Genetic resources and genes/QTLs for gram pod borer (Helicoverpa armigera Hübner) resistance in chickpea from the Western Himalayas.

Helicoverpa armigera (also known as gram pod borer) is a serious threat to chickpea production in the world. A set of 173 chickpea genotypes were evaluated for H. armigera resistance, including mean larval population (MLP), percentage pod damage (PPD), and pest resistance (PR) for 2 consecutive years (year 2020 and 2021). The same core set was also genotyped with 50K Axiom CicerSNP Array. The trait data and 50,000 single nucleotide polymorphism genotypic data were used together to work out marker-trait associations (MTAs) using different genome-wide association studies models. For MLP, a total of 53 MTAs were identified, including 25 MTAs in year 2020 and 28 MTAs in year 2021. A set of three MTAs was found common in both environments. For PPD, two MTAs in year 2020 and five MTAs in year 2021 were identified. A set of two MTAs were common in both environments. Similarly, for PR, only two MTAs common in both environments were identified. Interestingly, a common MTA (Affx_123255526) on chromosome 2 (Ca2) was found to be associated with all the three component traits (MLP, PPD, and PR) of pod borer resistance in chickpea. Further, we report key genes that encode SCAMPs (that facilitates the secretion of defense-related molecules), quinone oxidoreductase (enables the production of reactive oxygen species that promotes diapause of gram pod borer), and NB-LRR proteins that have been implicated in plant defense against H. armigera. The resistant chickpea genotypes, MTAs, and key genes reported in the present study may prove useful in the future for developing pod borer-resistant chickpea varieties.

Morphometric Analysis of Placenta and Fetal Doppler Indices in Normal and High-Risk Pregnancies.

Background High-risk pregnancies, encompassing pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), preeclampsia toxemia (PET), and intrauterine growth restriction (IUGR), represent intricate medical challenges with potential repercussions for maternal and fetal health. This research undertakes a comprehensive comparative investigation into the variations of Doppler indices and placental parameters within the context of these high-risk conditions when juxtaposed against pregnancies characterized as normal. Methodology Employing a rigorous cross-sectional study design, a diverse cohort of pregnant individuals with gestational diabetes, IUGR, PIH, and preeclampsia was meticulously assembled. Additionally, a group of normal pregnant women served as the comparative reference. Doppler ultrasound assessments, viz, pulsatility index (PI), were carefully performed to estimate blood flow velocities within critical maternal and fetal vessels, while placental parameters were meticulously quantified, encompassing dimensions, vascular architecture, and morphological features. Results Except in the GDM group, all high-risk groups had reduced estimated placental weight and actual birth weight than normal pregnant women. All high-risk groups showed a highly significant elevation of the PI of the umbilical artery and PI of the middle cerebral artery (MCA) than normal but the PI of MCA was significantly reduced in the PET group than in normal individuals. The cerebro-placental ratio in the GDM and IUGR groups revealed markedly greater values, whereas PET showed lower values. IUGR and PIH groups showed a substantial reduction in the fetal birth weight. All high-risk groups (GDM, IUGR, PIH, and PET) showed a highly significant reduction in luminal area umbilical artery 1 than the normal pregnant women. In IUGR, marginal placental insertion was very high, followed by GDM and PET groups. Conclusions This study reveals that Doppler indices, placental parameters, newborn weight, and their related ratios may be utilized to anticipate gestation difficulties and gain insight into the pathophysiology of problematic conceptions.

Narrow band-pass filtered canonical correlation analysis for frequency identification in SSVEP signals.

Steady-state visual evoked potentials (SSVEP) are generated in the parieto-occipital regions, accompanied by background noise and artifacts. A strong pre-processing method is required to reduce this background noise and artifacts. This study proposed a narrow band-pass filtered canonical correlation analysis (NBPFCCA) to recognize frequency components in SSVEP signals. The proposed method is tested on the publicly available 40 stimulus frequencies dataset recorded from 35 subjects and 4 class in-house dataset acquired from 10 subjects. The performance of the proposed NBPFCCA method is compared with the standard canonical correlation analysis (CCA) and the filter bank CCA (FBCCA). The mean frequency detection accuracy of the standard CCA is 86.21% for the benchmark dataset, and it is improved to 95.58% in the proposed method. Results indicate that the proposed method significantly outperforms the standard canonical correlation analysis with an increase of 9.37% and 17% in frequency recognition accuracy of the benchmark and in-house datasets, respectively.

