Duration of untreated psychosis and its associated sociodemographic and clinical factors in first-episode psychosis: A study from Eastern Nepal.

OBJECTIVE: Duration of untreated psychosis (DUP) is considered an important factor in outcome. Individual, familial and illness factors may prolong DUP. Little data on this issue is available from the country of Nepal. The purpose of the present study was to assess DUP in patients with first-episode psychosis and identify associations with patients' socio-demographic and clinical factors. METHODS: A cross-sectional, descriptive study was conducted in the department of psychiatry, of Tertiary Hospital in the Eastern part of Nepal. Eighty-six patients were enrolled. ICD-10 was used to make the diagnosis. Nottingham Onset Schedule-DUP version (NOS-DUP) was used to assess DUP. Positive and Negative Syndrome Scale (PANSS) was used to assess patients' clinical symptoms. RESULTS: The mean (SD) DUP was 21.4 (42.1) months and median DUP was 3.0 months (IQR = 23.5). Participants from mountainous region, the unemployed, having an insidious onset of illness, and patients with a diagnosis of schizophrenia had significantly longer DUP (P < .005). Duration of untreated psychosis was also positively correlated with negative symptoms (r = .42, (P < .001) and total PANSS score (r = .42, P < .001). CONCLUSION: Duration of untreated psychosis in first-episode psychotic patients was relatively long (compared to studies in other countries), and was found to be positively associated with mountainous regions of Nepal, being unemployed, having an insidious onset of illness, and having a diagnosis of schizophrenia. Programs and educational efforts are needed to ensure early treatment of patients with first-episode psychosis, especially in the mountainous rural areas of Nepal.

Correlation of hsa miR-101-5p and hsa miR-155-3p Expression With c-Fos in Patients of Oral Submucous Fibrosis (OSMF) and Oral Squamous Cell Carcinoma (OSCC).

Aim: MicroRNAs have been widely acknowledged as a diagnostic, prognostic, and/or therapeutic biomarker for the progression of OSCC, but the correlation of hsa-miR-101-5p and hsa-miR-155-3p is yet to be established with c-Fos in OSCC and OSMF. Methodology: An observational study enrolled 40 patients divided into 2 groups: Group I-21 OSMF patients without malignant transformation, Group II-19 patients with locally advanced, large-operable, or metastatic OSCC, after applying inclusion and exclusion criteria. Both miRNAs were extracted and analyzed from the tissue sample excised from the involved site. The linear regression analysis of the expression of hsa-miR-155-3p, hsa-miR-101-5p, and levels of c-fos in OSMF and OSCC patients and its correlation for habits, age, and gender were evaluated. Results: The expression of hsa-miR-101-5p was 0.81 times downregulated in OSCC tissue compared to OSMF, whereas hsa-miR-155-3p and c-fos were both upregulated 9.30 times and 1.75 times, respectively, in OSCC tissue. In Gutkha and tobacco chewers, the hsa-miR-155-3p expression could explain 12.3% (p = 0.031) for Gutkha chewers, whereas c-fos could explain 38.6% of the cases (p = 0.020) for tobacco chewers. The expression of hsa-miR-101-5p and hsa-miR-155-3p explained 43.7% and 59.5% of OSCC cases in alcoholics, respectively. Interestingly, in non-alcoholics, hsa-miR-155-3p and hsa-miR-101-5p were significant predictors of OSCC. Conclusion: Downregulation of tumor-suppressor hsa-miR-101-5p and upregulation of proto-onco hsa-miR-155-3p is responsible for intricate regulation of the progression of OSMF to OSCC via deregulated expression of c-Fos and tobacco chewing and advancing age is significant contributors for OSCC.

Utilization of dark fermentation effluent for algal cultivation in a modified airlift photobioreactor for biomass and biocrude production.

