in HR at T2 and T3 was seen in Group A only, which reached baseline values at T4 (P values <0.0001 and 0.037, respectively). No HR value was higher than the baseline readings in groups B and C. The decreasing trend of SBP, DBP and MAP was seen in all three groups. Groups B and C had a statistically significant decrease in all the values from baseline (P values <0.0001). Conclusion: Nebulised form of dexmedetomidine (1 µg/kg) and magnesium (40 mg/kg) seems to be superior to fentanyl (1 µg/kg) in blunting the stress response to laryngoscopy and tracheal intubation.

Assessment of Prevalence of Hypertension and its Risk Factors among Adult Tribal Population Residing in Lohandiguda Block of Bastar District of Chhattisgarh.

Background: Hypertension is known as the silent killer. It comprehends the top rank in non-infectious disease amongst adults; accountable for the deaths every year across the world. It is essential to consider the individual impact of risk factors and their impact on hypertension. This study thus elicited the socio-demographic characteristics, the prevalence of hypertension and associated risk factors, and its impact on adults with hypertension. To estimate the hypertension prevalence and its associated risk factors among adult tribal populations aged 25-60 years residing in Lohandiguda block of Bastar district of Chhattisgarh. Material and Methods: A community-based cross-sectional analytical study was used and the setting was done at the field practice area under the three primary health centers of Lohandiguda block, Bastar district of Chhattisgarh. It was carried out among 330 adult tribes residing for ≥1 year in the present locality. Data was collected by door-to-door visits through pre-designed, pretested, semi-structured questionnaire via face-to-face interview method and anthropometric measurement was done by using standard guidelines. The sampling method was multistage sampling. IBM SPSS STATISTICS-20.0 (IBM Corp., Armonk, NY, USA) software. Results: The overall prevalence of pre-hypertension and hypertension among tribal subjects was 34.9% and 47.3%, respectively. Of total hypertensive 27.3% were having stage-1 hypertension, 13.9% were having stage-2 hypertension and 6.0% were already diagnosed cases. Risk factors found in multivariate analysis are occupation (unemployed 0.012), frequency of smokeless tobacco used per day (0.,017) and central obesity (0.000). Conclusions: As hypertension is a multi-factorial disease the study found strong predictors like occupation, frequency of smokeless tobacco per day and having central obesity with significant difference.

Development and Validation of the AIIMS Facial Toolbox for Emotion Recognition.

Background: Emotional facial expression database, used in emotion regulation studies, is a special set of pictures with high social and biological relevance. We present the AIIMS Facial Toolbox for Emotion Recognition (AFTER) database. It consists of pictures of 15 adult professional artists displaying seven facial expressions-neutral, happiness, anger, sadness, disgust, fear, and surprise. Methods: This cross-sectional study enrolled 15 volunteer students from a professional drama college in India (six males and nine females; mean age = 26.2 ± 1.93 years). They were instructed to pose with different emotional expressions in high and low intensity. A total of 240 pictures were captured in a brightly lit room against a common, light background. Each picture was validated independently by 19 mental health professionals and two professional teachers of dramatic art. Apart from recognition of emotional quality, ratings were done for each emotion on a 5-point Likert scale with respect to three dimensions-intensity, clarity, and genuineness. Results are discussed in terms of mean scores on all four parameters. Results: The percentage hit rate for all the emotions, after exclusion of contempt, was 84.3%, with the mean kappa for emotional expression being 0.68. Mean scores on intensity, clarity, and genuineness of the emotions depicted in the pictures were high. Conclusions: The database would be useful in the Indian context for researching facial emotion recognition. It has been validated among a group of experts and was found to have high inter-rater reliability.

A Community-Based Cross-Sectional Study on the Epidemiology of Injuries in Raipur City, Chhattisgarh.

