Assessing the efficacy of Laser pulpotomy versus conventional pulpotomy in primary teeth: A systematic review and meta-analysis of clinical trials.

PURPOSE: This study systematically reviewed the clinical and radiographic outcomes of laser versus conventional pulpotomy in primary teeth. It also compared the success and effectiveness of different lasers to enhance the understanding and use of laser pulpotomy as an alternative treatment. METHODOLOGY: An electronic search was carried out in PubMed and Cochrane from 1st January 1999 to 31st December 2023. The published articles in the English language were searched using MeSH terms and text words. Only randomized controlled trials with a sample size of more than 10 and follow-ups over 6 months were included. Meta-analysis and forest plots were evaluated by utilizing Review Manager 5.4 software. Two reviewers assessed the risk of bias using the RoB 2 tool and discrepancies were resolved by the third reviewer. The success rates were combined using a random effects model to determine clinical and radiographic outcomes. We used risk ratios with 95% confidence intervals (CI) as the primary effect measures and set the significance level at 0.05. RESULTS: Only 18 studies met the inclusion criteria after an electronic search. Among them, 13 studies evaluated the clinical and radiographic outcomes of laser with formocresol pulpotomy, 2 studies compared with ferric sulfate pulpotomy, and the remaining studies with Mineral trioxide aggregate (MTA) pulpotomy. The various studies showed different levels of bias. There was no significant difference in the clinical success rate (p = 0.47; RR: 1.01; 95% CI 0.98-1.04; I2 = 0%; p = 0.70) and radiographic success rate (p = 0.94; RR: 1.00; 95% CI 0.91-1.09; I2 = 64%; p = 0.001) between laser pulpotomy and formocresol. Similarly, there was no significant difference between laser pulpotomy and ferric sulfate or MTA pulpotomy. CONCLUSION: Diode laser and LLLT can be considered as alternative pulpotomy agents to formocresol in primary teeth. However, high-quality trials are needed to confirm the accuracy and reliability of these findings.

Potential of phytocompounds from Brassica oleracea targeting S2-domain of SARS-CoV-2 spike glycoproteins: Structural and molecular insights.

By 24th Sep. 2021, there are more than 229 million COVID-19 cases worldwide, the researchers are tirelessly working to discover and develop an efficient drug molecule against this devastative viral infection. This study aims to evaluate the inhibitory efficiency of the organic acids and phenolic compounds present in Brassica oleracea (Tronchuda Cabbage) against spike glycoprotein in SARS-CoV-2. Thirty-seven phytocompounds are screened on the basis of their molecular weight (<500 g/mol) and 14 ligands are docked using Autodock Vina and Autodock4 (version 4.2.6). The stability of the top five docked complexes was analyzed using classical molecular dynamics (MD) simulation. ADMET analysis is performed for the top five compounds and their targets are identified using SwissTargetPrediction. Phytoactives from B. oleracea namely Astragalin, 3-p-coumaroylquinic acid, 4-p-coumaroylquinic acid and sinapoyl-D-glucoside showed high binding affinities and free energy of binding during molecular docking and MD simulation studies (∼ 8.5-9.0 kcal/mol) for the spike glycoprotein trimer of SARS-CoV2. The ADMET analysis revealed that these phytocompounds have good solubility in the aqueous phase and that they don't penetrate the blood brain barrier. Moreover, there is no P-gp substrate inhibition, CYP1A2 inhibition, CYP2C19 inhibition, CYP2C9 inhibition, CYP2D6 inhibition and CYP3A4 inhibition observed for these compounds. Additionally, zero PAINS alerts were reported. These findings from molecular docking and MD simulation studies suggest that astragalin and coumaroylquinic acids from Tronchuda cabbage possess potential inhibitory capacity against spike glycoprotein trimer of SARS-CoV-2 and could be further taken up as lead targets for drug discovery.

DBGC: Dimension-Based Generic Convolution Block for Object Recognition.