Developing an efficient photobioreactor (PBR) and reducing freshwater dependence are among the significant challenges for generating 3rd generation biomass feedstock. Addressing these, the present study focused on developing a modified airlift (MoAL) PBR. Its performance was further evaluated and compared with the traditional airlift PBR by cultivating microalgae in dark fermentation spent wash. Lower mixing time and higher interfacial mass transfer coefficient was observed in the MoAL PBR having a perforated draft tube. Experimentally, the MoAL exhibited the maximum biomass concentration of 3.18 g L-1, which was 30% higher than that of the conventional airlift PBR. The semi-continuous operation of the MoAL (with water recycling) achieved the maximum biomass productivity of 0.83 g L-1 d-1, two folds superior to that of batch culture. The comprehensive biomass characterization (proximate, ultimate, and thermochemical) further confirmed its potential for bioenergy application. Considering that, hydrothermal liquefaction of the biomass resulted in a maximum biocrude yield of 31% w/w with a higher heating value (HHV) of 36.6 MJ kg-1. In addition, the biocrude comprised 66.6% w/w lighter fraction (<343 °C), including 21.5% w/w of heavy naphtha, 20.5% w/w of kerosene, and 24.6% w/w of diesel. The results can help develop sustainable technology for simultaneous wastewater remediation and biocrude production.

Treatment and recycle of harvested microalgal effluent using powdered activated carbon for reducing water footprint and enhancing biofuel production under a biorefinery model.

In this study, the suitability of cultivating Monoraphidium sp. KMC4 was exhibited in different effluent based culture (EBC) media concentrations, the latter being treated with powdered activated carbon (PAC) with a loading of 5-50 mg L-1. The optimum EBC media treated with 30 mg L-1 PAC enhanced the biomass yield by 21.9% as compared to the untreated one (1.21 g L-1). A recyclability study performed in five batches resulted in an optimal growth up to three batches with an overall biomass yield of 4.21 g and a total water savings of 30%. Additionally, physico-chemical characterization and FAME profile of the biomass from the recyclability study validated feedstock's energy potential. Moreover, this study proposes a biorefinery model which could recover nutrient rich liquid effluent (3.1 million litres) and solid residue for various applications along with the generation of 5760 kg of biomass followed by 113 L d-1 biodiesel yield.

Cattle wastewater as a low-cost supplement augmenting microalgal biomass under batch and fed-batch conditions.

The utilization of costly chemical fertilizers and large freshwater requirements make the microalgae cultivation process uneconomical and highly unsustainable. To address this challenge, the present study aimed to integrate cattle wastewater (CW) (alternate for fertilizers) with domestic sewage wastewater (DSW) (substitute for freshwater) to cultivate Chlorella thermophile. To maximize the biomass yield, in-depth nutrient consumption patterns in both batch and fed-batch cultivation conditions were analyzed. Out of the eight (1%-4.5%) different CW feed concentrations tested during the batch cultivation, 2.5% CW set gave the highest biomass yield (2.17 g L-1), which was almost double the yield obtained using Bold Basal Medium (1.24 g L-1) and DSW without any CW addition (1.22 g L-1). However, the biomass yield declined with CW> 2.5%, and the ammonium (NH4+) inhibitory effect was observed. To address the (NH4+) toxicity challenge and further enhance the biomass yield, fed-batch experiments were designed with an intermittent CW feeding based on nutrient (NH4+) consumption pattern. The fed-batch cultivation resulted in twofold increased biomass yield (4.52 g L-1) in comparison to the batch process. The nutrient consumption pattern inferred that the (NH4+) concentration greater than 600 mg L-1 during the logarithmic phase was inhibitory for Chlorella thermophila cells. On biomass characterization, a significant improvement in protein content with CW addition was observed. The FAME analysis of the derived lipid stated its competitive biofuel quality with up-gradation of C:16 and C:18 groups. Based on the obtained results, projection analysis for an integrated rural model demonstrated the technology's potential for sustainable water management with valuable resource recovery.

Role of Orthopantomogram in Unexplained Earache.

