Publications by authors named "Ajay Kumar"

1,324 Publications

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Endoscopic retrograde cholangiopancreaticography-related complications - Experience from tertiary care teaching centre over half a decade.

J Minim Access Surg 2022 Jan 4. Epub 2022 Jan 4.

Department of Gastroenterology, G. B Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.

Introduction: Endoscopic retrograde cholangiopancreaticography (ERCP) is an essential therapeutic procedure with a significant risk of complications. Data regarding the complications and predictors of adverse outcomes such as mortality are scarce, especially from India and Asia. We aimed to look at the incidence and outcome of complications in ERCP patients.

Materials And Methods: This study is a retrospective analysis of prospectively collected data of all the patients who underwent ERCP and had a complication from January 2012 to December 2018. Data were recorded in predesigned pro forma. The data analysis was done by appropriate statistical tests.

Results: : A total of 17,163 ERCP were done. A total of 570 patients (3.3%) had complications; perforation (n = 275, 1.6%) was most common followed by pancreatitis (n = 177, 1.03%) and bleeding (n = 60, 0.35%). The majorities of perforations were managed conservatively (n = 205, 74.5%), and 53 (19%) required surgery. Overall, 69 (0.4%) patients died. Of these, 30 (10.9%) patients died with perforation. Age (odds ratio [OR]: 1.04, 95% confidence interval [CI]: 1.005-1.07) and need of surgery (OR: 5.11, 95% CI: 1.66-15.77) were the predictors of mortality in patients with perforation. The majority pancreatitis were mild (n = 125, 70.6%) and overall mortality was 5.6% (n = 10).

Conclusion: ERCP complications have been remained static over the years, with perforation and pancreatitis contributing the most. Most perforations can be managed conservatively with good clinical outcomes.
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http://dx.doi.org/10.4103/jmas.jmas_272_21DOI Listing
January 2022

A review on bioactive phytochemicals and ethnopharmacological potential of purslane ( L.).

Heliyon 2022 Jan 27;8(1):e08669. Epub 2021 Dec 27.

School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India.

The L. commonly known as purslane is distributed all over the world and easily grows in diverse soil and climatic conditions. It has been traditionally used as a nutritious and ethnomedicinal food across the globe. Various studies have shown that the plant is a rich source of various important phytochemicals such as flavonoids, alkaloids, terpenoids, proteins, carbohydrates, and vitamins such as A, C, E, and B, carotenoids and minerals such as phosphorus, calcium, magnesium and zinc. It is particularly very important because of the presence of a very high concentration of omega-3- fatty acids especially α-linolenic acid, gamma-linolenic acid and linoleic acid, which are not generally synthesized in terrestrial plants. Various parts of purslane are known for ethnomedicinal and pharmacological uses because of its anti-inflammatory, antidiabetic, skeletal muscle relaxant, antitumor, hepatoprotective, anticancer, antioxidant, anti-insomnia, analgesic, gastroprotective, neuroprotective, wound healing and antiseptic activities. Due to multiple benefits of purslane, it has become an important wonder crop and various scientists across the globe have shown much interest in it as a healthy food for the future. In this review, we provide an update on the phytochemical and nutritional composition of purslane, its usage as nutritional and an ethnomedicinal plant across the world. We further provide a detailed account on ethnopharmacological studies that have proved the ethnomedicinal properties of purslane.
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http://dx.doi.org/10.1016/j.heliyon.2021.e08669DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741462PMC
January 2022

An Insight into Cholangiocarcinoma and Recent Advances in its Treatment.

J Gastrointest Cancer 2022 Jan 13. Epub 2022 Jan 13.

Department of Pharmaceutical Chemistry, Institute of Pharmaceutical Research, GLA University, Mathura, 281406, India.

Background: Cholangiocarcinoma (CCA) is a malignant disease of the epithelial cells of the intrahepatic and extrahepatic bile ducts. This review focuses on various aspects of cholangiocarcinoma such as its associated causes, treatment criteria, and more.

Methods: Although it remains a rare malignancy and is the second most common primary malignancy of the liver, the incidence is increasing, especially the incidence of intrahepatic CCA. Several studies suggested that surgery is not only solution; recently, reported targeted drugs may have the potential to become an alternative option.

Results: This review provides an overview of the current scenario of targeted therapies for CCA, which were tabulated with their current status and it also included its associated causes and its treatment criteria.

Conclusion: Because of its rarity and complexity, surgery remains the preferred treatment in resectable patients. Howerver, the studies suggested that the recently reported drugs may have the potential to be an alternative option for the treatment of CCA and related complications. In addition, this review will certainly benefit the community and researcher for further investigation.
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http://dx.doi.org/10.1007/s12029-021-00728-5DOI Listing
January 2022

Mindfulness-Based Interventions: Potentials for Management of Internet Gaming Disorder.

Int J Yoga 2021 Sep-Dec;14(3):244-247. Epub 2021 Nov 22.

Department of Yoga & Psychology, SVYASA Yoga University, SVYASA, Bengaluru, Karnataka, India.

