Impact of fibromyalgia severity on patients mood, sleep quality, and quality of life.

Objectives: Fibromyalgia syndrome (FMS) is characterized by persistent widespread pain which greatly impacts the quality of life (QOL). Pain not only limits patients' daily activities but also restricts their social activities further leading to depression, anxiety, and stress. The present cross-sectional study elucidated the association of sleep quality and mood with increasing symptom severity of fibromyalgia and its impact on the QOL of fibromyalgia patients. Materials and Methods: Hundred adult fibromyalgia patients diagnosed by the American College of Rheumatology 2010 criteria were evaluated for: sleep - using the Pittsburgh sleep quality index, QOL by SF-36, pain-visual analog scales (VASs) and global pain scale (GPS), mood-depression, anxiety, stress scale-21, somatic symptoms, anxiety and depression - by patients health questionnaire somatic, anxiety, and depressive symptom scales (PHQ-SADS), and FMS severity was evaluated using fibromyalgia impact questionnaire (FIQR). Results: The mean pain score was 6.80 ± 1.58 on VAS and 54.10 ± 14.33 on GPS. FIQR score was 50.62 ± 13.68, mean sleep quality was poor (9.30 ± 3.88), and depression, anxiety, and stress scores were increased (10.04 ± 4.59, 8.33 ± 4.48, and 10.75 ± 4.66). An increasing trend of depression, anxiety, stress, and somatoform symptoms was observed with an increase in the severity of FMS when patients were compared according to FMS severity scores. Sleep also deteriorated with increasing severity of FMS from 5.66 ± 1.92 in mild FMS to 12.0 ± 3.41 in highly severe FMS patients. The QOL too deteriorated in all the domains with increasing severity. Conclusion: With the increasing severity of fibromyalgia, not only does the pain increase but mood and sleep quality also deteriorate, which further impacts the QOL of FMS patients. Thus, comorbid mood derangements must also be screened and addressed for maximum benefit of the patients.

Steroids in Headache: A Comprehensive Review of Recent Research.

Background: Headache is an extremely common symptom of the general outpatient department and also the headache clinic, with prevalence of 48.9% in the general population. None has ever experienced headache in life time. Headache is seen in 1 patient out of 10 general practitioner (GP) consultations, 1 referral out of 3 is headache in neurology OPD, and 1 in 5 of all emergency medical admissions. Of all headaches, around 98% constitute primary headache: migraine without aura, tension headache, and cluster headache. With advancement in various drug modalities, certain headache forms respond less well to the regular approved medications, and some headaches are complicated by the analgesic itself. Steroids have been tried in many subtypes of headache, especially in primary forms of headache with dysautonomia, headache with trigeminal pathway activation and disinhibition, and in certain medication-culprit headaches. This subgroup of headaches is almost a challenge in an emergency for the headache expert as well. So, we need to assess the role of steroids in less well-responsive headaches. Summary: Current reviewed evidence on the role of steroids in primary headache suggests that steroids have a role in status migrainosus and medication overuse headache when used in the mentioned and monitored manner. Consideration and further exploration of its role in other primary headaches may reveal insight into steroid efficacy as a treatment modality in various subtypes of headache. Key message: Steroids, when used cautiously in specifically selected primary headaches under supervision, proved miraculous where other modalities failed.

Missed Cerebral Venous Thrombosis: A Diagnostic Challenge.

Rates of cerebral venous sinus thrombosis (CVT) misdiagnosis or at times delayed diagnosis and related outcomes have remained underexplore, and also there is less knowledge about the long-term outcome of patients with untreated cerebral venous sinus thrombosis (CVT). Long-term presentations of untreated CVT are rare. We hereby presenting series of four interesting patients of chronic CVT whose diagnosis was missed and how varied chronic presentations of untreated CVT appeared to neurology and how subtle radiologic features helped with correct diagnosis.

Progress in appended calix[4]arene-based receptors for selective recognition of copper ions.

