Establishment of CRISPR-Cas9 ribonucleoprotein mediated MSTN gene edited pregnancy in buffalo: Compare cells transfection and zygotes electroporation.

Genome editing is recognized as a powerful tool in agriculture and research, enhancing our understanding of genetic function, diseases, and productivity. However, its progress in buffaloes has lagged behind other mammals due to several challenges, including long gestational periods, single pregnancies, and high raising costs. In this study, we aimed to generate MSTN-edited buffaloes, known for their distinctive double-muscling phenotype, as a proof of concept. To meet our goal, we used somatic cell nuclear transfer (SCNT) and zygotic electroporation (CRISPR-EP) technique. For this, we firstly identified the best transfection method for introduction of RNP complex into fibroblast which was further used for SCNT. For this, we compared the transfection, cleavage efficiency and cell viability of nucleofection and lipofection in adult fibroblasts. The cleavage, transfection efficiency and cell viability of nucleofection group was found to be significantly (P ≤ 0.05) higher than lipofection group. Four MSTN edited colony were generated using nucleofection, out of which three colonies was found to be biallelic and one was monoallelic. Further, we compared the efficacy, embryonic developmental potential and subsequent pregnancy outcome of SCNT and zygotic electroporation. The blastocyst rate of electroporated group was found to be significantly (P ≤ 0.05) higher than SCNT group. However, the zygotic electroporation group resulted into two pregnancies which were confirmed to be MSTN edited. Since, the zygotic electroporation does not require complex micromanipulation techniques associated with SCNT, it has potential for facilitating the genetic modification in large livestock such as buffaloes. The present study lays the basis for inducing genetic alternation with practical or biological significance.

Etiological and clinical profiles of patients with dysphagia: A teaching institution experience.

Background: Dysphagia can involve any structure from the mouth to the lower esophageal sphincter. The etiologies vary from benign causes to malignant lesions. There is dearth of data regarding dysphagia in our population. Methods: A total of 208 patients with complaints of dysphagia were screened for the study. After ruling out neurological/local oropharyngeal causes of dysphagia, 200 patients with suspected esophageal dysphagia (ED) were recruited in the study. Dysphagia was graded as per the dysphagia scoring system. All patients underwent upper gastro-intestinal endoscopy and were evaluated for the presence of mechanical and non-mechanical causes of ED. Results: The mean age of patients with dysphagia was 53.8 ± 15.4 years. with males and females being 82 and 118, respectively. The mean duration of the symptom was 7.2 ± 10.6 months (median 3 months). Ninety-eight patients (49%) having dysphagia were in the age group of 56-65 years. The dysphagia score was 0 among 58, and 4 among 26 subjects. Foreign body sensation was the most frequent chief complaint in 90 (45%) patients. Ninety-six (48%) and 104 (52%) patients had mechanical and non-mechanical causes of dysphagia, respectively. Among mechanical causes of dysphagia, 68 patients (70.8%) had esophageal growth and 28 (29.2%) had esophageal stricture. Sixty-seven patients had squamous cell carcinoma. Among non-mechanical causes, 50 (48.1%) had globus sensation, 24 (23.1%) had hiatus hernia, and 16 (15.4%) functional dysphagia. Conclusion: Dysphagia is a common problem with varied etiologies. The esophageal growth and globus sensation are among the predominant causes of ED. We stress that all patients of dysphagia must be meticulously investigated.

The Patient Population at Homeopathic Outpatient Clinics across India: A Clinical Data Collection Study.