Mindfulness-based interventions have been found to be efficacious among cases with substance addiction. Its role in Internet gaming disorder (IGD) has not been extensively studied. Prisma model approach was used to search for relevant articles from January 2009 to March 2021, to synthesize the role of empirical findings with mindfulness-based interventions to address various psychological domains in IGD. Eighteen relevant papers were included to understand the role of mindfulness-based interventions in IGD. Studies revealed the role of mindfulness-based interventions in the promotion of emotional regulation, metacognitive awareness, adaptive coping/cognition, reducing impulsivity, and craving for playing games. Studies also reveal neuro-biological basis for the effect of these interventions among users with IGD. Mindfulness-based interventions are potentially useful in IGD. It implicates the need to understand the empirical linkages within the root factors for a comprehensive understanding of the phenomenon of mindfulness-based treatment in IGD.
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http://dx.doi.org/10.4103/ijoy.ijoy_46_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8691447PMC
November 2021

Overview on agricultural potentials of biogas slurry (BGS): applications, challenges, and solutions.

Biomass Convers Biorefin 2022 Jan 4:1-41. Epub 2022 Jan 4.

Department of Biotechnology, Mewar Institute of Management, Vasundhara, Ghaziabad, UP 201012 India.

The residual slurry obtained from the anaerobic digestion (AD) of biogas feed substrates such as livestock dung is known as BGS. BGS is a rich source of nutrients and bioactive compounds having an important role in establishing diverse microbial communities, accelerating nutrient use efficiency, and promoting overall soil and plant health management. However, challenges such as lower C/N transformation rates, ammonia volatilization, high pH, and bulkiness limit their extensive applications. Here we review the strategies of BGS valorization through microbial and organomineral amendments. Such cohesive approaches can serve dual purposes viz. green organic inputs for sustainable agriculture practices and value addition of biomass waste. The literature survey has been conducted to identify the knowledge gaps and critically analyze the latest technological interventions to upgrade the BGS for potential applications in agriculture fields. The major points are as follows: (1) Bio/nanotechnology-inspired approaches could serve as a constructive platform for integrating BGS with other organic materials to exploit microbial diversity dynamics through multi-substrate interactions. (2) Advancements in next-generation sequencing (NGS) pave an ideal pathway to study the complex microflora and translate the potential information into bioprospecting of BGS to ameliorate existing bio-fertilizer formulations. (3) Nanoparticles (NPs) have the potential to establish a link between syntrophic bacteria and methanogens through direct interspecies electron transfer and thereby contribute towards improved efficiency of AD. (4) Developments in techniques of nutrient recovery from the BGS facilities' negative GHGs emissions and energy-efficient models for nitrogen removal. (5) Possibilities of formulating low-cost substrates for mass-multiplication of beneficial microbes, bioprospecting of such microbes to produce bioactive compounds of anti-phytopathogenic activities, and developing BGS-inspired biofertilizer formulations integrating NPs, microbial inoculants, and deoiled seed cakes have been examined.
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http://dx.doi.org/10.1007/s13399-021-02215-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725965PMC
January 2022

Medical gas pipeline system as a limiting factor for hospital oxygen supply during COVID-19 outbreak.

Indian J Anaesth 2021 Nov 23;65(11):834-836. Epub 2021 Nov 23.

Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, India.

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http://dx.doi.org/10.4103/ija.ija_683_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8680427PMC
November 2021

A review on experimental and numerical investigations of cortical bone fracture.

Proc Inst Mech Eng H 2022 Jan 8:9544119211070347. Epub 2022 Jan 8.

School of Engineering, Indian Institute of Technology Mandi (IIT Mandi), Kamand, Mandi 175005, Himachal Pradesh, India.

This paper comprehensively reviews the various experimental and numerical techniques, which were considered to determine the fracture characteristics of the cortical bone. This study also provides some recommendations along with the critical review, which would be beneficial for future research of fracture analysis of cortical bone. Cortical bone fractures due to sports activities, climbing, running, and engagement in transport or industrial accidents. Individuals having different diseases are also at high risk of cortical bone fracture. It has been observed that osteon orientation influences cortical bone fracture toughness and fracture mechanisms. Apart from this, recent studies indicate that fracture parameters of cortical bone also depend on many factors such as age, sex, temperature, osteoporosis, orientation, location, loading condition, strain rate, and storage facility, etc. The cortical bone regains its fracture toughness due to various toughening mechanisms. Owing to these factors, several experimental, clinical, and numerical investigations have been carried out to determine the fracture parameters of the cortical bone. Cortical bone is the dense outer surface of the bone and contributes to 80%-82% of the skeleton mass. Cortical bone experiences load far exceeding body weight due to muscle contraction and the dynamics of motion. It is very important to know the fracture pattern, direction of fracture, location of the fracture, and toughening mechanism of cortical bone. A basic understanding of the different factors that affect the fracture parameters and fracture mechanisms of the cortical bone is necessary to prevent the failure and fracture of cortical bone. This review has summarized the advancement considered in the various experimental techniques and numerical methods to get complete information about the fracture mechanisms of cortical bone.
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http://dx.doi.org/10.1177/09544119211070347DOI Listing
January 2022

Genetic and molecular mechanisms underlying mangrove adaptations to intertidal environments.

iScience 2022 Jan 30;25(1):103547. Epub 2021 Nov 30.

Department of Plant Science, School of Biological Sciences, Central University of Kerala, Kasaragod, Kerala 671316, India.

