043244   ZHU Z M, HUO F-C, PEI D-S (Pathology Dep, Xuzhou Medical Univ, Xuzhou 221004, China, Email: dspei@xzhmu.edu.cn) : Function and evolution of RNA N6-methyladenosine modification. Int J Biol Sci 2020, 16(11), 1929-40.

N6-methyladenosine (m⁶A) is identified as the most prevalent and abundant internal RNA modification, especially within eukaryotic mRNAs, which has attracted much attention in recent years since its importance for regulating gene expression and deciding cell fate. m⁶A modification is installed by RNA methyltransferases METTL3, METTL14 and WTAP (Writers), removed by the demethylases FTO and ALKBH5 (Erasers) and recognized by m⁶A binding proteins, such as YT521-B homology YTH domain-containing proteins (Readers). Accumulating evidence shows that m6A RNA methylation participates in almost all aspects of RNA processing, implying an association with important bioprocesses. In this review, we mainly summarize and discuss the functional relevance and importance of m6A modification in cellular processes.

4 illus, 135 ref

043243   AWADASSEID A,, WU Y, TANAKA Y, ZHANG W (Virus Inspection Dep, Zhejiang Provincial Center for Disease Control and Prevention, 630 Xincheng Road, Hangzhou, 310051, PR China, Email: ylwu@cdc.zj.cn) : Initial success in the identification and management of the coronavirus disease 2019 (COVID-19) indicates human-to-human transmission in Wuhan, China. Int J Biol Sci 2020, 16(11), 1846-60.

Coronavirus (CoV) has been one of the major pandemic threats to human health in the last two decades. The human coronavirus was first identified in 1960s. CoVs 229E, NL63, OC43, HKU1, SARS-CoV, and MERS-CoV have caused numerous disasters or human deaths worldwide. Recently, an outbreak of the previously unknown deadly CoV disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome CoV 2 (SARS-CoV-2, early named 2019-nCoV) occurred in Wuhan, China, and it had caused 81238 cases of confirmed infection, including 3250 deaths until March 19, 2020. Its risks and pandemic potential have brought global consideration. We summarized epidemiology, virological characteristics, clinical symptoms, diagnostic methods, clinical treatments, and prevention methods for COVID-19 to present a reference for the future wave of probable CoV outbreaks.

5 illus, 2 tables, 89 ref

045153   BOLLI R V, MARGASAHAYAM S V, SHENOY V U, AGRAWAL A M (Conservative Dentistry and Endodontics Dep, MGM Dental College and Hospital, Pune- 411 014, Maharashtra, Email: rashmi.bolli@gmail.com) : A comparative evaluation of the fracture resistance of endodontically treated teeth with simulated invasive cervical resorption cavities restored with different adhesive restorative materials: An in vitro study. J Conserv Dent 2020, 23(2), 174-9.

The aim of the study was to compare the fracture resistance of endodontically treated teeth with simulated invasive cervical resorption cavities, restored with different restorative materials, namely, conventional glass‑ionomer cement (CGIC), resin‑modified glass‑ionomer cement (RMGIC), flowable composite (FC), and giomer. Sixty extracted human permanent maxillary central incisor teeth were assigned to six groups,which were, Group 1 (intact teeth, control), Group 2 (teeth with biomechanical preparation and resorption cavity), Group 3 (CGIC), Group 4 (RMGIC), Group 5 (FC), and Group 6 (giomer). Except for Group 1, other groups were subjected to endodontic treatment. Teeth of Group 2 were left unobturated and teeth of Groups 3–6 were obturated. A simulated resorption cavity was prepared labially in the specimens belonging to Groups 2–6 and restored with respective restorative materials. The specimens were subjected to compressive load until failure in an Instron testing machine and the load at failure was recorded in Newtons.  The data obtained were statistically analyzed using one‑way ANOVA, pair‑wise comparison was made with Tukey’s multiple comparison test, and P < 0.05 was considered statistically significant.  There was a statistically significant difference in the fracture resistance of intact teeth and endodontically treated teeth with simulated invasive cervical resorption cavities restored with different adhesive restorative materials. Among the restored teeth, there was no significant difference.  Intact teeth were found to have the highest resistance to fracture followed by those restored with giomer, FC, RMGIC, and CGIC in that order.

1 illus, 2 tables, 26 ref

045152   JAMADAR A, VANTI A, UPPIN V, PUJAR M, GHIVARI S, VAGARALI H (Conservative Dentistry and Endodontics Dep, Maratha Mandal Nathagirao G Halgekar Institute of Dental Sciences and Research Centre, Belgaum- 590 010, Karnataka, Email: aasim.wise@gmail.com) : Comparative evaluation of shear bond strength of sixth- and seventh-generation bonding agents with varying pH – An in vitro study. J Conserv Dent 2020, 23(2), 169-73.

To compare and evaluate the shear bond strength of sixth‑ and seventh‑generation bonding agents with varying pH – an in vitro study. Eighty extracted human premolar teeth were collected and cleaned and polished with pumice and water. The root portion of teeth was resected, and only the coronal portion was embedded in the cold‑cure acrylic resin. The labial surface of mounted teeth was prepared with a high‑speed handpiece using #245 carbide bur. The samples prepared were divided into four groups, with 20 specimens in each group: •    Group A: Sixth‑generation bonding agent, Adper Prompt L‑Pop (APLP) (3M ESPE) • Group B: Sixth‑generation bonding agent, Xeno III (X III) (Dentsply) • Group C: Seventh‑generation bonding agent, Adper Easy One (AEO) (3M ESPE) • Group D: Seventh‑generation bonding agent, Xeno IV (X IV) (Dentsply). Tooth surface were rinsed and dried, and bonding agents were applied on tooth surface. Composite resin (Z‑350 XT, 3M ESPE) was placed in a two‑layer increment on tooth and was light cured. Specimens were subjected to the universal testing machine in a compression mode force at a crosshead speed of 1 mm/min keeping blade parallel to the adhesive–dentin interface. Shear force required to debond the specimen was recorded in megapascal. The data obtained were analyzed statistically using ANOVA and post hoc test. AEO (pH = 2.3, Group C seventh generation) showed higher bond strength, and pH values did not influence the shear bond strength significantly in the tested adhesive systems. The pH values did not influence the shear bond strength significantly in the tested adhesive systems. ADPER EASY ONE (pH= 2.3, GROUP C Seventh Generation) showed higher bond strength followed by XENO IV(pH = 2.1, GROUP D) ,XENO III (pH = 1.5, GROUP B) on dentinal surface ,where as ADPER PROMPT L POP (pH =0.7 to 1 Sixth Generation, GROUP A) showed lower bond strength.

4 illus, 2 tables, 22 ref

041422   RAMANJULU R, THOTA R S, AHMED A, JAIN P, SALINS N, BHATNAGAR S, CHATTERJEE A, BHATTACHARYA D (Anaesthesiology Dep, Homi Bhabha National Institute, Mumbai - 400 012, Maharashtra, Email: ragstho24@gmail.com) : Indian society for study of pain, cancer pain special interest group guidelines on pharmacological management of cancer pain (part i). Indian J Palliat Care 2020, 26(2), 173-9.

The Indian Society for Study of Pain (ISSP), Cancer Pain Special Interest Group guidelines on pharmacological management of cancer pain in adults provides a structured, step‑wise approach which will help to improve the management of cancer pain and to provide the patients with a minimally acceptable quality of life. The guidelines have been developed based on the available literature and evidence, to suit the needs, patient population, and situations in India. A questionnaire based on the key elements of each sub drafts addressing certain inconclusive areas where evidence was lacking, was made available on the ISSP website, and circulated by E‑mail to all the ISSP and Indian Association of Palliative Care (IAPC) members. We recommend that analgesics for cancer pain management should follow the World Health Organization three‑step analgesic ladder appropriate for the severity of pain. The use of paracetamol and nonsteroidal anti‑inflammatory drugs alone or in combination with opioids for mild‑to‑moderate pain should be used. For mild‑to‑moderate pain, weak opioids such as tramadol, tapentadol, and codeine can be given in combination with nonopioid analgesics. We recommend morphine as the opioid of first choice for moderate‑to‑severe cancer pain.

1 illus, 1 table, 40 ref

043242   ZHAO Q, CAI Y, JIANG Y, LIN X (Sports Medical Center Dep, First Affiliated Hospital of Zhejiang Univ, Shangcheng District, Hangzhou, China, Email: caiyouzhi@zju.edu.cn) : Exosomes in osteoarthritis and cartilage injury: Advanced development and potential therapeutic strategies. Int J Biol Sci 2020, 16(11), 1811-20.

Articular cartilage injury is a common clinical problem, which can lead to joint dysfunction, significant pain, and secondary osteoarthritis (OA) in which major surgical procedures are mandatory for treatment. Exosomes, as endosome-derived membrane-bound vesicles, participating in intercellular communications in both physiological and pathophysiological conditions, have been attached great importance in many fields. Recently, the significance of exosomes in the development of OA has been gradually concerned, while the therapeutic value of exosomes in cartilage repair and OA treatment has also been gradually revealed. The functional difference of different types and derivations of exosomes are determined by their specific contents. Herein, we provide comprehensive understanding on exosome and OA, including how exosomes participating in OA, the therapeutic value of exosomes for cartilage injury/OA, and related bioengineering strategies for future therapeutic design.

4 illus, 1 table, 75 ref

041421   CHATTERJEE A, THOTA R S, RAMANJULU R, AHMED A, BHATTACHARYA D, SALINS N, JAIN P, BHATNAGAR S (Anaesthesiology Dep, Homi Bhabha National Institute, Mumbai - 400 012, Maharashtra, Email: ragstho24@gmail.com) : Indian society for study of pain, cancer pain special interest group guidelines, for the diagnosis and assessment of cancer pain. Indian J Palliat Care 2020, 26(2), 164-72.

