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Background and AimsThoracic spinal anaesthesia (TSA) is emerging as an alternative to general anaesthesia for modified radical mastectomy (MRM) for carcinoma breast due to its favorable recovery profile. The present study aims to evaluate block characteristics and outcomes of isobaric and hyperbaric ropivacaine in TSA for the sameMethodsSixty patients scheduled for unilateral MRM were randomly allocated to equally to; Group I: (0.75% isobaric ropivacaine-1 mL) and Group H: (0.75% hyperbaric ropivacaine -1 mL) along with fentanyl (25 μg) in both groups for TSA at (T4-T5) level, administered in lateral position and turned to supine immediately. The primary objective of the study was to evaluate the block onset time at T2 dermatome and secondary objectives included peak sensory loss at 10 min, intraoperative cardio-respiratory changes and post operative pain scores. Data were compared using the two-sided Student t-test, Mann-Whitney and Chi-square tests.ResultsTime of onset of sensory block (in min) at T2 level (3.00 ± 0.00 versus 3.40 ± 1.04, p = 0.04) and peak sensory loss at 10 min (C5 sensory level at 10 min, 93% versus 60%, p <0.001) was faster with Group H. Intraoperative hypotension occurred in 63% in group I, while only 16% in group H. 10% of patients in group I had bradycardia, while none of in group H. Intraoperative apnea occurred in 23% in group I while none of the patients in group H. Postoperative pain scores were comparable till 24 h.ConclusionsThe hyperbaric ropivacaine (0.75%) provides faster onset of sensory blockade, better cardio-respiratory profile compared to isobaric ropivacaine (0.75%) in patients undergoing unilateral modified mastectomy for carcinoma breast under thoracic spinal anaesthesia.

Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionApplication for ESRA Abstract Prizes: I don’t wish to apply for the ESRA PrizesBackground and Aims Literature on thoracic spinal anaesthesia (TSA) for breast surgery is scarce. The present series explored block characteristics and outcomes in the patient undergoing Modified Radical Mastectomy (MRM) under TSA in female patients with ASA I-III physical status.Methods20 patients underwent unilateral MRM. TSA was given with 0.75% isobaric ropivacaine (1ml), fentanyl (25 μg) and dexmedetomidine (10 μg) at T4- T5 space. All patients received IM glycopyrrolate and IV ondansetron pre-operatively, pre-loaded with IV RL @10ml/kg. fentanyl sedation @1mcg/kg IV in divided doses. Intra-operative hemodynamics, block characteristics, intraoperative complications, pain score and analgesic consumption, postoperative adverse effects, and patient satisfaction with were studiedResultsTSA was performed easily in all the patients, including two patients who complained of paraesthesia. The TSA was effective for surgery in all 19 patients. 4 patients had intra-operative apnoea with only one patient requiring bag and mask ventilation but none requiring conversion to general anaesthesia. 6 patients required mephentermine more than the median dose i.e. 12mg IV. One patient had hypotension with tachycardia and 2 patients had intraoperative bradycardia none required IV atropine. Recovery was uneventful, only 3 patients had complaints of PONV and only 2 patients required IV tramadol (50mg). 16 patients were satisfied with the anaesthesia technique and 3 patients were dissatisfied.ConclusionsThis feasibility study has shown that TSA can be used successfully and effectively for MRM surgery. However, the use of anaesthetic techniques requires experience and great caution.

