Parturition of a rear-fanged rainbow water snake (Enhydrisenhydris) involved in snakebite and effects of its envenoming in Nepal.

Based on a specimen preserved in the snakebite treatment center in eastern Nepal, this study aims to analyse brief life history (i.e., litter size, parturition date, habitat preference) of Enhydris enhydris, effects of its envenoming, and anthropogenic threat on its populations. One euthanized gravid female E. enhydris collected alive from eastern Nepal by a snakebite victim was examined. The gravid female gave birth to 23 litters on July 11, 2012. This parturition suggested high reproductive potential. Its bite to a man walking on the road caused no ill-effects. However, the use of tourniquet as a part of prehospital care might be detrimental or be obstacle for in-hospital care of snakebite. The conflicts between E. enhydris and humans at roads and human-activity areas are inevitable across the distribution ranges of this species. The continued anthropogenic impact can threaten its populations. This study finding can be a basis for assessing conservation status and options for its conservation as well as prehospital care and prevention of its bites.

Longitudinal assessment of extreme climate events in Kinnaur district, Himachal Pradesh, north-western Himalaya, India.

It is vital to keep an eye on changes in climatic extremes because they set the stage for current and potential future climate, which usually have a reasonable adverse impact on ecosystems and society. The present study examines the variability and trends in precipitation and temperature across seasons in the Kinnaur district, offering valuable insights into the complex dynamics of the Himalayan climate. Using Climatic Research Unit gridded Time Series (CRU TS) datasets from 1951 to 2021, the study analyzes the data to produce 28 climate indices based on India Meteorological Department (IMD) convention indices and Expert Team on Climate Change Detection and Indices (ETCCDI). Although there may be considerable variation in climate indices in terms of absolute values within different products, there is consensus in both long-term trends and inter-annual variability. Analysis shows that even within a small area, there is variability in the magnitude and direction of historic temperature trends. Initially, the data were subjected to rigorous quality control procedures, which involved identifying anomalies. Statistical analysis like trend analysis, employing Mann-Kendall test and Sen's slope estimator, reveal significant (p < 0.05) increase in consecutive dry days (CDD) at 0.03 days/year and decrease in consecutive wet days (CWD) at 0.02 days/year. Notably, the frequency of heavy precipitation occurrences showed an increasing trend. Changes in precipitation in the Western Himalaya are driven by a complex interplay of orographic effects, monsoonal dynamics, atmospheric circulation patterns, climate change, and localized factors such as topography, atmospheric circulation patterns, moisture sources, land-sea temperature contrasts, and anthropogenic influences. Moreover, in case of temperature indices, there is significant increasing trend observed. Temperature indices indicate a significant annual increase in warm nights (TN90p) at 0.06%/year and warm days (TX90p) at 0.11%/year. Extreme temperature events have been trending upward, with monthly daily maximum temperature (TXx) increasing by 1.5 °C yearly. This study enhances our comprehension of the global warming phenomenon and underscores the importance of acknowledging alterations in the water cycle and their repercussions on hydrologic resources, agriculture, and livelihoods in the cold desert of the northwestern Indian Himalaya.

Experimental investigations on PVA/chitosan and PVA/chitin films for active food packaging using Oxytenanthera abyssinica lignin nanoparticles and its UV-shielding, antimicrobial, and antiradical effects.

This study investigated the effect of adding lignin nanoparticles (LNPs) derived from Oxytenanthera abyssinica via alkali-acid nanoprecipitation method to polyvinyl alcohol/chitosan (PVA/CI) and polyvinyl alcohol/chitin (PVA/CH) films for the active food packaging applications. Adding LNPs at concentrations of 1 % and 3 % improved the films' thermal stability and mechanical properties. The lowest water solubility and moisture content were observed in PVA/CI/LNPs films. LNPs exhibited effective 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activities, with the highest values observed in PVA/CH/LNPS and PVA/CI/LNPS films with values of 87.47 and 88.74 % respectively. The addition of LNPs also improved the UV-blocking abilities of the films. PVA/CH/LNP3 and PVA/CI/LNP3 have the smallest percentage transmission values of 3.34 % and 0.86 % in the UV range. The overall migration of dietary stimulants was lower in PVA/CI/LNPS and PVA/CH/LNPS films compared to PVA film. Antibacterial tests demonstrated the inhibitory capacity of the synthesized biofilms against both gram-positive and negative bacterial species, with the highest inhibitory value of 26 mm. The study suggests that PVA/CH/LNPS and PVA/CI/LNPS films have potential applications as active food packaging materials and can be explored in other potential applications such as drug delivery, tissue engineering, wound healing, and slow-release urea fertilizer development.

