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Background & objectives: Heart failure (HF) is emerging as a major health problem in India. The profile of HF in India is divergent from elsewhere in the world. While cardiologists must equip themselves with the requisite clinical management tools, scientists and health policymakers would need epidemiological data on HF and information on the resources required to meet the challenges ahead. The aim of this study was to identify the lacunae and to suggest recommendations to improve HF research. Methods: We surveyed a multidisciplinary group of HF experts using a two stage process. An email-based survey was conducted using a structured questionnaire, followed by an online discussion. The experts prioritized the major challenges in convergence research in India and inter-rater agreement values were calculated. In addition, they enlisted potential research gaps and barriers in the domains of epidemiology, diagnostics, management and technology and suggested recommendations to overcome those barriers. Results: The experts identified a paucity of data on HF burden, lack of state-of-the-art diagnostic facilities and trained personnel, overt dependence on imported devices/equipment/reagents, lack of interaction/awareness/information among stakeholders and lack of biobanks, as major barriers in HF research. Three fourths of the experts agreed that lack of interaction among stakeholders was the major challenge with the highest inter-rater agreement in both stages (19 out of 25 and 11 out of 17, respectively). The experts recommended the creation of multidisciplinary taskforces dedicated to population sciences, data sciences, technology development and patient management with short-, intermediate- and long-term strategies. Interpretation & conclusions: The study generated a wish list for advances in HF research and management, and proposed recommendations for facilitating convergence research as a way forward to reduce the burden of HF in India.

Background: Heavy menstrual bleeding is defined as excessive menstrual blood loss that interferes with a woman’s physical, social, emotional, or material quality of life. Puberty menorrhagia is excessive bleeding occurring between menarche and 19 years. The leading cause of puberty menorrhagia is hypothalamic pituitary-ovarian axis immaturity followed by bleeding disorders and endocrine disorders. Excessive blood loss leading to anemia has a negative impact over the development and quality of life of the adolescent, requiring immediate attention to these cases. The objective is to evaluate the treatment modalities in the management of cases of puberty menorrhagia admitted in a tertiary care center. Aims and Objectives: The aim of the study was to evaluate the treatment modalities in the management of cases of puberty menorrhagia admitted in a tertiary care center. Materials and Methods: A retrospective and observational study was done on adolescents admitted for management of puberty menorrhagia in Kempegowda Institute of Medical Sciences over a period lasting from January 2017 to October 2021 from hospital records. Results: Among the 35 admitted, 42% belonged to the age group 10–14 years. About 62.8% presented with symptoms lasting <6 months. About 20% presented with hemoglobin <4 g, 51.4% with hemoglobin between 4 g and 6 g, 28.6% with 6 g to 8 g. About 57.2% of patients had anovulatory cycles, 25.7% were PCOS, 11.4% had hypothyroidism, and 5.7% had fibroid uterus. About 42% ultrasonographies showed PCOS, 5.7% had fibroid uterus. The approach to managing these patients depends on the presentation of the patient. Severe anemia is treated with blood transfusion for anemia correction. For the cessation of bleeding anti fibrinolytic tranexemic acid, ethamsylate and hormone therapy with medroxyprogesterone and norethisterone is used. Combined oral contraceptives are also used. In our study, 20% received tranexemic acid and hematinics. About 31.42% received blood, hematinics, and tranexemic acid, 11.42% received hematinics, tranexemic acid, and thyroxine, 17.14% received blood, haematinics, tranexemic acid, and progesterone, 8.57% received hematinics, tranexemic acid, and COCs, 11.42% received hematinics, tranexemic acid, and progesterone. Conclusion: Patients with severe anemia required treatment with packed cells while moderate anemia were corrected with parenteral iron. To control bleeding, tranexemic acid and ethamsylate were sufficient but in 45% of them bleeding was persistent and in them, progestins like medroxyprogesterone and norethisterone were required for cessation of bleeding. In cases where hypothyroidism was diagnosed, thyroxine was started. Medical management was successful in all cases.

Methicillin-resistant Staphylococcus aureus (MRSA) has been a global health concern since the 1960s, and isolation of this pathogen from food-producing animals has been increasing. However, little information is available on the prevalence of MRSA and its clonal characteristics in seafood and the aquatic environment. In this study, 267 seafood and aquatic environment samples were collected from three districts of Kerala, India. Staphylococcal protein A (spa) typing and multilocus sequence typing (MLST) was performed for 65 MRSA strains isolated from 20 seafood and aquatic environment samples. The MRSA clonal profiles were t657-ST772, t002-ST5, t334-ST5, t311-ST5, t121-ST8, t186-ST88, t127-ST1, and two non-spa assignable strains. Whole spa gene sequence analysis along with MLST confirmed one strain as t711-ST6 and another as a novel MRSA clone identified for the first time in seafood and the aquatic environment with a t15669 spa type and a new MLST profile of ST420-256-236-66-82-411-477. The MRSA strains were clustered into five clonal complexes based on the goeBURST algorithm, indicating high diversity among MRSA strains in seafood and the aquatic environment. The novel clone formed a separate clonal complex with matches to three loci. This study recommends large-scale spa typing and MLST of MRSA isolates from seafood and the aquatic environment to determine the prevalence of new MRSA clones. This monitoring process can be useful for tracing local spread of MRSA isolates into the seafood production chain in a defined geographical area.

