Effect of Agility Exercises on Knee Health Status among Patients with Osteoarthritis.

Osteoarthritis is one of the most common causes of disability due to limitations of joint movement and accounts for more hospitalisations which ultimately result in increased health care costs. The present study was carried out to assess the effect of agility exercises on knee health status among patients with osteoarthritis. It was a quasi experimental study--one group pre-test post-test control group design- conducted over a period of three months in 50 subjects who were diagnosed as having mild and moderate knee osteoarthritis attending outpatient department of physical medicine and rehabilitation, Medical College Hospital, Thiruvananthapuram. Basic socio-demographic and clinical data of subjects were assessed using a semi-structured interview schedule. Knee related health status was assessed using WOMAC osteoarthritis index. Control group subjects were selected initially and given demonstration of range of motion and quadriceps setting exercises. Experimental group subjects were selected in the second half of the study and given demonstration of agility exercises along with range of motion and quadriceps setting exercises. All the subjects continued their prescribed medications also in home. A close relative is entrusted to supervise the exercises in home and the researcher herself called all the subjects daily to get the feedback. A home work exercise dairy was given to write the details of exercises done at home. Subjects were assessed after two weeks using WOMAC osteoarthritis index. Statistical analysis showed that both groups are comparable on the basis of baseline sociodemographic and clinical data and there was significant improvement in knee-related health status among experimental group subjects (p < 0.001). The results suggests that agility exercises can be included along with conventional exercise programme in patients with knee osteoarthritis.

Serum uric acid and high-sensitivity C-reactive protein levels among people living with HIV on dolutegravir and ritonavir-boosted atazanavir-based antiretroviral therapy: a comparative cross-sectional study.

Background: After the introduction of antiretroviral therapy, the care given to people living with HIV has become complicated by the appearance of comorbidities as a result of HIV and HAART toxicities, in which cardiovascular disease got the most attention. So, this study aimed to assess serum uric acid and high-sensitivity C-reactive protein levels among people living with HIV on dolutegravir (DTG) and ritonavir-boosted atazanavir (ATV/r)-based therapy. Methods: An institutional-based comparative cross-sectional study was conducted from November 4, 2021, to January 4, 2022. An equal number of dolutegravir- and ritonavir-boosted atazanavir-treated patients (n = 86 each) were enrolled. A consecutive sampling method was used to select participants. Data were entered into Epidata version 4.6, exported to SPSS version 25.0, and analyzed using Chi-square, Student's t-test, Mann-Whitney U-test, and logistic regression. Statistical significance was set at p < 0.05. Results: The prevalence of hyperuricemia and high-sensitivity C-reactive protein levels ≥2 mg/L were 46.5% (40/86) and 24.4% (21/86) in the DTG group, and 30.2% (26/86) and 44.2 (38/86) in the ATV/r group, respectively. When compared to ATV/r, a higher mean level of uric acid was found among DTG-based regimens (5.38 mg/dL). Duration of ART (AOR = 2, 95% CI: 1.2, 4.4) and DTG-based regimen (AOR = 1.9, 95% CI: 1.04, 3.8) were significant predictors of developing hyperuricemia. ATV/r-based regimen (AOR = 3, 95% CI: 1.5, 8.3) and high waist circumference (AOR = 2.5, 95% CI: 1, 3.5) were significantly associated with increased high-sensitivity C-reactive protein levels. Conclusion: It is observed that DTG-based and ATV/r-based ART are associated with hyperuricemia and increased high-sensitivity C-reactive protein levels, respectively. Therefore, it is important to consider and evaluate serum uric acid and high-sensitivity C-reactive protein levels in patients taking DTG and ATV/r-based ART, as well as among those on HAART for years and with a higher waist circumference, so as to detect and prevent early the risk of having CVD.

Serum Lipid Profiles, Blood Glucose, and High-Sensitivity C-Reactive Protein Levels Among People Living with HIV Taking Dolutegravir and Ritonavir-Boosted Atazanavir-Based Antiretroviral Therapy at Jimma University Medical Center, Southwest Ethiopia, 2021.

