Identification of potential molecular mimicry in pathogen-host interactions.

Pathogens have evolved sophisticated strategies to manipulate host signaling pathways, including the phenomenon of molecular mimicry, where pathogen-derived biomolecules imitate host biomolecules. In this study, we resurrected, updated, and optimized a sequence-based bioinformatics pipeline to identify potential molecular mimicry candidates between humans and 32 pathogenic species whose proteomes' 3D structure predictions were available at the start of this study. We observed considerable variation in the number of mimicry candidates across pathogenic species, with pathogenic bacteria exhibiting fewer candidates compared to fungi and protozoans. Further analysis revealed that the candidate mimicry regions were enriched in solvent-accessible regions, highlighting their potential functional relevance. We identified a total of 1,878 mimicked regions in 1,439 human proteins, and clustering analysis indicated diverse target proteins across pathogen species. The human proteins containing mimicked regions revealed significant associations between these proteins and various biological processes, with an emphasis on host extracellular matrix organization and cytoskeletal processes. However, immune-related proteins were underrepresented as targets of mimicry. Our findings provide insights into the broad range of host-pathogen interactions mediated by molecular mimicry and highlight potential targets for further investigation. This comprehensive analysis contributes to our understanding of the complex mechanisms employed by pathogens to subvert host defenses and we provide a resource to assist researchers in the development of novel therapeutic strategies.

Phytosynthesis of Silver Nanoparticles Using Oscimum sanctum Leaf Extract and Studies on Its Antidiabetic, Antioxidant, and Antibacterial Properties.

The green synthesis of plasmonic metal nanoparticles (NPs) has gained considerable attention among researchers as it is cost-effective, environmentally friendly, energy-saving, and nontoxic. We have synthesized silver NPs (Ag NPs) with Oscimum sanctum (holy Tulsi) medicinal plant leaf extract by green synthesis methods. Further, we investigate the antibacterial, antioxidant, and antidiabetic activities of the synthesized Ag NPs. Oscimum sanctum leaf extract has secondary metabolites such as phenolic and flavonoid compounds, which play a significant role in the synthesis of Ag NPs. Subsequently, these bioactive molecules get adsorbed on the large surfaces of the synthesized NPs. Spectroscopic techniques such as X-ray diffraction (XRD), UV-visible absorption, Fourier-transform infrared, and scanning electron microscopy have been used to study and characterize the phytosynthesized Ag NPs. The XRD pattern confirms the formation of crystalline Ag NPs with a high degree of intensity. UV-visible absorption spectra confirm the surface plasmon resonance peak in the range of 440-450 nm. A scanning electron microscopy picture reveals homogeneous growth of Ag NPs with particle sizes of 200-400 nm; however, crystallite size along different planes has been estimated in the range of 18-23 nm. We have found that these Ag NPs synthesized with Oscimum sanctum leaf extract show inhibitory activity against α-amylase and α-glucosidase enzymes in vitro. Our findings further reveal that these Ag NPs are more effective in inhibiting the growth of Salmonella typhi bacteria as compared to other bacterial strains.

The Association of Psychosocial Manifestations and Quality of Life With Inflammatory Markers in SARS-CoV-2 Patients: A Study From a Dedicated COVID-19 Tertiary Care Hospital.

