Publications by authors named "Abhishek Singh"

500 Publications

Aggregation of Amphiphilic Carbocyanines: Fluorination Favors Cylindrical Micelles over Bilayered Tubes.

J Phys Chem B 2021 Sep 10. Epub 2021 Sep 10.

Core Facility BioSupraMol, Institut für Chemie und Biochemie, Freie Universität Berlin, Fabeckstraße 36a, 14195 Berlin, Germany.

The synthesis of a new amphiphilic 5,5',6,6'-tetrachlorobenzimidacarbocyanine dye derivative with -(CH)-(CF)-CF chains attached to the nitrogen atoms in the 1,1'-position, CF8O3, is reported. Depending on the dye concentration and the addition of MeOH, CF8O3 forms J- and H-aggregates in aqueous solutions. The aggregation behavior was investigated using steady-state absorption, linear dichroism, and fluorescence spectroscopy, as well as by cryogenic transmission electron microscopy (cryo-TEM). The J-band of the MeOH-free solution is monomer-like, rather broad, and less red-shifted with respect to the monomer absorption, indicating weak excitonic coupling and disorder effects. Cryo-TEM reveals a diversity of supramolecular structures, wherein linear and branched cylindrical micelles dominate. It is concluded that the high stiffness of fluoroalkyl chains does not allow the chains to splay and completely fill up the hydrophobic gap between opposing chromophores. This destabilizes the bilayers and favors the micellar structure motifs instead. The aggregates appearing at 30% MeOH show a split absorption spectrum consisting of a broad blue-shifted H-band and an accompanying sharp red-shifted J-band with perpendicular polarizations. These HJ-type aggregates are also composed of micellar fibers, but these bundle into rope-like strands. For 10% MeOH, a narrow bilayered tube is the dominating morphology. The observed MeOH dependence of aggregation reveals a clear cosolvent effect.
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http://dx.doi.org/10.1021/acs.jpcb.1c05128DOI Listing
September 2021

Paranephric air in COVID-ARDS patient: an extension of pneumothorax.

Intensive Care Med 2021 Aug 30. Epub 2021 Aug 30.

Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.

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http://dx.doi.org/10.1007/s00134-021-06511-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8404757PMC
August 2021

Effects of Silicon and Silicon-Based Nanoparticles on Rhizosphere Microbiome, Plant Stress and Growth.

Biology (Basel) 2021 Aug 17;10(8). Epub 2021 Aug 17.

Division of Seed Science and Technology, ICAR-Indian Agricultural Research Institute, New Delhi 110012, India.

Silicon (Si) is considered a non-essential element similar to cadmium, arsenic, lead, etc., for plants, yet Si is beneficial to plant growth, so it is also referred to as a quasi-essential element (similar to aluminum, cobalt, sodium and selenium). An element is considered quasi-essential if it is not required by plants but its absence results in significant negative consequences or anomalies in plant growth, reproduction and development. Si is reported to reduce the negative impacts of different stresses in plants. The significant accumulation of Si on the plant tissue surface is primarily responsible for these positive influences in plants, such as increasing antioxidant activity while reducing soil pollutant absorption. Because of these advantageous properties, the application of Si-based nanoparticles (Si-NPs) in agricultural and food production has received a great deal of interest. Furthermore, conventional Si fertilizers are reported to have low bioavailability; therefore, the development and implementation of nano-Si fertilizers with high bioavailability could be crucial for viable agricultural production. Thus, in this context, the objectives of this review are to summarize the effects of both Si and Si-NPs on soil microbes, soil properties, plant growth and various plant pathogens and diseases. Si-NPs and Si are reported to change the microbial colonies and biomass, could influence rhizospheric microbes and biomass content and are able to improve soil fertility.
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http://dx.doi.org/10.3390/biology10080791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389584PMC
August 2021

Expression of p63 and Proliferating Cell Nuclear Antigen in Oral Submucous Fibrosis.

J Int Soc Prev Community Dent 2021 Jul-Aug;11(4):448-456. Epub 2021 Jul 30.

Department of Oral Pathology & Microbiology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India.

Aim: Oral squamous cell carcinoma (OSCC) may be preceded by potentially malignant disorders such as oral submucous fibrosis (OSMF). p63 can detect genetic changes in OSMF and it facilitates early detection of malignant transformation, whereas proliferating cell nuclear antigen (PCNA) is a marker of proliferation and may prove to be a useful objective indicator of the biological behavior of various tumors. The aim of this study was to investigate the expression and pattern of the intensity of p63 protein and PCNA in normal oral mucosa and OSMF using immunohistochemistry (IHC) and to correlate the expression of these biomarkers.

Materials And Methods: A total of 15 archival paraffin-embedded blocks obtained from our department, which were histopathologically diagnosed early OSMF ( = 4), intermediate OSMF (n = 4), and advanced OSMF ( = 2) and normal mucosa ( = 5), were taken as the standard for comparison. p63 and PCNA positivity was analyzed using Kruskall-Wallis test followed by pairwise comparison using Mann-Whitney U test. The pattern of staining and intensity was compared using Chi-Square test for which Statistical Package for the Social Sciences (SPSS, v 22.0, IBM Corporation, Armonk, New York) was used.

