Lateral Epicondylitis Treated with Platelet-Rich Plasma Injection and Corticosteroid Injection.

Introduction: Lateral epicondylitis, or tennis elbow, affects 1%-3% of adults aged 35-50, causing pain and weakness in the dominant elbow due to chronic inflammation of the extensor tendon. While corticosteroid injections (CSI) are commonly used for treatment, they offer only short-term relief. Platelet-rich plasma (PRP) is a promising alternative with potential for long-term benefits. This study compares the efficacy of PRP and CSI in treating lateral epicondylitis. Materials & Methods: A randomized controlled trial was conducted at Chettinad Hospital and Research Institute from February 2020 to March 2021, involving patients with lateral epicondylitis unresponsive to non-invasive treatments. Patients were randomly assigned to receive either PRP or CSI, with pre- and post-treatment pain and function assessed using VAS, PSFS, and PRTEE scores. Results: PRP showed better long-term pain reduction and functional improvement than CSI. At 6 months, PRP-treated patients had significantly lower VAS and PRTEE scores, indicating superior outcomes. Discussion: Although CSI provided quicker initial relief, PRP demonstrated sustained benefits at 3 and 6 months. PRP's effectiveness in promoting tissue healing may explain its long-term success. Conclusion: PRP is more effective than CSI for long-term management of lateral epicondylitis, offering superior pain relief and functional improvement.

Bone Preservation in Femoral Intercondylar Box Cut - A Comparative Study between Older and Newer Generation Implants.

Introduction: This study was conducted to compare the quantity of intercondylar bone removed during femoral box osteotomy for implantation of three contemporary newer generation posterior stabilized (PS) total knee arthroplasty designs Attune PS (DePuy), Anthem (Smith and Nephews), and NexGen Legacy (Zimmer) with the older version from the same manufacturers. Materials and Methods: We compared the maximum volumetric bone resection required for the housing of the PS mechanism of these six designs. Bone removal by each PS box cutting jig was three-dimensionally measured. The differences between the three designs were analyzed by the Kruskal-Wallis test. The Mann-Whitney U-test was used for pairwise comparisons. The level of significance was set at P < 0.05. Results: The newer generation implants save approximately 33% of bone that was resected from the box cut as compared to the older versions. DePuys Attune PS saved 27.1% bone as compared to Sigma PS resecting 6.96 cm3 of bone, and Zimmers Persona saved 40.57% bone as compared to NexGen from the intercondylar box cut resecting 6.18 cm3. Smith and Nephew s Anthem and Genesis have no difference in their box volume with both resecting 7.8 cm3 of bone. Conclusion: Irrespective of implant size, the Attune PS (DePuy) and Nexgen Legacy (Zimmer) cutting jigs always resected significantly less bone than did the jigs of older generations. There was no significant difference in the bone removed during femoral box osteotomy in the newer and older generations of Smith and Nephew.

Functional and Radiological Outcome after Internal Fixation of Intra-articular Calcaneal Fractures.

Introduction: Calcaneal fractures are rare injuries constituting 2% of all fractures. Fractures of calcaneum correspond to nearly 60-75% of the tarsal bone fractures. The calcaneum is the most commonly fractured tarsal bone 90% occur in males between 21 and 45 years of age. The calcaneal fracture may be extra-articular (sparing the subtalar joint) and intra-articular involving the subtalar joint. Intra-articular fractures account for approximately 75% of calcaneal fractures and have been associated with poor functional outcomes. In this study, we aim to assess the functional outcome of internal fixation in displaced intra-articular calcaneal fractures. Materials and Methods: A prospective interventional study was conducted on patients with only intra-articular calcaneal fractures admitted to Chettinad Hospital and Research Institute, Kelambakkam during the period from May 1, 2022, to February 29, 2024, and a total of 32 patients were considered. The functional outcome was assessed by the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scoring System. Results: The average age of the patients in our study was 39 years of which all were male. Fall from height is the most common mode of injury. The right calcaneum is more commonly involved than the left. The mean duration of hospital stay was around 10 days. The fracture classification was based on the sanders and Essex-Lopresti classification of which 17 patients were sanders type 3 and 13 patients were sanders type 2 and 1 patient was sanders type 4. The mean time for radiological union is 12 weeks. The Bohler's angle and Gissane's angle preoperatively 16.16 ± 8.87 and 121.48 ± 7.47 restored to near normal values after fixation 27.77 ± 6.02 and 113.485 ± 44, respectively. Heel height and heel width restored to near normal values of (pre-operative heel height - 24.74 ± 3.71 and heel width - 39.97 ± 4.11 and post-operative heel height - 31.55 ± 3.38 and heel width - 34.0 ± 3.1), respectively. The most common complications were wound-related complications (superficial wound infection - 9.7%, deep wound infection - 3.2%, and wound margin necrosis and wound dehiscence 6.4%) and the most common late complications were complex regional pain syndrome - 9.7% and subfibular lateral impingement with peroneal tendinitis - 6.5%. AOFAS grading of functional outcome had shown good to excellent results in 83.8% (26 patients) of the cases. The mean AOFAS score was 83.39 in our study. Conclusion: The present study shows that open reduction and internal fixation give superior radiographic results as shown by the restoration of Bohler's and Gissane's angle and height and width of the calcaneus to near normal values, indicating anatomical restoration of calcaneal shape. The functional outcome by AOFAS score showed good to excellent results in most of the patients with minimal wound complications.