BACKGROUND: Even though several initiatives have been undertaken in different locations worldwide to collect clinical data in homeopathy, it is important to further investigate these aspects in the context of health care in India. OBJECTIVE: The study aimed to gather and analyze patients' clinical data and to derive insights into homeopathic treatment using an internet-based software program for data storage, retrieval and repertorization. METHODS: A multi-center observational study was conducted across 14 homeopathy outpatient clinics in India that are affiliated with the Central Council for Research in Homoeopathy (CCRH). Patient symptoms and demographic details were documented anonymously, and prescriptions were guided by repertorial suggestions from the Vithoulkas Compass software. During follow-up visits, treatment outcome was also recorded using an online assessment form. A retrospective analysis of data on patients' demographics, follow-up visits, morbidity (International Classification of Diseases 11th Revision), rubrics used, prescribed medicines and the level of improvement was achieved using Microsoft Excel-generated pivot tables. RESULTS: Throughout the study duration of one year a total of 2,811 patients attended the 14 outpatient clinics, of whom 2,468 were new patients with a total of 2,172 initial homeopathic prescription entries. Across the study, there were 3,491 prescriptions and 1,628 follow-up consultations for 868 follow-up patients, all of which data were thoroughly analyzed. The highest frequency of patients was in the 20-49 age group, and a higher proportion of the patients overall was female. Musculoskeletal, dermatological and respiratory complaints were the most frequently reported. The rubrics "Desire for sweets" and "Desire for spices" emerged as the most commonly used in the repertorizations. Further, Sulphur stood out as the most commonly prescribed medicine overall. With homeopathic treatment, some degree of clinical improvement was reported in 86% of the follow-up cases. CONCLUSION: Homeopathy is prescribed in CCRH outpatient clinics for a wide range of ailments in people across India, with at least some clinical improvement noted in a high proportion of those patients. The large-scale systematic data collection in these clinics has provided clear insights into the use and clinical value of homeopathy in India, with the potential to build a substantive nationwide data inventory over time.

Correlation of Venous Blood Sugar Measured by Lab Method and Capillary Blood Sugar Measured by Glucometer in Neurosurgical Patients Receiving Dexamethasone.

Background Brain is vulnerable to extreme blood glucose levels that may occur due to multiple factors in neurosurgical patients; perioperative use of dexamethasone is the most common. Thus, frequent monitoring of blood sugar levels is advocated. This study aimed to assess correlation between venous blood sugar measured by lab method and capillary blood sugar by glucometer at various time intervals. Materials and Methods This prospective and observational study was conducted in 20 adult patients of either sex, American Society of Anesthesiologists grade I to III, scheduled to undergo brain tumor resection. The patients who were already on dexamethasone and received intraoperatively 8 mg dexamethasone were enrolled. Standard anesthesia technique and intraoperative monitoring were followed in all patients. Venous sample was withdrawn and blood sugar analyzed in laboratory, while at the same time capillary blood sugar was tested by glucometer. The sampling was done at baseline, 1 hourly after dexamethasone administration till 4 hours and then 8, 12, and 24 hours. The correlation between the two values was assessed. Results During the study, 160 venous and 160 capillary blood sugar levels were analyzed. Though capillary blood sugar levels were slightly higher than venous sugar levels, there was strong correlation between the two (Pearson correlation coefficient) with p -value less than 0.05 except at 24 hours when two values were not correlated. Conclusion Capillary blood sugar levels by glucometer have good correlation with venous sugar levels; therefore, this method may be adopted routinely for frequent blood sugar estimation as it is reliable, easy, and practical.

Stereoselective analysis of chiral pesticides: a review.

Chiral organic pollutants, including pesticides, herbicides, medicines, flame retardants, and polycyclic musk, represent a significant threat to both the environment and human health. The presence of asymmetric centers in the structure of chiral pesticides introduces stereoisomers with distinct distributions, fates, biomagnification capacities, and cytotoxicities. In aquatic environments, pesticides, as persistent/pseudo-persistent compounds, have been detected in substantial quantities, posing severe risks to non-target species and, ultimately, public health through water supply and food exposures. In response to this environmental challenge, stereoselective analytical methods have gained prominence for the identification of pesticide/drug enantiomers in recent years. This review examines the environmental impact of chiral pesticides, emphasizing the distinct biological activities and distribution patterns of their stereoisomers. By highlighting the advancements in liquid chromatography for enantiomeric analysis, the review aims to underscore the urgent need for a comprehensive understanding of these pollutants to facilitate informed remediation strategies and ensure the safer dispersal of chiral organic pollutants in the environment, thereby addressing the potential risks they pose to ecosystems and human health. Future research should focus on developing sustainable and efficient methodologies for the precise analysis of stereoisomers in complex matrices, particularly in sewage water, emphasizing the importance of sewage processing plants in ensuring water quality.

