Immunological Responses of Arsenicum album 30CH to Combat COVID-19: Protocol for a Double-Blind, Randomized, Placebo-Controlled Clinical Trial in the Pathanamthitta District of Kerala.

BACKGROUND: COVID-19 is a recent major public health concern caused by the SARS-CoV-2 virus, with approximately 44.6 million COVID-19-positive cases and 530,000 deaths in India (as of February 1, 2023). The COVID-19 vaccination drive in India was initiated in January 2021; however, an effective preventive strategy with high efficacy and immunological safety remains elusive. OBJECTIVE: The aim of this study is to assess the immunogenic responses of Arsenicum album 30CH (AA30CH) as COVID-19 prophylaxis, including assessment of immunological markers, innate and acquired immune responses, COVID-19 symptoms, and its associated antibody responses. METHODS: This randomized controlled clinical trial (RCT) will include two parallel comparator groups of AA30CH and placebo with an allocation ratio of 1:1 conducted in the Pathanamthitta district of Kerala, India. The placebo or AA30CH will be administered in three intervention schedules and blood samples will be collected before and after each of the intervention schedules. Based on the inclusion and exclusion criteria, 112 participants per arm (with an expected dropout of 20%) will be screened. Immunogenic responses will be evaluated by determining the antigen density and modulation in immunological markers and lymphocyte subsets CD3, CD4, CD8, CD24, CD27, CD38, CD4 interferon-γ, CD4 CD17, CD4 CD25 (activated T lymphocytes), T cells, B cells, dendritic cells (mature and immature), and natural killer cells on days 1, 5, 23,27, 45, 49, and 66. The innate and acquired immune responses will also be evaluated by a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) array profiler (84-gene set) before and after the study interventions. The toxicity status of AA30CH in study participants will be evaluated through hepatic, renal, and hematological parameters and peripheral smears on days 1, 5, 23, 27, 45, 49, and 66. The number of participants developing COVID-19-like symptoms per National Centre for Disease Control guidelines and the number of participants testing positive for COVID-19 in RT-PCR during follow-ups in any of the three intervention schedules will be identified. Moreover, a subgroup analysis will be used to assess the COVID-19 antibody responses between vaccinated and unvaccinated participants. RESULTS: This RCT protocol has been approved by various committees and funded by the Central Council for Research in Homoeopathy, Ministry of Ayush, Government of India. The project has been implemented in collaboration with the Department of Homoeopathy, Government of Kerala. The RCT was rolled out on January 25, 2023, and enrollment was completed April 3, 2023. The immunological assays will be conducted at the Department of Biotechnology-Translational Health Science and Technology Institute, Faridabad, India. CONCLUSIONS: This study will represent the first evaluation of the immunological efficacy and safety of AA30CH in an RCT, which may significantly impact the use of homeopathy as an evidence-based medicine approach. TRIAL REGISTRATION: Clinical Trials Registry-India CTRI/2022/08/045089; https://tinyurl.com/mryrpkvk. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48479.

Efficacy of a herbal mouthwash for management of periodontitis and radiation-induced mucositis - A consolidated report of two randomized controlled clinical trials.

BACKGROUND: Oral diseases like periodontitis and mucositis often require home care using topical agents in the form of mouthwashes. Many herbal mouthwashes are found to be beneficial; however lack proper scientific evidence to support their use. OBJECTIVES: Study 1 evaluated clinical efficacy of herbal mouthwash in the management of chronic periodontitis in comparison with chlorhexidine mouthwash. Study 2 aimed at assessment of herbal mouthwash in patients of radiation-induced mucosititis. METHODS: The novel herbal mouthwash used in the present study wa prepared from extracts of five plants namely Emblica Officinalis, Terminalia chebula, Terminalia bellerica, Glycyrrhiza glabra, and Azadirachta indica. 50 periodontitis patients were randomly allocated to two groups. As per allocation, they were instructed to use either herbal mouthwash or chlorhexidine mouthwash twice daily for two weeks after nonsurgical periodontal therapy. Similarly, patients with radiation-induced mucositis were randomly given herbal mouthwash and soda saline mouthwash. Intergroup and intragroup comparisons of continuous variables were conducted using paired and unpaired t-tests. Categorical variables were compared using the chi-square test. RESULTS: Significant reductions in gingival bleeding, plaque accumulation, and pocket depth were noticed in periodontitis patients in both groups. Patients reported acceptable taste, freshness, and satisfaction after the use of herbal mouthwash. The herbal mouthwash group noticed a significant reduction in the severity of radiation-induced mucositis and analgesic requirements. The intensity of pain, dryness of mouth, oral hygiene, and need for the use of antibiotic and antifungal during radiotherapy was not significant among the groups. CONCLUSION: The results of this preliminary clinical trial support the use of the tested herbal formulation mouthwash as an adjunct in the treatment of periodontitis as well as radiation-induced mucositis. CLINICAL TRIAL REGISTRATION NUMBER: For Study 1: CTRI/2019/10/021574, Study 2: CTRI/2020/04/024851.