BACKGROUND: Globally, injuries are a major public health concern. An injury is a physical damage that results when the human body is suddenly or briefly subjected to intolerable levels of energy. OBJECTIVES: The objectives of this study are to describe the nature and mechanism of injuries and their association with age and gender and to assess the health-seeking behavior and cost incurred due to mortality and morbidity related to injuries. METHODS AND MATERIALS: A cross-sectional study focused on the community was conducted in 10 chosen wards of Raipur City. The sample size was 310 injured individuals. The recall period was for a full year. Information was gathered by using a questionnaire that had been pretested. The results were given as percentages, and the association was determined using the chi-square test and Fischer's exact test. RESULTS: The majority (30.1%) of the study subjects suffered from cut/bite/open wound injuries, followed by fractures (17.3%). The leading type of injury was caused by falls (38.8%) and road traffic injuries (34.9%), followed by burns (7.1%) and dog bites (5.4%). Ninety percent of the study subjects had taken medical care. Half of them (51.3%) visited a private hospital, and 23.1% did not visit any hospital for treatment. Fifty percent of the study subjects or their family had expenses less than Indian National Rupee (INR) 500. A significant association was found between age and fracture and the sprain type of injury. The burn type of injury was more among females, which is significantly associated. A significant association was found between age and injury caused by a dog bite, fall, and traffic. The association between gender and injury caused by traffic, burn, and fall was significant. CONCLUSIONS: Focusing on reducing injury-related morbidity may be crucial in injury prevention techniques including behavioral changes, health education, and the urgent need for the proper implementation and oversight of a road safety act.

Can Quantitative Electroencephalography and Functional Near-Infrared Spectroscopy be a Good Guide in Kleine-Levin Syndrome?

There is scarce literature on functional neuroimaging data in Kleine-Levin syndrome. The current case report presents the electrical and metabolic status of cortical activity utilizing functional near-infrared spectroscopy (fNIRS) and quantitative electroencephalography (qEEG) before and after treatment of symptomatic phase of illness with modafinil.

Comparison of Conventional Oxygen Therapy With High-Flow Nasal Oxygenation in the Management of Hypercapnic Respiratory Failure.

INTRODUCTION: The effectiveness of high-flow nasal oxygenation (HFNO) in patients with hypercapnic respiratory failure (RF) remains controversial. The current study compared the effectiveness of HFNO in patients with hypercapnic RF with conventional oxygen therapy (COT). OBJECTIVES: The primary objective was to compare changes in the partial pressure of carbon dioxide (PaCO2) between those receiving COT and HFNO. The secondary objectives were to compare changes in the partial pressure of oxygen (PaO2), oxygen saturation (SpO2), respiratory rate (RR), serum bicarbonate level, base excess, lactate level, and incidence of the need for non-invasive ventilation (NIV) and mechanical ventilation (MV). METHODS: We recruited 30 patients with mild to moderate hypercapnic RF in the HFNO group, and data of 30 patients from historical controls, who matched the inclusion criteria, were obtained from medical records for comparison (COT group). The study was terminated after two hours, and patients were managed per the existing protocol after that. Arterial blood gas (ABG) analysis was repeated at the baseline, first, second, and third hours. RESULTS: In the COT group, the mean RR at the baseline, first, second, and third hours was 24.5 ± 2.61, 24.9 ± 3.03, 26.03 ± 3.4, and 22.90 ± 1.86, whereas, in the HFNO group, it was 25.93 ± 3.91, 23.00 ± 3.54, 22.50 ± 3.38, and 21.90 ± 3.57, respectively. The mean PaCO2 in the COT vs. HFNO groups was 54.45 ± 5.83 vs. 62.22 ± 9.15, 57.74 ± 6.05 vs. 58.65 ± 10.43, 60.79 ± 7.48 vs. 60.41 ± 11.24, and 55.23 ± 6.63 vs. 56.95 ± 10.31. The mean SpO2 in the COT group at these points of time was 94.50 ± 1.46, 95.4 ± 1.28, 96.10 ± 1.84, and 97.53 ± 2.05, whereas, in the HFNO group, it was 95.40 ± 2.55, 98.63 ± 1.43, 99.00 ± 1.66, and 99.50 ± 1.31, respectively. The patients who needed NIV after the study period were 50% and 36.67% in the COT and HFNO groups, respectively. CONCLUSIONS: There was no change in PaCO2 levels with HFNO, but there was a significant improvement in SpO2 and PaO2 levels and a decreased RR. Following the termination of the study protocol, more patients in the COT group needed NIV than those in the HFNO group.

Development and evaluation of indirect antibody ELISA assay for early diagnosis and surveillance of Crimean-Congo hemorrhagic fever infection in humans.