AIM: The second wave of the coronavirus disease 2019 (COVID-19) pandemic adversely affected an individual's physical and psychological well-being. Events such as nationwide lockdown, isolation, social distancing, loss of jobs, and mortality among close contacts and the neighborhood had a dreadful impact on the psychological well-being of the population. At the time of conducting the present study, limited literature was available on the psychosocial manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Indian population. Hence, the present study was conducted to find out the association between depression, anxiety, stress, and quality of life with inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), D-dimer, serum ferritin, procalcitonin (PCT) in SARS-CoV-2 patients during admission and follow-up in a tertiary care hospital. METHODS: This was an observational analytical study conducted during the second wave of the SARS-CoV-2 pandemic at a designated COVID-19 tertiary care hospital in New Delhi, India. Guidelines provided by the Ministry of Health and Family Welfare; the Government of India, were used for deciding hospital admissions. Sixty patients, confirmed positive by reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2, aged 18-60 years, were recruited for this study. All study subjects were screened by a rating scale for which the Hindi version of the 21-item Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was employed, and the Hindi version of the 26-item World Health Organization Quality of Life Brief Version (WHOQOL-BREF) was used to assess the quality of life. Special investigations like CRP, IL-6, D-dimer, serum ferritin, and PCT were sent on day one of admission. RESULTS: The prevalence of depression, anxiety, and stress was 63.3%, 85%, and 26.7%, respectively. The mean D-dimer level was found to be 957.32 ± 650.91 ng/ml, mean pro-calcitonin level was 1.04 ± 1.47 ng/ml, mean serum ferritin level was 722.24 ± 486.75 µg/L, mean CRP level was 65.36 ± 35.12 mg/L, and mean IL-6 level was 62.79 ± 49.05 pg/ml. The average score for the physical domain of the WHOQOL-BREF on days 7, 14, and 28 were 66.23, 77.43, and 82.18, respectively. The average score for the psychological domain on days 7, 14, and 28 were 73.93, 78.33, and 86.21, respectively. The average score for social domain on days 7, 14, and 28 were 82.63, 86.38, and 89.73, respectively. The average score for the environmental domain on days 7, 14, and 28 were 78.33, 88.78, and 90.98, respectively. The prevalence and severity of depression were significantly associated with D-dimer, CRP, ferritin, PCT, and Interleukin-6 (p<0.05). The prevalence and severity of anxiety were significantly associated with PCT, IL-6, and CRP (p<0.05). CONCLUSION: SARS-CoV-2 infection adversely affected our study population's mental well-being. An increased prevalence of psychosocial manifestations like depression, anxiety, and stress was noted in participants. We also concluded that increased levels of inflammatory markers (CRP, IL-6, PCT, D-dimer, and serum ferritin) were associated with increased prevalence of psychiatric manifestations like depression.

Stability-Indicating Densitometric Analysis of Evogliptin Tartrate in Bulk and Tablet Dosage Form.

BACKGROUND: Evogliptin tartrate is a novel dipeptidyl peptidase (DPP-4) inhibitor very recently introduced into the market as an oral hypoglycemic drug. OBJECTIVE: The literature review has revealed no reports of stability-indicating analytical methods so far for evogliptin tartrate. Thus, the goal of this study was to develop and validate a stability-indicating high-performance thin-layer chromatography (HPTLC) method for evogliptin tartrate in bulk and tablet dosage form. METHOD: For the study, precoated plates of silica gel 60F254 were used as stationary phase and acetonitrile-water-formic acid (30:8:2, v/v/v) was used as a developing system. The densitometric scanning was performed at 270 nm, and the method was validated as per International Council for Harmonisation (ICH) guidelines for accuracy, precision, limit of detection (LOD), and limit of quantitation (LOQ). Evogliptin was subjected to forced degradation studies and was exposed to various stress conditions such as acid/base hydrolysis, oxidation, thermal stress, and UV light. RESULTS: The developed method furnished compact spots of evogliptin (Rf 0.62 ± 0.05) and was linear in the concentration range of 1-5 µg/spot. The lowest detection and quantitation values were found to be 0.331 and 1.003 µg/spot, respectively, and % recovery was found to be 101.09. The low RSD values (below 2%) for intra-day (% RSD 1.86) and inter-day (% RSD 1.43) precision studies demonstrated the preciseness of the developed method. CONCLUSIONS: All the validation parameters were found to be within the acceptable range prescribed by ICH guidelines, indicating that the developed method was accurate, precise, selective, and reproducible. A total of five degradation products were resolved under various stress conditions. HIGHLIGHTS: The proposed method has a promising application commercially for identification, routine quantitative determination, and monitoring of stability of the evogliptin tartrate in bulk and tablet dosage forms to guarantee its safety, efficacy, and quality. Moreover, the developed method will also help in formulation development and in determining the appropriate storage conditions.