Mangroves are halophytic plants belonging to diverse angiosperm families that are adapted to highly stressful intertidal zones between land and sea. They are special, unique, and one of the most productive ecosystems that play enormous ecological roles and provide a large number of benefits to the coastal communities. To thrive under highly stressful conditions, mangroves have innovated several key morphological, anatomical, and physio-biochemical adaptations. The evolution of the unique adaptive modifications might have resulted from a host of genetic and molecular changes and to date we know little about the nature of these genetic and molecular changes. Although slow, new information has accumulated over the last few decades on the genetic and molecular regulation of the mangrove adaptations, a comprehensive review on it is not yet available. This review provides up-to-date consolidated information on the genetic, epigenetic, and molecular regulation of mangrove adaptive traits.
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http://dx.doi.org/10.1016/j.isci.2021.103547DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8693430PMC
January 2022

Cerebellar Agenesis: A Rare Cause of Seizure Disorder in a Young Boy.

Neurol India 2021 Nov-Dec;69(6):1850-1852

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

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http://dx.doi.org/10.4103/0028-3886.333472DOI Listing
January 2022

Deciphering the Role of Surface Protein LigA in Modulating the Host Innate Immune Response.

Front Immunol 2021 16;12:807775. Epub 2021 Dec 16.

Laboratory of Vaccine Immunology, National Institute of Animal Biotechnology, Hyderabad, India.

, a zoonotic pathogen, is known to infect various hosts and can establish persistent infection. This remarkable ability of bacteria is attributed to its potential to modulate (activate or evade) the host immune response by exploiting its surface proteins. We have identified and characterized the domain of the variable region of immunoglobulin-like protein A (LAV) involved in immune modulation. The 11 domain (A) of the variable region of LigA (LAV) induces a strong TLR4 dependent innate response leading to subsequent induction of humoral and cellular immune responses in mice. A is also involved in acquiring complement regulator FH and binds to host protease Plasminogen (PLG), there by mediating functional activity to escape from complement-mediated killing. The deletion of A domain significantly impaired TLR4 signaling and subsequent reduction in the innate and adaptive immune response. It also inhibited the binding of FH and PLG thereby mediating killing of bacteria. Our study discovered an unprecedented role of LAV as a nuclease capable of degrading Neutrophil Extracellular Traps (NETs). This nuclease activity was primarily mediated by A. These results highlighted the moonlighting function of LigA and demonstrated that a single domain of a surface protein is involved in modulating the host innate immune defenses, which might allow the persistence of in different hosts for a long term without clearance.
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http://dx.doi.org/10.3389/fimmu.2021.807775DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8716722PMC
December 2021

Chemoselective and Tandem Reduction of Arenes Using a Metal-Organic Framework-Supported Single-Site Cobalt Catalyst.

Inorg Chem 2022 Jan 30;61(2):1031-1040. Epub 2021 Dec 30.

Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India.

The development of heterogeneous, chemoselective, and tandem catalytic systems using abundant metals is vital for the sustainable synthesis of fine and commodity chemicals. We report a robust and recyclable single-site cobalt-hydride catalyst based on a porous aluminum metal-organic framework (DUT-5 MOF) for chemoselective hydrogenation of arenes. The DUT-5 node-supported cobalt(II) hydride (DUT-5-CoH) is a versatile solid catalyst for chemoselective hydrogenation of a range of nonpolar and polar arenes, including heteroarenes such as pyridines, quinolines, isoquinolines, indoles, and furans to afford cycloalkanes and saturated heterocycles in excellent yields. DUT-5-CoH exhibited excellent functional group tolerance and could be reusable at least five times without decreased activity. The same MOF-Co catalyst was also efficient for tandem hydrogenation-hydrodeoxygenation of aryl carbonyl compounds, including biomass-derived platform molecules such as furfural and hydroxymethylfurfural to cycloalkanes. In the case of hydrogenation of cumene, our spectroscopic, kinetic, and density functional theory (DFT) studies suggest the insertion of a trisubstituted alkene intermediate into the Co-H bond occurring in the turnover limiting step. Our work highlights the potential of MOF-supported single-site base-metal catalysts for sustainable and environment-friendly industrial production of chemicals and biofuels.
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http://dx.doi.org/10.1021/acs.inorgchem.1c03098DOI Listing
January 2022

Resource integration and dynamic capability of frontline employee during COVID-19 pandemic: From value creation and engineering management perspectives.

Technol Forecast Soc Change 2022 Mar 22;176:121446. Epub 2021 Dec 22.

School of Business, Maynooth University, Maynooth, Ireland.

The cornerstone of any successful organizations is the frontline employees. Frontline employees (FLEs) are always in action at the frontline of the business. They do not operate from the office space or from the corporate setting. Frontline employees directly interact with their customers. During the COVID-19 pandemic, many frontline employees experienced numerous challenges as most of the places there were full or partial lockdown imposed by the government agencies and the frontline employees could not be able to directly connect with their customers. Not many studies are there which investigated the issue of resource integration, dynamic capabilities, and engineering management abilities of the frontline employees such as technological capability, emotional intelligence, and psychological capability which perceived to influence the frontline employee adaptability and organization performance. In this background, the purpose of this study is to examine the relationship between frontline employee adaptability and organization performance during COVID-19 pandemic from technological, emotional, and psychological perspectives. With the help of dynamic capability view and different adaptability theories, a theoretical model has been developed conceptually. Later the conceptual model has been validated using partial least square - structural equation modeling technique considering 412 respondents from frontline employees of different organizations in Asia and EMEA. The study found that frontline employees' dynamic capabilities and engineering management abilities significantly and positively impact employee adaptability which in turn impact the performance of the organization mediating through employee job satisfaction and employee performance.
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http://dx.doi.org/10.1016/j.techfore.2021.121446DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8692063PMC
March 2022

Fabrication and characterization of high-performance forward-osmosis membrane by introducing manganese oxide incited graphene quantum dots.