Homeopathic Medicines in the Management of Dermatophytosis (Tinea Infections): A Clinico-epidemiological Study with Pre-post Comparison Design.

BACKGROUND: Dermatophytosis is a common fungal infection of the skin and nails. Insufficient data exist regarding the clinico-epidemiological profile of dermatophytosis and the usefulness of individualized homeopathic medicines (IHMs) for patients visiting a homeopathy outpatient department (OPD). OBJECTIVES: This article undertakes a clinico-epidemiological profiling of dermatophytosis and the usefulness of IHMs in its management. METHODS: This open-label, pre-post, comparative observational study was conducted in a homeopathy OPD from November 2018 to February 2020. IHMs were prescribed based on symptom totality and repertorization. A numeric rating scale (NRS) and the Dermatology Life Quality Index (DLQI) patient questionnaires were used, and results were analyzed using SPSS-IBM version 20. RESULTS: Data from a total of 103 patients, mean age 29.65 ± 15.40 years, were analyzed. Tinea cruris was the most common infection (29.1%), followed by tinea corporis (13.6%). After 3 months of treatment, significant reductions in NRS and DLQI scores were observed (8.51 ± 1.24 to 0.59 ± 0.83, p < 0.001, and 16.28 ± 5.30 to 1.44 ± 1.56, p < 0.001, respectively), with Sepia (15.5%), Sulphur (14.6%), Calcarea carbonica (11.7%), Natrum muriaticum (9.7%) and Bacillinum (8.7%) being the most frequently prescribed medicines. There was no significant correlation between occupation, sex, home location or marital status and the clinical types of dermatophytosis. No adverse events were reported. CONCLUSION: T. cruris and T. corporis were prevalent dermatophytic infections. The decrease in NRS and DLQI scores associated with homeopathy indicates its usefulness as an integrative treatment option for dermatophytosis. Further research in larger and more diverse population samples is needed.

Lanthanum nanoparticle (La2O3)-loaded adsorbents for removal of hexavalent chromium: a kinetics, isotherm, and thermodynamic study.

Nanocomposite adsorbents for wastewater treatment gained popularity in recent times. In the present study, nanoparticles prepared from lanthanum have been loaded on the powdered form of aquatic plants Salvinia molesta (S. molesta) and Typha latifolia (T. latifolia). These new adsorbents were NPS (nanoparticle-loaded S. molesta) and NPT (nanoparticle-loaded T. latifolia). The batch study was carried out to assess the effect of several factors on the adsorption of Cr(VI) by novel adsorbents NPS and NPT. XRD, SEM, FTIR, EDX, and Zeta potential were used for the characterization of nanoparticles formed and novel adsorbents. The maximal adsorption was noticed by both adsorbents at pH 1, 20 ppm of initial metal concentration, and 1 h of contact period with 150 rpm at 25 ℃. The adsorbent dose of 60 mg and 80 mg was observed as the equilibrium dose for NPS and NPT, respectively. The maximum adsorption capacity observed was 27.18 mg/g for NPS and 19.85 mg/g for NPT. Freundlich isotherm was better fitted for both adsorbents. Pseudo-second-order kinetics depicts the better mechanism of adsorption with R2 = 0.9995 and 0.9982 for NPS and NPT, respectively. Thermodynamic parameters show that the adsorption process was exothermic and spontaneous.

Practice, prescription habits, experience and perception of Indian homeopathic practitioners in treatment of diabetes mellitus: An online observational study.

