Green teeth associated with hyperbilirubinemia: a case report.

BACKGROUND: Green stain is an uncommon clinical condition associated with deposition of bilirubin in the dental hard tissues. The staining of the teeth is due to hyperbilirubinemia caused by systemic conditions. CASE REPORT: The purpose of this report is to present a case of green teeth of the primary dentition in a 17-month old girl associated with hydrocephalus and Hirschprung's disease. CONCLUSION: The clinical characteristics of the teeth may help in the diagnosis of current or past systemic diseases.

Sustainable intensification of climate-resilient maize-chickpea system in semi-arid tropics through assessing factor productivity.

Global trends show that the rapid increase in maize production is associated more with the expansion of maize growing areas than with rapid increases in yield. This is possible through achieving possible higher productivity through maize production practices intensification to meet the sustainable production. Therefore, a field experiment on "Ecological intensification of climate-resilient maize-chickpea cropping system" was conducted during consecutive three years from 2017-2018 to 2019-2020 at Main Agricultural Research Station, Dharwad, Karnataka, India. Results of three years pooled data revealed that ecological intensification (EI) treatment which comprises of all best management practices resulted in higher grain yield (7560 kg/ha) and stover yield compared to farmers' practice (FP) and all other treatments which were deficit in one or other crop management practices. Similarly, in the succeeding winter season, significantly higher chickpea yield (797 kg/ha) was recorded in EI. Further EI practice recorded significant amount of soil organic carbon, available nitrogen, phosphorus, potassium, zinc, and iron after completion of third cycle of experimentation (0.60%, 235.3 kg/ha,21.0 kg/ha,363.2 kg/ha,0.52 ppm and 5.2 ppm respectively). Soil enzymatic activity was also improved in EI practice over the years and improvement in each year was significant. Lower input energy use was in FP (17,855.2 MJ/ha). Whereas total output energy produced was the highest in EI practice (220,590 MJ ha-1) and lower output energy was recorded in EI-integrated nutrient management (INM) (149,255 MJ/ha). Lower energy productivity was noticed in EI-INM. Lower specific energy was recorded in FP and was followed by EI practice. Whereas higher specific energy was noticed is EI-INM. Each individual year and pooled data showed that EI practice recorded higher net return and benefit-cost ratio. The lower net returns were obtained in EI-integrated weed management (Rs. 51354.7/ha), EI-recommended irrigation management (Rs. 56,015.3/ha), integrated pest management (Rs. 59,569.7/ha) and farmers' practice (Rs. 67,357.7/ha) which were on par with others.

Evaluating newly approved drugs in combination regimens for multidrug-resistant tuberculosis with fluoroquinolone resistance (endTB-Q): study protocol for a multi-country randomized controlled trial.

BACKGROUND: Treatment for fluoroquinolone-resistant multidrug-resistant/rifampicin-resistant tuberculosis (pre-XDR TB) often lasts longer than treatment for less resistant strains, yields worse efficacy results, and causes substantial toxicity. The newer anti-tuberculosis drugs, bedaquiline and delamanid, and repurposed drugs clofazimine and linezolid, show great promise for combination in shorter, less-toxic, and effective regimens. To date, there has been no randomized, internally and concurrently controlled trial of a shorter, all-oral regimen comprising these newer and repurposed drugs sufficiently powered to produce results for pre-XDR TB patients. METHODS: endTB-Q is a phase III, multi-country, randomized, controlled, parallel, open-label clinical trial evaluating the efficacy and safety of a treatment strategy for patients with pre-XDR TB. Study participants are randomized 2:1 to experimental or control arms, respectively. The experimental arm contains bedaquiline, linezolid, clofazimine, and delamanid. The control comprises the contemporaneous WHO standard of care for pre-XDR TB. Experimental arm duration is determined by a composite of smear microscopy and chest radiographic imaging at baseline and re-evaluated at 6 months using sputum culture results: participants with less extensive disease receive 6 months and participants with more extensive disease receive 9 months of treatment. Randomization is stratified by country and by participant extent-of-TB-disease phenotype defined according to screening/baseline characteristics. Study participation lasts up to 104 weeks post randomization. The primary objective is to assess whether the efficacy of experimental regimens at 73 weeks is non-inferior to that of the control. A sample size of 324 participants across 2 arms affords at least 80% power to show the non-inferiority, with a one-sided alpha of 0.025 and a non-inferiority margin of 12%, against the control in both modified intention-to-treat and per-protocol populations. DISCUSSION: This internally controlled study of shortened treatment for pre-XDR TB will provide urgently needed data and evidence for clinical and policy decision-making around the treatment of pre-XDR TB with a four-drug, all-oral, shortened regimen. TRIAL REGISTRATION: ClinicalTrials.Gov NCT03896685. Registered on 1 April 2018; the record was last updated for study protocol version 4.3 on 17 March 2023.