Transgenic mice overexpressing human ALOX15 under the control of the aP2 promoter are partly protected in the complete Freund's adjuvant-induced paw inflammation model.

BACKGROUND, OBJECTIVES AND DESIGN: Arachidonic acid 15-lipoxygenase (ALOX15) has been implicated in the pathogenesis of inflammatory diseases but since pro- and anti-inflammatory roles have been suggested, the precise function of this enzyme is still a matter of discussion. To contribute to this discussion, we created transgenic mice, which express human ALOX15 under the control of the activating protein 2 promoter (aP2-ALOX15 mice) and compared the sensitivity of these gain-of-function animals in two independent mouse inflammation models with Alox15-deficient mice (loss-of-function animals) and wildtype control animals. MATERIALS AND METHODS: Transgenic aP2-ALOX15 mice were tested in comparison with Alox15 knockout mice (Alox15-/-) and corresponding wildtype control animals (C57BL/6J) in the complete Freund's adjuvant induced hind-paw edema model and in the dextran sulfate sodium induced colitis (DSS-colitis) model. In the paw edema model, the degree of paw swelling and the sensitivity of the inflamed hind-paw for mechanic (von Frey test) and thermal (Hargreaves test) stimulation were quantified as clinical readout parameters. In the dextran sodium sulfate induced colitis model the loss of body weight, the colon lengths and the disease activity index were determined. RESULTS: In the hind-paw edema model, systemic inactivation of the endogenous Alox15 gene intensified the inflammatory symptoms, whereas overexpression of human ALOX15 reduced the degree of hind-paw inflammation. These data suggest anti-inflammatory roles for endogenous and transgenic ALOX15 in this particular inflammation model. As mechanistic reason for the protective effect downregulation of the pro-inflammatory ALOX5 pathways was suggested. However, in the dextran sodium sulfate colitis model, in which systemic inactivation of the Alox15 gene protected female mice from DSS-induced colitis, transgenic overexpression of human ALOX15 did hardly impact the intensity of the inflammatory symptoms. CONCLUSION: The biological role of ALOX15 in the pathogenesis of inflammation is variable and depends on the kind of the animal inflammation model.

Yoga: A Natural Solution to Decrease Disease Burden in Children of MTHFR Deficient Parents.

Introduction: MTHFR being a key regulatory enzyme of 1-carbon metabolism pathway serves critical function of generation of SAM, replenishment of glutathione and nucleotide synthesis and finally methylation of the bio molecules. MTHFR gene mutation is a rare au-tosomal recessive inborn error of metabolism and presents with severe hyperhomocysteinemia. MTHFR polymorphisms on the other hand are commonly encountered of which two 677 C>T and 1298 A>C have been most widely studied and reported to increase the vulnerability to neural tube defects, congenital heart disease, various neuropsychiatric disorders like autism spectrum diseases and attention deficit hyperactiv-ity disease, cleft lip/ palate, acute leukaemia, cardiovascular diseases, occlusive vascular disease in children. Methods: We conducted this prospective clinical trial to examine whether yoga practice can up regulate MTHFR gene expression. Considering the prevalence of MTHFR polymorphism, varied spectrum of its implications in disease causation including male infertility, we conducted the trial involving 30 infertile men who underwent 3 weeks of supervised YBLI. Pre and post intervention assessment of the blood and semen sample was done to see the effects. Results: We have found more than fivefold up-regulation in the expression of MTHFR gene with significant reduction of seminal free radical levels after 3 weeks of yoga practice. Interestingly we noticed significantly higher MTHFR polymorphic variants in infertile male patients compared to healthy fertile controls. Conclusion: MTHFR polymorphisms are also independently associated with many paediatric diseases. Diagnosing MTHFR deficiency in children is a challenging job and requires high index of suspicion and continuous vigilance. Yoga based lifestyle may be adopted both by parents planning conception and also by adolescent children who are sufferers of this condition to halt the consequences of mild to moderate MTHFR deficiency.

