Role of Bilastine in Allergic Rhinitis: A Narrative Review.

Allergic rhinitis (AR) is considered a trivial disease and is often self-treated with over-the-counter drugs and home remedies. However, AR is a contributing risk factor for asthma associated with complications, including chronic cough, eosinophilic esophagitis, and otitis media with effusion. In AR, inflammation is primarily mediated by histamines. Guidelines advise using second-generation oral H1 antihistamines as the primary treatment for AR. Second-generation H1 antihistamines strongly prefer the H1 receptor, limiting their ability to enter the central nervous system. Thus, they have minimal adverse effects. Among these H1 antihistamines, bilastine is highly specific for H1 receptors with a slight affinity for other receptors. It has a rapid and prolonged action, which reduces the need for frequent dosing and has better compliance. In the long term, bilastine is well-tolerated with minimal adverse effects. It is not associated with drug interactions, so dosage adjustment is unnecessary. Bilastine does not penetrate the brain and is nonsedating at 80 mg once daily. The low possibility of drug-drug interactions and pharmacokinetics of bilastine makes it suitable for elderly patients, even with compromised hepatic and renal function, without dose adjustment. This review comprehensively discusses the guidelines and the role of bilastine in treating AR. How to cite this article: Tiwaskar M, Vora A, Tewary K, et al. Role of Bilastine in Allergic Rhinitis: A Narrative Review. J Assoc Physicians India 2023;71(11):58-61.

Speckle-based deep learning approach for classification of orbital angular momentum modes.

We present a speckle-based deep learning approach for orbital angular momentum (OAM) mode classification. In this method, we have simulated the speckle fields of the Laguerre-Gauss (LG), Hermite-Gauss (HG), and superposition modes by multiplying these modes with a random phase function and then taking the Fourier transform. The intensity images of these speckle fields are fed to a convolutional neural network (CNN) for training a classification model that classifies modes with an accuracy >99%. We have trained and tested our method against the influence of atmospheric turbulence by training the models with perturbed LG, HG, and superposition modes and found that models are still able to classify modes with an accuracy >98%. We have also trained and tested our model with experimental speckle images of LG modes generated by three different ground glasses. We have achieved a maximum accuracy of 96% for the most robust case, where the model is trained with all simulated and experimental data. The novelty of the technique is that one can do the mode classification just by using a small portion of the speckle fields because speckle grains contain the information about the original mode, thus eliminating the need for capturing the whole modal field, which is modal dependent.

Bio-therapeutics from human milk: prospects and perspectives.

Human milk is elixir for neonates and is a rich source of nutrients and beneficial microbiota required for infant growth and development. Its benefits prompted research into probing the milk components and their use as prophylactic or therapeutic agents. Culture-independent estimation of milk microbiome and high-resolution identification of milk components provide information, but a holistic purview of these research domains is lacking. Here, we review the current research on bio-therapeutic components of milk and simplified future directions for its efficient usage. Publicly available databases such as PubMed and Google scholar were searched for keywords such as probiotics and prebiotics related to human milk, microbiome and milk oligosaccharides. This was further manually curated for inclusion and exclusion criteria relevant to human milk and clinical efficacy. The literature was classified into subgroups and then discussed in detail to facilitate understanding. Although milk research is still in infancy, it is clear that human milk has many functions including protection of infants by passive immunization through secreted antibodies, and transfer of immune regulators, cytokines and bioactive peptides. Unbiased estimates show that the human milk carries a complex community of microbiota which serves as the initial inoculum for establishment of infant gut. Our search effectively screened for evidence that shows that milk also harbours many types of prebiotics such as human milk oligosaccharides which encourage growth of beneficial probiotics. The milk also trains the naive immune system of the infant by supplying immune cells and stimulatory factors, thereby strengthening mucosal and systemic immune system. Our systematic review would improve understanding of human milk and the inherent complexity and diversity of human milk. The interrelated functional role of human milk components especially the oligosaccharides and microbiome has been discussed which plays important role in human health.

A prospective study assessing feasibility of performing percutaneous nephrolithotomy in chronic kidney disease patients - What factors affect the outcome?