Results: All samples showed positive staining for p63 and PCNA. A statistically significant difference ( < 0.05) was seen between the frequency of occurrence of p63 and the PCNA pattern of expression among all the groups. The intensity of staining was mild to intense in the basal layer, as there was a progression toward the severity of the disease. Almost 75.4% correlation existed between p63 and PCNA, with high correlation and marked relationship.

Conclusions: The OSMF is considered a potentially malignant disorder that has the potential to get transformed into OSCC. The malignant transformation is often associated with changes at the genetic level, and these are reflected by the altered expression of proteins. Our results showed that biomarkers such as p63 and PCNA are significant in predicting the malignant transformation in OSMF, so in future they may serve as a prognostic tool in the early detection of malignancies.
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http://dx.doi.org/10.4103/jispcd.JISPCD_428_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352049PMC
July 2021

Machine learning analysis of non-marital sexual violence in India.

EClinicalMedicine 2021 Sep 1;39:101046. Epub 2021 Aug 1.

Center on Gender Equity and Health, Department of Medicine, University of California San Diego, San Diego, CA, USA.

Background: Machine learning techniques can explore low prevalence data to offer insight into identification of factors associated with non-marital sexual violence (NMSV). NMSV in India is a health and human rights concern that disproportionately affects adolescents, is under-reported, and not well understood or addressed in the country.

Methods: We applied machine learning methods to retrospective cross-sectional data from India's nationally-representative National Family Health Survey 4, a demographic and health study conducted in 2015-16, which offers 4000+ variables as potential independent variables. We used Least Absolute Shrinkage and Selection Operator (lasso) or L-1 regularized logistic regression models as well as L-2 regularized logistic regression or ridge models; we conducted an iterative thematic analysis (ITA) of variables generated from a series of regularized models.

Findings: Thematic analysis of regularized models highlight that past exposure to violence was most predictive of NMSV, followed by geography, sexual behavior, and poor sexual and reproductive health knowledge. After these, indicators largely related to resources and autonomy (e.g., access to health services, and income generating) were associated with NMSV. Exploratory analysis with the subsample of never married adolescents 15-19 years old, a population with higher representation of recent NMSV, further emphasized the role of wealth and mobility as key correlates of NMSV, along with poor HIV knowledge, tobacco use, higher fertility preferences, and attitudes accepting of marital violence.

Interpretation: Findings indicate the validity of machine learning with iterative theme analysis (ITA) to identify factors associated with violence. Findings were consistent with prior work demonstrating associations between NMSV and other violence experiences, but also showed novel correlates such as lower SRH knowledge and service utilization and, for girls, norms and preferences suggesting more restrictive gender norms. Sexual and reproductive health, gender equity and safety focused interventions are important for addressing NMSV in India, particularly for adolescents.
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http://dx.doi.org/10.1016/j.eclinm.2021.101046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350001PMC
September 2021

Phenotypic effects of changes in the FTVTxK region of an secondary wall cellulose synthase compared with results from analogous mutations in other isoforms.

Plant Direct 2021 Aug 5;5(8):e335. Epub 2021 Aug 5.

Department of Crop and Soil Sciences North Carolina State University Raleigh NC USA.

Understanding protein structure and function relationships in cellulose synthase (CesA), including divergent isomers, is an important goal. Here, we report results from mutant complementation assays that tested the ability of sequence variants of AtCesA7, a secondary wall CesA of , to rescue the collapsed vessels, short stems, and low cellulose content of the AtCesA7 null mutant. We tested a catalytic null mutation and seven missense or small domain changes in and near the AtCesA7 FTVTSK motif, which lies near the catalytic domain and may, analogously to bacterial CesA, exist within a substrate "gating loop." A low-to-high gradient of rescue occurred, and even inactive AtCesA7 had a small positive effect on stem cellulose content but not stem elongation. Overall, secondary wall cellulose content and stem length were moderately correlated, but the results were consistent with threshold amounts of cellulose supporting particular developmental processes. Vibrational sum frequency generation microscopy allowed tissue-specific analysis of cellulose content in stem xylem and interfascicular fibers, revealing subtle differences between selected genotypes that correlated with the extent of rescue of the collapsing xylem phenotype. Similar tests on PpCesA5 from the moss (formerly ) helped us to synergize the AtCesA7 results with prior results on AtCesA1 and PpCesA5. The cumulative results show that the FTVTxK region is important for the function of an angiosperm secondary wall CesA as well as widely divergent primary wall CesAs, while differences in complementation results between isomers may reflect functional differences that can be explored in further work.
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http://dx.doi.org/10.1002/pld3.335DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341023PMC
August 2021

Small Dense Low-Density Lipoprotein for Risk Prediction of Acute Coronary Syndrome.

Cardiol Res 2021 Aug 9;12(4):251-257. Epub 2021 Jul 9.

Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India.

Background: Elevated Low density Lipoprotein (LDL) levels have been traditionally associated with development of atherosclerotic coronary artery disease (CAD). As LDL-cholesterol levels are not always raised in acute coronary syndrome (ACS) patients, sd-LDL is an emerging risk factor. The purpose of the present study was tri-fold. Firstly, it aimed to investigate the association of sd-LDL as a risk factor in ACS patients. Secondly, it aimed to correlate the presence of sd-LDL with severity of coronary artery disease as determined by coronary angiography. Lastly, it aimed to correlate the presence of sd-LDL with short-term outcomes.