Synthesize palladium nanoparticles from the macroalgae Sargassum fusiforme: An eco-friendly tool in the fight against Plasmodium falciparum?

Although numerous drugs are practiced to control malaria and its vectors, more recently, eco-friendly control tools have been proposed to battle its etiologic agents. Thus, using green bionanotechnology approaches, we aimed to synthesize palladium nanoparticles (Pd NPs) from the macroalgae Sargassum fusiforme (Sf), its potential antiparasitic activity against P. falciparum, as well as its possible cytotoxicity, in HeLa cells. After the biosynthesis of the PdSf NPs, their characterization was carried out by UV-Vis, FESEM, and EDX analyses, and their hydrodynamic size, zeta potential, and surface area were determined. Furthermore, the functional groups of the PdSf NPs were analyzed by FT-IR and GC-MS. While PdSf NPs had an IC50 of 7.68 µg/mL (Chloroquine (CQ)-s) and 16.42 µg/mL, S. fusiforme extract had an IC50 of 14.38 µg/mL (CQ-s) and 35.27 µg/mL (CQ-r). With an IC50 value of 94.49 µg/mL, PdSf NPs exhibited the least toxic effect on the HeLa cells. The Lipinski rule of five and ADMET prediction were used to assess the in silico models of caffeine acid hexoside and quercetin 7-O-hexoside for the presence of drug-like properties. Pathogenic proteins, primarily responsible for motility, binding, and disease-causing, were the target of the structurally based docking studies between plant-derived compounds and pathogenic proteins. Thus, our study pioneered promising results that support the potential antiplasmodial activity of eco-friendly synthesized PdSf NPs using S. fusiforme extract against P. falciparum, opening perspectives for further exploration into the use of these NPs in malaria therapy.

Resiliencies of soil phosphorus fractions after natural summer fire are governed by microbial activity and cation availability in a semi-arid Inceptisol.

The unintended impact of natural summer fire on soil is complicated and rather less studied than its above-ground impact. Recognising the impact of a fire on silvopastoral soils and their resilience can aid in improving the management of silvopastoral systems. We studied the immediate (after 1 week (W)) and short-term (after 3 months (M)) recovery of different soil biological and chemical properties after the natural fire, with specific emphasis on phosphorus (P) dynamics. Soil samples were collected from four different layers (0-15, 15-30, 30-45, and 45-60 cm) of Morus alba, Leucaena leucocephala, and Ficus infectoria based silvopastoral systems. In the 0-15 cm soil layer, soil organic carbon (SOC) declined by ∼37, 42, and 30% after the fire in Morus-, Leucaena-, and Ficus-based systems, respectively within 1W of fire. However, after 3M of fire, Morus and Leucaena regained ∼6 and 11.5% SOC as compared to their status after 1W in the 0-15 cm soil layer. After 1W of the fire, soil nitrogen (N), sulfur (S), and potassium availability declined significantly at 0-15 cm soil layer in all systems. Iron and manganese availability improved significantly after 1W of the fire. Saloid bound P and aluminium bound P declined significantly immediately after the fire, increasing availability in all systems. However, calcium bound P did not change significantly after the fire. Dehydrogenase and alkaline phosphatase activity declined significantly after the fire, however, phenol oxidase and peroxidase activity were unaltered. Resiliencies of these soil properties were significantly impacted by soil depth and time. Path analysis indicated microbial activity and cationic micronutrients majorly governed the resilience of soil P fractions and P availability. Pasture yield was not significantly improved after the fire, so natural summer fire must be prevented to avoid loss of SOC, N, and S.

Advancements of sequencing batch biofilm reactor for slaughterhouse wastewater assisted with response surface methodology.

