042917   SURI J C, RAMAKRISHNAN N , GHOSHAL AG , BHATTACHARYA D , GOTHI D , DUTTA D , RAVAL G , GOEL M , RAMANATHAN RMPL , SHAIKH S, KHURANA S, SURI T M (JCS Institute of Pulmonary Critical Care and Sleep Medicine/Fortis Flt. Lt. Rajan Dhall Hospital, New Delhi, Email: docjcsuri@gmail.com) : A consensus statement on the sleep medicine practice during the covid-19 pandemic. Indian J Sleep Med 2020, 15(1), 21–5.

The coronavirus disease 2019 (COVID-19) pandemic has become a major public health concern worldwide profoundly impacting various aspects of the practice of sleep medicine. Nonetheless, new onset sleep disturbances including insomnia and circadian rhythm disorders have been reported during this period. Severe COVID-19 disease and obstructive sleep apnea (OSA) may have shared risk factors including advancing age, systemic hypertension, and cardiovascular disease. In light of the unprecedented situation and the lack of definitive evidence on ways to tackle the same, sleep physicians and surgeons from the Indian Sleep Disorders Association have prepared this consensus statement on the practice of sleep medicine in India during the COVID-19 pandemic. This document carries expert recommendations under the following categories: (i) sleep clinics and telemedicine, (ii) home sleep apnea testing (HSAT), (iii) in-laboratory polysomnography (PSG) and positive airway pressure (PAP) titration, and (iv) use of PAP devices in OSA. We hope that it will serve as a reference guide to sleep physicians to restart their practice in a safe manner during the COVID-19 pandemic.

25 ref

041104   ENSHAEI A, MOHAMMADI A, TOOMATARI S B M, YEKTA Z, TOOMATARI S E M, GHASEMI-RAD M, SHAMSPOUR S Z, SARABI Z K, SEPEHRVAND N (General Surgery Dep, Zanjan Univ of Medical Sciences, Zanjan, Iran, Email: bmoosavit@gmail.com) : Diagnostic value of a power Doppler ultrasound-based malignancy index for differentiating malignant and benign solid breast lesions. Indian J Cancer 2020, 57(1), 44-8.

Power Doppler ultrasound (PDUS) can provide useful information regarding the vascularity of breast lesions. The aim of this study was to investigate the diagnostic performance of a new PDUS-driven malignancy index in differentiating between malignant and benign causes of solid breast lesions. Patients with solid breast lesions were enrolled consecutively and evaluated first by PDUS and subsequently by histopathologic assessment after undergoing surgical biopsy. A custom-made software was used to extract data from images for calculating malignancy index formula. A total of 87 patients with solid breast lesions were enrolled. Histopathologic evaluation identified 49 patients as benign and 38 patients as malignant. Malignancy index was significantly higher in the malignant group as compared to benign tumors (6.31 vs 0.30, P < 0.001). Area under the receiver operating characteristics (ROC) curve (AUC) was 0.98 (95 % confidence interval (CI) 0.95–1.00). According to the ROC curve analysis, the cut-off point of 1.23 for malignancy index had a sensitivity and specificity of 94.7 % (95 % CI 82.2–99.3) and 94.0 % (95 % CI 83.1–98.7), respectively. Comparing with the histopathologic evaluation as the gold standard for diagnosing breast lesions, PDUS-driven malignancy index was shown to have a high discriminative performance in identifying malignant lesions with high sensitivity, specificity, and diagnostic accuracy. The noninvasive nature of PDUS is an important advantage that could prevent unnecessary biopsies.

4 illus, 2 tables, 30 ref

044846   DEEPSHIKHA, CHAUKSE A, GUPTA K, SONI M, PATIL G, SINGHAI A (Orthodontics Dep, Rishiraj Coll of Dental Sciences and Research Centre, Bhopal- 462 036, Madhya Pradesh, Email: deep.mandal9@gmail.com) : Torque in Orthodontics. J Orofac Res 2020, 9(3), 32-8.

Torque is a shear-based  moment, a  force obtained from a  twisted spring wire  in  its  effort  to  un-twist  itself  which  causes rotation. In dentition, it pertains to facio-lingual root movement and control. Also, it refers to the amount of twist applied to an arch wire in bracket engagement or activation. Despite the advent of numerous treatment philosophies, appliance systems and torque  prescriptions  and  considerable research  done  in  the  past, torque is  still an enigma. The  key  is  to  understand  not  only how we reach where we are but also to learn how to manage the torque properly, focusing on the technical and biomechanical purposes  that  led  to the change  of  the torque values over  time. The present  review  focuses on application of torque in orthodontics.

12 illus, 1 table, 36 ref

042916   CHATURVEDULA B B , GEORGE A M , MANI N K , DINESH S , SUBRAMANIAN A K (Orthodontics Dep, Saveetha Dental Coll, Chennai, Tamil Nadu, Email: ashwingeorge90@yahoo.com) : Pediatric obstructive sleep apnea vs adult obstructive sleep apnea: An orthodontic perspective. Indian J Sleep Med 2020, 15(1), 17–20.

The literature evidence currently available shows a significant shift toward orthodontics and the orthodontist for management of obstructive sleep apnea (OSA). Individuals with narrow airways and/or craniofacial anomalies may have an increased risk for OSA/hypopnea syndrome, and identification of these at an early stage quite often is done by the orthodontist. The management approach to pediatric OSA is diametrically different than that of adult OSA. This study was performed to determine the upper pharyngeal airway (UPA) space and the lower pharyngeal airway (LPA) space in children of South Indian origin and establish a correlation between airway measurements and growth patterns, if any. Lateral cephalometric radiographs of 100 medically fit children less than 12–13 years were assessed. The cephalograms were digitally analyzed using Facad and categorized into three growth patterns. McNamara airway analysis was used to measure the UPA and LPA space. Obtained results were subject to statistical analysis. Of total 100 subjects, 33 were in group I [horizontal growth pattern (HGP)], 30 in group II [average growth pattern (AGP)], and 37 in group III [vertical growth pattern (VGP)]. There was a significant reduction in both UPA and LPA dimensions in hyperdivergent or vertical growers: 9.56 ± 0.54 mm and 9.03 ± 1.67 mm, respectively. An odd’s ratio of 1.18 was obtained, suggestive of good correlation between Frankfurt mandibular plane angle (FMA) and airway measurements. The impact of OSA on the growth and development of a child may have detrimental effects on health, neuropsychological development, quality of life, and economic potential; therefore, OSA in children should be recognized as a public health problem as in the adult population. Results of this study clearly indicate that there is strong correlation between the pharyngeal space and type of growth pattern in children of South Indian origin.

2 illus, 2 tables, 18 ref

044845   KUMAR T, ARORA N, CHOPRA A, KAUR A (Oral Medicine and Radiology Dep, YIDSR, Yamunanagar, Email: drtarunomr@gmail.com ) : Flexural strength of denture base resin with different powder to liquid ratios: An In vitro study. J Orofac Res 2020, 9(2), 28-31.

Polymethyl methacrylate (PMMA) has been the most commonly usedmaterial for construction of dentures sincemany  decades. Although  it has  many  advantages like  good  esthetics,  accurate  fit,  stability  in  the  oral  environment, however lack of strength of material results in fracture. To evaluate the flexural strength of a heat-cured denture base resins with  different  powder/liquid  (P/L)  ratios. 150  acrylic  samples  were  made  using  high  impact  denture  base  resin (Travelon  Hi).  The  samples  were  divided  into  five  groups  based  on  different  powder/liquid ratios  (g/ml)  with  30  samples  in each group. The P/L ratio in Group 1 (2.2:1) was the manufacturer's recommended ratio and was used as control. In Group 2, the  ratio  was  2.7:1,  in  Group  3,  the  ratio  was  3.2:1,  in  Group  4,  the  ratio  was  1.9:1,  and  Group  5  the ratio  was  1.6:1.  The samples were tested for flexural strength. The values of flexural strength decreased significantly as the P/L ratio was increased  or  decreased  from  the  control  group  with  standard  deviation  4.50,  4.15,  4.11,  4.15  and  5.59  respectively  for  the various groups. Conclusion:For high impact resins, the manufacturer's recommended polymer/monomer mixing ratio should be used to obtain the appropriate strength of the material.

2 illus, 1 table, 13 ref

041103   SURENDRA K L, PATWARI S, AGRAWAL S, CHADAGA H, NAGADI A (Radiology Dep, Columbia Asia Referral Hospital, Bangalore, Karnataka, Email: sramdoc@gmail.com) : Percentage signal intensity recovery: A step ahead of rCBV in DSC MR perfusion imaging for the differentiation of common neoplasms of brain. Indian J Cancer 2020, 57(1), 36-43.