Biosynthesis, Characterization, Evaluation, and Shelf-Life Study of Silver Nanoparticles against Cotton Bollworm, Helicoverpa armigera (Hubner) (Noctuidae: Lepidoptera).

Nanoparticles provide a promising and alternative platform of eco-friendly technologies that encompasses better cost-resilient remedies against one of the most economically harnessing insect pests of cotton. The main goal of this research was to provide a better management strategy through biologically synthesizing (sunlight exposure method) green nanoparticles from leaf extracts of Azadirachta indica and Pongamia pinnata and proving their bioefficacy on H. armigera (2nd instar). Characterization of bio-synthesized silver nanoparticles was carried out using UV-Visible spectroscopy for confirming the formation of nanoparticles, a Particle Size Analyzer (PSA) for determining the size/distribution of particles, and a Scanning Electron Microscope (SEM) for analyzing the surface topology of nanoparticles. The results obtained from PSA analysis showed that A. indica and P. pinnata-based silver nanoparticles had an average diameter of 61.70 nm and 68.80, respectively. Topographical images obtained from SEM proved that most of the green synthesized silver nanoparticles were spherical in shape. A. indica-based silver nanoparticles were found to be comparatively more efficient and have higher insecticidal activity compared to P. pinnata-based nanoparticles. A. indica-based AgNPs recorded larval mortality of 60.00 to 93.33 percent at the concentrations of 500 to 2000 ppm, followed by P. pinnata-based nanoparticles, with 60.00 to 90.00 percent larval mortality. Shelf-life studies revealed that A. indica-based AgNPs had the maximum negative zeta potential of -58.96 mV and could be stored for three months without losing bioefficacy and up to six months with negligible reduction in bioefficacy. Symptoms caused by silver nanoparticles were leakage of body fluids, sluggishness, inactiveness, brittleness, etc.

Micromolar Metabolite Measurement in an Electronically Multiplexed Format.

OBJECTIVE: The detection of metabolites such as choline in blood are important in clinical care for patients with cancer and cardiovascular disease. Choline is only present in human blood at low concentrations hence accurate measurement in an affordable point-of-care format is extremely challenging. Although complementary metal-oxide semiconductor (CMOS) and microfluidics are individually mature technologies, their integration has presented challenges that we overcome in a novel, cost-effective, single-step process. METHODS: To demonstrate the process, we present the microfluidic integration of a metabolomics-on-CMOS point-of-care platform with four capillary microfluidic channels on top of a CMOS optical sensor array. RESULTS: The fabricated device was characterised to verify the required structural profile, mechanical strength, optical spectra, and fluid flow. As a proof of concept, we used the device for the in-vitro quantification of choline in human blood plasma with a limit of detection of 3.2 µM and a resolution of 1.6 µM. SIGNIFICANCE: Integration of microfluidics on to CMOS technology has the potential to enable advanced sensing technologies with extremely low limit of detection that are well suited to multiple clinical metabolite measurements.

Evaluating newly approved drugs for multidrug-resistant tuberculosis (endTB): study protocol for an adaptive, multi-country randomized controlled trial.