Crimean-Congo hemorrhagic fever (CCHF) is an important tick borne zoonotic viral disease of humans. CCHF virus causes sporadic cases of severe illness across a huge geographic area across Africa to Europe to Asia including India. CCHF has emerged as a major public health concern in western Indian states including Gujarat and Rajasthan, where regular human cases were reported since the year 2011. Human serve as the dead-end host, and they gain infection via infected tick bite, in close contact with ruminants and from slaughter house. Currently, the detection of this fatal infection is limited to BSL-4 laboratory which is scarce even in developed economies. Thus, a safe, sensitive assay for early immunodiagnosis is crucial for disease management and containing the outbreak. In this study, the conserved recombinant nucleoprotein was exploited as a safe, scalable alternate antigen for development of indirect IgM and IgG ELISA detection platform. The indirect ELISA was evaluated using suspected clinical samples collected from hotspot areas in India. Comparison with reference MAC ELISA and IgG ELISA revealed a correlation of 95% and 100% respectively. The results indicate that the developed IgM and IgG indirect ELISA has high sensitivity and specificity for detecting CCHFV antibodies among human. These assays are easy to perform and can be employed for high throughput screening of human samples for clinical diagnosis as well as serosurveillance. These assays are also amenable for conversion to low-cost point of care testing formats for application in resource limited settings.

Pulmonary function parameters and its determinants among cement factory workers in Chhattisgarh: A cross-sectional study.

BACKGROUND: Cement in one hand is the most used substance for construction all over the world but on the other hand prolonged exposure from cement dust particles along with smoking, long working duration in dusty environments and increasing age impairs pulmonary functions. OBJECTIVES: The study aimed to determine the effect of cement dust on the pulmonary functions of cement factory workers. METHODS: It was a cross-sectional observational study conducted from October 2019 to February 2020 among 360 workers of cement factories of Chhattisgarh state selected by systematic random sampling who were interviewed. Spirometry was done and their forced vital capacity, forced expiratory volume in one second, Forced expiratory flow, peak expiratory flow rate, and lung age were determined with a flow-sensing spirometer. Data were collected, entered in MS Excel spreadsheet, and analyzed using SPSS software (version 20.0) for Chi-square test, linear regression, and general linear model. RESULTS: One-third of the study subjects had pulmonary dysfunction, out of which 10% and 30% were having severe and moderate dysfunction, respectively. Significant higher Odds for developing impaired pulmonary functions were seen among >40 years of age (adjusted odds ratio [AOR] =1.88 [1.13, 3.12]), more than 10 years of service (AOR = 4.69 [2.32, 9.53]) and smokers (AOR = 4.45 [2.53, 7.83]). CONCLUSION: Working in dusty environment along with other factors in cement factories significantly decrease lung parameters. Exposure with dust is strong predictor for chronic respiratory symptoms.

Development of double antibody sandwich ELISA as potential diagnostic tool for rapid detection of Crimean-Congo hemorrhagic fever virus.

Crimean-Congo hemorrhagic fever (CCHF) virus, a highly pathogenic viral agent is responsible for severe fatal hemorrhagic infections in many parts of the world. The early diagnosis of CCHF infection is important for successful clinical management and epidemiological control. The nucleoprotein (NP) of CCHFV being highly conserved and immunogenic is used as early diagnostic marker. In this study, we report a rapid and sensitive double antibody based antigen capture ELISA to detect Crimean-Congo hemorrhagic fever virus (CCHFV). Highly specific polyclonal and monoclonal antibody against NP has been generated and used as capture and detector antibody respectively. The assay was able to detect viral nucleoprotein in different matrices including human serum, ticks and culture supernatant. The detection limit of the developed sandwich ELISA assay was 25 ng of purified antigen. Comparison with a real time RT-PCR revealed its detection limit to be 1000 genome equivalents of CCHFV. Further the assay was comparatively evaluated with a commercial kit employing gamma irradiated CCHFV, revealing a sensitivity and specificity of 100%. This newly developed sandwich ELISA (sELISA) with high sensitivity and specificity could be used as an efficient method for the detection of CCHF virus in humans, ticks and culture supernatant. The assay will be useful as alternate tool for diagnosis of acute infection and is amenable for screening of large scale samples in resource limited settings.