J Environ Manage 2022 Mar 21;305:114335. Epub 2021 Dec 21.

Department of Hydrology, Indian Institute of Technology Roorkee, Uttarakhand, 247667, India.

Forward osmosis (FO) is the futuristic membrane desalination technology as it transcends the disadvantages of other pressure-driven techniques. But, there still remain critical challenges like fabrication of highly permeable membrane with ideal structures maintaining high rejection rates that need to be addressed for implementation as a practical technology. In this work, novel thin-film composite (TFC) membranes were fabricated by means of incorporating manganese oxide (MnO) incited graphene quantum dots (GQDs) nanocomposite into a cellulose acetate (CA) suspension followed by phase inversion (PI) for enhanced FO performance. The surface morphology and chemical structure of fabricated membranes were studied using various characterization techniques like XRD, FT-IR, SEM-EDS, Mapping, AFM, and TGA. The structural parameters, water flux, reverse salt flux and salt rejection was estimated on the basis of data obtained from four varying initial draw solution concentrations. At high nanocomposites stacking, the hydrophilicity of the casting blend increase, and subsequently, the PI exchange rate additionally increases, which brings about noticeable difference in the surface morphology. The membrane with 0.5 wt% nanocomposite exhibited superior FO separation performance with osmotic water flux of 18.89, 34.49, 41.76 and 42.34 in L.m.h with variable concentrations of NaCl salt solution (0.25M, 0.5M, 1M, and 2M), respectively. Also, the porosity of the membrane was increased to 47.23% with 96.87% salt rejection. The results indicate that the hydrophilicity of the nanocomposite drives them to the interface among CA and water during PI process leading to solid hydrogen bonding to achieve high water permeability.
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http://dx.doi.org/10.1016/j.jenvman.2021.114335DOI Listing
March 2022

Potential Anti- Activity of Plant Secondary Metabolites: Insight with Molecular Docking Interactions.

Antioxidants (Basel) 2021 Dec 14;10(12). Epub 2021 Dec 14.

Department of Postharvest Science, Agriculture Research Organization, Volcani Center, Rishon LeZion 7505101, Israel.

Tuberculosis (TB) is a recurrent and progressive disease, with high mortality rates worldwide. The drug-resistance phenomenon of is a major obstruction of allelopathy treatment. An adverse side effect of allelopathic treatment is that it causes serious health complications. The search for suitable alternatives of conventional regimens is needed, i.e., by considering medicinal plant secondary metabolites to explore anti-TB drugs, targeting the action site of . Nowadays, plant-derived secondary metabolites are widely known for their beneficial uses, i.e., as antioxidants, antimicrobial agents, and in the treatment of a wide range of chronic human diseases (e.g., tuberculosis), and are known to "thwart" disease virulence. In this regard, in silico studies can reveal the inhibitory potential of plant-derived secondary metabolites against at the very early stage of infection. Computational approaches based on different algorithms could play a significant role in screening plant metabolites against disease virulence of tuberculosis for drug designing.
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http://dx.doi.org/10.3390/antiox10121990DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8750514PMC
December 2021

ESIPT Active Assemblies for 'On-On' Detection, Cell Imaging and Hampering Cellular Activity of 2,6-Dichloro-4-nitroaniline.

Chem Asian J 2021 Dec 23:e202101219. Epub 2021 Dec 23.

Department of Chemistry, UGC Sponsored-Centre of Advance Studies-II, Guru Nanak Dev University, Amritsar, 143005, India.

ESIPT active PBI-keto/enol assemblies have been developed which show 'on-on' optical response towards 2,6-dichloro-4-nitroaniline (DCN) due to a combined ESIPT-AIEE phenomenon with a detection limit of 1.65 nM. The potential of PBI-keto/enol assemblies to detect DCN has also been explored in grape juice/grape residue and soil for six consecutive days. Further, the biological applications of PBI-keto/enol assemblies to detect DCN in blood serum, in MG-63 cell lines and their ability to restrict the DCN-induced cell death have been demonstrated.
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http://dx.doi.org/10.1002/asia.202101219DOI Listing
December 2021

Digital supply chain management in the COVID-19 crisis: An asset orchestration perspective.

Int J Prod Econ 2022 Mar 16;245:108396. Epub 2021 Dec 16.

Emlyon Business School, France.

Although many firms are actively deploying various digital technology (DT) assets across their supply chains to mitigate the negative impact of the COVID-19 pandemic on operations, whether these DT assets are truly helpful remains unclear. To disentangle this puzzle, we investigate whether firms that have higher levels of DT asset deployment achieve better supply chain performance in the COVID-19 crisis than firms with lower levels. From an asset orchestration perspective, we focus on two dimensions of DT asset deployment: breadth and depth, which reflect the scope and scale of DT assets, respectively. The empirical results from 175 Chinese firms that have deployed DT assets to varying degrees reveal that both the breadth and the depth of DT asset deployment show positive relationships with supply chain visibility. In contrast, the depth but not the breadth of DT asset deployment poses a positive relationship with supply chain agility. Most importantly, high levels of supply chain visibility and supply chain agility were prerequisites for excellent supply chain performance in the COVID-19 crisis. We contribute to the digital supply chain management literature by uncovering the mechanism through which DT asset deployment generates impacts on supply chain performance from an asset orchestration perspective. Our study also assists firms in improving their digital transformation strategies to combat the COVID-19 pandemic.
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http://dx.doi.org/10.1016/j.ijpe.2021.108396DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674654PMC
March 2022

Antimicrobial resistant Shigella in North India since the turn of the 21st century.