Methods: This was a prospective, hospital-based, cross-sectional, case-control study conducted over a 1-year study duration. Patients above the age of 18 years diagnosed with ACS within 24 h of admission were studied. Blood samples were collected after all patients had undergone coronary angiography and sd-LDL levels were measured.

Results: ACS patients had significantly higher sd-LDL levels than non-ACS patients (16.10 ± 1.42 mg/dL vs. 12.67 ± 0.71 mg/dL, P = 0.036). Males had significantly higher sd-LDL levels than females (16.79 ± 1.55 mg/dl vs. 10.77 ± 2.62 mg/dl, P=0.047). Patients with non-left anterior descending coronary artery (LAD) involvement had significantly higher sd-LDL levels compared to patients with LAD involvement (21.92 ± 3.55 mg/dL vs. 14.03 ± 1.35 mg/dL, P = 0.007).

Conclusion: These results suggest that sd-LDL is a risk factor for the development of ACS in an Indian population.
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http://dx.doi.org/10.14740/cr1254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297045PMC
August 2021

Impact of imperfect corrugated interface in piezoelectric-piezomagnetic composites on reflection and refraction of plane waves.

J Acoust Soc Am 2021 Jul;150(1):573

Department of Mathematics and Computing, Indian Institute of Technology (Indian School of Mines), Dhanbad, Jharkhand, 826004, India.

Defects such as imperfect geometric/mechanical/dielectric/magnetic interfaces affect the performance and life of structural components used in aircraft technology and underwater navigation. The major drawback of an imperfect interface in a system is its disability to transfer stress or potential across the surface effectively. Nondestructive evaluation, particularly P-wave reflection imaging, contributes significantly to detecting defects and in situ conditions of such structural components. The present study encapsulates the reflection/refraction phenomenon of quasi-pressure waves when they strike the mechanically/dieletrically/magnetically imperfect corrugated interfaces of piezoelectric and piezomagnetic half-spaces. The reflected/refracted wave fields not only consist of regular bulk and surface waves but also a spectrum of irregular bulk waves, arising as the result of geometrical irregularities at the interface. The reflection and refraction coefficients (RECs/RACs) of all regular/irregular waves are derived analytically by using Rayleigh's method of slope approximation (first iteration of small perturbation). The existence of the critical angle is interpreted from the slowness curves of the bulk waves. The influences of the corrugation, angular frequency, and interface imperfection on the RECs/RACs are the major findings reported in the study. The reflected/refracted potential waves diminish for the dielectrically/magnetically imperfect interface. The energy coefficients of the reflected/refracted waves are derived, and the energy conservation law is satisfied.
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http://dx.doi.org/10.1121/10.0005544DOI Listing
July 2021

Linear triglycerol-based fluorosurfactants show high potential for droplet-microfluidics-based biochemical assays.

Soft Matter 2021 Aug;17(31):7260-7267

Institut für Chemie und Biochemie, Freie Universität Berlin, Takustrasse 3, 14195 Berlin, Germany.

Fluorosurfactants have expanded the landscape of high-value biochemical assays in microfluidic droplets, but little is known about how the spatial geometries and polarity of the head group contribute to the performance of fluorosurfactants. To decouple this, we design, synthesize, and characterize two linear and two dendritic glycerol- or tris-based surfactants with a common perfluoropolyether tail. To reveal the influence of spatial geometry, we choose inter-droplet cargo transport as a stringent test case. Using surfactants with linear di- and triglycerol, we show that the inter-droplet cargo transport is minimal compared with their dendritic counterparts. When we encapsulated a less-leaky sodium fluorescent dye into the droplets, quantitatively, we find that the mean fluorescence intensity of the PFPE-dTG stabilized PBS-only droplets after 72 h was ∼3 times that of the signal detected in PBS-only droplets stabilized by PFPE-lTG. We also demonstrate that the post-functionalization of PFPE-lTG having a linear geometry and four hydroxy groups enables the 'from-Droplet' fishing of the biotin-streptavidin protein complex without the trade-off between fishing efficiency and droplet stability. Thus, our approach to design user-friendly surfactants reveals the aspects of spatial geometry and facile tunability of the polar head groups that have not been captured or exploited before.
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http://dx.doi.org/10.1039/d1sm00890kDOI Listing
August 2021

A Rare Location of a Repeat Ectopic Pregnancy: A Case Report.

Cureus 2021 Jun 28;13(6):e15982. Epub 2021 Jun 28.

Obstetrics and Gynecology, Dr. Balwant Singh's Hospital, Georgetown, GUY.

Ectopic pregnancies often recur in the same patients as its etiology is tubal damage, which is rarely unilateral. In the setting of a well-documented history of ectopic pregnancy in the past where a salpingectomy was performed, and the clinical picture now suggests another ectopic, it can be reasonably concluded that the ectopic is in the remaining tube. In the case we present here, the ultrasound findings also suggested a tubal pregnancy in the remaining tube. Therefore, it was a surprise to find a profusely bleeding ectopic gestation in the stump of the same tube (where salpingectomy was performed earlier) on laparoscopy.
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http://dx.doi.org/10.7759/cureus.15982DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317251PMC
June 2021

BPH nomogram using IPSS, prostate volume, peak flow rate, PSA and median lobe protrusion for predicting the need for intervention: development and internal validation.

Am J Clin Exp Urol 2021 15;9(3):202-210. Epub 2021 Jun 15.