The object recognition concept is being widely used a result of increasing CCTV surveillance and the need for automatic object or activity detection from images or video. Increases in the use of various sensor networks have also raised the need of lightweight process frameworks. Much research has been carried out in this area, but the research scope is colossal as it deals with open-ended problems such as being able to achieve high accuracy in little time using lightweight process frameworks. Convolution Neural Networks and their variants are widely used in various computer vision activities, but most of the architectures of CNN are application-specific. There is always a need for generic architectures with better performance. This paper introduces the Dimension-Based Generic Convolution Block (DBGC), which can be used with any CNN to make the architecture generic and provide a dimension-wise selection of various height, width, and depth kernels. This single unit which uses the separable convolution concept provides multiple combinations using various dimension-based kernels. This single unit can be used for height-based, width-based, or depth-based dimensions; the same unit can even be used for height and width, width and depth, and depth and height dimensions. It can also be used for combinations involving all three dimensions of height, width, and depth. The main novelty of DBGC lies in the dimension selector block included in the proposed architecture. Proposed unoptimized kernel dimensions reduce FLOPs by around one third and also reduce the accuracy by around one half; semi-optimized kernel dimensions yield almost the same or higher accuracy with half the FLOPs of the original architecture, while optimized kernel dimensions provide 5 to 6% higher accuracy with around a 10 M reduction in FLOPs.

A pilot study for smartphone photography to assess bleb morphology and vasculature post-trabeculectomy.

PURPOSE: The current grading systems used for bleb morphology assessment in patients post-trabeculectomy are based on standardized slit-lamp photographs and anterior segment imaging devices. The lack of availability of these expensive and non-portable devices in resource-deficient settings is a significant deterrent in their widespread utilization for proper post-operative management. The rapidly evolving utilization of smartphone photography has significantly benefited diagnostics of posterior segment disorders and is now being increasingly utilized for monitoring anterior segment pathologies as well as post-surgical course. In this study, we study a novel use of smartphones for bleb photography for assessing the morphological characteristics as vascularity and microcysts. METHODS: In this pilot, observational study, we compared the trabeculectomy bleb images of five subjects, obtained by iPhone X (dual lens) and iPhone 6S (single lens). We captured two image sets with both smartphones first with a focussed torchlight and then with a built-in flash video light. RESULTS: The images resulting from the newer iPhone X were substantially superior than those from iPhone 6S. For the 12-megapixel dual-camera set-up on the iPhone X, the 1 × lens resulted in better images than the 2 × lens with contrast and overall clarity of the area of interest. While the macro-lens attachment had promising results at 1 × zoom, there is no added advantage of the macro-lens attachment as it resulted in considerable loss of image quality at twice the zoom. Using a 20 D lens helped attain higher magnification and better framing as it reduced the focussing distance needed to get sharp images. The images obtained from both smartphones were of higher quality when illuminated from an external source when compared to the native iPhone flash due to even exposure and fewer autofocus artefacts. CONCLUSION: Analyses of all image sets showed that the current generation in-built camera app on IOS and newer iPhone camera optics resulted in high-quality images of the ocular surface with high magnification without any loss in clarity.

A Block Adaptive Near-Lossless Compression Algorithm for Medical Image Sequences and Diagnostic Quality Assessment.

The near-lossless compression technique has better compression ratio than lossless compression technique while maintaining a maximum error limit for each pixel. It takes the advantage of both the lossy and lossless compression methods providing high compression ratio, which can be used for medical images while preserving diagnostic information. The proposed algorithm uses a resolution and modality independent threshold-based predictor, optimal quantization (q) level, and adaptive block size encoding. The proposed method employs resolution independent gradient edge detector (RIGED) for removing inter-pixel redundancy and block adaptive arithmetic encoding (BAAE) is used after quantization to remove coding redundancy. Quantizer with an optimum q level is used to implement the proposed method for high compression efficiency and for the better quality of the recovered images. The proposed method is implemented on volumetric 8-bit and 16-bit standard medical images and also validated on real time 16-bit-depth images collected from government hospitals. The results show the proposed algorithm yields a high coding performance with BPP of 1.37 and produces high peak signal-to-noise ratio (PSNR) of 51.35 dB for 8-bit-depth image dataset as compared with other near-lossless compression. The average BPP values of 3.411 and 2.609 are obtained by the proposed technique for 16-bit standard medical image dataset and real-time medical dataset respectively with maintained image quality. The improved near-lossless predictive coding technique achieves high compression ratio without losing diagnostic information from the image.