Background: Long-term use of antiretroviral therapy, especially dolutegravir and boosted-atazanavir, raises concerns about cardiovascular disease. Thus, this study aimed to assess lipid profiles, blood glucose, and high-sensitivity C-reactive protein levels among people living with HIV on dolutegravir and ritonavir-boosted atazanavir-based therapy. Methods: An institutional-based comparative cross-sectional study was conducted from November 4, 2021, to January 4, 2022. An equal number of dolutegravir- and ritonavir-boosted atazanavir-treated patients (n = 64 each) was enrolled. A consecutive sampling was used to select participants. The Chi-square, Student's t-test, Mann-Whitney U-test, and logistic regression were used as appropriate statistical tests using SPSS Version 25.0. Statistical significance was set at p < 0.05. Results: Dyslipidemia was found in 67.2% (43/64) of ritonavir-boosted atazanavir group and 48.4% (31/64) of dolutegravir group. The dolutegravir group had significantly higher mean and median values of high-density lipoprotein and random blood sugar, respectively, as well as lower median triglyceride and high-sensitivity C-reactive protein levels than the ritonavir-boosted atazanavir group. Ritonavir-boosted atazanavir-based regimens (AOR=3.4, 95% CI: 1.5, 8) and age >40 years were predictors of dyslipidemia, while BMI ≥25 kg/m2 (AOR=3.7, 95% CI: 1.3, 10.8) and dolutegravir-based regimens (AOR=4.6, 95% CI: 1.5, 14) were predictors of hyperglycemia. Ritonavir-boosted atazanavir-based regimens (ARR=3, 95% CI: 1.3, 8) and BMI ≥25 kg/m2 (ARR=2.5, 95% CI: 1.1, 6) were associated with increased high-sensitivity C-reactive protein by 1-3 mg/L. The risk of increased high-sensitivity C-reactive protein by >3 mg/L was greater in those patients with a CD4 cell count of <500 cells/mm3 (ARR=5, 95% CI: 1.1, 24). Conclusion: When compared to ritonavir-boosted atazanavir-based regimens, dolutegravir had favorable lipid profiles and high-sensitivity C-reactive protein but unfavorable blood glucose levels. Therefore, baseline blood glucose, lipid profiles, and high-sensitivity C-reactive protein levels should be routinely measured in patients on these regimens.

Clinical and molecular characterization of neonatal diabetes and monogenic syndromic diabetes in Asian Indian children.

Mutations in the pancreatic ATP sensitive K(+) channel proteins [sulfonyluea receptor 1 (SUR1) and inward rectifier K(+) channel Kir6.2 (Kir6.2), encoded by ATP-binding cassette transporter subfamily C member 8 (ABCC8) and potassium channel J11 (KCNJ11), respectively], are the most common cause of neonatal diabetes. We describe the clinical presentation and molecular characterization of Asian Indian children with neonatal diabetes mellitus and monogenic syndromes of diabetes. We sequenced KCNJ11, ABCC8 and insulin (INS) genes in 33 unrelated Indian probands with onset of diabetes below one year of age. A total of 12 mutations were identified which included ABCC8 mutations in seven, KCNJ11 mutations in three and INS mutations in two children. The Asp212Tyr mutation in ABCC8 was novel. We also detected two novel mutations (Val67Met and Leu19Arg) in children with syndromic forms of diabetes like Berardinelli Seip syndrome [1-acyl-sn-glycerol-3-phosphate acyltransferase beta (AGPAT2)] and Fanconi Bickel syndrome [solute carrier family 2A2 (SLC2A2)]. Children carrying the KCNJ11 (Cys42Arg, Arg201Cys) and ABCC8 (Val86Ala, Asp212Tyr) mutations have been successfully switched over from insulin therapy to oral sulfonylurea. Our study is the first large genetic screening study of neonatal diabetes in India.

Gut microbiota of healthy Asians and their discriminative features revealed by metagenomics approach.