Department of Urology, Muljibhai Patel Urological Hospital Nadiad, Gujarat, India.

Objective: The aim of the present study was to develop a nomogram to accurately predict the need for intervention in patients suffering from LUTS due to benign prostatic hyperplasia (BPH) and internally validate it.

Material And Methods: The data was collected from the community subjects from the state of Gujarat in western India. All the demographic data, physical examination, PSA, uroflowmetry and prostatic ultrasound was collected in 92 subjects and were followed up after 2 years. The data was analyzed and logistic regression model was used to build a predictive model. A nomogram was build using R software. Nomogram was internally validated using 50 subjects.

Results: 92 subjects were analyzed for developing the nomogram. Out of these, 17 patients needed intervention. 8 patients were started on medical therapy and 9 patients were taken up for surgical intervention. Of all the statistically significant predictors, peak flow rate was the most significant and was followed by median lobe enlargement, PSA, prostate volume and IPSS. These variables were used to develop a prediction model for the intervention required using reduced logistic regression model. The predictive accuracy of the model was 95.65% with a sensitivity of 88.28%, a specificity of 97.33%, a positive predictive value (PPV) of 88.24%, and a negative predictive value (NPV) of 97.33%. The AUC of the model was 0.799. Internal validation was done on 50 subjects which had sensitivity, specificity and AUC of the model at 89.66%, 90.48% and 0.968 respectively.

Conclusion: The study demonstrates the clinical application of nomogram which uses IPSS, PSA, peak flow rate, prostate volume and median lobe enlargement (intravesical prostatic volume). It has a sensitivity of 88.24%, specificity of 97.33%. It predicts the need for intervention in BPH patients with accuracy of 95.65% which was internally validated with an accuracy of 90%.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303027PMC
June 2021

Biodegradation of isoprene by Arthrobacter sp. strain BHU FT2: Genomics-proteomics enabled novel insights.

Bioresour Technol 2021 Nov 22;340:125634. Epub 2021 Jul 22.

Molecular Ecology Laboratory, Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, India. Electronic address:

The bacterial degradation of isoprene is important for maintaining its atmospheric concentration in unpolluted environment. It may be possible to use natural isoprene degrading bacteria in engineered systems to eliminate or limit isoprene emissions from various sources. Biodegradation of isoprene by Arthrobacter sp. strain BHU FT2 was investigated. The genome was found to contain 4151545 bp long chromosome having 3747 coding genes, and coded potential isoprene degrading enzymes. The molecular docking of monooxygenases with isoprene displayed a higher binding energy (-4.59 kcal/mol) for WP_015938387.1 monooxygenase. Analysis of the identified monooxygenases with the known isoprene monooxygenases revealed 67% sequence identity of WP_015938387.1 (Locus tag JHV56_10705) monooxygenase of the considered strain with the OPX16961.1 monooxygenase of Gordonia sp. i37 isoprene degrading starin. These results provided a strong evidence for the high isoprene degrading potential of the Arthrobacter sp. BHU FT2 which could be efficiently exploited for isoprene degradation in large scale bio-filtration units.
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http://dx.doi.org/10.1016/j.biortech.2021.125634DOI Listing
November 2021

In vivo imaging of the Schlemm's Canal and the response to Selective laser trabeculoplasty.

Am J Ophthalmol 2021 Jul 18. Epub 2021 Jul 18.

Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India 110029. Electronic address:

Objective: To evaluate the presence of angle dysgenesis on ASOCT (ADoA) as a predictive factor in determining outcomes of selective laser trabeculoplasty (SLT).

Design: A prospective clinical cohort study.

Subjects: Patients with Juvenile onset open-angle glaucoma (JOAG) without angle dysgenesis on gonioscopy (ADoG).

Method: JOAG patients with uncontrolled IOP, who were to undergo SLT, were evaluated for the presence or absence of ADoA, which was defined as the absence of Schlemm's canal (SC) and/or presence of hyper-reflective membrane (HM) over TM as identified on ASOCT before the SLT procedure. Further, the number of ASOCT B-scans in which SC was identified as present, were then quantified. Success of SLT was defined as a reduction of IOP by 20% or more from pre-laser value at 6-months follow-up without any further IOP-lowering medication or surgery. Only one repeat SLT was admissible for defining SLT success over the 6-month period. A successful reduction in IOP at six-month follow-up was correlated with the extent of ADoA.

Results: In comparison to pre-SLT IOP, 57.1% (20/35) eyes showed more than 20% reduction in IOP at six months with a mean reduction of 7.6±1.8mmHg (29.6%). When all three observers agreed, SC was identified in 80% (18/20) eyes with success vs 26.6% (4/15) eyes with failure (p < 0.001). All (5/5) eyes with presence of HM showed failure (p < 0.001). All eyes (19/19) in which SC was present in >50% ASOCT B-scans (>25/50 scans/eye) showed success (p < 0.001). On a bias reduced regression analysis, the identification of SC on any two consecutive scans increased the chances of success at 6months by 8.3 times, while the identification of SC in >50% of ASOCT scans was associated with a 21.4 times greater chance of success.

Conclusions: The presence of SC on ASOCT is a strong predictor for successful IOP reduction after SLT in JOAG eyes.
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http://dx.doi.org/10.1016/j.ajo.2021.07.002DOI Listing
July 2021

COVID-19 Pandemic: A Perspective from Nephrology Resident.