BACKGROUND: Studies have shown homoeopathy to effectively control blood sugar levels and improve quality of life (QOL), though a standard treatment protocol is required. OBJECTIVE: This study intended to assess the homoeopathic practice, prescription habits, experience, and perception of Indian Homeopathic Practitioners (HPs) in treating DM. METHODOLOGY: A web-based cross-sectional with a snowball sampling method was conducted between 30th July 2021 and 18th August 2021. A questionnaire to record clinical attributes of Indian HPs in the management of DM was formed after the consensus of the subject experts and pilot testing for feasibility. RESULTS: Participants were 513 HPs with mean age [Standard Deviation (SD)] of 40.44 years (11.16) and a mean duration of the homoeopathic medical practice of 14.67 years [95% Confidence Interval (CI) = 13.71-15.63]. The majority of HPs made classical homoeopathic prescription (201, 39.2%) though the success in the management of DM was better among HPs who prescribed more than one potentized medicine [vs classical prescription, Odds Ratio (OR) = 2.34, p = 0.032]. As perceived by the HPs, homoeopathic treatment resulted in a major improvement in QOL of the diabetic patients (418, 81.5%) with very few adverse effect (100, 19.5%). The blood sugar level was controlled better when homoeopathy was given alongside conventional medicine (348, 67.8%). CONCLUSION: The clinical experience of HPs in this study has shown that homoeopathic treatment can benefit DM patients in preventing complications and improving QOL. It further reported that homoeopathy can be an important adjuvant to conventional treatment in managing DM.

Genetic analysis for semen quality traits in buffalo bulls.

This study was attempted to estimate the genetic parameters of semen quality traits in buffalo bulls. The study data consisted of 10975 ejaculates from 45 Murrah buffalo bulls (aged 24-72 months) used for breeding program during year 2010 to 2020. Semen quality traits (ejaculate volume, concentration of sperm, mass activity, initial and post-thaw motility, number of sperms per ejaculate, motile sperm number and discard rates) were studied. It was observed that average ejaculate volume was 2.82 ± 1.45 mL with mean concentration of 1040.12 ± 523.26 million/mL. Higher heritability was observed for number of sperms per ejaculate, number of motile sperm and sperm concentration. Significant phenotypic correlation was obtained between volume and number of sperms per ejaculate as well as volume and number of motile sperms. Likewise, significant phenotypic correlation was evident between sperm concentration with sperm number per ejaculate. Highest phenotypic correlation was obtained between sperm count per ejaculate and motile sperm count. Estimated genetic trends showed significant change in volume and motile sperm number. In conclusion, this study ascertains that genetic parameters of semen traits can be considered during the selection of buffalo bulls in breeding program.

Effect of Normal Saline versus PlasmaLyte on Coagulation and Metabolic Status in Patients Undergoing Neurosurgical Procedures.

Background The choice of intraoperative fluid in neurosurgical patients is important as we need to maintain adequate cerebral perfusion and oxygenation and also avoid cerebral edema. Normal saline (NS) is commonly used in neurosurgeries, but it leads to hyperchloremic metabolic acidosis, which may result in coagulopathy. Balanced crystalloid with physiochemical composition akin to that of plasma has favorable effects on metabolic profile and may avoid the problems associated with NS. Against this background, the present study aimed to compare the effects of NS versus PlasmaLyte (PL) on coagulation profile in patients undergoing neurosurgical procedures. Methods This prospective, randomized, double-blinded study was conducted in 100 adult patients scheduled to undergo various neurosurgical procedures. Patients were randomly allocated in two groups of 50 each to receive either NS or PL intraoperatively and postoperatively till 4 hours after the surgery. Hemoglobin, hematocrit, coagulation profile (PT, PTT, and INR), serum chloride, pH, blood urea, and serum creatinine were measured prior to induction (baseline) and 4 hours after completion of surgery. Results Demographic characteristics were statistically similar between the two groups. Coagulation profile parameters were comparable between the two groups at baseline as well as 4 hours after surgery. pH was significantly lower in the NS group as compared to the PL group at 4 hours after surgery. Postoperatively blood urea, serum creatinine, and serum chloride levels were significantly raised in the NS group as compared to the PL group. Hemoglobin and hematocrit values were similar between the two groups. Conclusion Coagulation profile parameters were normal and statistically similar with intraoperative infusion of NS versus PL in patients undergoing neurosurgical procedures. However, use of PL was associated with a better acid-base and renal profile in these patients.