This study is conducted to identify the microbial architecture and its functional capacity in the Asian population via the whole metagenomics approach. A brief comparison of the Asian countries namely Malaysia, India, China, and Thailand, was conducted, giving a total of 916 taxa under observation. Results show a close representation of the taxonomic diversity in the gut microbiota of Malaysia, India, and China, where Bacteroidetes, Firmicutes, and Actinobacteria were more predominant compared to other phyla. Mainly due to the multi-racial population in Malaysia, which also consists of Malays, Indian, and Chinese, the population tend to share similar dietary preferences, culture, and lifestyle, which are major influences that shapes the structure of the gut microbiota. Moreover, Thailand showed a more distinct diversity in the gut microbiota which was highly dominated by Firmicutes. Meanwhile, functional profiles show 1034 gene families that are common between the four countries. The Malaysia samples are having the most unique gene families with a total of 67,517 gene families, and 51 unique KEGG Orthologs, mainly dominated by the metabolic pathways, followed by microbial metabolism in diverse environments. In conclusion, this study provides some general overview on the structure of the Asian gut microbiota, with some additional highlights on the Malaysian population. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03671-3.

Long-term response of dragon fruit (Hylocereus undatus) to transformed rooting zone of a shallow soil improving yield, storage quality and profitability in a drought prone semi-arid agro-ecosystem.

Agricultural crops especially fruit trees are constrained by edaphic stresses in shallow soils with low water retention and poor fertility. Therefore, interventions of shifting to trench planting for better root anchorage and replacing the filling soil were evaluated for 8 years in dragon fruit (Hylocereus undatus) cultivated in Deccan Plateau of peninsular India. When averaged for last 5-years, 44 % higher fruit yield (18.2 ± 1.0 Mg ha-1) was harvested from trees planted in trenches filled with 1:1 mixture (T-mixed) of native soil (loamy sand with 26.7 % stones (>2mm), field capacity, FC 0.20 cm3 cm-3; organic carbon, OC 0.17 %; Av-N 54.6 kg ha-1) and a black soil (clay 54.4 %; FC 0.42 cm3 cm-3; OC 0.70 %; Av-N 157.1 kg ha-1) than the recommended pit planting (12.4 ± 1.2 Mg ha-1). Improvements in fruit yields with trenches filled with black (T-black) and native (T-native) soil were 32 and 13 %, respectively. Yield losses (total- marketable yield) were reduced by 40, 20 and 18 % over pit method with T-mixed, T-black and T-native soil, respectively. Marketable quality attributes like fruit weight, fruit size metrics and pulp/peel content were further improved under T-mixed soil. Accumulation of total soluble solids (TSS), sugar content, phenolic and flavonoid compounds were higher in fruits from T-native soil. During storage, fruits from T-native soil and pit planting exhibited minimum physiological weight loss and retained more firmness, TSS, sugars, titratable acidity, phenolic-flavonoids contents, FARP and DPPH activities. T-mixed soil provided better hydrozone and nutrients for resilience of fruit plants while protecting from aeration problems envisaged in poorly drained black soils. With B:C ratio (1.85) and lower payback period (4-years), T-mixed soil showed superior economic viability. Therefore, soil management module of planting in trenches filled-in with mixture of native and black soils can be recommended to boost productivity of fruits from shallow soils under water scarce degraded regions without penalising agro-ecosystem.

Morvan's syndrome Presenting with Psychiatric Manifestations - A Case Report and Review of the Literature.

The term "la chorιe fibrillare" was used by the French physician Augustine Marie Morvan to describe a syndrome showing hyperactivity features involving the central, autonomic, and peripheral nervous system. The central hyperactivity symptoms are confusion, behavioral problems, hallucinations, myoclonus, and insomnia; the autonomic hyperactivity symptoms are hyperhidrosis and variations in blood pressure; and peripheral hyperexcitability is characterized by painful cramps, myokymia, and neuromyotonia. Here, we present a case that has typical features of Morvan's syndrome and provides a brief description based on available literature.

Evaluation of the Effect of Hydromethanolic Seed Extract of Lepidium sativum L. (Fetto) on Deep-fried Palm Oil Diet Induced Nonalcoholic Fatty Liver Disease on Male Swiss Albino Mice.

