Simultaneous removal of ternary heavy metal ions by a newly isolated Microbacterium paraoxydans strain VSVM IIT(BHU) from coal washery effluent.

In the present work, the removal of Cr (VI), Cd (II) and Pb (II) at 50 mg/L of each metal ion concentration was investigated by Microbacterium paraoxydans strain VSVM IIT(BHU). The heavy metal binding on the bacterial cell surface was confirmed through X-ray photoelectron spectroscopy and energy dispersive X-ray. X-ray photoelectron spectroscopy analysis also confirmed the reduction of Cr (VI) to Cr (III). Heavy metal removal dynamics was investigated by evaluating dimensionless, and the value of Nk (9.49 × 10-3, 9.92 × 10-3 and 1.23 × 10-2 for Cr (VI), Cd (II) and Pb (II) ions) indicated that the removal of heavy metals by bacterial isolate was mixed diffusion and transfer controlled. It was found that both the experimental and predicted values for isolated bacterial strain coincided with each other with a good R2 value in the L-M Algorithm range of 0.94-0.98 for the ternary metal ion system. The bacterial isolate presented a maximum heavy metal ion removal efficiency of 91.62% Cr (VI), 89.29% Pb (II), and 83.29% Cd (II) at 50 mg/L.

Psychosocial impact and coping strategies of frontline healthcare workers in Western Rajasthan during COVID-19 pandemic.

Background and Aims: Coronavirus disease-2019 (COVID-19) pandemic-related stress is an important but under-rated issue needing attention. Stress and causative factors vary between the regions and individuals depending on the availability of resources, socio-cultural differences, and individual perceptions. We aimed to study the psychosocial impact and coping strategies among the healthcare workers (HCWs) in Western Rajasthan during COVID-19 pandemic. Material and Methods: This questionnaire-based observational study, consisting of 59 questions in 6 sections, was conducted to identify stress, causative factors, coping strategies, and experiences of HCWs working in personal protective equipment (PPE). Chi-square test was used to compare the responses between different subgroups. Results: Majority of the HCWs felt responsible for treating COVID-19 patients (98.8%), but also felt that it was affecting their safety (81.4%). On subgroup analysis, doctors were found to be more stressed than nursing staff (P = 0.004). Major stressors included concerns about infecting family members and lack of specific treatment for COVID-19 (87.5%). Family support was found to be a major stress-relieving factor (97.3%). Most HCWs suggested that comfortable quarantine stay, adequate supply of PPE, and equipments would help in reducing stress. Conclusion: Frontline HCWs in Western Rajasthan were under significant stress during COVID-19 pandemic. We found that stress-causing factors and coping strategies varied between different subgroups based on profession, gender, and age. We recommend conducting such studies in different regions of the world to develop relevant and region-specific strategies to help HCWs cope with stress more efficiently, thereby, strengthening the healthcare system to deal with future pandemics.

YouTube as a source of information during the Covid-19 pandemic: a content analysis of YouTube videos published during January to March 2020.

BACKGROUND: Institutions, government departments, and healthcare professionals engage in social media because it facilitates reaching a large number of people simultaneously. YouTube provides a platform whereby anyone can upload videos and gain feedback on their content from other users. Many YouTube videos are related to health and science, and many people search YouTube for health-related information. YouTube has been acknowledged as a key public information source in recent crises caused by Zika, H1N1, swine flu, and most recently, COVID-19. METHODS: YouTube videos were collected from the YouTube Application Programming Interface (API) using the search terms COVID-19, coronavirus, COVID19, and corona. The search was conducted on April 4 and 5, 2020. The initial investigation found a total of 1084 videos. The second step involved identifying and verifying the videos for their relationship to COVID-19 information and excluding videos that did not relate to COVID-19 or were in a language other than English and Hindi. RESULTS: An analysis of YouTube videos covering COVID-19, uploaded in early 2020, in English and Hindi. The sample comprised 349 videos (n = 334 English). Videos were characterized by contributor, duration, content, and reception (views/likes/dislikes/comments). The majority contained general information, with only 4.01% focusing on symptoms and 11.17% on treatment and outcomes. Further, the majority (n = 229) were short videos of under 10 min duration. Videos provided by government and health care professionals comprised 6.87% and 5.74% % of the sample, respectively. News channels uploaded 71.63% of videos. CONCLUSIONS: YouTube may provide a significant resource for disseminating of information on public health issues like outbreaks of viral infections and should be utilized by healthcare agencies for this purpose. However, there is currently no way to determine whether a video has been produced or verified by authorized healthcare professionals. This limitation needs to be addressed so that the vital distribution services offered by platforms like YouTube can be fully utilized for increasing public understanding of healthcare science, particularly during a crisis such as a pandemic.