The Indian Society for Study of Pain (ISSP), Cancer Pain Special Interest Group (SIG) guidelines, for the diagnosis and assessment of cancer pain in adults provide a structured, step‑wise approach which will help to improve the management of cancer pain and to provide the patients with a minimally acceptable quality of life. The guidelines have been developed based on the available literature and evidence, to suit the needs of patient population and situations in India. Aquestionnaire based on the key elements of each sub draft addressing certain inconclusive areas where evidence was lacking, was made available on the ISSP website and circulated by E‑mail to all the ISSP and Indian Association of Palliative Care (IAPC) members. We recommend that a comprehensive pain assessment of all the patients should be conducted before initiating treatment. The patients should be educated about all the available pain control interventions. For assessing cancer pain, unidimensional tools such as Numeric Rating Scale, Visual Analog Scale, and Visual Rating Scale should always be used routinely. Patients with cancer pain should routinely be screened for distress and other psychological disorders, using the Patient Health Questionnaire‑9. The most reliable assessment of pain is patients’ self‑reporting.

4 illus, 1 table, 33 ref

043241   YANG S, WEI W, ZHAO Q (Macau Univ, Taipa, Macau SPR, China, Email: qizhao@um.edu.mo) : B7-H3, a checkpoint molecule, as a target for cancer immunotherapy. Int J Biol Sci 2020, 16(11), 1767-73.

B7-H3 (also known as CD276) is a newly found molecule of B7 family, which may be a promising target for cancer treatment. B7-H3 protein was demonstrated to be expressed in several kinds of tumor tissues including non-small-cell lung cancer (NSCLC) and prostate cancer. Its expression is highly associated with undesirable treatment outcomes and survival time, due to function of the immune checkpoint molecule. It was classified as either a co-stimulatory molecule for T cell activation or the nonimmunological role of regulating signaling pathways. Although there is still no agreed conclusion on the function of B7-H3, it may be a valuable target for cancer therapy. This review aims to provide a comprehensive, up-to-date summary of the advances in B7-H3 targeting approaches in cancer therapy. Although several challenges remain, B7-H3 offers a new therapeutic target with increased efficacy and less toxicity in future cancer treatment.

1 illus, 3 tables, 57 ref

043240   WANG S-Y, NI X, HU K-Q, MENG F-L, LI M, MA X-L, MENG T-T, WU H-H, GE D, ZHAO J, LI Y, LI Y, et al. (Jinan Central Hospital Affiliated to Shandong Univ, Jinan, China, Email: ly2354@zxyy.cn) : Cilostazol alleviate nicotine induced cardiomyocytes hypertrophy through modulation of autophagy by CTSB/ROS/p38MAPK/JNK feedback loop. Int J Biol Sci 2020, 16(11), 2001-13.

Nicotine is proved to be an important factor for cardiac hypertrophy. Autophagy is important cell recycling system involved in the regulation of cardiac hypertrophy. Cilostazol, which is often used in the management of peripheral vascular disease. However, the effects of cilostazol on nicotine induced autophagy and cardiac hypertrophy are unclear. Here, we aim to determine the role and molecular mechanism of cilostazol in alleviating nicotine-induced cardiomyocytes hypertrophy through modulating autophagy and the underlying mechanisms. Our results clarified that nicotine stimulation caused cardiomyocytes hypertrophy and autophagy flux impairment significantly in neonatal rat ventricular myocytes (NRVMs), which were evidenced by augments of LC3-II and p62 levels, and impaired autophagosomes clearance. Interestingly, cathepsin B (CTSB) activity decreased dramatically after stimulation with nicotine in NRVMs, which was crucial for substrate degradation in the late stage of autophagy process, and cilostazol could reverse this effect dramatically. Intracellular ROS levels were increased significantly after nicotine exposure. Meanwhile, p38MAPK and JNK were activated after nicotine treatment. By using ROS scavenger N-acetyl-cysteine (NAC) could reverse the effects of nicotine by down-regulation the phosphorylation of p38MAPK and JNK pathways, and pretreatment of specific inhibitors of p38MAPK and JNK could restore the autophagy impairment and cardiomyocytes hypertrophy induced by nicotine. Moreover, CTSB activity of lysosome regained after the treatment with cilostazol. Cilostazol also inhibited the ROS accumulation and the activation of p38MAPK and JNK, which providing novel connection between lysosome CTSB and ROS/p38MAPK/JNK related oxidative stress pathway. This is the first demonstration that cilostazol could alleviate nicotine induced cardiomyocytes hypertrophy through restoration of autophagy flux by activation of CTSB and inhibiting ROS/p38/JNK pathway, exhibiting a feedback loop on regulation of autophagy and cardiomyocytes hypertrophy.

8 illus, 50 ref

045151   INAMDAR M S, CHOLE D G, BAKLE S S, GANDHI N P, HATTE N R, RAO M P (Conservative Dentistry and Endodontics Dep, Pandit Deendayal Upadhyay Dental Coll, Solapur- 413 003, Maharashtra, Email: mahenaz.nk@gmail.com) : Comparative evaluation of BRIX3000, CARIE CARE, and SMART BURS in caries excavation: An in vivo study. J Conserv Dent 2020, 23(2), 163-8.

Chemomechanical caries removal has been a new leaf for caries excavation in this ultraconservative era of dentistry. BRIX3000 & Carie Care are papain based gel formulations while Smart Burs are polymer burs with self limiting ability.  To compare & evaluate the caries excavation efficacy of BRIX3000, Carie Care & Smart burs.  45 patients with wide class 1 carious lesions were selected and equally divided into 3 groups: BRIX 3000, Carie Care & Smart Burs. Caries excavation was performed in accordance with manufacturer’s instructions in each group & evaluation for reduction in bacterial count & mean working time was done. Data was analysed by One way ANOVA, Paired t-Test & Tukey’s Post Hoc test. The highest reduction in bacterial count was achieved by BRIX3000(156.93 × 10⁴) followed by Smart Burs(139.07× 10⁴) & Carie Care(135.80×10⁴) with p>0.5. Mean working time in minutes for excavation was : BRIX3000(13.66), Carie Care(18.30) &Smart Burs(20.60) with p<0.5. All the techniques reduced bacterial count potentially. BRIX 3000 proves the most effective among three.

4 illus, 2 tables, 20 ref

045150   GOKTURK H, OZKOCAK I, BUYUKGEBIZ F (Endodontics Dep, Bolu Abant izzet Baysal Univ, Bolu- 141 00 , Turkey, Email: gokturk82@hotmail.com) : Effect of different chelating agents on the bond strength of a silicone-based root canal sealer to root dentin. J Conserv Dent 2020, 23(2), 158-62.

The purpose of this study was to evaluate the impact of 7 % maleic acid (MA), 17 % ethylenediaminetetraacetic acid (EDTA) solution, 10 % citric acid (CA), or 2.25 % peracetic acid (PAA) on the dislodgment resistance of a silicone-based root canal sealer. Ninety-five mandibular incisors were shaped to size R50. The specimens were randomly assigned to the following five groups (n = 15) based on the final irrigation solution: 5 % sodium hypochlorite (NaOCl), 17 % EDTA, 7 % MA, 10 % CA, and 2.25 % PAA. Four specimens from each group were examined under scanning electron microscope. All the remaining canals were obturated with GuttaFlow^® Bioseal. Bond strength was assessed using the push-out test. The data were analyzed statistically by two-way analysis of variance and Bonferroni tests at the significance level of P = 0.05. The roots irrigated with chelators showed statistically significantly higher bond strength than the roots irrigated with NaOCl (P < 0.05). Overall, MA showed the highest bond strength, but there was no statistically significant difference among the other chelating solutions (P > 0.05).  The bond strength of the GuttaFlow Bioseal to the root canal dentin may increase by the removal of smear layer. Final irrigation with the investigated chelators resulted in similar bond strength of the GuttaFlow Bioseal.

1 illus, 2 tables, 24 ref

043239   LIU J, ZHAO S-Y, JIANG Q, QU Y, HUANG X, DU J, SUN W, YE Q (Medical Molecular Biology Dep, Beijing Institute of Biotechnology, Beijing 100850, China, Email: yeqn66@yahoo.com) : Long noncoding RNA MYLK-AS1 promotes growth and invasion of hepatocellular carcinoma through the EGFR/HER2-ERK1/2 signaling pathway. Int J Biol Sci 2020, 16(11), 1989-2000.

The epidermal growth factor receptor (EGFR) family members EGFR and HER2 play pivotal roles in oncogenesis and tumor progression. Anticancer drugs targeting EGFR and HER2 have been developed. Long noncoding RNAs (lncRNAs) have been reported to regulate cancer development and progression through signaling pathways. However, lncRNAs that regulate EGFR and HER2 expression remain unknown. Here, we show that lncRNA myosin light chain kinase-antisense RNA 1 (MYLK-AS1) promotes EGFR and HER2 expression and activates their downstream signaling pathway. MYLK-AS1 increases hepatocellular carcinoma (HCC) cell proliferation, migration, and invasion in vitro. Consistently, MYLK-AS1 knockdown hinders tumor growth in vivo. Mechanistically, MYLK-AS1 enhances HCC cell proliferation, migration, and invasion through stimulating the EGFR/HER2-extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway. In addition, MYLK-AS1 is overexpressed in HCC patients and negatively correlated with HCC prognosis. Thus, MYLK-AS1 is an upstream regulator of EGFR/HER2, and acts as an oncogene, suggesting an additional target for cancer therapeutics.

6 illus, 37 ref

041420   JOSE A, THOMAS L, BABURAJ G, MUNISAMY M, RAO M (Pharmacy Practice Dep, Manipal Coll of Pharmaceutical Sciences, Manipal - 576 104, Karnataka, Email: mahadev.rao@manipal.edu) : Cannabinoids as an alternative option for conventional analgesics in cancer pain management: A pharmacogenomics perspective. Indian J Palliat Care 2020, 26(1), 129-33.

The global cancer burden is significantly increasing at an alarming rate affecting patients, relatives, communities, and health‑care system. Cancer patients require adequate pain relief and palliative care throughout the life course, especially in terminal illness. Although opioid treatment is successful in majority of patients, around 40 % do not achieve enough analgesia or are prone to serious side effects and toxicity. The treatment of medical conditions with cannabis and cannabinoid compounds is constantly expanding. This review organizes the current knowledge in the context of SNPs associated with opioids and nonopioids and its clinical consequences in pain management and pharmacogenetic targets of cannabinoids, for use in clinical practice.

1 table, 44 ref

043238   CHEN Y-H, LIN H, WANG Q, HOU J-W, MAO Z-L, LI Y-G (Cardiology Dep, First Affiliated Hospital of Wenzhou Medical Univ, Wenzhou, Zhejiang, China, Email: chenyihe@wmu.edu.cn) : Protective role of silibinin against myocardial ischemia/ reperfusion injury-induced cardiac dysfunction. Int J Biol Sci 2020, 16(11), 1972-88.