Indian J Med Microbiol 2021 Dec 16. Epub 2021 Dec 16.

Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Purpose: The ubiquitous presence and rampant spread of antibiotic resistant strains of Shigella spp is a major public health concern. Therefore, monitoring the trends of antimicrobial resistance in them is essential.

Methods: A total of 15440 stool samples were inoculated on MacConkey agar, lysine deoxycholate agar and Selenite F enrichment broth from 2001 to 2015.Out of 491 shigellae isolated, 250 isolates were recovered from our culture collection. Antimicrobial susceptibility was performed by Kirby Bauer disc diffusion method, E-test and phenotypic resistance screening for ESBL and AmpC production was performed. For the detection of beta-lactamase genes, PCR for blaTEM, blaSHV, blaOXA, blaCTX-M-15, CMY-2 and mphA PCR in isolates with decreased susceptibility to azithromycin(DSA) was performed.

Results: S. flexneri (n ​= ​173) was most common, followed by S.dysenteriae (n ​= ​24), S.sonnei (n ​= ​23), S.boydii (n ​= ​10) and Non agglutinating Shigella (NAG, n ​= ​20). A see-saw pattern in the prevalence of S. flexneri and S. dysenteriae and rising prevalence of S. sonnei and NAG was seen. Majority (77%) of the isolates had MICs >4 ​mg/L for ciprofloxacin and >50% had high MIC (12 ​mg/L) for ceftriaxone and cefepime (8 ​mg/L). Nearly 20% of S.flexneri were resistant to third generation cephalosporin by disc diffusion and 33.7% had MIC ≥1 ​μg/mL. Among the ceftriaxone resistant isolates (n ​= ​29) the blaTEM beta-lactamase resistance gene was seen in all, blaCTX-M-15 in 37%, blaCMY-2 in 45.6% and blaOXA in 52%. The first report of DSA at our institute was in 2001 (n ​= ​1, 2.5%) which increased to 35.1% (n ​= ​40) in 2011-15. The isolates with DSA included S. flexneri (n ​= ​40), S. boydii (n ​= ​4) and S. sonnei (n ​= ​1) and plasmid mediated resistance to azithromycin by mphA gene was detected in 19 out of 40 isolates of S. flexneri.

Conclusion: Global emergence of resistance Shigella is a matter of concern and calls for systematic monitoring and periodic updates of countrywide and local antibiogram.
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http://dx.doi.org/10.1016/j.ijmmb.2021.12.001DOI Listing
December 2021

Caregiver burden among working women and homemakers taking care of psychiatric patients.

Ind Psychiatry J 2021 Oct 22;30(Suppl 1):S166-S171. Epub 2021 Oct 22.

Department of Psychiatry, PMCH, Patna, Bihar, India.

Background: Caregiver burden is defined as the physical, psychological or emotional, social, and financial problem that can be experienced by the members of family caring for impaired person. In India, women are twice more likely to become caregivers than men, despite emergence of men as caregivers.

Aim: The aim of the study is to assess burden of illness among working women and homemakers taking care of psychiatric patients.

Materials And Methods: This hospital-based, descriptive, cross-sectional comparative study was conducted on the caregivers who were recruited from outdoor patient department of psychiatry department of a tertiary care hospital attached to a medical college. Women who were 30-45 years old, working or homemakers and who were taking care of psychiatric patients diagnosed with schizophrenia and Bipolar affective disorder (BAPD) of either sex. Caregivers were first-degree relatives of patients. Sociodemographic data were recorded using a special performa and caregiver burden was assessed using caregiver burden questionnaire.

Results: Overall mean caregiver burden scores in Group 1 and Group 2 were 55.66 ± 4.09 and 58.16 ± 3.97, respectively, with statistically significant difference ( < 0.05).

Conclusion: Caregiver burden was more among working women compared to homemaker women.
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http://dx.doi.org/10.4103/0972-6748.328809DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611542PMC
October 2021

Psychiatric morbidity in individuals with permanent orthopedic disability.

Ind Psychiatry J 2021 Oct 22;30(Suppl 1):S97-S102. Epub 2021 Oct 22.

Department of Biochemistry, DMCH, Darbhanga, Bihar, India.

Background: Individuals with permanent orthopedic disability present with a number of physical and mental health issues. Psychiatric illnesses have been seen more frequently among people with disabilities as compared to normal population.

Aim: To study psychiatric morbidity among people with permanent orthopedic disability.

Materials And Methods: This cross-sectional, observational, hospital-based study was conducted at the department of psychiatry of a tertiary care hospital attached to a medical college during January 01, 2018, to December 31, 2018. The study included subjects over the age of 18 years comprising two groups: Group A ( = 50) including consecutive subjects with orthopedic disability and Group B ( = 50) including normal age- and sex-matched controls. Permission was obtained from the institutional ethics committee before the start of the study. Prior informed consent was obtained from all subjects. Sociodemographic variables were recorded, and psychiatric morbidity was screened on Mini International Neuropsychiatric Interview.