BACKGROUND: Treatment of multidrug- and rifampin-resistant tuberculosis (MDR/RR-TB) is expensive, labour-intensive, and associated with substantial adverse events and poor outcomes. While most MDR/RR-TB patients do not receive treatment, many who do are treated for 18 months or more. A shorter all-oral regimen is currently recommended for only a sub-set of MDR/RR-TB. Its use is only conditionally recommended because of very low-quality evidence underpinning the recommendation. Novel combinations of newer and repurposed drugs bring hope in the fight against MDR/RR-TB, but their use has not been optimized in all-oral, shorter regimens. This has greatly limited their impact on the burden of disease. There is, therefore, dire need for high-quality evidence on the performance of new, shortened, injectable-sparing regimens for MDR-TB which can be adapted to individual patients and different settings. METHODS: endTB is a phase III, pragmatic, multi-country, adaptive, randomized, controlled, parallel, open-label clinical trial evaluating the efficacy and safety of shorter treatment regimens containing new drugs for patients with fluoroquinolone-susceptible, rifampin-resistant tuberculosis. Study participants are randomized to either the control arm, based on the current standard of care for MDR/RR-TB, or to one of five 39-week multi-drug regimens containing newly approved and repurposed drugs. Study participation in all arms lasts at least 73 and up to 104 weeks post-randomization. Randomization is response-adapted using interim Bayesian analysis of efficacy endpoints. The primary objective is to assess whether the efficacy of experimental regimens at 73 weeks is non-inferior to that of the control. A sample size of 750 patients across 6 arms affords at least 80% power to detect the non-inferiority of at least 1 (and up to 3) experimental regimens, with a one-sided alpha of 0.025 and a non-inferiority margin of 12%, against the control in both modified intention-to-treat and per protocol populations. DISCUSSION: The lack of a safe and effective regimen that can be used in all patients is a major obstacle to delivering appropriate treatment to all patients with active MDR/RR-TB. Identifying multiple shorter, safe, and effective regimens has the potential to greatly reduce the burden of this deadly disease worldwide. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02754765. Registered on 28 April 2016; the record was last updated for study protocol version 3.3, on 27 August 2019.

Indian Publications on SARS-CoV-2: A bibliometric study of WHO COVID-19 database.

BACKGROUND & AIMS: Nowadays, the whole World is under threat of Coronavirus disease (COVID-19). The ongoing COVID-19 pandemic has resulted in many fatalities and forced scientific communities to foster their Research and Development (R&D) activities. As a result, there is an enormous growth of scholarly literature on the subject. We here in this study have assessed the Indian publications contributions on COVID-19. METHODS: WHO is curating global scientific literature on coronavirus since it declared COVID-19 a global pandemic through Global Research Database on COVID-19. The present study analyzed Indian publications on SARS-CoV-2 as found in WHO COVID-19 database. The research data was restricted for the period of March 2, 2020 to May 12, 2020. RESULTS: The study found that there is a considerable and constant growth of Indian publications on COVID-19 from mid-April. It is interesting to note that, the most prolific authors belong to either AIIMS or ICMR institutes. Delhi state contributed highest number of publications on COVID-19. The AIIMS, New Delhi was the most productive institution in terms of publications. The Indian Journal of Medical Research has emerged as the productive journal contributing highest number of the publications. In terms of research area, the majority of the publications were related to Epidemiology. CONCLUSIONS: The highly cited publications were of evidenced based studies. It is observed that the studies pertaining to virology, diagnosis and treatment, clinical features etc. have received highest citations than general studies on epidemiology or pandemic.

Lipid peroxidation and antioxidant activity in complicated pregnancies.

