How Is It Possible to Treat Diseases Without Medicine?: A Qualitative Study on the Attitude and Perceived Benefits of Yoga and Naturopathy Among Patients Admitted at an Inpatient Hospital.

Background: Yoga and naturopathy (Y&N) is a system of medicine primarily focusing on restoration of health and well-being. Objective of this study is to understand the knowledge, attitude, and perception about Y&N among the inpatients of a government Y&N institution in south India. Methods: Focus group discussion was conducted in eight adult patients aged between 30 and 60 years who took Y&N treatments for a period of 10 days or more. Purposive sampling method was adopted. Oral informed consent was obtained. Results: Knowledge about the Y&N system of medicine was primarily through referral or "word of mouth." Perceived benefits were both physical and psychological. Uniqueness of the hospital as mentioned by participants includes individual attention, tailor-made treatment protocols, and one-to-one care to the needy patients. Conclusion: An integrated approach is very much essential that might bring about better treatment outcomes in patients.

Evaluation of the Difference in the Rate of Canine Retraction Assisted by Piezocision and Discission in Human Subjects: A Preliminary Parallel-Arm Prospective Clinical Study.

Objective: The objective of the study was to evaluate the rate of orthodontic tooth movement assisted by piezocision and discission in extraction cases. Methods: Twelve adults (20-35 years) requiring upper premolar extraction for orthodontic treatment were included in this preliminary parallel-arm clinical study. Participants (randomly allocated) in Groups A and B received piezocision and discision-assisted corticotomy cuts at the premolar extraction site, respectively, contralateral side served as the control. Canine retraction was started bilaterally using closed coil NiTi (Nickel titanium) springs. A schedule of fortnightly activation was followed for 3 months. Stage models were made monthly (M0, M1, M2, M3). Models were scanned using a 3-shape intraoral scanner, and the displacement of the canine was measured bilaterally in the stage models. A self-designed questionnaire was used to assess patients pain and satisfaction levels on a visual analogue scale. Results: The rate of canine retraction at the piezocision site was twice that at the control site in group A (p=0.007). The rate of canine retraction at the dissection site was twice that at the control site in group B (p=0.012). However, there was no significant difference in the rate of retraction between the two surgical techniques. Pain and disturbance were noticed in the discission group at 50 and 67% respectively. Conclusion: Discision is comparable to piezocision for accelerating orthodontic tooth movement. Although dissection can speed orthodontic treatment, it should be used with caution as it could pose technical and clinical difficulties, particularly in the posterior buccal region of the oral cavity.

Assessment of the effect of frequency of low-level laser therapy exposure at different intervals on orthodontic tooth movement - A systematic review and meta-analysis.

OBJECTIVE: To assess the optimal intervals of exposure of low-level LASER therapy (LLLT) that would optimally accelerate orthodontic tooth movement. Second objective was to quantitatively analyze the difference in the time taken for alignment of anterior teeth with and without the application of LASER. MATERIALS AND METHODS: PROSPERO database registry was done (CRD42020196472) and review was conducted based on PRISMA guidelines. A search was systematically conducted in five major electronic databases without restrictions up to June 2020 along with a hand search of selected journals. The quality of evidence was assessed using the Grading of Recommended Assessment, Development, and Evaluation tool, risk of bias using Cochrane risk of bias tool, and meta-analysis was carried out using RevMan 5.4 software. RESULTS: Ten randomized controlled trials which met the inclusion criteria were evaluated and tabulated. A random-effects meta-analysis demonstrated that there is a statistically significant increase in the orthodontic tooth movement when patients were exposed to minimum of four intervals of LLLT in the first month, at P =0.03 by a standard mean difference of 0.46 mm with an overall heterogeneity of I2 = 0% at 95% confidence interval. There was a statistically highly significant reduction in the number of days taken for alignment of anterior teeth with the application of LASER (P <.00001). CONCLUSION: Application of LLLT for minimum of four irradiations in the first month has yielded better results in accelerating orthodontic tooth movement than application of LLLT once a month.

