Th17-associated cytokines IL-17 and IL-23 in inflamed skin of Darier disease patients as potential therapeutic targets.

Darier disease (DD) is a rare, inherited multi-organ disorder associated with mutations in the ATP2A2 gene. DD patients often have skin involvement characterized by malodorous, inflamed skin and recurrent, severe infections. Therapeutic options are limited and inadequate for the long-term management of this chronic disease. The aim of this study was to characterize the cutaneous immune infiltrate in DD skin lesions in detail and to identify new therapeutic targets. Using gene and protein expression profiling assays including scRNA sequencing, we demonstrate enhanced expression of Th17-related genes and cytokines and increased numbers of Th17 cells in six DD patients. We provide evidence that targeting the IL-17/IL-23 axis in a case series of three DD patients with monoclonal antibodies is efficacious with significant clinical improvement. As DD is a chronic, relapsing disease, our findings might pave the way toward additional options for the long-term management of skin inflammation in patients with DD.

Tea (Camellia sinensis (L.) Kuntze) as an emerging source of protein and bioactive peptides: A narrative review.

Tea residues represent one of the major agricultural wastes that are generated after the processing of tea. They account for 21-28% of crude protein and are often discarded without the extraction of valuable proteins. Due to various bioactivity and functional properties, tea proteins are an excellent alternative to other plant-based proteins for usage as food supplements at a higher dosage. Moreover, their good gelation capacity is ideal for the manufacturing of dairy products, jellies, condensation protein, gelatin gel, bread, etc. The current study is the first to comprehend various tea protein extraction methods and their amino acid profile. The preparation of tea protein bioactive peptides and hydrolysates are summarized. Several functional properties (solubility, foaming capacity, emulsification, water/oil absorption capacity) and bioactivities (antioxidant, antihypertensive, antidiabetic) of tea proteins are emphasized.

Surveillance of Antimicrobial Susceptibility Pattern of Chronic Suppurative Otitis Media in Tertiary Care Hospital of Southern Rajasthan.

The main aim of this work is to identify aerobic bacteriology and antibiotic sensitivity pattern of chronic suppurative otitis media in tertiary care hospital of southern Rajasthan. Two hundred and fifty clinically diagnosed cases of chronic suppurative otitis media of all age groups and both the sexes with the ear discharged of more than 6 weeks duration formed the subject of the study group. The specific identification of bacterial pathogens is done based on microscopic morphology, staining characteristics, cultural and biochemical properties using standard laboratory procedures. Antimicrobial susceptibility of the bacterial isolates to the commonly used antibiotics according to CLSI guideline is done by Kirby-Bauer disc diffusion method. Out of 250 cases, 226 (90.4%) were found to be smear positive and culture positive, 17 (6.8%) were found smear positive and culture negative, 7 (2.8%) were smear negative and culture negative. Pseudomonas spp was found the most common organism isolated was. Out of 244 isolates, 174 (71.3%) were found to be sensitive to Amikacin. In our study, Pseudomonas spp. 98% isolates were found to be most sensitive to Meropenem and 84.2% isolates were found to be most resistance to Ceftazidime. This study is useful to prevents the administration of unwanted antibiotics and in development of empirical policy. This may be helpful to medical practitioner for the prescribing antibiotics in the treatment of CSOM.

Sr(II) and Ba(II) Alkaline Earth Metal-Organic Frameworks (AE-MOFs) for Selective Gas Adsorption, Energy Storage, and Environmental Application.