Bhutan's First Emergency Air Medical Retrieval Service: The First Year of Operations.

OBJECTIVE: The Bhutan Emergency Aeromedical Retrieval (BEAR) Team is the only helicopter emergency medical service in Bhutan. This study was performed to review the clinical cases cared for by the BEAR Team, ascertain the types of interventions that were performed, and determine the outcomes of patients evacuated in its first year of operations. METHODS: This is a retrospective observational study in which medical evacuations performed in the first year of operations were analyzed. The number of airlifts activated during the study period determined the sample size (171). Data were obtained from case logs and trip sheets. RESULTS: The BEAR Team provided services to all regions of the country in its first year. The overall survival rate was 73.1%. The most common intervention required was securing a definitive airway (n = 24). The top 3 conditions requiring air medical retrieval were sepsis, acute mountain sickness, and trauma. CONCLUSION: Helicopter emergency medical services are known to decrease the time to definitive treatment. This is particularly pertinent in Bhutan, given the scattered population distribution, long transport times, and distribution of medical resources and specialty care. This study is the first of its kind in Bhutan, and this can pave way to conduct more studies involving patients transported by air ambulance.

Prevalence and risk factors of anemia and zinc deficiency among 4-6-year-old children of Allahabad District, Uttar Pradesh.

Anemia and zinc deficiency are two of the most daunting nutritional problems afflicting the young children among developing countries like India. Thus, in view of this the following study was designed to investigate the status of undernutrition and micronutrient status (iron and zinc) of children aged between 4 and 6 years of Allahabad district. The anthropometric measurements (height and weight); biochemical parameters (hemoglobin and serum zinc), and general information of the children were recorded. Out of the total 365 children studied, 92.9% were anemic out of which 90.6% (n = 307) were moderately anemic having and 2.3% belonged to mild anemic group. Serum zinc deficiency was 65.3%. Anemia was more commonly observed among undernourished children. In case of zinc deficiency poor nutritional status, the age of 60-71 months and rural settlement projected out to be the potent risk factors.

Layered Double Hydroxides as Precursors to Ti4+ Doped MgO Nanoparticles with Tunable Band Gap.

TixMg1-xO solid solutions with tunable band gap are potential candidates for various applications such as photocatalysis, water splitting, dielectrics, etc. Present study reports the synthesis of TixMg1-xO (x = 0.02 to 0.5) solid solution nanoparticles via a simple sol-gel method. First, layered double hydroxides (precursors) are produced by sol-gel method, which on calcination produce the TixMg1-xO solid solutions. The effect of concentration of titanium (introduced as titanium isopropoxide during the synthesis) on the optical properties of TixMg1-xO solid solution nanoparticles has been investigated. Phase analysis of the precursors demonstrates the formation of Mg-Ti layered double hydroxides and after calcination at 500 °C and 700 °C, Ti4+ doped MgO as well as Mg2TiO4 and MgTiO3 are formed. Scanning electron microscopy images show that the TixMg1-xO samples calcined at 500 °C possess flake-like morphology and after calcination at 700 °C, small agglomerated nanoparticles are formed. In the TEM images, flakes along with nanoparticles are observed in the TixMg1-xO solid solutions prepared using lower concentration of titanium isopropoxide (0.4 and 2.0 mmol) whereas agglomerated nanoparticles are formed in the TixMg1-xO solid solution prepared using higher concentration of titanium isopropoxide (5.0 mmol). Diffuse reflectance spectroscopic studies indicate that the band gap of TixMg1-xO solid solution nanoparticles can be tuned from 3.7 eV to 4.4 eV by varying the concentration of titanium and calcination temperature. Layered double hydroxides are excellent precursors that can yield band gap tunable TixMg1-xO solid solution nanoparticles on calcination with homogeneous elemental distribution.