Streptococcus mutans levels in patients who received orthodontic brackets bonded using probiotic impregnated resin composite - a randomized clinical trial.

To evaluate the effect of impregnating an orthodontic resin composite with probiotic bacteria (Lactobacillus rhamnosus GG) on the levels of Streptococcus mutans (S. mutans) in patients undergoing orthodontic treatment. Thirty patients were randomly selected and allotted by block randomization to two groups: an experimental group, who received brackets bonded with probiotic impregnated resin composite and a control group, who received brackets bonded with conventional light cure resin composite. Plaque samples were collected before (ET0 and CT0) and two months (ET1 and CT1) after bonding. Levels of S. mutans were assessed using the colony count method. Two months after bonding of the brackets, the S. mutans levels had decreased with statistical significance in the experimental group (p = 0.001), but not in the control group (p = 0.137). Impregnation of resin composite with probiotic bacteria for the purpose of preventing formation of white spot lesions on enamel holds promise. Long-term evaluation would be necessary to provide confirmatory results.

Foot reflexology for reduction of blood pressure in hypertensive individual: A systematic review.

IMPORTANCE: Hypertension is the modifiable risk factor associated with cardiovascular diseases and all-cause mortality. Foot reflexology has been proposed to reduce the blood pressure for the patients with hypertension but the available evidences are uncertain. OBJECTIVE: We conducted a systematic review and meta-analysis, know the efficacy of foot reflexology on blood pressure reduction in patients with hypertension. DATA SOURCES AND SELECTION: A systematic search of electronic databases such as PubMed, Scopus, ClinicalTrials.gov, Embase, and Cochrane library since inception till January 2022. Randomized controlled trial with foot reflexology as an intervention for lowering blood pressure (BP) in hypertensive patients was included in the study. DATA EXTRACTION AND OUTCOME MEASURES: Data was independently extracted by four authors. Systolic and diastolic blood pressure was the primary outcome measure. Standardized mean difference (SMD) and 95 % confidence interval (CI) were calculated to determine the effect size. RESULTS: The pooled effect of SBP (SMD: -2.70, 95 % of CI: -6.79, 1.39, I2 - 97 %, P < 0.001) and DBP (SMD: -2.12, 95 % of CI: -5.95, 1.71, I2 - 97 %, P < 0.001) changes are not favorable for foot reflexology in terms of reducing blood pressure. CONCLUSION: Findings from the studies showed that foot reflexology interventions were not much effective in the reduction of blood pressure among patients with hypertension.

Unprecedented effect of vitamin D3 on T-cell receptor beta subunit and alpha7 nicotinic acetylcholine receptor expression in a 3-nitropropionic acid induced mouse model of Huntington's disease.

Introduction: 3-NP induction in rodent models has been shown to induce selective neurodegeneration in the striatum followed by the cortex (Brouillet, 2014). However, it remains unclear whether, under such a neurotoxic condition, characterized by neuroinflammation and oxidative stress, the gene expression of the immune resident protein, T-cell receptor beta subunit (TCR-ß), α7 nicotinic acetylcholine receptor (α7 nAChRs), the nuclear factor kappa B (NF-κB), inflammatory cytokines (TNF-α and IL-6), and antioxidants (Cat and GpX4) get modulated on Vitamin D3 (VD) supplementation in the central nervous system. Methods: In the present study, real-time polymerase chain reaction (RT-PCR) was performed to study the expression of respective genes. Male C57BL/6 mice (8-12 weeks) were divided into four groups namely, Group I: Control (saline); Group II: 3-NP induction via i.p (HD); Group III: Vitamin D3 (VD) and Group IV: (HD + VD) (Manjari et al., 2022). Results: On administration of 500IU/kg/day of VD, HD mice showed a significant reduction in the gene expression of the immune receptor, TCR-ß subunit, nuclear factor kappa B (NF-κB), inflammatory cytokines, and key antioxidants, followed by a decrease in the acetylcholinesterase activity. Conclusion: A novel neuroprotective effect of VD in HD is demonstrated by combating the immune receptor, TCR-ß gene expression, antioxidant markers, and inflammatory cytokines. In addition, HD mice on VD administration for 0-15 days showed an enhancement in cholinergic signaling with restoration in α7 nAChRs mRNA and protein expression in the striatum and cortex.