Results: 62% ( = 31) of subjects in Group A had psychiatric morbidity as compared to Group B (22%, = 11). Maximum psychiatric morbidity noted among subjects with disability was generalized anxiety disorder (22%, = 11), followed by major depressive disorder (20%, = 10) and alcohol dependence (18%, = 9). Substance dependence was more in Group A (34%, = 17) as compared to Group B (18%, = 9). The most common substance dependence was for alcohol (18%, = 9), followed by opioids (8%, = 4) and tobacco (6%, = 3).

Conclusion: Psychiatric morbidity including substance dependence is more common among people with orthopedic disability as compared to normal control subjects.
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http://dx.doi.org/10.4103/0972-6748.328796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611563PMC
October 2021

A Connecticut healthcare system's response to the COVID-19 pandemic.

Am J Disaster Med 2021 Summer;16(3):195-202

Department of Surgery, Hartford Hospital, Hartford, Connecticut; Professor of Surgery, Department of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut.

Connecticut was impacted severely and early on by the COVID-19 pandemic due to the state's proximity to New York City. Hartford Healthcare (HHC), one of the largest healthcare systems in New England, became integral in the state's response with a robust emergency management system already in place. In this manuscript, we review HHC's prepandemic emergency operations as well as the response of the system-wide Office of Emergency Management to the initial news of the virus and throughout the evolving pandemic. Additionally, we discuss the unique acquisition of vital critical care resources and personal protective equipment, as well as the hospital personnel distribution in response to the shifting demands of the virus. The public testing and vaccination efforts, with early consideration for at risk populations, are described as well as ethical considerations of scarce resources. To date, the vaccination effort resulted in over 70 percent of the adult population being vaccinated and with 10 percent of the population having been infected, herd immunity is eminent. Finally, the preparation for reestablishing elective procedures while experiencing a second wave of the pandemic is discussed. These descriptions may be useful for other healthcare systems in both preparation and response for future catastrophic emergencies of all types.
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http://dx.doi.org/10.5055/ajdm.2021.0401DOI Listing
December 2021

Differential translational regulation of host exosomal proteins play key role in immunomodulation in antimony resistance in Visceral Leishmaniasis: A proteomic profiling study.

Acta Trop 2021 Dec 7;226:106268. Epub 2021 Dec 7.

Department of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007 Bihar, India; Department. of Microbiology, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar 800 014 India; Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal India. Electronic address:

In host-pathogen interactions, exosomal secretions are crucial for cell to cell communication and have an established role in immunomodulation. Protozoans, including Leishmania, modulates their host vesicular secretions for better survival; although the role of exosomal secretions in unresponsive against sodium antimony gluconate (SAG) has never been documented. In this study, the exosomal proteome of RAW macrophages infected with either SAG responsive (SAG) or SAG unresponsive (SAG) L. donovani parasites has been compared with uninfected RAW macrophages. Proteins isolated from exosomes were labelled with iTRAQ reagents; followed by subsequent LC-TOF/-MS analysis. In total, 394 proteins (p < 0.05) were identified which were shared common among all sets. Highly differentially expressed proteins were sorted by log2 value -1 and +1 as down regulated and up regulated respectively which yielded 58 proteins in SAG and 41 proteins during SAG infection. Out of the 58 proteins identified during SAG infection, 17 proteins were of immune modulatory function. Network visualization model and pathway analysis revealed the interactions among these proteins via different immunological pathways with reported involvement of some proteins in SAG resistance and host immune modulation. Hence, the differential abundance of immune pathway related proteins in exosomes of infected host during SAG infection supports the immune modulatory strategy adopted by SAG resistant parasites for enhanced survival .
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http://dx.doi.org/10.1016/j.actatropica.2021.106268DOI Listing
December 2021

Editorial: Genetics and Genomics to Enhance Crop Production, Towards Food Security.

Front Genet 2021 23;12:798308. Epub 2021 Nov 23.

Department of Crop and Soil Sciences, Washington State University, Pullman, WA, United States.

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http://dx.doi.org/10.3389/fgene.2021.798308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650130PMC
November 2021

Factors Associated with Unfavourable Treatment Outcomes in Patients with Tuberculosis: A 16-Year Cohort Study (2005-2020), Republic of Karakalpakstan, Uzbekistan.

Int J Environ Res Public Health 2021 12 5;18(23). Epub 2021 Dec 5.

World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark.

Tuberculosis (TB) remains a public health burden in the Republic of Karakalpakstan, Uzbekistan. This region-wide retrospective cohort study reports the treatment outcomes of patients registered in the TB electronic register and treated with first-line drugs in the TB Programme of the Republic of Karakalpakstan from 2005-2020 and factors associated with unfavourable outcomes. Among 35,122 registered patients, 24,394 (69%) patients were adults, 2339 (7%) were children, 18,032 (51%) were male and 19,774 (68%) lived in rural areas. Of these patients, 29,130 (83%) had pulmonary TB and 7497 (>22%) had been previously treated. There were 7440 (21%) patients who had unfavourable treatment outcomes. Factors associated with unfavourable treatment outcomes included: increasing age, living in certain parts of the republic, disability, pensioner status, unemployment, being HIV-positive, having pulmonary TB, and receiving category II treatment. Factors associated with death included: being adult and elderly, living in certain parts of the republic, having a disability, pensioner status, being HIV-positive, and receiving category II treatment. Factors associated with failure included: being adolescent, female, having pulmonary TB. Factors associated with loss to follow-up included: being male, disability, pensioner status, unemployment, receiving category II treatment. In summary, there are sub-groups of patients who need special attention in order to decrease unfavourable treatment outcomes.
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http://dx.doi.org/10.3390/ijerph182312827DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8657882PMC
December 2021

Operational Research to Inform Programmatic Approaches to the Management of Tuberculosis in Uzbekistan.

