Coded Tissue Superharmonic Imaging: An Analytical Study

Superharmonic imaging (SHI) benefits medical ultrasound imaging in achieving higher spatial and contrast resolution but gives poor signal-to-noise ratio (SNR) and penetration depth that require careful control on excitation power and frequency. In the present work, coded pulsed excitations (linear frequency modulated and nonlinear frequency modulated signals) are used to evaluate the superharmonic field generation and propagation (coded tissue superharmonic imaging). The evaluation includes the study of parameters such as peak side lobe level, beam width, axial level for analyzing SNR and penetration depth. The results for coded tissue SHI are reported in comparison with conventional SHI and with the performance of coded tissue harmonic imaging and fundamental ultrasound imaging

Study on knowledge and practice regarding no scalpel vasectomy (NSV) among male members of eligible couples in a rural community of West Bengal, India

Background: No Scalpel Vasectomy (NSV) was introduced in India with the aim to increase male participation in family planning methods. But in spite of the best of efforts, it has failed to achieve its goal. The current acceptance of NSV in India has declined from 1 percent (NFHS 3) to 0.3 percent (NFHS 4). This study was done to get an insight regarding knowledge and practice of NSV and elicit the perceived reasons for underutilization of vasectomy in the community.Methods: A community-based cross-sectional study was conducted among 340 male members of eligible couples in six randomly selected villages in Singur from September 2017 to February 2018. Each respondent was interviewed using a structured schedule. All ethical issues were addressed. Data entry and analysis was done using SPSS version 16.0.Results: Out of 340 participants, 57.9% have heard of NSV. Around 61% of the participants have heard of the male contraceptives from media. Although 57.8% knew it to be method of permanent male contraception, only 15.7% were aware that NSV does not need hospitalization. The most frequently reported reasons for underutilization of NSV in the community was fear of surgery (51.3%) and loss of earning due to prolonged bed rest (44.2%). Overall, the proportion of male members of the eligible couples who underwent NSV was 0.6%.Conclusions: Promotional activities should focus on bridging the prevailing information gap regarding NSV among the potential clients. The IEC activities including interpersonal communication and group counselling sessions must deal with their apprehensions thereby changing the behaviour of the society

Evaluation of coronary artery risk factors in premenopausal women (

Background: The present study was designed to evaluate the association of conventional coronary risk factors in the angiographically proven cases of younger women (<45 years) with significant CAD along with clinical profile and coronary angiographic findings.Methods: This was a hospital-based prospective study conducted at a tertiary-care center in India. A total of 200 premenopausal women (age ≤45 years) who presented with chest pain likely to be of cardiac origin were enrolled. Each patient was subjected to routine clinical investigations, examination of complete lipid profile, follicular stimulating hormone (FSH), luteinizing hormone (LH), and prolactin; and underwent non-invasive cardiac examination and coronary angiography.Results: Mean age of patients was 39.1±4.98 years. A total of 64 (32%) patients had history of spontaneous abortions and 80 (40%) patients presented with ST-elevated myocardial infarction. Increased FSH, LH and prolactin levels was found in 70 (35%), 20 (10%), and 88 (44%) patients, respectively. Total 196 (98%) patients underwent coronary angiography which revealed presence of significant CAD in 122 (63%) cases and of which 80 patients underwent coronary angioplasty and 12 underwent coronary artery bypass grafting. Of all, 8 death were reported up to the mean follow-up of 11 months.Conclusions: The study stated that premenopausal females (<45 years) represent a special subgroup where non-conventional risk factors play an important role in occurrence of CAD. So, careful history taking with detailed menstrual and obstetric history should be considered in such group of patients

Efficacy and safety of rituximab biosimilar (DRL_RI) versus MabThera®in low-tumor-burden follicular lymphoma: the FLINTER study

Background and objectives: This phase III study (RI-01-006; FLINTER) was conducted to demonstrate equivalent efficacy of DRL_RI to EU-approved rituximab (MabThera (R)) in patients with previously untreated Stage II-IV, CD20-positive, low-tumor-burden follicular lymphoma (LTB-FL). This study also evaluated safety, immunogenicity, rituximab concentrations, and pharmacodynamics (PD) of DRL_RI compared with MabThera.Design and methods: Previously untreated, stage II-IV, CD20-positive LTB-FL patients (N = 317) were randomized (1:1) to receive DRL_RI (n = 162) or MabThera (n = 155) as intravenous infusions of 375 mg/m(2) weekly for 4 weeks (induction period), and thereafter every 8 weeks from Week 12 to Week 36 (maintenance treatment), and followed up till Week 52. The primary end point was best overall response rate (BORR) up to Week 28 based on blinded independent central review. Efficacy equivalence was demonstrated if the two-sided 90% confidence interval (CI) for BORR difference was within the prespecified equivalence margin (+/- 17%). Secondary end points included objective and complete responses, duration of response, progression-free survival, overall survival, safety, immunogenicity, mean serum concentrations, and PD.Results: The BORR up to Week 28 was 80.2% versus 79.4% for DRL_RI versus MabThera group; with a difference of 0.89% (90% CI: -6.67 to 8.48; 95% CI: -8.05 to 9.93 within the prespecified margin). Both treatment groups were comparable for all secondary efficacy end points. Treatment-emergent adverse events were reported in 68.6% of patients; safety, immunogenicity, and mean serum concentrations were similar between groups. Peripheral B-cell counts declined below quantifiable limits in most patients, with a median time to B-cell depletion of 6.9 versus 7.0 days for DRL_RI versus MabThera.Conclusion: The study demonstrated efficacy equivalence of DRL_RI to MabThera; with comparable safety, immunogenicity, serum concentrations, and PD between groups.Trial registration: This trial was registered at ClinicalTrials.gov identifier: NCT03976102 and EudraCT (2018-004223-36)