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is the most prevalent disease due to a dramatic change in dietary habits, especially an increase in consumption of fat and carbohydrates in deep-fried foods. OBJECTIVE: The objective was to evaluate the effect of hydromethanolic seed extract of Lepidium sativum on deep-fried palm oil diet induced NAFLDon male mice. METHODS: An experimental study design was conducted. Twenty-four male mice aged 8 to 10 weeks, weighing 32-42 g were divided into four groups. The four groups were divided into two controls and two treatments. Mice in normal control (C0) were administered only with the basal diet whereas negative control (C1) provided only with the deep-fried palm oil diet. The treatment groups T1, and T2 were administered with deep-fried palm oil diet and HMSELS at dose of 200 and 400 mg/kg/day, respectively for 28 days. Then on day 29, the mice were fasted overnight, anaesthetized and sacrificed by cervical dislocation after blood was taken by cardiac puncture for liver function tests while liver tissues were taken for histopathology investigation. RESULTS: The serum ALT and total bilirubin showed significant decrement whereas the serum albumin levels showed significant increment in T2 group. However, serum AST and ALP levels were decreased significantly in both T1 and T2 groups. Besides, the T2 group liver sections of mice were showed better effect of HMSELS on restoring the damaged liver histopathology almost toward normal. CONCLUSION: The HMSELS at a dose of 400 mg/kg/day (T2) was more effective on the liver function tests and liver histopathology that altered by feeding deep-fried palm oil diet. The good protective effect of HMSELS against deep-fried palm oil diet-induced NAFLD might be due to its antioxidant content.

Recent advances in drying and dehydration of fruits and vegetables: a review.

Fruits and vegetables are dried to enhance storage stability, minimize packaging requirement and reduce transport weight. Preservation of fruits and vegetables through drying based on sun and solar drying techniques which cause poor quality and product contamination. Energy consumption and quality of dried products are critical parameters in the selection of drying process. An optimum drying system for the preparation of quality dehydrated products is cost effective as it shortens the drying time and cause minimum damage to the product. To reduce the energy utilization and operational cost new dimensions came up in drying techniques. Among the technologies osmotic dehydration, vacuum drying, freeze drying, superheated steam drying, heat pump drying and spray drying have great scope for the production of quality dried products and powders.

Mechanism of vasorelaxant activity of a fraction of root extract of Sesamum indicum Linn.

The petroleum ether soluble fraction (SIPE) of the root extract of S. indicum was evaluated for the vasorelaxant activity using isolated rat aorta. SIPE up to 180 microg/ml concentration significantly inhibited phenylephrine- and KCl-induced contraction to the extent of 98.13 +/- 6.37 and 70.19 +/- 3.43% respectively in isolated rat aorta in a concentration dependent manner. The vasorelaxant activity was not blocked by propranolol (10 microM), atropine (1 microM) indomethacin (10 microM) and glibenclamide (10 microM). Influence of SIPE on phenylephrine-induced contractions in aortic preparations in absence of functional endothelium and on pre-incubating the tissue with L-NAME (300 microM) or methylene blue (10 microM) was also studied. SIPE at 180 microg/ml concentration could elicit partial relaxation in presence of L-NAME or methylene blue to the extent of 34.26 +/- 6.13 and 25.66 +/- 10.95% respectively. However, in absence of functional endothelium, SIPE exhibited little relaxation to the extent of 6.70 +/- 4.87%. These studies revealed that the vasorelaxant activity of SIPE was chiefly mediated through endothelium-dependent pathway.

Olanzapine has better efficacy compared to risperidone for treatment of negative symptoms in schizophrenia.