AIMS AND OBJECTIVES: Preeclampsia and eclampsia are pregnancy complications with serious consequences for mother and infant. Uncontrolled lipid peroxidation may play an important role in the pathophysiology of preeclampsia and eclampsia by causing vascular endothelial cell dysfunction. Antioxidants serve to control lipid peroxidation. We attempted to ascertain whether antioxidant protective mechanisms are diminished in women with preeclampsia and eclampsia. MATERIALS AND METHODS: Lipid peroxidation and antioxidant markers were assayed in 25 healthy non-pregnant women as a control group, 25 third trimester normal pregnant women, 25 preeclamptic and 25 eclamptic patients of the same trimester by standard spectrophotometer methods. RESULTS: In preeclampsia and eclampsia malondialdehyde, a product of lipid peroxidation, was significantly increased while enzymatic antioxidants like superoxide dismutase, glutathione peroxidase, glutathione reductase and catalase were significantly reduced as compared to normal pregnant women and non-pregnant controls. CONCLUSION: Lipid peroxidation is an important factor in the pathogenesis of preeclampsia and eclampsia. The decrease in antioxidants is probably due to a compensatory nature responding to the increased lipid peroxide load in preeclamptic and eclamptic patients and may indicate the severity of the disease.

Lipid peroxidation and antioxidant status in hypertensive pregnancies.

AIMS AND OBJECTIVE: The present study was designed to evaluate the lipid peroxidation and non-enzymatic antioxidant status in hypertensive complications during pregnancy (preeclamptic and eclamptic) compared with healthy pregnant and non-pregnant patients as controls. MATERIALS AND METHODS: 25 healthy non-pregnant women as controls, 25 third trimester normal pregnant women and 25 preeclamptic and 25 eclamptic patients of the same trimester. Lipid peroxidation as a thiobarbituric acid reactive substance reduced glutathione, Vitamin E, Vitamin C and Vitamin A. RESULTS: Lipid peroxidation was significantly elevated and significantly decreased levels of antioxidants were found in preeclamptic and eclamptic patients as compared with normal pregnant and control subjects. CONCLUSION: Our study gives support to those few studies considering lipid peroxidation as an important factor in the pathogenesis of preeclampsia and eclampsia. The decrease in antioxidants, probably of a compensatory nature responding to the increased peroxide load in preeclampsia and eclampsia, may reflect the severity of the disease.

Role of lipid peroxidation and enzymatic antioxidants in pregnancy-induced hypertension.

AIMS AND OBJECTIVES: Preeclampsia remains a major cause of maternal mortality and morbidity. It is a leading indication for iatrogenic premature delivery. Oxidative stress is considered to be one of the factors in the disease process. The present study is centered on the concept that elevated levels of lipid peroxidation (malondialdehyde) due to a decline in the efficacy of antioxidant defenses may predispose an individual to preeclampsia. MATERIAL AND METHODS: In the present study we measured lipid peroxidation products (MDA) and the counteracting enzymatic antioxidants. The study comprises 25 healthy non-pregnant women as controls, 25 third trimester normal pregnant women and 25 preeclamptic patients of the same trimester. Estimation of lipid peroxidation by thiobarbituric acid (TBARS) and enzymatic antioxidants were carried out by standard methods. RESULTS: In the preeclamptic group malondialdehyde, a product of lipid peroxidation, was significantly increased while enzymatic antioxidants like superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase were reduced significantly as compared to normal pregnant and non-pregnant controls. CONCLUSION: Increased levels of lipid peroxides and reduced antioxidant activities clearly demonstrate the presence of oxidative stress in preeclampsia.

Epithelioid angiomyolipoma of the kidney: a case report.

Renal angiomyolipoma is a distinctive benign neoplasm that occurs either sporadically or in patients with tuberous sclerosis complex. A 45-year-old woman was admitted with history offlank pain and vomiting. There were no signs suggestive of tuberous sclerosis either in the patient or her family. At operation, she had a left renal mass with nephrolithiasis and hydronephrosis. Histopathology revealed epithelioid angiomyolipoma of the left kidney with chronic pyelonephritis. Immunohistochemistry confirmed the diagnosis of angiomyolipoma. This case is presented to highlight the epithelioid variant of angiomyolipoma which may behave in an aggressive manner.

Study of oxidative stress and enzymatic antioxidants in normal pregnancy.