A Comparative Study on Correlation between Magnetic Resonance Imaging and Arthroscopic Findings in the Knee Joint Injuries.

Introduction: The knee joint primarily allows for flexion and extension and is essentially a hinge joint. The knee joint, like all hinge joints, is strengthened by collateral ligaments - one on each side of the joint. Objective: Our study sought to investigate potential correlations between arthroscopy and magnetic resonance imaging (MRl) examination in the diagnosis of traumatic diseases of the knee. Methods and Materials: A prospective study was conducted on 30 persons who showed signs of having traumatic knee disease. Following a comprehensive evaluation of the patient s medical history and current state of health, we opted to undergo an arthroscopic evaluation and knee MRL. Results: The sensitivity of the MRI was 93.87%, the specificity was 91.54%, the accuracy was 92.50%, and the negative predictive value was 95.58% when compared to arthroscopic inspection as the gold standard. Conclusion: This study demonstrates that MRIs frequently misdiagnose individuals with multiple knee injuries or fail to detect a lesion while doing a diagnostic evaluation. Therefore, if the MRI comes out normal, there is no reason to deny the patient arthroscopy. Due to this MRI flaw, researchers have determined that arthroscopy can be performed following a comprehensive clinical assessment without the need for an MRI.

Single Stance Radiography of the Knee Joint - A Novel Approach to Assess the Degree of Knee Osteoarthritis.

Introduction: Conventional radiography has always been cited as the gold standard for assessing the structural changes associated with osteoarthritis (OA) of the knee. The purpose of the study was to compare the joint space width between both leg-standing and one-leg-standing radiographs in an assessment of the severity of OA of the knee. Materials and Methods: Fifty patients with medial compartment OA were deployed for the study. Patients underwent both leg standing radiographs and one-leg standing radiograph on the affected leg. Kellgren-Lawrence (KL) radiographic classification was used to assess the severity of OA using joint space width. Conclusion: The mean medial joint space width decreased from 3.26 mm in both legs of the standing radiograph to 1.98 mm in the one-leg standing radiograph. Patients on both leg standing radiographs appreciated an increase in grade during the single leg radiograph. Nearly 52% of patients with both leg standing radiographs have changed the KL grading to a more severe grade when undergone a single leg standing radiograph. One-leg standing radiograph was found to be a better representation of joint space width than both-leg standing radiographs.

Elucidating the Role of Electron Transfer in the Photoluminescence of MoS2 Quantum Dots Synthesized by fs-Pulse Ablation.

Herein, MoS2 quantum dots (QDs) with controlled optical, structural, and electronic properties are synthesized using the femtosecond pulsed laser ablation in liquid (fs-PLAL) technique by varying the pulse width, ablation power, and ablation time to harness the potential for next-generation optoelectronics and quantum technology. Furthermore, this work elucidates key aspects of the mechanisms underlying the near-UV and blue emissions the accompanying large Stokes shift, and the consequent change in sample color with laser exposure parameters pertaining to MoS2 QDs. Through spectroscopic analysis, including UV-visible absorption, photoluminescence, and Raman spectroscopy, we successfully unraveled the mechanisms for the change in optoelectronic properties of MoS2 QDs with laser parameters. We realize that the occurrence of a secondary phase, specifically MoO3-x, is responsible for the significant Stokes shift and blue emission observed in this QD system. The primary factor influencing these activities is the electron transfer observed between these two phases, as validated by excitation-dependent photoluminescence and XPS and Raman spectroscopies.