In the past two decades, there has been significant progress in the design and development of synthetic receptors for molecular recognition as they find application in the field of chemical, biological, medical, and environmental sciences. Synthetic receptors based on calix systems appended with fluorogenic and chromogenic groups have gained considerable attention for sensing and recognition of ions and molecules. Copper (Cu2+) is an essential element required in trace amounts in all living organisms to carry out various biological processes. The aim of this review is to summarize advancement in π-conjugated fluorogenic and chromogenic groups appended to calix[4]arene motifs for detection and quantitation of Cu2+ ion. The focus is to present a comprehensive account of extended calix[4]arene systems with different linkers and highlight the unique design and binding characteristics for the recognition and sensing of Cu2+ ions.

Recent Insights into Osimertinib Analogues against EGFR Positive Non-small Cell Lung Cancer.

BACKGROUND: Lung cancer is a highly lethal malignancy with a poor prognosis and the leading cause of mortality worldwide. The development of mutations makes lung cancer treatment more challenging and expensive. Successful identification of epidermal growth factor receptor (EGFR) mutations led to the discovery of various third-generation tyrosine kinase inhibitors. Osimertinib is one of the promising and efficacious third-generation EGFR inhibitors and is mainly employed in the treatment of non-small cell lung cancer. Despite the initial effective response, osimertinib causes resistance in most of the patients after around 10 months of therapy, resulting in disease progression. To mitigate the effect of developed resistance, different osimertinib derivatives have been synthesized and evaluated by numerous research groups across the globe. METHODS: Present article illustrates recent research advancements for the utilization of osimertinib and its derivatives in non-small cell lung cancer (NSCLC). Last seven years literature search has been conducted from PubMed, ScienceDirect, and Google Scholar databases, etc. Result: The present review emphasizes the recent advancements of osimertinib analogues that lead to enhanced antitumor potential and safety profile against non-small cell lung cancer. This manuscript also summarizes the different synthetic schemes involved in the synthesis of osimertinib analogues against EGFR reported by different research groups. CONCLUSION: Anticancer mechanistic insights, analytical prospects, drug interactions, pharmacokinetic considerations, and resistance profile of osimertinib are highlighted in the current manuscript.

Prevalence of white spot lesions in children up to 71 months of age in Gujarat state.

Introduction: The earliest sign of a new carious lesion is the appearance of chalky white spots on the surface of the tooth, indicating an area of demineralization of enamel. At this stage, the demineralization process can be reversed or arrested. This study aimed to determine the prevalence of white spot lesions (WSLs) among children up to 71 months in Gujarat state and to increase awareness among parents about its various preventive measures. Materials and Methods: Oral examination was done using the mouth mirror and tongue depressor. The prevalence of WSL was recorded using the International Caries Detection and Assessment System II coding and WSL index by Gorelick. Results: The overall prevalence of WSL was 31.8% (n = 2025) in Gujarat state. The parents of the participating children explained the various preventive measures to prevent decay followed by diet counseling and toothbrushing techniques. Conclusion: Knowledge of the actual prevalence of WSL will help in the implementation of appropriate and timely preventive measures required to decrease the incidence of early childhood caries in that region.

Recent insights into antibacterial potential of benzothiazole derivatives.

Antimicrobial resistance (AMR) is a worldwide concern among infectious diseases due to increased mortality, morbidity and treatment cost. According to WHO 2019 report, among the 32 antibiotics in the clinical trials, only six were classified as innovative and containing novel moiety. The remaining antibiotics from this list contain previously known moiety (WHO AMR 2019). Therefore, the development of novel antibiotics to control resistance problems is crucial. Benzothiazole derivatives are of great interest due to their wide range of biological activities and medicinal applications. Reported data indicated that benzothiazole derivatives displayed antibacterial activity by inhibiting the dihydroorotase, DNA gyrase, uridine diphosphate-n-acetyl enol pyruvyl glucosamine reductase (MurB), peptide deformylase, aldose reductase, casdihydrofolate reductase, enoyl acyl carrier protein reductase, dialkylglycine decarboxylase, dehydrosqualene synthase, dihydropteroate synthase and tyrosine kinase. The present review analyzed the synthesis, structure-activity relationship (SAR) and mechanism of action studies of benzothiazole derivatives as antibacterial agents reported by various research groups in the last five years (2018-2022). Different patents on the antimicrobial activity of benzothiazole derivatives have also been summarized. The finding of the present review will be beneficial for the researchers in the development of novel antibacterial molecules based on benzothiazole moiety.