Relative cerebral blood volume (rCBV) and percentage signal recovery (PSR) obtained from T2* dynamic susceptibility contrast magnetic resonance imaging are important parameters for brain tumor assessment. To study the accuracy of PSR in the differentiation of low-grade glioma, high-grade glioma, lymphoma, and metastases particularly in comparison to rCBV. Retrospective observational study. Study included pathologically confirmed cases of 10 low-grade glioma, 22 high-grade glioma, 6 lymphoma, and 12 metastases (Total 50). PSR, relative PSR (rPSR), and rCBV were calculated. Accuracy of these parameters studied statistically using analysis of variance and ROC (Receiver operating characteristic) curves. rCBV was higher in metastases (3.45 ± 2.82) and high-grade glioma (3.47 ± 1.62), whereas was low in lymphoma (1.03 ± 0.74) and low-grade glioma (1.43 ± 0.47) with P value of 0.030. PSR was low in metastases(48 ± 16.18), intermediate in glioma (73.24 ± 6.39 and 88.26 ± 6.05, high and low grade), and high in lymphoma (112.16 ± 10.57) with P value < 0.000. rPSR was higher for lymphoma (1.73 ± 0.57) than high-grade glioma (0.85 ± 0.11) and metastasis (0.69 ± 0.19) with P value <.000. Area under ROC for PSR was greater than rCBV in differentiating metastases from lymphoma (1.00 vs 0.13), high-grade glioma from lymphoma (1.00 vs 0.38), high-grade glioma from metastases (0.89 vs 0.58), and high-grade glioma from low-grade glioma (0.96 vs 0.03) with excellent curve characteristics. F values for PSR and rPSR from ANOVA analysis were 71.47 and 36.77, was better than rCBV (3.84) in differentiating these groups. Percentage of signal recovery shows low recovery values in metastases, intermediate recovery values in glioma, and overshoot in lymphoma. PSR values show lower overlap than rCBV between lymphoma and metastases; and between high grade glioma and metastases. PSR difference is also higher than rCBV between low- and high-grade gliomas. Hence, PSR can potentially help as an additional perfusion parameter in the preoperative differentiation of these tumors.

7 illus, 3 tables, 21 ref

044844   CHOPRA R, MATHUR S, SHARMA N, SACHDEV V, PAL C (Periodontics Dep, I.T.S- Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Email: rahulchopra.dr@gmail.com ) : Role of nitrous oxide inhalation sedation in minor peri odontal surgery – A pilot study. J Orofac Res 2020, 9(2), 24-7.

Alleviation  of  patient’s  anxiety  and  pain  during  periodontal  surgical  procedures  is  a  major concern  in  the  field.  Amongst  the  various  modalities  used  till  date,  inhalation  sedation  has  gained  attention  in  recent  times. Thus  the  present  study  evaluates  the  effectiveness  of  inhalation  sedation  for  better  acceptance  of  minor  periodontal  surgicalprocedures. In  this  split  mouth  study,  patients  with  chronic  periodontitis  were  divided  into  two groups. Gingival curettage  was  performed  under  Local  Anaesthesia  (LA)  in  group  1,  while  in  group  2  gingival  curettage  was  performed  on contra-lateral  site  under  LA  as  well  as  inhalation  sedation.  Saturation  of  Peripheral  Oxygen(SpO₂)  and  pulse  rate  were recorded at baseline, during procedure and after procedure from both the groups. Visual Analogue Scale (VAS) for pain during procedure  was  also  recorded. Pulse  rate  values  decreased  and  improved  SpO₂ values  were  observed  in  group  2 compared to group 1 thereby indicating decreased anxiety levels in the former. Further The VAS scores  for pain experienced during  the  procedure  were  better  in  group  2. In  anxious  patients  undergoing  minor  periodontal  surgical procedures  Nitrous  oxide  inhalation  sedation  can  be  used  for  better  management  of  pain  perception  and  decreasing  anxiety levels.

16 ref

041102   SUCHONSKA B, GAJEWSKA M, MADEJ A, WIELGOS M (Obstetrics and Gynecology Dep, Medical Univ of Warsaw, Pl. Starynkiewicza 1/3, Warszawa, Poland, Email: ma.gajewska@gmail.com) : Cervical intraepithelial neoplasia during pregnancy. Indian J Cancer 2020, 57(1), 31-5.

The aim was to analyze the unaffected course of cervical intraepithelial neoplasia (CIN) in pregnant women and to compare the rates of lesion persistence, progression, and regression. Patients with abnormal cytology included in the study underwent colposcopy, followed by a biopsy of the cervix. At the end of the postpartum period, all patients underwent Pap smear, colposcopy, and endocervical curettage to obtain tissue samples. The findings were compared to the baseline to assess the rates of persistence, regression, and progression of CIN. The study group were 53 pregnant women. CIN was confirmed in 35 (66 %) of them: CIN1 (n = 8, 22.9 %); CIN 2+ (n = 26, 74.3 %); and stage IA1 cervical cancer (n = 1, 2.9 %). At the end of the postpartum period in 50 % cases, there was no change compared to the baseline. Progression was seen in 2.9 % and regression in 47.1 %. A tendency for persistence and spontaneous regression of the lesions was observed. Although in many cases CIN tends to regress spontaneously after delivery, such outcome is not to be expected in all patients. When invasive cervical cancer has been excluded, definitive treatment for cervical dysplasia may be deferred to the postpartum period without any harm to the mother.

2 tables, 13 ref

044843   GUPTA P (Swami Vivekananda Medical Mission, Ambphalla, Jammu, Email: pankajmds2807@gmail.com) : Potential benefits of novel agent Tanshinone in the management of oral submucous fibrosis. J Orofac Res 2020, 9(2), 20-23.

Oral  submucous  fibrosis(OSMF)  is  a  chronic  insidious  disease  characterized  by  difficulties  in  mouth  opening  and  tongue movement, burning sensation and fibrosis of the oral mucosa leading to dietary restrictions, impaired speech, and difficulty in maintaining  oral  health.Several  factors  may  attribute  to  the  disease  that  include  areca  nut  chewing,  genetic  predisposition, immunologic processes,  consumption of  chillies and nutritional deficiencies. Currently many treatment modalities for OSMF are available with varied results such as antioxidants, vitamins, corticosteroids, peripheral vasodilators, enzymes and surgical procedures.  However,  no  single  therapy  can  completely  relieve  the  symptoms  of  OSMF.  Therefore,  identification  of  an effective  treatment  modality  for  OSMF  is  necessary.  The  current review  article  highlights the  potential  benefits  of  the  novelagent tanshinones (TSNs) in the management of OSMF.

2 illus, 16 ref

042915   UTPAT K , DESAI U , JOSHI J M , BHARMAL R N (Pulmonary Medicine Dep, Topiwala National Medical Coll and BYL Nair Hospital, Mumbai, Maharashtra, Email: drjoshijm@gmail.com) : Obesity hypoventilation syndrome: New insights in diagnosis and management. Indian J Sleep Med 2020, 15(1), 9–14.

Obesity hypoventilation syndrome (OHS) is a syndrome characterized by a constellation of obesity [body mass index (BMI) ≥ 30 kg/m2 ], daytime hypercapnia (arterial carbon dioxide tension ≥ 45 mm Hg), and sleep-disordered breathing (SDB), provided other conditions leading to alveolar hypoventilation have been objectively ruled out. Delayed diagnosis can precipitate significant cardiorespiratory morbidity in the form of pulmonary hypertension, heart failure, and coronary disease. Sleep fragmentation, oxidative stress, and obesity-related deconditioning are the predominant mechanisms of the clinical predicament and the poor quality of life. The diagnosis requires a due awareness about its presence and a prone index of suspicion in the suitable clinical context. The diagnosis is conclusively established on basis of a sleep study and arterial blood gases (ABGs). Management requires a holistic approach focusing on weight reduction, lifestyle modification, treatment of comorbidities, and control of the SDB by means of continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) and pulmonary rehabilitation. Opportune therapy facilitates an optimistic prognosis and improves the quality of life.

1 illus, 1 table, 35 ref

041101   YAN M, PAN X-T, CHENG X, LU Y (Hematology and Oncology Dep, Taicang Hospital Affiliated to Suzhou Univ, Taicang, China, Email: yeludoc@163.com) : Characteristics and significance of changes of thrombomodulin and plasma protein C in patients with cancer before and after PICC. Indian J Cancer 2020, 57(1), 27-30.