Int J Environ Res Public Health 2021 11 23;18(23). Epub 2021 Nov 23.

World Health Organization Regional Office for Europe, DK-2100 Copenhagen, Denmark.

Globally, an estimated 10 million people fell ill with tuberculosis (TB) in 2019, a number that has been declining very slowly in recent years [...].
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http://dx.doi.org/10.3390/ijerph182312308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656530PMC
November 2021

Serum and urine profiles of TGF-β superfamily members in reproductive aged women.

Clin Chim Acta 2022 Jan 5;524:96-100. Epub 2021 Dec 5.

Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 TW Alexander Drive, Research Triangle Park, NC, United States. Electronic address:

Background: TGF-β superfamily members are important biomarkers of reproductive health in women desiring fertility and during pregnancy. TGF-β proteins derived from the ovary and/or placenta have been detected in serum in women, but there have been very few attempts to measure them non-invasively, such as in urinary samples, and to compare them to serum concentrations.

Methods: We measured inhibin A, inhibin B, total inhibin, AMH, activin A, activin B, activin AB, follistatin, the GDF-9/BMP-15 complex, and GDF-15 in paired serum and urine samples from healthy reproductive aged women and in pregnant (second trimester) women.

Results: We detected all hormones in serum in both pregnant and non-pregnant women. Inhibin A, total inhibin, activin A, activin AB, follistatin, and GDF-15 were significantly higher in pregnant than in non-pregnant women. GDF-15 was the only hormone consistently detected in urine. We also measured, for the first time, the GDF-9/BMP-15 functional heterodimer and the GDF-15 protein harboring the H202D polymorphism.

Conclusions: We report the successful measurement of the GDF-9/BMP-15 heterodimer (its native form) in serum and the ability to measure GDF-15 non-invasively, in urinary samples. This novel GDF-15 assay also captures the antigen in the presence of a common genetic variant.
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http://dx.doi.org/10.1016/j.cca.2021.12.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8740174PMC
January 2022

Evaluation of lignocaine, dexmedetomidine, lignocaine-dexmedetomidine infusion on pain and quality of recovery for robotic abdominal hysterectomy: a prospective randomized controlled trial.

Braz J Anesthesiol 2021 Nov 27. Epub 2021 Nov 27.

Department of Gynaecology.

Background: Acute postoperative pain is associated with poor quality of recovery after surgery. Perioperative use of intravenous lignocaine or dexmedetomidine have demonstrated better pain control, early return of bowel function, and effects on quality of recovery.

Methods: Ninety-six women planned for elective robotic abdominal hysterectomy were randomized into four groups. Groups received lignocaine infusion (1.5 mg.kg loading, 2 mg.kg.h infusion) (Group I), dexmedetomidine infusion (1 µg.kg loading, 0.6 µg.kg.h infusion) (Group 2), lidocaine (1.5 mg.kg loading, 2 mg.kg.h infusion), and dexmedetomidine infusions (1 µg.kg loading, 0.5 µg.kg.h infusion) (Group 3), and normal saline 10 mL loading, 1 mL.kg.h infusion) (Group 4). Primary outcome was visual analogue pain scores at 1, 2, 4, 12, and 24 hours after surgery. Secondary outcomes included postoperative fentanyl requirement, time of return of bowel sounds and flatus, QoR15 score on day 1, 2, and discharge.

Results: The VAS was significantly lower in Groups 2 and 3 compared to Groups 1 and 4. Total postoperative fentanyl consumption in the first 24 hours was 256.25 ± 16.36 mcg (Group 1), 177.71 ± 16.81 mcg (Group 2), 114.17 ± 16.19 mcg (Group 3), and 304.42 ± 31.26 mcg (Group 4), respectively. Time to return of bowel sounds and passage of flatus was significantly shorter in Groups 2 and 3 (p < 0.01). QoR15 scores after surgery were higher in Group 3 compared to Groups 1, 2, and 4, (p < 0.01) respectively.

Conclusion: Combined infusion of lignocaine and dexmedetomidine significantly decreased postoperative pain, fentanyl consumption, and improved quality of recovery score after surgery in patients undergoing Robotic abdominal hysterectomy.
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http://dx.doi.org/10.1016/j.bjane.2021.10.005DOI Listing
November 2021

Assessing the role of industry 4.0 for enhancing swift trust and coordination in humanitarian supply chain.

Ann Oper Res 2021 Nov 24:1-33. Epub 2021 Nov 24.

AIM Research Centre on Artificial Intelligence in Value Creation, EMLYON Business School, 23 Avenue Guy de Collongue, 69130 Ecully, France.