Evaluation of the Efficacy of Neo-endo, Hyflex Re-treatment File Systems and H-Files for Removing Gutta-Percha From Root Canal Treated Tooth by Using Stereomicroscope-An In Vitro Study.

Aim: To evaluate the efficacy of Neo-endo, Hyflextm retreatment file systems, and H-files for removing gutta-percha from root canal treated tooth. Materials and Methods: Thirty extracted single-rooted human teeth with a single canal were opted. The shaping of the root canals was done with pro-taper universal files and later obturated. The samples were grouped based on the file system chosen for removing the obturating material: Group I-H-files; Group II-Neo-endo retreatment files; Group III-Hyflex™ retreatment files. The quantity of remaining gutta-percha still present after the retreatment procedure was assessed under a stereomicroscope. One-way Analysis of Variance (ANOVA) was used to statistically analyze the data. Results: Hyflex™ files left less remaining filling material than with Neo-endo and H-files. Conclusion: The Hyflex™ retreatment files were most efficient in removing the gutta-percha from the root canal.

State-of-the-Art on Advancements in Carbon-Phenolic and Carbon-Elastomeric Ablatives.

Ablative composites serve as sacrificial materials, protecting underlying materials from high-temperature environments by endothermic reactions. These materials undergo various phenomena, including thermal degradation, pyrolysis, gas generation, char formation, erosion, gas flow, and different modes of heat transfer (such as conduction, convection, and radiation), all stemming from these endothermic reactions. These phenomena synergize to form a protective layer over the underlying materials. Carbon, with its superb mechanical properties and various available forms, is highlighted, alongside phenolics known for good adhesion and fabric ability and elastomers valued for flexibility and resilience. This study focuses on recent advancements in carbon-and-phenolic and carbon-and-elastomeric composites, considering factors such as erosion speed; high-temperature resistance; tensile, bending, and compressive strength; fiber-matrix interaction; and char formation. Various authors' calculations regarding the percentage reduction in linear ablation rate (LAR) and mass ablation rate (MAR) are discussed. These analyses inform potential advancements in the field of carbon/phenolic and carbon/elastomeric ablative composites.

In Silico Assessment of Biomolecule Reactivity with Leachables.

Leachables in pharmaceutical products may react with biomolecule active pharmaceutical ingredients (APIs), for example, monoclonal antibodies (mAb), peptides, and ribonucleic acids (RNA), potentially compromising product safety and efficacy or impacting quality attributes. This investigation explored a series of in silico models to screen extractables and leachables to assess their possible reactivity with biomolecules. These in silico models were applied to collections of known leachables to identify functional and structural chemical classes likely to be flagged by these in silico approaches. Flagged leachable functional classes included antimicrobials, colorants, and film-forming agents, whereas specific chemical classes included epoxides, acrylates, and quinones. In addition, a dataset of 22 leachables with experimental data indicating their interaction with insulin glargine was used to evaluate whether one or more in silico methods are fit-for-purpose as a preliminary screen for assessing this biomolecule reactivity. Analysis of the data showed that the sensitivity of an in silico screen using multiple methodologies was 80%-90% and the specificity was 58%-92%. A workflow supporting the use of in silico methods in this field is proposed based on both the results from this assessment and best practices in the field of computational modeling and quality risk management.

Purtscher's like retinopathy - A rare ocular complication of acute pancreatitis.