Restorative Action of Vitamin D3 on Motor Dysfunction Through Enhancement of Neurotrophins and Antioxidant Expression in the Striatum.

A number of studies has explored a positive correlation between low levels of serum Vitamin D3 (VD; cholecalciferol) and development of neurodegenerative diseases including Huntington's disease (HD). In the present study, the prophylactic effect of VD on motor dysfunction was studied in an experimental model of HD. An HD-like syndrome was induced in male C57BL/6 mice through an intraperitoneal injection (i.p) of 3-NP for 3 consecutive doses at 12 h interval of time as described previously (Amende et al. 2005). This study investigated thein-vivotherapeutic potential of VD (500 IU/kg/day) supplementation on movement, motor coordination, motor activity and biochemical changes in this HD model. Mice were divided into four groups: Group I: Control (saline); Group II: 3-NP induced HD (HD); Group III: Vitamin D3 (VD) and Group IV: 3-NP induced + post Vitamin D3 injection (HD + VD). All groups of mice were tested for locomotion, gait analysis and rotarod performances over a span of 30-days. VD administration rescued locomotor dysfunction and neuromuscular impairment in HD mice with no change in gait dynamics. In addition, administration of VD to 3-NP treated mice led to a significant enhancement in the expression of key neurotrophic factors including brain-derived neurotrophic factor (BDNF) and nerve-growth factor (NGF), the Vitamin D receptor (VDR), and antioxidant markers (catalases [Cat] and glutathione peroxidase [GpX4]) in the striatum, suggesting a detoxification effect of VD. Altogether, our results show that VD supplementation induces survival signals, diminishes oxidative stress, and reduces movement and motor dysfunction in HD.

Omics Technologies to Enhance Plant Based Functional Foods: An Overview.

Functional foods are natural products of plants that have health benefits beyond necessary nutrition. Functional foods are abundant in fruits, vegetables, spices, beverages and some are found in cereals, millets, pulses and oilseeds. Efforts to identify functional foods in our diet and their beneficial aspects are limited to few crops. Advances in sequencing and availability of different omics technologies have given opportunity to utilize these tools to enhance the functional components of the foods, thus ensuring the nutritional security. Integrated omics approaches including genomics, transcriptomics, proteomics, metabolomics coupled with artificial intelligence and machine learning approaches can be used to improve the crops. This review provides insights into omics studies that are carried out to find the active components and crop improvement by enhancing the functional compounds in different plants including cereals, millets, pulses, oilseeds, fruits, vegetables, spices, beverages and medicinal plants. There is a need to characterize functional foods that are being used in traditional medicines, as well as utilization of this knowledge to improve the staple foods in order to tackle malnutrition and hunger more effectively.

Factors associated with referral for polysomnography in children with Down syndrome.

