Total Synthesis of Vibrio Cholerae O43 Tetrasaccharide Repeating Unit.

Vibrio cholerae is a pathogen responsible for the deadly pandemic - cholera. The glycans present on the surface of various strains of V. cholerae are considered as potential vaccine candidates. The tetrasaccharide repeating unit (RU) of V. cholerae O43 is decorated with less-explored rare deoxy amino sugars like d-quinosamine and d-viosamine, along with a rare amino acid, N-acetyl-l-allothreonine. Herein, we report a detailed account of the total synthesis of V. cholerae O43 tetrasaccharide RU. In our earlier attempt, while a one-pot assembly of trisaccharide was successful, the final coupling with a fully functionalized d-viosamine donor was low yielding. The successful route involved employing the Fmoc-protected d-viosamine building block as a donor and a late-stage amide bond formation of the tetrasaccharide.

Total Synthesis of a Structurally Complex Tetrasaccharide Repeating Unit of Vibrio cholerae O43.

Herein we report the first total synthesis of a densely functionalized tetrasaccharide repeating unit of Vibrio cholerae O43, which contains rare deoxy amino sugars d-quinovosamine and d-viosamine attached with the rare amino acid N-acetyl-l-allothreonine. Synthesis of orthogonally protected rare sugars and unnatural amino acid building blocks, stereoselective construction of three consecutive 1,2-cis glycosidic linkages, amide coupling, and the presence of five nitrogen atoms dispersed over four sugar units as well as the carboxylic acid functionality make the total synthesis a formidable task.

A Systematic Review and Meta-analysis of Prevalence of Epilepsy, Dementia, Headache, and Parkinson Disease in India.

BACKGROUND: There are wide variations reported in the prevalence rates of common neurological disorders in India leading to huge treatment gap. There is no comprehensive systematic review reporting prevalence of common neurological conditions affecting Indians which is essential for developing and aligning health services to meet patient care. OBJECTIVES: The aim of this study was to perform a systematic review and meta-analysis of prevalence of epilepsy, dementia, headache, and Parkinson's disease (PD) in India from 1980 to 2019. METHODS AND MATERIALS: We performed a bibliographic systematic search in PubMed and Google Scholar along with manual search for peer-reviewed cross-sectional studies and community-based surveys reporting prevalence of epilepsy, dementia, headache, and PD in India from January 1980 to July 2019. Meta-analysis was performed adopting a random-effects model using "Metafor" package in R. RESULTS: The systematic review and meta-analysis included 50 studies [epilepsy (n = 22), dementia (n = 19), headache (n = 6), and PD (n = 3)] including a total of 179,1541 participants of which 5,890 were diagnosed with epilepsy, 1,843 with dementia, 914 with headache, and 121 were diagnosed with PD. The pooled prevalence of epilepsy was 4.7 per 1,000 population (95% CI: 3.8-5.6) with high heterogeneity (P < 0.01, I2 = 98%). The prevalence of dementia was found to be 33.7 per 1,000 population (95% CI: 19.4-49.8) (P = 0, I2 = 100%). The pooled prevalence of headache and PD were found to be 438.8 per 1,000 population (95% CI: 287.6-602.3) (P < 0.0001, I2 = 97.99%), and 0.8 per 1,000 population (95%CI: 0.4-1.3) (P < 0.01, I2 = 95%), respectively. CONCLUSIONS: The findings could be used for appropriate policy measures and targeted treatments for addressing these conditions.

COVID-19 infection: Disease detection and mobile technology.

BACKGROUND: A pneumonia outbreak of unknown etiology took place in Wuhan, Hubei province, China and spread quickly worldwide in December 2019. Chinese Center for Disease Control and Prevention identified a novel beta-coronavirus called 2019-nCoV, now officially known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) that is responsible for the pandemic. The coronavirus COVID-19 affected 215 countries and territories around the world and more than 99 hundred thousand people at present (Nature Nanotechnology, 2020). At present, there are no specific vaccines or treatments available for COVID-19. However, there are many ongoing clinical trials evaluating potential treatments. At this time the experts recommend precautions such as social distancing, hand washing, and wearing face masks to reduce disease transmission. This review article aims to improve the readers' awareness towards the important role of mobile technology for SARS-CoV-2. METHODOLOGY: To achieve this objective, we performed a COVID-19 literature review from various sources that include data from the published articles as well as World Health Organization reports on coronavirus disease and how mobile technology is useful to fight against this disease. RESULTS: Mobile technology can be helpful in mapping disease spread and provides an easy way to provide awareness that promotes safety and adoption of necessary precautions to mitigate and stop community transmission. CONCLUSION: The spread rate of COVID-19 is very high and until now no vaccines are available to control this disease. To this end we should leverage other avenues such as digital technologies to protect ourselves from this disease. Mobile technology such as smartphones are playing an important role in this pandemic, by launching apps to track coronavirus infected people. These apps are very easy to use and provide self-isolation guidelines as well as other safety tips.