Evaluation of Gall Bladder Stones Using Susceptibility Weighted Imaging.

OBJECTIVE: To evaluate the visualization of gallbladder stones on susceptibility-weighted imaging (SWI). MATERIALS AND METHODS: Imaging data from 47 patients who underwent clinically indicated cholecystectomy was reviewed. Breath-hold SWI was added to the magnetic resonance imaging protocol and magnitude and phase data was reviewed for gall-stones visualization. Phase signature, that is, diamagnetic, paramagnetic, or mixed, was also noted in the stones. Magnetic susceptibility value of surgically extracted gallstones were imaged ex vivo (n = 37). RESULTS: In 45 of 47 cases, gallstones were surgically confirmed. In 43 cases, gallstones were visualized in the SWI. In 1 case, although routine imaging failed, stones were visualized on SWI. In 29 diamagnetic, 7 paramagnetic and 9 cases mixed phase were seen. In an ex vivo study, magnetic susceptibility of stones was found ranging between -0.102 and -0.916 ppm for diamagnetic and 0.203 and 486 ppm for paramagnetic stones. CONCLUSIONS: Gallbladder stones can be visualized with SWI and may be added to the routine magnetic resonance imaging protocol for its evaluation.

Essential Yet Neglected Role of Primary Care Physicians in Palliation Team.

Quality home-based care for patients with the end-stage disease is increasingly being preferred. Responding to disease associated symptoms and complications may pose an array of challenges in evolving palliative care systems, as no formal institutional mechanism exists to respond to patient and caregiver's wishes. Family and primary care physicians can play an instrumental role in such scenarios by bridging the gaps between cancer specialists and patient and caregivers expectations.

Effectiveness of Pregabalin Compared to Duloxetine in Diabetic Peripheral Neuropathic Pain: An Observational Study.

INTRODUCTION: Neuropathy is a comorbid complication of diabetes and Pregabalin and Duloxetine are the two most common drugs used for the treatment of neuropathic pain. AIM: To determine the effectiveness and side effects of Pregabalin and Duloxetine in patients with diabetic peripheral neuropathic pain. MATERIALS AND METHODS: This prospective observational study was conducted at Max Super Speciality Hospital. Patients attending the endocrinology department, above 18 years of age who were prescribed with Pregabalin or Duloxetine were screened and included in this study. The data was collected for all study participants using a specially designed case record form by conducting personal interviews. SF-MPQ, Mc-Gill, NRS and DN-4 questionnaires were used to assess the extent of pain and the side-effects associated with the drugs. RESULTS: Based on the responses from the Numerical Rating Scale and McGill Pain Questionnaire, Pregabalin was seen to be less effective compared to Duloxetine. The only side effect observed with Pregabalin was drowsiness, which was observed in 4% cases at 50 mg dose whereas those reported with Duloxetine were drowsiness (22.2% at 20 mg and 33.3% at 30 mg), vomiting (11.1% at 20mg and 30mg), headache (11.1% at 20 mg and 30 mg), and dizziness (0% at 20mg and 11.1% at 30 mg). CONCLUSION: Pregabalin has a better safety profile and tolerability compared to Duloxetine but the latter is more effective in treating Diabetic Peripheral Neuropathic Pain. However, further studies with a larger sample size and longer duration are required to be conducted for finding the effectiveness of these drugs, specifically in the Indian population.

A review of metabolic potential of human gut microbiome in human nutrition.

