Synthesis, characterization, DFT analysis and docking studies of a novel Schiff base using 5-bromo salicylaldehyde and ß-alanine.

Poly(ADP-ribose) polymerase-1(PARP-1) is a DNA-dependent enzyme, forming part of ADP-ribosyltransferase family. Although some PARP inhibitors find therapeutical applications in cancer therapy and exhibits crucial role in DNA damage response. Here a novel Schiff base, (E)-3-((5-bromo-2-hydroxybenzylidene) amino) propanoic acid was synthesized using 5-bromo salicylaldehyde and ß-alanine. Characterization was carried out using IR, UV-Vis,1H and 13C NMR and mass spectrum. Present study involves the evaluation of a novel Schiff base as an inhibitor against human breast cancer cell lines (pdb:3GEY) using 2-(dimethylamino)-N-(6-oxo-5,6-dihydrophenanthridin-2-yl) acetamide (DDA) as a native ligand. In silico study of 3GEY inhibitor is a variant of PARP-15, docking with two different ligands (E)-3-((5-bromo-2-hydroxybenzylidene) amino) propanoic acid (SBL) and the native ligand. Synthesized ligandis docked in to the B chain of PARP enzyme binding site to visualize the best docked poseand favorable ligand-protein binding interactions. Swiss ADME tool determines the drug likeness and strongly suggests that SBL can be a promising candidate to fight against breast cancer. DFT studies were done to support the experimental results using B3LYP/6-311+G(d,p) and geometry optimization was performed. Various thermodynamic parameters and NLO properties were found out. ECD and VCD spectrum were explained using DFT studies. Vibrational and Raman frequencies were also reported. HOMO-LUMO band gaps, Mulliken charges were calculated and the electrostatic potential surface was mapped with various properties. Experimental findings obtained are in good agreement with that of theoretical DFT analysis.

Impact of dietary counselling on the nutritional status and quality of life among pulmonary tuberculosis patients - A randomized control trial.

BACKGROUND & AIM: Undernutrition and TB have a bidirectional relationship, which is especially relevant in the Indian context. Undernutrition is an established risk factor for the progression of latent TB infection to active TB. Undernutrition at the population level contributes to an estimated 55% of annual TB incidence in India. TB leads to weight loss, wasting, and worsening of nutritional status. Hence, the present study aimed to determine the impact of dietary counselling on the nutritional status and the health-related quality of life of PTB patients. MATERIALS & METHOD: This was an interventional study (randomized controlled trial) that involved patients with PTB. 46 patients (23 patients as experimental and 23 patients as a control group) were enrolled in the study from June 2019 to February 2020 and they were divided into 2 categories based on BMI (underweight and normal weight). The special dietary counselling was given to the experimental group patients and the normal protocol was followed with the control group. The patients were followed up, till completion of treatment i.e., 6 months from enrolment. RESULTS: In our study, nearly half of the patients were underweight and DM was the predominant comorbidity. The BMI increased after dietary counselling in the experimental group than the control group (P = 0.0053) in underweight individuals. Total protein (P = 0.0025), and serum albumin (P = 0.0048) levels were found to be significantly improved in the experimental group. SGRQ symptom score (P = 0.0036) has significantly reduced in the experimental group in underweight individuals than the control group. CONCLUSION: Personalized dietary counselling was found to have a positive impact on BMI, total protein, and albumin levels in the experimental group, especially in underweight individuals. Besides, the quality of life measured using SGRQ showed that symptom score were also significantly reduced in the experimental group than the control group.

Visible light photodegradation of 2,4-dichlorophenol using nanostructured NaBiS2: Kinetics, cytotoxicity, antimicrobial and electrochemical studies of the photocatalyst.

Removal of the hazardous and endocrine-disrupting 2,4-dichlorophenol (2,4-DCP) from water bodies is crucial to maintain the sanctity of the ecosystem. As a low bandgap material (1.37 eV), NaBiS2 was hydrothermally prepared and used as a potential photocatalyst to degrade 2,4-DCP under visible light irradiation. NaBiS2 appeared to be highly stable and remained structurally undeterred despite thermal variations. With a surface area of 6.69 m2/g, NaBiS2 has enough surface-active sites to adsorb the reactive molecules and exhibit a significant photocatalytic activity. In alkaline pH, the adsorption of 2,4-DCP on NaBiS2 appeared to decrease whereas, the acidic and neutral environments favoured the degradation. An increase in the photocatalyst dosage enhanced the degradation efficiency from 81 to 86 %, because of higher vacant adsorbent sites and the electrostatic attraction between NaBiS2 and 2,4-DCP. The dominant scavengers degraded 2,4-DCP by forming a coordination bond between chlorine's lone pair of electrons and the vacant orbitals of bismuth, following the order hole> OH > singlet oxygen. Being non-toxic to both natural and aquatic systems, NaBiS2 exhibits antifungal properties at higher concentrations. Finally, the electron-rich NaBiS2 is an excellent electrocatalyst that effectively degrades organic pollutants and is a promising material for industrial and environmental applications.