Vaccines against Tuberculosis: Where Are We Now?

Tuberculosis (TB) is among the top 10 leading causes of death in low-income countries. Statistically, TB kills more than 30,000 people each week and leads to more deaths than any other infectious disease, such as acquired immunodeficiency syndrome (AIDS) and malaria. TB treatment is largely dependent on BCG vaccination and impacted by the inefficacy of drugs, absence of advanced vaccines, misdiagnosis improper treatment, and social stigma. The BCG vaccine provides partial effectiveness in demographically distinct populations and the prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB incidences demands the design of novel TB vaccines. Various strategies have been employed to design vaccines against TB, such as: (a) The protein subunit vaccine; (b) The viral vector vaccine; (c) The inactivation of whole-cell vaccine, using related mycobacteria, (d) Recombinant BCG (rBCG) expressing Mycobacterium tuberculosis (M.tb) protein or some non-essential gene deleted BCG. There are, approximately, 19 vaccine candidates in different phases of clinical trials. In this article, we review the development of TB vaccines, their status and potential in the treatment of TB. Heterologous immune responses generated by advanced vaccines will contribute to long-lasting immunity and might protect us from both drug-sensitive and drug-resistant TB. Therefore, advanced vaccine candidates need to be identified and developed to boost the human immune system against TB.

Application of annotation-agnostic RNA sequencing data analysis tools for biomarker discovery in liquid biopsy.

RNA sequencing analysis is an important field in the study of extracellular vesicles (EVs), as these particles contain a variety of RNA species that may have diagnostic, prognostic and predictive value. Many of the bioinformatics tools currently used to analyze EV cargo rely on third-party annotations. Recently, analysis of unannotated expressed RNAs has become of interest, since these may provide complementary information to traditional annotated biomarkers or may help refine biological signatures used in machine learning by including unknown regions. Here we perform a comparative analysis of annotation-free and classical read-summarization tools for the analysis of RNA sequencing data generated for EVs isolated from persons with amyotrophic lateral sclerosis (ALS) and healthy donors. Differential expression analysis and digital-droplet PCR validation of unannotated RNAs also confirmed their existence and demonstrates the usefulness of including such potential biomarkers in transcriptome analysis. We show that find-then-annotate methods perform similarly to standard tools for the analysis of known features, and can also identify unannotated expressed RNAs, two of which were validated as overexpressed in ALS samples. We demonstrate that these tools can therefore be used for a stand-alone analysis or easily integrated into current workflows and may be useful for re-analysis as annotations can be integrated post hoc.

The Psychological Impact of Rhino-Orbital Mucormycosis During the Second Wave of COVID-19 Pandemic From South East Asian Country.

AIM: The present study addressed overcoming the lacunae in the literature of psychiatric manifestations associated with rhino-orbital mucormycosis. The current study aimed to assess the symptoms of depression, anxiety, stress, coping measures, suicidal intent, and visual disability in patients of rhino-orbital mucormycosis (ROM) during the epidemic of the disease at the nodal tertiary care center in North India. METHODS: Fifty-four inpatients of laboratory-proven rhino-orbital mucor-mycosis (ROM) were included for an observational, cross-sectional study at nodal, designated COVID-19, and mucormycosis treating tertiary care hospital. Patients with Hindi Mini-Mental State Examination score <24, prior psychiatric illness, and severely ill requiring ventilator support were excluded. The psychological variables were assessed using Depression, Anxiety, and Stress Scale 21 (DASS 21), Beck's Suicide intent Scale, Coping Scale Questionnaire, and Visual disability scale (IND-VFQ33). Their socioeconomic status was assessed using the Modified Kuppuswamy Scale. RESULTS: Ninety percent of patients with ROM had diabetes mellitus. The majority (44%) of patients belonged to lower socioeconomic strata. Higher frequencies of severe depression (28%), extremely severe anxiety (26%), and mild stress (17%) were noted in the study participants. On the Tukey test, depression score was higher in patients of ROM compared to COVID (with ROM) (p-value= 0.016). On Tukey analysis, anxiety score was significantly higher in ROM patients compared to COVID (with ROM) patients (p-value = 0.018). Coping scores were significantly higher in COVID (with ROM) patients compared to ROM patients (p value = 0.035). Mild to moderate visual disability was noted in the study participants.  Conclusion: The current study reflects the association of higher depression and anxiety scores in cases with ROM that indicated higher mental health needs. Early assessment, early detection, and early intervention for psychological help, along with the multidisciplinary team, helped to improve the overall psychological outcome of the affected patients.