OBJECTIVE: The safety and efficacy profile of risperidone and olanzapine were compared in a double-blind trial that used doses widely accepted in clinical practice. METHODS: Subjects (n = 71) who met Diagnostic and Statistical Manual of Mental Disorders-IV criteria for schizophrenia were randomly assigned to receive 2-8 mg/day of risperidone (mean modal dose = 5.5 mg/day) or 5-20 mg/day of olanzapine (mean modal dose = 14.4 mg/day) for 1 year. RESULTS: The two study groups were similar at baseline in all aspects. Seventy-four percent of the participants completed the trial, with no between-differences in the proportion of dropouts. Olanzapine group showed significantly greater improvement in negative symptoms in assessments at 3rd, 6th, 9th, and 12th months (P = 0.05, 0.00, 0.00, and 0.00, respectively). Clinical global impression of severity (CGI-S) scores were consistently lower in the olanzapine group at 3rd, 6th, and 9th months (P = 0.01, 0.03, and 0.05, respectively) as measured by positive and negative symptom scale (PANSS). Total scores on PANSS, positive symptoms, general psychopathology, and CGI improvement showed comparable improvement at 3rd, 6th, 9th, and 12th months of follow-up (all subjects, including dropouts). Severity of extrapyramidal symptoms was low in both groups, with no between-group differences. Mean change in body weight, fasting blood sugar, and fasting cholesterol was comparable in both groups. Risperidone group had significant hyperprolactinemia after one year (P = 0.03). CONCLUSIONS: Both treatments were well-tolerated and efficacious. Greater reductions in severity of the illness and negative symptoms were seen with olanzapine consistently through 1 year. The frequency and severity of extrapyramidal symptoms were negligible and similar in the two treatment groups. Weight gain, hyperlipidemia, and hyperglycemia were comparable in both groups. Risperidone produced significant hyperprolactinemia.

Phytoproteins in green leaves as building blocks for photosynthesis of gold nanoparticles: An efficient electrocatalyst towards the oxidation of ascorbic acid and the reduction of hydrogen peroxide.

Herein, we present a simple and green method for the synthesis of gold nanoparticles (AuNPs) using the phytoproteins of spinach leaves. Under ambient sunlight irradiation, the isolated phytoprotein complex from spinach leaves reduces the gold chloride aqueous solution and stabilizes the formed AuNPs. As prepared nanoparticles were characterized by UV-visible spectroscopy, Fourier transform infra-red (FTIR) spectroscopy, zeta potential, transmission electron microscopy (TEM) and energy dispersive X-ray analysis (EDS). The surface plasmon resonance (SPR) maximum for AuNPs was observed at 520 nm. The zeta potential value estimated for the AuNPs is -27.0 mV, indicating that the NPs are well separated. Transmission electron micrographs revealed that the particles are spherical in nature with the size range from 10 to 15 nm. AuNPs act as a catalyst in the degradation of an azo dye, methyl orange in an aqueous environment. The reduction rate was determined to be pseudo-first order. Electrocatalytic efficiency of the synthesized AuNPs via this green approach was studied by chronoamperometry using ascorbic acid and hydrogen peroxide as a model compound for oxidation and reduction, respectively. Electrocatalytic studies indicate that the gold nanoparticles can be used to detect ascorbic acid and hydrogen peroxide in micromolar concentrations with response time less than 3s.

Risk factors for suicide in elderly in comparison to younger age groups.

BACKGROUND: The elderly population has a significant risk of suicide when compared to any other age group. Despite this, suicide among the aged receives scant attention. Hence, identification of suicide risk factors specific to this population will help in the development of suitable prevention strategies for this group. AIMS: Comparison of risk factors for attempting the suicide in the elderly versus younger suicide attempters. MATERIALS AND METHODS: A total 1159 suicide attempters attended the suicide prevention clinic of IQRAA International Hospital and Research Centre. They were evaluated using a specially designed psycho-sociodemographic proforma. The group was divided into those above 65 years (elderly) and those below 65 years (younger) and all the risk factors were compared between these two groups. RESULTS: Most suicide attempters in the elderly category were found to be married, less educated, unemployed and hailed from a rural background and joint families. They had a higher rate of family history of psychiatric illness, past psychiatric illness, concurrent medical illness and history of medical contact in the three months prior to the attempt. A significant number in the elderly group had attempted suicide more than a week after a stressor. CONCLUSION: The results from this study suggests that in suicide attempters from Indian geriatric population, co-morbid physical illness, mental illness (particularly depression) and family burden of psychiatric illness are important predictors in comparison to younger populations. Also, these attempters had contact with a medical professional in the three months prior to the attempt. Specific preventive interventions need to be tailored for this population to reduce the risk of suicide rather than adopting generalized suicide prevention strategies.