Evaluation of the National Health Service (NHS) Direct Pilot Telehealth Program: Cost-Effectiveness Analysis.

OBJECTIVE: To evaluate the cost-effectiveness of a pilot telehealth program applied to a wide population of patients with chronic obstructive pulmonary disease (COPD). DESIGN: Vital signs data were transmitted from the home of the patient on a daily basis using a patient monitoring system for review by community nurse to assist decisions on management. SETTING: Community services for patients diagnosed with COPD. PARTICIPANTS: Two Primary Care Trusts (PCTs) enrolled 321 patients diagnosed with COPD into the telehealth program. Two hundred twenty-seven (n = 227) patients having a complete baseline record of at least 88 days of continuous remote monitoring and meeting all inclusion criteria were included in the statistical analysis. INTERVENTION: Remote monitoring. METHODS: Resource and cost data associated with patient events (inpatient hospitalization, accident and emergency [A&E], and home visits) 12 months before, immediately before and during monitoring, equipment, start-up, and administration were collected and compared to determine cost-effectiveness of the program. MAIN OUTCOME MEASURES: Cost-effectiveness of program, impact on resource usage, and patterns of change in resource usage. RESULTS: Cost-effectiveness was determined for the two PCTs and the two periods before monitoring to provide four separate estimates. Cost-effectiveness had high variance both between the PCTs and between the comparison periods ranging from a saving of £140,800 ($176,000) to an increase of £9,600 ($12,000). The average saving was £1,023 ($1,280) per patient per year. The largest impact was on length of stay with a fall in the average length of inpatient care in PCT1 from 11.5 days in the period 12 months before monitoring to 6.5 days during monitoring, and similarly in PCT2 from 7.5 to 5.2 days. CONCLUSION: There was a wide discrepancy in the results from the two PCTs. This places doubt on outcomes and may indicate also why the literature on cost-effectiveness remains inconclusive. The wide variance on savings and the uncertainty of monitoring cost do not allow a definitive conclusion on the cost-effectiveness as an outcome of this study. It might well be that the average saving was £1,023 ($1,280) per patient per year, but the variance is too great to allow this to be statistically significant. Each locality-based clinical service provides a service to achieve the same clinical goal, but it does so in significantly different ways. The introduction of remote monitoring has a profound effect on team learning and clinical practice and thus distorts the cost-effectiveness evaluation of the use of the technology. Cost-effectiveness studies will continue to struggle to provide a definitive answer because outcome measurements are too dependent on factors other than the technology.

An investigation of accessory canals in primary molars - an analytical study.

AIM: To evaluate the number, anatomical morphology and patency of accessory canals in the furcation of carious primary molar teeth and to ascertain whether these anatomic variations contribute to endodontic infection. DESIGN: The accessory canals were observed under radiovisiography or RVG (Phase 1), scanning electron microscopy or SEM (Phase 2) and light microscopy (Phase 3). RESULTS: The prevalence of accessory canals was 34.3% with a mean ± SD of 0.73 ± 0.980 in Phase 1, 73.3% with a mean ± SD of 3.07 ± 3.151 in Phase 2 and 64.3% with a mean ± SD of 1.68 ± 2.405 in Phase 3. The results observed were Phase 1 vs Phase 2<0.001 (highly significant), Phase 1 vs Phase 3 0.110 (ns) and Phase 2 vs Phase 3<0.001 (highly significant) employing Wilcoxon signed-rank test. The canals were predominantly oval in shape and ranged from 1 µ to 225 µ in diameter. Only 7% canals were observed to be patent. CONCLUSIONS: Accessory canals may not be the primary cause of transmission of infection in the inter-radicular area of primary molars. Other factors enhancing permeability of the pulpal floor may be of more significance and need evaluation on a larger scale.