Abnormal Ambulatory Blood Pressure and Early Renal Dysfunction in Sickle Cell Disease.

OBJECTIVES: There is sparsity of studies evaluating blood pressure in children with sickle cell disease (SCD), which have shown inconsistent results. Few of the studies have documented lower office blood pressure (BP) in SCD patients, whereas, others have shown presence of masked hypertension and abnormal ambulatory blood BP monitoring (ABPM). Thus, the present study was conducted to examine 24 h ABPM parameters and renal dysfunction in children with SCD and compare them with healthy controls. METHODS: A cross-sectional study was conducted on 56 children (30 children having SCD and 26 controls). ABPM and evaluation of renal functions including serum creatinine, serum urea, urinary creatinine, urinary protein and specific gravity was performed. RESULTS: Spot urinary protein to creatinine ratio was found to be higher in patients with SCD (63.3%) as compared to controls (p < 0.001). Proteinuria was observed in 1/4th of the SCD patients less than ten years of age. Masked hypertension was present in 2 (6.6%) patients, ambulatory hypertension in 4 (13.3%), ambulatory pre-hypertension in 1 (3.3%) and abnormal dipping in 60%. A statistically significant correlation of BMI for age Z-score and standard deviation score (SDS/Z) of 24 h systolic BP (r = 0.56, p = 0.002); estimated glomerular filtration rate (eGFR) with 24 h diastolic BP SDS (r = -0.52; p = 0.038) and age with e GFR (r = 0.54; p = 0.025) was found in the present study. CONCLUSIONS: The present study corroborates that ABPM abnormalities (ambulatory hypertension, non-dipping pattern, ambulatory prehypertension) and early onset proteinuria are significant findings in patients with SCD. This underscores the importance of regular screening for proteinuria and ABPM in routine care, for early detection and prevention of progressive renal damage in SCD.

Identification of functional epitopes of structural proteins and in-silico designing of dual acting multiepitope anti-tick vaccine against emerging Crimean-Congo hemorrhagic fever virus.

Recurrent outbreaks of Crimean-Congo hemorrhagic fever (CCHF) virus infection in different parts of world are a major global health concern. The CCHF viral infection is associated with severe hemorrhagic fevers and mortality up to 40%. More than 30 countries in Asia, Europe and Africa are affected with CCHF infection. Prevention of infection through vaccine becomes more important when no effective antiviral and associated therapies are available. Further ticks play a crucial role in maintenance and transmission of CCHFV. Therefore, the control of transmission by ticks is warranted for ultimate prevention of outbreak. The study employed a series of immunoinformatics approaches to design novel multiepitope vaccine targeting highly immunodominant epitopes of major structural proteins (Nucleoprotein and Glycoprotein complex) of CCHFV. Vaccine was designed by incorporating linear and conformational B cell, helper and cytotoxic T cell epitopes from these crucial immunogenic proteins adjoined with appropriate linkers and adjuvant. This vaccine construct was also complemented with a highly immunogenic and conserved protective tick salivary antigen named subolesin to impart dual activity as a unique transmission blocking vaccine. The B-cell peptides were also experimentally validated. The designed vaccine was further in silico validated for its physiochemical properties, allergenicity and immunogenicity etc. The proposed candidate vaccine construct has the potential to function both as a vaccine against CCHF virus as well as a universal anti-tick vaccine.

Development of Multispecies Recombinant Nucleoprotein-Based Indirect ELISA for High-Throughput Screening of Crimean-Congo Hemorrhagic Fever Virus-Specific Antibodies.