Indian J Nephrol 2021 Mar-Apr;31(2):209-210. Epub 2020 Oct 9.

Institute of Renal Science, Sir Gangaram Hospital, New Delhi, India.

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http://dx.doi.org/10.4103/ijn.IJN_276_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240922PMC
October 2020

High-field THz pulses from a GaAs photoconductive emitter for non-linear THz studies.

Opt Express 2021 Jun;29(13):19920-19927

We report the emission of high-field terahertz pulses from a GaAs large-area photoconductive emitter pumped with a Ti:Sapphire amplifier laser system at 800 nm wavelength and 1 kHz repetition rate. The maximum estimated terahertz electric field at the focus is ≳ 230 kV/cm. We also demonstrate the capability of the terahertz field to cause a non-linear effect, which usually requires high-field terahertz pulses generated through optical rectification or an air plasma. A significant drop in the optical conductivity of optically pumped GaAs due to Γ-L inter-valley scattering of free electrons caused by the strong THz field is found.
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http://dx.doi.org/10.1364/OE.427247DOI Listing
June 2021

Hepatocyte-specific suppression of ANGPTL4 improves obesity-associated diabetes and mitigates atherosclerosis in mice.

J Clin Invest 2021 Jul 13. Epub 2021 Jul 13.

Department of Comparative Medicine, Yale University School of Medicine, New Haven, United States of America.

Hepatic uptake and biosynthesis of fatty acids (FA), as well as the partitioning of FA into oxidative, storage, and secretory pathways are tightly regulated processes. Dysregulation of one or more of these processes can promote excess hepatic lipid accumulation, ultimately leading to systemic metabolic dysfunction. Angiopoietin-like-4 (ANGPTL4) is a secretory protein that inhibits lipoprotein lipase (LPL) and modulates triacylglycerol (TAG) homeostasis. To understand the role of ANGPTL4 in liver lipid metabolism under normal and high-fat fed conditions, we generated hepatocyte specific Angptl4 mutant mice (Hmut). Using metabolic turnover studies, we demonstrate that hepatic Angptl4 deficiency facilitates catabolism of TAG-rich lipoprotein (TRL) remnants in the liver via increased hepatic lipase (HL) activity, which results in a significant reduction in circulating TAG and cholesterol levels. Consequently, depletion of hepatocyte Angptl4 protects against diet-induce obesity, glucose intolerance, liver steatosis, and atherogenesis. Mechanistically, we demonstrate that loss of Angptl4 in hepatocytes promotes FA uptake which results in increased FA oxidation, ROS production, and AMPK activation. Finally, we demonstrate the utility of a targeted pharmacologic therapy that specifically inhibits Angptl4 gene expression in the liver and protects against diet-induced obesity, dyslipidemia, glucose intolerance, and liver damage, which likely occurs via increased HL activity. Notably, this novel inhibition strategy does not cause any of the deleterious effects previously observed with neutralizing antibodies.
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http://dx.doi.org/10.1172/JCI140989DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409581PMC
July 2021

Isolated ST-Elevation Myocardial Infarction Involving Leads I and aVL: Angiographic and Electrocardiographic Correlations from a Tertiary Care Center.

Cardiol Res Pract 2021 21;2021:7638020. Epub 2021 Jun 21.

Department of Cardiology, King George's Medical University, Lucknow 226003, Uttar Pradesh, India.

Background: Determining the infarct-related artery in STEMI during a coronary angiogram can be challenging due to the affliction of multiple vessels. Isolated STEMI involving only EKG leads I and aVL is infrequent. Localization of infarct-related artery based on EKG findings has not been previously done in this subset.

Methods: All consecutive de novo acute coronary syndrome (ACS) patients admitted to coronary care unit with ST elevations involving only leads I and aVL were screened for enrollment. Patients with ST elevation in any additional lead and those who refused a coronary angiogram were excluded. Subsequently, a coronary angiogram was done as part of primary PCI or a pharmacoinvasive approach to identify the infract-related artery (IRA). IRA was defined by characteristics of lesion, flow of blood through stenosis, and presence of intracoronary thrombus. Coronary angiogram was interpreted by two independent observers blinded to the EKG findings. ST changes in inferior and precordial leads were analyzed to find ECG predictors of the culprit artery.

Results: A total of 54 eligible patients of ACS were included in the study. The first major diagonal (D1) was the most frequent IRA in 35.2% followed by left circumflex-obtuse marginal (LCX-OM11) in 29.6%, left anterior descending (LAD) in 20.4%, and ramus intermedius (RI) in 14.8%. Out of total patients with ST depression in lead V2, the LCX-OM11 group was IRA in 50% cases while the RI, D1, and LAD groups accounted for 31.8%, 13.6%, and 4.5%, respectively ( < 0.001). Similarly, LCX-OM1 was the most frequent IRA subjects with ST depressions in leads V1 and V3 (44.4%; = 0.010 and 46.2%; = 0.003, resp.). On the contrary, in patients with ST depression in lead III, LAD and D1 were the most frequent IRA as compared to LCX-OM1 and RI though statistical significance was not attained ( = 0.857 for lead III). ST-segment depression in lead V2 had a positive predictive value of 60% and a negative predictive value of 100% for LCX-OM1 as IRA. Similarly, ST-segment depression in lead V2 had a positive predictive value of 20% and a negative predictive value of 100% for the RI group.