Purification and characterization of a high molecular weight serine protease from Microbacterium paraoxydans sp. SKS10.

Alkaline proteases from microbial sources have been found suitable for diverse industrial applications, with serine proteases being the most common enzymes used in the detergent industry. In the present study, we have purified and characterized an extracellular alkaline serine protease from Microbacterium paraoxydans sp. SKS10. The protease was purified using ammonium sulfate precipitation followed by different chromatography techniques (fold purification 6.919). Km and Vmax for the protease were determined to be 0.183 mg/mL and 4.904 U/mL, respectively. This enzyme is a thermostable high molecular weight (∼109.4 kDa) protease which has maximal activity at 60°C, and above pH 10. Inhibitor assays revealed the enzyme to be a serine protease whose activity increased by 2.5-fold in the presence of EDTA. This enzyme remained active in the presence of various metal salts and organic solvents and was compatible with commercially available laundry detergents highlighting its potential for use in the detergent industry.

Epsilon poly-lysine in buffalo semen extender: A step towards reducing the development of antibiotic resistance.

The use of antibiotics in semen extenders can contribute to the development of antibiotic resistance. The objective of the study was to evaluate epsilon-polylysine (Ɛ-PL) as a substitute for antibiotics in the buffalo semen extender. For this, 20 semen ejaculates were collected from four Murrah buffalo bulls. Each ejaculate was divided into three equal aliquots and extended into an egg yolk-based semen extender containing either antibiotics (strepto-penicillin) or different concentrations of Ɛ-PL (0.64 and 1.28 g/L) to make the final concentration 80 million sperm/mL and cryopreserved as per the standard procedure. The antibiogram sensitivity test confirmed that Ɛ-PL is an effective antimicrobial against microbes present in buffalo semen ejaculates. Furthermore, the addition of Ɛ-PL in the semen extender significantly reduces the colony forming unit (CFU)/mL in cryopreserved semen equivalent to strepto-penicillin. The sperm motility and kinematic parameters assessed by a computer-assisted sperm analyser showed that Ɛ-PL did not inhibit either sperm motility not kinematic parameters of cryopreserved sperm. The flow-cytometric evaluation of frozen-thawed sperm revealed interesting results. The extender supplemented with Ɛ-PL protected sperm acrosome and mitochondrial membrane potential greater than the extender supplemented with strepto-penicillin. Further, Ɛ-PL reduced significantly the production of superoxide anions from mitochondria during the cryopreservation process. In this way, Ɛ-PL may be a suitable alternative to antibiotics in semen extenders. In conclusion, Ɛ-PL at a concentration of 0.64 g/L acts as an effective antimicrobial as well as antioxidant in semen extender for cryopreservation of buffalo sperm.

A prospective randomized study to evaluate the efficacy of pressure support ventilation with and without positive end expiratory pressure for preoxygenation in adult patients.

