Iron pill aspiration syndrome: A case report and literature review.

Aspiration of iron pill containing ferrous sulfate into the airway can induce fulminant chemical burn and necrosis of the airway mucosa. Acute chemical burn and inflammatory response can result in life-threatening airway compromise. It can also result in long-term sequelae including but not limited to fibrosis and airway stenosis. Considering the common use of iron supplements, and the potential severity of aspiration related airway injury, clinicians should be fully cognizant of the interaction between aspirated iron and airway passages. Herein, we present a case report with pertinent review of the literature.

Clinical Equivalence of Trubond® and Ethibond® Braided Polyester Sutures for Valvular Prosthesis Fixation During Aortic or Mitral Valve Replacement: A Single-Blind Randomized Controlled Trial.

Background Paravalvular leak (PVL) following valve replacement is a serious cardiovascular complication that increases morbidity and mortality. Valve replacement with the interrupted suture technique using polyester suture provides adequate tensile strength and reduces the probability of tissue reaction. This study compared the clinical equivalence of Trubond®(Healthium) and Ethibond® (Ethicon, Johnson & Johnson) braided polyester sutures for valvular prosthesis fixation using interrupted suturing, with respect to the proportion of subjects having PVL after aortic valve (AV) or mitral valve (MV) replacement. Methodology Patients undergoing AV/MV replacement were enrolled and randomized in this study. The primary endpoint of this prospective, multicentric, two-arm, randomized (1:1), parallel-group, single-blind study (December 2020-October 2022) was the presence of PVL in Trubond® (n = 40) and Ethibond® (n = 42) groups within 26 weeks of surgery. The secondary endpoints included event rate of all-cause mortality, cardiac death, stroke, myocardial infarction, re-hospitalization, re-intervention, wound infection, operative time, intraoperative suture parameters, postoperative hospital stay, time to resume normal activities and work, quality of life, patient satisfaction, and adverse events in both groups. Results Patients who underwent AV/MV replacement and were followed up until 26 weeks had no incidence of PVL or other postoperative complications. No requirement for readmission or re-intervention was noted in both groups. Intraoperative suture handling characteristics, operative time, and hospital stay were also comparable between the groups. With each follow-up, subjects in both groups exhibited improved postoperative functional abilities, quality of life, and health status. Conclusions Trubond® braided polyester suture is clinically equivalent to Ethibond® braided polyester suture. Trubond® suture is safe and effective for valvular prosthesis fixation in patients undergoing AV or MV replacement.

Effect of nano-hydroxyapatite incorporation on fluoride-releasing ability, penetration, and adaptation of a pit and fissure sealant.

BACKGROUND: Dental caries is one of the most common multifactorial oral diseases and can be prevented using pit and fissure sealants. AIM: To evaluate the effect of nano-hydroxyapatite (nanoHAP) incorporation on fluoride-releasing ability, penetration, and adaptation of a pit and fissure sealant. DESIGN: This was an in vitro study with two groups: conventional sealant and nanoHAP-incorporated sealant. Sealant penetration and adaptation were assessed using stereomicroscope and scanning electron microscope (SEM) (15 and 10 samples per group, respectively). Fluoride release was analyzed using ion-selective electrode (15 samples per group). The chi-square test was used to compare penetration and adaptation between the 2 groups, and an independent Student t test was used to compare fluoride release. RESULTS: The nanoHAP group showed significantly more samples with no bubbles (P = .001) and no debris (P < .001). SEM analysis showed a significantly greater percentage of adequate fissures in the test group (P = .007). The fluoride release was significantly higher in test samples with p values of .001 and .016 on day 1 and day 60, respectively. CONCLUSION: The incorporation of nanoHAP into the conventional pit and fissure sealant improved its penetration and adaptation properties along with fluoride release.

Altered Sleep Duration and Poor Quality of Sleep Among Pharmacy Students Amidst COVID-19 Lockdown: A South-Indian Study.