This study aimed to evaluate the changes and clinical significance of thrombomodulin (TM) and plasma protein C (PC) in patients with cancer before and after peripherally inserted central catheter placement (PICC). The levels of plasma TM and PC in 35 patients with cancer before and after PICC were measured by enzyme-linked immunosorbent assay, and the significance of the differences was analyzed. TM was 3.57 ± 1.01 µg/L at 1 day after catheterization, which was significantly lower than the value of 4.41 ± 1.26 µg/L before catheterization; these values were 4.30 ± 1.81 and 4.73 ± 0.97 µg/L at 30 and 90 days after catheterization, respectively (F = 4.14, P < 0.05). PC was 3.32 ± 1.35 µg/L at 1 day after catheterization, which was significantly lower than the value of 5.32 ± 2.12 µg/L before catheterization; these values were 4.64 ± 2.44 and 5.83 ± 3.14 µg/L at 30 and 90 days after catheterization, respectively (F = 6.28, P < 0.01). There were no significant differences in platelet (PLT) counts, plasma D-D, and coagulation parameters among the four time points before and after catheterization. There was a positive correlation between TM and PC (r = 0.5420, P < 0.01) on day 1 after PICC line insertion. The levels of TM and PC were not related to PLT, plasma D-dimer, or various coagulation parameters. The levels of TM and PC in the patients 1 day after PICC were significantly decreased and showed a positive correlation, but were not related to PLT, plasma D-dimer, or coagulation function.

1 illus, 3 tables, 20 ref

042914   DIPTI G , MOHIT A , ISHANI D (Pulmonary Medicine Dep, ESI-Postgraduate Institute of Medical Sciences and Research, Basai Darapur, New Delhi, Email: diptigothi@gmail.com) : Three narcoleptics with restless leg syndrome. Indian J Sleep Med 2020, 15(1), 5–8.

We are reporting the third largest Indian narcolepsy case series. Among 250 consecutive patients referred to our sleep center for polysomnography (PSG), 3 of them were diagnosed to have narcolepsy with cataplexy (NC). They had history of excessive daytime sleepiness (EDS) and sudden loss of muscle power leading to fall without alteration in consciousness. Their polysomnographies did not have obstructive sleep apnea (OSA). All of them had multiple sleep latency test (MSLT) showing sleep latency of less than 8 minutes and two sleep-onset rapid eye movement period (SOREMP). Since narcolepsy patients commonly have restless leg syndrome (RLS), RLS was studied in detail in them. All our patients with NC had RLS. The patients from Western countries with NC and RLS have normal or high iron level. But the serum iron level was low in two patients and normal in one patient. The management of RLS secondary to iron deficiency is thus an important component of NC in Indian patients. Clinical history is very important for suspicion of narcolepsy. • Multiple sleep latency test is diagnostic of narcolepsy in the current clinical context. • Restless leg syndrome is diagnosed on history alone. Since it occurs commonly with narcolepsy, history of RLS in important in narcolepsy patients. • Iron deficiency can also be causative factor for RLS in narcolepsy in Indian patients though it is reported to be due to narcolepsy itself in Western counterparts. • Modafinil alone is not useful in the treatment of narcolepsy; a tailor-made pharmacological and supportive non-pharmacological approach is essential.

3 tables, 13 ref

041100   AGARWAL J P, PILAR A, MUMMUDI N, GUPTA M, LASKAR S G, PATHAK R S, TIBDEWAL A R, KINHIKAR R, GHADI Y, TANDON S ET AL (Radiation Oncology Dep, Homi Bhabha National Institute, Mumbai, Maharashtra, Email: agarwaljp@tmc.gov.in) : Stereotactic body radiation therapy for medically inoperable early-stage lung cancer: Tata Memorial Hospital perspective and practice recommendations. Indian J Cancer 2020, 57(1), 18-24.

Stereotactic body radiotherapy (SBRT) is now considered the standard treatment for medically inoperable early-stage non-small lung cell cancer (ES-NSCLC). There is a paucity of data related to outcomes with SBRT in ES-NSCLC from the developing countries. We report the early outcomes of ES-NSCLC patients treated with SBRT at our institute. Between 2007 and 2015, 40 consecutive patients with histologically proven ES-NSCLC were treated with SBRT. Median age was 71 years(range: 46–88 years) and median Charlson comorbidity index (CCI) was 3. The majority had stage I (70 %) and 45 % of the tumors were centrally located. The median tumor diameter was 3.8 cm (range: 2–7.6 cm). The mean gross tumor volume was 41 cc (range: 4–139 cc) and the mean planning target volume (PTV) was 141 cc (range: 27–251 cc). Varying dose and fraction (fr) sizes were used depending on tumor location, tumor size, and treatment period. The median biologically effective dose (BED) was 77 Gy₁₀ (range: 77–105 Gy₁₀) for the initial cohort (2007–2012) and 105 Gy₁₀ (range: 77–132 Gy₁₀) for the subsequent cohort (2013–2015). After a median follow-up of 16 months (range: 3–99 months), the 2-year local control (LC), overall survival, and cancer-specific survival (CSS) rates were 94 %, 41 %, and 62 %, respectively. The univariate and multivariate analysis determined CCI >3 and PTV >80.6 cc as significant predictors of worse OS and CSS (P < 0.01). The clinical stage, tumor location, BED, and treatment period (2007–2012 vs. 2013–2015) did not significantly predict any of the outcomes. The most common acute toxicities were skin erythema (10 %), grade 1 esophagitis (8 %), and exacerbation of previous chronic obstructive pulmonary disease (10 %). Grade ≥2 late radiation pneumonitis was seen in 17.5 %. One patient developed a rib fracture. No neurological or vascular complications were seen. SBRT results in excellent local control (LC) and acceptable survival in medically inoperable ES-NSCLC with minimal adverse effects. Charlson comorbidity index and target volume are important prognostic factors and may aid in patient selection.

3 illus, 4 tables, 37 ref

041099   LI J, TONG X, LI H (Oncology Dep, The First People’s Hospital of Jingzhou, Jingzhou, China, Email: 124072851@qq.com) : Efficacy and safety of apatinib monotherapy in elderly patients with advanced metastatic non-small cell lung cancer. Indian J Cancer 2020, 57(1), 13-7.

No effective and definitive chemotherapeutic regimen has been established in patients with non-small cell lung cancer (NSCLC) who failed second-line treatment. The aim of this study was to evaluate apatinib, a VEGFR-2 inhibitor, as monotherapy in elderly patients with advanced metastatic NSCLC. We evaluated the efficacy and safety of apatinib in elderly patients (≥65 years old) with advanced metastatic NSCLC who failed second-line treatment from 2015 to 2016 in Huanggang Central Hospital. Survival analysis was performed by the Kaplan–Meier method. Toxicities were evaluated according to the National Cancer Institute Common Toxicity Criteria version 4.0. Twenty patients were included in the present study. Two patients achieved partial response, and 9 achieved stable disease, representing a response rate of 10 % and a disease control rate of 55 %. Median progression-free survival and overall survival were 2.8 and 6.0 months, respectively. The toxicities associated with apatinib were generally acceptable with a total grade 3/4 toxicity of 50 %. Apatinib is an optional choice as salvage treatment in elderly patients with advanced metastatic NSCLC, with modest efficacy and acceptable toxicities.

2 illus, 3 tables, 20 ref

042913   CHAKRABARTI S , BEHERA D, GUPTA P, VISWESVARAN B, GUPTA N, ISH P (Pulmonary Dep, Vardhman Mahavir Medical Coll and Safdarjung Hospital, New Delhi, Email: drdebasis8@gmail.com) : A study to evaluate sleep-disordered breathing in patients with chronic respiratory failure. Indian J Sleep Med 2020, 15(1), 1–4.

Sleep-disordered breathing (SDB) in patients with chronic respiratory failure (CRF) due to pulmonary disease remains an underrated and undiagnosed entity. A prospective descriptive study in patients with CRF with history suggestive of SDB was carried out using polysomnography (PSG) over a period of 12 months. Thirty patients with the Epworth sleepiness scale greater than 11 and CRF underwent PSG. Ninety percent patients had obstructive sleep apnea (OSA) syndrome using the respiratory disturbance index (RDI) of 5 as cut-off. Mean RDI was 13.4 and mean apnea-hypopnea Index (AHI) was 10.5. Besides, the patients had a poor sleep quality; sleep efficiency was 69.38 ± 14.44 %, sleep onset time was 30.35 ± 24.31 minutes. Wake after sleep onset (WASO) was 107.25 ± 57.71 minutes. Rapid-eye-movement (REM) sleep latency was 126.08 ± 66.61 minutes. N1 was 23.75 ± 14.89, N2 was 45.22 ± 12.69, N3 was 20.02 ± 12.57, and REM sleep period was 11.33 ± 8 minutes. The body mass index (BMI) and Epworth sleepiness score (ESS) had a significant correlation with AHI with p value < 0.005. Sleep-disordered breathing is an important comorbidity in patients with CRF leading to increased morbidity and mortality. A high of suspicion must be kept for the same especially in patients with higher BMI and high ESS. Such patients have a poor quality of sleep besides increased incidence of sleep apnea.