Slaughterhouse wastewater (SWW) contains a significant volume of highly polluted organic wastes. These include blood, fat, soluble proteins, colloidal particles, suspended materials, meat particles, and intestinal undigested food that consists of higher concentrations of organics such as biochemical oxygen demand (BOD), chemical oxygen demand (COD), nitrogen and phosphorus hence an efficient treatment is required before discharging into the water bodies. The effluent concentrations and performance of simultaneous sequential batch biofilm reactor (SBBR) with recycled plastic carrier media support are better than the local single-stage sequential batch reactor (SBR), which is lacking in the literature in terms of COD, NH3, NO3, and PO4 treatment efficiency. The present study reports a novel strategy to remove the above mentioned contaminants using an intermittently aerated SBBR with recycled plastic carrier media support along with simultaneous nitrification and denitrification. The central composite design was evaluated to optimize the treatment performance of seven different process variables including; different alternating conditions (Oxic/anoxic) for aeration cycles (3/2 h in a 6 h cycle, 6/5 h in a 12 h cycle and 9/8 h in an 18 h cycle) and hydraulic retention time (6, 12 and 18 h). The average removal efficiencies are 94.5% for NH3, 93% for NO3 and 90.1% for PO4, and 99% for COD. The study reveals that the denitrification in the post-anoxic phase was more efficient than the pre-anoxic phase for pollutant removal and maintaining higher quality effluent. The effluent concentrations and performance of simultaneous SBBR with recycled polyethylene carrier support media were better than local SBR system in terms of COD, NH3, NO3 and PO4 treatment efficiency. Results stipulated the suitability of SBBR for wastewater treatment and reusability as a sustainable approach for wastewater management under optimum conditions.

Long-term effects of clinical interventions on nutritional status in patients with chronic pancreatitis - A systematic review.

BACKGROUND AND AIMS: Malnutrition in chronic pancreatitis is complex and multifactorial, with malabsorption, pain, toxic dependencies and co-morbidities, such as diabetes, each playing a role. The aims of this systematic review were to assess the impact of nutritional intervention on markers of nutritional status in this complex patient group. MATERIALS AND METHODS: A systematic review of EMBASE and PubMed was carried out in February 2020, identifying 2620 articles. After screening to exclude those reporting short term changes (less than 3 months), with only one data point, or in the wrong population, eight papers were selected for analysis. RESULTS: Seven studies documented the impact of a nutritional intervention, one was an observational study only. Overall, studies were limited by predominantly retrospective designs, heterogenous populations and poor control of potentially confounding variables. Data could not be combined due to variability in reporting methods. All studies exploring nutritional intervention, whether that consisted of advice by a specialist dietitian, dose escalation of pancreatic enzymes, oral nutritional supplements or enteral feeding, demonstrated improved body weight and pain control, whereas patients who did not receive an intervention deteriorated nutritionally. CONCLUSION: Patients with chronic pancreatitis benefit from nutritional intervention. Further work is required to explore the impact of nutritional intervention on body composition and functional outcomes.

TB free India: Reaching the unreached tribal population under National Tuberculosis Elimination Programme.

India is the highest TB burden country in the world. The burden however is not uniform in different strata including tribal population - one of the key affected populations in the country. As the evidences from tribal population are hardly available, most of the policies and strategies implemented under National Tuberculosis Elimination Programme (NTEP) are usually based on the evidences from general populations. NTEP is continuously taking steps to strengthen TB services in tribal areas. The Social Action Plan including Tribal Action Plan is in place and the appropriate strategies are incorporated in the National Strategic Plan (NSP) to ensure universal access to quality TB services to vulnerable population groups. However, its implementation becomes challenging especially in tribal areas as different tribal groups have their own unique ways of dealing with health issues. These issues are therefore required to be addressed holistically involving all the stakeholders. In view of this a symposium was jointly organized by the Central TB Division (CTD), Govt. of India and ICMR - National Institute of Research in Tribal Health (NIRTH), Jabalpur on 17th and 18th December, 2019 at ICMR - NIRTH, Jabalpur. It provided an excellent platform for all the stakeholders from different parts of the country to share their experiences in tuberculosis particularly among marginalized populations. The recommendations emerged out of this interactive symposium highlight the sincere effort of NTEP to tackle TB situation in tribal population and show the way forward towards India's TB elimination goal by 2025 especially in hard to reach tribal areas.

In-vitro tribological study and submodeling finite element technique in analyzing wear of zirconia toughened alumina against alumina with bio-lubricants for hip implants.