Silibinin is a traditional medicine and utilized for liver protection with antioxidant, anti-inflammation and anti-apoptosis properties. However, its role in myocardial I/R injury and the mechanism involved is currently unknown. In the present study, Silibinin treatment improves cardiac function and limits infarct size, and subsequently inhibits fibrotic remodeling in mice with myocardial I/R injury. Mechanistically, silibinin reduces cardiomyocytes apoptosis, attenuates mitochondrial impairment and endoplasmic reticulum (ER) stress, alleviates ROS generation, neutrophil infiltration and cytokines release. Consistently, silibinin prevents H9C2 cells from hypoxia/reperfusion-induced cell death, oxidative stress and inflammation in vitro. Furthermore, H9C2 cells treated with silibinin blocks NF-κB signaling activation by inhibiting IKKα phosphorylation, IκBα degradation and p65 NF-κB nuclear translocation during hypoxia/ reperfusion. In addition, silibinin plus BAY 11-7082 (a selected NF-κB inhibitor) do not provide incremental benefits in improving myocytes apoptosis, oxidative stress and inflammation in comparison with NF-κB signaling inhibition only. Thus, silibinin-mediated cardioprotection in myocardial I/R injury is associated with decreased apoptosis, oxidative stress and inflammatory response through deactivation of NF-κB pathway.

12 illus, 1 table, 49 ref

045149   SHARMA A, THOMAS M S, SHETTY N, SRIKANT N (Conservative Dentistry and Endodontics Dep, Manipal Coll of Dental Sciences, Mangalore- 575 001, Karnataka, Email: manuel.st@manipal.edu) : Evaluation of indirect pulp capping using pozzolan-based cement (ENDOCEM-Zr®) and mineral trioxide aggregate - A randomized controlled trial. J Conserv Dent 2020, 23(2), 152-7.

Pulp capping should always be considered as the primary treatment of choice for teeth without irreversible pulpitis in lesions approaching dental pulp. The predictability of vital pulp therapy has improved with the introduction of newer bioceramic materials. The purpose of this randomized controlled trial was to compare the outcomes of mineral trioxide aggregate (MTA) (Angelus, Londrina, Brazil) and a pozzolan‑based cement (ENDOCEM‑Zr® [Maruchi, Wonju, Korea]) as an indirect pulp capping (IPC) material. IPC was performed in forty patients who were randomly divided into ENDOCEM‑Zr^® and MTA groups. The outcome was assessed using clinical and radiographic tests at different time intervals. The prognostic factors on the outcome of IPC were also evaluated. The success rate of ENDOCEM‑Zr^® and MTA groups was 94.7 % and 89.4 %, respectively. The results were not statistically significant. Binary logical regression showed that the age of the patient and the status of the pulp before treatment were deciding variables for the outcome of the study. Therefore, it was concluded from the study that the evaluated pozzolan‑based cement could be used as an alternative to MTA because of its faster setting time and lower discoloration potential. In addition, pulp capping should be performed with caution in individuals above 40 years and in teeth with reversible pulpitis.

2 illus, 3 tables, 20 ref

041419   ALEXANDER A, SREENATH K, MURTHY R S (Psychology Dep, CHRIST (Deemed To Be Univ), Bengaluru - 560 029, Karnataka, Email: annie@sjri.res.in) : Beyond numbers – recent understanding of emotional needs of persons diagnosed with cancer 2007–2018. Indian J Palliat Care 2020, 26(1), 120-8.

Epidemiology is a vital tool of public health. The usefulness of epidemiology is not only about numbers of persons’ ill in the community but also to understand the associations, the presentation, identification of new syndromes, to map the historical trends, and calculate morbid risk. The emotional impact of the diagnosis of cancer is well‑recognized. Indian cancer research relating to the psychosocial aspects has been largely limited to counting the numbers with psychiatric syndromes. The review covers 12 years of the Indian research in psycho‑oncology to understand the different aspects of epidemiology. During the review period, there are growing number of epidemiological studies(29); psychiatric morbidity ranges from 41.7 % to 46 %; and prevalence rate ranges from 4.4 % to 97.8 % for anxiety and 1.2 %–89.9 % for depression; majority of the studies have used one‑stage screening for assessment, which is not the ideal method of identifying mental disorders. The severity of the disorders is presented only in nine studies. Quality of life is the most common associated dimension of the studies. There is the absence of studies of posttraumatic growth, resilience, and spirituality. This review calls for greater rigor in the planning of studies of emotional impact, especially the use of two‑stage method, longitudinal studies, studies of different types of cancer and in different stages, include additional measures such as disease burden, coping, resilience, spirituality, and the family/social factors to understand the emotional aspects of living with cancer. There is a need for describing the emotional aspects of living with cancer (lived‑in experiences) beyond the clinical syndromes.

2 illus, 1 table, 48 ref

043237   LUAN F, LI X, CHENG X, HUANGFU L, HAN J, GUO T, DU H, WEN X, JI J (Peking Univ Cancer hospital & institute, 52 Fucheng Road, Beijing, China, Email: wenxz@bjmu.edu.cn) : TNFRSF11B activates Wnt/β-catenin signaling and promotes gastric cancer progression. Int J Biol Sci 2020, 16(11), 1956-71.

Tumor necrosis factor receptor superfamily member 11B (TNFRSF11B) has been studied to be involved in the development and progression of several human malignancies. However, little is unveiled regarding the complex mechanisms of TNFRSF11B in human gastric cancer (GC). The clinical significance of TNFRSF11B was assessed in 70 and 160 GC tissues using immunohistochemistry method and gene microarray analysis, respectively. The biological function of TNFRSF11B was studied in vitro and in vivo assays. Immunofluorescence assay was used to evaluate the expression of β-catenin in the nucleus. The expression of β-catenin and related protein was determined by Western blot. The interaction between TNFRSF11B and GSK3β was detected by co-immunoprecipitation. We demonstrated that TNFRSF11B was highly expressed in the cytoplasm of GC and associated with the patient poor outcome. Our studies showed that TNFRSF11B in GC cells significantly promoted cell proliferation, migration, invasion in vitro and tumorigenic ability in vitro and in vivo. Meanwhile, TNFRSF11B inhibited GC cell apoptosis. The proportion of nuclear active β-catenin showed positively correlation with TNFRSF11B expression. TNFRSF11B directly combined with GSK-3β upregulating its phosphorylation, and increased expression of β-catenin and its downstream effectors. Collectively, these findings demonstrate that TNFRSF11B promote the aggressive phenotypes of GC cells and activated Wnt/β-catenin signaling. Accordingly, TNFRSF11B had potential as a biomarker and inhibition of TNFRSF11B expression might offer a new therapeutic target for GC patients.

6 illus, 1 table, 36 ref

041418   SAMUEL S R, GANDHI A R, KUMAR K V, SAXENA P U P (Physiotherapy Dep, Kasturba Medical Coll, Mangalore, Karnataka, Email: vijay.kk@manipal.edu) : Pedometer based exercise interventions for patients with breast cancer receiving chemotherapy – a systematic review. Indian J Palliat Care 2020, 26(1), 105-9.

lking are prescribed for the patients with breast cancer receiving chemotherapy, but only a few studies include pedometers in conjunction with the routine exercises prescribed. Thus, the aim was to find if the adherence and performance of exercise is improved or has no impact if coupled with the physical activity monitors. A systematic search using the keywords was conducted in PubMed Central, CINAHL, Embase, Cochrane Library, and Scopus. The search revealed 275 articles, of which 3 randomized controlled trials were selected for qualitative analysis based on the inclusion and exclusion criteria for the review. The three studies retrieved by the systematic review have used different protocols of pedometer‑based walking on patients with breast cancer undergoing chemotherapy and studied the following outcome measures: fatigue, body composition, quality of life, and psychological factors. The evidence obtained from the review suggests that pedometer‑based walking programs have a positive impact on cancer‑related fatigue and overall quality of life of patients with breast cancer receiving chemotherapy.

1 illus, 3 tables, 12 ref

041417   NAYERI N D, BAKHSHI F, KHOSRAVI A, NAJAFI Z (Tehran Univ of Medical Sciences, Tehran, Iran, Email: f_bakhshi@razi.tums.ac.ir) : The effect of complementary and alternative medicines on quality of life in patients with breast cancer: A systematic review. Indian J Palliat Care 2020, 26(1), 95-104.

Breast cancer disease and its classic treatment lead to decrease in patients’ quality of life (QOL). This systematic review aimed to compare the effectiveness of complementary and alternative medicines (CAMs) categories on the QOL of women with breast cancer. English clinical trials from PubMed, Emabase, Scupos, and Google Scholar databases were searched electronically by the end of 2018 with the Cochrane Collaboration protocol. Two researchers independently extracted data such as participants’ characteristics, CAM methods, QOL assessment tools. CAMs were classified into three categories of dietary supplements, herbal medicine, and mind‑body techniques. During the initial search, 1186 articles were found. After reviewing titles, abstracts, and full texts based on inclusion and exclusion criteria, 28 clinical trials were included in the systematic review, 18 of which was randomized controlled trial (RCT). Participants included women with breast cancer who were undergoing the first three phases of breast cancer or postcancer rehabilitation. Among CAM interventions, one article used a dietary supplement, and the other 27 articles included a variety of mind‑body techniques. Twenty‑seven studies showed improved QOL (P > 0.05). The findings may indicate the potential benefits of CAMs, especially mind‑body techniques on QOL in breast cancer patients. Further RCTs or long‑term follow‑up studies are recommended. Moreover, the use of similar QOL assessment tools allows for more meta‑analysis and generalizability of results, especially for the development of clinical guidelines.

2 illus, 2 tables, 58 ref

041416   AGHAEI M H, VANAKI Z, MOHAMMADI E (Nursing Dep, Tarbiat Modares Univ, Tehran, Iran, Email: vanaki_z@modares.ac.ir) : Emotional bond: The nature of relationship in palliative care for cancer patients. Indian J Palliat Care 2020, 26(1), 86-94.