Two new alkaline earth metal-organic frameworks (AE-MOFs) containing Sr(II) (UPJS-15) or Ba(II) (UPJS-16) cations and extended tetrahedral linker (MTA) were synthesized and characterized in detail (UPJS stands for University of Pavol Jozef Safarik). Single-crystal X-ray analysis (SC-XRD) revealed that the materials are isostructural and, in their frameworks, one-dimensional channels are present with the size of ~11 × 10 Å2. The activation process of the compounds was studied by the combination of in situ heating infrared spectroscopy (IR), thermal analysis (TA) and in situ high-energy powder X-ray diffraction (HE-PXRD), which confirmed the stability of compounds after desolvation. The prepared compounds were investigated as adsorbents of different gases (Ar, N2, CO2, and H2). Nitrogen and argon adsorption measurements showed that UPJS-15 has SBET area of 1321 m2 g-1 (Ar) / 1250 m2 g-1 (N2), and UPJS-16 does not adsorb mentioned gases. From the environmental application, the materials were studied as CO2 adsorbents, and both compounds adsorb CO2 with a maximum capacity of 22.4 wt.% @ 0 °C; 14.7 wt.% @ 20 °C and 101 kPa for UPJS-15 and 11.5 wt.% @ 0°C; 8.4 wt.% @ 20 °C and 101 kPa for UPJS-16. According to IAST calculations, UPJS-16 shows high selectivity (50 for CO2/N2 10:90 mixture and 455 for CO2/N2 50:50 mixture) and can be applied as CO2 adsorbent from the atmosphere even at low pressures. The increased affinity of materials for CO2 was also studied by DFT modelling, which revealed that the primary adsorption sites are coordinatively unsaturated sites on metal ions, azo bonds, and phenyl rings within the MTA linker. Regarding energy storage, the materials were studied as hydrogen adsorbents, but the materials showed low H2 adsorption properties: 0.19 wt.% for UPJS-15 and 0.04 wt.% for UPJS-16 @ -196 °C and 101 kPa. The enhanced CO2/H2 selectivity could be used to scavenge carbon dioxide from hydrogen in WGS and DSR reactions. The second method of applying samples in the area of energy storage was the use of UPJS-15 as an additive in a lithium-sulfur battery. Cyclic performance at a cycling rate of 0.2 C showed an initial discharge capacity of 337 mAh g-1, which decreased smoothly to 235 mAh g-1 after 100 charge/discharge cycles.

Tinospora cordifolia (Willd.) Hook.f. & Thomson polysaccharides: A review on extraction, characterization, and bioactivities.

Human awareness of the need for health and wellness practices that enhance disease resilience has increased as a result of recent health risks. Plant-derived polysaccharides with biological activity are good candidates to fight diseases because of their low toxicity. Tinospora cordifolia (Willd.) Hook.f. & Thomson polysaccharides extract from different plant parts have been reported to possess significant biological activity such as anti-oxidant, anti-cancer, immunomodulatory, anti-diabetic, radioprotective and hepatoprotective. Several extraction and purification techniques have been used to isolate and characterize T. cordifolia polysaccharides. Along with hot-water extraction (HWE), other novel techniques like microwave-assisted extraction (MAE), ultrasound-assisted extraction (UAE), pulsed electric field (PEF), supercritical-fluid extraction (SFE), and enzyme-assisted extraction (EAE) are used to extract T cordifolia polysaccharides. SFE is a revolutionary technology that gives the best yield and purity of low-molecular-weight polysaccharides. According to the findings, polysaccharides extracted and purified from T. cordifolia have a significant impact on their structure and biological activity. As a result, the methods of extraction, structural characterization, and biological activity of T. cordifolia polysaccharides are covered in this review. Research on T. cordifolia polysaccharides and their potential applications will benefit greatly from the findings presented in this review.

Suspecting and diagnosing transthyretin amyloid cardiomyopathy (ATTR-CM) in India: An Indian expert consensus.