Trends in carbapenem resistance in Pre-COVID and COVID times in a tertiary care hospital in North India.

BACKGROUND: Carbapenem resistance is endemic in the Indian sub-continent. In this study, carbapenem resistance rates and the prevalence of different carbapenemases were determined in Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa during two periods; Pre-COVID (August to October 2019) and COVID (January to February 2021) in a north-Indian tertiary care hospital. METHODS: Details of patient demographics and clinical condition was collated from the Hospital Information System and detection of carbapenemases NDM, OXA-48, VIM, IMP and KPC was done by Polymerase chain reaction (PCR) in 152 and 138 non-consecutive carbapenem resistant isolates during the two study periods respectively. Conjugation assay and sequencing of NDM and OXA-48 gene was done on a few selected isolates. RESULTS: As compared to Pre-COVID period, co-morbidities and the mortality rates were higher in patients harbouring carbapenem resistant organisms during the COVID period. The overall carbapenem resistance rate for all the four organisms increased from 23 to 41% between the two periods of study; with Pseudomonas aeruginosa and Klebsiella pneumoniae showing significant increase (p < 0.05). OXA-48, NDM and co-expression of NDM and OXA-48 were the most common genotypes detected. NDM-5 and OXA-232 were most common variants of NDM and OXA-48 family respectively during both the study periods. CONCLUSION: Higher rate of carbapenem resistance in COVID times could be attributed to increase in number of patients with co-morbidities. However, genetic elements of carbapenem resistance largely remained the same in the two time periods.

Increased Pill Burden and Adverse Effects of Psychotropics Correlated with Poor Quality of Life and Medication Nonadherence: A Cross-sectional Drug Utilization Study at a Tertiary Care Hospital in Delhi during COVID-19 Pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has led to an increase in mental health problems such as depression and anxiety. This study aims to investigate the prescribing pattern of psychotropic drugs in patients with common mental disorders which might be altered during the pandemic and also whether the pandemic could alter their quality of life (QOL) and medication adherence. MATERIALS AND METHODS: After prior ethical approval, a descriptive cross-sectional drug utilization study (DUS) of 200 prescriptions was undertaken to evaluate the pattern of psychotropic drug usage as per WHO (World Health Organization)/International Network of Rational Use of Drugs (INRUD) guidelines. The correlation of the average number of drugs per prescription with QOL was observed. The correlation of adverse drug reactions (ADRs) with medication adherence was also analyzed. RESULTS: The average number of drugs per prescription during the pre-COVID-19 and COVID-19 period was estimated to be 2.48 and 2.96. The percentage of drugs prescribed by generic name in the two different periods (pre-COVID-19 and COVID-19) was 97.40 and 95.77%. The percentage of drugs prescribed from the list of essential medicines was 89.40 and 85.12%, respectively. The percentage of prescriptions with injections was 0.45% and 0.53%, respectively for the two periods. The QOL during the COVID-19 pandemic was found to be negatively correlated to the average number of drugs per prescription (correlation coefficient = -0.61) and medication adherence was found to be poor in patients who developed ADRs with the drugs prescribed (p-value of 0.001). CONCLUSION: In the tertiary care hospital described, rational drug prescribing was followed. Increase in the number of drugs per prescription was found to be associated with poor QOL and the development of ADRs led to medication nonadherence in the patients. Further studies with larger sample sizes are needed to confirm these results. How to cite this article: Kumar A, Halder S, Srivastava S, et al. Increased Pill Burden and Adverse Effects of Psychotropics Correlated with Poor Quality of Life and Medication Nonadherence: A Cross-sectional Drug Utilization Study at a Tertiary Care Hospital in Delhi during COVID-19 Pandemic. J Assoc Physicians India 2023;71(9):14-18.