The human gut contains a plethora of microbes, providing a platform for metabolic interaction between the host and microbiota. Metabolites produced by the gut microbiota act as a link between gut microbiota and its host. These metabolites act as messengers having the capacity to alter the gut microbiota. Recent advances in the characterization of the gut microbiota and its symbiotic relationship with the host have provided a platform to decode metabolic interactions. The human gut microbiota, a crucial component for dietary metabolism, is shaped by the genetic, epigenetic and dietary factors. The metabolic potential of gut microbiota explains its significance in host health and diseases. The knowledge of interactions between microbiota and host metabolism, as well as modification of microbial ecology, is really beneficial to have effective therapeutic treatments for many diet-related diseases in near future. This review cumulates the information to map the role of human gut microbiota in dietary component metabolism, the role of gut microbes derived metabolites in human health and host-microbe metabolic interactions in health and diseases.

S9A Serine Protease Engender Antigenic Gluten Catabolic Competence to the Human Gut Microbe.

The human gut microbiome has a significant role in host physiology; however its role in gluten catabolism is debatable. Present study explores the role of human gut microbes in gluten catabolism and a native human gut microbe Cellulomonas sp. HM71 was identified. SSU rDNA analysis has described human gut microbiome structure and also confirmed the permanent residentship of Cellulomonas sp. HM71. Catabolic potential of Cellulomonas sp. HM71 to cleave antigenic gluten peptides indicates presence of candidate gene encoding biocatalytic machinery. Genome analysis has identified the presence of gene encoding S9A serine protease family-prolyl endopeptidase, with Ser591, Asp664 and His685 signature residues. Cellulomonas sp. HM71 prolyl endopeptidase activity was found optimal at pH 7.0 and 37 °C with a KM of 35.53 µmol and specifically cleaves at proline residue. Current study describes the gluten catabolism potential of Cellulomonas sp. HM71 depicting possible role of human gut microbes in gluten catabolism to confer resistance mechanisms for the onset of celiac diseases in populations with gluten diet.

High pre-diagnosis attrition among patients with presumptive MDR-TB: an operational research from Bhopal district, India.

BACKGROUND: Pre-diagnosis attrition needs to be addressed urgently if we are to make progress in improving MDR-TB case detection and achieve universal access to MDR-TB care. We report the pre-diagnosis attrition, along with factors associated, and turnaround times related to the diagnostic pathway among patient with presumptive MDR-TB in Bhopal district, central India (2014). METHODS: Study was conducted under the Revised National Tuberculosis Control Programme setting. It was a retrospective cohort study involving record review of all registered TB cases in Bhopal district that met the presumptive MDR-TB criteria (eligible for DST) in 2014. In quarter 1, Line Probe Assay (LPA) was used if sample was smear/culture positive. Quarter 2 onwards, LPA and Cartridge-based Nucleic Acid Amplification Test (CbNAAT) was used for smear positive and smear negative samples respectively. Pre-diagnosis attrition was defined as failure to undergo DST among patients with presumptive MDR-TB (as defined by the programme). RESULTS: Of 770 patients eligible for DST, 311 underwent DST and 20 patients were diagnosed as having MDR-TB. Pre-diagnosis attrition was 60% (459/770). Among those with pre-diagnosis attrition, 91% (417/459) were not identified as 'presumptive MDR-TB' by the programme. TAT [median (IQR)] to undergo DST after eligibility was 4 (0, 10) days. Attrition was more than 40% across all subgroups. Age more than 64 years; those from a medical college; those eligible in quarter 1; patients with presumptive criteria 'previously treated - recurrent TB', 'treatment after loss-to-follow-up' and 'previously treated-others'; and patients with extra-pulmonary TB were independent risk factors for not undergoing DST. CONCLUSION: High pre-diagnosis attrition was contributed by failure to identify and refer patients. Attrition reduced modestly with time and one factor that might have contributed to this was introduction of CbNAAT in quarter 2 of 2014. General health system strengthening which includes improvement in identification/referral and patient tracking with focus on those with higher risk for not undergoing DST is urgently required.

Isoniazid Preventive Therapy among Children Living with Tuberculosis Patients: Is It Working? A Mixed-Method Study from Bhopal, India.