Exploring the macrominerals and heavy metals profile of deep-sea fishes: A pioneering study on trawl bycatch and discards in the Arabian Sea.

This study assesses macrominerals (Na, K, Ca, Mg, P) and heavy metals (As, Cd, Cr, Cu, Ni, Pb, Se, Sn, Mn, Co, Fe, and Zn) content of deep-sea fish bycatch in the Arabian Sea, offering insights into their nutritional value, toxicant levels and health implications. Variations in Ca, K, P, Mg, and Na levels across species highlight mineral diversity. Setarches guentheri has the highest Ca (7716 mg/kg ww), K (2030.5 mg/kg ww), and P (13,180 mg/kg ww) concentrations. Dactyloptena orientalis exceeds the Cd limit (0.1284 mg/kg ww). Elevated Se levels in fishes were noted, with Dactyloptena orientalis (0.8607 mg/kg ww), Satyrichthys laticeps (0.7303 mg/kg ww), and Snyderina guentheri (0.6193 mg/kg ww). Fish like Pterygotrigla hemisticta contains high Zn (32 mg/kg ww), meeting Recommended Dietary Allowance limits. Deep-sea fish have safe heavy metal levels, but Cd, Se, and Zn exceed acceptable limits. It has been concluded that the consumption of fish species will not pose a potential health risk to humans.

Isolation and characterization of potential multiple extracellular enzyme-producing bacteria from waste dumping area in Addis Ababa.

Extremozymes are innovative and robust biocatalysts produced by various microorganisms from harsh environments. As thermophilic organisms can only develop in a few places, studying them in geothermal environments has provided new insights into the origins and evolution of early life and access to significant bio-resources with potential biotechnology applications. The work aimed to isolate and identify likely multiple extracellular enzyme-producing thermophilic bacteria from an Addis Ababa landfill (Qoshe). The streaking approach was used to purify 102 isolates acquired by serial dilution and spread plate method. The isolates were morphologically and biochemically characterized. Thirty-five cellulases, 22 amylase, 17 protease, and nine lipase-producing bacteria were identified using primary screening methods. Further secondary screening using Strain safety evaluation; two bacterial strains (TQ11 and TQ46) were identified. Based on morphological and biochemical tests, they were found to be gram-positive and rod-shaped. Furthermore, molecular identification and phylogenic analysis of selected promising isolates confirmed the identity of the isolates, Paenibacillus dendritiformis (TQ11) and Anoxybacillus flavithermus (TQ46). The results indicated that, multiple extracellular enzyme-producing thermophilic bacteria isolated from a waste dumping area in Addis Ababa offer useful features for environmental sustainability in a wide range of industrial applications due to their biodegradability and specialized stability under extreme conditions, increased raw material utilization, and decreased waste.

Serum Calcitonin Gene-Related Peptide Is Elevated in Patients With Migraine and Ophthalmoplegia.

BACKGROUND: There is ongoing debate about whether the oculomotor (III), trochlear (IV), or abducens (VI) nerve paresis in patients with migraine is directly attributable to migraine (ophthalmoplegic migraine [OM]) or is due to an inflammatory neuropathy (recurrent painful ophthalmoplegic neuropathy [RPON]). As migraine is associated with elevated serum calcitonin gene-related peptide (CGRP) levels, we studied serum CGRP levels among patients with OM/RPON to determine whether they are elevated during and between attacks. This is the first study assessing CGRP levels in the serum of patients with OM/RPON. METHODS: The aim of this case-control study was to assess serum CGRP levels in patients with ophthalmoplegia and a headache consistent with migraine according to ICHD-3 criteria. Serum CGRP levels were measured during the ictal and interictal phases in 15 patients with OM/RPON and compared with age-matched and sex-matched controls without migraine (12 patients). RESULTS: The median serum CGRP levels were significantly elevated ( P = 0.021) during the ictal phase (37.2 [36.4, 43.6] ng/L) compared with controls (32.5 [30.1, 37.3] ng/L). Serum CGRP levels during the attack correlated with the total duration of ophthalmoplegia. A CGRP level of 35.5 ng/L in the ictal phase of the attack had a sensitivity of 86.7% and specificity of 75.0% in diagnosing a patient with OM/RPON. CONCLUSIONS: Elevated serum CGRP levels during the ictal phase of OM/RPON favor migraine as the underlying cause of episodic headache with ophthalmoplegia.