Conclusions: In patients presenting with isolated ST elevation in leads I and aVL, the most frequent IRA on angiogram was first diagonal. ST depressions in EKG leads V1-V3 were the most common predictor of LCX-OM1 while those in inferior leads indicated LAD-D1 as the IRA.
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http://dx.doi.org/10.1155/2021/7638020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8241503PMC
June 2021

Key genetic and forensic attributes of Uttarakhand population of India.

Int J Legal Med 2021 Jun 30. Epub 2021 Jun 30.

Zoological Survey of India, New Alipore, Kolkata, West Bengal, 700 053, India.

The present study aimed to investigate the genetic and forensic attributes of Uttarakhand population based on 20 autosomal STR loci implemented in PowerPlex® 21 System. Results unveiled 219 alleles ranging from 6 (TH01, TPOX) to 20 (Penta E). Forensic analysis revealed locus Penta E as the most polymorphic and discriminative loci, whereas genetic analysis indicated presence of higher heterozygosity within population. Phylogenetic analysis indicated higher genetic affinity of Uttarakhand population with the neighbouring Himachal Pradesh population. Overall, the study indicates that the PowerPlex® 21 System is suitable for genetic and forensic analysis in Uttarakhand population.
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http://dx.doi.org/10.1007/s00414-021-02637-5DOI Listing
June 2021

Spectrum of Self-Reported Childhood Sexual Abuse Among Medical Students: A Single Center Experience.

Indian Pediatr 2021 Jun;58(6):564-567

Medical Intern, Indira Gandhi Medical College and Research Institute, Puducherry.

Objective: To study the prevalence and spectrum of self-reported childhood sexual abuse (CSA) in a sample of medical students from a medical college in Southern India.

Methods: A self-administered questionnaire was distributed to consenting students of a medical college located at Puducherry. Those students who could not be contacted despite three attempts were excluded.

Results: Of total 452 students, 148 (32.7%) students reported experiencing one or other form of CSA. Prevalence of CSA was almost equal in both the sexes. Most instances of CSA occurred either at own house (33.8%) or at a neighbor's house (22.9%). Majority (60.1%) did not inform anyone; due to fear of negative consequences (43.2%) and feelings of guilt (30.4%) most commonly.

Conclusions: Approximately one third of medical students reported an incident of sexual abuse at least once in his/her life. Both girls and boys are equally likely to face CSA.
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June 2021

Utility of Blood as the Clinical Specimen for the Molecular Diagnosis of Post-Kala-Azar Dermal Leishmaniasis.

J Clin Microbiol 2021 Aug 18;59(9):e0013221. Epub 2021 Aug 18.

ICMR-National Institute of Pathology, Safdarjung Hospital Campus, New Delhi, India.

The countries in the Indian subcontinent have reported a dramatic decline in visceral leishmaniasis (VL) cases. However, the presence of the parasite reservoir in the form of post-kala-azar dermal leishmaniasis (PKDL), a dermal sequel of VL, is a hurdle in attaining VL elimination. Presently employed clinical specimens for the diagnosis of PKDL include skin biopsy specimens and slit skin smears. In this study, the use of blood as a clinical specimen was investigated in different manifestations of PKDL in India. This is a bicentric study (National Institute of Pathology, Indian Council of Medical Research [ICMR], New Delhi, and Institute of Medical Sciences [IMS], Banaras Hindu University, Varanasi), with 215 participants (120 PKDL patients and 95 controls). Highly sensitive quantitative real-time PCR (Q-PCR) and field-deployable loop-mediated isothermal amplification (LAMP) were employed using blood samples for diagnosis. Promising sensitivities of 77.50% (95% confidence interval [CI], 69.24 to 84.05%) for Q-PCR and 70.83% (95% CI, 62.16 to 78.22%) for LAMP were obtained for the diagnosis of PKDL. Further, enhanced sensitivities of 83.33% (95% CI, 71.28 to 90.98%) and 77.78% (95% CI, 65.06 to 86.80%) for Q-PCR and LAMP, respectively, were recorded for the detection of macular cases. The study revealed an inverse correlation between the parasite load estimated in slit and blood samples, thereby favoring the use of blood for the diagnosis of the macular variant, which may be missed due to scant parasite loads in the slit. This study is the first to propose the promising potential of blood as a clinical specimen for accurate diagnosis of PKDL, which would aid in fast-tracking VL elimination.
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http://dx.doi.org/10.1128/JCM.00132-21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373003PMC
August 2021

Design and Development of a Digital Program for Training Non-Specialist Health Workers to Deliver an Evidence-Based Psychological Treatment for Depression in Primary Care in India.

J Technol Behav Sci 2020 Dec 31;5(4):402-415. Epub 2020 Aug 31.

Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.

Background: Digital technologies hold promise for building capacity of non-specialist health workers towards scaling up depression care in low-resource settings. The purpose of this study was to describe the systematic approach to designing a digital program for training non-specialist health workers to deliver an evidence-based brief psychological treatment for depression, called the Healthy Activity Program, in primary care in rural India.