A primary concern for anesthesiologists is the maintenance of oxygenation during general anesthesia. Extending the safe apnea time, which is the time from the onset of apnea until the oxygen saturation concentration reaches 90% or less, increases the margin of safety with tracheal intubation. Preoxygenation before anesthetic induction has been a widely accepted manoeuver to increase oxygen reserves and hence delay the onset of arterial desaturation during apnea. This study aimed to evaluate the efficacy of pressure support ventilation with/without positive end-expiratory pressure (PEEP) for preoxygenation in adult patients. A total of 132 patients, aged 20 to 50 years, scheduled for elective surgery under general anesthesia, requiring endotracheal intubation, were included and randomly divided into three groups (n = 44 per group): spontaneous ventilation (SV), pressure support ventilation without PEEP (PS), and pressure support ventilation with PEEP (PEEP) groups. In the SV group, the patients breathed spontaneously without any support using a face mask; in the PS group, the patients breathed spontaneously with the inspiratory pressure support of 12 cm H2O without PEEP; and in the PEEP group, the patients were subjected to preoxygenation (similar to the PS group) with PEEP at 6 cm H2O. Preoxygenation was terminated when the fraction of expired oxygen reached 90% and the duration was recorded. Time from 90 seconds after administration of rocuronium bromide until oxygen saturation fell to 93% was recorded and taken as safe apnea time. The time taken for preoxygenation (the expired oxygen fraction reaches 90) was significantly shorter in patients of PEEP and PS groups when compared to the SV group. The safe apnea time was significantly longer in patients of PEEP and PS groups compared with the SV group. Application of inspiratory pressure support of 12 cm H2O and PEEP of 6 cm H2O during preoxygenation significantly reduces the preoxygenation time and prolongs the safe apnea time compared with conventional preoxygenation.

A new role of H89: Reduces capacitation-like changes through inhibition of cholesterol efflux, calcium influx, and proteins tyrosine phosphorylation during sperm cryopreservation in buffalo.

It is a known fact that cryopreservation initiates premature capacitation in spermatozoa during the cryopreservation process. Protein tyrosine phosphorylation is a landmark of cascade reaction accountable for capacitation or capacitation-like changes in spermatozoa. Therefore, our hypothesis was to test an inhibitor (H89) that reversibly inhibits the cascade reaction responsible for capacitation during the cryopreservation process but does not hamper normal capacitation and fertilizing ability of sperm. For this, sixteen ejaculates were collected from Murrah buffalo bulls (n = 4). Each ejaculate was divided into four equal aliquots and diluted in an egg yolk-based semen dilutor supplemented with 0, 2, 10, and 30 µM concentrations of H89 and cryopreserved. Interestingly, H89 reduces cholesterol efflux from spermatozoa and protects spermatozoa from membrane damage during the cryopreservation process. H89 did not prevent lipid peroxidation of the sperm membrane. H89 reduced intracellular calcium concentration in spermatozoa in a dose-dependent manner, but tyrosine phosphorylation reduction was observed in the 2 and 10 µM H89 groups. The CTC assay revealed that the percentage of uncapacitated spermatozoa in different treatment groups increases in a dose-dependent manner. In the in vitro capacitation medium, the effect of H89 is abolished and spermatozoa underwent normal capacitation, but H89-treated spermatozoa attached to zona pellucida in large numbers compared to untreated spermatozoa. In conclusion, H89 does not only inhibit tyrosine phosphorylation of spermatozoa but it reduces cholesterol efflux and calcium influx, and ultimately reduces capacitation-like changes during the cryopreservation process.

Mitochondria-targeted antioxidant MitoQ ameliorates ROS production and improves cell viability in cryopreserved buffalo fibroblasts.

Cryopreservation commonly decreases the cellular functionality and post-thaw viability of cells. Reactive oxygen species (ROS) generated during cryopreservation degrade mitochondrial activity and promote the release of cytochrome C which activates caspases required for apoptosis. Antioxidants have the potential to improve the recovery efficiency of cells by reducing ROS production and maintaining mitochondrial membrane potential (MMP). The present study was conducted to explore the role of MitoQ, a derivative of coenzyme Q10 on cryopreserved fibroblasts derived from buffalo skin. To achieve our goal, buffalo skin fibroblasts were treated with varying concentrations of MitoQ (0, 0.1, 0.5, 1, 2, and 10 µM) for 24, 48, and 72 h. The MMP, ROS generation, cell viability was measured by flow cytometry. Furthermore, expression of genes related to mitochondrial oxidative stress (NRF2, GPX, and SOD), apoptosis (BAK and caspase 3) and cell proliferation (AKT) were also assessed. The results showed that over a period of 72 h lower concentrations of MitoQ (0.1-0.5 µM) decrease the ROS production, improves MMP and cell viability whilst the high concentration of MitoQ (2-10 µM) increased the oxidative damage to the cells. Taken together, our study provide important insights into the novel role of MitoQ in cryopreserved buffalo skin fibroblasts. In conclusion, we demonstrated the dose-dependent functional role of MitoQ on cryopreserved fibroblasts for improving post-thaw cell viability and cellular function.