Prevention and Treatment of Cardiovascular Diseases with Plant Phytochemicals: A Review.

Cardiovascular diseases (CVDs) are the world's leading killers, accounting for 30% deaths. According to the WHO report, CVDs kill 17.9 million people per year, and there will be 22.2 million deaths from CVD in 2030. The death rates rise as people get older. Regarding gender, the death rate of women by CVD (51%) is higher than that of men (42%). To decrease and prevent CVD, most people rely on traditional medicine originating from the plant (phytochemicals) in addition to or in preference to commercially available drugs to recover from their illness. The CVD therapy efficacy of 92 plants, including 15 terrestrial plants, is examined. Some medicinal plants well known to treat CVD are, Daucus carota, Nerium oleander, Amaranthus Viridis, Ginkgo biloba, Terminalia arjuna, Picrorhiza kurroa, Salvia miltiorrhiza, Tinospora cordifolia, Mucuna pruriens, Hydrocotyle asiatica, Bombax ceiba, and Andrographis paniculate. The active phytochemicals found in these plants are flavonoids, polyphenols, plant sterol, plant sulphur compounds, and terpenoids. A general flavonoid mechanism of action is to prevent low-density lipoprotein oxidation, which promotes vasodilatation. Plant sterols prevent CVD by decreasing cholesterol absorption in the blood. Plant sulphur compound also prevent CVD by activation of nuclear factor-erythroid factor 2-related factor 2 (Nrf2) and inhibition of cholesterol synthesis. Quinone decreases the risk of CVD by increasing ATP production in mitochondria while terpenoids by decreasing atherosclerotic lesion in the aortic valve. Although several physiologically active compounds with recognized biological effects have been found in various plants because of the increased prevalence of CVD, appropriate CVD prevention and treatment measures are required. More research is needed to understand the mechanism and specific plants' phytochemicals responsible for treating CVD.

Effects of Momordica Charantia (Karela/bitterguord) in Type 2 Diabetic Patients Taking Allopathic Drugs: A pilot study.

Background Momordica charantia is evoloving as supplementary therapy in type 2 diabetes mellitus. Animal studies reveal its anti-diabetic and lipid lowering property. However, clinical studies with human subjects are very few. Objective To find out the effects of Momordica charantia supplements on glycemic and lipid profile among type 2 diabetes mellitus patients taking allopathic drugs. Method A comparative study was conducted in internal medicine department of B P Koirala Institute of Health Sciences, Dharan from July 2015 to May 2016 after ethical clearance. Twenty two uncomplicated type-2 diabetes mellitus patients were enrolled. Group A patients were supplemented with allopathic drug (oral anti-diabetic agents) only and Group B with add on treatment of 200 ml juice of Momordica charantia along with allopathic drug daily for ninety days. Fasting, post prandial blood sugar and lipid profile levels were compared between baseline and ninety days post supplementation. Data was collected and entry was done in Statistical Packages for Social Services version 20.0, using independent t test with p < 0.05. Result Add on treatment with 200 ml of Momordica charantia along with anti-diabetic drug daily significantly reduced fasting (p= < 0.0001) and post prandial blood sugar (p < 0.0001). Treatment with anti-diabetic drugs only reduced fasting (p = 0.0008) and post-prandial blood sugar but the reduction was not significant ((p =0.0001). There was improvement in lipid profile by both anti-diabetic drugs alone and Momordica charantia along with anti-diabetic drug, but it was not significant. Conclusion Add on treatment with 200 ml/day juice of Momordica charantia is effective in glycaemic control in type-2 diabetes mellitus patients as compared to the allopathic treatment alone.

Development of the Asia Pacific Consortium on Osteoporosis (APCO) Framework: clinical standards of care for the screening, diagnosis, and management of osteoporosis in the Asia-Pacific region.