Transthyretin cardiac amyloidosis (ATTR-CM) is a rare and under-recognized disorder characterized by the aggregation of transthyretin-derived insoluble amyloid fibrils in the myocardium. Heterogeneity of symptoms at presentation, makes its diagnosis often delayed. An expert panel gathered on a virtual platform across India to conduct a meeting for developing a guiding tool for ATTR-CM diagnosis. The panel recommended younger age (≥40 years) for suspecting ATTR-CM and thick-walled non-dilated hypokinetic ventricle was considered as one of the important red flags. Electrocardiogram (ECG) and echocardiography (ECHO) findings were recommended as primary tests to raise the suspicion while nuclear scintigraphy and hematological tests were recommended to confirm the diagnosis and rule out amyloid light-chain (AL) amyloidosis. Cardiac magnetic resonance (CMR) and biopsy were recommended in case of ambiguity in the presence of red flags. Considering the lack of expert guidelines in the Indian scenario, a standardized diagnostic algorithm was also proposed.

A Comparative Study of Blood Loss With and Without Infusion of Tranexamic Acid in Total Knee Replacement.

INTRODUCTION: Total knee replacement (TKR) is associated with significant blood loss in intra- and postoperative periods. This trial was designed to determine the efficacy of tranexamic acid (TXA) in the reduction of perioperative blood loss and the need for blood transfusion in patients undergoing primary TKR. MATERIALS AND METHODS: This study was performed at a tertiary care institute with 30 cases of primary unilateral TKR. The patients were randomly divided into two groups comprising 15 patients each. Group A comprised patients who received TXA by intravenous route and locally. Group B served as control, which comprised patients who had not received TXA. Patients were assessed in terms of intraoperative and postoperative blood loss, reduction in haemoglobin, the requirement of blood transfusion, and any untoward effects of TXA at 24 and 72 hours after surgery. RESULTS: In group A, the mean number of swabs used intraoperatively was 2.3 ± 0.5 swabs while in group B, the mean number was 4.3 ± 0.7 swabs (p = 0.0000). The mean drop in the postoperative haemoglobin concentration in group A was 0.6 gm/dl (24 hours) and 1.3 gm/dl (72 hours), with a mean postoperative drain collection of 247.3 ± 50.6 ml (24 hours) and 316.7 ± 55.6 ml (72 hours). In comparison, the mean drop in the postoperative haemoglobin in group B was 1.5 gm/dl (24 hours) and 2.3 gm/dl (72 hours), with a mean drain collection of 474 ± 30.7 ml (24 hours) and 453.3 ± 37.7 ml (72 hours) (p < 0.001). In group A, significantly fewer patients (four) required blood transfusion while 13 patients required blood transfusion in group B (p = 0.0004). CONCLUSION: The data from this study conclude that the use of TXA in TKR significantly reduces perioperative blood loss and the need for postoperative blood transfusion without significantly altering the liver and renal functions and coagulation profile of patients.

Comparison of two drainage parameters on diuretic renogram in predicting the fate of prenatally detected pelvi-ureteric junction-like obstruction.

Introduction: In infants with suspected pelviureteric junction (PUJ) like obstruction, we compared the drainage patterns suggested by t 1/2 and normalized residual activity (NORA) to determine which parameter can differentiate obstructive from nonobstructive dilatation and thus predict the need for surgery. Materials and Methods: Infants presenting with prenatally detected PUJ-like obstruction from January 2014 to March 2020 were evaluated with ultrasonography. Diuretic renogram was performed using Tc99m ethylene dicysteine using the F0 protocol. Subjects with a differential renal function >40% were included in the study. The t ½ values were noted. NORA was calculated by dividing the tracer values at 60 min with the values at 2 min. The infants were followed using ultrasonography. Renogram was repeated if there was increase in hydronephrosis or after 6 months if hydronephrosis did not regress. The follow-up was continued till a decision for pyeloplasty was made or the hydronephrosis regressed. Pyeloplasty was advised if differential function dropped to below 40%. Results: 34 patients met the inclusion criteria. NORA and t ½ had very poor concordance in defining the drainage pattern. t ½ values did not correlate with the need for surgery or conservative management (P ≥ 0.05). Good drainage pattern by NORA was associated with regression of hydronephrosis (P ≤ 0.001). NORA predicted obstruction more accurately. Conclusion: NORA can define good drainage in a much larger subset of patients with PUJ-like obstruction who eventually do not need surgery. However, further multicenter studies are needed to confirm this.