Effect of Early Yoga Practice on Post Stroke Cognitive Impairment.

Background: Post-stroke cognitive impairment (PSCI) is a clinical entity that encompasses all types of cognitive impairment following an index stroke. Yoga has been proven to have a beneficial effect not only on cardiovascular risk factors but also on cognition. Hence, this study explored the PSCI spectrum and assessed the effect of yoga on PSCI. Methods: Forty stroke patients were enrolled in each yoga and control arm in this study. After the baseline assessment, control arm was administered standard care (including physiotherapy) while yoga arm received additional yoga intervention. Change in MoCA scores by 2 points in either direction, or FAB scale by 2 points at 6 months was taken as primary outcome, whereas improvement in MRS, CDPSS, CBS, and P300 values were considered as secondary outcomes. Results: Significant improvements were observed in MoCA, FAB, MRS, CPDSS, and CBS scores in both groups after 6 months. However, intergroup comparisons revealed better MoCA (25.5, IQR 22-27) and FAB scores (15.5, IQR 14-17) in yoga group compared to controls (24, IQR20-25.75) and (14, IQR12-15.75). Equivalent improvement was observed in MRS and CBS scores in both groups at 6 months; however, CDPSS score was better in yoga group (p = 0.0008). Both P300 amplitudes and latencies improved in all patients and median P300 amplitudes were significantly better in control group; however, no difference could be appreciated in P300 latencies improvement on intergroup comparisons at follow-up. Conclusion: Study reveals that early yoga intervention in stroke survivors leads to better improvement in cognitive abilities which would further facilitate in early reduction of caregiver burden.

Benzene Sulfonyl Linked Tetrasubstituted Thiacalix[4]arene for Selective and Sensitive Fluorometric Sensing of Sulfosulfuron along with Theoretical Studies.

Herein, we designed two fluorescent tetrasubstituted benzene sulfonyl appended Thiacalix[4]arene receptors named L1 and L2, which sensitively and selectively detect Sulfosulfuron among other herbicides and pesticides. The detection limit (LOD) was found to be 0.21 ppm and 0.35 ppm, and the enhancement constant (Ks) was determined to be 7.07 X 104 M-1 and 5.55 X 104 M-1 for L1 and L2, respectively. Using the non-linear regression method, the association constant was obtained as 2.1 X 104 M-1 and 2.23 X 104 M-1 whereas, the binding ratio was found to be 1:1 for both L1 and L2, respectively. Additionally, the interference studies show the selective nature of receptors for Sulfosulfuron among its sulfonylurea family. To further confirm the interaction mechanism, 1H-NMR spectroscopy, and a computational investigation were carried out, which validates the 1:1 binding ratio. The receptors were found to be recyclable in nature with simple acid-base treatment. This new approach of using supramolecules as fluorescent probes for sensitive and selective detection of herbicides is rare in the literature.

Genome survey sequencing-based SSR marker development and their validation in Dendrocalamus longispathus.

Bamboo is an important genetic resource in India, supporting rural livelihood and industries. Unfortunately, most Indian bamboo taxa are devoid of basic genomic or marker information required to comprehend the genetic processes for further conservation and management. In this study, we perform genome survey sequencing for development of de novo genomic SSRs in Dendrocalamus longispathus, a socioeconomically important bamboo species of northeast India. Using Illumina platform, 69.49 million raw reads were generated and assembled into 1,145,321 contig with GC content 43% and N50 1228 bp. In total, 46,984 microsatellite repeats were mined-out wherein di-nucleotide repeats were most abundant (54.71%) followed by mono- (31.91%) and tri-repeats (9.85%). Overall, AT-rich repeats were predominant in the genome, but GC-rich motifs were more frequent in tri-repeats. Afterwards, 21,596 SSR loci were successfully tagged with the primer pairs, and a subset of 50 were validated through polymerase chain reaction amplification. Of these, 36 SSR loci were successfully amplified, and 16 demonstrated polymorphism. Using 13 polymorphic SSRs, a moderate level of gene diversity (He = 0.480; Ar = 3.52) was recorded in the analysed populations of D. longispathus. Despite the high gene flow (Nm = 4.928) and low genetic differentiation (FST = 0.119), severe inbreeding (FIS = 0.407) was detected. Further, genetic clustering and STRUCTURE analysis revealed that the entire genetic variability is captured under two major gene pools. Conclusively, we present a comprehensive set of novel SSR markers in D. longispathus as well as other taxa of tropical woody bamboos.