Unpredictable natural and man-made disasters highlight importance of humanitarian supply chain (HSC) to serve people and affected areas. The main challenges of applying effective relief operations are creating "swift trust" and "coordination" between aid organizations. Implementation of Industry 4.0 facilitates coordination and swift trust within HSC performance. The study intends to assess the readiness status of swift trust and coordination between stakeholders as well as to recommend the most suitable Industry 4.0 tools for improving relief operations. Firstly, a comprehensive set of critical success factors for implementing Industry 4.0 tools are introduced. The factors are categorized into limited groups using Exploratory Factor Analysis. In the next step, hierarchy fuzzy expert system is designed for assessing the readiness status of swift trust and coordination as well as to suggest the most suitable Industry 4.0 tool for enhancing HSC performance within given case study. The framework was applied for three aid organizations to address the pandemic disease in Iran. The outcome denotes that the organization has the highest readiness in logistic and transparency while information quality received the lowest readiness value. In addition to that, the organization should invest on the development of Industry 4.0 enablers including "Internet of Things and Big Data Analytics". The study extends organizational information process theory within HSC for reaching competitive advantage by information processing. The study suggests theoretical and practical implications by introducing a comprehensive set of critical success factors for implementation of Industry 4.0 and providing practical advice for enhancing HSC performance.
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http://dx.doi.org/10.1007/s10479-021-04430-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611642PMC
November 2021

Fracture Toughness of Acrylic PMMA Bone Cement: A Mini-Review.

Indian J Orthop 2021 Oct 21;55(5):1208-1214. Epub 2021 Aug 21.

School of Engineering, Indian Institute of Technology Mandi, Mandi, Himachal Pradesh 175005 India.

Background: Acrylic PMMA bone cement is an essential component in cemented implants and formed the cement-bone and cement-implant interfaces. The information on the fracture parameters of PMMA bone cement would be decisive for all doctors, researchers, and orthopaedic surgeons.

Purpose: This review aims to indicate the parameters responsible for the variation in the fracture toughness of PMMA bone cement. This mini-review also points out some limitations of the earlier published research article, which can be added in the future analysis and can be helpful to get the more realistic data of the fracture parameters of PMMA bone cement.

Conclusion: Different mixing techniques, storage medium, temperature, loading conditions, frequency and environment, cement viscosity, type of specimen, and the ASTM standards (shape, size, and geometry), constituents, loading rate, and cement porosity were the critical parameters to affect the fracture toughness of PMMA bone cement. This study will also be helpful to increase the structural integrity of PMMA bone cement and the cemented implant.
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http://dx.doi.org/10.1007/s43465-021-00495-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8586281PMC
October 2021

L-ornithine L-aspartate in acute treatment of severe hepatic encephalopathy: A double-blind randomized controlled trial.

Hepatology 2021 Nov 25. Epub 2021 Nov 25.

Department of Gastroenterology, GB Pant Hospital, New Delhi, India.

Background And Aims: Data on the use of intravenous L-ornithine L-aspartate (LOLA) in the treatment of overt HE (OHE) is limited. We evaluated the role of intravenous LOLA in patients of cirrhosis with OHE grade III-IV.

Approach And Results: In a double-blind randomized placebo-controlled trial, 140 patients were randomized to a combination of LOLA, lactulose, and rifaximin (n = 70) or placebo, lactulose, and rifaximin (n = 70). LOLA was given as continuous intravenous infusion at a dose of 30 g over 24 h for 5 days. Ammonia levels, TNF-α, ILs, and endotoxins were measured on days 0 and 5. The primary outcome was the improvement in the grade of HE at day 5. Higher rates of improvement in grade of HE (92.5% vs. 66%, p < 0.001), lower time to recovery (2.70 ± 0.46 vs. 3.00 ± 0.87 days, p = 0.03), and lower 28-day mortality (16.4% vs. 41.8%, p = 0.001) were seen in the LOLA group as compared with placebo. Levels of inflammatory markers were reduced in both groups. Significantly higher reductions in levels of blood ammonia, IL-6, and TNF-α were seen in the LOLA group.

Conclusions: Combination of LOLA with lactulose and rifaximin was more effective than only lactulose and rifaximin in improving grades of HE, recovery time from encephalopathy, with lower 28-day mortality.
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http://dx.doi.org/10.1002/hep.32255DOI Listing
November 2021

Design, Synthesis, biological investigations and molecular interactions of triazole linked tacrine glycoconjugates as Acetylcholinesterase inhibitors with reduced hepatotoxicity.

Bioorg Chem 2022 01 13;118:105479. Epub 2021 Nov 13.

Natural Product Chemistry Division, CSIR-IIIM, Jammu 180001, India; Academy of Scientific and Innovative Research (AcSIR-IIIM), Jammu 180001, India. Electronic address:

Tacrine is a known Acetylcholinesterase (AChE) inhibitors having hepatotoxicity as main liability associated with it. The present study aims to reduce its hepatotoxicity by synthesizing tacrine linked triazole glycoconjugates via Huisgen's [3 + 2] cycloaddition of anomeric azides and terminal acetylenes derived from tacrine. A series of triazole based glycoconjugates containing both acetylated (A-1 to A-7) and free sugar hydroxyl groups (A-8 to A-14) at the amino position of tacrine were synthesized in good yield taking aid from molecular docking studies and evaluated for their in vitro AChE inhibition activity as well as hepatotoxicity. All the hybrids were found to be non-toxic on HePG2 cell line at 200 μM (100 % cell viability) as compared to tacrine (35 % cell viability) after 24 h of incubation period. Enzyme kinetic studies carried out for one of the potent hybrids in the series A-1 (IC 0.4 μM) revealed its mixed inhibition approach. Thus, compound A-1 can be used as principle template to further explore the mechanism of action of different targets involved in Alzheimer's disease (AD) which stands as an adequate chemical probe to be launched in an AD drug discovery program.
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http://dx.doi.org/10.1016/j.bioorg.2021.105479DOI Listing
January 2022
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