A STUDY ON FACTORS AFFECTING THE INTENTIONS TO ACCEPT TELEMEDICINE SERVICES IN INDIA DURING COVID-19 PANDEMIC.

The goal of the current study is to comprehend the factors that influence a decision to use telemedicine for healthcare. India saw a massive surge in the use of telemedicine services in the year 2020-21, with teleconsultations increasing by almost 300%. Lockdowns and Covid-19 limitations sped up the introduction of telemedicine services. The advantages of telemedicine healthcare services, however, have not yet reached the vast majority of the population. A pilot survey is done, and a study framework is suggested, to better understand the factors that influence people's decisions to use telemedicine healthcare services. The following variables are taken into account for the study: personal norms, telemedicine use expectation, knowledge, telemedicine usage, initial satisfaction, and covid phobia -19 (CP-19). The suggested framework is then put to the test using SEM (Structural equation modelling), and a good model fit was found. Policymakers and marketers can use the findings to increase the acceptance of telemedicine healthcare services among the general public in order to promote convenience, accessibility, and healthy living.

Transverse dislocation of the elbow with ipsilateral shaft of radius fracture in an adult.

STUDY DESIGN: A report of a rare case of transverse dislocation of the elbow associated with fracture of the shaft of the ipsilateral radius. OBJECTIVE: To describe a rare variety of elbow dislocation associated with radial shaft fracture. INTRODUCTION: Transverse dislocation of the elbow is a rare injury and most of the cases have been described in pediatric patients. Association of this injury with fracture of forearm bones is rare. We describe a case of transverse dislocation of the elbow associated with a fracture of the ipsilateral shaft of the radius in an adult. MATERIAL AND METHODS: A 21-year-old male patient sustained trauma to his left upper limb in a traffic accident. Radiographic evaluation revealed transverse dislocation of the elbow and fracture of the shaft of the ipsilateral radius. Closed reduction of the elbow dislocation was carried out followed by open reduction and internal fixation of the fracture. RESULTS: Eight months after trauma, the patient is asymptomatic with complete range of motion and no instability. Radiographs show a well-healed fracture and congruent elbow joint. CONCLUSION: To the best of our knowledge, this is first case of transverse dislocation of the elbow with an ipsilateral radial shaft fracture in an adult. Closed reduction of such dislocations is usually achievable, though open reduction may be required in some case.

A Geminivirus-Satellite Complex is Associated with Leaf Deformity of Mentha (Mint) Plants in Punjab.

A widespread leaf deformity disease of mentha (mint), accompanied by whiteflies, the vectors of begomoviruses, was observed in Punjab in the last few years. The presence of begomovirus was indicated by DNA dot-blot analysis using the conserved coat protein and replication-associated protein genes of another begomovirus, Sri Lankan cassava mosaic virus (SLCMV). A DNA fragment (2.0 kb), representing a partial genomic DNA of a begomovirus, amplified from the symptomatic mentha leaves was used to design end-primers and further amplify an additional 0.9 kb fragment, representing the remaining portion of the resident viral DNA. The two sequences, assembled together (2.7 kb), showed that they represented the complete sequence of an isolate of Tomato leaf curl Karnataka virus (ToLCKV) DNA. Using universal betasatellite primers, a 1.4 kb fragment was amplified from the same sample. This cloned DNA fragment showed complete sequence identity with the previously reported Cotton leaf curl Multan betasatellite (CLCuMB). Majority of the symptomatic mentha leaf samples, collected from four districts of Punjab, showed cross-hybridization in DNA dot-blot using cloned SLCMV and CLCuMB DNA, indicating the presence of one or more begomoviruses related to SLCMV and the betasatellite, CLCuMB. The begomovirus and betasatellite could be mechanically transmitted to Nicotiana benthamiana. Whitefly transmission of the resident begomovirus could also be demonstrated on mentha. The evidence indicates the association of ToLCKV and CLCuMB, a hitherto new combination of a begomovirus and a betasatellite associated with a leaf deformity disease in mentha in Punjab.

Somatic embryogenesis and plant regeneration from cell suspension and tissue cultures of mature himalayan poplar (Populus ciliata).

Somatic embryogenesis and plantlet formation were obtained from callus and cell suspension cultures of 40-year- old Himalayan Poplar (Populus ciliata Wall ex Royle). Callus and cell suspensions were obtained by transfer of inoculum of semiorganized leaf cultures, which were maintained on Murashige and Skoog (MS) medium supplemented with benzylaminopurine (BAP), to MS with 2,4-dichlorophenoxyacetic acid (2,4-D). Reduction of 2,4-D concentration during subsequent subculture of cell suspensions resulted in the formation of embryoids. These embryoids developed further only after being transferred to agar-based MS medium supplemented with BAP and naphthalene acetic acid. Loss of embryogenic potential was observed in cell suspensions after 6 subcultures. However, callus cultures retained the embryogenic potential even after repeated subcultures for more than a year. Plantlets could be successfully hardened and grown in natural outdoor conditions.

The human factor in development.

PIP: 3 approaches to the determinants of development and socio-economic change are found in current literature. 1 approach stresses the importance of individual's attitudes, values and beliefs as a precondition to development while a second approach emphasizes a country's socio-political structure. A third approach maintains the crucial factor in development is the resource base which allows the political system to provide incentives and opportunities to people. Studies indicate that when socio-political structure and resource base is held constant the human factor accounts for significant variation in development change. Inkels, for example, concluded after conducting surveys in 6 nations that psychological characteristics like acceptance of new ideas and a faith in science and technology are common to persons in modern societies irrespective of cultural differences.^ieng

Pulmonary involvement in adult-onset Still's disease.