Mobile App Based Strategy Improves Door-to-Needle Time in the Treatment of Acute Ischemic Stroke.

BACKGROUND: Time to revascularization is critical in improving outcomes in stroke thrombolysis. We studied the effectiveness of a mobile app based strategy to improve door-to-needle time (DNT) in treatment of acute ischemic stroke. METHODS: Consecutive patients presenting with acute ischemic stroke to the emergency department at a tertiary care hospital in Southern India between April 2017 - September 2018 were included. The app enabled rapid entry of patient parameters, the NIH stroke scale (NIHSS), thrombolysis checklist and dose calculation along with team synchronization, notifying all on-call members and team leaders of the patient movement, and sharing of radiological images. DNT captured from the app was compared to previous values from our center using one-way Analysis of Variance (ANOVA) after adjusting for differences in baseline variables. RESULTS: A total of 76 patients were thrombolysed during the study period, while using the mobile app. The mean DNT was 41 min, with 89% being thrombolysed within 60 min and 57% being thrombolysed within 45 min. Compared to 100 consecutive patients thrombolysed in the months prior to April 2017 where the mean DNT was 57 min, with 67% thrombolysed within 60 min and 47% being thrombolysed within 45 min, there was a mean DNT decrease of 16 min with 1.3x increase in DNT < 60 min. This difference was statistically significant after adjusting for age, sex and NIHSS Score (p=0.005, One-Way ANOVA). CONCLUSION: We have been able to demonstrate a significant improvement in DNT using mobile app as a tool to improve team performance.

Consensus Statement - Suggested Recommendations for Acute Stroke Management during the COVID-19 Pandemic: Expert Group on Behalf of the Indian Stroke Association.

The ongoing pandemic of COVID-19 is a global public health emergency. This has led to challenges for healthcare facilities to optimally manage other important medical emergencies. Stroke is an important public health emergency with significant mortality and morbidity. Timely treatment of acute stroke is critical to prevent disability. The current expert consensus statement on behalf of the Indian Stroke Association outlines the issues and suggestions related to the management of stroke during this ongoing COVID-19 pandemic.

Gray matter volume covariance patterns associated with gait speed in older adults: a multi-cohort MRI study.

Accelerated gait decline in aging is associated with many adverse outcomes, including an increased risk for falls, cognitive decline, and dementia. Yet, the brain structures associated with gait speed, and how they relate to specific cognitive domains, are not well-understood. We examined structural brain correlates of gait speed, and how they relate to processing speed, executive function, and episodic memory in three non-demented and community-dwelling older adult cohorts (Overall N = 352), using voxel-based morphometry and multivariate covariance-based statistics. In all three cohorts, we identified gray matter volume covariance patterns associated with gait speed that included brain stem, precuneus, fusiform, motor, supplementary motor, and prefrontal (particularly ventrolateral prefrontal) cortex regions. Greater expression of these gray matter volume covariance patterns linked to gait speed were associated with better processing speed in all three cohorts, and with better executive function in one cohort. These gray matter covariance patterns linked to gait speed were not associated with episodic memory in any of the cohorts. These findings suggest that gait speed, processing speed (and to some extent executive functions) rely on shared neural systems that are subject to age-related and dementia-related change. The implications of these findings are discussed within the context of the development of interventions to compensate for age-related gait and cognitive decline.

Unmasking of complements using proteinase-K in formalin fixed paraffin embedded renal biopsies.