Crystal structure of a plant albumin from Cicer arietinum (chickpea) possessing hemopexin fold and hemagglutination activity.

MAIN CONCLUSION: Crystal structure of a reported PA2 albumin from Cicer arietinum shows that it belongs to hemopexin fold family, has four beta-propeller motifs and possesses hemagglutination activity, making it different from known legume lectins. A plant albumin (PA2) from Cicer arietinum, presumably a lectin (CAL) owing to its hemagglutination activity which is inhibited by complex sugars as well as glycoproteins such as fetuin, desialylated fetuin and fibrinogen. The three-dimensional structure of this homodimeric protein has been determined using X-ray crystallography at 2.2 Å in two crystal forms: orthorhombic (P21212) and trigonal (P3). The structure determined using molecular replacement method and refined in orthorhombic crystal form reached R-factors R free 22.6 % and R work 18.2 % and in trigonal form had 22.3 and 17.9 % in the resolution range of 20.0-2.2 and 35.3-2.2 Å, respectively. Interestingly, unlike the known legume lectin fold, the structure of this homodimeric hemagglutinin belonged to hemopexin fold that consisted of four-bladed ß-propeller architecture. Each subunit has a central cavity forming a channel, inside of which is lined with hydrophobic residues. The channel also bears binding sites for ligands such as calcium, sodium and chloride ions, iodine atom in the case of iodine derivative and water molecules. However, none of these ligands seem important for the sugar recognition. No monosaccharide sugar specificity could be detected using hemagglutination inhibition. Chemical modification studies identified a potential sugar-binding site per subunit molecule. Comparison of C-alpha atom positions in subunit structures showed that the deviations between the two crystal forms were more with respect to blades I and IV. Differences also existed between subunits in two forms in terms of type and site of ligand binding.

Nurses' and community support workers' experience of telehealth: a longitudinal case study.

BACKGROUND: Introduction of telehealth into the healthcare setting has been recognised as a service that might be experienced as disruptive. This paper explores how this disruption is experienced. METHODS: In a longitudinal qualitative study, we conducted focus group discussions prior to and semi structured interviews post introduction of a telehealth service in Nottingham, U.K. with the community matrons, congestive heart failure nurses, chronic obstructive pulmonary disease nurses and community support workers that would be involved in order to elicit their preconceptions and reactions to the implementation. RESULTS: Users experienced disruption due to the implementation of telehealth as threatening. Three main factors add to the experience of threat and affect the decision to use the technology: change in clinical routines and increased workload; change in interactions with patients and fundamentals of face-to-face nursing work; and change in skills required with marginalisation of clinical expertise. CONCLUSION: Since the introduction of telehealth can be experienced as threatening, managers and service providers should aim at minimising the disruption caused by taking the above factors on board. This can be achieved by employing simple yet effective measures such as: providing timely, appropriate and context specific training; provision of adequate technical support; and procedures that allow a balance between the use of telehealth and personal visit by nurses delivering care to their patients.

Designing effective visualizations of habits data to aid clinical decision making.

BACKGROUND: Changes in daily habits can provide important information regarding the overall health status of an individual. This research aimed to determine how meaningful information may be extracted from limited sensor data and transformed to provide clear visualization for the clinicians who must use and interact with the data and make judgments on the condition of patients. We ascertained that a number of insightful features related to habits and physical condition could be determined from usage and motion sensor data. METHODS: Our approach to the design of the visualization follows User Centered Design, specifically, defining requirements, designing corresponding visualizations and finally evaluating results. This cycle was iterated three times. RESULTS: The User Centered Design method was successfully employed to converge to a design that met the main objective of this study. The resulting visualizations of relevant features that were extracted from the sensor data were considered highly effective and intuitive to the clinicians and were considered suitable for monitoring the behavior patterns of patients. CONCLUSIONS: We observed important differences in the approach and attitude of the researchers and clinicians. Whereas the researchers would prefer to have as many features and information as possible in each visualization, the clinicians would prefer clarity and simplicity, often each visualization having only a single feature, with several visualizations per page. In addition, concepts considered intuitive to the researchers were not always to the clinicians.