5 tables, 15 ref

041098   AMBEKAR A, RAO V, PAI S A, BINDHU M R, MIDHA D, KAUSHAL S, PATIL S, JAGDALE R, SONI S, MENON S et al (Pathology Dep, Homi Bhabha National Institute, Mumbai, Maharashtra, Email: mensantosh@gmail.com) : Grossing and reporting of testicular tumor specimens: An evidence-based approach. Indian J Cancer 2020, 57(1), 7-12.

The majority of testicular tumors are germ cell tumors (GCTs), but there are numerous other types, making testicular tumors one of the most diverse areas of human pathology, despite their relative rarity. Testicular tumors are usually diagnosed only after radical surgery, as biopsies are not performed. Further management of the patient is dependent on the diagnosis at microscopy, which itself is based on the sections taken at the time of grossing the specimen. Many pathologists often aren’t well versed with guidelines for handling of orchiectomy specimens and for microscopy. This article discusses, in detail, the approach to grossing of a testicular tumour specimen and elaborates of the reasons as to why we do what we do at the initial “cut-up”. It explains the logic behind the reporting guidelines for testicular tumors and offer a clinical primer to the pathologist as to why we do what we do while grossing testicular tumor specimens.

2 illus, 2 tables, 22 ref

044842   MODGI C, AWARI K, RAJANI P, PALASKAR J, JADHAV P, VINAY V (Prosthodontics Dep, Yogita Dental Coll and Hospital, Khed- –415709, Maharashtra, Email: dr.chetanmodgi@gmail.com ) : Radiological examination of impact of edentulismon the articular eminence inclination using orthopantomogram. J Orofac Res 2020, 9(1), 1-5.

Occlusion  is  an  important  component  of  the  temporomandibular  joint  (TMJ).  Little  is  known  about  the association  between  missing  teeth  and  TMJ  changes.  The  objective  of  this  study  was  to  compare  inclination  of  the  articular eminence (AE) between dentulous and edentulous arch. A total of 500 patients were divided into group A (dentulous) and group B (edentulous). Group B was further divided into subgroups based on years of edentulism into group 1, group 2 and group  3.  On  patient’s  panoramic  radiograph,  the  sagittal  outline  of  the  AE  and  glenoid  fossa  were  traced,  and  a  sagittal condylar path inclination was constructed by joining the crest of the glenoid fossa and the crest of AE. This was then related to the constructed Frankfurt’s horizontal plane to determine the inclination of AE. The mean measured value for the AE inclination was varying with all the groups. The mean and standard deviation value (combining right & left) for Group A was 42.8+/-6.83 degrees, Group B was 30.45+/-6.55 degrees, Group 1 was 30.2+/-7.23 degrees, Group 2 was 31.2+/-4.75 degrees, and Group  3  was  27.5+/-9.3  degrees. Significant  differences  were  found  in  AE  inclination  between  the dentulous  and  edentulous groups (P  <0.05).  A  significant  difference  in  the  AE  inclination  was  found  between  dentulous  and  edentulous groups as well as with increase in the period of edentulism.

1 illus, 1 table, 14 ref

042897   SINGH J, AGGARWAL H K, DAHIYA S, PAHUJA T, KULKARNI V, MITTAL S, AGARWAL A (Medicine Dep, Pt. BD Sharma PGIMS Rohtak, Haryana) : To study the causes of hospital admission of chronic kidney disease patients in a tertiary care centre. Indian J Sci Res 2020, 11(1), 35-9.

There is a huge load of chronic kidney disease (CKD) patients in India who are at risk of premature morbidity and mortality coupled with inadequate public health infrastructure. Adult patients of CKD admitted in our institute and who gave written informed consent were included in the study. Mean age of subjects in our study was 46.16 ± 15.03 years with 63 % of them in 31-60 year age bracket and with male predominance (66 %). The etiological factors of CKD were hypertension (66 %), diabetes mellitus (22 %), glomerulonephritis (14 %), obstructive uropathy (11 %), and autosomal dominant polycystic kidney disease (5 %), with some patients having multiple factors. The common factors associated with hospital admission were severe anemia (50 %), metabolic and electrolyte abnormalities (42 %), uncontrolled hypertension (25 %), Sepsis/ infection (23 %) and cardiovascular disease (20 %). CKD is associated with a wide range of complications like hypertension, anemia, cardiovascular disease, sepsis and poor quality of life. Therapeutic interventions like early detection and prevention of CKD especially in high risk groups like type 2 diabetes, hypertension and age >60 years will help prevent the large scale morbidity and mortality.

2 tables, 24 ref

042896   PANDEY P, VARMA H S, PANDEY K K, PEEPRA D (Orthopaedics Dep, Traumatology and Rehabilitation, Jabalpur, M.P.) : To evaluate the outcome of subtrochanteric femoral fractures fixation using contralateral reversed distal femoral locking plate-prospective and single centric study. Indian J Sci Res 2020, 11(1), 27-34.

The two primary options for treatment of sub trochanteric fractures are intramedullary fixation and extra medullary fixation. However as several complications may be encountered with all these methods, there is still no ideal treatment. In our study we intend to present a reversed (upside down) contralateral (plate of opposite limb) distal femoral locking compression plate (DFLCP) as a biomechanically sound alternative extra medullary device for this fracture fixation. 30 (21 male and 9 female) patients with mean age 30 year of sub trochanteric femoral fracture were fixed with Contralateral Reversed Distal Femoral Locking Plate. Outcome was assessed by using Harris hip score and VAS score. Mean time of union was 13 wk. Mean Harris hip score and VAS Score at final follow up was 88.3 and 1.27 respectively. In our study one patient had plate bending and two patients had screw breakdown which leads to varus deformity at fracture site. Our study showed that reversed contralateral DFLCP, when used for fixation of the subtrochanteric fractures shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices.

1 illus, 24 ref

042894   LAMBA S, RAWAL M, KAUR R D, GARG S (Paediatrics Dep, Bhagat Phool Singh Government Medical Coll for Women, Sonepat, Haryana) : Prospective study of vitamin d in critically ill patients and its association with mortality. Indian J Sci Res 2020, 11(1), 17-22.

A potential role of vitamin D in immune response modulation was first identified with the discovery of vitamin D receptors in activated human inflammatory cells. Both vitamin D deficiency and insufficiency are prevalent worldwide. Neither condition poses an immediate risk in otherwise healthy individuals. However, vitamin D deficiency or insufficiency may influence outcomes in critically ill patients. Analysis of samples collected from 60 patients admitted to a medical/surgical ICU in a tertiary care hospital was done. Data collected included the underlying disease, basic hematological and biochemical blood test results, APACHE II scores, SOFA scores and serum 25-hydroxyvitamin D₃ levels. A total of patients 49 (81.6 %) had insufficient or deficient level of vitamin D. Mortality was higher in patients who had APACHE II scores, SOFA scores and lactate levels on admission and had more difficult clinical courses with more organ dysfunction (p < 0.05). Also, they had lower ionized calcium levels, lower glomerular filtration rates and higher levels of parathyroid hormone. Positive findings in prospective studies may establish 25(OH) D₃ as an important and modifiable risk factor for ICU mortality. There is no doubt that Vitamin D deficiency is commonly seen in intensive care patients. Although it is not an independent decisive factor for mortality, it might be related to worse clinical status at ICU admission. The effect of vitamin D replacement on mortality is controversial, but the APACHE II score and number of organs dysfunctional are still important parameters for increased mortality.

5 tables, 20 ref

042888   SHEKINAH R L, SAHEB S K M, MRUNALINI P (Anaesthesiology Dep, NRI Academy of Medical Sciences, Guntur, Andhra Pradesh) : Risk assessment and anaesthesia implications in a case of hypertrophic obstructive cardiomyopathy for non cardiac surgery. Indian J Sci Res 2020, 10(2), 133-5.