Unusual Presentation of Ileal Intussusception Due to Submucosal Lipoma in a Child and its Management.

Idiopathic intussusception is the most common form of intussusception in infants and young children. In older children and adults, intussusception being rare, the lead point is usually an underlying bowel pathology (Meckel's diverticulum, hemangioma, carcinoids, polyps, submucous lipomas, etc.) and these are called pathological lead points (PLP's). The management of an obese child with recurrent abdominal pain for over 2 years, diagnosed with ileo-ileal intussusception due to submucosal lipoma is reported here.

Traumatic Optic Neuropathy: Analysis of Demographic and Clinical Parameters Over Three Years in a Tertiary Care Hospital in India.

Background Treatment options for traumatic optic neuropathy (TON) are limited and the role of steroids in the treatment of TON is still controversial. Hence this study was planned to highlight the role of steroids in the treatment of TON. Purpose The study aims to highlight the epidemiological and clinical characteristics, as well as the role of steroids, in TON cases seen during a three-year period at a tertiary care center in India. Methods This was a retrospective study that reviewed records of all cases of TON between January 2018 to January 2020. Results Twenty-three cases of TON were seen representing 1.26% cases of head injuries. The median age was 18 years. One patient (4.34%) had bilateral TON and 18 patients (78.26%) were referred from accident and trauma care. None of the patients presented directly to an ophthalmologist. The most common cause of injury was automobile accident (69.56%). Visual acuity at presentation was 20/80-20/100 in six (26.08%) cases. Fifteen (65.4%) patients had associated closed globe injury. Seven (30.43%) patients had ocular adnexal involvement and 10 (43.47%) patients had orbital fractures. Seventeen (73.91%) received steroid treatment and six of these patients showed visual improvement. Conclusions The study showed that there was no significant association between presenting visual acuity and treatment. The presence of significant ocular injury and orbital injury increased the likelihood of treatment. There was no difference between the treated and untreated groups with respect to final visual acuity.

A Comparative Study of Platelet-Rich Fibrin and Platelet-Rich Fibrin with Hydroxyapatite to Promote Healing of Impacted Mandibular Third Molar Socket.

Aim: The purpose of this study was to compare the efficacy of platelet-rich fibrin (PRF) and platelet-rich fibrin (PRF) with hydroxyapatite (HA) on postoperative pain, swelling, soft tissue healing and osseous regeneration in mandibular third molar extraction socket in human patient. Materials and Methods: This prospective study included total 40 patients who reported to the Department of Oral and Maxillofacial Surgery (OMFS), Teerthanker Mahaveer Dental College and Research Centre (TMDC&RC), Moradabad (U.P.). Twenty patients each in both the groups of PRF and PRF with HA were included for the management of impacted mandibular 3rd molar extraction sockets and were evaluated for effectiveness. Evaluation was done on the basis of following parameters pain and swelling at time interval of 1st, 3rd, 7th day, soft tissue healing at time interval of 3rd, 7th, 14th day and osseous regeneration at time intervals of 1st, 3rd, 6th month postoperatively. Results: Pain and swelling were less in the PRF with HA group when compared to PRF group. Soft tissue healing was better in the PRF with HA group compared to the PRF group. The result of the study shows rapid bone regeneration in the extraction socket treated with the PRF with HA group when compared with the PRF group. Also there was less postoperative discomfort in the PRF with HA-treated group. Conclusion: PRF a mitogenic promoter together with a bone graft forms a scaffolding, promotes early healing thus being creating beneficial for the patient and is also economic.

Hematological alterations in large Babesia species infection in dogs of Kannur District of Kerala.