Relationship between care providers and cancer patients is one of the main elements in providing healthcare to these patients. Understanding the characteristics and the nature of the relationship is a basis for further organization of palliative care and will enhance the performance of care providers. The purpose of this study was to investigate the nature of the relationship in palliative care for cancer patients. In this qualitative study, 16 participants with rich experiences in the field of cancer patient’s palliative care were selected by purposive sampling. A semi‑structured face‑to‑face interview was conducted with each of the participants. After data collection, all interviews were transcribed and reviewed, and then primary codes, sub‑categories, and categories were extracted. Data analysis emerged three categories; being alongside the patient, establishing and maintaining cordiality relationship, and mutual understanding with the patient. Moreover, an emotional bonding was the main theme that defined the nature of relationship between the care provider team and cancer patients in a palliative care approach. Effective relationship based on emotional bonding is the foundation of palliative care in cancer patients. Considering the structures and palliative care settings in health systems, it is possible to provide training programs regarding the strategies related to establishing emotional bond for effective delivery of palliative care.

1 table, 53 ref

041415   MPATENI A, KANG’ETHE S M (Social Work and Social Development Dep, Fort Hare Univ, Alice, South Africa, Email: aphiwempateni@gmail.com) : An autopsy of palliative health hazards associated with the contemporary traditional male circumcision rite: The case of 2016 alice study. Indian J Palliat Care 2020, 26(1), 80-5.

This article examined the health hazards associated with the contemporary traditional circumcision rite in Alice, Eastern Cape, South Africa. The study from which this article was extracted was explorative, descriptive, and employed a qualitative method. The study took use of one‑on‑one interviews, with the use of interview guide as an instrument to ease focus group discussions and interviews. Data were then analyzed thematically. The findings brought the following factors; hospitalization of initiates; contraction of diseases; amputation of manhood organs; and maltreatment leading to health hazards. This article then recommended that, government, cultural custodians, and parents are requested to work hand in hand to curb all these health hazards associated with the contemporary rite.

1 table, 28 ref

043236   ZHONG Y, CAO L, MA H, WANG Q, WEI P, YANG J, MO Y, CAO L, SHUAI C, PENG S (Central South Univ, Changsha, Hunan 410013, China, Email: shuping@csu.edu.cn) : Lin28A regulates stem-like properties of ovarian cancer cells by enriching RAN and HSBP1 mRNA and up-regulating its protein expression. Int J Biol Sci 2020, 16(11), 1941- 53.

Ovarian cancer (OC) is one of the malignant tumors that seriously threaten women's health, with the highest mortality rate in gynecological malignancies. The prognosis of patients with advanced OC is still poor, and the 5-year survival rate is only 20-30 %. Therefore, how to improve the early diagnosis rate and therapeutic effect are urgent for patients with OC. In this research, we found that Lin28A can promote the expression of stem cell marker molecules CD133, CD44, OCT4 and Nanog. We later confirmed that Lin28A can enrich the mRNA of ras-related nuclear protein (RAN) and heat shock factor binding protein 1 (HSBP1) through RIP assay, and that Lin28A can regulate their protein expression. We also identified that RAN and HSBP1 are highly expressed in OC tissues, and that they are significantly positively correlated with the expression of Lin28A and negatively correlated with the survival prognosis of OC patients. After stable knockdown of RAN or HSBP1 in OC cells with high expression of Lin28A, the expression of the stem cell marker molecules such as OCT4, CD44 and Nanog are reduced. And after knocking down of RAN or HSBP1 in Lin28A highly expressed OC cells, the survival and invasion of OC cells and tumor size of OC xenograft in nude mice were markedly inhibited and apoptosis was increased. Our data also showed that knock down of RAN or HSBP1 can inhibit the invasion ability of OC cells by decreasing the expression of N-cadherin, Vimentin and promoting the expression of E-cadherin. Meanwhile, knockdown of RAN or HSBP1 induced cell apoptosis by inhibiting the expression of PARP. Our results indicated that Lin28A could regulate the biological behaviors in OC cells through RAN/HSBP1. These findings suggest that Lin28A/RAN/HSBP1 can be used as a marker for diagnosis and prognosis of OC patients, and RAN/HSBP1 may be a potential new target for gene therapy of OC.

7 illus, 51 ref

045148   KAPASI K, KESHARANI P, KANSARA P, PATIL D, KANSARA T, SHETH S (Conservative Dentistry and Endodontics Dep, Dental Sciences and Research Center Coll, Ahmedabad, Gujarat, Email: pooja.keshrani@yahoo.com) : In vitro comparative evaluation of efficiency of XP-endo shaper, XP-endo finisher, and XP-endo finisher-R files in terms of residual root filling material, preservation of root dentin, and time during retreatment procedures in oval canals – A cone‑beam computed tomography analysis. J Conserv Dent 2020, 23(2), 145-51.

In an oval‑shaped canal, no single instrumentation systems were effective in absolute removing obturation. The aim of the study was to evaluate the performance of ProTaper Universal Retreatment (PTUR) system, XP‑endo Shaper (XPS), XP‑endo Finisher (XPF), and XP‑endo Finisher‑R (XPF‑R) in removing root‑canal filling material and preservation of sound dentin during retreatment procedure.  Root‑canal preparation was performed on 60 mandibular premolars with oval‑shaped canals using the ProTaper Gold file system. Preobturation scans were performed to measure canal volume of the canal and recorded. Obturation was performed and the samples were randomly assigned into four groups according to the retreatment protocol used (n = 15): H‑file, PTUR files, PTUR followed by XPF file, and XPS supplemented with XPF‑R file. After retreatment, the specimens were rescanned and volumetric analysis of remaining root filling material, volume of the canal space were measured using EZ-3Di Software Version 5.0.0.2. All the data were subjected to one‑way ANOVA and post hoc Tukey’s test with a significance of 5 %.  XPS + XPF‑R showed promising results in the removal of obturating material and preservation of root dentin than any other group. The difference is statistically significant. XPS + XPF‑R removed gutta‑percha more significantly without sacrificing the sound dentin along with instrumentation.

2 illus, 3 tables, 24 ref

041414   ALIKHANI M, VATANKHAH S, GORJI H A, RAVAGHI H (Health Services Management Dep, Iran Univ of Medical Sciences, Tehran, Iran, Email: Vatankhah.s@iums.ac.ir) : How cancer supportive and palliative care is developed: comparing the policy making process in three countries from three continents. Indian J Palliat Care 2020, 26(1), 72-9.

Supportive and palliative care worldwide is recognized as one of the six main cancer control bases and plays an important role in managing the complications of cancer. Limited studies have been published in the field of this policy analysis in the world. This study aimed to analysis the policy‑making process of supportive and palliative cancer care in three countries. This qualitative study is a part of a comparative study. The data were collected through reviewing scientific and administrative documents, the World Health Organization website and reports, government websites, and other authoritative websites. Searches were done through texts in English and valid databases, in the period between 2000 and 2018. To investigate the policy process, heuristic stages model is implemented consisting of the four stages: agenda setting, policy formulation, policy implementation, and policy evaluation. The findings of the study were categorized based on the conceptual model used in four areas related to the policy process, including agenda setting, policy formulation, policy implementation, and evaluation of cancer palliative care policies. Several factors are involved in how cancer palliative care policy is included in policy‑makers’ agenda؛ understanding a necessity, raising public awareness, and acceptance as a result of sensing the physical and nonphysical care outcomes. The stages of development, implementation, and evaluation of palliative care in countries regardless of existing differences are a function of the health system and context of each country.

1 illus, 2 tables, 28 ref

043235   ZHAO X, FENG H, WANG Y, WU Y, GUO Q, FENG Y, MA M, GUO W, SONG X, ZHANG Y, et al. (China Medical Univ, Shenyang, Liaoning Province, 110122, China, Email: lcao@cmu.edu.cn) : Septin4 promotes cell death in human colon cancer cells by interacting with BAX. Int J Biol Sci 2020, 16(11), 1917-28.

Septin4 is a tumor suppressor protein that promotes cell programmed death in various cell types through specifically antagonizing XIAP (X linked inhibitor of apoptosis), little is known its other novel binding partner and role in colorectal cancer. In this study, we found that Septin4 significantly expressed lower in human colon cancer when compared to peri-tumor benign cells, and its low expression was significantly associated with worse prognostic outcomes. Furthermore, Septin4 participated in DOX-induced colon cancer cell death in vitro. Septin4-overexpressing colon cancer cells displayed augmented apoptotic cell death and ROS production. Additionally, Septin4-knockdown cells revealed a resistance of DOX-induced cell death and reduced ROS production. Importantly, we first identified that BAX is a novel Septin4 binding partner and the interaction is enhanced under DOX treatment. Finally, Septin4-knockdown promoted colon cells growth in vivo. These observations suggest that Septin4 as an essential molecule contribute to the occurrence and development of human colon cancer and provide new technical approaches for targeted treatment of this disease.

6 illus, 1 table, 37 ref

045147   TALAN J, GUPTA S, NIKHIL V, JAISWAL S (Conservative Dentistry and Endodontics Dep, Swami Vivekanand Subharti Univ, Meerut- 250 005, Uttar Pradesh, Email: janvitalan1507@gmail.com) : Effect of mechanical alteration of enamel surface on shear bond strength of different bonding techniques. J Conserv Dent 2020, 23(2), 141-4.

This study was conducted to evaluate the effect of mechanical alteration of enamel surface on shear bond strength in different bonding techniques. Seventy samples were fabricated and randomly divided into three groups: Group A (n = 30) – prepared enamel surfaces, Group B (n = 30) – unprepared enamel surfaces, and Group C (n = 10) – prepared enamel surfaces + etch and rinse which served as a control group. Group A and Group B were further divided into three subgroups (n = 10), sub‑Group A1, B1 (nanohybrid composite + self‑etch), sub‑Group A2, B2 (self‑adhering composite), and A3, B3 (self‑adhering composite + self‑etch). Teflon ring molds were used to make composite resin cylinders with the specific bonding protocol of each group. Shear bond strength testing was conducted, and data were analyzed. Mean shear bond strength values were as follows: C> A1> A3>A2>B1> B3> B2.  Prepared enamel surfaces resulted in higher shear bond strength values as compared to unprepared enamel surfaces. Prior application of self‑etch agent resulted in higher shear bond strength values of self‑adhering composite in prepared and unprepared enamel surfaces.