OBJECTIVES: To primarily evaluate the functional outcomes of PCNL for bilateral renal calculi/calculi in solitary functioning kidney with Chronic Kidney Disease(CKD). To identify factors affecting the renal replacement therapy following PCNL. MATERIALS AND METHODS: Patients with bilateral renal calculi/calculi in solitary kidney and CKD (eGFR<60/s.creatinine>2) and Good Performance Status [Eastern Cooperative Oncology Group (ECOG): 0-2] were included in the study. RESULTS: A total of 60 patients with CKD who had bilateral renal calculi/calculi in solitary functioning kidney underwent PCNL. At 6 months, eGFR improved or stabilized in 45 (75%) patients, while in 15 (25%) patients eGFR deteriorated. A total of 5 (14.28%) and 2 (25%) patients of CKD stage 4 and 5 respectively had improvement in eGFR as well as CKD stage. Fourteen (82.35%), 21 (60%), 3 (37.5%) patients of CKD stage 3, 4, 5 had improvement in eGFR but not signifi cant enough to cause stage migration. Again 3 (17.65%), 9 ( 40%) and 3 (37.5%) patients of CKD stage 3, 4, 5 had reduction in eGFR but not signifi cant enough to cause stage migration. None of the patients had worsening of CKD stage. Preoperative CKD stage and eGFR were compared with measurements made at the fi nal follow up visit (6 months). CONCLUSION: Our results indicate that most patients of renal calculi with CKD show improvement or stabilization of renal function with aggressive stone removal. Improvement is more in patients who have mild to moderate CKD. Aggressive management of comorbidities, peri-operative UTI and complications may delay or avoid progression of CKD status in such patients.

Comparison of fluticasone/formoterol with budesonide/formoterol pMDI in adults with moderate to severe persistent asthma: Results from a 12-week randomized controlled trial.

BACKGROUND: Combination therapy of inhaled corticosteroid/long acting ß2-agonist (ICS/LABA) is the cornerstone of managing asthmatics who are uncontrolled with low-medium dose of ICS. The novel ICS/LABA combination of fluticasone propionate and formoterol (flu/form) provides potent anti-inflammatory and rapid bronchodilatory effect. This randomized, multi-centre, double-blind study compared the efficacy and safety of flu/form (125/6 mcg BD; Maxiflo®) with the well-established budesonide/formoterol combination (bud/form 200/6 mcg BD), both delivered through a pressurized metered dose inhaler (pMDI) in patients with moderate to severe persistent asthma over 12 weeks. METHODS: This study enrolled patients between 18 and 65 years. The primary end-point was to demonstrate non-inferiority for the mean change in the pre-dose morning peak expiratory flow values (PEF). The secondary end-points included lung function assessments, number of symptom-free days and nights, rescue medication use, day-and night-time symptom scores and safety evaluation. RESULTS: Two hundred and thirty-two patients were randomized to either flu/form (n = 117) or bud/form (n = 115). At the end of 12 weeks, flu/form was non-inferior to bud/form with regards to the primary end-point of morning PEF (48.07 L/min vs. 49.03 L/min, p > 0.05). These improvements were statistically significant (p < 0.0001) vs baseline. Similar improvements were observed between the two groups for secondary efficacy end-points including FEV1, symptom-free nights, rescue medication use, day-and night-time symptom scores (p > 0.05). Flu/form exhibited a safety profile comparable to that of bud/form. CONCLUSION: Fluticasone/formoterol combination administered through a pMDI is as efficacious and well-tolerated as budesonide/formoterol and offers a new therapeutic option for patients with moderate to severe persistent asthma.

Assessment of Bt trait purity in different generations of transgenic cottons.