Pregnancy is a physiological state accompanied by a high-energy demand and an increased oxygen requirement. Augmented levels of oxidative stress would be expected because of the increased intake and utilization of oxygen. Evidence of increased oxidative stress in normal pregnancy in comparison with nonpregnant controls was estimated by measuring Thiobarbituric acid reactive substance (TBARS), enzymatic antioxidants like Superoxide dismutase, Glutathione peroxidase, Glutathione reductase and catalase. It was observed that pregnant women were more susceptible to oxidative damage than non-pregnants as indicated by increased TBARS and decreased antioxidants.

Posthysterectomy ureteric injuries: Presentation and outcome of management.

PURPOSE: The purpose of the study was to evaluate the presentation and management of posthysterectomy ureteral injuries. PATIENTS AND METHODS: Fourteen patients with ureteric injuries after hysterectomy for benign diseases were evaluated. The diagnosis was done based on clinical presentation, intravenous urogram, computed tomography, cystoscopy, and retrograde pyelogram (RGP) depending on the clinical situation. RESULTS: Sixteen iatrogenic ureteric injuries in 14 patients over a 2-year period were evaluated. Hysterectomy was the cause of injury in all the cases, 12 abdominal and 2 were vaginal. Two patients presented with anuria, one had ureteric, and bladder injury with hemoperitoneum underwent emergency laparotomy and bilateral ureteral reimplantation. Another patient underwent RGP followed by stenting on the right side, left side unable to put stent so percutaneous nephrostomy (PCN) was done followed by antegrade stenting later. Two patients presented with septicemia and pyonephrosis were managed initially with PCN followed by balloon dilatation and JJ stenting. RGP and retrograde stenting was done in seven of the remaining ten patients and ureteric reimplantation in three patients. CONCLUSION: Patient with ureteric injury should be evaluated and intervened at the earliest. Patients presenting early, within 2 weeks after hysterectomy have higher chances of success with endourological procedures, obviating the need for open surgery.

HSP27 modulates agonist-induced association of translocated RhoA and PKC-alpha in muscle cells of the colon.

The recruitment of signal transduction molecules to the membrane is crucial for the efficient coupling of extracellular signals and contractile response. The trafficking is dynamic. We have investigated a possible cross talk between agonist-induced association of translocated RhoA and translocated protein kinase C-alpha (PKC-alpha) and a role for heat shock protein 27 (HSP27) in mediating this interaction. Immunoprecipitation with HSP27 monoclonal antibody followed by immunoblotting with either RhoA antibody or PKC-alpha antibody indicated that acetylcholine induced associations of HSP27-RhoA and HSP27-PKC-alpha in the membrane fraction but not in the cytosolic fraction. Immunoprecipitation with anti-RhoA monoclonal antibody followed by immunoblotting with PKC-alpha antibody indicated that acetylcholine induced a significant complexing of RhoA-PKC-alpha in the membrane fraction but not in the cytosolic fraction. In summary, the data indicate that agonist-induced contraction is associated with 1) association of translocated RhoA with HSP27 on the membrane, 2) association of translocated PKC-alpha with HSP27 on the membrane, and 3) association of PKC-alpha with RhoA on the membrane. The data suggest an important role for HSP27 in modulating a multiprotein complex that includes translocated RhoA and PKC-alpha.

Antifertility and hormonal properties of flavones of Striga orobanchioides.

The two flavones, apigenin and luteolin, isolated from Striga orobanchioides, were investigated for endocrine and contraceptive properties. Graded doses of these compounds (5-25 mg/kg body weight/day) when administered from day 1 to day 4 of pregnancy showed dose-dependent and significant anti-implantation activity. The mean effective Dose 100% (MED(100)) for both compounds was found to be 25 mg/kg body weight. Oral administration of these compounds caused a significant increase in uterine weight in immature ovariectomised rats. It also caused a significant increase in uterine diameter, thickness of the endometrium and its epithelial cell height when compared with those of control rats. The uterotrophic potency was less than that of ethinyl estradiol. Simultaneous administration of these compounds with ethinyl estradiol caused a significant increase in uterine weight, uterine diameter, thickness of the endometrium and height of endometrial epithelium. The extent of these changes was also less than that in only ethinyl estradiol-treated rats. Hence the compounds exhibited estrogenic properties at their contraceptive dose level when given alone. However, along with ethinyl estradiol, they exhibited slight anti-estrogenic activity.