Renal biopsy interpretation requires histopathology, direct immunofluorescence (DIF) and electron microscopy. Formalin-fixed, paraffin-embedded tissue (FFPE) sent for light microscopy can be used for DIF after antigen retrieval. However, complement staining has not been satisfactory. We standardized DIF using proteinase-K for antigen retrieval in FFPE renal biopsies. A pilot study was conducted on known cases of membranous glomerulonephritis (MGN), membranoproliferative type-1 (MPGN-1), immunoglobulin A nephropathy (IgAN), and anti-glomerular basement disease (anti-GBM). Immunofluorescence panel included fluorescein isothiocyanate (FITC) conjugated IgG, IgA, IgM, complements (C3 and C1q), light chains (kappa, lambda) and fibrinogen antibodies. After standardization of the technique, 75 renal biopsies and 43 autopsies cases were stained. Out of 43 autopsy cases, immune-complex mediated glomerulonephritis (GN) was confirmed in 18 cases (Lupus nephritis-11, IgAN-6, MGN-1), complement-mediated dense deposit disease (DDD-1) and monoclonal diseases in 4 cases (amyloidosis-3, cast nephropathy-1). Immune-mediated injury was excluded in 17 cases (focal segmental glomerulosclerosis -3, crescentic GN-6 [pauci-immune-3, anti-GBM-3], thrombotic microangiopathy-5, atherosclerosis-3). Renal biopsies (n-75) where inadequate or no frozen sample was available; this technique classified 52 mesangiocapillary pattern as MPGN type-1-46, DDD-2 and (C3GN-4). Others were diagnosed as IgAN-3, lupus nephritis-2, MGN-4, diffuse proliferative glomerulonephritis (DPGN)-1, Non-IC crescentic GN-1, monoclonal diseases-3. In nine cases, DIF on FFPE tissue could not help in making diagnosis. Proteinase-K enzymatic digestion of FFPE renal biopsies can unmask complements (both C3 and C1q) in immune-complexes mediated and complement-mediated diseases. This method showed good results on autopsy tissues archived for as long as 15 years.

White Matter Hyperintensities in Older Adults and Motoric Cognitive Risk Syndrome.

INTRODUCTION: Motoric cognitive risk (MCR) syndrome is a recently described pre-dementia syndrome characterized by slow gait and cognitive complaints that has been implicated as a predictor of cognitive decline and dementia in older adults. Previous work suggests that cerebrovascular disease is associated with MCR. White matter hyperintensities (WMH) are postulated to be a product of cerebrovascular disease, and have been associated with impaired mobility and impaired cognition. This study aimed to determine if MCR is associated with regional WMH. METHODS: Two cross-cultural cohorts of non-demented older adults were examined: 174 from a French memory clinic (62.1% male, mean age 70.7 ± 4.3 years) and 184 from an Indian community-dwelling cohort (55.4% male, mean age 66.2 ± 5.2 years). Participants were evaluated for slow gait, cognitive complaints, and regional WMH via MRI (fluid attenuated inversion recovery) FLAIR sequence. RESULTS: Overall, 20.7% of participants met criteria for MCR, and 72.9% of participants had WMH on FLAIR. WMH in the frontal, parieto-occipital, temporal, basal ganglia, cerebellum, or brainstem were not associated with MCR in either of the two cohorts. CONCLUSION: WMH was not significantly associated with MCR in this studied sample of participants, suggesting that other cerebrovascular pathophysiological mechanisms, or combination of mechanisms, might underlie MCR.

Leukoencephalopathy with intracranial calcifications and cysts in an adult: Case report and review of literature.

Leukoencephalopathy, intracranial calcifications, and cysts (LCC) is a very rare cerebral disorder, first described in 3 children in 1996. It has subsequently been reported in adults and children from Europe and America, but has not so far been reported from Asia. We report an adult patient with pathologically proven LCC from a tertiary care hospital in South India. He presented with features of ataxia and raised intracranial pressure. Magnetic resonance imaging of the brain showed multiple bilateral cerebral cystic lesions along with diffuse white matter lesions in the cerebral and cerebellar white matter, and computed tomography of brain showed multiple calcifications in the white matter and basal ganglia. A large right cerebellar cyst causing mass effect was surgically excised. Histopathologic features were consistent with earlier reports of LCC and showed Rosenthal fibers, angiomatous changes, and calcifications. Our report suggests that although it is rare, LCC has a global distribution.

Intravenous thrombolysis for acute ischemic stroke: the Malabar experience 2003 to 2008.

We report the 5-year experience with thrombolysis in acute ischemic stroke from a tertiary care hospital in the Malabar region of South India. All stroke patients thrombolyzed with intravenous recombinant tissue plasminogen activator (rt-PA) from May 2003 to May 2008 were studied in an open, non-randomized, prospective study. Of 2,308 ischemic stroke patients admitted, 57 patients (2.5%) were thrombolyzed with rt-PA (age range, 35-78 years: 40 males, 17 females). The time from presentation at the hospital to initiation of thrombolysis ranged from 15 to 120 minutes (median 50 minutes). The dose of rt-PA used was from 0.6 mg/kg to 0.9 mg/kg. At 3 months 29 patients (51%) were functionally independent, with a modified Rankin scale score of 2 or less. Seven patients (12%) died within 3 months; one had an intracerebral hemorrhage (1.7%). The benefit of treatment was seen in all stroke subtypes. We have been able to show that intravenous thrombolysis in acute ischemic stroke is safe, effective and feasible in our part of the world.