Introduction/background: The nationwide lockdown enforced due to the spread of coronavirus disease-2019 had a definite impact on sleep. Objective: To observe any changes in the duration, pattern and quality of sleep among pharmacy students due to the lockdown. Methods: A google form-based cross-sectional and descriptive study was carried out after approval was obtained from the ethical committee in the month of July 2021 among 310 pharmacy students. The validated form was electronically administered after obtaining the informed consent. All the data pertaining to duration, pattern and quality of sleep before and during the lockdown was collected and analyzed using STATA version 16.0. Results and Discussion: Out of 310 participants, the study revealed an increase in the time needed to fall asleep (p value < 0.001) and in the total duration of sleep (p value < 0.001). A delay in the time of sleep in the morning (p value < 0.001) and at night (p value < 0.001) was also one among the many significant results. The incidences of jerky leg movements (p value < 0.001), snoring (p value < 0.001), frequent nightmares (p value < 0.001) and anxiety (p value < 0.001) were also increased as a direct effect of the lockdown. Conclusion: The study has confirmed the detrimental impact of the lockdown on sleep among pharmacy students. All attributes of sleep duration and sleep quality have achieved statistical significance signifying the need to develop cognitive behavioral interventions and prevent the worsening of mental health amidst the COVID-19 era.

Study of psychological effects of deployment at extreme high altitude area on soldiers.

BACKGROUND: The Indian Armed Forces are fighting the battle at extreme High Altitude, the most inhospitable terrain in the world, for the last thirty five years. The stress of being isolated under harsh environmental conditions on a daily basis can have an adverse effect on their mind. However, so far, no study has been undertaken to assess the psychological effects of deployment at extreme High Altitude. METHODS: Three hundred thirty-four troops selected for deployment were initially evaluated using the General Health Questionnaire-12 (GHQ-12) and Armed Forces Medical College Life Events Scale (AFMC LES) as screening tools to assess mental health status after obtaining ethical clearance and informed consent. On deinduction after a deployment for more than three months, they were reassessed. The data collected were statistically analysed. RESULTS: As per GHQ-12 evaluation, after the deployment score increased from 0.2574 to 0.9162, but remained lower than the 'caseness' level of 2. Among the 79 troops with a score of 2 and more, the majority were married and had past history of tenures at high-altitude areas. There was statistically significant increase in the AFMC LES scores also on deployment. CONCLUSION: Deployment at extremely high-altitude areas for even three months produces significant psychological morbidity among troops.

Odderon Exchange from Elastic Scattering Differences between pp and pp[over ¯] Data at 1.96 TeV and from pp Forward Scattering Measurements.

We describe an analysis comparing the pp[over ¯] elastic cross section as measured by the D0 Collaboration at a center-of-mass energy of 1.96 TeV to that in pp collisions as measured by the TOTEM Collaboration at 2.76, 7, 8, and 13 TeV using a model-independent approach. The TOTEM cross sections, extrapolated to a center-of-mass energy of sqrt[s]=1.96 TeV, are compared with the D0 measurement in the region of the diffractive minimum and the second maximum of the pp cross section. The two data sets disagree at the 3.4σ level and thus provide evidence for the t-channel exchange of a colorless, C-odd gluonic compound, also known as the odderon. We combine these results with a TOTEM analysis of the same C-odd exchange based on the total cross section and the ratio of the real to imaginary parts of the forward elastic strong interaction scattering amplitude in pp scattering for which the significance is between 3.4σ and 4.6σ. The combined significance is larger than 5σ and is interpreted as the first observation of the exchange of a colorless, C-odd gluonic compound.

Myofascial release versus Mulligan sustained natural apophyseal glides' immediate and short-term effects on pain, function, and mobility in non-specific low back pain.