Pregnancy With Uterine Fibroids: Obstetric Outcome at a Tertiary Care Hospital of Central India.

BACKGROUND: Uterine fibroids are the most frequent benign tumor of the female reproductive system, with a significantly lower frequency in pregnancy. This could be due to the fact that uterine fibroids are linked to infertility and low implantation rates following in vitro fertilization (IVF). The goal of this study was to look at the obstetrics outcomes of uterine fibroids and their consequences in a tertiary hospital. MATERIALS AND METHODS: The current study was a observational cohort study that evaluated the cases of pregnancy with fibroid. Study was undertaken at the Department of Obstetrics and Gynecology (OBGY) at a medical college in central India and it was conducted over a period of nine months from 1st November 2021 to 31st July 2022. All pregnant women who had an ultrasonography (USG)-documented uterine fibroid diagnosed prenatally or antenatally were enrolled. All demographic information, laboratory and USG results were noted and their mode of delivery, obstetric complications, if any, and neonatal outcomes were evaluated. RESULTS: A total of 110 cases were enrolled as per inclusion and exclusion criteria. The majority of patients (42.73%) were in the 26- to 30-year-old age group. In this study, the majority of cases were carried to term (80.9%). The most prevalent mode of delivery was caesarean section (61.82%). Major complications during pregnancy were threatened preterm labor (21.82%), and blood transfusion (20.00%), whereas postpartum hemorrhage (PPH) occurred in 9.09% cases, and 47 patients (42.72%) were asymptomatic throughout pregnancy. Major neonatal outcomes in our study were neonatal intensive care unit (NICU) hospitalization (20%), required neonatal resuscitation (14.55%), and neonatal mortality occurring in 1.82% cases. Gestational age at termination of pregnancy, when compared with different characteristics of fibroid, like type (p value 0.663), location (p value 0.552) and number of fibroid (p value 0.112), did not show any significant association. Similarly, maternal complications also did not show significant association (p value >0.05) with different characters of fibroid.  Conclusion: Pregnancies with fibroid are high-risk pregnancies that are linked to difficulties throughout the antepartum, intrapartum, and postpartum periods, as well as increased chances of cesarean delivery and PPH.

An Evaluation of the Effectiveness of Various Luting Cements on the Retention of Implant-Supported Metal Crowns.

Background and objective Cement-retained prostheses have replaced screw-retained prostheses as the preferred restoration in recent years in order to overcome the latter's limitations. In this study, four different luting cements were compared to evaluate their efficacy on the retention of cement-based metal crowns to implant abutments. Materials and methods In the right and left first molar regions, four implant analogs (Internal Hex, Adin Dental Implant Systems Ltd., Tel-Aviv, Israel) were screwed into epoxy resin casts (Araldite CY 230-1 IN, India) that were positioned perpendicular to the cast's plane. Four metal copings were created and cemented. Group A: polycarboxylate cement (DUR) (DurelonTM, 3M Espe, St. Paul, MN); Group B: PANAVIA™ F 2.0 dual-cure resin cement (Kuraray America, Inc., New York, NY); Group C: resin-modified glass ionomer (3M™ RelyX™ Luting, 3M Espe); and Group D: non-eugenol temporary resin cement (Kerr-Temp, KaVo Kerr, Brea, CA) were used to cement crowns. To check the retention capacity, samples were put through a pull-out test on an Instron universal testing machine (TSI­Tecsol, Bengaluru, India) with a crosshead speed of 0.5 mm/min. Each coping's de-cementing load was noted, and average values for every sample were computed and statistically analyzed. Results The findings demonstrated that non-eugenol temporary resin implant cement has the lowest retention value at 138.256 N, followed by resin-modified glass ionomer cement at 342.063 N, polycarboxylate luting cement at 531.362 N, and resin cement at 674.065 N. The average difference in retentive strength across all four groups was statistically very significant (p=0.001). Conclusion Based on our findings, non-eugenol temporary resin implant cement enables simple retrievability of the prosthesis in the event of a future failure and is appropriate for implant restorations with cement retention. Also, cements made of polycarboxylate and resin have the highest retention values.