INTRODUCTION AND IMPORTANCE: Purtscher retinopathy is the rare form of occlusive microvasculopathy, characterized by multiple retinal white areas around the optic nerve head and fovea with paravascular clearing and may be related to intraretinal hemorrhages. Acute Pancreatitis (AP) is one of the most common gastrointestinal reasons for hospital admissions globally. The complications of Acute Pancreatitis may include Purtscher's-like retinopathy, which has a low incidence rate of less than 0.24 instances per million cases. This case report highlights the value of thorough medical history taking and examination, and it apprises the consideration of ophthalmological manifestation in patients of Acute Pancreatitis. CASE PRESENTATION: A 34-year-old female came to the emergency room due to intense abdominal pain associated with nausea and vomiting, which worsened over the last 24 h. The pain was described as continuous, sharp, and cramping-like in the upper abdomen, radiating to the back. Lab tests revealed elevated serum amylase and lipase levels, indicating pancreatitis, along with slight leukocytosis. A contrast-enhanced CT scan confirmed acute pancreatitis with mild inflammation and enlargement of the pancreas. Two days after admission, the patient experienced a sudden and painless loss of central vision in both eyes. There was no history of trauma or any other significant relevant history, other than pancreatitis. The ophthalmologist's examination found reduced visual acuity (6/60 in the right eye, 3/60 in the left eye), normal corneas, and anterior chambers. DISCUSSION: Inkeles and Walsh established the first link between acute pancreatitis and Purtscher-like retinopathy when they reported three cases of the distinctive retinal appearance in individuals with acute pancreatitis in 1975. CONCLUSION: The recovery and prognosis in cases of Purtscher-like retinopathy is variable and further research is required to ascertain the usage of corticosteroids and pentoxifylline in improving the course of a patient's with Purtscher's-like retinopathy.

The Clinical Efficacy of Accelerated Deep Repetitive Transcranial Magnetic Stimulation in Depression and Obsessive-Compulsive Disorder: Multi-centric Real-World Observational Data.

Background Of late, the interest in accelerated treatment protocols in repetitive transcranial magnetic stimulation (TMS) for the treatment of depression and obsessive-compulsive disorder (OCD) has been gaining momentum. Studies have already found that the patterned theta burst stimulation is non-inferior to the standard high-frequency stimulation in treating depression. The objective of the present study was to evaluate the clinical efficacy of a customized accelerated combination TMS naturalistic setting. Methods Retrospective analysis of pre and post-deep repetitive TMS responses in depression and OCD patients was performed. About 391 Depression and 239 OCD patients' data was analyzed. Customized treatment protocols consisted of twice daily high-frequency stimulations intervened by one theta burst stimulation. The outcome measures were a day six score in depression and a day 10 score in OCD, compared to day one baseline scores. Results The overall response rate in depression was 60.86%, estimated as a >50% reduction in the Hamilton Depression Rating Scale (HAM-D) 21 items score, and 62.76% in OCD, estimated as a >35% reduction in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score. The mean reduction of YBOCS and HAM-D was statistically significant at p<0.0001 (Mann-Whitney U test statistic=9442.5, z=12.66 for YBOCS and 16673.5, z=18.92 for HAM-D). Corresponding effect size estimations revealed Cohen's d value of 1.40 and 1.59, respectively. Conclusions The response rates achieved at day six and day 10 in depression and OCD, respectively, were comparable to previous studies employing standard treatment protocols. The accelerated protocol produced satisfactory short-term clinical outcomes that were effective in the early management of the illness without any serious adverse effects.

Sacral Osteoblastoma in a Young Male Presenting as Radicular Pain: A Rare Case Report.