Adequate expression of Bt (Bacillus thuringiensis) toxins and purity of seeds of Bt-transgenic cottons are important for controlling bollworms, and thereby increasing the cotton productivity. Therefore, we examined the variability in expression of Bt toxin proteins in the seeds and in leaves of different cotton (Gossypium hirsutum (L.) hybrids (JKCH 226, JKCH 1947, JKCH Durga, JKCH Ishwar, JKCH Varun KDCHH 441 and KDCHH 621) expressing Bt toxins in F1 and F2 generations, using bioassays against the cotton bollworm, Helicoverpa armigera (Hübner), and the lateral flow strip (LFS) test. Toxicity of Bt toxin proteins in the seeds of Bt-transgenic cottons to H. armigera correlated with their toxicity in the leaves in one- toxin Bt cotton hybrids. The Bt-F1 and Bt-F2 seeds of JKCH 1947 were more toxic to H. armigera than those of JKCH Varun seeds. The seeds and leaves of F1s showed greater toxicity than the F2 seeds or leaves of one-toxin (cry1Ac) Bt cotton hybrids. However, no significant differences were observed for the two-toxin (cry1Ac and cry2Ab) hybrid, KDCHH 621. Toxicity of leaves to H. armigera increased with crop age, until 112 days after seedling emergence. The Bt trait purity in F1 seeds of four two-toxin Bt cotton hybrids ranged from 86.7 to 100%. The present study emphasizes the necessity of 95% Bt trait purity in seeds of transgenic cotton for sustainable crop production.

Development of low fat potato chips through microwave processing.

Since snacks high in fats are known to be a significant source of fat and energy intake, these have been put in high dietary restraint category. Therefore, an attempt was made to process potato chips through microwave processing without incorporation of any oil in potato chips. Microwave processing of potato chips was done using microwave power varying from 180 to 600 W using constant sample size. Among eleven different drying models, Parabolic model was found to be the best fit through non-linear regression analysis to illustrate drying kinetics of potato chips. The structural, textural and colour attributes of microwaved potato chips were similar to commercial fried potato chips. It was found that at 600 W after 2.5-3.0 min of processing, potato chips gained the fracturability and crispiness index as that of commercial fried chips. Microwave processing was found suitable for processing of potato chips with low fat content (~3.09 vs 35.5 % in commercial preparation) and with acceptable sensory scores (≥7.6 on 9.0 point on hedonic scale vs 8.0 of control preparation).

Host-mediated gene silencing of a single effector gene from the potato pathogen Phytophthora infestans imparts partial resistance to late blight disease.

RNA interference (RNAi) has proved a powerful genetic tool for silencing genes in plants. Host-induced gene silencing of pathogen genes has provided a gene knockout strategy for a wide range of biotechnological applications. The RXLR effector Avr3a gene is largely responsible for virulence of oomycete plant pathogen Phytophthora infestans. In this study, we attempted to silence the Avr3a gene of P. infestans through RNAi technology. The P. infestans inoculation resulted in lower disease progression and a reduction in pathogen load, as demonstrated by disease scoring and quantification of pathogen biomass in terms of Pi08 repetitive elements, respectively. Transgenic plants induced moderate silencing of Avr3a, and the presence and/or expression of small interfering RNAs, as determined through Northern hybridization, indicated siRNA targeted against Avr3a conferred moderate resistance to P. infestans. The single effector gene did not provide complete resistance against P. infestans. Although the Avr3a effector gene could confer moderate resistance, for complete resistance, the cumulative effect of effector genes in addition to Avr3a needs to be considered. In this study, we demonstrated that host-induced RNAi is an effective strategy for functional genomics in oomycetes.

Variation of Stable Carbon and Nitrogen Isotopic Composition of PM10 at Urban Sites of Indo Gangetic Plain (IGP) of India.

This paper presents the variation of elemental concentrations of total carbon (TC), total nitrogen (TN) and isotopic ratios of δ13C and δ15N along with δ13OC and OC of PM10 mass over Delhi, Varanasi and Kolkata of the Indo Gangetic Plain (IGP), India. For Delhi, the average concentrations of TC and TN of PM10 were 53.0±33.6 and 14.9±10.8 µg m(-3), whereas δ13C and δ15N of PM10 were -25.5±0.5 and 9.6±2.8‰, respectively. For Varanasi, the average values of δ13C and δ15N of PM10 were -25.4±0.8 and 6.8±2.4‰, respectively. For Kolkata, TC and TN values for PM10 ranged from 9.1-98.2 to 1.4-25.9 µg m(-3), respectively with average values of 32.6±24.9 and 9.3±8.2 µg m(-3), respectively. The average concentrations of δ13C and δ15N were -26.0±0.4 and 7.4±2.7‰, respectively over Kolkata with ranges of -26.6 to -24.9‰ and 2.8±11.5‰, respectively. The isotopic analysis revealed that biomass burning, vehicular emission and secondary inorganic aerosols were likely sources of PM10 mass over IGP, India.