Heat stress results in misfolding and aggregation of cellular proteins. Heat shock proteins (Hsp) enable the cells to maintain proper folding of proteins, both in unstressed as well as stressed conditions. Hsp70 genes encode for a group of highly conserved chaperone proteins across the living systems encompassing bacteria, plants, and animals. In the cellular chaperone network, Hsp70 family proteins interconnect other chaperones and play a dominant role in various cell processes. To assess the functionality of rice Hsp70 genes, rice genome database was analyzed. Rice genome contains 32 Hsp70 genes. Rice Hsp70 super-family genes are represented by 24 Hsp70 family and 8 Hsp110 family members. Promoter and transcript expression analysis divulges that Hsp70 superfamily genes plays important role in heat stress. Ssc1 (mitochondrial Hsp70 protein in yeast) deleted yeast show compromised growth at 37 °C. Three mitochondrial rice Hsp70 sequences (i.e., mtHsp70-1, mtHsp70-2, and mtHsp70-3) complemented the Ssc1 mutation of yeast to differential extents. The information presented in this study provides detailed understanding of the Hsp70 protein family of rice, the crop species that is the major food for the world population.

Free Space Optical communication (FSO) has engrossed a large section of researchers in recent times due to its wide bandwidth, effortless deployment and immune links making it appropriate for communication purposes. This wireless optical technique requires clear and non-turbulent atmospheric conditions for efficient transmission. In this paper, authors aim at reducing the effect of turbulent atmospheric conditions like scintillation effect on FSO. Multibeam technique, which uses spatially diverse transmitters for transmission, has been used for increasing the achievable link distance of the FSO system. Parameters like quality factor and bit error rate have been used to check the received signal quality.

Free space optics has revolutionized the telecom industry through its exquisite data transfer capability and cost effectiveness. It proves out to be an excellent solution to the last mile problem and arduous digging of grounds for laying fiber optic cables. But atmospheric turbulences and obscure weather conditions limit the extensive use of this technology. This paper analyses the use of multibeam technology in enduring the effect of hazy weather on the FSO link by comparing it with the single beam technology. The results obtained from the multibeam system for clear and hazy weather conditions have been validated by using MATLAB codes.

Protein folding and disaggregation are crucial processes for survival of cells under unfavorable conditions. A network of molecular chaperones supports these processes. Collaborative action of Hsp70 and Hsp100 proteins is an important component of this network. J-proteins/DnaJ members as co-chaperones assist Hsp70. As against 22 DnaJ sequences noted in yeast, rice genome contains 104 J-genes. Rice J-genes were systematically classified into type A (12 sequences), type B (9 sequences), and type C (83 sequences) classes and a scheme of nomenclature of these proteins is proposed. Transcript expression profiles revealed that J-proteins are possibly involved in basal cellular activities, developmental programs, and in stress. Ydj1 is the most abundant J-protein in yeast. Ydj1 deleted yeast cells are nonviable at 37 °C. Two rice ortholog proteins of yeast Ydj1 protein namely OsDjA4 and OsDjA5 successfully rescued the growth defect in mutant yeast. As Hsp70 and J-proteins work in conjunction, it emerges that rice J-proteins can partner with yeast Hsp70 proteins in functioning. It is thus shown that J-protein machine is highly conserved.

Non-Communicable Diseases (NCDs) are now a leading cause of mortality and morbidity globally, and mental illness is a significant part of it. In India, the treatment gap for common mental disorders is over 80%. In order to bridge this gap, mental health treatment models recommend task-shifting to non-specialists and integration of mental health care into general healthcare services. Other NCDs are being managed effectively by non-specialist healthcare workers (HCWs) at primary care, and mental illness and substance misuse are highly comorbid with other NCDs; hence, integrating mental health care within the NCD services and care framework seems logically feasible and effective. However, country-specific characteristics pose a significant challenge to the implementation of integrated care for mental disorders and NCDs. The primary objective of this study includes the development and implementation of a service delivery model that would result in at least 70% coverage of screening, linkage to care, and management of common mental disorders and substance use disorders (MSUD) among persons seeking care for NCDs at public health facilities. Secondary objectives include assessment of the feasibility of adoption of the implementation model by the health care system and to evaluate the cost of the mental health service strengthening intervention package from the health system’s and the patient’s perspectives. It will be a multi-site implementation research study, employing a mixed-methods quasi-experimental, within-site, three-phase, single-arm, interrupted time series design. The implementation model comprises screening, treatment, and linkage of mental health services integrated into NCD care in at least three blocks in each of the seven selected districts of the seven selected states of India, which are geographically far apart. The expected outcome would be to increase the proportion of patients screened and managed for MSUDs among persons seeking care for NCDs at the public health facilities. The results of this implementation research will provide a roadmap for scaling up of integrated MSUDs services within general healthcare.