Hypertrophic Cardiomyopathy with or without left ventricular outflow tract obstruction is characterised by Asymmetric hypertrophy of the interventricular septum causing intermittent obstruction of the left venticular out flow tract. Because Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease it may present to the anaesthesiologist more often than anticipated. Surgery and Anesthesia often complicate the perioperative outcome of these patients. Aim of this case report is to highlight the importance of perioperative risk assessment of the patient and proper understanding of the pathophysiology of the disease for optimal anaesthetic management and postoperative outcome. A 62 yr old male who is a known case of Hypertrophic Obstructive Cardiomyopathy incidently diagnosed 9 yrs back had undergone ORIF with plating of left fibula following a trauma 5 yrs back under spinal anaesthesia. He has now been posted for cannulated cancellous screw removal.

1 illus, 5 ref

042885   HUSEN N (Pathology Dep, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh) : Haematological manifestations in vitamin b₁₂ deficiency casessingle centre study in North India. Indian J Sci Res 2020, 10(2), 115-9.

In this study vitamin B₁₂ deficiency is correlated with the haematological manifestations which are common in the human population of the northern parts of India. The importance of haematological manifestations in relation to vitamin B₁₂ deficiency is not recorded in the literature so far. Estimation of the clinical profile of vitamin B₁₂ deficiency in the human population of north region of India and to stabilized association/relationship between hematologic manifestations with vitamin B₁₂ deficiency. All symptomatic patients of pernicious anemia requiring blood transfusions and vitamin B₁₂ who had either raised their mean corpuscular volume (MCV) or bicytopenia/pancytopenia on complete blood count were symptomatic screened for vitamin B₁₂ deficiency. A total of 110 cases and 110 controls were diagnosed those have anemia records. Total 110 (50.0 %) were males and 110 (50 %) were females of all the age groups. The average mean age was found 35.5±9.7. Vitamin B₁₂ deficiency was recorded in 120 (70 %) patients. This deficiency was severe in 40 (3.12 %) cases and moderate Vitamin B₁₂ deficiency was recorded in 10 (12.5 %) cases. In the present study vitamin B₁₂ deficiency has found a strong co-relation with the as pernicious anemia. This study has clear indications to evaluate to B₁₂ status in cases manifesting with such features especially in cases.

3 tables, 23 ref

042884   PURI M, TATHE G, BATHE A (GMC, Gondia, Maharashtra) : Assessment of anthropometric measurement of under 5 ages of children in tribal area and its correlation with sociodemographic factors. Indian J Sci Res 2020, 10(2), 107-13.

Malnutrition is one of the leading causes of morbidity and mortality among children under the age of 5 years in low and middle income countries like India. Children with severe acute malnutrition (SAM) are more likely to die than children without malnutrition. The anthropometric measurements of under 5 children have not been clearly assessed in Indian scenario. The objectives of study were to assess the anthropometric measurement, proportion of malnutrition among children aged 0-60 months and its correlation with socio-demographic factors with special reference to tribal population, in the Gondia district in Maharashtra. This study was a hospital-based observational study, conducted in GMC, Gondia. The WHO growth standards were used to calculate conventional indices of malnutrition (underweight, stunting and wasting) and composite index of anthropometric failure (CIAF). Univariate, bivariate and multiple logistic regression analysis was also used to find out the correlates of malnutrition. The participants were universal sample of 72 children (9 tribal and 63 non-tribals) was included in this study selected from immunization OPD of tertiary care centre over the period of 2 months. Overall, the proportion of malnourished children (MAM) under the age of 5 years was 73.6 % and SAM was 52.8 %. The current study states that the proportion of underweight, stunting and wasting was 54.17 %, 36.11 % and 45.8 % respectively. The factors as occupation of father, birth weight and weight gain during pregnancy were significantly associated with malnourished children. On multivariate regression, only birth weight was confirmed as statistically significant factor (P=0.001). When tribal and nontribal children are compared, factors as age of mother at first delivery, education, income and Socio-economic status were found to be statistically significantly related to tribal population. Hence, it can be said that major cause for malnutrition in children was lower income group and early age of mother at first delivery due to cultural practices. A multi-sector approach is essential to address malnutrition in this part. There is a need for further studies not only focusing on anthropometry but also large scale multicentric studies for proper availability of data.

3 tables, 26 ref

042883   GUNASUNDARI P, SATHYAMOORTHY M, PAUL C M P, SELVI K, EVANGELINE I P, KIRAN A, KUMAR S K (Pediatrics Dep, ACS Medical Coll & Hospital (Dr. M.G.R. Educational and Research Institute), Chennai, Tamilnadu) : A study on intravenous odansetron in children with gastroenteritis. Indian J Sci Res 2020, 10(2), 103-5.

To evaluate the efficacy of odansetron for the treatment of vomiting and thus reducing the need for hospital stay and intravenous rehydration in children with gastroenteritis.

1 illus, 3 tables, 12 ref

042880   GUNASUNDARI P, SATHYAMOORTHY M, PAUL C M P, VICTOR K, EVANGELINE I P, KIRAN A, KUMAR S K (Pediatrics Dep, ACS Medical Coll & Hospital (Dr. M.G.R. Educational and Research Institute), Chennai, Tamilnadu) : A cross sectional study on the thyroid profile of neonates born to hypothyroid mothers in a tertiary care centre in Chennai. Indian J Sci Res 2020, 10(2), 81-3.

Retrospective study was done to estimate the prevalence of congenital hypothyroidism (CH) among new born babies born to hypothyroid mothers on thyroxine in ACS Medical College & Hospital. Datas were collected from the case sheets in medical record department. The prevalence of CH was 1 in 2500 live births with no gender difference.

1 illus, 4 tables, 9 ref

042877   KUMAR A, BANSAL A, AHMED M, HASAN M (Pathology Dep, Varun Arjun Medical Coll, Shahjahanpur, Uttar Pradesh) : Sessile serrated adenoma of appendix: Is fecolith a cause?. Indian J Sci Res 2020, 10(2), 65-9.

Sessile serrated adenoma (SSA) originally conceptualized in 1990 shared his to pathological features of both hyper plastic polyps and adenoma. Traditionally sessile serrated adenomas were reported in colon, review of other similar lesions found that serrated adenomas may occur in appendix. The importance of recognizing these underreported proliferations is their link to colon carcinogenesis. The importance of extensive sampling and total processing of the appendectomy specimen, especially in patients greater than 30 years is of utmost importance in diagnosing sessile serrated adenomas. The present study was designed to study the association between acute appendicitis due to fecolith and sessile serrated adenomas. We entirely submitted 246 consecutive appendectomy specimens, with clinical diagnoses of acute appendicitis, at two institutions (Varun Arjun Medical College, (VAMC) and Jawahar Lal Nehru Medical College (JNMC), for a period of one year, from 2018-2019. Statistical analysis was done using Fischer 2 tailed exact test. Fecolith was seen in 142 cases of acute appendicitis and was more prevalent in JNMC (47.9 %, 46/96) as compared to VAMC (43 %, 65/150). The incidence of SSA in absence of fecolith was 5.8 % when compared with presence of fecolith (19.7 %). This association was statistically significant (P=.002, two-tailed). The study shows that SSA is strongly associated with fecolith related acute appendicitis, which may be a contributing factor in development of these proliferations. The role of meat rich, fiber lacking diet is a known factor for fecolith formation needs further evaluation in pathogenesis of SSA.

3 illus, 2 tables, 18 ref

042876   BALA N, WAKHLOO A, TABASSUM N, KAUR N, ANAND S (Obstetrics and Gynaecology Dep, GMC Jammu, Jummu & Kashmir) : Study of perinataloutcome in patients presenting with first trimester bleeding. Indian J Sci Res 2020, 10(2), 55-64.

Fist trimester is very crucial period of pregnancy having high risks of pregnancy losses. The occurrence of first trimester bleeding is approximately 25 % of all pregnancies. Vaginal bleeding in first trimester is a common complaint. Among these 200 patients, 19 % patients aborted. Ectopic and molar pregnancy was seen in 5 % and 1.5 % patients respectively. Healthy fetus was present in 74.5 % cases. Among abortion, missed abortion was seen in 9 %, inevitable abortion in 2 %, incomplete abortion in 7.5 %, and complete abortion occurred in 0.5 % cases. Fetal outcome included LBW (28.19 %), preterm delivery (21.48 %), IUGR (13.42 %), fetal distress (11.41 %), MSAF (7.38 %), malpresentation (2.01 %), congenital anomaly (1.34 %), IUD and still birth (0.67 % each).Neonatal outcome included NICU admission (12.08 %), birth asphyxia (5.36 %), RDS (4.03 %), neonatal sepsis and neonatal jaundice (1.34 % each). We concluded that patients with first trimester bleeding are at increased risk for spontaneous pregnancy loss and adverse fetal outcomes like preterm, intrauterine growth restriction, low birth weight, fetal distress, NICU admission and rarely congenital malformation where as there was no significant increase in perinatal mortality. So by knowing the etiology and fetal outcome of first trimester vaginal bleeding, we can predict the complications which will occur in later pregnancy and manage it properly.