Postpartum Use of Shavari Bar® Improves Breast Milk Output: A Double-Blind, Prospective, Randomized, Controlled Clinical Study.

Background and objectives Appropriate nutrition, along with the establishment of lactation, is of paramount importance for the feeding mother and the growing neonate. Asparagus racemosus, a common name for Shatavari, is a well-known herb that has been used as a galactagogue in traditional Indian culture. It is also referenced in Ayurvedic medicine. Despite multiple formulations available, palatability has been a concern always as Shatavari is very bitter. We have devised a palatable and nutritionally rich formulation of Shatavari with no artificial ingredients. To understand the efficacy, we have conducted this double-blind, prospective, randomized, controlled study to evaluate the effect of oral Shatavari formulation (Shavari Bar®) on breast milk output in postpartum women. Methods A prospective, randomized, parallel-group, double-blind, placebo-controlled study was conducted at two centers in women with gestational age 37 weeks or more who intended to breastfeed. Hundred and four women were screened, of which 78 were randomized to receive either bar containing Shatavari and oats (n=39, study) or an identical placebo bar (n=39, control). All 78 women completed the study, 61 delivered by a lower segment Caesarean section (LSCS), and 17 had a full-term normal vaginal delivery. Time to first noticeable breast fullness was measured and expressed milk volume measurements were done 72 hours after delivery or after consumption of four bars, whichever was later using a standardized breast pump. Comparison between the two groups was analyzed using a t-test. Results Demography and baseline data of patients enrolled were similar in the two groups. The mean total milk volume expressed was higher (p=0.008) with Shavari (64.74 ml) compared to placebo (49.69 ml). The time to breast fullness was shorter (p=0.024) with Shavari (30.49 hours) compared to placebo (38.09 hours). No adverse events were noted in either of the study groups. Global assessment of the satisfaction of mothers with lactation, the well-being of the child, taste, and ease of use was better in the treatment arm than in the placebo arm. Conclusion The use of the Shavari bar can be an effective option in postpartum women to establish early lactation and build confidence in breastfeeding along with nonpharmacological intervention.

Early wound-responsive cues regulate the expression of WRKY family genes in chickpea differently under wounded and unwounded conditions.

Insect wounding activates a large number of signals that function coordinately to modulate gene expression and elicit defense responses. How each signal influences gene expression in absence of wounding is also important since it can shed light on changes occurring during the shift to wound response. Using simulated Helicoverpa armigera herbivory on chickpea, we had identified at least 14 WRKY genes that showed 5-50 fold increase in expression within 5-20 min of wounding. Our studies show that contrary to their collective effects upon wounding, individual chemical cues show distinct and often opposite effects in absence of wounding. In particular, jasmonic acid, a key early defense hormone, reduced transcripts of most WRKY genes by > 50% upon treatment of unwounded chickpea leaves as did salicylic acid. Neomycin (a JA biosynthesis inhibitor) delayed and also reduced early wound expression. H2O2 transiently activated several genes within 5-20 min by 5-8 fold while ethylene activated only a few WRKY genes by 2-5 fold. The summation of the individual effects of these chemical cues does not explain the strong increase in transcript levels upon wounding. Detailed studies of a 931 nt region of the CaWRKY41 promoter, show strong wound-responsive GUS expression in Arabidopsis even in presence of neomycin. Surprisingly its expression was lost in the coi1, ein2 and myc2myc3myc4 mutant backgrounds suggesting the requirement of intact ethylene and JA signaling pathways (dependent on MYCs) for wound-responsive expression. The studies highlight the complexity of gene regulation by different chemical cues in the presence and absence of wounding. Supplementary Information: The online version contains Supplementary material available at 10.1007/s12298-022-01170-y.