ABSTRACT Background: There are more than 5 million people with dementia in India. Multicentre studies looking at details of treatment for people with dementia In India are lacking. Clinical audit is a quality improvement process which aims to systematically assess, evaluate, and improve patient care. Evaluating current practice is the key to a clinical audit cycle. Aim: This study aimed to assess the diagnostic patterns and prescribing practices of psychiatrists for patients with dementia in India. Method: A retrospective case file study was conducted across several centers in India. Results: Information from the case records of 586 patients with dementia was obtained. Mean age of the patients was 71.14 years (standard deviation = 9.42). Three hundred twenty one (54.8%) were men. Alzheimer's disease (349; 59.6%) was the most frequent diagnosis followed by vascular dementia (117; 20%). Three hundred fifty five (60.6%) patients had medical disorders and 47.4% patients were taking medications for their medical conditions. Eighty one (69.2%) patients with vascular dementia had cardiovascular problems. Majority of the patients (524; 89.4%) were on medications for dementia. Most frequently prescribed treatment was Donepezil (230; 39.2%) followed by Donepezil-Memantine combination (225; 38.4%). Overall, 380 (64.8%) patients were on antipsychotics. Quetiapine (213, 36.3%) was the most frequently used antipsychotic. Overall, 113 (19.3%) patients were on antidepressants, 80 (13.7%) patients were on sedatives/hypnotics, and 16 (2.7%) patients were on mood stabilizers. Three hundred nineteen (55.4%) patients and caregivers of 374 (65%) patients were receiving psychosocial interventions. Conclusions: Diagnostic and prescription patterns in dementia which emerged from this study are comparable to other studies both nationally and internationally. Comparing current practices at individual and national levels against accepted guidelines, obtaining feedback, identifying gaps and instituting remedial measures help to improve the standard of care provided.

Apiculture has become a profitable profession due to the high economic importance of honey and various beehive products. Honeybees are tiny social insects that perform a crucial function in the agricultural field and are necessary for good yields. Honeybees are the biological indicators of environmental health. Unforeseen rapid decrease in honeybee numbers characterized by the departure of honeybees from the colonies and accompanied by the total absence of any dead bees in the hive surrounding and inside it suggests a condition called Colony Collapse Disorder (CCD). Pesticides, pathogens, and other ecological stresses such as nutritional deficiency may add to bee extinction or CCD. Besides this, the exposure to low-level radiofrequency and microwave radiations from mobile phones also have profound undesirable effects on honeybees. Research has shown changes in biology and behaviour which includes some undesirable changes in the biomolecules concentration in honeybees because of radiation exposure. Extremely low-frequency electromagnetic field (ELF- EMF ) also affects honeybee`s immune system and navigation activities. The radiation induces emotional disturbance and genetic disorders in brood which attributes to a decline in the breeding efficiency of bees. The present review is an attempt to compile the causes of CCD and discuss the management practices to be followed by the beekeepers to avoid the devastating loss to them and the planet Earth.

The COVID-19 pandemic has forced substantial changes in the practice of psychiatry, including that of electroconvulsive therapy (ECT). There is higher risk of transmission of the SARS-CoV-2 virus during ECT unless due care is taken. However, in many cases, ECT cannot be avoided. In this paper, we discuss various measures that may be adapted to reduce the risk of transmission of the virus during ECT. We also suggest certain modifications to the practice of ECT in order to achieve a balance between risks and benefits of the procedure during the pandemic.