Diosgenin: An Updated Pharmacological Review and Therapeutic Perspectives.

Plants including Rhizoma polgonati, Smilax china, and Trigonella foenum-graecum contain a lot of diosgenin, a steroidal sapogenin. This bioactive phytochemical has shown high potential and interest in the treatment of various disorders such as cancer, diabetes, arthritis, asthma, and cardiovascular disease, in addition to being an important starting material for the preparation of several steroidal drugs in the pharmaceutical industry. This review aims to provide an overview of the in vitro, in vivo, and clinical studies reporting the diosgenin's pharmacological effects and to discuss the safety issues. Preclinical studies have shown promising effects on cancer, neuroprotection, atherosclerosis, asthma, bone health, and other pathologies. Clinical investigations have demonstrated diosgenin's nontoxic nature and promising benefits on cognitive function and menopause. However, further well-designed clinical trials are needed to address the other effects seen in preclinical studies, as well as a better knowledge of the diosgenin's safety profile.

Carica papaya L. Leaves: Deciphering Its Antioxidant Bioactives, Biological Activities, Innovative Products, and Safety Aspects.

The prevalence of viral infections, cancer, and diabetes is increasing at an alarming rate around the world, and these diseases are now considered to be the most serious risks to human well-being in the modern period. There is a widespread practice in Asian countries of using papaya leaves (C. papaya L.) as herbal medicine, either alone or in combination with prescribed medications, to treat a variety of ailments. The importance of conducting the necessary descriptive studies in order to determine the safety of papaya leaf consumption is also emphasized in the context of their application in the healthcare sector. Electronic databases such as Google Scholar, Scopus, and PubMed were used to gather information on papaya leaves, their therapeutic potential, and clinical evidence-based studies. The literature was gathered from publications on papaya leaves, their therapeutic potential, and clinical evidence-based studies. The antidengue, anticancer, antidiabetic, neuroprotective, and anti-inflammatory effects of papaya leaves discussed in this article are supported by evidence from preclinical, in vivo, in vitro, and clinical trial studies, as well as from other sources. Leaves have been investigated for their mechanism of action as well as their potential to be used in the development of novel herbal products for the health business. According to the reports gathered, only a small number of research demonstrated that leaf extract at high concentrations was hazardous to certain organs. The collective literature reviewed in this review provides insights into the use of papaya leaves as a cure for epidemic diseases, highlighting the phytochemical composition and pharmacological attributes of papaya leaves, as well as the results of various preclinical and clinical studies that have been conducted so far on the subject. The review clearly demonstrates the successful medical evidence for the use of papaya leaf extracts in the healthcare system as a supplemental herbal medication in a variety of clinical settings.

Doxorubicin impacts chromatin binding of HMGB1, Histone H1 and retinoic acid receptor.

Doxorubicin (Dox), a widely used anticancer DNA-binding drug, affects chromatin in multiple ways, and these effects contribute to both its efficacy and its dose-limiting side effects, especially cardiotoxicity. Here, we studied the effects of Dox on the chromatin binding of the architectural proteins high mobility group B1 (HMGB1) and the linker histone H1, and the transcription factor retinoic acid receptor (RARα) by fluorescence recovery after photobleaching (FRAP) and fluorescence correlation spectroscopy (FCS) in live cells. At lower doses, Dox increased the binding of HMGB1 to DNA while decreasing the binding of the linker histone H1. At higher doses that correspond to the peak plasma concentrations achieved during chemotherapy, Dox reduced the binding of HMGB1 as well. This biphasic effect is interpreted in terms of a hierarchy of competition between the ligands involved and Dox-induced local conformational changes of nucleosome-free DNA. Combined, FRAP and FCS mobility data suggest that Dox decreases the overall binding of RARα to DNA, an effect that was only partially overcome by agonist binding. The intertwined interactions described are likely to contribute to both the effects and side effects of Dox.