TB positive cases go up in ongoing COVID-19 pandemic despite lower testing of TB: An observational study from a hospital from Northern India.

The whole world is wrestling against SARS-CoV-2 infection (COVID-19). COVID-19-TB co-infection is also reported but there are limited number of studies which analyze the impact of COVID-19 pandemic in TB diagnosis and management. In this retrospective study, we observed that the TB diagnosis was reduced in pandemic time. Before COVID-19 pandemic (March-December 2019), there were 644 TB tests out of which 127 were TB positive. In ongoing COVID-19 pandemic (January-October 2020), 484 TB tests were performed and 146 patients were TB positive. Male accounted for 64%/57% of TB cases in 2019/2020 whereas female patients were 35%/42% in 2019/2020. Increase in female TB positive cases was a noticeable feature. The newly diagnosed with TB cases in 2019/2020 were 112/130 respectively. Though, we have seen only 7 COVID-TB co-infection cases, we could not establish the causal relationship in COVID-TB co-infection. The increase in the number of TB positive cases during COVID-19 pandemic clearly showed how adversely COVID-19 has affected TB diagnosis and management. Anticipating the increase in TB cases in future, we emphasize the need to ensure continuous TB testing and treatment despite the pandemic burden. Further study on the COVID-TB co-infection in high TB-burden countries like India, is required to enable analyses of interactions, risk factors in COVID-19-TB co-infection.

Association of serotonin transporter gene polymorphism with efficacy of the antidepressant drugs sertraline and mirtazapine in newly diagnosed patients with major depressive disorders.

OBJECTIVE: We examined the association of serotonin receptor transporter gene polymorphism in patients with MDD with the clinical efficacy of mirtazapine (MZ) and sertraline (ST). METHOD: Newly diagnosed, treatment naïve, 80 MDD patients (aged 18-45) diagnosed using DSM-5 criteria and with Beck's depression inventory score (BDI) score ≥21 were included and randomly divided into two groups of 40 participants and were administered MZ 15-45 mg/day or ST 25-200 mg/day respectively. Patients were followed up for 6 weeks for evaluation of BDI scores. Genotypic evaluation was done and three allele variants were identified based on the polymerase chain reaction fragment sizes: short (S; 486 bp), long (L; 529 bp), or extralong (XL; 612 or 654 bp) and classified into five genotypes: S/S,S/L, L/L, S/XL, and L/XL. RESULT: We found that 32.5% patients belonged to the S/S genotype, suggesting that individuals with the SS genotype are at higher risk of developing MDD. No statistically significant association was seen with ST or MZ groups on the basis of genotypes. Clinically significant improvement was observed with a more than 50% reduction in BDI scores at 6 weeks of treatment with both drugs. CONCLUSION: Identification of risk population can be carried out by genotype testing. Prior genotyping in MDD patients might help to predict a better clinical outcome with antidepressants.

Correlation between telomere length and efficacy of oral and long-acting injectable antipsychotics on severity and cognitive impairment of schizophrenia.

OBJECTIVE: To study the correlation between telomere length (TL) and long-acting injectable (LAI) and oral atypical antipsychotic (OAA) efficacy on schizophrenia (SCZ) severity and cognitive impairment. METHODS: Sixty Schizophrenia patients of 18-50 years and of either sex were included in a 12-week study. Thirty patients were recruited in each group, LAI and OAA. Positive and Negative Syndrome Scale (PANSS) and National Institute of Mental Health and Neuro-Sciences (NIMHANS) neuropsychological battery tests were evaluated at baseline and 12 weeks. TL was estimated at baseline. RESULTS: Both groups showed a significant improvement in PANSS and NIMHANS battery test scores after treatment (p < 0.001) within the group, though not between the groups. Mean TL at baseline was 407.58 ± 143.93 and 443.40 ± 178.46 in LAI and OAA groups respectively. A significant negative correlation (r = -0.28, p = 0.03) of TL was seen with the mean change in negative PANSS score after treatment. CONCLUSIONS: LAI antipsychotics are similar to OAA in decreasing the disorder severity and improving the cognitive impairment in schizophrenia. Also, patients who have shorter TL show greater improvement in the negative PANSS score. Hence, TL holds the potential of predicting antipsychotic drug response in schizophrenia patients.KEY POINTSLong-acting injectable antipsychotic was comparable to oral atypical antipsychotics in bringing out improvement in disorder severity, cognitive functions over 12 weeks.Shorter telomere length has been found to be associated with a greater response in negative symptoms of schizophrenia.