Challenges in evaluating telehealth through RCT-the problem of randomization.

Telehealth is heralded as a panacea to control burgeoning demand on healthcare resources and lack of streamlining in care delivery. However, evaluating the effectiveness of telehealth on health and care delivery outcomes through randomized controlled trials (RCTs) has been an issue of contention. This research investigates the issues that affect telehealth evaluation. The strategy adopted in this research involved conducting a qualitative longitudinal case study, in the UK. Data was collected through focus group discussions and interviews; and analyzed thematically. The results of this research indicate that there are both practical and methodological issues that affect evaluation of telehealth through RCT in healthcare. Addressing these issues is vital in order to understand how an evaluation strategy should be deployed, and whether it is suited to the healthcare context.

Cellular and molecular mechanisms, genetic predisposition and treatment of diabetes-induced cardiomyopathy.

Diabetes mellitus is a common disease affecting millions of people worldwide. This disease is not limited to metabolic disorders but also affects several vital organs in the body and can lead to major complications. People with diabetes mellitus are subjected to cardiovascular complications, such as cardiac myopathy, which can further result in major complications such as diabetes-induced cardiac failure. The mechanism underlying diabetes-induced cardiac failure requires further research; however, several contributing factors have been identified to function in tandem, such as reactive oxygen species production, inflammation, formation of advanced glycation end-products, altered substrate utilisation by mitochondria, activation of the renin-angiotensin-aldosterone system and lipotoxicity. Genetic factors such as microRNAs, long noncoding RNAs and circular RNAs, as well as epigenetic processes such as DNA methylation and histone modifications, also contribute to complications. These factors are potential targets for developing effective new therapies. This review article aims to facilitate in depth understanding of these contributing factors and provide insights into the correlation between diabetes mellitus and cardiovascular complications. Some alternative targets with therapeutic potential are discussed to indicate favourable targets for the management of diabetic cardiomyopathy.

Assessment of the prevalence of congenital heart disease in children with pneumonia in tertiary care hospital: A cross-sectional study.

BACKGROUND AND OBJECTIVES: Pneumonia is the most common cause of death in children under five years of age. Epidemiological factors and the disease burden differ in developing and industrialized countries. The present study is a cross sectional observational study, carried out from August 2018 to August 2020 in Hindu Rao Hospital, to assess the prevalence of congenital heart disease (CHD) in patients with pneumonia in children up to 5 years. The main objectives of the study were to study the prevalence of congestive cardiac failure (CCF) in pneumonia with and without congenital heart disease. MATERIAL AND METHODS: Patients under 5 years of age, presenting with pneumonia during August 2018 to July 2020 were enrolled for study. The bio-data of each patient was documented each patient was clinically evaluated thoroughly and findings noted. Pneumonia was diagnosed on typical history, physical findings, blood investigations and chest radiographic finding of pneumonia infiltrates in either one or both lung fields. All the cases of pneumonia underwent transthoracic 2 Dimensional (2D) and Doppler echocardiography, done by the cardiologist. Any congenital heart disease so found was noted. The type and size of the defects was documented. The ventricular septal defects were classified based on the site and size. The size of the patient ductus arteriosus was also determined. These measurements were taken to evaluate the impact of defect size on pneumonia. CCF was diagnosed when the patient fulfilled the clinical diagnostic criteria of heart failure. All the cases of pneumonia underwent transthoracic 2 Dimensional (2D) and Doppler echocardiography for diagnosis of any congenital heart disease. RESULTS: Mean age of the children with pneumonia was 9.94 months with 77.5% of the cases below 1 year of age. Male predominance was seen with 56.3% males to 43.8% females. Prevalence of congenital heart disease among cases of pneumonia was 12.5% while that of congestive heart failure was 27.5%. Most common CHD observed was VSD (14 cases; 8.8%) followed by PDA, ASD and TGA (4; 2.5% and 3; 1.9% and 1; 0.6% cases respectively). A significant association was observed between presence of congenital heart disease and development of CCF. CONCLUSION: Our study demonstrates that most patients with pneumonia or recurrent pneumonia are likely to have an underlying illness at the time of pneumonia. Recurrent ALRTI often occurred in children with history of congenital heart diseases (CHD) and is also associated with Congestive Cardiac Failure. Children with CHD are more vulnerable to recurrent respiratory tract infection.