Introduction: Osteoblastoma is an uncommon benign bone tumor characterized by the formation of osteoid tissue, occurring more frequently in men than in women. It is often associated with osteoid osteoma and can be found at various locations in the skeleton, although it is rare in the sacrum. Typically, these lesions involve the posterior elements of the spine, including the pedicle and the lamina. We would like to present a case of sacral osteoblastoma, clinically presenting as lumbar radiculopathy, which was treated at our institute. Case Report: A 23-year-old male presented to us with left gluteal pain radiating to the left lower limb pain for 2 years. He had multiple consultations elsewhere and was being treated as a probable case of a lumbar disc lesion with left lower limb radiculopathy. X-rays appeared normal. Magnetic resonance imaging of the lumbar spine and pelvis revealed a T2 hyperintense lesion affecting the posterior elements of S3, compressing the nerve roots. Computed tomography (CT) was a better investigation modality for osteoblastoma. En bloc excision and curettage were performed, and the histopathological analysis confirmed the diagnosis of osteoblastoma. The patient had immediate relief of symptoms postoperatively with no complications. At 2-year follow-up, the patient had no evidence of recurrence on a follow-up CT scan. Conclusion: Osteoblastomas predominantly occur in the spine, with rare instances in the sacrum. Treatment typically involves en bloc excision. Confusing clinical presentation may delay diagnosis, resulting in persistent morbidity.

Research on clinical aspects of bipolar disorder: A review of Indian studies.

Background: Bipolar disorder is one of the severe mental disorders that are associated with significant morbidity of the patients. Despite advancements in our understanding about the disorder, it remains a challenging proposition to treat bipolar disorder, largely since the prophylactic treatment of the disorder requires assessment of complex clinical algorithms. The revisions of the classificatory systems have also changed the conceptualization of the disorder. In this background, we conducted a review of the Indian studies conducted on the clinical aspects of bipolar disorder. Methods: A narrative review was conducted with focus on the literature published from India. The databases searched included PubMed, Scopus, and Google Scholar, and articles published over the last 15 years by Indian authors were included for this review. Results: In our review, we could access a substantial volume of research published from India. We could identify studies that catered to most of the relevant themes in bipolar disorder including epidemiology, etiology, comorbidities, stigma, disability, clinical course, cognitive profile, pathways to care, and recovery. Conclusion: The research trajectory was in line with the research conducted elsewhere in the world. However, certain dissimilarities in terms of focus could also be observed. The possible reason behind this deviation could be the difference in clinical need and unique challenges faced in the management and rehabilitation of patients in bipolar disorder in Indian scenario.

Harnessing the power of native biocontrol agents against wilt disease of Pigeonpea incited by Fusarium udum.

Fusarium wilt, caused by (Fusarium udum Butler), is a significant threat to pigeonpea crops worldwide, leading to substantial yield losses. Traditional approaches like fungicides and resistant cultivars are not practical due to the persistent and evolving nature of the pathogen. Therefore, native biocontrol agents are considered to be more sustainable solution, as they adapt well to local soil and climatic conditions. In this study, five isolates of F. udum infecting pigeonpea were isolated from various cultivars and characterized morphologically and molecularly. The isolate from the ICP 8858 cultivar displayed the highest virulence of 90%. Besides, 100 endophytic bacteria, 100 rhizosphere bacteria and three Trichoderma spp. were isolated and tested against F. udum isolated from ICP 8858 under in vitro conditions. Out of the 200 bacteria tested, nine showed highest inhibition, including Rb-4 (Bacillus sp.), Rb-11 (B. subtilis), Rb-14 (B. megaterium), Rb-18 (B. subtilis), Rb-19 (B. velezensis), Eb-8 (Bacillus sp.), Eb-11 (B. subtilis), Eb-13 (P. aeruginosa), and Eb-21 (P. aeruginosa). Similarly, Trichoderma spp. were identified as T. harzianum, T. asperellum and Trichoderma sp. Notably, Rb-18 (B. subtilis) and Eb-21 (P. aeruginosa) exhibited promising characteristics such as the production of hydrogen cyanide (HCN), cellulase, siderophores, ammonia and nutrient solubilization. Furthermore, treating pigeonpea seedlings with these beneficial microorganisms led to increased levels of key enzymes (POD, PPO, and PAL) associated with resistance to Fusarium wilt, compared to untreated controls. In field trials conducted for four seasons, the application of these potential biocontrol agents as seed treatments on the susceptible ICP2376 cultivar led to the lowest disease incidence. Specifically, treatments T2 (33.33) (P. aeruginosa) and T3 (35.41) (T. harzianium) exhibited the lowest disease incidence, followed by T6 (36.5) (Carbendizim), T1 (36.66) (B. subtilis), T4 (52.91) (T. asperellum) and T5 (53.33) (Trichoderma sp.). Results of this study revealed that, P. aeruginosa (Eb-21), B. subtilis (Rb-18) and T. harzianum can be used for plant growth promotion and management of Fusarium wilt of pigeonpea.