OBJECTIVES: Children with Down syndrome (DS) are recommended to undergo polysomnography (PSG) by the age of four years due to the high prevalence of obstructive sleep apnea (OSA) in this group, but compliance is incomplete. To further understand referral patterns for PSG in this condition, we aimed to compare demographics, PSG results, OSA severity, behavior, daytime functioning and quality of life (QOL) between children with DS referred for sleep testing and those recruited from the community. STUDY DESIGN: Children 3-19 years with DS was included: 20 referred clinically for assessment of OSA and 24 volunteers from the community. Demographic and anthropometric data, PSG parameters, sleep-related symptoms and QOL, behavior and daytime functioning were compared between groups. RESULTS: OSA severity did not differ between groups: 50% of the clinical and 42% of the community group had moderate/severe OSA. The clinical group had a higher weight z-score, BMI z-score, waist and hip circumference and neck-to-waist ratio. Questionnaire scores for daytime functioning, behavior and QOL were not different between groups. CONCLUSIONS: Despite not being referred for clinical sleep assessment, 42% of children with DS recruited from the community had moderate/severe OSA. There was no difference in the QOL, behavior, daytime functioning and sleep symptoms questionnaires although the clinical group had a higher BMI-Z score and overt signs of obesity. These findings underscore the importance of PSG screening of all children with DS.

Suppressing fatty acid uptake has therapeutic effects in preclinical models of prostate cancer.

Metabolism alterations are hallmarks of cancer, but the involvement of lipid metabolism in disease progression is unclear. We investigated the role of lipid metabolism in prostate cancer using tissue from patients with prostate cancer and patient-derived xenograft mouse models. We showed that fatty acid uptake was increased in human prostate cancer and that these fatty acids were directed toward biomass production. These changes were mediated, at least partly, by the fatty acid transporter CD36, which was associated with aggressive disease. Deleting Cd36 in the prostate of cancer-susceptible Pten-/- mice reduced fatty acid uptake and the abundance of oncogenic signaling lipids and slowed cancer progression. Moreover, CD36 antibody therapy reduced cancer severity in patient-derived xenografts. We further demonstrated cross-talk between fatty acid uptake and de novo lipogenesis and found that dual targeting of these pathways more potently inhibited proliferation of human cancer-derived organoids compared to the single treatments. These findings identify a critical role for CD36-mediated fatty acid uptake in prostate cancer and suggest that targeting fatty acid uptake might be an effective strategy for treating prostate cancer.

Role of FNAC in Hepatic lesions: Risk of track metastases.

BACKGROUND: Liver is one of the most common site of metastases in patients with malignancy and the evaluation of space occupying lesions (SOL) of liver in patients with malignancy is important. Its important to differentiate benign from malignant to take necessary decisions. MATERIALS AND METHODS: We have performed a retrospective analysis of liver SOLs for which fine needle aspiration cytology (FNAC) was done in the year 2011. Risks and benefits associated with FNAC were evaluated. RESULTS: We analyzed 755 patients who underwent FNAC of which 524 patients had secondary metastases to liver, 148 patients had primary hepatocellular carcinoma, 14 cases were benign neoplasms and 53 were nonneoplastic conditions. Histological correlation with FNAC was available in 112 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93%, 90.9%, 98.9%, 58.8%, and 92.8%, respectively. Though there were no incidence of bleeding, two patients developed track metastases following FNAC. One was a case of Hepatocellular carcinoma and the other a case of metastatic breast cancer. CONCLUSION: FNAC was very much useful in our setup where most of the patients could not afford for Computer tomography (CT) scan and was useful in counseling them especially in patients with advanced malignancy where no active cancer directed therapy is required.

Identification of Taxol-producing endophytic fungi isolated from Salacia oblonga through genomic mining approach.

The most promising anti-tumor agent developed in the past three decades is Taxol. It is proven to be effective against many cancers. It is necessary to isolate pharmacologically potent endophytic microbial strains from medicinal plants with special reference to Taxol production. In the current study, endophytic fungi were isolated from the bark of the medicinal plant, Salacia oblonga. The isolated endophytes were identified morphologically, and further characterized by ITS-PCR using genomic DNA samples, later the products were sequenced for identification and phylogenetic linkage mapping. The samples were screened for the potential to produce Taxol or taxanes, employing PCR. The resulted data have been sequenced to confirm the presence of the two genes implicated in Taxol biosynthesis, 10-deacetylbaccatin III-10-O-acetyl transferase (DBAT) and C-13 phenylpropanoid side chain-CoA acyltransferase (BAPT). Seven samples showed the amplicons of DBAT gene and one showed the amplicons of BAPT gene. Sequencing of these products was carried out, of which one sample has revealed sequence homology to the original DBAT gene from Taxus. The present work confirms and substantiates the potential of genomic mining approach to discover novel Taxol-producing endophytic fungi.