2 tables, 17 ref

043234   TAE I H, SON J Y, LEE S H, AHN M-Y, YOON K, YOON S, MOON H R, KIM H S (Sungkyunkwan Univ, 2066, Seobu-ro, Suwon 16419, Republic of Korea, Email: hkims@skku.edu) : A new SIRT1 inhibitor, MHY2245, induces autophagy and inhibits energy metabolism via PKM2/mTOR pathway in human ovarian cancer cells. Int J Biol Sci 2020, 16(11), 1901-16.

Ovarian cancer is a common gynecological cancer that is found worldwide. Class III histone deacetylase (HDAC) inhibitors, a new class of anticancer agents, induce autophagy in various human cancer cells. The aim of the present study was to investigate the antitumor activity of MHY2245, a new synthetic SIRT inhibitor, on human ovarian cancer cells. We found that MHY2245 exhibited potent cytotoxicity to SKOV3 cells in a time- and concentration-dependent manner. The cytotoxicity of MHY2245 (IC₅₀=0.32 µM) was higher than that of doxorubicin (DOX, IC₅₀=1.38µM) against SKOV3 cells. MHY2245 significantly inhibited SIRT1 enzyme activity, reduced the expression of SIRT1, increased cell cycle arrest at G₂/M phase, and induced apoptotic cell death in SKOV3 cells via expression of cytochrome c, cleaved-PARP, cleaved caspase-3, and Bax. This might be associated with blocking of the pyruvate kinase M2 (PKM2)/mTOR pathway. MHY2245 also inhibited tumor growth and reduced tumor size when SKOV3 cells were transplanted into nude mice. Our results indicate that MHY2245 exerts antitumor activity against ovarian cancer cells by blocking the PKM2/mTOR pathway. We suggest that MHY2245 is a promising anticancer agent that disrupts ovarian cancer cell metabolism.

8 illus, 64 ref

041413   GUPTA A, PARMAR B, ARORA M H, MIRIYALA R, ANAND N, GHOSHAL S (Radiotherapy and Oncology Dep, Post Graduate Institute of Medical Education and Research, Chandigarh, Email: ravitejamiriyala@gmail.com) : Factors influencing the initiation of strong opioids in cancer patients on palliative care: An audit from a tertiary cancer center in India. Indian J Palliat Care 2020, 26(1), 66-70.

This audit was done to analyze the factors influencing the use of strong opioids in cancer patients receiving comprehensive palliative care from a tertiary institute. Case records of patients registered for palliative care at our center in 3 months were retrospectively reviewed and followed up throughout the course of their illness. Demographic factors, prior treatments, social support system, analgesic use at registration, and use of radiation and adjuvant analgesics were recorded. Strong opioid use and their time of initiation were evaluated, and multivariate analysis was used to identify the factors correlating with the above. After registration, strong opioids were initiated in 16 % of the patients. It was observed that patients younger than 55 years and those with visceral metastases and history of use of weak opioids at the time of registration had a higher probability of being started on strong opioids. Factors associated with a significantly longer strong opioid‑free interval were having spouse as primary caregiver, presence of skeletal metastases, use of palliative radiotherapy, and low socioeconomic status. It is certain that the use of strong opioids for adequate analgesia is a necessity for palliative‑care patients. However, optimal utilization of adjunctive analgesic modalities, coupled with good supportive care, can minimize the requirement and duration of strong opioid use, especially in developing countries with limited access to specialist palliative care.

4 tables, 17 ref

043233   CHEN K, LIU Y, HE J, PAVLOS N, WANG C, KENNY J, YUAN J, ZHANG Q, XU J, HE W (Joint Orthopaedics Dep, Guangzhou Univ of Chinese Medicine, Guangzhou, Guangdong 510405, China, Email: hw13802516062@163.com) : Steroid-induced osteonecrosis of the femoral head reveals enhanced reactive oxygen species and hyperactive osteoclasts. Int J Biol Sci 2020, 16(11), 1888-900.

Steroid-induced osteonecrosis of the femoral head (ONFH) is a progressive bone disorder which typically results in femoral head collapse and hip joint dysfunction. It is well-accepted that abnormal osteoclast activity contributes to loss of bone structural integrity and subchondral fracture in ONFH. However, the pathophysiologic mechanisms underlying the recruitment and hyperactivation of osteoclasts in ONFH remain incompletely understood. We assessed the changes of reactive oxygen species (ROS) level and subsequent osteoclast alterations in steroid-induced osteonecrotic femoral heads from both patients and rat ONFH models. When compared with healthy neighboring bone, the necrotic region of human femoral head was characterized by robust up-regulated expression of osteoclast-related proteins [cathepsin K and tartrate-resistant acid phosphatase(TRAP)] but pronounced down-regulation of antioxidant enzymes (catalase, γ-glutamylcysteine synthetase [γ-GCSc], and superoxide dismutase 1 [SOD1]). In addition, the ratio of TNFSF11 (encoding RANKL)/TNFRSF11B (encoding OPG) was increased within the necrotic bone. Consistently, in rat ONFH models induced by methylprednisolone (MPSL) and imiquimod (IMI), significant bone loss in the femoral head was observed, attributable to increased numbers of TRAP positive osteoclasts. Furthermore, the decreased expression of antioxidant enzymes observed by immunoblotting was accompanied by increased ex-vivo ROS fluorescence signals of dihydroethidium (DHE) in rat ONFH models. Therefore, this study lends support to the rationale that antioxidant agents may be a promising therapeutic avenue to prevent or mitigate the progression of steroid-induced ONFH by inhibiting ROS level and hyperactive osteoclasts.

6 illus, 51 ref

041412   WARRIER M G, SADASIVAN A, POLAVARAPU K, KUMAR V P, MAHAJAN N P, REDDY C P C, VENGALIL S, NASHI S, NALINI A, THOMAS P T (Psychiatric Social Work Dep, National Institute of Mental Health and Neuro Sciences, Bengaluru - 260 029, Karnataka, Email: priyathomasat@gmail.com) : Lived experience of spouses of persons with motor neuron disease: Preliminary findings through interpretative phenomenological analysis. Indian J Palliat Care 2020, 26(1), 60-5.

Motor neuron disease (MND) is a progressive neuromuscular disorder that can have significant and debilitating impact on the affected patient and families. Spouses are the primary carers for persons with MND in India, and the life of the person with MND and their spouse is never the same after the diagnosis. The objective was to explore the lived experience of spouses of persons diagnosed with MND. A qualitative exploratory study with three‑point interviews was conducted with spouse caregivers of two persons diagnosed with MND who were receiving treatment from a national tertiary referral care center for neurological disorders. All the patients were diagnosed as definite MND according to the modified El Escorial criteria. With the spouses, in‑depth interviews were conducted at their home, lasting on an average of 1 hour using a semi‑structured interview guide (prompts). Interpretative phenomenological analysis was used to derive themes from the interviews. The major themes emerged from the analysis were meaning of MND which contained the subthemes of delay in diagnosis and deterioration, psychological response across illness trajectory, relationship with the subthemes of changing roles in being acarer, marital relationship, to be seen as doing “right,” and communication; adaptation with the subthemes of coping strategies and support system and life without the loved one. The changes in the lives of spouses and in strategies for caring the partner with deterioration of symptoms in the illness trajectory are explained in this study. The palliative approach in the management of MND has to take into account, the experiences and needs of carers since care happens at home.

2 tables, 29 ref

043232   XIE J, LI L, DENG S, CHEN J, GU Q, SU H, WEN L, WANG S, LIN C, QI C, ZHANG Q, et al. (Guangdong Pharmaceutical Univ, Guangzhou 510006, Guangdong, PR China, Email: wanglijing@gdpu.edu.cn) : Slit2/Robo1 mitigates DSS-induced ulcerative colitis by activating autophagy in intestinal stem cell. Int J Biol Sci 2020, 16(11), 1876-87.

Ulcerative colitis (UC) is a recurrent intestinal inflammatory disease. Slit2, a secreted protein, interacts with its receptor Robo1 to regulate the differentiation of intestinal stem cells and participate in inflammation and tumor development. However, whether Slit2/Robo1involved in the pathogenesis of UC is not known. We investigated Slit2/Robo1-mediated UC using a dextran sodium sulfate (DSS)-induced model. Eight-week-old male Slit2-Tg (Slit2 transgene) mice, Robo1/2^+/- (Robo1^+/- Robo2^+/- ) mice, and their WT littermates were allocated into two groups: (I) control group (n=10), of mice fed a normal diet and tap water and (II) DSS group (n=10), of mice fed a normal diet and drinking water with 2 % DSS for 7 days. Colon tissues were collected and analyzed by qPCR, immunohistochemistry, western blot, and immunofluorescence. Slit2-Tg DSS mice showed less body weight loss, less blood in the stool, and less viscous stool compared to those of WT_Slit DSS mice. Robo1/2^+/- DSS mice displayed a heavier degree of blood in the stool and a more apparent viscosity of the stool compared to those of WT_Robo1/2 DSS mice. Slit2 overexpression maintained Lgr5⁺ stem cell proliferation in the crypt after DSS treatment, significantly increased the LC3II/I ratio, and slightly stimulated p62 expression in the crypt compared to those of DSS-induced WT_Slit mice. Robo1/2 partial knockout reduced the number of Lgr5⁺ stem cells, decreased the LC3II/I ratio, and markedly increased p62 expression in the crypt compare to those of DSS-treated WT_Robo1/2 mice. Our findings suggest that Slit2/Robo1 mediates DSS-induced UC probably by activating the autophagy of Lgr5⁺ stem cells.

6 illus, 40 ref

041411   NIKOLOUDI M, LYMVAIOS L, ZYGOGIANNI A, PARPA E, STRIKOU D-A, TSILIKA E, KOULOULIAS V, MYSTAKIDOU K (Radiology Dep, National and Kapodistrian Univ of Athens, 115 26 Athens, Greece, Email: mistakidou@yahoo.com) : Quality of life, anxiety, and depression in the head and neck cancer patients, undergoing intensity modulated radiotherapy treatment. Indian J Palliat Care 2020, 26(1), 54-9.