20 tables, 29 ref

042866   KATHIRVELU C, MALINE A S , SIVASANKARI S (Entomology Dep, Annamalai Univ, Chidambaram - 608 002, TN, Email: ckathirveluau@gmail.com) : Fumigant effect of essential oils against pulse beetle (Callosobruchus chinensis L.) and rice weevil (Sitophilus oryzae L.) in stored products. Indian J Sci Technol 2020, 13(25), 2575–81.

To develop a method to replace the usage of synthetic fumigants in stored product pest management. For this purpose, we employed four plant based essential oils namely, Lantana camara (Lantana) oil, Citronella nardus (Citronella) oil, Cinnamomum zeylanicum (Cinnamon) oil and Trachyspermmum copicum (Ajwain) oil and evaluated against pulse beetle, Callosobruchus chinensis L., and rice weevil, Sitophilus oryzae L., for their fumigant toxicity and the weight loss caused by them. The oils of Lantana and Citronella were extracted from leaves, Cinnamon and Ajwain from barks and seeds respectively. Among the essential oils tested for fumigant toxicity, C. zeylanicum performed better with Lethal Concentration (LC50) of 23.16 and 21.91µl in minimal period of exposure i.e. at 12 h of treatment and found effective against adults of test insects viz., C. chinensis, and S. oryzae respectively. During the maximum period of exposure i.e. at 72 h. the fumigation efficacy of T. copicum was noticed to be the highest (3.43 µl) against adults of C. chinensis whereas C. zeylanicum was found better against S. oryzae (6.19 µl). The minimum loss of pulse grains was observed in C. zeylanicum treated at 60 % of 24 h LC50 , with 7.41 % weight loss. The minimum weight loss was noticed in C. zeylanicum about 60 % of 24 h LC50 with 9.68 per cent against S. oryzae. The fumigant toxicity bioassay revealed that as the exposure period increases, mortality of test insects also found increased i.e. exposure period directly proportional to mortality of insects.

3 tables, 29 ref

041042   SAINI K S, KAUR J, SINGH T, CHAHAL T S, MANHAS S S (Punjab Agricultural Univ, Jalandhar, Punjab - 144 303, Email: sainiks@pau.edu) : Productivity, economics and energetics of potato (Solanum tuberosum)-based systems as an alternative to rice (Oryza sativa)–wheat (Triticum aestivum) in Doaba region of Punjab. Indian J Agron 2020, 65(1), 125-9.

A field experiment was conducted on potato (Solanum tuberosum L.)-based cropping systems as an alternate to rice (Oryza sativa L.)–wheat (Triticum aestivum L.) cropping system at Jallowal (Jalandhar), Punjab, during 2016–17. Eight cropping systems, viz. potato–spring maize (Zea mays L.)–basmati rice, potato (Solanum tubersoum L.)–okra [Abelmoschus esculentus (L.) Moench]–basmati rice, potato–bottle gourd [Lagenaria siceraria (Molina) Standl.]–maize, potato–bitter gourd (Momordica charantia L.)–maize, potato–onion (Allium cepa L.)– maize, potato–summer greengram [Vigna radiata (L.) R. Wilezek]–maize, potato–summer greengram–basmati rice and rice–wheat, were laid out in randomized complete-block design with 3 replications. Rice-equivalent yield was higher in potato–onion–maize system (32.4 t/ha), being significantly higher than all the other systems. Potato–onion–maize system also resulted in the highest net returns of ` 293,000/ha followed by potato–bitter gourd–maize (`260,000/ha) and potato–okra–basmati rice (`249,000/ha) compared to rice–wheat systems (`113,000/ha). The highest benefit: cost ratio of 1.32 was obtained in potato–onion–maize system. The production efficiency was also recorded higher in the same system. Both, energy-use efficiency and specific energy were the highest in rice– wheat system, which was statistically at par with potato–summer greengram–maize and potato–spring maize– basmati rice.

5 tables, 12 ref

042840   Alshehri A S (Psychology Dep, King Khalid Univ, Saudi Arabia, Email: asaalshehri@kku.ed.sa) : The impact of perfectionism trait on anxiety and academic procrastination among international Saudi Arabian students studying in United States Universities. Indian J Sci Technol 2020, 13(23), 2282–93.

To investigate the relationship of perfectionist personality traits to anxiety traits and academic procrastination. Also to examine the possibility of predicting trait anxiety and academic procrastination by measuring perfectionist personality traits. The study followed the survey methodology. The sample consisted of 521 Saudi students studying in United States universities during the 2017-2018 academic year. Students participants were invited to complete an electronic survey that incorporated the: 1) Multidimensional Perfectionism Scale; 2) State-Trait Anxiety Inventory - Form Y; and 3) Tuckman Procrastination Scale. Regression analysis was utilized for study findings. The results of the study showed a significant positive linear relationship among trait anxiety with the three perfectionism dimensions: socially-prescribed perfectionism, self-oriented perfectionism, and other-oriented perfectionism. The findings also revealed a significant positive correlation between self-oriented perfectionism and academic procrastination. This study is the first of its kind to investigate the perfectionist trait and its relationship to academic procrastination and anxiety among Saudi students studying in the US.

6 tables, 45 ref

044816   GUL-E-NAZISH, SHAHZAD M, ALI L, JOHNSON N (Pharmacology Dep, Health Sciences Univ, Lahore, Pakistan) : Effectiveness of Azadirachta indica bark extract in periodontitis induced rabbit model. J Pharmacogn Phytochem 2020, 9(2), 15-21.

Azadirachta indica twigs have been used to maintain healthy periodontium for many years in Pakistan and India. Leaves and fruit oil have also been used to treat and as a prophylactic agent for periodontitis in the form toothpastes, mouthwashes, oral chips. However, there is lack of scientific data for its efficacy in this particular condition. The present study was designed to see the effectiveness of Azadirachta indica bark extract in rabbit model of experimentally induced periodontitis. Experimental procedures: 24 rabbits were distributed into four groups. Group A served as healthy control, Group B, C and D were induced with periodontitis. Group C and D were treated with Azadirachta indica bark extract and amoxicillin, respectively. Parameters recorded were periodontal index, total leukocyte count in blood and gingival crevicular fluid, erythrocyte sedimentation rate and levels of IL- 6 in serum and gingival crevicular fluid. The treatment with Azadirachta indica bark extract and amoxicillin significantly reduced inflammation. There was a significant reduction in bleeding on probing, plaque accumulation, probing pocket depth, total leukocyte count in gingival crevicular fluid and blood; also levels of IL 6 in gingival crevicular fluid were reduced in both treatment groups. Results indicate that Neem (Azadirachta indica) bark extract possesses the capacity to improve periodontal inflammation

5 illus, 3 tables, 23 ref

044778   ELFOULY A E, ISMAIL M A, KAMAL H M, AHMED S A, FIALA L E (Family Medicine Dep, Suez Canal Univ, Egypt) : Safety of an intervention with nigella sativa on adult patients with dyslipidemia attending family practice clinic-Suez Canal University Hospital, Ismailia, Egypt. J Med Plants Stud 2020, 8(1), 52-7.

Dyslipidemia is responsible for the development of atherosclerotic cardiovascular diseases as ischemic heart diseases. Although statins is the mainstay therapy for dyslipidemia, it has many side effects such as muscle weakness, aching pain, tenderness, cramps. Nigella sativa is a herb with many pharmaceutical potential. A lot of animal studies have already been done to determine the various activities of N. sativa oil on different components of the metabolic syndrome. Objectives: Determine safety of Nigella Sativa on clinical and biochemical parameters among patients with dyslipidemia. The study is double blinded trial that was conducted in Family practice clinic, 19 patients were included in intervention group and 19 in control. Intervention group received their routine therapy for dyslipidemia (statins) in addition to crushed nigella sativa seeds daily for 6 weeks. Control group received their routine in addition to placebo. The baseline blood pressure, fasting blood sugar, liver transaminases and serum creatinine were measured before the trial and repeated after 6 weeks. The patients in the intervention group had significantly lower creatinine level (p=0.037) after intervention. B.P. fasting blood sugar, liver transaminases and serum creatinine measures between both intervention and control groups were not statistically significant after adding nigella sativa. Favorable impact of N. sativa was noted on almost all measures in intervention group but were not statistically significant when compared to control group. Adding N. sativa to therapy for dyslipidemia is safe on B.P., blood sugar, liver and kidney function tests.