Adult-onset Still's disease (AOSD) is a rare splenic disorder with an unknown cause. It is not uncommon for AOSD to involve other organs, such as the liver; the kidney; the bone marrow; and, less often, the lungs. In this review, we discuss the pulmonary complications of AOSD. Pulmonary involvement in AOSD usually consists of pleural effusion or transient pulmonary infiltrates, but it may become life threatening if it progresses to the adult respiratory distress syndrome. Chronic conditions, such as restrictive lung disease, have also been reported in patients with AOSD. The only treatment currently available is high-dose steroids, although other agents, such as intravenous immunoglobulin, cyclophosphamide, and azathioprine, have been tried with some success.

Interstitial lung disease in systemic lupus erythematosus.

Systemic lupus erythematosis (SLE) is a heterogenous disease of unknown etiology. It is not uncommon to see pleuropulmonary involvement in isolation or along with the involvement of other organ systems in SLE. Pulmonary manifestations of SLE can involve the pleura, lung parenchyma, airways, pulmonary vasculature, and the respiratory muscles. In this review we discuss two important pulmonary manifestations of SLE: acute lupus pneumonitis and diffuse interstitial lung disease. These two conditions have a major impact on the mortality and morbidity of patients with SLE and it is essential to recognize and treat them appropriately. High-resolution computed tomographic scans of the chest and pulmonary function tests help to establish a diagnosis and aid long-term follow-up of these patients. High-dose corticosteroids are the mainstay of treatment for the two conditions, although other agents such as cyclophosphamide, azathioprine, intravenous gamma globulin, and plasmapheresis have been used with varying degrees of success.

Interstitial lung disease in systemic sclerosis.

Systemic sclerosis is a multisystem disorder of unknown etiology and involves organ systems such as the skin, peripheral vasculature, gastrointestinal tract, kidney, heart, and the lungs is observed quite frequently. In this review, we discuss the development of interstitial lung disease, one of the common pulmonary manifestations and a major cause of mortality and morbidity in this disorder. It is, however, under-recognized and diagnosed late in the course of the illness. Early use of pulmonary function tests followed by bronchoalveolar lavage in appropriate cases helps in early diagnosis. Recent studies emphasize the role of various profibrotic and inflammatory cytokines both locally in the lung and systemically in its pathogenesis. Treatment is helpful in arresting the progression if initiated early. Cyclophosphamide with or without corticosteroids given orally or as intravenous pulse may be helpful.

Elevated serum B lymphocyte stimulator levels in patients with systemic immune-based rheumatic diseases.

OBJECTIVE: To determine whether serum levels of B lymphocyte stimulator (BLyS) are elevated in patients with systemic immune-based rheumatic diseases and correlate with serum Ig levels and/or autoantibody titers. METHODS: Sera from 185 patients with various systemic immune-based rheumatic diseases (95 with systemic lupus erythematosus [SLE], 67 with rheumatoid arthritis [RA], 23 with other diagnoses) were assayed for BLyS and Ig. In 7 patients who required arthrocentesis of a swollen knee, coincident serum and synovial fluid samples were assayed for BLyS. Medical charts were retrospectively reviewed for elevated autoantibody titers and proteinuria within a 1-month period before or after collection of sera for BLyS and Ig determination. Sera concurrently collected from 48 normal healthy subjects served as controls. RESULTS: Serum BLyS levels were elevated in 38 of 185 patients (21%) and correlated significantly with serum IgG levels. Serum BLyS levels did not correlate with the patients' age, sex, race, or medications, but correlated positively with anti-double-stranded DNA antibody titers among SLE patients and with rheumatoid factor titers among seropositive RA patients. In contrast, serum BLyS levels correlated inversely with nephrotic-range proteinuria among SLE patients. In every case tested, BLyS levels in clinically inflamed synovial fluids were greater than those in simultaneously obtained sera. CONCLUSION: BLyS may be an important factor in driving polyclonal hypergammaglobulinemia and elevated autoantibody titers in patients with systemic immune-based rheumatic diseases. Local production of BLyS in the joints may contribute to joint pathology. Patients with elevated serum BLyS levels may be ideal candidates for therapeutic targeting of BLyS.

Inverse association between circulating APRIL levels and serological and clinical disease activity in patients with systemic lupus erythematosus.

OBJECTIVE: To assess longitudinal expression of a proliferation-inducing ligand (APRIL) in patients with systemic lupus erythematosus (SLE) and its correlation with B lymphocyte stimulator (BLyS) expression, serum anti-dsDNA titres, and clinical disease activity. METHODS: Sixty eight patients with SLE were longitudinally followed up for a median of 369 days. At each visit the physician assessed disease activity by SLEDAI, and blood was collected for determination of serum APRIL and BLyS levels and of blood APRIL and BLyS mRNA levels. Fifteen normal control subjects underwent similar laboratory evaluation. RESULTS: Dysregulation of APRIL was not as great as that of BLyS. Changes in serum levels of APRIL and BLyS over time were usually discordant, whereas blood levels of APRIL and BLyS mRNA strongly paralleled each other. Serum APRIL levels modestly, but significantly, inversely correlated with serum anti-dsDNA titres in anti-dsDNA positive patients analysed in aggregate. Moreover, serum APRIL levels modestly, but significantly, inversely correlated with clinical disease activity in all patients analysed in aggregate. CONCLUSION: Serum levels of APRIL and BLyS are differentially regulated. APRIL may serve as a down modulator of serological and/or clinical autoimmunity in patients with SLE. This may have important ramifications for BLyS targeted treatment, and it remains to be determined whether agents which neutralise only BLyS will be preferable to agents which neutralise both BLyS and APRIL.