Novel Insights Into the Epidemiological and Clinico-Pathological Profile of Triple-Negative Breast Cancer: Dissection of an Aggressive Variant.

Objective Triple-negative breast cancer (TNBC) represents an aggressive and prognostically poor variant of breast cancer. Over the years, detailed research has been conducted and published in Western literature. However, there lacks a detailed account of TNBC cases from the perspective of a low-volume institution. This study aims to assess the clinical features of TNBC, as well as their prognostic implications in a tertiary care centre. Methods and materials This prospective observational study took place at a tertiary health centre for two years, spanning from 2021 to 2023. The study aimed to investigate various clinicopathological and epidemiological parameters, thereby highlighting the shortcomings in the existing knowledge about the subject in the context of a low-volume centre, as well as additional contributing factors in developing countries like India. A group of 150 participants diagnosed with TNBC through biopsy and immunohistochemistry and >40 years of age were included in the study. Patients who tested positive for hormonal receptors and who refused to give consent for participation were excluded from the study. The study subjects were categorized according to their clinical TNM (cTNM) stage and eventually segregated into two primary heads, namely pre-surgery chemotherapy with breast-conserving surgery (BCS) after a good response, or modified radical mastectomy (MRM) upfront. Important demographic details, including age, socioeconomic status, and education, were also recorded. A comprehensive follow-up assessment post-treatment was performed to detect early recurrence. After data collection, the recurrence rates were correlated with the TNBC status to establish the aggressiveness of the cancer. Statistical analysis of the data was done using the Statistical Package for Social Sciences (SPSS) -16version software. Results The average age of the 150 participants in the study was 52.21 years (SD±4.89 years). The highest recorded age was 64 years, while the lowest recorded age was 45 years. In the study, it was observed that 41% of the participants diagnosed with TNBC had stage III disease, whereas 33.5% had stage I disease, 22% had stage IV disease and 3.6% had stage II disease. A total of 27.5% of individuals with TNBC exhibited metastases in various anatomical sites, whereas the other 72.5% did not show any signs of metastasis. Conclusion Triple-negative breast cancer has earned its position as a unique subtype of breast cancer due to its unusual molecular characteristics, aggressive behavior, limited treatment options, and poor prognosis. The lower per-capita income and limited knowledge pertaining to this variant, along with the absence of more specific treatment options, contribute to the already high levels of morbidity and mortality associated with this illness. To effectively address this unique and very virulent ailment and customize our strategies, it is imperative to do further comprehensive investigations, thereby enabling us to deliver the highest quality of medical attention to individuals afflicted by this pathology.

Genetic Diagnosis of Retinoblastoma Using Aqueous Humour-Findings from an Extended Cohort.

The identification of somatic RB1 variation is crucial to confirm the heritability of retinoblastoma. We and others have previously shown that, when tumour DNA is unavailable, cell-free DNA (cfDNA) derived from aqueous humour (AH) can be used to identify somatic RB1 pathogenic variation. Here we report RB1 pathogenic variant detection, as well as cfDNA concentration in an extended cohort of 75 AH samples from 68 patients. We show cfDNA concentration is highly variable and significantly correlated with the collection point of the AH. Cell-free DNA concentrations above 5 pg/µL enabled the detection of 93% of known or expected RB1 pathogenic variants. In AH samples collected during intravitreal chemotherapy treatment (Tx), the yield of cfDNA above 5 pg/µL and subsequent variant detection was low (≤46%). However, AH collected by an anterior chamber tap after one to three cycles of primary chemotherapy (Dx1+) enabled the detection of 75% of expected pathogenic variants. Further limiting our analysis to Dx1+ samples taken after ≤2 cycles (Dx ≤ 2) provided measurable levels of cfDNA in all cases, and a subsequent variant detection rate of 95%. Early AH sampling is therefore likely to be important in maximising cfDNA concentration and the subsequent detection of somatic RB1 pathogenic variants in retinoblastoma patients undergoing conservative treatment.