Objective: We assessed uptake of isoniazid preventive therapy (IPT) among child contacts of smear-positive tuberculosis (TB) patients and its implementation challenges from healthcare providers' and parents' perspectives in Bhopal, India. Methods: A mixed-method study design: quantitative phase (review of programme records and house-to-house survey of smear-positive TB patients) followed by qualitative phase (interviews of healthcare providers and parents). Results: Of 59 child contacts (<6 years) of 129 index patients, 51 were contacted. Among them, 19 of 51 (37%) were screened for TB and one had TB. Only 11 of 50 (22%) children were started and 10 of 50 (20%) completed IPT. Content analysis of interviews revealed lack of awareness, risk perception among parents, cumbersome screening process, isoniazid stock-outs, inadequate knowledge among healthcare providers and poor programmatic monitoring as main barriers to IPT implementation. Conclusion: National TB programme should counsel parents, train healthcare providers, simplify screening procedures, ensure regular drug supply and introduce an indicator to strengthen monitoring and uptake of IPT.

Efficacy and Safety of Skin Radiance Collagen on Skin and Hair Matrix: A Placebo-Controlled Clinical Trial in Healthy Human Subjects.

Purpose: Collagen supplements are rising in the market as collagen has been demonstrated to be an important protein in the human aging process. Also, it is safe and easily absorbed in the body. Hence the aim of this study was to examine the effectiveness and safety of a collagen and antioxidant-rich treatment compared to a placebo in relation to various skin and hair indicators in healthy adult human subjects. Patients and Methods: Forty healthy adult non-pregnant/non-lactating women (aged 38-50 years) provided their informed consent in writing before their participation. Skin Radiance Collagen (SRC) treatment and a placebo were assessed for efficacy before application on Day 1, and post-application on Days 28 and 56, to measure changes in skin elasticity, hydration, brightness, pigmentation; texture, wrinkles, dryness, smoothness, fine lines, changes in the crow's feet region; as well as hair strength and hair fall. Results: It was observed after 56 days that therapy with SRC, compared to placebo, produced a substantial effect on reduction of wrinkle depth and fine lines by 48.11% and 39%, respectively, with p-value <0.01 in the test group. There was a 15.69% improvement in skin hydration observed and 28% reduction in hair fall with p-value <0.01. Conclusion: SRC, a combination of collagen with hyaluronic acid (HA), biotin, and vitamins C and E, showed a significant improvement in skin and hair health, including improvements in skin elasticity, skin hydration, reduction in crow's feet area wrinkles and fine lines, hair fall, and decrease in roughness, leading to improved skin texture. Vitamin C in the formulation also acts as a collagen builder for the body and helps in preventing oxidative stress in the body. The test treatment SRC was found to be efficacious and safe in healthy human adult subjects.

Mapping the Landscape of Indian Genomics Research: A Scientometric Analysis.

This Scientometric study aimed to provide state-of-the-art information on research growth and trends, areas of potential growth and development in genomics in India, and identify the key players (organizations or institutions, and funding agencies). It was found that the number of publications and citations related to genomics research has been steadily increasing over the years, indicating a growing interest and investment in the field as the Indian Council of Agricultural Research was the leading contributor to the field. Among the 159 contributing countries from 2012 to 2021, India contributed 4.46% of publications. The Department of Biotechnology (Ministry of Science and Technology, India) provided the most funds for genomics research. In the last decade, research was primarily focused on "Genetic Diversity," "Polymorphism," "Comparative Genomics," "Phylogeny," " Random amplification of polymorphic DNA (RAPD)," "Single nucleotide polymorphism (SNP)," "Polymerase chain reaction (PCR)," "Gene Expression," etc. The study's findings may shed light on the strengths and weaknesses of the country's research infrastructure, as well as the effectiveness of government policies and funding mechanisms.

Sparking attention on African swine fever research on social media platform: An altmetric evaluation of top 100 highly cited articles.

African swine fever (ASF) is one of the highly contagious diseases of pigs that affect both domestic and wild pigs. The primary purpose of this research was to evaluate the online social attention on the ASF research to inform the research scientists and key stakeholders in the field by reporting the concise information of the most influential articles, social engagement, and impacts of the research. This study employed the altmetrics tool to evaluate the research papers. Bibliographic data of 100 articles were collected from Scopus; altmetric data was collected from the Altmetric.com database and analyzed using SPSS and Tableau. The articles were mainly mentioned on Twitter, followed by News Outlets and significant readers on Mendeley. Pearson correlation coefficients revealed a weak and insignificant correlation between Scopus Citation and Altmetric Attention Score (AAS). Mendeley Readership and Scopus Citation were moderately correlated. However, there was a significant positive correlation between the AAS and Mendeley readership. Using altmetric tools, the paper is the first research to shed light on the characteristics of ASF on social media.