Tribological study of zirconia toughened alumina against alumina is investigated using ball-on-disk tribometer with different bio-lubricants. Friction and wear coefficients are estimated for these bio-lubricants under four different loading conditions which are equivalent to regular and risky human gait activities. Experiments are carried out for a total sliding distance of 10 km with each bio-lubricant to estimate its friction and wear coefficients. Using submodeling finite element approach, cumulative linear and volumetric wear is estimated with the help of contact pressure. The sesame oil bio-lubricant showed better wear coefficient for risky gait activities and Ringer's solution exhibited minimum wear coefficient for normal walking gait activity. Overall minimum cumulative linear and volumetric wear for 2 million cycles was obtained for Ringer's solution.

Indian Academy of Pediatrics Revised Guidelines on School Reopening: First Revision, September 2021.

JUSTIFICATION: The COVID-19 pandemic has affected schooling for more than 24 crores students, since March 2020. Students need a respite from the long standing social isolation so that they regain their chance to develop holistically, but after the devastating effects of the second wave, the administrators as well as parents are skeptical about the decision of school reopening. PROCESS: The Indian Academy of Pediatrics constituted a task force comprising of national and international experts in the field who deliberated on the issue. OBJECTIVES: To bring out scientifically supported guidelines on the prerequisites of opening and attending the schools, in the current context of the COVID-19 pandemic. RECOMMENDATIONS: The task force recommends i) Decentralization of the school reopening decision; ii)Three epidemiological parameters, case positivity rate (<5 or steadily declining number of cases for past two weeks), number of new cases(<20 per lakh population per day for past two weeks) and vaccination coverage (>60% of the vaccine-eligible population) to be met at the local level, before the schools reopen; and iii) Criteria regarding health and vaccination to be met by the schoolattendees.

Modelling and process optimization for biodiesel production from Nannochloropsis salina using artificial neural network.

In the present investigation, calcium oxide solid nanocatalyst derived from the egg shell and Nannochloropsis salina were used for the production of biodiesel. The morphological characteristics and functional groups of synthesized nanocatalyst was characterized by SEM and FTIR analysis. Process variables optimization for biodiesel production was studied using RSM and ANN. The R2 values for RSM and ANN was found to be 0.8751 and 0.957 which showed that the model was significantly fit with the experimental data. The maximum FAME conversion for the synthesized nanocatalyst CaO was found to be 86.1% under optimum process conditions (nanocatalyst amount: 3% (w/v); oil to methanol ratio 1:6 (v/v); reaction temperature: 60 °C; reaction time 55 min). Concentration of FAME present in biodiesel was identified by GC-MS analysis.

Characterization, biological evaluation and molecular docking of mulberry fruit pectin.

Contemplating the exemplary benefits of pectin on human health, we precisely characterized and evaluated the antibacterial and anticancer activities from purified Mulberry Fruit Pectins (MFP). Here, we tested BR-2 and S-13 varieties of mulberry fruit pectins against six bacterial strains and two human cancer cell lines (HT-29 and Hep G-2), using MIC and an in vitro cell-based assay respectively. The BR-2 mulberry fruit pectin performs superior to S-13 by inhibiting strong bacterial growth (MIC = 500-1000 µg/mL) against tested bacterial strains and cytotoxic activities at the lowest concentration (10 µg/ml) against the Hep G-2 cell line. However, both tested drugs failed to exhibit cytotoxicity on the human colon cancer cell line (HT-29). Based on molecular interaction through docking, pectin binds effectively with the receptors (1e3g, 3t0c, 5czz, 6j7l, 6v40, 5ibs, 5zsy, and 6ggb) and proven to be a promising antimicrobial and anti-cancer agents. The pursuit of unexploited drugs from mulberry fruit pectin will potentially combat against bacterial and cancer diseases. Finally, future perspectives of MFP for the treatment of many chronic diseases will help immensely due to their therapeutic properties.

Glycolipid-Based Oleogels and Organogels: Promising Nanostructured Structuring Agents.