Frontal assessment battery in Parkinson's disease: A study on 170 patients.

BACKGROUND: Frontal assessment battery (FAB) was devised as a specific study design to assess frontal lobe dysfunction. Since Parkinson's disease (PD) is often associated with cognitive and other higher mental function complications, FAB test has been carried out by a number of workers to assess the integrity of the frontal lobe. On the other hand, the other frequently conducted test, performed in order to evaluate the mental status, is the Mini Mental State examination of Folstein (MMSE), but its reliability has been questioned in PD, since it does not assess the functions of the frontal lobe alone. MATERIAL AND METHODS: The present study was undertaken in order to assess the suitability of application of the FAB test in Indian patients and to perform its comparative analysis with the MMSE scale. RESULTS AND CONCLUSIONS: It was observed that the FAB test correlated with the age and the level of education of the patient. The results also correlated with that of the MMSE study, in spite of the fact that the latter is not considered to be a test which can assess exclusively the status of the frontal lobe. To the best of our knowledge, this is first study undertaken in India in this regard.

Drug safety monitoring in patients of movement disorders of a tertiary care hospital.

BACKGROUND: Movement disorders (MD) are neurological conditions that affect the speed, fluency, quality, and ease of movement and commonly include Parkinson's disease, tremor and dystonias. Drugs are important causes of MD, and the incidence and prevalence of such disorders are possibly underappreciated because of the lack of recognition. OBJECTIVES: To assess the incidence of all adverse drug reactions (ADRs) and estimate the prevalence of drug-induced MD among patients attending the clinic. MATERIALS AND METHODS: This prospective observational study was conducted at an outpatient referral MD clinic of a tertiary care hospital for 1 year. The demographic data, drug intake, diagnosis, and ADRs experienced by the subjects were recorded. Causality assessment was done by Naranjo's scale. RESULTS: Incidence of ADR among patients who attended this clinic was 19.7% (151 out of 768 patients experienced at least one ADR). A total of 299 ADRs were detected out of which 30.8% were gastrointestinal, 28.4% psychiatric, and 26% MD effects. The commonly implicated suspect drugs were levodopa (37.8%) and trihexyphenidyl (25.1%). The prevalence of drug-induced MD was 10.15% and drug-induced dyskinesias and dystonias were the most common. CONCLUSION: MDs are clinically important neurological disorders which are often caused by drugs and interestingly drugs used for its management are also associated with high incidence of ADRs. Hence these ADRs should be carefully monitored.

Is Parkinson's disease a homogeneous disorder--what is the burden of Parkinson's disease in India.

Movement disorders are common neurological illnesses among the elderly. These include essential tremor, Perkinsonian disorders and chorea of different aetiologies. Parkinsonian disorders can be divided into two major groups of disorders--classical idiopathic Parkinson's disease and Parkinson plus syndrome. The most common and important cause of Parkinsonism is idiopathic Parkinson's disease. Idiopathic Parkinson's disease is most confidently clinically diagnosed if we follow the United Kingdom Parkinson's Disease Society Brain Bank Diagnostic Criteria for Parkinson's disease. The most common degnerative diseases, which minic idiopathic Parkinson's disease are collectively called Parkinson plus syndrome. The most important diseases comprising Parkinson plus syndrome are: progressive supranuclear palsy, multiple system atrophy, cortical-basal ganglionic degneration, diffuse Lewy body disease and Parkinson-dementia-ALS complex. In India the prevalence of Parkinson's disease varied markedly from one study to another. The prevalence rate is high among the urban Parsi community of Mumbai. Incidence and prevalence of Parkinson's disease increase with increasing age. Some risk factors for Parkinson's disease have been narrated briefly. As the number of cases of Parkinsonism is likely to increase along with increasing population, the general practitioners or consultant physicans should have to play a greater role referring the cases to attend neurologists or movement disorder clinic early.