Aim: This study is proposed to assess the knowledge and practices among dental practitioners in the implementation of biomedical waste (BMW) management rules (2016) in Kumbakonam, Tamil Nadu; to assess the effective usage of the four colour-coded bins, those are used to handle the BMW; and to assess the service of the BMW collecting and disposing agents. Methodology: A questionnaire comprising of 12 closed-ended and 1 open-ended question regarding the dental practitioner's management of BMW in their daily clinical practice was developed. After validation, the questionnaire was sent as Google forms to 54 dental practitioners who are practicing at Kumbakonam, and responses were received from all. The collected data was entered in an Excel sheet, and then percentages were obtained for each response from the participants. Result: The most common challenges were, space-occupying BMW disposal bins as well as the lack of regular collection of BMW, this may be because the disposal agent's services cover a larger geographical area with lesser wastage collecting manpower. Though most of the study participants were well aware and practiced the management, still a small percentage of practitioners were lacking in this. The responses on storage and handling the BMW management reflect the knowledge gap in more than half of them. Conclusion: These challenges indicate the need for a well-established network of BMW collecting agencies and cost-effective, tailor-made colour-coded bins for suitable and continuous usage in dentistry.

Cryopreservation of testicular tissue holds an important role in the field of fertility preservation, particularly for prepubertal boys diagnosed with cancer. However, prepubertal testicular tissue cryopreservation is still considered to be in the experimental stage necessitating the refinement of cryopreservation protocol. Considering the fact that loss of membrane lipids is the primary cause of freeze–thaw-induced loss of testicular cell functions, in this study, we explored the beneficial properties of exogenous supplementation of membrane lipids in the form of liposomes in enhancing the cryosurvival of prepubertal testicular tissue. The freezing medium supplemented with liposomes (prepared from soy lecithin, phosphatidylethanolamine, phosphatidylserine, and cholesterol) was used for the experiments. Prepubertal testicular tissues from Swiss albino mice were cryopreserved in a liposome-containing freezing medium (LFM) composed of 0.25 mg/mL liposomes, 5% DMSO, and 30% FCS in the DMEM/F12 medium using a slow freezing protocol. The tissues were thawed and assessed for various testicular cell functions. Freezing in LFM mitigated the loss of viability, decreased malondialdehyde level ( p  < 0.05), and reduced apoptosis ( p  < 0.05) in the testicular cells compared to the testicular tissue cryopreserved in the control freezing medium (CFM). Further, DMSO (5%) appears to be the ideal penetrating cryoprotectant for prepubertal testicular tissue cryopreservation with liposome-based freezing medium. Similar enhancement in cryosurvival of cells was observed in adult human testicular tissue frozen with LFM. These findings highlight the translational value of liposome-based freezing medium in the cryopreservation of testicular tissue of prepubertal boys undergoing chemotherapy.

The development of a cost-effective biopolymer composite membrane using starch is found to be efficient to be used for heavy metal removal from waste water. In the present work we have used starch containing amylose/amylopectin as the biopolymer and graphene oxide (GO) as the carbon nanomaterial to develop the composite membrane. Synthesis of graphene oxide, characterization of the graphene oxide, composite preparation using starch-graphene oxide, development of the membrane, characterization and analysis of the heavy metal removal efficiency were the major objectives of the present work. Scanning electron microscopy (SEM), Atomic absorption spectroscopy (AAS) and Raman spectroscopy were used for the characterization studies. Analysis being done for studying the effectiveness of membrane for removal of heavy metal ions including Pb, Cd, Zn and Mg by varying certain parameters, revealed that the membrane is efficient in the range 85-95 % for lower concentrations of these metals in the waste water.

Background: Jaundice during pregnancy poses significant risks to both maternal and fetal health. This retrospective study aimed to assess the incidence, causes, and outcomes of jaundice among pregnant women admitted to a tertiary care center over a 3-year period. Aims and Objectives: The primary objectives were to identify the incidence of jaundice, analyze its causes, and evaluate the maternal and fetal outcomes in cases of jaundice during pregnancy. Materials and Methods: Conducted as a case series with clinical correlation, the study spanned 3 years (2021–2023) at the Department of Obstetrics and Gynecology, Kempegowda Institute of Medical Science, Bangalore. Data from parturition books and case sheets were collected after institutional ethical committee approval. Investigations included a complete blood count, liver function tests, coagulation profile, and serology. Fetal and maternal outcomes were recorded. Results: Out of 9 cases, 7 were diagnosed with intrahepatic cholestasis of pregnancy (IHCP), while 1 case each involved hemolysis, elevated liver enzymes, low platelet syndrome, and unconjugated hyperbilirubinemia specific to pregnancy. IHCP is correlated with adverse perinatal outcomes, including meconium-stained amniotic fluid and fetal distress. Cesarean sections were prevalent (58%), often indicated by previous lower segment cesarean sections and non-progression of labor. Conclusion: The study underscores the substantial association between IHCP and adverse perinatal outcomes, emphasizing the heightened prevalence of cesarean sections in pregnancies complicated by jaundice. It highlights the necessity for vigilant monitoring and tailored management strategies to mitigate risks and ensure favorable maternal and fetal outcomes in cases of jaundice during pregnancy.