Over the past few decades, the scientific community is actively involved in the development of edible structuring agents suitable for food, cosmetics, agricultural, pharmaceutical, and biotechnology applications. In particular, edible oil structuring using simple amphiphiles would be the best alternative for the currently used trans and saturated fatty acids, which cause deleterious health effects and cardiovascular problems. In this report, we have made an attempt to address the aforementioned consequences, by synthesizing a new class of structuring agents by a judicious combination of δ-gluconolactone and ricinoleic acid, compounds classified as GRAS, using simple steps in good yield. To our delight, the synthesized glycolipids self-assemble in a wide variety of vegetable oils and commercially viable glycerol, ethylene glycol, and polyethylene glycol via various intermolecular interactions to form a gel. The morphology of molecular gels was investigated by optical microscopy and FESEM analysis, which reveal the existence of a tubular architecture with a diameter ranging from 75 to 150 nm. Rheological studies disclosed the viscoelastic nature, thermal processability, and thixotropic behavior of both oleogels and organogels. Altogether, self-assembled oleogel and organogel reported in this paper would potentially be used in food, agricultural, cosmetics, pharmaceutical, and biotechnological applications.

Marker assisted improvement of low soil phosphorus tolerance in the bacterial blight resistant, fine-grain type rice variety, Improved Samba Mahsuri.

Improved-Samba-Mahsuri (ISM), a high-yielding, popular bacterial blight resistant (possessing Xa21, xa13, and xa5), fine-grain type, low glycemic index rice variety is highly sensitive to low soil phosphorus (P). We have deployed marker-assisted backcross breeding (MABB) approach for targeted transfer of Pup1, a major QTL associated with low soil P tolerance, using Swarna as a donor. A new co-dominant marker, K20-1-1, which is specific for Pup1 was designed and used for foreground selection along with functional markers specific for the bacterial blight resistance genes, Xa21, xa13, and xa5. A set of 66 polymorphic SSR marker were used for the background selection along with a pair of flanking markers for the recombination selection in backcross derived progenies and in BC2F2 generation, 12 plants, which are homozygous for Pup1, all the three bacterial blight resistance genes and possessing agro-morphological traits equivalent to or better than ISM were selected and selfed to produce BC2F3s. They were evaluated in plots with low soil P and normal soil P at ICAR-IIRR, Hyderabad for their low soil P tolerance, and bacterial blight resistance and superior lines were advanced to BC2F6. One of the lines, when tested at multiple locations in India was found promising under both normal as well as low soil P conditions.

Chlorogenic Acid Enriched Green Coffee Ameliorated Renal Injury in Rats.

The incidence of acute kidney injury (AKI) during the treatment with gentamicin (GM) is very common in hospitalized patients. Green coffee bean, containing chlorogenic acid (CGA) has been reported to improve non communicable diseases. In the present study, CGA enriched fraction of green coffee bean was evaluated on GM induced nephrotoxicity in rats. It was a preclinical case-controlled experimental intervention conducted in the Department of Pharmacology, R G Kar Medical College, Kolkata, India from 2016-2019 using animal model. CGA content of green coffee bean extract (GCBE) was isolated and quantified by high performance thin layer chromatography (HPTLC) (6.426%). The rats were treated with GCBE at the dose of 100, 200 and 400mg/kg in gentamicin (GM) induced AKI for five consecutive days. At day 6, the renal function was assessed through analysing urine, blood and renal tissues. GCBE dose dependently and significantly (p<0.001) lowered blood urea, creatinine and potassium while, enhanced sodium compared to AKI control. Moreover, it showed significant elevation in glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) and reduction in lipid peroxides (p<0.001). It was suggested that chlorogenic acid of green coffee seed can protect kidney through down regulation of p53 transcription factor and thereby attenuation of oxidative stress, inflammation and apoptotic process in renal tubules.

Complete genome sequence and genetic organization of a Garlic virus D infecting garlic (Allium sativum) from northern India.

The present paper describes first full genome sequence of the Garlic virus D (GarV-D) from northern India with a genome size of 8425 bp long ssRNA. The infected leaves and bulbs of garlic variety Yamuna Safed (G-282) plants suspected for GarV-D infection were collected with the aim to identify contagion virus during March, 2018. The total RNA was extracted from the pooled garlic plants using TRIzol reagent and sequenced using an Illumina HiSeq 2000 platform. BLASTn search in the NCBI database identified contagion as GarV-D (MK518067). It shared 83.63-85.83% nucleotide sequence identities with other (GarV-D) isolates from Argentina (KF550407, KF555653, KR819505) and 83.15% with isolates from China (MF795136, MF363012). Keywords: Allium sativum; Allexivirus; Garlic virus D; India.