Guidelines for doctors managing osteoporosis in the Asia-Pacific region vary widely. We compared 18 guidelines for similarities and differences in five key areas. We then used a structured consensus process to develop clinical standards of care for the diagnosis and management of osteoporosis and for improving the quality of care. PURPOSE: Minimum clinical standards for assessment and management of osteoporosis are needed in the Asia-Pacific (AP) region to inform clinical practice guidelines (CPGs) and to improve osteoporosis care. We present the framework of these clinical standards and describe its development. METHODS: We conducted a structured comparative analysis of existing CPGs in the AP region using a "5IQ" model (identification, investigation, information, intervention, integration, and quality). One-hundred data elements were extracted from each guideline. We then employed a four-round Delphi consensus process to structure the framework, identify key components of guidance, and develop clinical care standards. RESULTS: Eighteen guidelines were included. The 5IQ analysis demonstrated marked heterogeneity, notably in guidance on risk factors, the use of biochemical markers, self-care information for patients, indications for osteoporosis treatment, use of fracture risk assessment tools, and protocols for monitoring treatment. There was minimal guidance on long-term management plans or on strategies and systems for clinical quality improvement. Twenty-nine APCO members participated in the Delphi process, resulting in consensus on 16 clinical standards, with levels of attainment defined for those on identification and investigation of fragility fractures, vertebral fracture assessment, and inclusion of quality metrics in guidelines. CONCLUSION: The 5IQ analysis confirmed previous anecdotal observations of marked heterogeneity of osteoporosis clinical guidelines in the AP region. The Framework provides practical, clear, and feasible recommendations for osteoporosis care and can be adapted for use in other such vastly diverse regions. Implementation of the standards is expected to significantly lessen the global burden of osteoporosis.

Novel use of the Bakri balloon to minimize empty pelvis syndrome following laparoscopic total pelvic exenteration.

AIM: Pelvic exenteration is the only surgical option for locally advanced pelvic malignancies infiltrating the surrounding organs. The resultant pelvic void after the procedure is responsible for a number of complications, collectively termed empty pelvis syndrome (EPS). We aim to show how EPS can be minimized by presenting a case series demonstrating the surgical technique of laparoscopic total pelvic exenteration with bilateral pelvic node dissection along with a novel use of the Bakri balloon. METHOD: This is a case series of three successive patients undergoing laparoscopic total pelvic exenteration for locally advanced primary, nonmetastatic rectal adenocarcinoma over a period of 1 month in a specialized colorectal unit at a tertiary cancer centre. The Bakri balloon was deployed in all three patients and retained for variable time intervals postoperatively. Features of EPS were prospectively documented. RESULTS: In the first patient, the Bakri balloon was completely deflated and removed on postoperative day (POD) 5. The patient developed subacute intestinal obstruction which resolved with conservative management by POD 12. In the second and third patients, the Bakri balloon was deflated in a sequential manner, beginning on POD 8, until it was finally removed on POD 11. Neither of these patients had any abdominal complaints. A postoperative CT scan of both these patients showed the small bowel loops clearly above the pelvic inlet. CONCLUSIONS: The Bakri balloon is a simple, safe and cost-effective method to reduce the complications of EPS following laparoscopic total pelvic exenteration. A prospective study is ongoing to objectively quantify the benefits of this technique.

Efficacy of Isotretinoin and Antihistamine versus Isotretinoin Alone in the Treatment of Moderate to Severe Acne: A Randomised Control Trial.

Background Acne vulgaris has considerable impact on physical and psychological health. Isotretinoin is considered most effective drug available for acne therapy but with limited acceptance because of its adverse effects. Antihistamine inhibits inflammatory mediators, Propionibacterium acne induced itching, reduction of squalene and sebum in sebocyte, reduces anxiety and further lessens hormonal derangement and inhibits mast cell induced fibrosis and scars. Clinical relevance is lacking in the use of antihistamine in the treatment of acne and its potential efficacy needs to be clarified. Objective To evaluate the efficacy and safety of combining isotretinoin and antihistamine compare to isotretinoin alone in patients with moderate to severe acne at week 12. Method One hundred patients with moderate to severe acne were included in this randomised, controlled comparative study. Fifty patients were treated with isotretinoin and 50 patients were treated with additional antihistamine, levocetirizine and assessment was done at baseline, 4, 8 and 12 weeks of treatment. Result At week 12, compared to isotretinoin only group, combination of isotretinoin and levocetirizine group showed more statistically significant decrease in score of global acne grading system (51.0 vs. 38.5%) and acne lesion counts (non-inflammatory lesion: 63.2 vs. 44.5%; inflammatory lesions: 75.9 vs. 62.7%; total lesions: 66.07 vs. 48.7%; all p< 0.05). Flaring up of acne occurred less frequently and adverse effects were more tolerable in levocetirizine group. Conclusion Use of antihistamine with isotretinoin provides synergic effect while minimizing the side effect of isotretinoin and greater clearance of the lesion and scars.