Earache is one of the most common symptom for a patient to visit ENT doctor. It poses difficulty to diagnose the root cause when ENT examination is normal and still the pain persists, hence many a times patients are presumed to have psychosomatic element. While evaluation of earache dental status is often overlooked. 93 such patients of persistent earache with normal ENT examination were evaluated. In 70 of these patients the earache was attributed to either absent, unerupted or obliquely positioned upper or lower last molars which was confirmed by Orthopantomogram.

Virtual Bronchoscopy: Highly Sensitive Time and Life Saving Investigation in the Diagnosis of Foreign Body Aspiration-Our Experience.

Foreign body airway is a common cause of morbidity and mortality in children. Virtual bronchoscopy is a new investigative technique useful in locating non radiopaque FB missed on plain radiography. The aim of the study was to study the clinical profile of patients with suspected foreign body aspiration and to evaluate the changing trends in the diagnosis and quicker management of foreign body aspiration as a way of virtual bronchoscopy. This was a retrospective and prospective cross sectional study conducted in the Department of Otorhinolaryngology M.G.M.M.C. and M.Y. Hospital Indore for a period of 10 years. The medical records of patients with foreign body aspiration, from August 2006 to September 2016 were reviewed. Data was collected regarding their clinical presentation, examination and chest X-ray, virtual bronchoscopy, rigid bronchoscopy findings. Patients with suspected foreign body aspiration were subjected to virtual bronchoscopy and rigid bronchoscopy was performed. The techniques and methods to extract different types of foreign bodies has been elaborated in this study. In the 150 subjects, we observed mean age group of presentation was 2.1 years, male is to female ratio was 4.1, 70% of the cases came from the rural areas, 86% were vegetative foreign bodies, and remaining non vegetative were aspirated mostly during the winter season. Betel nut was the most common aspirated foreign body 0.63% had a positive history of foreign body aspiration, where as 37% had a negative history. Right main bronchus was the most common site of lodgement. Breathlessness and reduced air entry were the most common symptoms and signs. We also observed, that chest radiograph were normal in as many as 40% cases. Hence negative chest radiographs does not rule out FB. In 150 patients with foreign body aspiration, which was detected by virtual bronchoscopy, 148 patients were diagnosed to have foreign body on rigid bronchoscopy. This amounts to a positive predictive value of 97.3% which was similar to the positive predictive value of rigid bronchoscopy which was 99%. Virtual bronchoscopy is the only imaging modality which gives 99.9% reassurance about the presence or absence of a foreign body, because of its high sensitivity and specificity, hence proves to be a life saving tool.

Microalgal bioenergy production under zero-waste biorefinery approach: Recent advances and future perspectives.

In view of the globalization and energy consumption, an economic and sustainable biorefinery model is essential to address the energy security and climate change. From this perspective, renewable biofuel production from microalgae along with a wide range of value-added co-products define its potential as a biorefinery feedstock. However, economic viability of microalgal biorefinery at its current state is not considered sustainable. Reduce, recycle, and reuse of waste derived from algal bioenergy conversion process will lead to an energy efficient and sustainable zero-waste microalgal biorefinery. This review focuses on three major aspects of zero-waste microalgal biorefinery approach; (1) recent advances on microalgal bioenergy conversion processes (chemical, biochemical and thermochemical); (2) mitigation and transformation of liquid and solid waste and (3) techno-economic analysis (TEA) and lifecycle assessment (LCA). In addition, the study also focuses on the challenges and future perspectives for an advanced microalgal biorefinery model.

Comprehensive characterization of microalgal isolates and lipid-extracted biomass as zero-waste bioenergy feedstock: An integrated bioremediation and biorefinery approach.