Retraction Note to: Pathogen virulence of Phytophthora infestans: from gene to functional genomics.

[This retracts the article DOI: 10.1007/s12298-012-0157-z.].

Mathematical modeling to study influence of porosity on apple and potato during dehydration.

Several structural and physical changes in foodstuffs are the consequence of water removal during the drying process. Porosity (volume fraction of pores) is one of the key parameter that affects the quality and other properties of foods (such as apple and potato). To understand the effect of dehydration in apple and potato, in the present study an arbitrary small cubic volume element is considered which contains pores (intracellular spaces) distributed in it. Further, it is assumed that each pore in the cubic volume element is spherical. A mathematical relation is developed between porosity (volume fraction of pores) and pressure generated (due to contraction of cells during water removal) in outward direction on the surface of spherical elements containing pore. The developed relation is satisfactory in respect of experimental observations given in the literature. For the given pressure range, acquired porosity range is 0.1 to 0.92 for apple and 0.03 to 0.89 for potato which is matched with the existing experimental values. The results showed that the porosity is increasing with the increasing values of pressure, as expected, during moisture removal. Further, it is observed that the current porosity is depended on the initial porosity for both apple and potato.

Kumbh Mela 2013: Healthcare for the millions.

Mass gatherings pose challenges to healthcare systems anywhere in the world. The Kumbh Mela 2013 at Allahabad, India was the largest gathering of humanity in the history of mankind, and posed an exciting challenge to the provision of healthcare services. At the finale of the Mela, it was estimated that about 120 million pilgrims had visited the site. Equitable geospatial distribution of adhoc health care facilities were created on a standardised template with integrated planning of evacuation modalities. Innovative and low cost response measures for disaster mitigation were implemented. Emergency patient management kits were prepared and stocked across the health care facilities for crisis response. Dynamic resource allocation (in terms of manpower and supplies) based on patient volumes was done on a daily basis, in response to feedback. An adhoc mega township created on the banks of a perennial river (Ganga) in the Indian subcontinent for accommodating millions of Hindu pilgrims. Conventional mindset of merely providing limited and static healthcare through adhoc facilities was done away with. Innovative concepts such as riverine ambulances and disaster kits were introduced. Managing the medical aspects of a mass gathering mega event requires allocation of adequate funds, proactive and integrated medical planning and preparedness.

Enhanced up-conversion and temperature-sensing behaviour of Er(3+) and Yb(3+) co-doped Y2Ti2O7 by incorporation of Li(+) ions.

Y2Ti2O7:Er(3+)/Yb(3+) (EYYTO) phosphors co-doped with Li(+) ions were synthesized by a conventional solid-state ceramic method. X-ray diffraction studies show that all the Li(+) co-doped EYYTO samples are highly crystalline in nature with pyrochlore face centred cubic structure. X-ray photon spectroscopy studies reveal that the incorporation of Li(+) ions creates the defects and/or vacancies associated with the sample surface. The effect of Li(+) ions on the photoluminescence up-conversion intensity of EYYTO was studied in detail. The up-conversion study under ∼976 nm excitation for different concentrations of Li(+) ions showed that the green and red band intensities were significantly enhanced. The 2 at% Li(+) ion co-doped EYYTO samples showed nearly 15- and 8-fold enhancements in green and red band up-converted intensities compared to Li(+) ion free EYYTO. The process involved in the up-conversion emission was evaluated in detail by pump power dependence, the energy level diagram, and decay analysis. The incorporation of Li(+) ions modified the crystal field around the Er(3+) ions, thus improving the up-conversion intensity. To investigate the sensing application of the synthesized phosphor materials, temperature-sensing performance was evaluated using the fluorescence intensity ratio technique. Appreciable temperature sensitivity was obtained using the synthesized phosphor material, indicating its applicability as a high-temperature-sensing probe. The maximum sensitivity was found to be 0.0067 K(-1) at 363 K.