Neuroborreliosis: Unusual clinical presentation and imaging features.

Lyme disease is a tick-borne infectious disease caused by Borrelia burgdorferi which causes a multi-organ involvement. It is endemic in North America and Europe, but not very commonly seen in India. Neurological manifestations (Lyme's Neuroborreliosis,) can occur in both the early and late disseminated stages, and the classic triad consists of aseptic meningitis, painful radiculoneuritis, and cranial neuropathy. If untreated, it can be fatal and may lead to significant morbidity. We report a case with neuroborreliosis who developed acute onset and rapidly progressive bilateral vision loss, and we also report characteristic features on neuroimaging, including a characteristic "rounded M sign." This unusual presentation, along with the characteristic imaging features, should be borne in mind to avoid misdiagnosis.

CTV Based Sensor for the Rapid Detection of Nitro Toluene With Computational Studies and Molecular Modelling.

A new tri-naphthoylated Cyclotriveratrylene molecule has been synthesized for the rapid and sensitive detection of 4-nitrotoluene (4-NT) among various nitro aromatic compounds (NACs) by using a spectrofluorimetric method. The newly derrivatized cyclotriveratrylene compound is successfully confirmed by using the available techniques of 1H-NMR, 13CNMR, and ESI-MS. This synthesised molecule is 1NC-CTV (1-Naptholy Chloride-Cyclotriveratrylene). Strong quenching in the fluorescence intensity of 1NC-CTV was observed upon the addition of 4-NT. Further quantum yield studies were carried out and by using the stern volmer it was concluded that the fluorescence quenching mechanism is dynamic or static. The molecule 1NC-CTV was further studied with the help of computational methods such as molecular docking to study the binding interactions and properties of the molecule.

Nematode community structure along elevation gradient in high altitude vegetation cover of Gangotri National Park (Uttarakhand), India.

The study was undertaken to understand the dynamics of soil nematode communities association along elevation gradient and associated variables in high-altitude regions of Western Himalaya. The diversity and distribution pattern of soil nematodes were investigated at four elevation ranges (Elv1, Elv2, Elv3, and Elv4 each of 500 m class) along altitudinal gradient (3000-5000 m). The nematode community comprised 58 genera of which 37 genera showed sensitivity towards altitudinal variation and the community structure also varied among elevation classes. It was found that elevation significantly affect the nematodes trophic group, diversity composition, and the nematode indices. Nematode generic richness and evenness index indicated a relatively low biodiversity of soil nematodes is supported at higher altitudes. Moreover, maturity indices reflected lower sustenance of k-strategic nematodes at higher elevations. Structure index depicted fewer connections in the soil food web at higher elevations. Nematode faunal profile showed low nutrient and low disturbance in the region. Carbon footprint of the whole nematode assemblage declined along the elevation. Overall substantial differences in the nematode composition, abundance, trophic structure, and contribution to belowground carbon cycling were observed with change in elevation. These findings could be utilized as useful tool in the long-term monitoring and to understand the region's soil health.

Predictors of Stroke Subtype and Severity in Patients of a Tertiary Care Hospital, Dehradun.

CONTEXT: Stroke caused 6.7 million deaths worldwide in 2013. In India, the cumulated incidence of stroke was 105-152/100,000 persons per year in last decade. Dearth of data on predictors of stroke subtype and severity in India lead to this study. AIMS: (1) To categorize presenting stroke patients by subtype and severity. (2) To establish association of risk factors with above. (3) To predict subtype and severity by risk factors. SETTINGS AND DESIGN: Hospital-based cross-sectional analytic, retrospective study. SUBJECTS AND METHODS: A predesigned, pretested, semi-structured questionnaire with standard tool (National Institute of Health Stroke Scale Score), informed consent after prior approval of institutional ethics and research committees. STATISTICAL ANALYSIS USED: Percentages, proportions, Chi-square trends, linear regression, independent t-test, and analysis of variance (ANOVA). RESULTS: Mean age of 102 patients was 62.1 (±12.8 years). Stroke subtype associated with socioeconomic status (χ2 = 6.38775, P = 0.0115) and stroke severity (χ2 = 18.98, P = 0) and stroke severity associated with stroke subtype (χ2 = 9.79366, P = 0.0018). Stroke subtype could be predicted by stroke severity and stroke severity by subtype, sex, and dyslipidemia (regression models). Independent t-test revealed excessive alcohol intake was a significant predictor and one-way ANOVA revealed education was a significant predictor of severe stroke. CONCLUSIONS: Stroke subtype is significantly associated with higher socioeconomic status and severe stroke. Stroke severity is significantly associated with hemorrhagic stroke. Stroke subtype, sex, dyslipidemia, alcohol intake, and education may act as predictors of stroke severity.