The present study investigated the feasibility of domestic sewage wastewater (DSW) as an alternate to fresh-water microalgae growth media towards high-value bioenergy feedstock production. Eight native microalgal strains were screened from DSW and the effect of raw DSW (RDSW), and autoclaved DSW (ADSW) on growth and bioremediation potential were evaluated and compared with control BG11 medium. The study confirmed RDSW as a potential growth medium while Monoraphidium sp. KMC4 showed superior biomass (1.47 ±â€¯0.08 g L-1) and lipid yield (436.01 ±â€¯0.06 mg L-1). The corresponding values for bioremediation of ammonia, nitrate, phosphate, as well as COD remained within 88-100%. CHNS, biochemical, TGA, FTIR, FAME analysis of KMC4 confirmed it's potential as bioenergy feedstock. Additionally, a comprehensive characterization of lipid-extracted microalgae biomass (LEMB) was carried out which suggested that LEMB can be used as a growth promoter as well as feedstock for biogas, bioethanol, and bio-oil production.

Assessment of a Novel Algal Strain Chlamydomonas debaryana NIREMACC03 for Mass Cultivation, Biofuels Production and Kinetic Studies.

A novel microalgae strain Chlamydomonas debaryana (KJ210856) was isolated from a freshwater lake of Punjab, India, and cultivated considering climatic sustainability and inherent adaptability concern. C. debaryana was grown in a 30-L indoor photobioreactor to study the mass cultivation prospect and biofuel potential. Physicochemical characterization of biomass and the lipid was performed with effect to nitrogen stress. It showed a higher biomass yield (1.58 ± 0.02 g L(-1), dry weight) and twofold increase in lipid yield (552.78 ± 9 mg L(-1)) with 34.2 ± 0.19 % lipid content under nitrogen deficient condition. Strikingly, increase in triglycerides achieved with nitrogen depletion containing over 96 % of total fatty acids (C 14, C 16, and C 18). Proximate and ultimate analysis suggested the presence of relatively higher volatile matter and carbon-hydrogen ratio. Furthermore, lower moisture and ash content signified C. debaryana biomass has promising features towards biofuel applications. The pyrolytic behavior of the whole biomass was also studied using thermogravimetric analyzer (TGA) and kinetic parameters were estimated using different methods. Promising growth rate and lipid yield leading to feasible biofuel feed stock production in indoor photobioreactor along with autosediment potential of cells validates C. debaryana NIREMACC03, a potential strain for mass cultivation.

Liquid chromatography tandem mass spectrometry method for the simultaneous stereoselective determination of venlafaxine and its major metabolite, O-desmethylvenlafaxine, in human plasma.

A sensitive, accurate and highly stereoselective assay for the simultaneous determination of venlafaxine (VEN) and its equipotent metabolite, O-desmethyl venlafaxine (ODV), in human plasma was developed and validated. Analytes were simultaneously extracted from plasma using solid-phase extraction and detected by tandem mass spectrometry in positive ion mode with a turbo ion spray interface. Deuterium-labeled VEN and ODV were used as internal standards. Chromatographic separation was performed on a Chiral AGP column, using a time programmed gradient flow with a total run time of 16 min. The method has a lower limit of quantitation of 0.60 ng/mL. The assay was linear over a range 0.60-300.00 ng/mL for both the enantiomers of VEN and ODV, respectively, with coefficient of correlation > 0.99. The extraction recoveries were >77.0% on an average for all the four analytes. The analytes were found stable in plasma through three freeze (-15 °C) and thaw cycles and under storage at room temperature for 8 h, and also in mobile phase at 10 °C for 54 h. The method has shown good reproducibility, with intra- and inter-day variation coefficients < 9%, for all the analytes, and has proved to be very reliable for analysis of VEN and its metabolite in clinical study samples.

Establishing bioequivalence of racemic venlafaxine formulations using stereoselective assay method: Is it necessary?