Characterization of Ralstonia insidiosa C1 isolated from Alpine regions: Capability in polyhydroxyalkanoates degradation and production.

This study ventures into the exploration of potential poly-3-hydroxybutyrate (PHB) degradation in alpine environments. PHB-degrading bacteria were identified in both campus soil, representing a residential area, and Mt. Kurodake soil, an alpine region in Hokkaido, Japan. Next-generation sequencing analysis indicated that the campus soil exhibited higher microbial diversity, while Ralstonia insidiosa C1, isolated from Mt. Kurodake soil, displayed the highest proficiency in PHB degradation. R. insidiosa C1 efficiently degraded up to 3% (w/v) of PHB and various films composed of other biopolymers at 14 °C. This bacterium synthesized homopolymers using substrates such as 3-hydroxybutyric acid, sugars, and acetic acid, while also produced copolymers using a mixture of fatty acids. The analysis results confirmed that the biopolymer synthesized by strain C1 using glucose was PHB, with physical properties comparable to commercial products. The unique capabilities of R. insidiosa C1, encompassing both the production and degradation of bioplastics, highlight its potential to establish a novel material circulation model.

Differences in Childhood Growth Parameters Between Patients With Somatic and Heritable Retinoblastoma.

Purpose: Little is known regarding differences in childhood growth between somatic and heritable retinoblastoma (Rb) populations. We aimed to compare childhood growth parameters between somatic and heritable Rb cohorts at birth and at time of diagnosis with Rb. Methods: A multinational, longitudinal cohort study was conducted with patients from 11 centers in 10 countries who presented with treatment naïve Rb from January to December 2019. Variables of interest included age, sex, and size characteristics at birth and at time of presentation, as well as germline mutation status. After Bonferroni correction, results were statistically significant if the P value was less than 0.005. Results: We enrolled 696 patients, with 253 analyzed after exclusion criteria applied. Between somatic (n = 39) and heritable (n = 214) Rb cohorts, with males and females analyzed separately, there was no significant difference in birth weight percentile, weight percentile at time of diagnosis, length percentile at time of diagnosis, weight-for-length percentile at time of diagnosis, or change of weight percentile from birth to time of diagnosis. Patients with heritable Rb had a smaller mean weight percentile at birth and smaller mean weight and length percentiles at time of diagnosis with Rb, although this difference was not statistically significant. All cohorts experienced a slight negative change of weight percentile from birth to time of diagnosis. No cohort mean percentiles met criteria for failure to thrive, defined as less than the 5th percentile. Conclusions: Children with Rb seem to have normal birth and childhood growth patterns. There is no definitive evidence that somatic or heritable Rb has a biological or environmental impact on childhood growth parameters.

Complete genome characterization of chilli veinal mottle virus associated with mosaic and mottling disease of tomato and development of LAMP assay for quick detection.