The aim of this study is to investigate and compare distress and quality‑of‑life parameters among head‑and‑neck cancer patients who underwent intensity‑modulated radiotherapy (IMRT). The patients’ sample consists of 55 individuals under IMRT treatment. Three questionnaires (Quality of Life Questionnaire [QLQ]‑C30 and QLQ‑H and N35) of the European Organization for the Research and Treatment of Cancer and the Greek Hospital Anxiety and Depression Scales were used. Functioning and symptoms scales measured a week before the scheduled treatment worsen significantly until the end of the treatment and at the 3‑month follow‑up, tend to revert to their pretreatment values. Our results showed that all parameters (functioning scales, symptoms scales, and G‑HAD subscales) worsen from the start to the end treatment and tend to revert to their pretreatment values after a 3‑month period.

5 tables, 34 ref

045146   ZINGE P R, SARAF P A, RATNAKAR P , KARAN S, SARAF S P, HAZARI P (Conservative Dentistry and Endodontics Dep, Tatyasaheb Kore Dental Coll and Research Center, Kolhapur¸ Maharashtra, Email: priyankazinge123@gmail.com) : Assessment of effect of 1 % phytic acid and 17 % ethylenediaminetetraacetic acid on calcium ion loss of radicular dentin: An ex vivo study. J Conserv Dent 2020, 23(2), 137-40.

The purpose of this study was to evaluate and compare the effectiveness of phytic acid and ethylendiamine tetraacetic acid (EDTA) in the removal of calcium ion from radicular dentin during endodontic procedure. Twenty‑five single‑rooted mandibular premolar teeth were decoronated, and the roots were split longitudinally into two halves. Among obtained specimens, 45 specimens were randomly selected and divided into three groups (n = 15): Group 1 – distilled water, Group 2 – 17 % EDTA, and Group 3 – 1 % phytic acid. Samples in each group were immersed in the test solutions for specific time intervals, after which the same solution samples were subjected for the evaluation of amount of calcium ion release into the solution by Atomic Absorption Spectrophotometer. Data were analyzed using the one‑way analysis of variance test.  The use of 17 % EDTA resulted in more calcium ion loss as compared to 1 % phytic acid and distilled water. One percent phytic acid seems to be an appropriate irrigating solution because of its less demineralizing effect as compared to 17 % EDTA on radicular dentin.

2 tables, 22 ref

043231   ZHU Y, YAN Z, DU Z, ZHANG S, FU C, MENG Y, WEN X, WANG Y, HOFFMAN A R, HU J-F, et al. (First Hospital of Jilin Univ, Changchun, Jilin 130021, China, Email: jdyylw@163.com) : Osblr8 orchestrates intrachromosomal loop structure required for maintaining stem cell pluripotency. Int J Biol Sci 2020, 16(11), 1861-75.

Induced pluripotent stem cells (iPSCs), derived from reprogramming of somatic cells by a cocktail of transcription factors, have the capacity for unlimited self-renewal and the ability to differentiate into all of cell types present in the body. iPSCs may have therapeutic potential in regenerative medicine, replacing injured tissues or even whole organs. In this study, we examine epigenetic factors embedded in the specific 3-dimensional intrachromosomal architecture required for the activation of endogenous pluripotency genes. Using chromatin RNA in situ reverse transcription sequencing (CRIST-seq), we identified an Oct4-Sox2 binding long noncoding RNA, referred as to Osblr8, that is present in association with pluripotency status. Osblr8 was highly expressed in iPSCs and E14 embryonic stem cells, but it was silenced in fibroblasts. By using shRNA to knock down Osblr8, we found that this lncRNA was required for the maintenance of pluripotency. Overexpression of Osblr8 activated endogenous stem cell core factor genes. Mechanistically, Osblr8 participated in the formation of an intrachromosomal looping structure that is required to activate stem cell core factors during reprogramming. In summary, we have demonstrated that lncRNA Osblr8 is a chromatin architecture modulator of pluripotency-associated master gene promoters, highlighting its critical epigenetic role in reprogramming.

7 illus, 77 ref

045145   NANDAKUMAR M, NASIM I (Conservative Dentistry and Endodontics Dep, Saveetha Univ, Chennai, Tamil Nadu, Email: nasimiffat@gmail.com) : Effect of intracanal cryotreated sodium hypochlorite on postoperative pain after root canal treatment - A randomized controlled clinical trial. J Conserv Dent 2020, 23(2), 131-6.

The postendodontic pain is caused by either microbial, mechanical, or chemical factors or combinations of these. The incidence of postoperative pain ranges from 1.4 % to 53 %. The management of postendodontic pain is a crucial factor for a successful practitioner. Cryotherapy is a new therapeutic option applied in sports medicine and surgery for the management of pain and for postoperative care. The purpose of this study was to evaluate and to compare the effect of intracanal cryotreated sodium hypochlorite and room temperature sodium hypochlorite on postoperative pain after root canal treatment.  Sixty‑four patients were selected according to inclusion criteria and baseline score was recorded. After obtaining consent, the access cavity was opened under local anesthesia. On the completion of cleaning and shaping, the patients were randomly divided into two groups: Group A: Normal Room temperature NaOCl and Group B: Cryotreated NaOCl (2 °C–4 °C), each of the canals further received 20 ml of the respective irrigants based on the groups allocated. The final rinse was done with saline, and canals were dried and obturated in the same appointment. Postoperative visual analogue scale pain levels were recorded at 6, 24, and 48 h over the phone. The data were analyzed using SPSS software. The results of the present study showed that cryotherapy group showed a statistically significant reduction in postoperative pain levels at all tested time intervals and reduced analgesic intake at 6 h postoperatively. Cryotherapy could be used as an easy and cost‑effective technique for controlling postendodontic pain in the day‑to‑day clinical practice.

4 tables, 21 ref

041410   RAVINDRAN A, SUNNY A, KUNNATH R P, DIVAKARAN B (Nephrology Dep, Kmct Medical Coll, Manassery, Kerala, Email: rajeshpkunnath@gmail.com) : Assessment of quality of life among end stage renal disease patients undergoing maintenance hemodialysis. Indian J Palliat Care 2020, 26(1), 47-53.

Renal failure is a chronic disease that can seriously affect quality of life (QOL). Health‑Related QOL represents the physical, psychological, and social domains of health that are influenced by a person’s experience, beliefs, expectations, and perceptions. The aim of this study is to explore QOL of Stage 5 chronic kidney disease (CKD) patients on maintenance hemodialysis (MHD) in South India. This was a cross‑sectional observational study conducted among patients with CKD undergoing MHD at 11 major centers in South India. Demographic data were collected using a predesigned questionnaire. QOL index was measured using the 26‑item WHOQOL‑BREF questionnaire, and statistical analysis was carried out using the SPSS version 24 (Academy of Medical Sciences, Kannur, Kerala, India). Five hundred and three patients undergoing MHD were enrolled, and the following QOL scores were recorded: social relationship (51.65 ± 21.03), environmental (46.91 ± 19.29), psychological (41.07 ± 20.30), and physical health (40.17 ± 17.05). QOL of patients declined with aging in all four domains. Being male, younger, educated, and unmarried appeared to have a favorable effect on several aspects of patients’ QOL. The evaluation of QOL in CKD patients undergoing hemodialysis showed that it was relatively compromised. Because the patients had a chronic, progressive irreversible disease, the most affected was physical domain. Age, education, employment, and marital status were found to affect one or more domains of QOL. Age and education are significant independent variables; as the age increases, QOL decreases, and higher the education better the QOL.

5 tables, 14 ref

045144   LOUREIRO M A Z, ROSSI-FEDELE G, AMEZCUA O G, SOUZA P C, SILVA J A, ESTRELA C, DECURCIO D A (Oral Science Dep, Federal Univ of Goiás, Goiás, Brazil) : Dynamic torque analysis of rotary and reciprocating instruments during root canal instrumentation in simulated canals by an endodontist or a general dentist. J Conserv Dent 2020, 23(2), 126-30.

Excessive torque is associated with engine‑driven file fracture. The aim of this study to evaluate the real‑time torque of rotary and reciprocating instruments, working time, and the occurrence of procedural errors during root canal preparation of simulated canals by an endodontist and a general dentist. Thirty‑six commercially available simulated “J‑shaped” root canals in resin blocks were used. Instrumentation was performed using WaveOne, WaveOne Gold, ProTaper Next, Reciproc, Reciproc Blue, and Mtwo. The real‑time torque analysis and the number of times the maximum torque applied to the instrument were evaluated. Images were obtained to assess the occurrence of procedural errors, and working time was recorded. Statistical Analysis: The one‑way analysis of variance with a Bonferroni post hoc test, Mann Whitney test and the t‑test was used for statistical analysis (P < 0.05). Reciprocating instruments showed lower values in the number of times that reached maximum torque and percentage time in the area of critical torque, with significant differences compared to rotary instruments (P < 0.05). Operators influenced torque values only with rotary motion instruments. There was no significant difference in mean working time between the operators or instruments. No fracture of instruments or canal transportation occurred. Rotary instruments were associated with higher peaks in real‑time torque variation during the preparation of simulated root canals.

2 illus, 2 tables, 28 ref

041409   RAJESHWARI A, REVATHI R, PRASAD N, MICHELLE N (Psycho-Oncology Services Dep, Cytecare Cancer Hospitals, Bengaluru - 560 064, Karnataka, Email: keerthana.kirti@gmail.com) : Assessment of distress among patients and primary caregivers: Findings from a chemotherapy outpatient unit. Indian J Palliat Care 2020, 26(1), 42-6.

Chemotherapy is one of the treatment modalities for cancer. The side effects of treatment, at times, can affect the emotional well‑being of patients and their caregivers, thereby leading to distress. This paper aims at screening and identifying levels of distress among patients undergoing chemotherapy and their caregivers. A cross‑sectional study design was used. Patients (n = 102) undergoing chemotherapy in the outpatient daycare unit and their caregivers (n = 101) were screened for distress using the National Comprehensive Cancer Network distress thermometer and the problem checklist. Data were analyzed using descriptive and inferential statistics. Patients(53.4 %) and their caregivers(22.2 %) reported experiencing moderate‑to‑severe levels of distress. Patients reported significant distress in the areas of physical (P = 0.000) and emotional problems, whereas caregivers reported distress in the areas of family (P = 0.000) and emotional problems. There was no significant difference in emotional problems(P ≥ 0.05) between the patients and their caregivers. There was a positive correlation between physical and emotional problems (r = 0.760, P = 0.000). Majority of patients (85.2 %) and caregivers (80.1 %) showed interest to avail psycho‑oncology services. Distress is prevalent among patients with cancer undergoing chemotherapy and their caregivers. Clinical implications highlight the need to identify and address caregiver distress during routine distress screening for patients using specific psychosocial interventions. Future research warrants the use of administering specific assessments to identify severe psychological issues, such as depression and anxiety for patients reporting severe levels of distress on the screening tool.