Plant-Based Antioxidant Extracts and Compounds in the Management of Oral Cancer.

Oral cancer continues to be a leading cause of death worldwide, and its prevalence is particularly high in developing countries, where people chew tobacco and betel nut on a regular basis. Radiation-, chemo-, targeted-, immuno-, and hormone-based therapies along with surgery are commonly used as part of a treatment plan. However, these treatments frequently result in various unwanted short- to long-term side effects. As a result, there is an urgent need to develop treatment options for oral cancer that have little or no adverse effects. Numerous bioactive compounds derived from various plants have recently attracted attention as therapeutic options for cancer treatment. Antioxidants found in medicinal plants, such as vitamins E, C, and A, reduce damage to the mucosa by neutralizing free radicals found in various oral mucosal lesions. Phytochemicals found in medicinal plants have the potential to modulate cellular signalling pathways that alter the cellular defence mechanisms to protect normal cells from reactive oxygen species (ROS) and induce apoptosis in cancer cells. This review aims to provide a comprehensive overview of various medicinal plants and phytoconstituents that have shown the potential to be used as oral cancer therapeutics.

Tomato (Solanum lycopersicum L.) seed: A review on bioactives and biomedical activities.

The processing of tomato fruit into puree, juices, ketchup, sauces, and dried powders generates a significant amount of waste in the form of tomato pomace, which includes seeds and skin. Tomato processing by-products, particularly seeds, are reservoirs of health-promoting macromolecules, such as proteins (bioactive peptides), carotenoids (lycopene), polysaccharides (pectin), phytochemicals (flavonoids), and vitamins (α-tocopherol). Health-promoting properties make these bioactive components suitable candidates for the development of novel food and nutraceutical products. This review comprehensively demonstrates the bioactive compounds of tomato seeds along with diverse biomedical activities of tomato seed extract (TSE) for treating cardiovascular ailments, neurological disorders, and act as antioxidant, anticancer, and antimicrobial agent. Utilization of bioactive components can improve the economic feasibility of the tomato processing industry and may help to reduce the environmental pollution generated by tomato by-products.

Renal cortical transit time in the evaluation of prenatally detected presumed pelvi ureteric junction like obstruction: A systematic review.

INTRODUCTION: Differentiating nonobstructive from obstructive dilatation of the kidney is a clinical dilemma in prenatally detected hydronephrosis. Many radionuclide renogram parameters have been used to differentiate obstructed from non-obstructed units, including cortical transit time (CTT). We evaluate the role of CTT in identifying obstruction through a systematic review. METHODS: A literature search of the MEDLINE, MEDLINE In-Process, and MEDLINE Epub Ahead of Print, EMBASE, Google scholar, Pub Med, and Cochrane Library was done using key words - radionuclide renogram, CTT, parenchymal transit time, cortical transit, renography to identify articles on the subject. The identified articles were assessed for appropriateness and reviewed. RESULTS: The initial search yielded a total of 1583 articles, after adding the articles from references and applying the inclusion and exclusion criteria a total of 28 articles were selected. CTT showed good inter observer agreement in identifying obstruction. The use of CTT as a single parameter for determining the need for surgery and to identify those kidneys which will have functional improvement after surgery has been evaluated and has been found to be useful. CTT is best used in conjunction with ultrasonography to make clinical decisions. CONCLUSION: The commonly used visual method of estimating the CTT, is a promising parameter for the evaluation of prenatally detected pelviureteric junction obstruction. Further well-designed multicenter prospective studies are needed to establish it as the most specific parameter to differentiate obstructive from nonobstructive dilatation of the pelvicalyceal system.

Comparative study of perioperative and survival outcomes after video endoscopic inguinal lymphadenectomy (VEIL) and open inguinal lymph node dissection (O-ILND) in the management of inguinal lymph nodes in carcinoma of the penis.