BACKGROUND: Myofascial release (MFR) and Mulligan Sustained Natural Apophyseal Glides (SNAGs) are manual therapy techniques routinely practiced in the management of non-specific low back pain (NSLBP). As a solo intervention or along with other therapies, both methods have reported positive results for individuals with NSLBP. However, which technique improves NSLBP-related pain, restricted range of motion (ROM) and disability, warrants further research. OBJECTIVE: To study the comparative effects of MFR and SNAGs on pain, disability, functional ability, and lumbar ROM in NSLBP. METHOD: A parallel-group study was conducted at tertiary care hospitals. Sixty-five Sub-acute or chronic NSLBP patients were allocated to receive strengthening exercises along with either MFR (n = 33) or SNAGs (n = 32) for six treatment sessions over one week. An independent assessor evaluated outcome measures such as the Visual Analog Scale (VAS), Patient-Specific Function Scale (PSFS), and ROM at baseline, immediate (after 1st treatment), and short-term (post-sixth day of the intervention). The Modified Oswestry disability index (MODI) was assessed at baseline and short-term. RESULTS: Within-group analysis found clinically and statistically significant (p < 0.05) changes for VAS and PSFS at immediate and short-term for both the groups. The lumbar extension also showed improvement immediately and in the short-term. Improvement in Lumbar flexion was seen only in the SNAGs group over the short-term. A statistically significant improvement was seen for MODI in both the groups but was not clinically significant in the MFR group. The analysis observed no statistically significant difference (p < 0.05) between the groups at both the immediate and short-term. CONCLUSIONS: Pain and restricted function associated with NSLBP can be improved using SNAGs or MFR, along with strengthening exercises. For limited lumbar flexion ROM, Mulligan SNAGs have a better outcome than MFR over the short-term. Hence, both manual therapy techniques can be incorporated along with exercises for immediate and short-term management of sub-acute to chronic NSLBP.Clinical Trial Registration. CTRI/2018/12/016787 (http://ctri.nic.in/Clinicaltrials/).

Conceptualization of functional single nucleotide polymorphisms of polycystic ovarian syndrome genes: an in silico approach.

PURPOSE: Polycystic ovarian syndrome (PCOS) is a multi-faceted endocrinopathy frequently observed in reproductive-aged females, causing infertility. Cumulative evidence revealed that genetic and epigenetic variations, along with environmental factors, were linked with PCOS. Deciphering the molecular pathways of PCOS is quite complicated due to the availability of limited molecular information. Hence, to explore the influence of genetic variations in PCOS, we mapped the GWAS genes and performed a computational analysis to identify the SNPs and their impact on the coding and non-coding sequences. METHODS: The causative genes of PCOS were searched using the GWAS catalog, and pathway analysis was performed using ClueGO. SNPs were extracted using an Ensembl genome browser, and missense variants were shortlisted. Further, the native and mutant forms of the deleterious SNPs were modeled using I-TASSER, Swiss-PdbViewer, and PyMOL. MirSNP, PolymiRTS, miRNASNP3, and SNP2TFBS, SNPInspector databases were used to find SNPs in the miRNA binding site and transcription factor binding site (TFBS), respectively. EnhancerDB and HaploReg were used to characterize enhancer SNPs. Linkage Disequilibrium (LD) analysis was performed using LDlink. RESULTS: 25 PCOS genes showed interaction with 18 pathways. 7 SNPs were predicted to be deleterious using different pathogenicity predictions. 4 SNPs were found in the miRNA target site, TFBS, and enhancer sites and were in LD with reported PCOS GWAS SNPs. CONCLUSION: Computational analysis of SNPs residing in PCOS genes may provide insight into complex molecular interactions among genes involved in PCOS pathophysiology. It may also aid in determining the causal variants and consequently contributing to predicting disease strategies.

Rapid spectral variability of a giant flare from a magnetar in NGC 253.

Magnetars are neutron stars with extremely strong magnetic fields (1013 to 1015 gauss)1,2, which episodically emit X-ray bursts approximately 100 milliseconds long and with energies of 1040 to 1041 erg. Occasionally, they also produce extremely bright and energetic giant flares, which begin with a short (roughly 0.2 seconds), intense flash, followed by fainter, longer-lasting emission that is modulated by the spin period of the magnetar3,4 (typically 2 to 12 seconds). Over the past 40 years, only three such flares have been observed in our local group of galaxies3-6, and in all cases the extreme intensity of the flares caused the detectors to saturate. It has been proposed that extragalactic giant flares are probably a subset7-11 of short γ-ray bursts, given that the sensitivity of current instrumentation prevents us from detecting the pulsating tail, whereas the initial bright flash is readily observable out to distances of around 10 to 20 million parsecs. Here we report X-ray and γ-ray observations of the γ-ray burst GRB 200415A, which has a rapid onset, very fast time variability, flat spectra and substantial sub-millisecond spectral evolution. These attributes match well with those expected for a giant flare from an extragalactic magnetar12, given that GRB 200415A is directionally associated13 with the galaxy NGC 253 (roughly 3.5 million parsecs away). The detection of three-megaelectronvolt photons provides evidence for the relativistic motion of the emitting plasma. Radiation from such rapidly moving gas around a rotating magnetar may have generated the rapid spectral evolution that we observe.