3 illus, 3 tables, 22 ref

041408   MOSLEMI M, NIKFARID L, NOURIAN M, NASIRI M, REZAYI F (Pediatric Nursing Dep, Shahid Beheshti Univ of Medical Sciences, Tehran, Iran, Email: l.nikfarid@sbmu.ac.ir) : Translation, cultural, and age related adaptation and psychometric properties of persian version of “quality of dying and death” in nurses working in neonatal intensive care units. Indian J Palliat Care 2020, 26(1), 34-9.

Death and dying care is an area with less attention in nursing. This even is evidenced as more challenging in some populations such as neonates. Neonatal intensive care unit (NICU) nurses should be aware of the quality of care they provide for dying neonates and their families to find the areas which need attention. The aim of this study was to assess the psychometric features of the Quality of Dying and Death (QODD) questionnaire in NICU nurses in Tehran, the capital city of Iran. This methodological study was conducted in 2017. For this purpose, using census method, 130 NICU nurses working in selected hospitals participated. After the backward–forward translation, based on the method proposed by the International Test Commission, the psychometric properties of the Persian QODD were examined through the assessment of the face, content and construct validity, internal consistency, and stability. Final Persian QODD’s content and face validity were accepted through a qualitative method. In the confirmatory factor analysis, the original version of QODD was not confirmed. Subsequently, an exploratory factor analysis was carried out in which phrases were included in three dimensions (symptom control, preparation for death of neonate, and professional attention) that explained 75 % of the variance. Cronbach’s alpha values ranged from 0.82 to 0.88 for these three dimensions. The intraclass correlation coefficient (ICC) was ICC = 0.94 between two tests performed with a 2‑week interval on twenty eligible nurses. The Persian version of QODD has acceptable psychometric properties in nurses working with the neonatal population and can be used to investigate the NICU nurses’ opinion on the QODD provided in NICU patients.

1 illus, 5 tables, 33 ref

041407   YEUN Y R (Nursing Dep, Kangwon National Univ, Gangwondo, 25949, Korea, Email: yeunyr@kangwon.ac.kr) : A study on the motivations of Korean hospice volunteers. Indian J Palliat Care 2020, 26(1), 24-7.

Volunteers play a key role in hospice and palliative service. This study was performed to investigate the motivations of Korean hospice volunteers and to identify the predictors that affect their service period. The accomplished questionnaire sheets of 93 subjects were included in the analysis. Inventory of Motivations for Hospice Palliative Care Volunteerism to measure the motivations of the hospice volunteers was used. The collected data were subjected to a statistical analysis of the mean and standard deviation, a t‑test, and multinomial logistic regression analysis. The motivation score of the hospice volunteers in South Korea is 75.57 ± 10.97, and the top three in the motivation list were altruism, civic responsibility, and self‑promotion. Among the subdomains, altruism, 1–4‑year working experience (B = 0.79, standard error (SE) = 0.26, P = 0.002, Exp (B) =0.45), and more than 10‑year working experience (B = 1.00, SE = 0.30, P = 0.001, Exp (B) =0.36) had statistically significant influences. The finding of this study can be used as basic information for the recruitment and management of hospice volunteers in South Korea.

2 tables, 29 ref

045143   ZAFAR K, NAZEER M R, GHAFOOR R, KHAN F R (Aga Khan Univ, Karachi- 748 00, Pakistan, Email: kamil.zafar@yahoo.com) : Success of pulpotomy in mature permanent teeth with irreversible pulpitis: A systematic review. J Conserv Dent 2020, 23(2), 121-5.

The objective of the present systematic review is to evaluate the success of pulpotomy in mature permanent teeth presented with irreversible pulpitis. The following databases were searched: PubMed, Oral and Dentistry Database, Cochrane, and CINAHL plus. We included studies published in the English language only. However, narrative reviews and case reports/series were excluded. The first electronic and hand search yielded a total of 2851 articles. After going through extensive screening and eligibility process, only six articles were finally selected for the review. The follow‑up period ranged from 1 to 10 years. Randomized controlled trial compared pulpotomy with the root canal treatment and reported comparable and even better success of the pulpotomy (78% success). All the other studies have also shown better clinical and radiographic success of pulpotomy (68 %–100 %). Pulpotomy can be considered an alternative option for mature permanent teeth with irreversible pulpitis.

3 illus, 3 tables, 32 ref

041406   KALYANI C V, SHARMA S K, KUSUM K, LIJUMOL K J (Nursing Dep, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, Email: vasantharaj2003@gmail.com) : Healthcare related quality of life and lived existential experiences among young adults diagnosed with cancer: A mixed method study. Indian J Palliat Care 2020, 26(1), 19-23.

As cancer is a noncommunicable disease and it is a major global burden in terms of finances. It is also affecting quality of life of a person completely. The aim of the present study was to identify the effect of cancer on quality of life of an individual as a whole. The present study was triangulation study, and we examined 30 young adult cancer patients of age group 20–44 years who were admitted in different oncological units of our hospital in 2018. We included all their case datasheets for identifying clinical variables. Data collection tools used were the European organization for research and treatment for cancer quality of life questionnaire (version 3‑Hindi). Qualitative data were collected using open‑ended questionnaire regarding young adult cancer patient’s experiences, feelings, and difficulties faced during cancer diagnosis and treatment. Results concluded that young adult cancer patient’s global health status score were average. Their physical function as well as social function score depicted that both were affected significantly, whereas cognitive functions were not affected anymore. Most commonly symptoms faced by young adult’s cancer patients were pain, insomnia, fatigue, nausea, vomiting, and appetite loss. Financial burden was major burden faced by patient as well as caregiver during the diagnosis and treatment of cancer. From qualitative data of the study, it was concluded that when patient were first told about cancer diagnosis first, they feel sad. Their primary relatives were first informed about their diagnosis. Most of patient’s cancer were diagnosed in first stage. Cancer had affected patient’s personal as well as social life completely. Nobody helps them during the diagnosis and treatment of their disease. Majority of cancer treatment options were chemotherapy, radiation therapy, and surgery and majority of them were getting chemotherapy from AIIMS, Rishikesh. The most common difficulty the patient’s faced during the diagnosis of cancer was financial. Patient’s opinion for cancer and its treatment were that everybody who had any symptoms of cancer they should immediately come to hospital for treatment. When we asked them about effect of cancer as a whole their responses were disturbed family role, disturbed attachment with family and friends, disturbed social role, financial burden as well as disturbed education, respectively. From this study, we concluded that quality of life of young adult cancer patients were affected badly in terms of physical, social, symptomatically, and financially. It may also help to plan ahead by patients as well as health professionals to improve the patient’s quality of life.

10 tables, 7 ref

041405   SINGH V K, SHETTY Y C, SALINS N, JAIN P (Pharmacology and Therapeutics Dep, Seth GSMC and KEMH, Mumbai, Maharashtra, Email: yashashrirajit@gmail.com) : Prescription pattern of drugs used for neuropathic pain and adherence to neupsig guidelines in cancer. Indian J Palliat Care 2020, 26(1), 13-8.

The objective of the present research was to evaluate the prescription pattern of the drugs used in the pharmacological treatment of cancer‑related neuropathic pain (CRNP) and to assess the adherence of the physicians to the Neuropathic Pain Special Interest Group (NeuPSIG) Guidelines. This was a cross‑sectional, observational study where patients who presented to the pain and palliative care outpatient clinic of the tertiary care hospital with CRNP were prospectively recruited. Participants were screened for neuropathic pain using DN4 questionnaire. Demographic details, diagnosis, medication details, and adherence to NeuPSIG guidelines were assessed using a validated questionnaire. Of 300 patients screened, 64 % were male and 36 % were female, with a mean age of 48.26 ± 13.05 years. The predominant symptoms found were pin‑and‑needle sensation (99 %) followed by tingling sensation (98.66 %). The most common diagnosis was head‑and‑neck cancers (37.3 %) followed by bone cancers (17.3 %) and lung cancers (15.3 %). Among the first‑line drugs recommended in NeuPSIG for CRNP, pregabalin (78.7 %) was the most common drug prescribed followed by amitriptyline (67 %). The most common co‑prescribed drugs were acid suppressants drugs (50.7 %). Tapentadol, which is not part of the NeuPSIG guidelines, was prescribed on 51 occasions for neuropathic pain. Underdosing was observed in 272 prescriptions. Only 12 prescriptions completely adhered, while 275 had partial, and 13 prescriptions had poor adherence to NeuPSIG guidelines. The most commonly used drugs in the treatment of CRNP were pregabalin and amitriptyline. Most physician partially or did not adhere to the NeuPSIG guideline in the management of CRNP.

1 table, 30 ref

045142   MAZUMDAR P, KAUSHIK M, CHANDRASEKHAR V, MOHAN KUMAR R S, RAJAWAT A (Conservative Dentistry and Endodontics Dep, Guru Nanak Institute of Dental Sciences and Research, Secunderabad, Telangana) : Position statement of iacde for managing dental patients during covid-19. J Conserv Dent 2020, 23(2), 114-20.

Coronavirus disease 2019 (COVID‑19) has been a major health concern globally ever since it was declared as Pandemic by the World Health Organization in March 2020. Due to the evolving and contagious nature of coronavirus, it continues to remain a threat for dental health‑care personnel. As the virus travels from person-to-person via direct contact through droplet inhalation, cough, and sneeze or through contact transmission, it remains infectious even through inanimate surfaces. A seemingly healthy asymptomatic person may have the potential to trigger the spread of this disease. Coronavirus has the capability of spreading through community transmission. There is no specific treatment or vaccine as of now for stopping the spread of COVID‑19, hence universal precautions and awareness with mass involvement is required to ward off this pandemic. Dental health‑care personnel are at immense risk due to the near proximity with patients and continual exposure to saliva, blood, and other body fluids. Management protocol regarding awareness and preventive measures should be laid down for dental clinic/hospital to contain the outspread of this infectious disease.