Determination of volatile organic compounds and associated health risk assessment in residential homes and hostels within an academic institute, New Delhi.

The purpose of this study was to investigate the concentrations of volatile organic compounds (VOCs) in different indoor microenvironments of residential homes and hostels in an academic institute, in New Delhi, during March-May 2011. Eleven VOCs (aromatic and halogenated) were assessed. Sampling and analytical procedure were based on National Institute for Occupational Safety and Health (NIOSH) standard method. The lifetime cancer and non-cancer risk were calculated for targeted VOCs using US Environmental Protection Agency guidelines. The mean concentrations of ∑ VOCs (sum of monitored VOCs) and individual VOC were found to be higher indoors as compared to outdoors at both types of premises. Indoor to outdoor (I/O) ratios of the targeted VOCs exceeded 1.0, suggesting the significant presence of indoor sources. Strong correlations between I/O concentrations of VOCs in the current study suggest the presence of common sources. Factor analysis (FA) was used for source evaluation separately at two premise types. The estimated lifetime cancer risks in the current study for all occupants at both premises exceeded 10(-6) .

Screening of novel microorganisms for biosurfactant and biocontrol activity against Phytophthora infestans.

In the present study, 95 isolates of bacteria were tested for their biosurfactant as well as biocontrol activity against Phytophthora infestans. The results revealed that only 15.8% isolates showed biosurfactant activity. The emulsification index ranged from 0-68% and 24.2% isolates showed positive reaction for biosurfactant properties. In emulsification assay and oil spreading test, 18.95% and 5.26% isolates, respectively scored positive for biosurfactant production. Among all, only five isolates were found effective against P. infestans, for biocontrol properties. Pseudomonas aeruginosa-1 showed 62.22% inhibition zone after 72 hrs while P. aeruginosa-3 showed 46.42%. Forty-eight hrs old culture supernatants were highly effective in food-poisoning test, tuber slice test and detached leaf method against P. infestans. In whole potato plant test, bacterial cell based formulation, culture supernatant and bacterial cell suspension of P. aeruginosa-1 showed 10.42%, 9.94% and 17.96% diseases severity respectively, as against 53.96% in control. This isolate holds promise as biological control agent against P. infestans in field.

Glyceraldehyde-3-phosphate dehydrogenase of the parasitic nematode Haemonchus contortus binds to complement C3 and inhibits its activity.

Haemonchus contortus is an economically important gastrointestinal parasite that infects primarily sheep and goats. To survive inside the host, the parasite must overcome the host immune response. In this study, we have identified and characterized a complement-C3-binding protein (H.c-C3BP) from this parasite employing biochemical and molecular biology tools. Initially, a truncated form of the protein was isolated from the excretory-secretory products of the parasite using C3-Sepharose column that facilitated its identification by mass spectroscopy. Subsequently, the parent molecule was generated in E. coli, and sequence analysis confirmed it as glyceraldehyde-3-phosphate dehydrogenase (GAPDH). GAPDH reacted with the antiserum raised against the truncated protein, and the truncated protein reacted with anti-GAPDH antiserum. The protein inhibited complement function as measured by haemolytic assay and membrane attack complex (MAC) formation. Sera from H. contortus-infected animals reacted with GAPDH as well as the truncated form of the protein, which further lend support to protein secretion. Thus, the C3-binding property of H. contortus GAPDH is a new function, and it represents a new entity of complement-binding protein. Identification and characterization of H.c-C3BP should facilitate development of new therapeutics considering a key role of this protein in immune modulation.

Structural and up-conversion properties of Er3+ and Yb3+ co-doped Y2Ti2O7 phosphors.