Association of sociodemographic factors with various domains of alcohol-induced sexual dysfunction - An Indian perspective.

BACKGROUND: Sexual dysfunction is frequently seen in alcohol-use disorders. The available research on this topic has studied erectile dysfunction and premature ejaculation using nonvalidated scales. This study was undertaken to study the other major domains of sexual dysfunction, namely sexual desire, orgasmic dysfunction and satisfaction, and their association with sociodemographic factors. MATERIALS AND METHODS: A cross-sectional descriptive study design was used and 78 male patients were recruited. The assessment was conducted using a specially designed intake pro forma, International Index of Erectile Function (IIEF-15) Scale, DSM-5 and International Classification of Disease, 10th revision, diagnostic criteria for research. A correlation between the amount of alcohol consumed and its effect on various domains of sexual dysfunction was also carried out using Pearson's correlation coefficient. RESULTS: The sociodemographic profile was studied in association with the overall (total) IIEF-15 subscale using analysis of variance (ANOVA). Statistically significant differences were observed among age groups, education subgroups, marital disharmony, years of alcohol use, and lifetime alcohol use. Further, since the values of ANOVA were significant, Tukey's post hoc analysis was carried out which showed a statistically significant difference among the groups. Various domains of sexual dysfunction showed a strongly negative correlation for overall IIEF subscale followed by intercourse satisfaction, sexual desire, and orgasmic function with years of alcohol use and lifetime alcohol use. CONCLUSION: Sexual dysfunction in alcohol dependence patients was significantly associated with a family history of paternal alcohol abuse, lower educational background, increasing age, and marital disharmony. This study also found a strongly negative correlation between various domains of sexual functioning and years of alcohol use/lifetime alcohol use.

Observation of inverse Compton emission from a long γ-ray burst.

Long-duration γ-ray bursts (GRBs) originate from ultra-relativistic jets launched from the collapsing cores of dying massive stars. They are characterized by an initial phase of bright and highly variable radiation in the kiloelectronvolt-to-megaelectronvolt band, which is probably produced within the jet and lasts from milliseconds to minutes, known as the prompt emission1,2. Subsequently, the interaction of the jet with the surrounding medium generates shock waves that are responsible for the afterglow emission, which lasts from days to months and occurs over a broad energy range from the radio to the gigaelectronvolt bands1-6. The afterglow emission is generally well explained as synchrotron radiation emitted by electrons accelerated by the external shock7-9. Recently, intense long-lasting emission between 0.2 and 1 teraelectronvolts was observed from GRB 190114C10,11. Here we report multi-frequency observations of GRB 190114C, and study the evolution in time of the GRB emission across 17 orders of magnitude in energy, from 5 × 10-6 to 1012 electronvolts. We find that the broadband spectral energy distribution is double-peaked, with the teraelectronvolt emission constituting a distinct spectral component with power comparable to the synchrotron component. This component is associated with the afterglow and is satisfactorily explained by inverse Compton up-scattering of synchrotron photons by high-energy electrons. We find that the conditions required to account for the observed teraelectronvolt component are typical for GRBs, supporting the possibility that inverse Compton emission is commonly produced in GRBs.

Radiofrequency electromagnetic radiation-induced behavioral changes and their possible basis.

The primary objective of mobile phone technology is to achieve communication with any person at any place and time. In the modern era, it is impossible to ignore the usefulness of mobile phone technology in cases of emergency as many lives have been saved. However, the biological effects they may have on humans and other animals have been largely ignored and not been evaluated comprehensively. One of the reasons for this is the speedy uncontrollable growth of this technology which has surpassed our researching ability. Initiated with the first generation, the mobile telephony currently reaches to its fifth generation without being screened extensively for any biological effects that they may have on humans or on other animals. Mounting evidences suggest possible non-thermal biological effects of radiofrequency electromagnetic radiation (RF-EMR) on brain and behavior. Behavioral studies have particularly concentrated on the effects of RF-EMR on learning, memory, anxiety, and locomotion. The literature analysis on behavioral effects of RF-EMR demonstrates complex picture with conflicting observations. Nonetheless, numerous reports suggest a possible behavioral effect of RF-EMR. The scientific findings about this issue are presented in the current review. The possible neural and molecular mechanisms for the behavioral effects have been proposed in the light of available evidences from the literature.