Crimean-Congo hemorrhagic fever (CCHF) is a re-emerging zoonotic viral disease prevalent in many parts of Asia, Europe, and Africa. The causative agent, Crimean-Congo hemorrhagic fever orthonairovirus (CCHFV), is transmitted through hard ticks. Tick vectors especially belonging to the Hyalomma species serve as the reservoir and amplifying host. The vertebrate animals including sheep, goat, and bovine act as a short-lasting bridge linking the virus and ticks. CCHFV causes fatal hemorrhagic fever in humans. Humans are usually infected with CCHFV either through the bite of infected ticks or by close contact with infected animals. Immunological assays, primarily enzyme-linked immunosorbent assay (ELISA) using whole viral antigen, are widely used for serosurveillance in animals. However, the whole virus antigen poses a high biohazard risk and can only be produced in biosafety level 4 laboratories. The present study focuses on the development and evaluation of safe, sensitive, and specific IgG indirect enzyme-linked immunosorbent assay (iELISA) using recombinant nucleoprotein (NP) of CCHF virus as an antigen. The codon-optimized NP gene sequence was synthesized, cloned, and expressed in pET28a+ vector. The recombinant NP was purified to homogeneity by affinity chromatography and characterized through Western blot and MALDI-TOF/MS analysis. The characterized protein was used to develop an indirect IgG microplate ELISA using a panel of animal sera. The in-house ELISA was comparatively evaluated vis-à-vis a commercially available ELISA kit (Vector-Best, Russia) with 76 suspected samples that revealed a concordance of 90% with a sensitivity and specificity of 79.4 and 100%, respectively. The precision analysis revealed that the assay is robust and reproducible in different sets of conditions. Further, the assay was used for serosurveillance in ruminants from different regions of India that revealed 18% seropositivity in ruminants, indicating continued circulation of virus in the region. The findings suggest that the developed IgG iELISA employing recombinant NP is a safe and valuable tool for scalable high-throughput screening of CCHFV-specific antibodies in multiple species.

Use of the backslopping method for accelerated and nutritionally enriched idli fermentation.

BACKGROUND: Idli is a cereal-legume-based fermented food, widely consumed in India. It is popular for its nutritional content, sour taste and appetising aroma. The fermentation time of idli batter varies from 12 to 14 h. A reduction in fermentation time of idli batter is of great significance for large-scale idli production units since it will reduce the batch time and will lead to a greater output. Accelerated fermentation can be potentially achieved by using the backslopping method. The inoculum for backslopping was optimally fermented (12 h) idli batter, dried at room temperature. RESULTS: Backslopping reduced the fermentation time of idli batter from the conventional 12 h to 3 h while successfully maintaining sensory attributes of the product. In the idlis prepared by backslopped expedited batter, thiamine was found to be 50% higher; while reduction of anti-nutrients phytate (11%) and trypsin inhibitor (16%) was higher than the conventionally fermented (12 h) idli batter. CONCLUSION: Backslopping not only accelerated idli batter fermentation but also enhanced its nutritional value. A similar process can be designed for other fermented foods, to expedite fermentation thus reducing the time requirement.

An unusual case of compound odontome associated with maxillary impacted central incisor.

Odontomas are the most common type of odontogenic tumor occurring within the jaws and are frequently associated with the retained deciduous teeth interfering with the eruption of permanent teeth. Compound odontomas are usually diagnosed in the anterior portion of the jaws and resemble tooth-like structure. These are usually asymptomatic. Complex odontomas are normally diagnosed in the posterior part of the jaws and consist of a disorganized mass with no morphologic resemblance to a tooth. The present case report of a 16-year-old female is a typical case of compound odontoma in the maxillary anterior region associated with retained deciduous incisor, which also resulted in failure of eruption of the permanent maxillary right central incisor. An intraoral periapical radiograph revealed the presence of a radio-opaque tooth-like structure in the apical region of retained deciduous incisor and an impacted permanent right central incisor whose path of eruption was impeded by the structure. Treatment included the surgical removal of the lesion followed by orthodontic extrusion of the impacted incisor. Follow-up was done for one 1 year and no recurrence was seen.

The potential role of probiotics in periodontal health

Introduction : Probiotics represent an area in which bacterial interaction with the hosts is being put to practical and therapeutic use. The mechanism of action of probiotics is related to its ability to compete with pathogenic microorganisms for adhesion sites, to antagonize these pathogens or to modulate the host's immune response. Therefore, changing the actual composition of plaque from an inflammatory cytokine-rich environment to a more benign environment dominated by neutral or even helpful organisms can contribute to overall systemic health.Objective: This non systematic review summarizes the currently available data on the potential benefits of probiotics for periodontal health. Literature review: Current and relevant references were selected in order to summarize the studies conducted so far on probiotics in preventing and treating oral infections. Conclusion: Probiotics as a treatment modality deserves to be explored further with long term studies with specific focus on its role in prevention.