Y(2)Ti(2)O(7) (YTO) and Er(3+)/Yb(3+) co-doped Y(2)Ti(2)O(7) (EYYTO) phosphors have been prepared by solid-state reaction method. Structures of YTO and EYYTO phosphors are identified as face centered cubic pyrochlores. Up-conversion emission spectra of EYYTO under 976 nm excitation is studied, which revealed three prominent emission lines at ~524, 548 and 661 nm originating from (2)H(11/2)→(4)I(15/2), (4)S(3/2)→(4)I(15/2) and (4)F(9/2)→(4)I(15/2) electronic transitions of Er(3+) ion, respectively in green and red regions. The power dependence study suggests that these bands arise due to two photon absorption. The monodispersed laser ablated colloidal solution of EYYTO shows strong red and green emissions on excitation with 976 nm laser. The variation of luminescence intensity at different laser excitation powers is observed and thus a color can be tuned. The photoluminescence lifetime of green band at 548 nm ((4)S(3/2) level) has been found to be ~446 µs.

Pathogen virulence of Phytophthora infestans: from gene to functional genomics.

The oomycete, Phytophthora infestans, is one of the most important plant pathogens worldwide. Much of the pathogenic success of P. infestans, the potato late blight agent, relies on its ability to generate large amounts of sporangia from mycelia, which release zoospores that encyst and form infection structures. Until recently, little was known about the molecular basis of oomycete pathogenicity by the avirulence molecules that are perceived by host defenses. To understand the molecular mechanisms interplay in the pathogen and host interactions, knowledge of the genome structure was most important, which is available now after genome sequencing. The mechanism of biotrophic interaction between potato and P. infestans could be determined by understanding the effector biology of the pathogen, which is until now poorly understood. The recent availability of oomycete genome will help in understanding of the signal transduction pathways followed by apoplastic and cytoplasmic effectors for translocation into host cell. Finally based on genomics, novel strategies could be developed for effective management of the crop losses due to the late blight disease.

Analysis of genetic stability of in vitro propagated potato microtubers using DNA markers.

The genetic stability of in vitro propagated potato microtubers was assessed using random amplified polymorphic DNA (RAPD), inter simple sequence repeat (ISSR), simple sequence repeat (SSR) and amplified fragment length polymorphism (AFLP) markers. Microtubers were developed through in vitro from potato microplants using standardized protocols. The microtubers were conserved for 1 year under three different culture media and consequently microplants were regenerated for the DNA analyses. During the study, a total of 38 (10 RAPD, 11 ISSR, 12 SSR and 5 AFLP) primers produced a total of 407 (58 RAPD, 56 ISSR, 96 SSR and 197 AFLP) clear, distinct and reproducible amplicons. Cluster analysis revealed 100 % genetic similarity among the mother plant and its derivatives within the clusters by SSR, ISSR and RAPD analyses, whereas AFLP analysis revealed from 85 to 100 % genetic similarity. Dendrogram analysis based on the Jaccard's coefficient classified the genotypes into five clusters (I-V), each cluster consisting of mother plant and its derivatives. Principal component analysis (PCA) also plotted mother plant and its genotypes of each cluster together. Based on our results, it is concluded that AFLP is the best method followed by SSR, ISSR and RAPD to detect genetic stability of in vitro conserved potato microtubers. The in vitro conservation medium (T2) is a safe method for conservation of potato microtubers to produce true-to-type plans.

Prosthetic management of post surgical nasal skin graft contracture.

The sequelae of trauma to the nose include nasal deformity and nasal obstruction that can have a long term negative impact on patient's quality of life. Successful management of posttraumatic nasal obstruction relies on a detailed history, careful analysis, and accurate diagnosis. Treatment must balance the seemingly disparate goals of re-establishing structure, improving contour and esthetics, as well as restoring the nasal airway. Indications and technical steps for fabricating bilateral nasal stents are presented, for a case of surgical opening of bilateral nasal synechia necessitated due to failed initial corrective surgery, post contracture and collapse of skin grafts. The objective of nasal stent was to maintain patency of nasal passage post surgical intervention. This is achieved by support to graft and residual tissues and prevention of mouth breathing. The nasal stents were modified post insertion at regular intervals to ensure adaptation to changes in mucosal lining of nasal.