Clinical profile and outcome of clinical BCG disease in infants.

OBJECTIVE: To describe the clinical profile, immunological status and outcome of BCG disease in infants. METHODS: All infants with a diagnosis of BCG disease in a period of 17 months were followed up. RESULTS: Among 25 infants with BCG disease; 19 had local/regional involvement and 6 had suspected or confirmed distant/disseminated disease, Mean (range) age of presentation was 3.6 (1.5-9) months. Two of 6 infants with disseminated disease required second-line anti-tubercular treatment. One infant with confirmed disseminated disease had INFg R1 receptor deficiency. There was no mortality. CONCLUSION: Most infants with BCG- related disease have local or regional disease.

Mapping QTLs for plant phenology and production traits using indica rice (Oryza sativa L.) lines adapted to rainfed environment.

Drought is a major abiotic stress limiting rice production and yield stability in rainfed ecosystems. Identifying quantitative trait loci (QTL) for rice yield and yield components under water limited environments will help to develop drought resilient cultivars using marker assisted breeding (MAB) strategy. A total of 232 recombinant inbred lines of IR62266/Norungan were used to map QTLs for plant phenology and production traits under rainfed condition in target population of environments. A total of 79 QTLs for plant phenology and production traits with phenotypic variation ranging from 4.4 to 72.8% were detected under non-stress and drought stress conditions across two locations. Consistent QTLs for phenology and production traits were detected across experiments and water regimes. The QTL region, RM204-RM197-RM217 on chromosome 6 was linked to days to 50% flowering and grain yield per plant under both rainfed and irrigated conditions. The same genomic region, RM585-RM204-RM197 was also linked to harvest index under rainfed condition with positive alleles from Norungan, a local landrace. QTLs for plant production and drought resistance traits co-located near RM585-RM204-RM197-RM217 region on chromosome 6 in several rice genotypes. Thus with further fine mapping, this region may be useful as a candidate QTL for MAB, map-based cloning of genes and functional genomics studies for rainfed rice improvement.

Triple negative breast cancer - our experience and review.

Triple negative breast cancer (TNBC) constitutes 10-25% of patients with breast cancer. TNBC is an aggressive phenotype affecting younger age groups and has poor prognosis. We retrospectively analysed 50 triple negative breast cancer patients attending our outpatient department among 270 breast cancer patients. The incidence of TNBC was 18.5%, and most of them were premenopausal 56% (28/50) with mean age was 46.66 ± 13.87 (Range 28-72 years). Most of them had Invasive ductal cancer 94% (47/50) and were high grade (Grade 3-96%)(48/50). Five patients presented with metastatic disease (2 patients only Skeletal, 1 patient with Skeletal and Lung, 1 patient with Lung and 1 patient with Liver) and 7 patients developed recurrence (all 7 had chest wall recurrence, 3 had supraclavicular lymph node recurrence, 2 had skeletal metastases and 1 had developed brain metastases) during follow up. The mean disease free survival was 15 months (Range 3-58 months) and overall survival was 20.14 months (Range 5-70 months). Fifty six percent (28/50) of patients were premenopausal and mean age of presentation was 46.66 ± 13.87 years (Range 28-72 years). Ten percent (5/50) presented with metastatic disease and 15% (7/45) developed metastases during follow up. Five patients (10%) died during follow up. Hence, Triple negative breast cancer is aggressive, with rapid progression leading to mortality in younger patients.

Fine mapping QTL for drought resistance traits in rice (Oryza sativa L.) using bulk segregant analysis.