Open inguinal lymph node dissection (O-ILND) is the gold standard in the management of lymph nodes in carcinoma penis; however, video endoscopic inguinal lymphadenectomy (VEIL) is performed in some centers. Our primary objective is to compare perioperative and survival outcomes in patients undergoing VEIL with O-ILND, as very few studies have reported long-term survival outcomes till date. We analyzed patients who underwent O-ILND and VEIL (laparoscopic or robot-assisted) from January 2009 to January 2020 in our institute for carcinoma of the penis. Patient details, perioperative complications, and survival outcomes were analyzed. Perioperative outcomes were analyzed by logistic regression and survival outcomes by log-rank and Cox regression methods. We analyzed 79 patients (32 O-ILND, 47 VEIL) with a median follow-up of 51 (IQR 25.5-75.5) and 42 months (IQR 21-62). Wound complications were common in O-ILND group (65.6%) compared to VEIL group (27.7%) (p = 0.001), predominantly skin flap necrosis in 14 groins (23.73%) after O-ILND and none after VEIL. Median overall survival was 80 and 88 months (p = 0.840) with five-year survival of 65% and 66.8% (p = 0.636) and five-year DSS of 76.6% and 73.9% (p = 0.96) in O-ILND and VEIL, respectively. Multivariate analysis showed that grade and pathological node status were significant (HR-2.650, p = 0.040; HR-3.218, p = 0.024) factors for survival. The retrospective nature of the study design is the limitation. Management of inguinal lymph nodes in carcinoma penis by VEIL is safe, associated with lesser wound-related complications, and equivalent survival outcomes compared to O-ILND. It should be considered as an alternative option for inguinal lymph node dissection.

Comparative evaluation of crestal bone level in patients having low level of Vitamin D treated with dental implant with or without Vitamin D3 supplements.

INTRODUCTION: Vitamin D has been shown to play a vital role in bone mineral homeostasis by stimulating the intestinal absorption of calcium and phosphate. The critical role of Vitamin D in bone metabolism triggered the need to evaluate the effect of Vitamin D deficiency and hence replacement of the same on osseointegration of dental implants. This prospective study evaluated the crestal bone level in patients having low level of Vitamin D treated with dental implant with or without Vitamin D3 supplements. MATERIALS AND METHODS: A prospective clinical study was conducted on 32 patients based on the inclusion and exclusion criteria. Patients were divided into two groups on the basis of Vitamin D level < 30 ng/ml (Group I: patients receiving Vitamin D3 supplements, i.e., cholecalciferol 1 g sachet 60,000 IU/month) or <30 ng/ml (Group II: not receiving Vitamin D3 supplements). The crestal bone level measurements were made with the help of Digimizer Image Analysis, MedCalc software. RESULTS: All implants showed clinically acceptable crestal bone level at interval of 1 week (baseline), 3 months, and 6 months. There was a statistically nonsignificant difference seen for the values between the groups (P > 0.05) for all other values at various time intervals. However, there was a statistically significant/highly significant difference seen for the values between the groups (P < 0.01, 0.05) for 3 months distal with higher values for Group I as compared to Group II. CONCLUSION: From the study, it can be concluded that cholecalciferol has systemic effects on accelerating bone formation around titanium implant.

Siponimod therapy implicates Th17 cells in a preclinical model of subpial cortical injury.

Subpial demyelination is a specific hallmark of multiple sclerosis and a correlate of disease progression. Although the mechanism(s) that mediate pathogenesis in the subpial compartment remain unclear, it has been speculated that inflammation in the overlying meninges may be associated with subpial injury. Here we show that adoptive transfer of proteolipid protein-primed Th17 cells into SJL/J recipient mice induces subpial demyelination associated with microglial/macrophage activation, disruption of the glial limitans, and evidence of an oxidative stress response. This pathology was topologically associated with foci of immune cells in the meninges and occurred in the absence of measurable anti-myelin oligodendrocyte glycoprotein IgM or IgG antibodies. To test the role of brain-infiltrating leukocytes on subpial injury, we modulated sphingosine 1-phosphate (S1P) receptor1,5 activity with BAF312 (siponimod) treatment. Administration of BAF312, even after adoptively transferred T cells had entered the brain, significantly ameliorated clinical experimental autoimmune encephalomyelitis and diminished subpial pathology, concomitant with a selective reduction in the capacity of transferred T cells to make Th17 cytokines. We conclude that sustained subpial cortical injury is associated with the capacity for brain-resident T cells to produce Th17 cytokines, and this pathological process occurs in an S1P receptor1,5-dependent manner.