Methods: The design and development of the training program involved 5 steps: 1) develop program blueprint; 2) create instructional content; 3) digitize content for a smartphone app; 4) develop a platform for uploading and hosting the digital content; and 5) user-testing and refinements to ensure program functioning. This was followed by field-testing and focus group discussions with non-specialist health workers recruited from primary care facilities in Madhya Pradesh, India, to inform further modifications and improvements to the digital training program.

Results: Training program development occurred over 12-months, and the final digital training consisted of 16 modules with videos, role-plays, and digital content tailored to the local culture and context. Focus group discussions with 19 non-specialist health workers generated three key action items and modifications to the digital training in response to participant feedback: 1) addressing technical challenges by making the digital content available offline; 2) account for low digital literacy by including a comprehensive orientation session about navigating the smartphone app; and 3) addition of remote coaching to support participants in completing the training.

Conclusions: This study illustrates a step-wise approach to combine evidence-based content with iterative feedback from stakeholders to develop a digital training program tailored to the context in a low-resource setting. Further research is needed to validate this approach and to evaluate the effectiveness of the final modified digital training program, while considering whether this approach can be adopted and replicated in other settings.
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http://dx.doi.org/10.1007/s41347-020-00154-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211059PMC
December 2020

Functional Surfactants for Molecular Fishing, Capsule Creation, and Single-Cell Gene Expression.

Nanomicro Lett 2021 Jun 19;13(1):147. Epub 2021 Jun 19.

Institut Für Chemie Und Biochemie, Freie Universität Berlin, Takustrasse 3, 14195, Berlin, Germany.

Creating a single surfactant that is open to manipulation, while maintaining its surface activity, robustness, and compatibility, to expand the landscape of surfactant-dependent assays is extremely challenging. We report an oxidation-responsive precursor with thioethers and multiple 1,2-diols for creating a variety of functional surfactants from one parent surfactant. Using these multifunctional surfactants, we stabilize microfluidics-generated aqueous droplets. The droplets encapsulate different components and immerse in a bioinert oil with distinct interfaces where an azide-bearing surfactant allow fishing of biomolecules from the droplets, aldehyde-bearing surfactant allow fabrication of microcapsules, and hydroxyl-bearing surfactants, with/without oxidized thioethers, allow monitoring of single-cell gene expression. Creating multifunctional surfactants poses opportunities for broad applications, including adsorption, bioanalytics, catalysis, formulations, coatings, and programmable subset of emulsions.
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http://dx.doi.org/10.1007/s40820-021-00663-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214653PMC
June 2021

Thoracic Endometriosis: Still a Diagnostic Dilemma.

Cureus 2021 Jun 12;13(6):e15610. Epub 2021 Jun 12.

Radiology, Mayo Clinic, Jacksonville, USA.

We report a case of thoracic endometriosis syndrome (TES) presenting with a five-week history of progressive shortness of breath, cough, and wheezing. Investigations revealed a large, right-sided pleural effusion that was bloody on aspiration. A diagnosis of TES was one of the diagnoses entertained and eventually confirmed on finding evidence of pelvic endometriosis on laparotomy. The management of TES should include hormonal therapy, surgical management, or a combination of both.
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http://dx.doi.org/10.7759/cureus.15610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196491PMC
June 2021

Point of Care Ultrasound in Coronavirus Disease 2019 Pandemic: One Modality Helping Multiple Specialties.

J Med Ultrasound 2021 Jan-Mar;29(1):9-14. Epub 2021 Mar 20.

Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.

After the detection of novel coronavirus (2019) as the cause of a cluster of pneumonia in Wuhan, China, at the end of 2019, more than 10 million confirmed cases of coronavirus disease 2019 (COVID-19) have been reported around the globe. In the COVID-19 intensive care unit (ICU), the use of stethoscope is minimal for obvious reasons. Shifting of COVID-19 patients out of ICU setup increases the risk of transmission of infection to health-care workers as well as jeopardizes the safety of patients. Hence, diagnostic imaging has emerged as a fundamental component of the current management of COVID-19. Lung ultrasound (LUS) imaging has become a safe bedside imaging alternative that does not expose the patient to radiation and minimizes the risk of contamination. Ultrasound (USG) can be used to scan almost all vital organs (heart, kidney, vascular, brain, etc.) and also help in rapid decision-making regarding the management of COVID-19 patients. In this note, we review the current state of the art of LUS in evaluating pulmonary changes induced by COVID-19. The goal is to identify characteristic sonographic findings most suited for the diagnosis of COVID-19 pneumonia infections as well as to assess the impact of infection on other organs and utilizing the same in the management of COVID patients without compromising on the safety of patient or health-care provider.
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http://dx.doi.org/10.4103/JMU.JMU_114_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081099PMC
March 2021

Applicability of human-specific STR systems, GlobalFiler™ PCR Amplification Kit, Investigator 24plex QS Kit, and PowerPlex® Fusion 6C in chimpanzee (Pan troglodytes).

BMC Res Notes 2021 May 29;14(1):212. Epub 2021 May 29.

State Forensic Science Laboratory, Directorate of Forensic Services, Junga, Shimla, 171218, Himachal Pradesh, India.

Objectives: Human identification systems based on STRs are widely used in human population genetics and forensic analysis. This study aimed to validate the cross-reactivity of three widely known human-specific STR identification systems i.e. GlobalFiler™ PCR Amplification Kit, Investigator 24plex QS Kit, and PowerPlex® Fusion 6C in chimpanzee.