Cirrhosis presenting as Parkinsonism.

Cirrhosis presenting as Parkinsonism is a distinct subset of acquired chronic hepatocerebral degeneration. The entity is not rare, and unless suspected, cirrhosis can easily be overlooked. We report our experience with three such patients. They presented to us, over a period of two years, with symmetrical Parkinsonism and were later diagnosed to have cirrhosis with portal hypertension. All patients had minimal or absent tremors. Reversal of serum albumin to globulin ratio and evidence of cirrhosis on abdominal ultrasound were consistent. All three patients had the characteristic MRI abnormality of symmetrical T1 hyperintensity in basal ganglia and anterior midbrain. They improved to variable extents after treatment for cirrhosis, along with dopa agonists. We stress the importance of recognizing this syndrome and briefly review the relevant literature.

Modeling the energy content of combustible ship-scrapping waste at Alang-Sosiya, India, using multiple regression analysis.

Alang-Sosiya is the largest ship-scrapping yard in the world, established in 1982. Every year an average of 171 ships having a mean weight of 2.10 x 10(6)(+/-7.82 x 10(5)) of light dead weight tonnage (LDT) being scrapped. Apart from scrapped metals, this yard generates a massive amount of combustible solid waste in the form of waste wood, plastic, insulation material, paper, glass wool, thermocol pieces (polyurethane foam material), sponge, oiled rope, cotton waste, rubber, etc. In this study multiple regression analysis was used to develop predictive models for energy content of combustible ship-scrapping solid wastes. The scope of work comprised qualitative and quantitative estimation of solid waste samples and performing a sequential selection procedure for isolating variables. Three regression models were developed to correlate the energy content (net calorific values (LHV)) with variables derived from material composition, proximate and ultimate analyses. The performance of these models for this particular waste complies well with the equations developed by other researchers (Dulong, Steuer, Scheurer-Kestner and Bento's) for estimating energy content of municipal solid waste.

Distribution, enrichment and accumulation of heavy metals in coastal sediments of Alang-Sosiya ship scrapping yard, India.

Since its inception in 1982, the Alang-Sosiya yard has become the largest ship scrapping works in the world. Several hundreds of ships arrive every year. The degree of heavy metal contamination has been studied in bulk and fine sediments from the intertidal zone of this ship scrapping yard, two stations, one on either side at 5 km distance and one reference station 60 km distance near Mahuva, towards the south. The samples have been subjected to a total digestion technique and analysed for elements: Cd, Co, Cu, Cr, Fe, Mn, Ni, Pb, Zn and Al, and %TOC. The absolute metal concentrations reflected variations in BF and FF sediment samples with organic matter content. Enrichment factors (EF) and geoaccumulation indices (Igeo) have been calculated and the relative contamination levels are assessed at these sites. At Alang-Sosiya, the enrichment of heavy metals has been observed to be relatively high.

Quantification and classification of ship scraping waste at Alang-Sosiya, India.

Alang-Sosiya located on the Western Coast of Gulf of Cambay, is the largest ship recycling yard in the world. Every year on average 365 ships having a mean weight (2.10x10(6)+/-7.82x10(5) LDT) are scrapped. This industry generates a huge quantity of solid waste in the form of broken wood, rubber, insulation materials, paper, metals, glass and ceramics, plastics, leather, textiles, food waste, chemicals, paints, thermocol, sponge, ash, oil mixed sponges, miscellaneous combustible and non-combustible. The quantity and composition of solid waste was collected for a period of three months and the average values are presented in this work. Sosiya had the most waste 15.63 kg/m(2) compared to Alang 10.19 kg/m(2). The combustible solid waste quantity was around 83.0% of the total solid waste available at the yard, which represents an average weight of 9.807 kg/m(2); whereas, non-combustible waste is 1.933 kg/m(2). There is not much difference between the average of total solid waste calculated from the sampling data (96.71 MT/day) and the data provided by the port authorities (96.8 MT/day).

Restless legs syndrome: diagnosis and treatment.

AIM: To describe clinical, biochemical and electrophysiological profile in Indian patients with Restless Legs Syndrome. MATERIAL AND METHODS: A total of 84 patients with sleep disorders were evaluated. Eight patients were diagnosed to have RLS. All underwent series of hematological, biochemical investigations and electrophysiological studies. Severity was assessed before and after specific treatment RESULTS: Eight patients presenting with clinical features of RLS formed the study group. The mean age was 51.6 +/- 13.8 years. The male : female ratio was 7:1. Six cases were primary and two were of secondary type of RLS. Seven patients reported significant improvement in symptoms after treatment CONCLUSION: RLS can be diagnosed purely on clinical criteria; and appropriate treatment results in significant relief. Thus, the recognition of this entity is essential.