Pharmacological and toxicological evaluation of Sulcona(®), a traditional Siddha medicine used in the treatment of burns.

Sulcona, a Siddha proprietary medicine used for the treatment of burns, has been in practice for more than 50 years. This medicine has been successfully used on several burned patients with an excellent recovery and safety record. In this manuscript, we investigate some of its pharmacological and safety profiles. Treatment of cells with Sulcona induced a statistically significant increase in population doubling compared to concurrent controls in proliferating human lymphocytes as well as in Balb/c 3T3 cells, suggesting that it stimulates cell proliferation. Sulcona exhibited some antibacterial activity against Pseudomonas aeruginosa, Salmonella typhi and Staphylococcus aureus. Carrageenan-induced rat paw edema testing suggested that Sulcona has some anti-inflammatory properties. Patch testing showed that Sulcona has mild anesthetic effects. The above properties suggest Sulcona's pharmacological properties aidin treatment of burns. Sulcona did not show any skin irritation or sensitization or mutagenic potential suggesting that it is safe for use. Further work is necessary to elucidate its exact mechanisms of action.

Enhanced super-hydrophobic and switching behavior of ZnO nanostructured surfaces prepared by simple solution--immersion successive ionic layer adsorption and reaction process.

A simple and cost-effective successive ionic layer adsorption and reaction (SILAR) method was adopted to fabricate hydrophobic ZnO nanostructured surfaces on transparent indium-tin oxide (ITO), glass and polyethylene terephthalate (PET) substrates. ZnO films deposited on different substrates show hierarchical structures like spindle, flower and spherical shape with diameters ranging from 30 to 300 nm. The photo-induced switching behaviors of ZnO film surfaces between hydrophobic and hydrophilic states were examined by water contact angle and X-ray photoelectron spectroscopy (XPS) analysis. ZnO nanostructured films had contact angles of ~140° and 160°±2 on glass and PET substrates, respectively, exhibiting hydrophobic behavior without any surface modification or treatment. Upon exposure to ultraviolet (UV) illumination, the films showed hydrophilic behavior (contact angle: 15°±2), which upon low thermal stimuli revert back to its original hydrophobic nature. Such reversible and repeatable switching behaviors were observed upon cyclical exposure to ultraviolet radiation. These biomimetic ZnO surfaces exhibit good anti-reflective properties with lower reflectance of 9% for PET substrates. Thus, the present work is significant in terms of its potential application in switching devices, solar coatings and self-cleaning smart windows.

Comparison of various approaches for exposure of infraorbital rim fractures of zygoma.

OBJECTIVE: The aim of this study was to randomly compare four incisionssubciliary, subtarsal, infraorbital and transconjunctival with lateral canthotomy for treatment of orbital rim or floor fractures. METHODS: 40 patients with zygomatic complex fractures either isolated or in association with pan facial fractures, were selected for the study. They were divided into four groups of 10 patients each, Group I-Transconjunctival with lateral canthotomy, Group II-Subciliary [single eyelid incision], Group III-Subtarsal incision, and Group IV-Infraorbital incision. The following parameters were compared a) The average time from incision to fracture exposure b) The amount of exposure of the site provided c) The aesthetic appearance of the 'scar' d) Complications e) Factor of 'time' - its effect on scar and complications. RESULTS: The study revealed that all four incisions provided adequate exposure of fracture site and transconjunctival (22 minutes) required the maximum time for exposure. The complications included ectropion in group I and prolonged edema in group IV. Group II and III patients had relatively lesser number of complications. Group IV patients had visible scar as compared to no scar in group I patients. CONCLUSION: We conclude by saying that transconjunctival approach provides an excellent aesthetic result when done meticulously. However the subciliary and the subtarsal incisions provide a more rapid, direct approach to the orbital floor and infraorbital rim with minimal morbidity and an aesthetically acceptable scar. The infraorbital incision is the least acceptable aesthetically.