IN VITRO ANTI-INFLAMMATORY AND ANTIOXIDANT ACTIVITIES OF HINGULESWARA RASABASED HERBOMINERAL FORMULATIONS

Objective: The aims of the present investigation were to develop the herbal and/or herbomineral formulations of Hinguleswara rasa and to compare their anti-inflammatory and antioxidant activities, in vitro, with that of standard drug samples.Methods: This study was an interventional investigation in three samples: In the first sample, Hinguleswara rasa (HR1) was prepared as per methodology described in Rasatarangini using Shuddha Hingula (10 g), Shuddha Vatsanabha (10 g), and Pippali (10 g). In the second and third sample, respectively, Hinguleswara rasa was prepared by replacing Shuddha Hingula with Kajjali where Kajjali made from Hingulotha parada and Sodhita parada constitutes two varieties of Hinguleswara rasa, i.e. HR2 and HR3. In vitro antioxidant activity was studied using 2,2-diphenyl-1-picrylhydrazyl, and the absorbance was recorded at 517 nm. For evaluating the in vitro anti-inflammatory studies, the inhibition of albumin denaturation technique was performed.Results: The results showed that the formulation of Hinguleswara rasa has shown dose-dependent activity which was observed in 100 μg concentration. HR1, HR2, and HR3 showed 36.11, 17.22, and 16.11% radical scavenging activity.Conclusion: It could be concluded that the changes made in the formulations did not affect the in vitro anti-inflammatory and antioxidant effects of the herbomineral formulations

A systematic review of diabetic foot infections: pathogenesis, diagnosis, and management strategies

BackgroundDiabetic foot infection represents a significant complication of diabetes mellitus, contributing substantially to morbidity, mortality, and healthcare expenditure worldwide. Accurate diagnosis relies on a comprehensive assessment integrating clinical evaluation, imaging studies, and microbiological analysis. Management necessitates a multidisciplinary approach, encompassing surgical intervention, antimicrobial therapy, and advanced wound care strategies. Preventive measures are paramount in reducing the incidence and severity, emphasizing patient education, regular foot screenings, and early intervention.MethodsThe researchers performed a systematic review of literature using PUBMED MESH keywords. Additionally, the study was registered in the International Prospective Register of Systematic Reviews at the Center for Reviews and Dissemination, University of York (CRD42021277788). This review provides a comprehensive overview of the microbial spectrum and antibiotic susceptibility patterns observed in diabetic foot infections.ResultsThe search through the databases finally identified 13 articles with 2545 patients from 2021 to 2023. Overall, the predominant Gram-positive microbial species isolated were Staphylococcus aureus, Enterococcus fecalis, Streptococcus pyogenes, Streptococcus agalactiae, and Staphylococcus epidermidis. Whereas the predominant Gram-negative included Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Pseudomonas aeruginosa.ConclusionDiabetic foot infections represent a complex and multifaceted clinical entity, necessitating a holistic approach to diagnosis, management, and prevention. Limited high-quality research data on outcomes and the effectiveness of guideline recommendations pose challenges in updating and refining existing DFI management guidelines.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021277788, identifier CRD42021277788

SBSPKS: structure based sequence analysis of polyketide synthases

Polyketide synthases (PKSs) catalyze biosynthesis of a diverse family of pharmaceutically important secondary metabolites. Bioinformatics analysis of sequence and structural features of PKS proteins plays a crucial role in discovery of new natural products by genome mining, as well as in design of novel secondary metabolites by biosynthetic engineering. The availability of the crystal structures of various PKS catalytic and docking domains, and mammalian fatty acid synthase module prompted us to develop SBSPKS software which consists of three major components. Model_3D_PKS can be used for modeling, visualization and analysis of 3D structure of individual PKS catalytic domains, dimeric structures for complete PKS modules and prediction of substrate specificity. Dock_Dom_Anal identifies the key interacting residue pairs in inter-subunit interfaces based on alignment of inter-polypeptide linker sequences to the docking domain structure. In case of modular PKS with multiple open reading frames (ORFs), it can predict the cognate order of substrate channeling based on combinatorial evaluation of all possible interface contacts. NRPS–PKS provides user friendly tools for identifying various catalytic domains in the sequence of a Type I PKS protein and comparing them with experimentally characterized PKS/NRPS clusters cataloged in the backend databases of SBSPKS. SBSPKS is available at http://www.nii.ac.in/sbspks.html