Nuclear Medicine in India: A Historical Journey.

Evidence-based historical accounts of critical events, which shaped nuclear medicine in India today, are presented in this article. There was parallel activity happening in the northern and western region of India in the early 60s. Radiation Medicine Center (RMC) at Mumbai inaugurated in September 1963 by Dr. Bhabha; and Institute of Nuclear Medicine and Allied Sciences, Delhi dedicated to the nation in February 1964. The isotope division of Bhabha Atomic Research Center endured as the backbone in the supply of indigenously produced medical radioisotopes in research reactors APSARA (1958) and CIRUS (1960). Design and dispatch of economical generators (loaded with low specific activity 99Mo) with indigenously designed solvent extraction (Methyl Ethyl Ketone) technique had led to rapid growth of nuclear medicine facilities in the country. As per recently released list (July 2018) of the Atomic Energy Regulatory Board, there are 293 nuclear medicine departments in the country. Of which 14% are in the government sector, and the remaining 86% are under private ownership. There are currently 233 functioning gamma cameras (Single-photon emission computed tomography [SPECT]/SPECT-computed tomography [CT]) units in India since 1969 when the first gamma camera was commissioned at RMC. The first medical cyclotron (2002) and first positron emission tomography (PET) (2002) and first PET-CT (2004) in Mumbai had triggered revolution of molecular imaging in India. There are 222 PET-CT, 3 PET-magnetic resonance imaging scanners, and 19 cyclotrons operating currently. India has witnessed relatively slower headways in terms of high dose radionuclide therapy facilities. After first indoor facility at RMC in 1964, only 92 radionuclide therapy (isolation) wards have come up with no more than 200 beds for the entire country in the last 54 years. India started Delhi university approved structured postgraduate diploma in nuclear medicine in 1963 at the Institute of Nuclear Medicine and Allied Sciences (INMAS), first of its kind course in the world at that time. RMC started Mumbai University recognized diploma courses for physicians (Diploma in Radiation Medicine) and technologists (Diploma in Medical Radioisotope Techniques) in 1973. National Board of Examination (Government of India) recognized nuclear medicine as a broad specialty in 1982 and accredited RMC for training for Diplomate of National Board. Doctor of Medicine (MD) started first time in India and Asia at Sanjay Gandhi Postgraduate Institute, Lucknow in 1990. Doctorate of Therapeutic Nuclear Medicine commenced at All India Institute of Medical Sciences Delhi in 2015. There are 18 teaching hospitals currently imparting MD/DNB nuclear medicine residency for physicians with annual intake of 50. Eighteen institutions are offering bachelors and masters programs for nuclear medicine technology with an average annual intake of 110-120 students. Society of Nuclear Medicine, India (SNMI) is the oldest and largest professional body with total life membership of 1425 nuclear medicine professionals. SNMI was established in 1967 and hosted the first Annual Conference at RMC, Mumbai in 1968. Since then, SNMI is organizing its Annual Conferences in various parts of the country with the objective of scientific exchange and popularizing the modality amongst clinicians. Postgraduate Institute of Medical Education Research is hosting the 50th Annual Conference of SNMI (SNMICON-18) as mark of golden jubilee celebration.

Postpartum Intrauterine Device Refusal in Delhi: Reasons Analyzed.