Canine babesiosis is a tick-borne disease caused by apicomplexan intraerythrocytic hemoprotozoan parasites. It is caused by the small (Babesia gibsoni, B. conradae, and B. vulpes) and large (B. vogeli, B. canis, and B. rossi) Babesia groups. As per the recent reports, the most prominent Babesia species encountered in the Kerala state are the small Babesia, B. gibsoni followed by the large Babesia, B. vogeli. The latter is regarded as mildly pathogenic, causing subclinical or mild disease; however severe complications like systemic inflammatory response syndrome, multiple organ dysfunction syndrome, etc. have also been reported. The information on the status of hematological alterations in naturally infected dogs with large Babesia is lacking, particularly from the state of Kerala. The present study involves a retrospective study of clinical cases of large Babesia infection in dogs. The complete haematological profile from well-documented laboratory records of 4039 dogs suspected for babesiosis presented to District Veterinary Centre, Kannur during the period from December 2018 to October 2020 was analyzed for the study. Natural infections were recorded in 35 (0.87%) dogs based on the presence of intraerythrocytic piroplasm of large Babesia spp. by light microscopic examination of Giemsa-stained blood smears. The most consistent features observed were mild to moderate regenerative, normocytic and normochromic anemia, lowered to normal neutrophil count and thrombocytopenia. In comparison to hemolytic anemia, thrombocytopenia was the most frequent clinicopathological finding in the study with an increased presence of large activated platelets or macro-platelets.

Aberrant Promoter Hypermethylation of p16 and RASSF1a Genes in Colorectal Cancer - Significance in Young Patients.

OBJECTIVE: The clinical profile of colorectal cancers (CRC) in India is different from that described in western countries. Microsatellite instability and APC mutation explain the molecular biology of up to 50% of colorectal cancers. Global genome hypermethylation may be the cause in at least 20% of cases. Few studies from India have examined the epigenetic profile of colorectal cancers. This study was designed to study aberrant promoter hypermethylation of two select tumour suppressor genes (p16, RASSF1a) in patients with colorectal cancer and their association with clinicopathologic features. METHODS: A total of 41 samples including controls were collected from colorectal cancer patients. DNA was isolated from tumour tissue, and methylation-specific PCR was performed for the 2 genes. RESULTS: p16 and RASSF1a promoter hypermethylation was found in 26% and 48% of CRC cases, respectively. RASSF1a promoter hypermethylation was more often seen in young CRC patients aged 40 years or less, and this was found to be statistically significant (p value = 0.037). CONCLUSION: RASSF1a hypermethylation is peculiar to rectal cancers and left-sided colonic tumours in young patients. Large-scale population-based studies with extensive genetic and epigenetic characterization are required for a better understanding and further validation of our findings. For individuals diagnosed with sporadic CRC, these studies on specimen might help predict prognosis and response to therapy.

Effect of Preoperative Biliary Stenting on Outcomes of Pancreaticoduodenectomy.

Biliary drainage before pancreaticoduodenectomy was introduced to decrease morbidity from obstructive jaundice. Recent retrospective and randomised data show that preoperative biliary drainage (PBD) increases perioperative infectious complications. Most patients presenting to our tertiary care centre have undergone drainage procedures prior to surgical consultation. We analysed the impact of PBD, specifically endoscopic stent placement, on the postoperative outcome of pancreaticoduodenectomy at our centre. A cohort of 87 patients undergoing pancreaticoduodenectomy from 2012 to 2016 was identified. Data was collected retrospectively and a comparative analysis of stented and nonstented patients was done. Comparison of the 23 stented patients was done with 23 nonstented patients after matching them for age, sex and bilirubin levels. Median total bilirubin level in stented patients was 10.2 mg/dl versus 7.7 mg/dl in nonstented patients. The infectious complication rate in the stented group was 39.1% versus 12.7% in the nonstented group (P value < 0.05). There was no difference in the anastomotic leak rate between the two groups. Time to curative surgery in the stented group was significantly more than in the nonstented group. Stented patients are at a higher risk for postoperative infectious complications. Patients with obstructive jaundice awaiting surgery should undergo selective biliary drainage after careful planning and discussion between the operating surgeon and the endoscopist.

SARS-CoV-2 infection and mortality during the first epidemic wave in Madurai, south India: a prospective, active surveillance study.