Psychological trauma and depression in recovered COVID-19 patients: a telecommunication based observational study.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is adversely affecting the mental health of patients infected with the virus and the psychological impact on recovered COVID-19 patients is unclear. OBJECTIVES: The study aimed to assess posttraumatic stress disorder (PTSD) and depression among COVID-19 patients after recovery from the disease. METHODS: This cross-sectional study was conducted from November 9, 2020, to December 23, 2020. The study used a telemedicine model to enroll recovered COVID-19 patients from a database of patients provided by the health authorities. The National Stressful Events Survey PTSD Short Scale (NSESSS) for adults was used to assess PTSD symptoms and the Patient Health Questionnaire (PHQ-9) was used to assess depression. RESULTS: The study enrolled 503 recovered COVID-19 patients with a mean age of 41.90 years. The majority were asymptomatic (64.6%), while 21.5% had had moderate to severe forms of the disease. Prevalence rates of PTSD symptoms and depression were 56.9 and 29% respectively. COVID-19 patients with severe forms of the disease were significantly more affected by PTSD symptoms (vs. mild, odds ratio [OR] = 18.7, 95%confidence interval [CI] 9.9-35.5) and depression (vs. mild, OR = 19.8, 95% CI 9.9-39.5). Similarly, patients who required oxygen or ventilator support reported significantly higher rates of PTSD symptoms (vs. managed at home, OR = 17.4, 95% CI 8.3-36.4) and depression (vs. managed at home, OR = 22.0, 95% CI 10.1-47.7). CONCLUSION: This study reports that recovered COVID-19 patients suffered from a significant amount of depression and experienced significant PTSD symptoms. It will help with addressing a major psychological concern among the recovered subjects.

Comparison between Air Q and intubating laryngeal mask airway as intubation conduits in patients with simulated fixed cervical spine: a prospective observational study.

The intubating laryngeal mask airway (ILMA) can be used for ventilation and oxygenation between intubation attempts, but there is a varied success rate ranging from 33% to 96%. Air Q is a relatively new entrant. Parker flex tube aids in atraumatic intubation. The primary aim of this study was to compare Air Q intubating laryngeal airway with ILMA as intubation conduits in patients with simulated fixed cervical spine using a Parker flex tube. It was a single-blinded, randomized, prospective, and comparative study conducted on 91 patients aged between 18 to 60 years of either sex, scheduled to undergo elective surgery under general anesthesia belonging to the American Society of Anesthesiologists physical status I and II. Out of 45 patients in each group, Air Q was successfully placed in 43 patients and ILMA was successfully placed in 44 patients. 35.56% of the patients required maneuvers for placing the Air Q, whereas, for placing the ILMA, only 15.56% of the patients required maneuvers. Intubation through the AIR Q was successful in 39 patients and through the ILMA in 44 patients, but there was no significant difference between the two groups. The number of attempts and the time of device insertion were comparable. There were a similar number of attempts, maneuvers required, and time is taken for endotracheal intubation. The incidence of cough and sore throat was comparable in both groups. We conclude that ILMA has a higher success rate than Air Q for tracheal intubation with Parker Flex tube in patients with simulated fixed cervical spine. More optimized maneuvers were required for the placement of Air Q.