Results: The present study revealed the successful amplification of 18 loci using GlobalFiler™ PCR Amplification Kit, 18 loci using Investigator 24plex QS Kit, and 20 loci using PowerPlex® Fusion 6C system. The marker Amelogenin (AMEL) showed differential allele size between male and female revealing the gender identity of chimpanzees and thus validates their application concerning forensic examination, population estimation, and genetic analysis.
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http://dx.doi.org/10.1186/s13104-021-05632-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164790PMC
May 2021

Ditans vs Gepants: A Systematic Review and Indirect Network Meta-Analysis for Comparative Analysis of Efficacy and Safety.

Neurol India 2021 Mar-Apr;69(Supplement):S43-S50

Department of Pediatrics, Paramitha Children Hospital, Hyderabad, Telangana, India.

Background: An acute attack of migraine, incapacitates the migraineurs, and is widely prevalent. And to warden off its symptoms, recently two groups of drugs have been approved and launched.

Objective: The aim of this systematic review and indirect meta-analysis is to evaluate and summarize the effectiveness of these pharmacological interventions in managing the aforesaid disease.

Material And Methods: An extensive literature search was done through Cochrane library, Pub Med, clincialtrials.gov, for a period of 5 years (2015-2020), using key words: lasmiditan; ubrogepant; rimegepant; and acute migraine. Randomized double-blind phase III clinical trials, published in English language, were included which explored the efficacy and safety of these drugs. The outcomes of this meta-analysis included proportion of patients' headache, most bothersome symptoms free, and no disability at all at 2 h post-dose, with sustained pain freedom 2-24 h, and experiencing any adverse event. An indirect network meta-analysis was also conducted to determine the comparative effectiveness of these drugs.

Results: A total of seven RCTs involving 7266 patients were included. In general, the new drugs demonstrated better result in all the efficacy parameters. The adverse events were observed in treatment group compared to placebo. While in the indirect comparison, lasmiditan emerged to be superior in all the outcomes, except for sustained pain freedom 2-24 h (rimegepant was better). The adverse events were more with lasmiditan.

Conclusion: All the newer drugs have shown significant improvement in the outcomes analyzed. Lasmiditan appears to be superior among the newer drugs in efficacy; however it has more adverse effects.
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http://dx.doi.org/10.4103/0028-3886.315991DOI Listing
June 2021

A Rare Cause of Apparent Anuria After Caesarean Section: A Case Report.

Cureus 2021 Apr 10;13(4):e14400. Epub 2021 Apr 10.

Obstetrics and Gynaecology, Dr. Balwant Singh's Hospital, Georgetown, GUY.

Development of anuria in the setting of post-caesareansection is a cause of concern for surgeons, and it requires rapid evaluation for detecting its possible etiology and the initiation of appropriate treatment. When the cause of anuria is not immediately apparent in a hemodynamically stable patient, one must rule out other possible differentials as part of the diagnostic process. In this report, we present a rare case of a patient undergoing a trial of labour after a caesarean section, who had a Foley catheter accidentally placed and inflated in the right ureter, instead of the bladder. This led to apparent anuria, which was not identified until the patient's caesarean section had been completed. We also seek to shed light on a method for safely removing a ureteral Foley with a blocked inflation channel.
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http://dx.doi.org/10.7759/cureus.14400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108723PMC
April 2021

Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study.

BMJ 2021 05 12;373:n1087. Epub 2021 May 12.

Department of Medicine, Mayo Clinic, Rochester, MN, USA

Objective: To estimate population health outcomes with delayed second dose versus standard schedule of SARS-CoV-2 mRNA vaccination.

Design: Simulation agent based modeling study.

Setting: Simulated population based on real world US county.

Participants: The simulation included 100 000 agents, with a representative distribution of demographics and occupations. Networks of contacts were established to simulate potentially infectious interactions though occupation, household, and random interactions.

Interventions: Simulation of standard covid-19 vaccination versus delayed second dose vaccination prioritizing the first dose. The simulation runs were replicated 10 times. Sensitivity analyses included first dose vaccine efficacy of 50%, 60%, 70%, 80%, and 90% after day 12 post-vaccination; vaccination rate of 0.1%, 0.3%, and 1% of population per day; assuming the vaccine prevents only symptoms but not asymptomatic spread (that is, non-sterilizing vaccine); and an alternative vaccination strategy that implements delayed second dose for people under 65 years of age, but not until all those above this age have been vaccinated.

Main Outcome Measures: Cumulative covid-19 mortality, cumulative SARS-CoV-2 infections, and cumulative hospital admissions due to covid-19 over 180 days.

Results: Over all simulation replications, the median cumulative mortality per 100 000 for standard dosing versus delayed second dose was 226 179, 233 207, and 235 236 for 90%, 80%, and 70% first dose efficacy, respectively. The delayed second dose strategy was optimal for vaccine efficacies at or above 80% and vaccination rates at or below 0.3% of the population per day, under both sterilizing and non-sterilizing vaccine assumptions, resulting in absolute cumulative mortality reductions between 26 and 47 per 100 000. The delayed second dose strategy for people under 65 performed consistently well under all vaccination rates tested.

Conclusions: A delayed second dose vaccination strategy, at least for people aged under 65, could result in reduced cumulative mortality under certain conditions.
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http://dx.doi.org/10.1136/bmj.n1087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114182PMC
May 2021
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