Exploring Patterns of Medication Usage in Affective Disorder Patients: A Comprehensive Investigation at a Psychiatry Outpatient Clinic of a Tertiary Care Hospital.

INTRODUCTION: Affective disorders impose a significant burden on public health due to their high prevalence and associated suffering. This study addresses gaps in current literature and clinical practice by providing insights into medication usage trends, which can inform treatment strategies and optimize patient care. The study aims to investigate drug utilization patterns, particularly focusing on defined daily dose/1000/day, among individuals attending a psychiatric outpatient department of a tertiary care hospital. METHODS: This cross-sectional, prospective drug utilization study included 600 affective disorder patients aged 18 years and above. The study period spanned 12 months, from March 2021 to February 2022. Data on demographics, diagnosis, treatment, and counseling were collected and analyzed using descriptive statistics. RESULTS:  Among the 600 patients analyzed, bipolar mood disorder was the most prevalent (239 patients, 39.83%), followed by depressive disorder (208 patients, 34.67%). Triple therapy was the most common prescription regimen, accounting for 308 encounters (51.33%). The average number of drugs per encounter was 3.75 ± 1.01. A combination of psychotherapy and medication counseling sessions was provided to 594 patients or their relatives, representing 99% of the total encounters. CONCLUSION: The study highlights the prevalent use of triple therapy in managing affective disorders, especially bipolar mood disorder and mania disorder. Effective utilization of essential drug lists and comprehensive patient counseling underscores the importance of holistic care in psychiatric outpatient settings. RECOMMENDATION:  Given the high prevalence of triple therapy, further research into the efficacy and safety of this treatment approach is warranted. Additionally, continued emphasis on patient education and counseling can enhance treatment adherence and overall outcomes in individuals with affective disorders.

Characterization of Bioactive Metabolites and Antioxidant Activities in Solid and Liquid Fractions of Fresh Duckweed (Wolffia globosa) Subjected to Different Cell Wall Rupture Methods.

Fresh Wolffia globosa, the smallest flowering plant well-known for its favorable nutrient composition and rich content of bioactive compounds, was subjected to boiling, freeze-thawing, and mechanical crushing to reduce its excessive (95-96%) moisture level and consequent drying time. The resultant three wolffia matrixes were filtered through a plankton net to fractionate into the residue and the filtrate. The proximate composition, bioactive metabolites, antioxidant activity, and characterization of bioactive metabolites by LC-ESI-QTOF-MS/MS and Fourier transform infrared spectroscopy were made from oven-dried residues and filtrates. Among residues, crude protein (29.84%), crude lipid (5.77%), total carotenoids (TCC; 722.8 µg/g), and vitamin C (70.02 mg/100 g) were the highest (p < 0.05) for freeze-thawing against higher ash (7.99%), total phenolic content (TPC; 191.47 mg GAE g-1 dry weight), total flavonoid content (TFC; 91.54 mg QE g-1 dry weight), DPPH activity (47.46%), and ferric reducing antioxidant power (FRAP) activity (570.19 µmol FeSO4 equiv/mg) for the crushed counterpart and Chl-b in residues from boiling. No significant variation was evident in the total tannin content (TTC). Among filtrates, higher total phenolic content (773.29 mg GAE g-1 dry weight), TFC (392.77 mg QE g-1 dry weight), TTC (22.51 mg TAE g-1), and antioxidant activity as DPPH activity (66.46%) and FRAP (891.62 µmol FeSO4 equiv/mg) were evident for boiling, while that from crushing exhibited the highest TCC (1997.38 µg/g DM). LC-ESI-QTOF-MS/MS analysis identified 72 phenolic compounds with the maximum in residue (33) and filtrate (33) from freeze-thawing, followed by crushing (18 and 19) and boiling (14 and 13) in order, respectively. The results indicated that the predrying cell rupturing method significantly impacted quantitative, as well as qualitative compositions of residues and filtrates from fresh wolffia.