BACKGROUND: SARS-CoV-2 has spread substantially within India over multiple waves of the ongoing COVID-19 pandemic. However, the risk factors and disease burden associated with COVID-19 in India remain poorly understood. We aimed to assess predictors of infection and mortality within an active surveillance study, and to probe the completeness of case and mortality surveillance. METHODS: In this prospective, active surveillance study, we used data collected under expanded programmatic surveillance testing for SARS-CoV-2 in the district of Madurai, Tamil Nadu, India (population of 3 266 000 individuals). Prospective testing via RT-PCR was done in individuals with fever or acute respiratory symptoms as well as returning travellers, frontline workers, contacts of laboratory-confirmed COVID-19 cases, residents of containment zones, patients undergoing medical procedures, and other risk groups. Standardised data collection on symptoms and chronic comorbid conditions was done as part of routine intake. Additionally, seroprevalence of anti-SARS-CoV-2 immunoglobulin G was assessed via a cross-sectional survey recruiting adults across 38 clusters within Madurai District from Oct 19, 2020, to Nov 5, 2020. We estimated adjusted odds ratios (aORs) for positive RT-PCR results comparing individuals by age, sex, comorbid conditions, and aspects of clinical presentation. We estimated case-fatality ratios (CFRs) over the 30-day period following RT-PCR testing stratified by the same variables, and adjusted hazard ratios (aHRs) for death associated with age, sex, and comorbidity. We estimated infection-fatality ratios (IFRs) on the basis of age-specific seroprevalence. RESULTS: Between May 20, 2020, and Oct 31, 2020, 13·5 diagnostic tests were done per 100 inhabitants within Madurai, as compared to 7·9 tests per 100 inhabitants throughout India. From a total of 440 253 RT-PCR tests, 15 781 (3·6%) SARS-CoV-2 infections were identified, with 8720 (5·4%) of 160 273 being positive among individuals with symptoms, and 7061 (2·5%) of 279 980 being positive among individuals without symptoms, at the time of presentation. Estimated aORs for symptomatic RT-PCR-confirmed infection increased continuously by a factor of 4·3 from ages 0-4 years to 80 years or older. By contrast, risk of asymptomatic RT-PCR-confirmed infection did not differ across ages 0-44 years, and thereafter increased by a factor of 1·6 between ages 45-49 years and 80 years or older. Seroprevalence was 40·1% (95% CI 35·8-44·6) at age 15 years or older by the end of the study period, indicating that RT-PCR clinical testing and surveillance testing identified only 1·4% (1·3-1·6%) of all infections in this age group. Among RT-PCR-confirmed cases, older age, male sex, and history of cancer, diabetes, other endocrine disorders, hypertension, other chronic circulatory disorders, respiratory disorders, and chronic kidney disease were each associated with elevated risk of mortality. The CFR among RT-PCR-confirmed cases was 2·4% (2·2-2·6); after age standardisation. At age 15 years or older, the IFR based on reported deaths was 0·043% (0·039-0·049), with reported deaths being only 11·0% (8·2-14·5) of the expected count. INTERPRETATION: In a large-scale SARS-CoV-2 surveillance programme in Madurai, India, we identified equal risk of asymptomatic infection among children, teenagers, and working-age adults, and increasing risk of infection and death associated with older age and comorbidities. Establishing whether surveillance practices or differences in infection severity account for gaps between observed and expected mortality is of crucial importance to establishing the burden of COVID-19 in India. FUNDING: The Bill & Melinda Gates Foundation, the National Science Foundation, and the National Institute of General Medical Sciences. TRANSLATION: For the Hindi translation of the abstract see Supplementary Materials section.

Bromelain and Olea europaea (L.) leaf extract mediated alleviation of benzo(a)pyrene induced lung cancer through Nrf2 and NFκB pathway.

Lung cancer is the most aggressive as well as deadly form of cancer and most of the lung cancer cases are involved in direct smoking or passive smoking. Oxidative stress and pulmonary inflammation regulated by some transcription factors like Nrf2, NF-κB etc. play important roles in lung cancer. Various combinations of therapies are currently attributed to lung cancer treatment. A plethora of evidence supports that the consumption of plant-derived foods can prevent chronic diseases like cancer. Leaves of olive (Olea europaea L.) are rich in phenolic compounds which are having antioxidant and anti-inflammatory property. Also, bromelain from pineapple juice and from pineapple stem is a potent anti-inflammatory agent. We took a pragmatic approach to prevent carcinogenesis by supplementing the combination of these two extracts. In this study, we have tried to evaluate the amelioration of various hallmarks associated with benzo(a)pyrene-induced lung carcinogenesis upon the combinatorial treatment of ethanolic olive leaf extract (EOLE) and bromelain. We have studied the role of EOLE in amelioration of BaP-induced oxidative stress in the lung. As several reports of anticancer activity of bromelain are available, we have combined EOLE with bromelain to study their protective role against BaP-mediated lung damage. Changes in DNA integrity, LPO level in lung after EOLE-treated animal were examined. Then, we have evaluated the synergistic role of EOLE and bromelain. We have found that EOLE in combination with bromelain was able to increase the translocation of Nrf2 from cytoplasm to nucleus and decrease the translocation of NF-κB from cytoplasm to nucleus. Combination of treatment also reduced the expression of TNFα, IL-6, and some matrix metalloproteinases in lung tissue. Our findings suggest that EOLE and bromelain can synergistically reduce the BaP-induced lung carcinogenesis associated with inflammation and oxidative stress via regulating the expression of various inflammatory markers and also modulating the activity of pulmonary antioxidant armories.