Chilli veinal mottle virus (ChiVMV) is a potyvirus known to cause havoc in many solanaceous crops. Samples from tomato plants exhibiting typical mosaic and mottling symptoms in two locations from farmers' fields were collected and tested using DAC ELISA for the presence of ChiVMV and other viruses known to infect tomato. ChiVMV Gauribidanur isolate from infected tomato was mechanically inoculated to Datura metel, Nicotiana tabacum, Nicotiana benthamiana, Nicotiana glutinosa, chilli, and tomato plants which exhibited systemic mosaic and mottling symptoms 10 days post-inoculation. This results were further confirmed by RT-PCR and DAC ELISA using CP gene-specific primers and ChiVMV antisera, respectively. Transmission electron microscopy revealed the presence of long filamentous particles (800 × 11 nm) resembling viruses in the Potyviridae family. The complete genome of ChiVMV comprised 9716 nucleotides except for poly A tail, with a predicted open reading frame spanning 9270 nucleotides encoding polyproteins of 3089 amino acids. Comparative analysis revealed that ChiVMV-tomato isolates reported across the world shared maximum nucleotide identity (93-96.7%) with chilli isolates from India and Pakistan. These results were well supported by sequence demarcation analysis. Further, the Neibhor-Net network analysis of the complete genome of ChiVMV-tomato, along with other host isolates, formed a reticular network phylogenetic tree suggesting recombination events. Subsequently, RDP5 detected intra-specific recombination breakpoints at the positions 1656-5666 nucleotides with major parent ChiVMV (MN508960) Uravakonda and minor parent ChiVMV (MN508956) with a significant average p value of 1.905 × 10-22. The LAMP assay using ChiVMV-specific primers resulted in ladder-like amplified products on electrophoresed gel and a distinct red colour pattern with hydroxy naphthalene blue, indicating a positive reaction for the presence of ChiVMV in infected tomato samples. To validate LAMP-designed primers, RNA extracted from ChiVMV-infected tomato, chilli, datura, and tobacco samples were subjected to LAMP assay and it accurately detected the presence of ChiVMV in infected plant samples. Overall, this study provides holistic information of ChiVMV infecting tomato, spanning diagnosis, transmission, genetic characterization, and detection of recombination events, which collectively contribute to effective disease management, crop protection, and informed decision-making in agricultural practices.

Analysis of the Accuracy of the Modified CT Severity Index in Predicting Clinical Outcomes in Acute Pancreatitis: A Cross-Sectional Study.

OBJECTIVE: To evaluate the accuracy of the modified CT severity index (MCTSI) in predicting the severity of acute pancreatitis and to prognosticate the clinical outcomes. METHODS AND MATERIALS: The study was conducted at a tertiary health center between January 2021 and June 2023. A total of 150 consecutive patients with clinical/laboratory features suggestive of acute pancreatitis were included in the study and underwent a contrast-enhanced CT scan within 24 hours of admission. Based on their MCTSI score, these patients had conservative or surgical/endoscopic treatment. Clinical outcomes were assessed in terms of recovery, development of complications, or death. The receiver operating characteristic curve and descriptive statistics were computed to determine the sensitivity and specificity. The data were analyzed using SPSS version 16 software (SPSS Inc., Chicago, IL), and an attempt was made to evaluate the accuracy of MCTSI in predicting these clinical outcomes. RESULTS: The mean age of patients in our study was 49.21 ± 11.02 years. Out of the 150 included patients, 103 were men and 47 were women. Compared to 11.68% of severe acute pancreatitis patients who died, 88.32% recovered. The area under the curve was determined as 0.865, based on which the MCTSI score predicted acute pancreatitis clinical outcome with 64% sensitivity and 92% specificity. The MCTSI demonstrated value in predicting clinical outcomes with a p-value of 0.043 ± 0.012 (p < 0.05) in the recovered patients while p = 0.032 ± 0.012 for patients who succumbed. The p-value for MCTSI in predicting complications was p = 0.0012 ± 0.0008 (p < 0.05). CONCLUSION: Our study was able to demonstrate the high level of accuracy of the MCTSI score in predicting complications and clinical outcomes, especially in patients with severe acute pancreatitis. The MCTSI serves as a valuable asset in the preliminary evaluation of acute pancreatitis, thereby facilitating appropriate management.

Breaking Free from Knee Pain: A Surgical Triumph in Managing Pellegrini-Stieda Syndrome with Massive Lesion: A Case Report.