Psychological trauma and depression in recovered COVID-19 patients: a telecommunication based observational study

Abstract Introduction Coronavirus disease 2019 (COVID-19) is adversely affecting the mental health of patients infected with the virus and the psychological impact on recovered COVID-19 patients is unclear. Objectives The study aimed to assess posttraumatic stress disorder (PTSD) and depression among COVID-19 patients after recovery from the disease. Methods This cross-sectional study was conducted from November 9, 2020, to December 23, 2020. The study used a telemedicine model to enroll recovered COVID-19 patients from a database of patients provided by the health authorities. The National Stressful Events Survey PTSD Short Scale (NSESSS) for adults was used to assess PTSD symptoms and the Patient Health Questionnaire (PHQ-9) was used to assess depression. Results The study enrolled 503 recovered COVID-19 patients with a mean age of 41.90 years. The majority were asymptomatic (64.6%), while 21.5% had had moderate to severe forms of the disease. Prevalence rates of PTSD symptoms and depression were 56.9 and 29% respectively. COVID-19 patients with severe forms of the disease were significantly more affected by PTSD symptoms (vs. mild, odds ratio [OR] = 18.7, 95%confidence interval [CI] 9.9-35.5) and depression (vs. mild, OR = 19.8, 95% CI 9.9-39.5). Similarly, patients who required oxygen or ventilator support reported significantly higher rates of PTSD symptoms (vs. managed at home, OR = 17.4, 95% CI 8.3-36.4) and depression (vs. managed at home, OR = 22.0, 95% CI 10.1-47.7). Conclusion This study reports that recovered COVID-19 patients suffered from a significant amount of depression and experienced significant PTSD symptoms. It will help with addressing a major psychological concern among the recovered subjects.

Mobile dental clinic for oral health services to underserved rural Indian communities.

Mobile dental vehicle (MDVs) can be adopted to address the oral healthcare needs of different populations. Therefore, it is of interest to evaluate mobile dental clinic program in providing oral health services to underserved rural communities. A 2 x 2.5 meter box trailer is used by the UN, and it can be carried by a vehicle with all-wheel drive for all types of weather. There was a small box trailer with its weather proof canvas cover extended, changing it into four dental operators and an integrated waiting and teaching space. Clinical examination, scaling, polishing, health education, individual and group teaching in dental hygiene, fluoride applications, fissure sealants, amalgam and composite restorations, extractions, and minor oral surgery were all supplied at no cost to the patients. In a longitudinal study of 3 years in underserved rural areas, a total of 6326 patients were provided different dental treatments. It was found that 93.3% patients did not undergo any dental treatment in the past.

A Comparative Study of Intravenous Dexmedetomidine with Local Infiltration of Ropivacaine in Attenuation of Stress Response to Skull Pin Insertion in Craniotomies.

Objective Skull pin insertion in patients undergoing craniotomies elicits hemodynamic and neuroendocrine stress response that may be deleterious to the patient. Various drugs and techniques have been documented in literature to abate this stress response. Against this background, we aimed to compare the efficacy of intravenous dexmedetomidine and local infiltration of ropivacaine for attenuation of stress response to pin insertion in craniotomies. Methods Eighty-eight adult patients undergoing craniotomy under general anesthesia from March 2019 to April 2020 requiring application of head holder were randomized into two equal groups. After intubation, 0.75 µg kg -1 of dexmedetomidine over 10 minutes through infusion was given in group D, while local infiltration at pin sites was done with 0.5% ropivacaine, 2 mL at each site in group R. Hemodynamic parameters and levels of serum cortisol, prolactin, and blood glucose were measured before and after pin insertion. Unpaired t -test for continuous variables and Mann-Whitney U test was used for nonnormally distributed variables. Results Heart rate was statistically similar between the two groups at all the observed time points. The difference in mean arterial pressure values between the two groups was found to be statistically significant only from 10 to 20 minutes after pin insertion being statistically similar at rest of the time points. Levels of serum glucose, cortisol, and prolactin values 30 minutes after pin insertion were statistically similar between both groups. Conclusion We concluded that both interventions are equally efficacious in attenuation of hemodynamic and stress response to head holder application in patients undergoing craniotomies.