Complementary gene interaction and xenia effect controls the seed coat colour in interspecific cross between Trifolium alexandrinum and T. apertum.

Trifolium alexandrinum (Egyptian clover) is a widely cultivated winter annual fodder. Present work deals with inheritance of the seed coat colour in segregating progenies of the interspecific cross between T. alexandrinum and T. apertum. Although, both the parent species possessed yellow seed coat, the F1 seeds were black coloured in the reciprocal cross (T. apertum × T. alexandrinum). Seeds borne on individual F2 plants and the advancing generations segregated in yellow and black seed coat colour, which confirmed xenia effect. F2 seeds collected from individual F1 plants exhibited nine black and seven yellow segregation ratio. The segregation of the seed coat colour recorded from F3 to F5 generations revealed that yellow seed coat was true breeding (i.e. non-segregating) in this interspecific cross (including the reciprocal crosses). However, the black seeded progenies were either true breeding or segregated in nine black: seven yellow ratio or three black: one yellow ratio suggesting a complementary gene interaction or duplicate recessive epistasis. It indicated that the seed coat colour is controlled by complementary gene interaction along with xenia effect in interspecific crosses between T. alexandrinum and T. apertum. Occurrence of the complementary genes across the species could suggest T. apertum to be the progenitor of T. alexandrinum. Inheritance of seed coat colour in reference to its importance in Egyptian clover breeding is also discussed.

Bacillus clausii UBBC-07 reduces severity of diarrhoea in children under 5 years of age: a double blind placebo controlled study.

Acute diarrhoea is one of the leading causes of mortality in infants and young children. Evidence suggests that probiotics can reduce diarrhoea duration. As the effects of probiotics are strain specific, the effect of Bacillus clausii UBBC-07, a safe probiotic strain in the treatment of acute diarrhoea in children was studied. The double blind, randomised, placebo-controlled, parallel group multicentric study was conducted at two outpatient facility sites in Lucknow, India. Children aged six months to five years suffering from acute diarrhoea, were randomly assigned to receive either probiotic (B. clausii UBBC-07) spore suspension or placebo suspension twice daily apart from oral rehydration solution (ORS). The duration of treatment was for five days with a follow -up until the 10th day. Outcomes evaluated were duration and frequency of diarrhoea, consistency of stool, fever and vomiting. The duration of diarrhoea was significantly shorter (P<0.05) in patients who received B. clausii suspension (75.66±13.23 h) than in placebo treated group (81.6±15.43 h). The average daily number of stools (frequency) was 8.67±3.42 at baseline in treatment group receiving B. clausii and 8.53±3.19 in placebo group. By day 4, there was a significant reduction (P<0.01) in frequency of stools in probiotic treated group (3.46±0.66) as compared to placebo group (4.57±1.59). Improvement in stool consistency was also observed in the probiotic treated group as compared to the placebo group. There was no effect on vomiting and duration of fever. B. clausii UBBC-07 significantly decreased the duration and frequency of diarrhoea as compared to placebo indicating effectiveness of strain in the treatment of acute diarrhoea in children and could be a safe alternative to antibiotics.

Acute Primary Tuberculous Ulcer of Glans Penis.

Acute primary tuberculous ulcer of glans penis is a rare entity even in the endemic region. We present a 55 year old male with multiple undermined ulcers for short duration of 4 weeks with raised erythrocyte sedimentation rate, negative Mantoux test and histopathology revealed a diagnosis of tuberculous ulcer which responded well to antitubercular therapy.

Strong Purcell Effect on a Neutral Atom Trapped in an Open Fiber Cavity.

We observe a sixfold Purcell broadening of the D_{2} line of an optically trapped ^{87}Rb atom strongly coupled to a fiber cavity. Under external illumination by a near-resonant laser, up to 90% of the atom's fluorescence is emitted into the resonant cavity mode. The sub-Poissonian statistics of the cavity output and the Purcell enhancement of the atomic decay rate are confirmed by the observation of a strongly narrowed antibunching dip in the photon autocorrelation function. The photon leakage through the higher-transmission mirror of the single-sided resonator is the dominant contribution to the field decay (κ≈2π×50 MHz), thus offering a high-bandwidth, fiber-coupled channel for photonic interfaces such as quantum memories and single-photon sources.