Obstructive sleep apnoea: a case-control study.

INTRODUCTION: Obstructive sleep apnoea (OSA), is characterized by loud snoring and excessive daytime sleepiness. Though the gold standard for diagnosis is overnight polysomnography (PSG), sleep questionnaires have also been used to diagnose this with good predictive value. MATERIAL AND METHODS: A pre-designed proforma with clinical details, symptom-specific questions for diagnosis of OSA, and Epworth Sleepiness Scale (ESS) was administered to 20 patients presenting to the Sleep Disorder Clinic of our hospital and to 40 age and sex-matched relatives (control group). The students 't-test' and chi-square were used as the statistical tests. RESULTS: There were 20 patients with a mean age of 41+/- 8 years, and 40 controls with a mean age of 41 +/- 6 years (P=>0.05). Seven had family history of snoring in the study group and 3 in the control group (P=0.02). Four had met with road traffic accidents in the study group and none in the control group (P=0.001). The body mass index (BMI) was 29.9 (SD 4.4) in the study group and 24.5 (SD3.5) in the controls (P=0.001). The mean ESS was 13.3 +/- 6 in the patients and 4.2+ 4 in the controls (P=0.001). A larger number of patients with OSA had hypertension: 5/20 vs. 3/40 (P=0.01). CONCLUSION: Patients with OSA had significantly higher BMI and ESS score, and were more likely to have hypertension and road traffic accidents. Increased awareness of this entity is essential.

Cervical spondylotic myelopathy: functional and radiographic long-term outcome after laminectomy and posterior fusion.

OBJECTIVE: To evaluate the long-term efficacy of cervical laminectomy with posterior lateral mass fusion/fixation in the treatment of patients with cervical spondylotic myelopathy (CSM). METHOD: Twenty-five patients treated for CSM by laminectomy and lateral mass fusion at the Division of Neurosurgery at The Ohio State University between 1989 and 1994 were studied retrospectively. Only patients with longer than 2-year postoperative follow-up durations were included. At follow-up examination, each patient completed an SF36 questionnaire, underwent a physical examination, underwent plain radiography showing the spinal curvature with plate and screw position, and underwent magnetic resonance imaging of the cervical spine, which evaluated dural sac decompression and spinal cord abnormalities. Patient-generated data were used for outcome measurements. RESULTS: The mean follow-up duration was 47.5 months. Good outcome was defined by the presence of three criteria: ability to walk unassisted (Grade IIIA or better), ability to write unassisted, and ability to manage buttons and/or zippers unassisted. The inability to meet these criteria was defined as a poor outcome. Two patients (8%) experienced complications that resulted from the surgery. There was no instability or progression to significant kyphosis. Lesions that were hyperintense on magnetic resonance images did not correlate with outcome. Eighty percent of the patients achieved good outcomes, and 76% had improved myelopathy scores. None of the patients had late neurological deterioration. Patients with better neurological statuses at the time of surgery (Grade IIIA or better) were more likely to improve (P < 0.0001); the likelihood of a change in status for those starting with poorer grades (IIIB or worse) was not statistically significant (P < 0.08). CONCLUSION: Cervical laminectomy with posterior fusion/fixation proved useful in the treatment of patients with CSM with straight or lordotic spines and multilevel compression. This therapy addresses the dynamic and compressive forces that are important in the pathogenesis of CSM, resulting in minimal complications and possible improvement in long-term outcomes.

Lessons from atypical groin pain: presentation and treatment of a schwannoma.

A 16-year-old boy presented with pain in the right knee, groin, and hip after a touch football game. He was initially diagnosed as having a medial collateral ligament sprain of the right knee and an adductor muscle strain. Despite standard conservative therapy, he had persistent hip pain and migratory pain to the right lower abdomen and flank. A bone scan and abdominal CT scan were negative, but MRI revealed a mass in the cauda equina at L3-4, confirmed with myelography. A benign schwannoma was surgically excised without neurologic sequelae. The patient resumed daily activities 5 weeks after surgery.

Granular cell tumour of the spinal cord in a patient with Rubenstein-Taybi syndrome.

A case of cervical spinal cord granular cell tumour in a patient with Rubenstein-Taybi syndrome is described. A granular cell tumour arising from the spinal cord itself has never been previously described. Complete excision of the tumour could not be achieved owing to its location. It subsequently recurred and was treated with radiotherapy. The patient made a complete recovery with no further recurrence after 2 years of follow-up.