AIM: To assess knowledge and attitude of women toward postpartum intrauterine contraceptive device (PPIUCD) and analyze reasons of refusal. SETTING AND DESIGN: Hospital-based cross-sectional study for 1 year. MATERIALS AND METHODS: 550 women were enrolled in the study. Sociodemographic characteristics, knowledge, and attitude toward contraception especially PPIUCD were noted, and the reasons for refusal of PPIUCD were analyzed. STATISTICAL ANALYSIS: SPSS version 17.0 is used. Continuous variables were reported using mean, and categorical variables were reported using percentages. OBSERVATIONS: PPIUCD insertion rate was 9.1 %. 78.6 % of women in the study belonged to the age group of 20-30 years, with 79.2 % having education of Class X and above. The overall contraceptive knowledge was 94.4 %. Although 48.4 % women were aware of Cu T as a method of contraception, only 21.9 % of 48.4 %, however, were aware of PPIUCD. None of the women had ever used it before. The commonest prevalent myths regarding Cu T were fear of malignancy (38 %) and fear of menorrhagia (36.4 %). The husband and mother-in-law played important roles in decision regarding PPIUCD insertion and refused the same in 59 % of cases. CONCLUSION: The study shows that awareness of PPIUCD is low in this region despite good education, leading to high refusal rates. The commonest reason is lack of appropriate counseling, and not only the woman but the husband and mother-in-law also must be provided the knowledge of it as they play important roles in our society.

Do we really need to differentiate mesenchymal stem cells into insulin-producing cells for attenuation of the autoimmune responses in type 1 diabetes: immunoprophylactic effects of precursors to insulin-producing cells.

BACKGROUND: Type 1 diabetes (T1D) is a multifactorial autoimmune disorder where pancreatic beta cells are lost before the clinical manifestations of the disease. Administration of mesenchymal stem cells (MSCs) or MSCs differentiated into insulin-producing cells (IPCs) have yielded limited success when used therapeutically. We have evaluated the immunoprophylactic potentials of precursors to insulin-producing cells (pIPCs) and IPCs in nonobese diabetic (NOD) mice to ask a basic question: do we need to differentiate MSCs into IPCs or will pIPCs suffice to attenuate autoimmune responses in T1D? METHODS: Bone marrow-derived MSCs from Balb/c mice were characterized following the International Society for Cellular Therapy (ISCT) guidelines. MSCs cultured in high-glucose media for 11 to 13 passages were characterized for the expression of pancreatic lineage genes using real-time polymerase chain reaction. Expression of the PDX1 gene in pIPCs was assessed using Western blot and fluorescence-activated cell sorting (FACS). Triple-positive MSCs were differentiated into IPCs using a three-step protocol after sorting them for cell surface markers, i.e. CD29, CD44, and SCA-1. Nonobese diabetic mice were administered pIPCs, IPCs, or phosphate-buffered saline (PBS) into the tail vein at weeks 9 or 10 and followed-up for 29-30 weeks for fasting blood glucose levels. Two consecutive blood sugar levels of more than 250 mg/dl were considered diabetic. RESULTS: MSCs grown in high-glucose media for 11 to 13 passages expressed genes of the pancreatic lineage such as PDX1, beta2, neurogenin, PAX4, Insulin, and glucagon. Furthermore, Western blot and FACS analysis for PDX-1, a transcription factor necessary for beta cell maturation, confirmed that these cells were precursors of insulin-producing cells (pIPCs). NOD mice administered with pIPCs were better protected from developing diabetes with a protective efficacy of 78.4% (p < 0.009); however, administration of IPCs gave protective efficacy of 55% at the end of 28-30 weeks. CONCLUSIONS: Precursors to insulin-producing cells seem to have better potential to arrest autoimmune response in type 1 diabetes when administered before the onset of the disease in NOD mice. When translated to humans, autologous mesenchymal stem cells grown in high-glucose media for 10 to 13 passages may have beneficial effects in individuals at high risk of developing type 1 diabetes.