Stuttering frequency and severity in Kannada-English balanced bilingual adults.

There is limited research concerning the nature of stuttering in balanced bilinguals. Hence, the aim of this study was to compare aspects of stuttering between two languages in balanced bilinguals who stutter (BWS). Eighteen adult Kannada-English BWS participated in the study, with Kannada as the first language (L1) and English as the second language (L2). As indicated by online language proficiency test results, all the participants were highly proficient balanced bilinguals. Audio-video recordings were done in both the languages across three tasks (reading, spontaneous speech, and telephonic conversation) and two situations (within the clinic and beyond clinic). They were analyzed for percentage of syllables stuttered (%SS) and perceptual severity rating scores (SEV). Results suggest significantly higher %SS in English compared to Kannada for both spontaneous speech (SS) and telephonic conversation (TC) tasks. SEV scores indicated significantly higher scores for English compared to Kannada for TC task. A significant positive correlation was also found across the %SS-SEV pair. Results highlight variability in the nature of stuttering in balanced BWS. Apart from the other factors, differences in the linguistic structure may be one of the reasons for differences in stuttering.

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL).

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is one of the most common heritable cerebral arteriopathy. Responsible for stroke and dementia in young adults and can be diagnosed by skin biopsy. We report a case of a 42 year old man with recurrent transient ischemic attacks (TIA). A detailed neurologic examination revealed poor score in MMSE (20/30) defect mainly seen in recall, repetitions. Executive dysfunction, memory and language impairment were also found. Motor system examination revealed grade 3 power in right upper and lower limb with more severe weakness of distal muscles in form of grip weakness and slippage of chappals. Neuroimaging and genetic analysis for Notch-3 confirmed the diagnosis. Imaging studies suggested greater involvement in the temporal and frontal lobes along with deep areas of the brain.

Spectrum of Cerebral Venous Thrombosis in Uttarakhand.

BACKGROUND: CVT is an uncommon but important cause of stroke that is often misdiagnosed delaying its treatment. High suspicion is essential in early recognition and treatment. OBJECTIVE: To study the clinical features and etiology of patients with Cerebral Venous Thrombosis (CVT) and relation between septic and non septic CVT if any. PATIENTS AND METHODS: A prospective study was done in SMIH that enrolled 40 patients of CVT in 2 years duration (Jan 2014 to Dec 2015). The patients were diagnosed as CVT according to Magnetic Resonance Venogram (MRV) and clinical status. RESULTS: Forty (40) patients of CVT were enrolled during 2 years period, most were females (22/30) and aged between 18-50 years (mean age 30.2+4.9). Most common presentation was headache followed by seizures and focal deficit. Other symptoms encountered were cranial nerve palsies, meningeal signs, papilloedema. Most common headache type was tension type headache. Most common cranial nerve involvement was abduscens nerve. Superior Sinus Thrombosis (SSS) involvement was most commonly thrombosed followed by its involvement with other sinuses. Isolated lateral sinus involvement also seen. On screening for cause, non septic CVT outnumbered septic CVT (22/8) and the most common cause of non septic CVT was unknown followed by coagulation defect. Among septic CVT group puerperial sepsis in females and mastoiditis in males were the dominant cause. CONCLUSION: Septic CVT prognosis had better than non septic CVT. Hence, CVT presents with wide range of presentations and anticoagulation is the treatment. Septic CVT if intervened timely with proper antibiotics have better prognosis. Antibiotics are the mainstay of therapy for septic CVT.