Trends associated with codon usage in molluscum contagiosum virus (MCV) and factors governing the evolution of codon usage have not been investigated so far. In this study, attempts were made to decipher the codon usage trends and discover the major evolutionary forces that influence the patterns of codon usage in MCV with special reference to sub-types 1 and 2, MCV-1 and MCV-2, respectively. Three hypotheses were tested: (1) codon usage patterns of MCV-1 and MCV-2 are identical; (2) SCUB (synonymous codon usage bias) patterns of MCV-1 and MCV-2 slightly deviate from that of human host to avoid affecting the fitness of host; and (3) translational selection predominantly shapes the SCUB of MCV-1 and MCV-2. Various codon usage indices viz. relative codon usage value, effective number of codons and codon adaptation index were calculated to infer the nature of codon usage. Correspondence analysis and correlation analysis were performed to assess the relative contribution of silent base contents and significance of codon usage indices in defining bias in codon usage. Among the tested hypotheses, only the second and third hypotheses were accepted.

Background & Objectives:This study was performed to assess the use and efficacy of Alveolar ridge splitting technique for implant placement.Methods:This prospective clinical study included a total of 10 patients ( average age 18- 53 years ) in which a total of 14 implants were placed patient were selected with inadequate alveolar width between 3 to 4 millimeters by using cone beam computed tomography pre-operatively with adequate alveolar bone height, Ridge splitting technique was done with Series of Thin osteotomes and gradual lateralization of the buccal segment until sufficient gap was obtained followed by the simultaneous placement of implant All the implants were clinically followed up for 3 months.Interpretation & conclusion :Ridge splitting technique can be used efficaciously in horizontally deficient narrow atrophied ridge for immediate implant placement. This technique is stable,minimally invasive,cost effective,allows controlled expansion of bone with predictable outcome.

The magnetic grain size, mineralogy and concentration of five ultisol sequences (lateritic soil profiles) developed on different parent rocks (syenite, dolerite, charnockite, gneiss and sandstone) in southwestern India were investigated to gain a better understanding of the pedogenic processes under tropical climate. Field investigations reveal the presence of various horizons in the lateritic profiles, such as saprolite, saprock, pallid zone, mottled zone, pebble horizon and top soil. These horizons exhibit differences in their mineral magnetic, Fourier Transform Infrared Spectroscopic (FTIR), Diffuse Reflectance Spectroscopic (redness %, amplitudes of goethite (AGt) and haematite (AHm)) and particle size properties. Magnetic susceptibility (χ lf ) values of the ultisol profiles varies from 5.8 to 2858.7 × 10 −8 m 3 kg −1 , whereas percentage frequency dependent susceptibility (χ fd %) ranges between 0.15% and 14.0%. The FTIR spectra reveal the presence of minerals like haematite, goethite, kaolinite and quartz. The upper horizons (top-soil and pebble horizon) are marked by magnetic enhancement by ultra-fine grained superparamagnetic (SP) minerals with low coercivity, most likely magnetite/maghemite. Whereas, the lower horizons (saprock, saprolite, pallid zone horizons) exhibit no magnetic enhancement and are characterized by antiferromagnetic minerals, e.g., haematite/goethite. The unweathered parent rock is characterized by low coercivity minerals of coarser magnetic grain size with a little to no superparamagnetic (SP) grains. However, the magnitude of enhancement of fine grained ferrimagnetic grains in the top soil in relation to bottom horizons varies among the five lateritic profiles. The degree of enhancement and production of the fine-grained superparamagnetic grains in topsoil decreases in the order charnockite > syenite > sandstone > gneiss > dolerite. Because the doleritic parent rock exhibits a high initial Fe concentration, it is difficult to ascertain the degree of pedogenesis, due to a strong lithogenic signature, which decreases towards the profile top. The tropical soils in the region have undergone a higher degree of pedogenesis with increased magnetic mineral concentration compared to temperate soils. However, magnetic grain size appears to be the same in both soil types. The magnetic enhancement in the topsoil may be due to the neoformation of fine-grained SP magnetite, aided by sufficient Fe supply, alternate wetting and drying cycles, dehydration, oxidation and redox conditions.