Sexuality in the 21st century: Leather or rubber? Fetishism explained.

The sexual physical act is related to sexual attraction, sexual fantasy and sexual behaviour. Fetish has been recognised as an attraction to objects with the aim of achieving sexual gratification. There have been historical accounts of fetishism, and the subject has been of significant interest to clinicians especially those who work in the field of managing mental illnesses. There are various types of fetishism. Reported for the first time in the 19th century, the condition is of various subtypes. Of these, fetishistic disorder can be recognised as sexual fantasies, sexual urges and sexual behaviours which cause significant distress or impairment in an individual in social, occupational or other important areas of function. Fetishism may be related to specific body parts, non-living objects or others. In clinical settings, patients with fetishistic disorders are often referred because of having got into trouble with the law. Fetishism needs to be differentiated from paraphilias. Various explanations including psychoanalysis and behavioural theories have been offered to explain the genesis and management of fetishistic disorders. A fetish is attraction to an object. Treatments can include behavioural, cognitive or psychoanalytic strategies. In this review article, a brief overview on the fetish is offered with suggestions for management.

Game of thorns: Modern day opium.

With the advent of internet and mobile communication the virtual space of world wide web has become a playground; people plugged in to it at distant horizon completely unfamiliar to each other are players; keyboard, touchpad and joysticks have become the tools of play; webmaster, app developer are self designated referees of the game; while the virtual media is the largest ever spectators in this amphitheatre of the web. More and more youth are getting hooked onto this and are gradually becoming dependent on these games. World Health Organization has recognized this as a diagnosable medical illness and included as Internet Gaming Disorder (IGD) in its International Classification of Diseases (ICD) -11 released in 2018. Various aspects of this problem are discussed in this article.

Modulatory effect of 900 MHz radiation on biochemical and reproductive parameters in rats.

In the present study, the effect of 900 MHz radiation exposure on blood biochemical and reproductive parameters was evaluated in adolescent rats. Male albino Wistar rats (8-10 weeks of age) were exposed to 900 MHz radiation (1hr/day, power density - 146.60 µW/cm2) from a mobile phone for 28 days. On 29th day the animals were euthanized and malondialdehyde (MDA), total antioxidants (TA) levels and Glutathione-S transferase (GST) activity were studied in the blood. Reproductive parameters such as total sperm count, percentage of non-motile sperms, and sperm morphology were determined. Testes sections were stained with H(et)E staining and their cellular integrity was evaluated. Caspase-3 activity in the testes was also determined. MDA concentration was increased but TA levels and GST activity were not found to be different in 900 MHz group compared to controls. Sperm motility was found to be slightly reduced in 900 MHz group. Percentage of abnormal sperm was significantly elevated in 900 MHz group. Additionally, loss of germ cells particularly spermatocytes and spermatids was found in the testes of 900 MHz group. Testes caspase-3 activity was slightly elevated in 900 MHz exposed rats. Chronic 900 MHz exposure induced oxidative damage in the blood and lead to alterations in reproductive parameters in rats (Fig. 4, Ref. 33).

Measurement of the Effective Weak Mixing Angle in pp[over ¯]→Z/γ

We present a measurement of the effective weak mixing angle parameter sin^{2}θ_{eff}^{ℓ} in pp[over ¯]→Z/γ^{*}→µ^{+}µ^{-} events at a center-of-mass energy of 1.96 TeV, collected by the D0 detector at the Fermilab Tevatron Collider and corresponding to 8.6 fb^{-1} of integrated luminosity. The measured value of sin^{2}θ_{eff}^{ℓ}[µµ]=0.23016±0.00064 is further combined with the result from the D0 measurement in pp[over ¯]→Z/γ^{*}→e^{+}e^{-} events, resulting in sin^{2}θ_{eff}^{ℓ}[comb]=0.23095±0.00040. This combined result is the most precise measurement from a single experiment at a hadron collider and is the most precise determination using the coupling of the Z/γ^{*} to light quarks.