Prevalence of Vitamin D Deficiency Among Newborns.

We observed that 760 (92.1%) out of 825 healthy newborns at our institution had vitamin D deficiency (VDD) at birth. These observations highlight the importance of regular screening and supplementation of vitamin D in the early years of life.

A prospective randomized controlled trial comparing conventional Intuitive® procedure card recommended port placement with the modified Indian (Manipal) technique.

INTRODUCTION: The da Vinci® X hybrid systems (Intuitive Surgical®, Sunnyvale CA) provides standard sites recommendations for port placement during robotic surgery; including that for colorectal procedures. The author's encountered challenges while adhering to the provided instructions, such as clash of instruments and arms and need for additional ports, and hence to overcome these challenges attempted a few innovative technical modifications. The surgical results as well as merits of the revised Indian (Manipal) port placement with single docking technique are presented here. METHODS: Twenty patients underwent robotic rectal resection at the Department of Surgical Oncology and Robotic Surgery, Manipal Comprehensive Cancer Centre, Bengaluru, India, between December 2017 and June 2018. A randomised controlled study was conducted to compare the two techniques. Ten patients were operated using hybrid da Vinci® 'X' system using the manufacturer's recommendations and 10 by the modified Indian (Manipal) port placement with a single docking technique. RESULT AND CONCLUSIONS: The Indian (Manipal) modifications of port placements are optimal for colorectal procedures such as low anterior resection as well as for ultralow anterior resections. The intraoperative parameters compared between the recommendations of the Intuitive® (da Vinci® systems) and attempted modifications demonstrated statistically significant advantages with the use of the revised techniques. The improvements offered by this modification include no additional requirements of ports or staplers, lesser clash amongst instruments as well as arms, better mobilisation of splenic flexure amongst others.

Observational Study of Third-Trimester Vitamin D3 Supplementation and Implications for Mothers and Neonates at Term.

OBJECTIVE: To determine 25-hydroxyvitamin D (25OHD) levels in pregnant women at 28 weeks and supplement based on these levels and check maternal and neonatal levels after delivery at term. DESIGN: This is a prospective observational study wherein pregnant women aged 18-35 years received cholecalciferol from 28 weeks till delivery at term. Women with 25OHD levels ≥ 75 nmol/L received 12.5 µg/day, those with levels 50-74.9 nmol/L received 100 µg/day and those with  levels ≤ 49.9 nmol/L received 1500 µg/week. RESULTS: Of 555, 532 women (95.8%) completed the study. Of 532, 77 (14.5%) women had 25OHD ≥ 75 nmol/L at 28 weeks; 34/77 (44.15%) became deficient at term, and the mean 25OHD reduced from 99 ± 29.9 to 77 ± 30.4 nmol/L (p < 0.0001). One hundred and seventy-one women had 25OHD 50-74.9 nmol/L at 28 weeks; in 99 (57.89%), levels normalised at term, and mean 25OHD increased from 60.5 ± 7.5 to 78.2 ± 21.9 nmol/L (p < 0.0001). Two hundred and nineteen women had 25OHD 25-49.9 nmol/L at 28 weeks; in 135 (61.64%), levels normalised at term, and mean 25OHD increased from 36.6 ± 7.5 to 83.3 ± 32.7 nmol/L (p < 0.0001). Sixty-five women had 25OHD < 25 nmol/L at 28 weeks; In 39 (60.94%), levels normalised at term, and the mean 25OHD increased from 17.9 ± 5 to 80.6 ± 34.1 nmol/L (p < 0.0001). Seven neonates (1.3%) had cord blood ionised calcium values < 1 mmol/L, and all these had 25OHD < 50 nmol/L (mean 22.2 ± 2.5 nmol/L). CONCLUSIONS: Standard 12.5 µg/day supplementation in women with normal 25OHD levels at 28 weeks leads to deficiency in 44% women by term. Cholecalciferol in doses of 100 µg/day and 1500 µg/week leads to a significant increase in 25OHD levels in vitamin D-deficient pregnant women though nearly 40% may still have deficient levels at term along with their newborns. Only 1.3% of newborns had hypocalcaemia.