Role of melatonin in attenuation of hemodynamic response to intubation and anesthetic requirements: a randomized, controlled, double-blind study.

BACKGROUND: Melatonin has been studied to have anxiolytic, sedative, and analgesic effects. However, there is limited data on the effect of melatonin in the attenuation of hemodynamic response to intubation. We aimed to study whether preanesthetic oral melatonin attenuates hemodynamic responses to intubation and anesthetic requirements. METHODS: Sixty-four patients scheduled for laparoscopic cholecystectomy were randomized into melatonin or placebo group (n...=...32 each). Melatonin group received two tablets (3...mg each) of melatonin, and the placebo group received two tablets of vitamin D3 120...min before induction. Hemodynamic parameters were recorded during induction and postintubation for 15...minutes. Total induction dose of propofol, total intraoperative fentanyl consumption, and adverse effects of melatonin were also noted. RESULTS: Postintubation rise in heart rate (HR) was less in the melatonin group compared to the placebo group (10.59% vs. 37.08% at 1...min, respectively) (p...<...0.0001). Maximum percentage increase in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) was lesser in melatonin group than placebo group (SBP 9.25% vs. 37.73%, DBP 10.58% vs. 35.51%, MBP 9.99% vs. 36.45% at 1 min postintubation. respectively) (p...<...0.0001). Induction dose of propofol (1.42 mg.kg-1 vs. 2.01...mg.kg-1) and the number of patients requiring additional fentanyl intraoperatively (3 vs. 11) were also significantly reduced in the melatonin group. CONCLUSION: Premedication with 6...mg of oral melatonin resulted in significant attenuation of postintubation rise in HR, SBP, DBP, and MBP. It also reduced the induction dose of propofol, total intraoperative fentanyl consumption without any adverse effects.

Comorbidities and Vaccination Status of COVID-19 All-Cause Mortality at a Tertiary Care Center of Western India.

INTRODUCTION: COVID-19 vaccines have been found to be efficacious for preventing severe disease, yet breakthrough infections and deaths have occurred in a small proportion of vaccinated individuals. This study aimed to describe the vaccination status and comorbidities of COVID-19 all-cause deaths. METHODS: This descriptive observational study was conducted at a tertiary care center in western India. A total of 310, RT-PCR positive COVID-19 deaths, aged 45 years and above irrespective of the cause of death (all-cause mortality), were included in the study. Death after breakthrough infection was defined as death in patient with disease onset after 14 days of the second dose of vaccine. RESULTS: Diabetes was the most common comorbidity found in 17.1% of the deaths, followed by hypertension. Cardiovascular disease and renal disease were other common comorbidities seen in 8.7% and 4.83% deaths respectively. Other less common comorbidities include neurological disorders, HIV, autoimmune disorders. Out of these 310 deaths, 21.4% of patients developed disease within 14 days of the first dose. Death after true breakthrough infection (after 14 days of both doses) was seen in only two patients (0.6%). One of these two patients was aged 60 years and had diabetes, while the other was aged 72 years and had a history of smoking. CONCLUSION: Diabetes and hypertension were the most common comorbidities, indicating a higher risk of mortality among comorbid patients. Only a small proportion of deaths (0.6%) occurred after breakthrough infection beyond 14 days of two doses. COVID-19 vaccines have shown promising efficacy against severe disease, thus high vaccination coverage needs to be achieved to prevent morbidity and mortality.

Epidemiology of Mucormycosis Cases During the Second Wave of COVID-19 in a Tertiary Care Institute in Western Rajasthan, India.