Semen characteristics of the captive Indian leopard, Panthera pardus.

Semen samples from 11 Indian leopards (Pantherapardus) from 3 different zoos in India were collected by electroejaculation. A computer-aided semen analyzer (CASA) was used for assessing the quality of the semen vis-à-vis sperm motility. The volume of the ejaculate, sperm density, and the number of motile and morphologically normal spermatozoa were found to be 1.57 +/- 1.26 mL, 55.78 million +/- 38.67 million per mL, 57.05% +/- 16.96% and 71.92% +/- 15.32%, respectively. Although the spermatology varied between individuals in the study, Box-Whisker-plot analysis suggested that the distribution was normal (P > .05). The ejaculated sperm were cryopreserved after diluting in test-yolk buffer. The post-thaw motility was 32.14% and did not differ at 30 or 60 days after cryopreservation. CASA indicated that the progressive velocity (VSL) of cryopreserved spermatozoa was decreased and, as a consequence, they moved more slowly than the neat (VSL 76.3 microm/sec in neat vs 53.8 microm/sec in cryopreserved spermatozoa) and the trajectories were less planar. However, both cryopreserved and neat spermatozoa penetrated the zona-free hamster oocyte with equal efficiency (79% neat vs 80% cryopreserved). The study also reports application of CASA for feline spermatozoa and provides information for the first time on the spermatology of the Indian leopard. This baseline data could be used in captive breeding programs. The results are compared and discussed with the available information on other felines.

Nicotine induced inhibition of the activities of accessory reproductive ducts in male rats.

Adult male albino rats were treated with 0.4 mg nicotine/100 g body weight either orally or intraperitoneally for 30 days. All animals were autopsied on the 31st day. Epididymis and vas deferens were dissected out, weighed and processed for biochemical estimations. Nicotine caused a reduction in the weight of epididymis and vas deferens in both drug treated groups. The total cholesterol content is increased while protein, DNA and RNA contents and the epididymal sperm count were decreased. The acid phosphatase content is also decreased, whereas alkaline phosphatase is increased. The surface epithelial cell height of these ducts is decreased and secretory activity is reduced with the disruption of epithelial cell projections. These changes may be due to non-availability of androgens in nicotine treated rats.

Post-coital antifertility activity of Acalypha indica L.

Four successive solvent extracts of the whole plant Acalypha indica L. (Euphorbiaceae) were tested for post-coital antifertility activity in female albino rats. Of these, the petroleum ether and ethanol extracts were found to be most effective in causing significant anti-implantation activity. The antifertility activity was reversible on withdrawal of the treatment of the extracts. Both the extracts at 600 mg/kg body weight showed estrogenic activity. Histological studies of the uterus were carried out to confirm this estrogenic activity.

Effect of ethanol extract of Rivea hypocrateriformis on the estrous cycle of the rat.

The ethanol extract of Rivea hypocrateriformis was administered orally at the dose levels of 200 and 400 mg/kg body weight to adult albino rats and resulted in an irregular estrous cycle with shortened estrus and metestrus, and with lengthened proestrus in non-dose dependent manner. Significant decreases in number of graffian follicles and corpora lutea and significant increases in number of atretic follicles in treated rats during experimental period indicated the antiovulatory effect of the extract. Increases in the weight of the uterus, its thickness and diameter indicated the uterotrophic effect of the extract. The significant increase in the level of cholesterol in the tissues of treated rats indicated the inhibition of steroidogenesis of cholesterol by ovarian endocrine tissues. Restoration of normal estrous cycles after withdrawal of treatment indicate the reversible effect of ethanol extract in rats.