A bioequivalence study for venlafaxine generic formulation was conducted as an open label, balanced, randomized, two-way crossover, single-dose study. In this study, a comparison of various pharmacokinetic parameters of venlafaxine hydrochloride 150 mg modified release capsules of Ranbaxy and EFEXOR®-XR 150 mg capsules of Wyeth, in healthy, adult, male, human subjects under fasting condition was performed to conclude bioequivalence. Venlafaxine and its major active metabolite O-desmethylvenlafaxine (ODV) are racemates. The "(S)-(+)" and "(R)-(-)" enantiomers of venlafaxine and ODV are established as being active. Hence, subject samples were analyzed using nonstereoselective and stereoselective assay methods. Both (S)-(+) and (R)-(-) enantiomers of venlafaxine and ODV showed similar absorption and disposition. The 90% confidence intervals for venlafaxine, (R)-(-)-venlafaxine as well as (S)-(+)-venlafaxine were within acceptance range concluding bioequivalence. The results obtained by stereoselective assay were comparable to the nonstereoselective analysis, as sum of concentrations of (S)-(+)- and (R)-(-)-enantiomers of venlafaxine and ODV. The mean (S)-(+)/(R)-(-) ratios of the enantiomers of venlafaxine and ODV at various time points were consistent in the study subjects. Therefore, the estimation of venlafaxine and ODV using nonstereoselective assay method is effective in distinguishing formulation differences (if any) in bioequivalence studies in a cost-effective manner.

Determination of valganciclovir and ganciclovir in human plasma by liquid chromatography tandem mass spectrometric detection.

OBJECTIVES: The aim of this work was to develop a simple, sensitive and selective LC/MS/MS method for the assay of valganciclovir and ganciclovir in human plasma. DESIGN AND METHODS: Sample preparation involved solid phase extraction on mix mode cation exchanger. Separation was performed on Chromolith RP18e column using water, trifluoroacetic acid (1M, pH 4.4) and methanol (29.9:0.1:70, v/v) as mobile phase. Both analytes were detected by electro spray ionization mass spectrometry in positive ion multiple reaction monitoring mode. RESULTS: CCs with good linearties having r≥0.9990 and ≥0.9992 were obtained in the range of 5-800ng/mL and 70-11,200ng/mL for valganciclovir and ganciclovir, respectively. The extraction recoveries were around 85% for both the analytes. CONCLUSION: The method provided a simple and selective procedure that can be easily used for the evaluation of the pharmacokinetic profile of valganciclovir and ganciclovir in human plasma.

Differential occurrence of oxidative burst and antioxidative mechanism in compatible and incompatible interactions of Solanum lycopersicum and Ralstonia solanacearum.

Striking increase in reactive oxygen species (ROS) such as hydrogen peroxide (H(2)O(2)) has been demonstrated to occur in plants in response to pathogen attack. The aim of this study was to investigate the biochemical aspects of ROS generation, antioxidative mechanism and cell wall reinforcement as responses of tomato cultivars Arka Meghali (AM; susceptible) and BT-10 (BT; resistant) against Ralstonia solanacearum (Ralsol). While the oxidative burst was characterized by a single phase ROS increase in AM, there was a clear bi-phasic ROS generation in BT. The first significant increase of H(2)O(2) production was noticed at 12 h post-inoculation (hpi) followed by a sharp increase in H(2)O(2) generation after 36 hpi. Lipid peroxidation was more in roots of AM than that of BT after pathogen inoculation. Superoxide dismutase and catalase activities were continuously at very high level in Ralsol-inoculated BT plants, whereas activities of the enzymes were observed to decrease at later stage in Ralsol-inoculated AM plants. Guaiacol peroxidase activity was high in Ralsol-inoculated roots of both cultivars, but BT recorded much higher activity than AM. Higher activity of ascorbate peroxidase in inoculated BT might be an indication of better scavenging activity of the enzyme. Total phenolic content and lignin deposition were significantly higher in Ralsol-inoculated BT compared to inoculated AM. Our results indicate that increased level of ROS production coupled with more efficient antioxidative system, lower rate of lipid peroxidation and high lignin deposition in cell wall may contribute to the resistance of tomato plants to Ralsol.