1 illus, 2 tables, 52 ref

041404   PAI A, SIVANANDH B, UDUPA K (Medical Oncology Dep, Manipal Univ, Manipal, Karnataka, Email: dr.pai.ananth@gmail.com) : Quality of sleep in patients with cancer: A cross sectional observational study. Indian J Palliat Care 2020, 26(1), 9-12.

Insomnia and poor sleep quality are common problems in patients with cancer. It interferes with the coping ability, symptoms, and treatment outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a reliable, valid instrument to assess the quality of sleep in patients with cancer. The study was conducted at the department of medical oncology of a tertiary cancer care center. Consecutive eligible participants were recruited and evaluated for sleep quality using PSQI questionnaire. The questionnaire was administered only once with the questions evaluating to the quality of sleep over the last 1 month. A PSQI total score of ≤5 was suggestive of good quality of sleep and a score of >5 was indicative of poor quality of sleep. Ninety‑two consecutive consenting cancer patients admitted for chemotherapy participated in the study. Thirty‑one (33.7 %) patients had early cancer and 35 (38 %) patients had Stage IV metastatic disease. Thirty‑six (39.1 %) patients reported sleep of <6 h and 30 (32.6 %) patients had impaired functioning during day due to sleepiness. Fifty‑three (57.6 %) patients had poor total PSQI score, of which 39 (73.5 %) were female and 14 (26.5 %) were male. The study showed no correlation of the PSQI scores with the stage of the disease, and the prior treatment received. The study showed that Indian cancer patients have short sleep duration and poor quality of sleep. A higher prevalence of sleep disturbances was seen among female cancer patients. PSQI questionnaire can be a cost‑effective way of screening cancer patients for poor quality of sleep.

5 illus, 2 tables, 20 ref

041403   JAIN P N, CHATTERJEE A (Pain Div, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, Email: pnj5@hotmail.com) : A randomized placebo controlled trial evaluating the analgesic effect of salmon calcitonin in refractory bone metastasis pain. Indian J Palliat Care 2020, 26(1), 4-8.

Injection calcitonin is a natural hormone inhibiting osteoclastic bone resorption have been used as an analgesic to control bone metastasis pain or pain due to osteoporosis or fracture. This randomized double blind placebo controlled trial was undertaken to determine the role of injection Salmon Calcitonin therapy to control refractory pain caused due to bone metastasis arising from cancer breast, lung, prostate or kidney. All patients had received palliative radiotherapy and were suffering unsatisfactory pain relief on NSAIDs and tab morphine. Fourteen days inj. calcitonin or placebo injections were administered in 23 patients initially as high dose induction dose (800 IU per day SC) followed 200 IU subcutaneous (SC) once a day. Patients were assessed for pain intensity and quality of life on EORTC QLQ-30 questionnaire 6 hourly for 2 days and on 7^th and 30^th day. Any incidence of hypercalcemia, bone fracture, nerve root and bone marrow compression were also noted. This study found a significant reduction in pain after SC calcitonin injection therapy at 14 and 30 days’ assessment. No patients in the study group required rescue analgesia after 18 hrs. There was a statistically significant difference in rescue analgesics required between the groups during two days hospitalization. Global health as well as physical and social wellbeing was better at 30 and 90 days in the study group as compared to control group, however it could not reach a statistical significance which may be attributed to the small sample size of the study.

6 illus, 1 table, 9 ref

045141   KAMAL S, CHANDRA R, SINGH S M, KUMAR A, MITTRA K K, ROY N (Regional Office of Health & Family Welfare, Lucknow, U.P) : Mass drug administration (MDA) for lymphatic filariasis elimination in Uttar Pradesh, India: Issues, gaps & challenges. J Commun Dis 2020, 52(3), 62-73.

Uttar Pradesh is the largest state of India and is comprised of 75 revenue districts.  51 districts of eastern Uttar Pradesh are endemic for LF and are under Elimination of Lymphatic Filariasis (ELF). In order to ensure elimination of the disease from the people, the  mass drug administration (MDA) is being observed in these 51 districts since 2004 by ensuring administration of drug  Di-ethyl Carbamazine Citrate (DEC)  alone  once in a year according to the age excluding children <2years, pregnant women and seriously ill persons. Thereafter, 400 mg  albendazole to >2 years age group was added with DEC since 2008.  When both the drugs are administered together, the effect is on the adult worm too and therefore the parasite will be destroyed preventing the infected person from developing clinical manifestation. NVBDCP guidelines envisages that administration of drug to the 65 % of the total population or 85 % of the targeted population for five consecutive years will bring down the microfilarimia to <1 % among the population, ultimately leading to the elimination of the disease after conducting Transmission Assessment Survey (TAS) thrice at an interval of two years among the virgin/protected group of children i.e. 6-7 years. The Transmission Assessment Survey (TAS)  is conducted  after ensuring <1 % microfilariamia  in 10 additional sites  selected randomly.The state could subject only one district Rampur  under post MDA surveillance, which cleared TAS-1 & TAS-2. The other districts  subjected  for TAS during 2016, 2017, 2018 & 2019 but could not qualify for conducting TAS in additional m.f. survey as microfilariamia during 2016, 2017, & 2018  was found >1 % and during 2019,  the antigenemia was found >2 % in  13 districts. The possible gaps, issues and challenges at various levels of the programme implementation have been discussed in the present paper, the rectification of which may lead the state for achieving the goal of elimination of the disease.

7 illus, 4 ref

045139   SHARMA A, RAMESH K L, SHARMA R, VERMA N, MARWAL R, PANDEY A K, RADHAKRISHNAN V S (NCD Div, National Center for Disease Control, Delhi) : Assessment of iodine in salt samples from North Delhi schools. J Commun Dis 2020, 52(3), 49-52.

Iodine is an essential micronutrient required for normal thyroid function, growth, and development. Iodine deficiency can lead to a variety of health and developmental consequences known as Iodine Deficiency Disorders (IDDs). Realizing the magnitude of the problem and to ensure its prevention by 100 % consumption of adequately iodized salt (≥15ppm), National Iodine Deficiency Disorders Control Programme (NIDDCP) is being implemented in India. However, periodic assessment of the salt used is needed to ensure the same. Hence, with the objective of assessment of iodine, household salt samples were collected from students of four schools in North Delhi in October 2019. Awareness programme was also planned among the school children in view of Global Iodine Deficiency Disorders Prevention Day. The iodine content of the salt was estimated by standard iodometric titration method. 10 (10.4 %) salt samples were found to have iodine content < 15 ppm. Reasons for low iodine content in the 10 samples need to be assessed along with the information regarding the type of salt used. Measures need to be taken to ensure 100 % consumption of adequately iodized salt (≥ 15 ppm). Also, such periodic assessment should be undertaken to find out the situation in different schools.

2 illus, 2 tables, 13 ref

043230   ZHENG J, LEI L, ZHENG Q, YAO Y, WU Y, LI Q, GAO L, DU H, XIE Y, HUANG J, TAN W, et al. (Dermatology Dep, Central South Univ, Changsha, Hunan 410013, China, Email: xiaoyun3@csu.edu.cn) : Ozone therapy attenuates NF-κB–mediated local inflammatory response and activation of Th17 cells in treatment for psoriasis. Int J Biol Sci 2020, 16(11), 1833-45.

Ozone therapy has been widely used to treat many skin diseases, including infections, allergic dermatosis, and skin ulcers. However, its efficacy as a treatment for psoriasis is unclear. In this study, we explored the clinical efficacy and the underlying molecular mechanisms of ozone therapy on psoriasis. We found that topical ozone treatment significantly decreased patients’ psoriasis area and severity index (PASI) scores and the expression of psoriasis-associated cytokines in their peripheral blood CD4+ T cells. In the IMQ-induced psoriasis mouse model, topical ozone treatment significantly inhibited the formation of IMQ-induced psoriasis-like lesions and the expression of psoriasis-associated inflammatory factors. High-throughput sequencing confirmed that IMQ-induced activation of toll-like receptor 2 (TLR2)/ nuclear factor-κB (NF-κB) signaling pathway was significantly suppressed in psoriasis-like lesions after topical ozone treatment. Furthermore, the activation of spleen T helper (Th) 17 cells was blocked in the mouse model; this was associated with the downregulation of cytokines and NF-κB pathways upon topical ozone treatment. Ozone therapy can attenuate local inflammatory reactions and the activation of Th17 cells in psoriasis by inhibiting the NF-κB pathway. Our results show that ozone therapy is effective in treating psoriasis. We recommend further evaluations for its clinical applications.

5 illus, 57 ref

043229   WANG H, DENG Z, CHEN J, QI X, PANG L, LIN B, ADIB Y T Y, MIAO N, WANG D, ZHANG Y, et al. (Shanghai Advanced Research Institute, Shanghai 201210, China, Email: lijs@sari.ac.cn) : A novel vehicle-like drug delivery 3D printing scaffold and its applications for a rat femoral bone repairing in vitro and in vivo. Int J Biol Sci 2020, 16(11), 1821-32.

The high surface area ratio and special structure of mesoporous bioactive glass (MBG) endow it with excellent physical adsorption of various drugs without destroying the chemical activity. Silicate 1393 bioactive glass (1393) is famous for its fantastic biodegradability and osteogenesis. Herein, we have built a novel vehicle-like drug delivery 3D printing scaffold with multiplexed drug delivery capacity by coating MBG on the surface of 1393 (1393@MBG). Furthermore, we have applied DEX and BMP-2 on the 1393@MBG scaffold to endow it with antibacterial and osteogenic properties. Results indicated that this 1393@MBG scaffold could effectively load and controlled release BMP-2, DNA and DEX, which can be applied for orthopedic treatment. The in vitro study showed that the DEX loaded 1393@MBG exhibited excellent antibacterial ability, which was evaluated by Staphylococcus aureus (S. aureus), and the BMP-2 loaded 1393@MBG can improve the alkaline phosphatase (ALP) activity and upregulate the expression of osteogenesis-related genes (OCN and RUNX2) of human bone mesenchymal stem cells (hBMSCs). Moreover, the in vivo study further confirmed that the BMP-2 loaded 1393@MBG group showed better osteogenic capacity as compared to that of the 1393 group in a rat femoral defect. Together, these results suggested that the vehicle-like drug delivery 3D printing scaffold 1393@MBG could be a promising candidate for bone repair and relative bone disease treatment.

8 illus, 49 ref