Introduction: Introduction: Pellegrini-Stieda syndrome, characterized by medial collateral ligament (MCL) calcification or ossification, often follows a history of trauma. While rare, its distinct radiographic features pose diagnostic challenges. Conservative treatments are effective for many, but surgical intervention is necessary when they fail. Case Report: A 31-year-old male with knee pain and stiffness, an inability to extend his knee, and a fixed flexion deformity. Radiological examinations confirmed heterotopic ossification along the MCL, indicating post-traumatic Pellegrini-Stieda syndrome. Despite 3 months of conservative treatment, the patient's pain persisted, leading to surgical excision. The surgical approach involved diagnostic arthroscopy, revealing arthritic changes and adhesions. Arthroscopic adhesiolysis and open excision of the ossified mass significantly improved the patient's range of motion. Histopathological examination confirmed heterotopic bone formation. Follow-up appointments at 1, 3, and 6 months showed a pain-free and mobile knee joint, with the Pellegrini-Stieda lesion disappearing from radiographs. Conclusion: This case underscores the effectiveness of surgical intervention for refractory Pellegrini-Stieda syndrome, offering hope for improved patient outcomes and highlighting the importance of early diagnosis and tailored treatment in managing this rare condition.

Network Pharmacology Approach to Identify the Calotropis Phytoconstituents' Potential Epileptic Targets and Evaluation of Molecular Docking, MD Simulation, and MM-PBSA Performance.

Epilepsy originates from unusual electrical rhythm within brain cells, causes seizures. Calotropis species have been utilized to treat a wide spectrum of ailments since antiquity. Despite chemical and biological investigations, there have been minimal studies on their anticonvulsant activity, and the molecular targets of this plant constituents are unexplored. This study aimed to investigate the plausible epileptic targets of Calotropis phytoconstituents through network pharmacology, and to evaluate their binding strength and stability with the identified targets. In detail, 125 phytoconstituents of the Calotropis plant (C. procera and C. gigantea) were assessed for their drug-likeness (DL), blood-brain-barrier (BBB) permeability and oral bioavailability (OB). Network analysis revealed that targets PTGS2 and PPAR-γ were ranked first and fourth, respectively, among the top ten hub genes significantly linked with antiepileptic drug targets. Additionally, docking, molecular dynamic (MD) simulation, and Molecular Mechanics-Poisson-Boltzmann Surface Area (MM-PBSA) were employed to validate the compound-gene interactions. Docking studies suggested ergost-5-en-3-ol, stigmasterol and ß-sitosterol exhibit stronger binding affinity and favorable interactions than co-crystallized ligands with both the targets. Furthermore, both MD simulations and MM-PBSA calculations substantiated the docking results. Combined data revealed that Calotropis phytoconstituents ergost-5-en-3-ol, stigmasterol, and ß-sitosterol might be the best inhibitors of both PTGS2 and PPAR-γ.

Kynurenines Dynamics in the Periphery and Central Nervous System Steers Behavioral Deficits in Rats under Hypobaric Hypoxia.

People travel to high-altitude regions as tourists, workers, and military personnel on duty. Despite the consistent 21% oxygen content in the atmosphere, ascending to higher altitudes results in a decrease in the partial pressure of oxygen, inducing a state known as hypobaric hypoxia (HH). HH is an environmental stress that is responsible for neuroinflammation and behavioral deficits (anxiety, depression, mood disturbance, etc.), but little is known about its metabolic pathways. The kynurenine pathway (KP) is a promising candidate to uncover the mysteries of HH stress, as it is an important regulator of the immune system and is associated with behavioral deficits. To investigate the role of KP under HH, the levels of KP metabolites in the serum, cerebrospinal fluid (CSF), and brain tissue (prefrontal cortex-PFC, neocortex, and hippocampus) of male Sprague-Dawley rats exposed to HH at 7620 m for 1, 3, and 7 days were estimated utilizing high-performance liquid chromatography (HPLC). The behavioral analogs for anxiety-like and depression-like behavior were assessed using the open field test and forced swim test, respectively. Upon HH exposure, crosstalk between the periphery and central nervous system and KP metabolite region-dependent differential expression in the brain were observed. KP metabolites showed a positive correlation with behavioral parameters. The results of our study are indicative that KP can be proposed as the etiology of behavioral deficits, and KP metabolite levels in serum or CSF can be used as plausible markers for anxiety-like and depression-like behaviors under HH stress with a scope of targeted therapeutic interventions.