Perception of power quality disturbances using Fourier, Short-Time Fourier, continuous and discrete wavelet transforms.

Electric power utilities must ensure a consistent and undisturbed supply of power, with the voltage levels adhering to specified ranges. Any deviation from these supply specifications can lead to malfunctions in equipment. Monitoring the quality of supplied power is crucial to minimize the impact of fluctuations in voltage. Variations in voltage or current from their ideal values are referred to as "power quality (PQ) disturbances," highlighting the need for vigilant monitoring and management. Signal processing methods are widely used for power system applications which include understanding of voltage disturbance signals and used for retrieval of signal information from the signals Different signal processing methods are used for extracting information about a signal. The method of Fourier analysis involves application of Fourier transform giving frequency information. The method of Short-Time Fourier analysis involves application of Short-Time Fourier transform (STFT) giving time-frequency information. The method of continuous wavelet analysis involves application of Continuous Wavelet transform (CWT) giving signal information in terms of scale and time where frequency is inversely related to scale. The method of discrete wavelet analysis involves application of Discrete Wavelet transform (DWT) giving signal information in terms of approximations and details where approximations and details are low and high frequency representation of original signal. In this paper, an attempt is made to perceive power quality disturbances in MATLAB using Fourier, Short-Time Fourier, Continuous Wavelet and Discrete Wavelet Transforms. Proper understanding of the signals can be possible by transforming the signals into different domains. An emphasis on application of signal processing techniques can be laid for power quality studies. The paper compares the results of each transform using MATLAB-based visualizations. The discussion covers the advantages and disadvantages of each technique, providing valuable insights into the interpretation of power quality disturbances. As the paper delves into the complexities of each method, it takes the reader on a journey of signal processing complexities, culminating in a nuanced understanding of power quality disturbances and their representations across various domains. The outcomes of this research, elucidated through energy values, 3D plots, and comparative analyses, contribute to a comprehensive understanding of power quality disturbances. The findings not only traverse theoretical domains but also find practical utility in real-world scenarios.

Shelf-Stability of Kiln- and Liquid-Smoked Inulin-Fortified Emulsion-Type Pangasius Mince Sausage at Refrigerated Temperature.

The objective of this study was to investigate the effects of the kiln (SK-S) and liquid smoking (LS-S) processes on the quality of inulin-fortified emulsion-type Pangasius mince sausages. The moisture content during the storage significantly (p < 0.05) decreased in C-S (control) sausages and increased (p < 0.05) in SK-S and LS-S sausages. The protein content decreased (p < 0.05) in C-S, SK-S, and LS-S throughout the storage period. Initially, among the three processed sausages, LS-S showed a lower pH value, and as the days of storage progressed, all the treatments exhibited a declining trend (p < 0.05). A significant (p < 0.05) increase in the PV was observed in all the sausages during the storage days at 5 ± 1 °C, but the intensity of the increase was lower in SK-S and LS-S. The total viable count of C-S and SK-S sausages reached the limit of acceptability (6 log10cfu g-1) on the 20th day and on the 24th day of storage. The electrophoretic protein pattern of LS-S samples exhibited retention of all bands, indicating the lower proteolysis of MHC, actin, and troponin T in comparison with other treatments. The hardness (p < 0.05) and cohesiveness (p > 0.05) values of both SK-S and LS-S reduced as the storage days progressed. The present study indicates that the emulsion-type Pangasius sausages incorporated with inulin powder (2%) exposed to kiln smoking and commercial liquid smoking retained good-to-better sensory attributes up to day 16 (C-S) and day 20 (SK-S and LS-S) under refrigerated storage at 5 ± 1 °C in low-density vacuum polyethylene (LDPE) pouches.

Carboxy Methyl Cellulose, Xanthan Gum, and Carrageenan Coatings Reduced Fat Uptake, Protein Oxidation, and Improved Functionality in Deep-Fried Fish Strips: An Application of the Multiobjective Optimization (MOO) Approach.