Comparison Between Inflammatory Biomarkers (High-Sensitivity C-Reactive Protein and Neutrophil-Lymphocyte Ratio) and Psychological Morbidity in Suicide Attempt Survivors Brought to Medicine Emergency.

OBJECTIVES: This study aimed to compare inflammatory biomarkers (high-sensitivity {hs} C-reactive protein, neutrophil-lymphocyte ratio) and psychological morbidity in suicide attempt survivors. METHODS: One hundred ninety-eight poisoning cases screened, 40 age-matched suicide attempt survivors (SAS), 40 healthy controls (HC) between the age of 18 years and 60 years were included. Complete hemogram, neutrophil-lymphocyte ratio (NLR), hsCRP values obtained, compared with Hospital Anxiety and Depression Scale (HADS), suicide intent scale, presumptive stressful life events scale (PSLES), general health questionnaire 12-item (GHQ-12) (Hindi version), and Hindi Mental State Examination (HMSE). RESULTS: A statistically significant difference was observed in hsCRP (p=0.016) and NLR (p=0.029) of depressed-suicidal participants vs healthy controls. hsCRP values of anxious-suicidal subjects vs healthy controls showed a statistically significant difference (p=0.001). There was a statistically significant difference between patients, healthy controls in HADS anxiety and HADS depression mean scores (p<0.001). The PSLES items were ranked according to the mean stress scores of all the items (mean±SD), highest four were excessive alcohol use by the family member 47.50 (±27.03), conflicts with in-laws 50 (±27.73), family conflict 50 (±29.42), marital conflict 50.63 (±32.76). There was a statistically significant difference in hemoglobin (p<0.001), red blood cells count (p<0.001), hematocrit (p<0.001) between suicide attempt survivors and healthy controls. CONCLUSION: Both hsCRP and NLR have emerged as potential inflammatory biomarkers for depressive patients with suicidal attempts. Additionally, there may be a link between anemia and suicide risk in patients with depression.

Aptamers: An Emerging Tool for Diagnosis and Therapeutics in Tuberculosis.

Tuberculosis (TB) has been plaguing human civilization for centuries, and currently around one-third of the global population is affected with TB. Development of novel intervention tools for early diagnosis and therapeutics against Mycobacterium tuberculosis (M.tb) is the main thrust area in today's scenario. In this direction global efforts were made to use aptamers, the chemical antibodies as tool for TB diagnostics and therapeutics. This review describes the various aptamers introduced for targeting M.tb and highlights the need for development of novel aptamers to selectively target virulent proteins of M.tb for vaccine and anti-TB drugs. The objective of this review is to highlight the diagnostic and therapeutic application of aptamers used for tuberculosis. The discovery of aptamers, SELEX technology, different types of SELEX development processes, DNA and RNA aptamers reported for diseases and pathogenic agents as well have also been described in detail. But the emphasis of this review is on the development of aptamers which can block the function of virulent mycobacterial components for developing newer TB vaccine candidates and/or drug targets. Aptamers designed to target M.tb cell wall proteins, virulent factors, secretory proteins, or combination could orchestrate advanced diagnosis and therapeutic measures for tuberculosis.

Behavioral Intervention in Children with Functional Abdominal Pain Disorders: A Promising Option.