Peste Des Petits Ruminants in Atypical Hosts and Wildlife: Systematic Review and Meta-Analysis of the Prevalence between 2001 and 2021.

Peste des petits ruminants (PPR) or goat plague is considered a leading, highly contagious, and most lethal infectious viral disease of small ruminants affecting the worldwide livestock economy and international animal trade. Although sheep and goats are the primarily affected, the PPR Virus (PPRV) host range has expanded to other livestock (large ruminants) and wildlife animals over the last few decades, resulting in serious concern to the ongoing PPR global eradication program, which is primarily optimized, designed, and targeted towards accessible sheep and goat population. A systematic review and meta-analysis study was conducted to estimate the prevalence and spill-over infection of PPRV in large ruminants (bovine and camel) and wildlife. Published articles from 2001 to October 2021 on the "PPR" were searched in four electronic databases of PubMed, Scopus, Science direct, and Google Scholars. The articles were then selected using inclusion criteria (detection/prevalence of PPRV in bovine, camel, and wildlife population), exclusion criteria (only sheep or goats, lack of prevalence data, experimental trial, test evaluation, and reviews written in other languages or published before 2001), and the prevalence was estimated by random effect meta-analysis model. In the current study, all published articles belonged to Africa and Asia. The overall pooled prevalence of PPR estimates was 24% (95% CI: 15-33), with 30% in Asia (95% CI: 14-49) and 20% in Africa (95% CI: 11-30). The overall estimated pooled prevalence at an Africa-Asia level in bovine and camel was 13% (95% CI: 8-19), and in wildlife, it was 52% (95% CI: 30-74) with significant heterogeneity (I2 = 97%) in most pooled estimates with a high prevalence in atypical hosts and wildlife across Asia and Africa. Over the last two decades, the host range has increased drastically in the wildlife population, even for prevalent PPR in the unnatural hosts only for a short time, contributing to virus persistence in multi-host systems with an impact on PPR control and eradication program. This observation on the epidemiology of the PPRV in unnatural hosts demands appropriate intervention strategies, particularly at the livestock-wildlife interface.

Thyrotoxic periodic paralysis: A retrospective, observational study from India.

Background & objectives: Thyrotoxic periodic paralysis (TPP) is an endocrine emergency presenting with acute-onset flaccid paralysis in a patient having thyrotoxicosis accompanied by hypokalaemia. This study was conducted to evaluate the clinical profile of patients with TPP presenting to three centres in India. Methods: This retrospective, observational study was conducted at three tertiary care Armed Forces medical centres, located at Lucknow, Kolkata and Delhi. The history, clinical features, treatment details and outcomes were evaluated. Results: Of the 244 patients with thyrotoxicosis, 15 were diagnosed with TPP and included in the study. These 15 patients (14 male and 1 female) had 32 episodes of TPP which were analyzed. The mean age was 30.2±6.2 yr (range: 21-39), and overt thyrotoxicosis was seen in all patients except one who had subclinical hyperthyroidism. Graves' disease was the most common cause of thyrotoxicosis (13/15) and the remaining two patients had subacute thyroiditis and gestational thyrotoxicosis. Hypokalaemia (serum potassium <3.5 mmol/l) was seen in 12 patients, and the mean serum potassium was 3.2±0.9 mmol/l (range: 2.1-4.9). All patients had flaccid weakness, predominantly involving the lower limb with no bulbar, respiratory or cranial nerve involvement. The average duration of paralysis was 10.6±5.7 h (range: 3-28 h). Interpretation & conclusions: Our study demonstrated an early age of presentation and presence of clinical and biochemical thyrotoxicosis in majority of patients with TPP. Hypokalaemia may not always be evident in patients with TPP.