In this study, a multiobjective optimization (MOO) approach was utilized for effective decision-making when several variables were changing simultaneously during frying. Carboxy methyl cellulose (CMC), xanthan gum, and carrageenan coatings in different concentrations (0.25-1.50%, w/v) were applied on fish strips to reduce the oil uptake and protein oxidation during frying. The pickup of the strips increased significantly (p < 0.05) with increasing concentration. The CMC was effective in oil uptake reduction and protein oxidation, as revealed by the lower carbonyl and sulfhydryl contents in the fried strip. The hardness and chewiness of the coated fish strips were found to be declined significantly (p < 0.05) with increasing coating concentrations. The moisture, lipid, toughness, hardness, cutting force, oiliness, sulfhydryl content (all min), oil uptake reduction, and carbonyl content (both max) were considered as multiple criteria for the MOO technique, and fried strips coated with 1% CMC, followed by 0.75% xanthan gum and 0.75% carrageenan, emerged as the best optimal coating.

Ventricular Arrhythmias in a Patient With Propionic Acidemia.

Propionic acidemia (PA) is a metabolic disorder that involves a defective copy of propionyl-CoA carboxylase (PCC). It has previously been shown that there is an association between QT-prolongation in propionic acidemia. The patient seen in this case is a male in his early twenties with known PA who was found unconscious on initial presentation due to cardiac arrest with a downtime of twenty minutes. He was subsequently resuscitated and stabilized. The patient underwent placement of an automatic implantable cardioverter-defibrillator (AICD) nineteen days after the initial presentation.

Quality characteristics of fortified silver carp surimi with soluble dietary fiber: Effect of apple pectin and konjac glucomannan.

The study focused on assessing quality parameters of the surimi incorporated with soluble dietary fibers apple pectin and konjac glucomannan at different levels. The results showed that apple pectin at 0.025% and konjac glucomannan at a 2% level exhibited improved gel-forming ability significantly (p < 0.05). SDS- PAGE revealed high molecular weight protein crosslinks in apple pectin treated surimi gels and disappearance of myosin bands in konjac glucomannan treated surimi gels. The water holding capacity of surimi was the highest when 0.075 g/100 g of apple pectin was added. Konjac glucomannan treated gels exhibited superior whiteness values. The analysis of soluble protein revealed that hydrophobic bonds increased in both the treatments. The hardness values of pectin gels enhanced as the level increased. Other TPA parameters are shown an inconsistent trend. It can be demonstrated that the incorporation of apple pectin and konjac glucomannan at a level of 0.025 and 2.0% may be a novel strategy to improve the gel strength of the surimi.

WITHDRAWN: Strategic evaluation of local ethics and culture in shaping entrepreneurial economic development in various businesses and its impact on finance management during COVID-19 outbreaks.

This article has been withdrawn at the request of the editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Gut Microbiota in Vascular Disease: Therapeutic Target?

BACKGROUND: Gut microbiota is increasingly recognized as a powerful regulator of host physiology. Most of its effects are mediated through metabolites acting as energy sources, signaling receptor ligands and substrates for host enzymes. Owing to the meta-stability and high amenability of the gut microbiota to modification by diet and environment predicting specific gut microbes or its metabolites responsible for different host metabolic states is often confounded. METHODS: The Pubmed was searched for research articles on gut microbiota and cardiovascular disease. RESULTS: The searched articles reported a direct role of gut microbes in cardiovascular disorders (CVD). The interaction among gut microbial metabolism (through breakdown of certain dietary nutrients like choline), host immune system and lipid metabolism generate conditions that promote atherosclerosis development. Importantly, components of this interactive system can be explored to identify points of intervention in the path of disease development. Based on this strategies targeting gut microbial composition and activity are being explored as therapies against CVD. Use of archaebiotics and 3,3-dimethyl- 1-butanol aiming to reduce TMA (trimethylamine) conversion to TMAO (trimethylamine-N-oxide) and high fibre diets to reduce TMA precursors while simultaneously selecting for beneficial gut bacteria are attractive anti-atherogenic approaches. CONCLUSION: Success of these approaches in humans however, requires extensive research.