BACKGROUND: The objectives of this study were to identify and classify patients with functional abdominal pain disorders (FAPD) into its various subtypes as per the Rome IV criteria and to evaluate the underlying psychological factors and the effect of behavioral intervention in children with FAPD. METHODS: A validated Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS) based on Rome IV criteria was used to identify and classify children presenting with abdominal pain. The children diagnosed as having FAPD were referred for psychological screening to evaluate for underlying psychosocial problems. The scales namely Pediatric Anxiety Rating Scale (PARS), Depression self-rating scale (DSRS), and Visual Analog Scale (VAS) were administered to children to assess the response of the child to behavioral therapy. RESULTS: Of 100 children, 32, 26, 22, and 20% of children belonged to the subtypes of functional abdominal pain-not otherwise specified, abdominal migraine, irritable bowel syndrome, and functional dyspepsia, respectively. The most common associated psychosocial factors were academic burden, poor financial condition, exam-related stress, and bullying at school. The influence of behavioral therapy was statistically significant (P < .05). The mean (±standard deviation) PARS and DSRS scores were significantly reduced at 3 months of follow-up. DISCUSSION: The most common subtypes reported were functional abdominal pain-not otherwise specified and abdominal migraine. Psychological factors such as academic burden, poor financial condition, exam-related stress, and bullying at school need to be ruled out in children with this condition. Non-pharmacological intervention such as behavioral therapy can confer a remarkable improvement in the symptoms of children with FAPD.

Mycobacterium tuberculosis protein PPE2 binds to DNA region containing promoter activity.

ppe2 gene is predicted to be present in operon with non pe/ppe genes, cobq1 and cobu as ppe2-cobq1-cobu. Thus, we were interested to investigate the role of ppe2 in operonic organization. We performed microscale thermophoresis (MST) experiment which revealed that PPE2 protein could bind to upstream DNA segments of ppe2-cobq1-cobu operon. Upstream region of ppe2 had shown promoter activity in ß-gal assay. In this study, for the first time, a physical interaction between PPE2 protein and DNA fragment was reported, suggesting that PPE2 protein plays a role in the regulation of the putative ppe2-cobq1-cobu operon, via unknown mechanism.

Relationship between subjective and objective measures of anticipatory anxiety prior to extraction procedures in 8- to 12-year-old children.

BACKGROUND: This study assessed anticipatory dental anxiety levels among 8- to 12-year-old children based on subjective and physiological measures and their correlation. The variations in anxiety based on sex, age, temperament, and academic performance were evaluated. METHODS: An observational study was conducted in 60 children recruited from the waiting room over a 6-month period. The operator recorded subjective anxiety in the children using a novel visual facial anxiety scale. The operator also noted the demographic details and child's temperament using the nine dimensions of the Thomas and Chess criteria, and graded children as "easy," "slow to warm-up," and "difficult." The academic performance of the children was graded (parental ratings) on a five-point Likert scale. Physiological variables (heartrate [HR], oxygen saturation[SpO2], and blood pressure [BP]) were recorded by another evaluator. The correlation between anxiety levels and physiological variables was also assessed. The effects of age, sex, temperament, and academic performance on anxiety were evaluated. RESULTS: The study included 60 children aged 8-12 years, including 36 boys and 24 girls. Seventy percent of children had mild to moderate levels of pre-extraction anxiety, while 30% of children demonstrated high anxiety. A significant positive correlation was noted between anxiety levels and HR (rs = 0.477, P < 0.001*) and systolic BP (rs = 0.294, P < 0.05), while a significant but inverse correlation was observed with SpO2 (rs = -0.40, P < 0.05). Anxiety did not influence diastolic BP. Children with difficult temperament and poor academic performance had significantly higher anxiety. CONCLUSION: A high percentage (70%) of children aged 8-12 years had mild to moderate anxiety prior to the extraction procedure. Increased HR, systolic BP, and reduced SpO2 were significantly associated with high levels of anticipatory dental anxiety. Pre-extraction anxiety was significantly related to the temperament and scholastic performance.