10 tables, 16 ref

044769   BAISHYA A, DAS B, SARMA D (Govt. Ayurvedic Coll, Guwahati, Assam) : A detail pharmacognostic, physicochemical and phytochemical study of Satyadi yoga. J Med Plants Stud 2020, 8(1), 7-10.

Standardization of a compound Ayurvedic formulation is a critical and essential issue to be considered in assuring the therapeutic efficacy and safety and to rationalize their use in the health care. Satyadi yoga churna is a polyherbal Ayurvedic formulation which is mentioned in the classical book named Yogaratnakar at 17 th century. Satyadi yoga is a polyherbal medicine consisting of dried rhizhomes of Sati (Hedychium spicatum Ham) and Sunthi (Zingiber officinale),dried fruits of Haritaki (Terminalia chebula),dried roots and rhizhome of Vacha (Acorus calamus) and Ativisha (Aconitum heterophyllum),dried stem of Guduchi (Tinospora cordifolia) and dried bark of Devadaru (Cedrus deodara) thats are native to the Indian subcontinent. It is prescribed for the treatment of amavata with special reference to rheumatoid arthritis which is mentioned in the classical textbook of Yogaratnakar. The rising use of herbal drug by the human is forcing the driving force to evaluate the health claim of these agents and to develop standards of quality, purity, safety and efficacy of the drug. Mostly herbal drugs are effective but due to adulteration and lack of standardization, the effectiveness of the herbal drug is decreased. So there is need of development of standardization parameters. In this standardization of the Ayurvedic drug the physical, chemical and analytical parameters are carried out. It assures the quality, purity and safety of herbal drug.

8 illus, 2 tables, 11 ref

044767   MANI M R, JOHNSON A R, JOSEPH J, JYOTHIS S, JOSEPH L, CLEETUS R P, SULEKHA T (Community Health Dep, St. John’s Medical Coll, Bangalore- 34, Karnataka, Email: nakulsulekha13@gmail.com) : Knowledge regarding pregnancy and child care among mothers in possession of mother and child protection card in a Rural Maternity Hospital in Karnataka. J Med Sci Health 2020, 6(2), 36-42.

The mother and child protection card (MCP card) have been developed as a tool to learn, understand, and follow positive practices for achieving good health of pregnant women, young mothers, and children. The objectives of the study were to assess the level of knowledge regarding pregnancy and child health care among mothers in possession of MCP card. This was a cross-sectional study done among pregnant and post-natal mothers availing health services in a rural maternity hospital in Karnataka, using a structured interview schedule, capturing socio-demographic details and knowledge regarding pregnancy care, danger signs, infant care, institutional delivery, benefit schemes, and family planning based on information provided by MCP card. Each correct response was awarded a score of one, giving a maximum possible knowledge score of 71. Independent t-test, one-way ANOVA, and Pearson’s correlation were used to find association between total knowledge score and different socio-demographic variables. Of the 226 participants, all had MCP card, but only 13.3 % mothers had read the MCP card. The overall mean knowledge score of the participants was 19.6 ± 5.5 and median knowledge score was 19.0 (IQR=16, 23). All the women in our study were found to have poor knowledge as none of the subjects had a knowledge score of 35 or above. Higher socio-economic status of the mother was significantly associated with higher mean knowledge score regarding pregnancy and child care (P < 0.0001). The mean knowledge score was higher among women who said that their primary source was village level workers (ASHA/AWW/ ANM), media, and self-reading the MCP card (P < 0.0001), as compared to doctor. This study has shown that in spite of MCP card having being developed as a tool for health education, maternal awareness remains poor among the mothers in possession of an MCP card. There is a need for re-enforcing among village level and primary healthcare workers that the MCP is an excellent resource for transferring knowledge regarding pregnancy and child care to rural mothers.

7 tables, 20 ref

044766   NARASIPURAM A, CHANDRAPUTULA M, FATIMA H (Anatomy Dep, Apollo Medical Coll, Hyderabad, Telangana, Email: drarchanaajay@gmail.com) : Anatomic study of number of pulmonary veins draining into the left atrium and their variations. J Med Sci Health 2020, 6(2), 43-5.

Pulmonary veins originate from the alveolar capillary plexus and carry oxygenated blood to the left atrium. The fibrous pericardium is perforated by the pulmonary veins and they drain separately in the posterosuperior aspect of the left atrium as the right and left pulmonary veins. From the dorsal atrial wall, primordial vein arises as an outgrowth just to the left of the septum primum. The primordial pulmonary vein and its main branches are incorporated into the wall of the left atrium as the atrium expands and results in the formation of four pulmonary veins. The knowledge of the variations in the pulmonary veins is helpful for endoscopists and also for the surgeons operating for arrhythmias. The aim of the study was to assess the number of pulmonary veins opening into the left atrium and their variations. The present study was conducted in the Department of Anatomy, Apollo Medical College, Hyderabad. This study is an observational study; the study material comprised 30 embalmed cadaveric heart specimens of unknown sex. Old and damaged cadaveric heart specimens were excluded from the study. The number of pulmonary veins opening into the left atrium and their variations was observed. The percentage of variations on the right and left side was calculated. In the present study, out of 30 heart specimens which were used for the study, four pulmonary veins draining into the left atrium were observed in 26 heart specimens which are a normal pattern. A variation in the number of pulmonary veins opening into the left atrium was observed in only four heart specimens which were of a different pattern. The variation in the number of pulmonary veins in all the four heart specimens was on the right side. Knowledge about the variations in number of pulmonary veins is helpful as pulmonary veins are an important source of ectopic atrial electrical activity and can be useful for cardiologists, radiologists, and cardiothoracic surgeons in radiofrequency ablation surgeries.

3 illus, 10 ref

044764   SHARMA R, DHATTARWAL S K (Forensic Medicine Dep, Government Medical Coll, Nuh, Haryana, Email: surwar10@gmail.com) : Estimation of stature from ring finger length in Haryanavi population: An anthropometric study. J Med Sci Health 2020, 6(1), 1-4.

Stature helps to determine a person’s identity. In dead and mutilated bodies, height can be estimated from body parameters using a regression equation or multiplication factor. The present study was conducted to find the multiplication factor between percutaneous ring finger length (RFL) and stature in the Haryana region, for which 145 medical students (80 males and 65 females) of Post Graduate Institute of Medical Sciences, Rohtak, Haryana, were measured. The correlation coefficient between height and RFL was found to be positive. Stature can be accurately estimated from RFL using simple regression equation or multiplication factor. The regression equation determined for male was Height = 1.798 × RFL + 158.6 and for female was Height = 0.919 × RFL + 152.3. Conclusion: Our study has a great importance to estimate stature from RFL among Haryana region from the anatomical and medicolegal point of view.

1 illus, 1 table, 13 ref

044763   DEY A, SHARMA A (Pathology Dep, ESIC Medical Coll and ESIC Hospital, Kolkata, West Bengal, Email: anirunad@gmail.com) : Computed topographic-guided core needle biopsy of lung masses: Our experience at a diagnostic center in western India. J Med Sci Health 2020, 6(1), 5-11.

Lung carcinomas are one of the most common malignancies and major cause of cancer-related deaths worldwide. India also shares a great burden of this disease. Computed topography (CT)-guided fine-needle aspiration cytology of lung masses is a widely used and simple diagnostic tool which is being replaced increasingly by CT-guided core biopsies. This study shows our experience at a diagnostic center.  This was a prospective study conducted over a period of 1 year from April 2018 to April 2019 and consisted of 107 cases. After taking detailed history, CT-guided core biopsies were obtained using coaxial needles of 17–19 gauge and biopsy needles of 18–20 gauge. The tissues were then examined histopathologically and the results were noted. Out of the 107 patients, 81.3 % were male and 18.7 % were female. The age range of patients was from 33 to 92 years, with mean age being 63.7 years. Majority of the lesions were located in the right lung (57.9 %). The most common histopathological diagnosis was squamous cell carcinoma 74.7 %, followed by small cell carcinoma (12.1 %) and adenocarcinoma (9.3 %), Hodgkin lymphoma (1.8 %), malignant mesothelioma (0.9 %), and angiosarcoma (0.9 %). This study shows our experience regarding lung malignancies in a diagnostic center in Western India. The epidemiology of lung malignancies seen across the Indian subcontinent reflects in our study. CT-guided core needle biopsies though less invasive may cause complications in some patients. Hence, utmost care should be taken during the procedure to ensure patient safety.