Keloids: an unwanted spontaneity in rubinstein-taybi syndrome.

Rubinstein-Taybi syndrome (RTS) is a rare developmental disorder comprising of mental retardation, unusual facial appearance, broad thumbs, and big toes. It is frequently associated with molecular lesions in the cAMP response element binding protein. Many cutaneous abnormalities are associated with RTS. Multiple spontaneous keloids are some of them. We hereby report a case of this rare syndrome associated with keloids without any preceding trauma.

Human subcutaneous dirofilariasis of forearm an unusual presentation.

Human subcutaneous dirofilariasis (HSD) is a rare zoonotic filarial infection caused by filarial worms of the genus Dirofilaria. In view, recent rise in human Dirofilaria repens infections in several regions of the world, is considered as emerging zoonotic infection transmitted to man by zooanthrophilic blood sucking insects. Most of the documented cases of human dirofilariasis recorded in India are ocular infections and very few cases of subcutaneous dirofilariasis have been reported. We hereby present a case of subcutaneous human dirofilariasis of forearm and also emphasize on increased awareness of this entity for clinicians and pathologists in the differential diagnosis of patients with subcutaneous nodules.

Oxidative stress mediated mitochondrial and vascular lesions as markers in the pathogenesis of Alzheimer disease.

Mitochondrial dysfunction plausibly underlies the aging-associated brain degeneration. Mitochondria play a pivotal role in cellular bioenergetics and cell-survival. Oxidative stress consequent to chronic hypoperfusion induces mitochondrial damage, which is implicated as the primary cause of cerebrovascular accidents (CVA) mediated Alzheimer's disease (AD). The mitochondrial function deteriorates with aging, and the mitochondrial damage correlates with increased intracellular production of oxidants and pro-oxidants. The prolonged oxidative stress and the resultant hypoperfusion in the brain tissues stimulate the expression of nitric oxide synthase (NOS) enzymes, which further drives the formation of reactive oxygen species (ROS) and reactive nitrogen species (RNS). The ROS and RNS collectively contributes to the dysfunction of the blood-brain barrier (BBB) and damage to the brain parenchymal cells. Delineating the molecular mechanisms of these processes may provide clues for the novel therapeutic targets for CVA and AD patients.

A zebrafish model of PINK1 deficiency reveals key pathway dysfunction including HIF signaling.

The PTEN induced putative kinase 1 (PINK1) gene is mutated in patients with hereditary early onset Parkinson's disease (PD). The targets of PINK1 and the mechanisms in PD are still not fully understood. Here, we carried out a high-throughput and unbiased microarray study to identify novel functions and pathways for PINK1. In larval zebrafish, the function of pink1 was inhibited using splice-site morpholino oligonucleotides and the samples were hybridized on a two-color gene expression array. We found 177 significantly altered genes in pink1 morphants compared with the uninjected wildtype controls (log fold change values from -1.6 to +0.9). The five most prominent pathways based on critical biological processes and key toxicological responses were hypoxia-inducible factor (HIF) signaling, TGF-ß signaling, mitochondrial dysfunction, RAR activation, and biogenesis of mitochondria. Furthermore, we verified that potentially important genes such as hif1α, catalase, SOD3, and atp1a2a were downregulated in pink1 morphants, whereas genes such as fech, pax2a, and notch1a were upregulated. Some of these genes have been found to play important roles in HIF signaling pathways. The pink1 morphants were found to have heart dysfunction, increased erythropoiesis, increased expression of vascular endothelial growth factors, and increased ROS. Our findings suggest that a lack of pink1 in zebrafish alters many vital and critical pathways in addition to the HIF signaling pathway.