Drought stress is a major limitation to rice (Oryza sativa L.) yields and its stability, especially in rainfed conditions. Developing rice cultivars with inherent capacity to withstand drought stress would improve rainfed rice production. Mapping quantitative trait loci (QTLs) linked to drought resistance traits will help to develop rice cultivars suitable for water-limited environments through molecular marker-assisted selection (MAS) strategy. However, QTL mapping is usually carried out by genotyping large number of progenies, which is labour-intensive, time-consuming and cost-ineffective. Bulk segregant analysis (BSA) serves as an affordable strategy for mapping large effect QTLs by genotyping only the extreme phenotypes instead of the entire mapping population. We have previously mapped a QTL linked to leaf rolling and leaf drying in recombinant inbred (RI) lines derived from two locally adapted indica rice ecotypes viz., IR20/Nootripathu using BSA. Fine mapping the QTL will facilitate its application in MAS. BSA was done by bulking DNA of 10 drought-resistant and 12 drought-sensitive RI lines. Out of 343 rice microsatellites markers genotyped, RM8085 co-segregated among the RI lines constituting the respective bulks. RM8085 was mapped in the middle of the QTL region on chromosome 1 previously identified in these RI lines thus reducing the QTL interval from 7.9 to 3.8 cM. Further, the study showed that the region, RM212-RM302-RM8085-RM3825 on chromosome 1, harbours large effect QTLs for drought-resistance traits across several genetic backgrounds in rice. Thus, the QTL may be useful for drought resistance improvement in rice through MAS and map-based cloning.

Recent progress in percutaneous coronary intervention: evolution of the drug-eluting stents, focus on the XIENCE V drug-eluting stent.

Although originally the practice of using balloon catheters proved successful in the short term, the long-term prognosis was less promising because of restenosis, which occurred in >or=30% of patients. This prompted the development of new techniques and mechanical adjuncts, or stents, to maintain lumen patency after balloon angioplasty. Bare metal stents (BMS), the first type of stent used in percutaneous coronary intervention, were designed to address the issues met by balloon angioplasty. BMS reduced the angiographic and clinical restenosis rates in de novo lesions compared to percutaneous transluminal coronary angioplasty alone and decreased the need for emergency coronary artery bypass graft surgery. BMS substantially reduced the incidence of abrupt artery closure, but restenosis still occurred after 6 months in about 20% of cases, necessitating repeat procedures. Drug-eluting stents (DES) improved on the principle of BMS by also delivering drugs locally to inhibit neointimal hyperplasia. DES greatly reduced the incidence of restenosis and resulted in a better safety profile as compared to radiation or systemic drug administration. These advantages and a lower cost compared to surgical interventions make DES an attractive option to treat coronary artery disease. Currently, five DES are available in the USA: the CYPHER sirolimus-eluting stent from Cordis (approved by FDA on 24 April 2003), the TAXUS Express(2) and Liberté paclitaxel-eluting stents from Boston Scientific (approved by FDA on 4 March 2004 and 10 October 2008, respectively) (hereafter TAXUS Express is referred to as TAXUS), the ENDEAVOR zotarolimus-eluting stent from Medtronic (approved by FDA on 1 February 2008), and the XIENCE V everolimus-eluting stent from Abbott Vascular (approved by FDA on 2 July 2008). Following the approval of CYPHER and TAXUS, the clinical data suggested a potential small increase in the rate of stent thrombosis (ST) in DES compared with BMS after implantation. To determine the differences in ST and other rare events between different stents, some modifications have been made to DES clinical trial design, and postmarket surveillance programs have been included to further evaluate the safety and efficacy of each DES. In this review, we will discuss the key clinical outcomes of DES clinical trials, design and key features of the current coronary stents, and major clinical development programs. Postmarket trials, designed to establish long-term safety around ST and other rare clinical events, are also discussed. The future of DES design technologies will also be outlined.