Introgressing cry1Ac for Pod Borer Resistance in Chickpea Through Marker-Assisted Backcross Breeding.

The gram pod borer Helicoverpa armigera is a major constraint to chickpea (Cicer arietinum L.) production worldwide, reducing crop yield by up to 90%. The constraint is difficult to overcome as chickpea germplasm including wild species either lacks pod borer resistance or if possessing resistance is cross-incompatible. This study describes conversion of elite but pod borer-susceptible commercial chickpea cultivars into resistant cultivars through introgression of cry1Ac using marker-assisted backcross breeding. The chickpea cultivars (PBG7 and L552) were crossed with pod borer-resistant transgenic lines (BS 100B and BS 100E) carrying cry1Ac that led to the development of BC1F1, BC1F2, BC1F3, BC2F1, BC2F2, and BC2F3 populations from three cross combinations. The foreground selection revealed that 35.38% BC1F1 and 8.4% BC1F2 plants obtained from Cross A (PBG7 × BS 100B), 50% BC1F1 and 76.5% BC1F2 plants from Cross B (L552 × BS 100E), and 12.05% BC2F2 and 82.81% (average) BC2F3 plants derived from Cross C (PBG7 × BS 100E) carried the cry1Ac gene. The bioassay of backcross populations for toxicity to H. armigera displayed up to 100% larval mortality. BC1F1 and BC1F2 populations derived from Cross B and BC2F3 population from Cross C segregated in the Mendelian ratio for cry1Ac confirmed inheritance of a single copy of transgene, whereas BC1F1 and BC1F2 populations obtained from Cross A and BC2F2 population from Cross C exhibited distorted segregation ratios. BC1F1 plants of Cross A and Cross B accumulated Cry1Ac protein ranging from 11.03 to 11.71 µgg-1 in leaf tissue. Cry1Ac-positive BC2F2 plants from Cross C demonstrated high recurrent parent genome recovery (91.3%) through background selection using SSR markers and phenome recovery of 90.94%, amongst these 30% plants, were homozygous for transgene. The performance of BC2F3 progenies derived from homozygous plants was similar to that of the recurrent parent for main agronomic traits, such as number of pods and seed yield per plant. These progenies are a valuable source for H. armigera resistance in chickpea breeding programs.

Dynamics of the secreted frizzled related protein Sizzled and potential implications for binding to bone morphogenetic protein-1 (BMP-1).

Sizzled (Szl) is both a secreted frizzled related protein (sFRP) and a naturally occurring inhibitor of the zinc metalloproteinase bone morphogenetic protein-1 (BMP-1), a key regulator of extracellular matrix assembly and growth factor activation. Here we present a new crystal structure for Szl which differs from that previously reported by a large scale (90°) hinge rotation between its cysteine-rich and netrin-like domains. We also present results of a molecular docking analysis showing interactions likely to be involved in the inhibition of BMP-1 activity by Szl. When compared with known structures of BMP-1 in complex with small molecule inhibitors, this reveals features that may be helpful in the design of new inhibitors to prevent the excessive accumulation of extracellular matrix that is the hallmark of fibrotic diseases.