MANF regulates dopaminergic neuron development in larval zebrafish.

Mesencephalic astrocyte derived neurotrophic factor (MANF) is recognized as a dopaminergic neurotrophic factor, which can protect dopaminergic neurons from neurotoxic damage. However, little is known about the function of MANF during the vertebrate development. Here, we report that MANF expression is widespread during embryonic development and in adult organs analyzed by qPCR and in situ hybridization in zebrafish. Knockdown of MANF expression with antisense splice-blocking morpholino oligonucleotides resulted in no apparent abnormal phenotype. Nevertheless, the dopamine level of MANF morphants was lower than that of the wild type larvae, the expression levels of the two tyrosine hydroxylase gene transcripts were decreased and a decrease in neuron number in certain groups of th1 and th2 cells in the diencephalon region in MANF morphants was observed. These defects were rescued by injection of exogenous manf mRNA. Strikingly, manf mRNA could partly restore the decrease of th1 positive cells in Nr4a2-deficient larvae. These results suggest that MANF is involved in the regulation of the development of dopaminergic system in zebrafish.

Sub-cellular internalization and organ specific oral delivery of PABA nanoparticles by side chain variation.

BACKGROUND: Organic nanomaterials having specific biological properties play important roles in in vivo delivery and clearance from the live cells. To develop orally deliverable nanomaterials for different biological applications, we have synthesized several fluorescently labelled, self-assembled PABA nanoparticles using possible acid side chain combinations and tested against insect and human cell lines and in vivo animal model. Flurophores attached to nanostructures help in rapid in vivo screening and tracking through complex tissues. The sub-cellular internalization mechanism of the conjugates was determined. A set of physio-chemical parameters of engineered nanoskeletons were also defined that is critical for preferred uptake in multiple organs of live Drosophila. RESULTS: The variability of side chains alter size, shape and surface texture of each nanomaterial that lead to differential uptake in human and insect cells and to different internal organs in live Drosophila via energy dependent endocytosis. Our results showed that physical and chemical properties of C-11 and C-16 acid chain are best fitted for delivery to complex organs in Drosophila. However a distinct difference in uptake of same nanoparticle in human and insect cells postulated that different host cell physiology plays a critical role in the uptake mechanism. CONCLUSIONS: The physical and chemical properties of the nanoparticle produced by variation in the acid side chains that modify size and shape of engineered nanostructure and their interplay with host cell physiology might be the major criteria for their differential uptake to different internal organs.

The comparative neuroanatomy and neurochemistry of zebrafish CNS systems of relevance to human neuropsychiatric diseases.

Modulatory neurotransmitters which signal through G protein-coupled receptors control brain functions which deteriorate in degenerative brain diseases. During the past decade many of these systems have been mapped in the zebrafish brain. The main architecture of the systems in zebrafish brain resembles that of the mammals, despite differences in the development of the telencephalon and mesodiencephalon. Modulatory neurotransmitters systems which degenerate in human diseases include dopamine, noradrenaline, serotonin, histamine, acetylcholine and orexin/hypocretin. Although the number of G protein-coupled receptors in zebrafish is clearly larger than in mammals, many receptors have similar expression patterns, binding and signaling properties as in mammals. Distinct differences between mammals and zebrafish include duplication of the tyrosine hydroxylase gene in zebrafish, and presence of one instead of two monoamine oxidase genes. Zebrafish are sensitive to neurotoxins including MPTP, and exposure to this neurotoxin induces a decline in dopamine content and number of detectable tyrosine hydroxylase immunoreactive neurons in distinct nuclei. Sensitivity to important neurotoxins, many available genetic methods, rapid development and large-scale quantitative behavioral methods in addition to advanced quantitative anatomical methods render zebrafish an optimal organism for studies on disease mechanisms.