INTRODUCTION: Mucormycosis is a serious but rare fungal infection that showed a sharp surge during the second wave of coronavirus disease 2019 (COVID-19) in India. This study aimed to describe the epidemiological aspects of mucormycosis cases presenting to a tertiary care centre of Western Rajasthan, India, as well as to identify potential risk factors for Mucormycosis. METHODS: This cross-sectional descriptive study included 55 patients admitted with a diagnosis of mucormycosis between May and June, 2021, covering the second wave's post-COVID-19 period. Data was collected using a pre-designed, semi-structured questionnaire and hospital case sheets. RESULTS: The mean age of the patients was 54.4±12.53 years, with a male-to-female ratio of 1.89:1. Of the patients, 49% were obese and had no prior history of diabetes. Most COVID-19 patients (54.6%) were treated at home and did not require oxygen support during their COVID-19 course. The majority (89%) were on steroid medication, which was mainly intravenous (93.8%) and lasted 5-10 days in most patients. Rhinoorbitocerebral mucormycosis was the most common type seen in this setting, with symptoms appearing 15-30 days after the onset of COVID-19 symptoms. During the fungal infection, about 61.8% of patients had random blood sugar readings of more than 140 mg/dl. Mortality occurred in 14.5% of patients with mucormycosis. Mortality was observed to be associated with high BMI, raised glycated haemoglobin (HBA1C), and urban residency. CONCLUSION: Mucormycosis appears to be caused by impaired glycemic control due to pre-existing or new-onset diabetes, which may be exacerbated by unintentional glucocorticoid use. It is necessary to use steroids with caution and maintain care for at least 15-30 days after the onset of COVID-19 symptoms.

Baseline Assessment of Evidence-Based Intrapartum Care Practices in Medical Schools in 3 States in India: A Mixed-Methods Study.

INTRODUCTION: Implementation research with pre- and post-comparison was planned to improve the quality of evidence-based intrapartum care services in Indian medical schools. We present the baseline study results to assess the status of adherence to intrapartum evidence-based practices (IP-EBP) in study schools in 3 states in India and the perception of the faculty. METHODS: A concurrent mixed-methods approach was used to conduct the baseline assessment in 9 medical schools in Rajasthan, Gujarat, and Union Territory from October 2018 to June 2019. IP-EBP among pregnant women in uncomplicated first (n=135), second (n=120), and third stage (n=120) of labor were observed using a predesigned, pretested checklist quantitatively. We conducted in-depth interviews with 33 obstetrics and gynecology faculty to understand their perceptions of intrapartum practices. Quantitative data were analyzed using SPSS (version 22). COM-B (Capability, Opportunity, and Motivation Behavior) model was used to understand the behaviors, and thematic analysis was done for the qualitative data. FINDINGS: Unindicated augmentation of labor was done in 64.4%, fundal pressure applied in 50.8%, episiotomy done in 58.3%, and delivery in lithotomy position was performed in 86.7% of women in labor. CONCLUSIONS: Intrapartum practices that are not recommended were routinely practiced in the study medical schools due to a lack of staff awareness of evidence-based practices and incorrect beliefs about their impact.

Discovery and Optimization of Biaryl Alkyl Ethers as a Novel Class of Highly Selective, CNS-Penetrable, and Orally Active Adaptor Protein-2-Associated Kinase 1 (AAK1) Inhibitors for the Potential Treatment of Neuropathic Pain.

Recent mouse knockout studies identified adapter protein-2-associated kinase 1 (AAK1) as a viable target for treating neuropathic pain. BMS-986176/LX-9211 (4), as a highly selective, CNS-penetrable, and potent AAK1 inhibitor, has advanced into phase II human trials. On exploring the structure-activity relationship (SAR) around this biaryl alkyl ether chemotype, several additional compounds were found to be highly selective and potent AAK1 inhibitors with good druglike properties. Among these, compounds 43 and 58 showed very good efficacy in two neuropathic pain rat models and had excellent CNS penetration and spinal cord target engagement. Both compounds also exhibited favorable physicochemical and oral pharmacokinetic (PK) properties. Compound 58, a central pyridine isomer of BMS-986176/LX-9211 (4), was 4-fold more potent than 4 in vitro and showed lower plasma exposure needed to achieve similar efficacy compared to 4 in the CCI rat model. However, both 43 and 58 showed an inferior preclinical toxicity profile compared to 4.