14 illus, 1 table, 26 ref

044758   KUMAWAT N, SHROTRIYA A K, HEIGRUJAM M S, PATRO K, KUMAR S, BANSAL A K, MUNJAL R K ANAND A K (Radiation Oncology Dep, Max Super Speciality Hospital, New Delhi- 110 017, Email: ninunaveen@gmail.com) : Development and validation of a matlab software program for decoding the treatment errors in real-time position managementtm gating generated breathing trace. J Med Phys 2020, 45(1), 16-23.

The Real-time Position ManagementTM (RPM)is used as a motion management tool to reduce normal tissue complication. However, no commercial software is available to quantify the “beam‑on” errors in RPM‑generated breathing traces. This study aimed to develop and validate an in‑house‑coded MATLAB program to quantify the “beam‑on” errors in the breathing trace. A graphical user interface (GUI) was developed using MATLAB(Matrix Laboratory Ra2016) software. The GUI was validated using two phantoms(Varian‑gated phantom and Brainlab ET gating phantom) with three regular motion profiles. Treatment time delay was calculated using regular sinusoidal motion profile. Ten patient’s irregular breathing profiles were also analyzed using this GUI. The beam‑on comparison between the recorded reference trace and irradiated trace profile was done in two ways: (1) beam‑on time error and (2) beam‑on displacement error. These errors were ≤1.5 % with no statistical difference for phase‑ and amplitude‑based treatments. The predicated amplitude levels of reference phase‑based profiles, and the actual amplitude levels of amplitude‑based irradiated profiles were almost equal. The average treatment time delay was 47 ± 0.003 ms. The irregular breathing profile analysis showed that the amplitude‑based gating treatment was more accurate than phase based.  The developed GUI gave the same and acceptable results for all regular profiles. These errors were due to the lag time of the linear accelerator with gating treatment. This program can be used as to quantifying the intrafraction “beam‑on” errors in breathing trace with both mode of gating techniques for irregular breathing trace, and in addition, it is capable to convert phase‑based gating parameters to amplitude‑based gating parameters for treatment.

6 illus, 6 tables, 12 ref

044756   D’SOUZA H, WEATHERBURN H, DWIVEDI A, GANESH T (Radiation Oncology Dep, Washington Adventist Hospital, MD, USA, Email: harold_1966@yahoo.com) : Volumetric arc therapy treatment plan dosimetry correction method to account patient weight loss during a course of radiation therapy. J Med Phys 2020, 45(1), 1-6.

This study aims to validate volumetric arc therapy (VMAT) plan correction method for a patient’s lost weight during the course of radiotherapy.  VMAT plans of prostate and head and neck cancers were considered to evaluate dosimetric effects due to external surface changes caused by patient’s weight loss during treatment. Accepted VMAT treatment plan was recalculated on the planning computed tomography (CT) with a newly created external contour from cone‑beam CT and was compared with the original plan. Monitor unit (MU) correction was applied based on a simple formalism, and doses were recalculated. Dose statistics were compared with the original plan. Ten patients with significant weight loss were considered to validate proposed MU correction method by comparing the dose statistics before and after MU corrections. We observed 3.7 %–5.2 % change in the plan maximum dose for one cm change in path length to isocenter with increased planning target volume dose, D95 by 4 %. The organs at risk (OAR) doses increased as high as 6.8 %. Using MU correction method, target volume and OARs dose changes were reduced to <1 % when compared with the original plan. The correction method brought down the maximum plan dose and volume of 95 % isodose (V95) cloud below an acceptable range of 1 %–2 % in 10 patients treatment plans. Image‑guided radiation therapy process detects the weight loss, which affects the treatment plan’s dose distribution and should be corrected. Applying the correction method described here keeps the patient dosimetry within 1 % of the original plan, which is clinically acceptable. The process of plan dosimetry correction to address weight loss can be completed within 30 min without repeating imaging and planning process.

4 illus, 2 tables, 9 ref

044751   KAYA H D (Northeastern State Univ, OK- 74014, United States) : Business friendliness and small firm characteristics. J Manag Res 2020, 20(1), 47-59.

In this study, we examine whether small firm characteristics in business-friendly U.S. states differ from those of other less business-friendly states. For this purpose, we employ a national survey titled the “United States Small Business Friendliness Survey”. This survey asks opinions of small business owners on topics such as “ease of start”, “ease of hire”, “overall regulations”, and “training and networking programs”. Our results show that, in comparison to other states, there are fewer firms that operate in more than five states in business-friendly states. Again, in these states, there are fewer firms with a single employee but more firms with 2 to 20 employees, as compared to other states. In business-friendly states, there are more firms in the “Home” industry but fewer firms in the “Writing” industry. According to our findings, the “ease of start” affects all firm characteristics, while “ease of hire” affects only size and industry, and “training and networking programs” affect age and industry. Meanwhile “Overall regulations” affect size, operational area, and industry

6 tables, 22 ref

044746   GHOSH A, DAS S K (Medicine Dep, The West Bengal Univ of Health Sciences, Kalyani, West Bengal, Email: drsomak.das@gmail.com) : The association between chronic kidney disease, waist circumference and body mass index: A case-control study from a Tertiary Hospital of West Bengal, India. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 103-6.

In this hospital‑based study, we investigated the association between chronic kidney disease (CKD) and two globally accepted obesity parameters – waist circumference (WC) and body mass index (BMI). To investigate the association between CKD with BMI and WC. We included 416 consecutive CKD patients (age >20 years, calculated glomerular filtration rate <60 ml/ min/1.73 m2 ) as the case group and 408 consecutive age‑ and sex‑matched non‑CKD patients as the control group for our study. after obtaining consent, all groups were tested for WC and BMI.  Of 416 cases, the prevalence of high WC according to the International Diabetes Federation (IDF) criteria was 37.5 % and of obesity according to the Indian BMI scale was 38.46 %. When compared with the control group, we found that WC (p < 0.0001, odds ratio [OR] 2.182, 95 % confidence interval [CI] 1.099–1.852) and BMI (p = 0.006, OR 3.125, 95 % CI 1.625–3.125) were significantly high in the CKD group. The parameters of obesity were found to be significantly associated with the non-edematous CKD group.

2 tables, 20 ref

044745   POSH S, RAFIQ S, MANZOOR F, ASHRAF O, AHMAD M (Obstetrics and Gynaecology Dep, SKIMS, Jammu and Kashmir, Email: suhailrafiq777@gmail.com) : Accuracy of magnetic resonance imaging in assessing types of degeneration in leiomyomas. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 99-102.

Leiomyomas are the most common benign uterine neoplasms arising from smooth muscle cells. Magnetic resonance (MR) imaging is the most accurate imaging technique for detecting and localizing leiomyomas. As leimyomas grow, they may outgrow their blood supply resulting in various types of degeneration such as myxoid, hyaline, cystic, red, and calcification. Degenerated leiomyomas have variable appearances on T2‑weighted images and contrast‑enhanced images. This was a retrospective hospital‑based study done in Government Medical College, Srinagar, from January 2018 to December 2019. The study included 78 patients with more than 2 cm pathologically proven fibroids who underwent myomectomy or hysterectomy and preoperative MR imaging (MRI). We assessed the accuracy of MR for picking degeneration in fibroids. The aim and objective of this study is to determine the sensitivity, specificity, positive, and negative predictive value of MRI in assessing degeneration in uterine fibroids. The sensitivity, specificity, positive and negative predictive values of MRI in assessing degeneration in uterine fibroids were 60 %, 93.7 %, 85.7 %, and 78.9 % respectively. Menorrhagia followed by dysmenorrhea was the most common presenting symptom. MRI has average sensitivity and very good specificity for picking fibroid degenerations. MRI has high accuracy for picking up myxoid, cystic, and red degeneration.

3 illus, 1 table, 15 ref

044744   PATIL R R, BADOLE C M, MOTE G B, WANDILE K N (Orthopedics Dep, MGIMS, Sevagram, Maharashtra, Email: girishmotekop@gmail.com) : Why do orthopedic implants break?: A retrospective analysis of implant failures at a rural Tertiary Care Centre in central India. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 95-8.

The AO Foundation’s Association for the Study of Internal Fixation has advocated rigid fixation with implants in the form of plates and screws. Focus is on development of implants which are stronger, more acceptable to the body, cheaper, and durable. The aim of this study was to find the factors responsible for implant breakage.  We have retrospectively analyzed the data from January 2008 to December 2018 (10 years). Information on sociodemographic characteristics, clinical features, and radiographic features was retrieved from the hospital information system. Data were entered and analyzed with Epi Info software. Of the 37 patients, there were 33 (89.2 %) males and four (10.8 %) females in the age group of 17-95 years. The most common site for implant breaks was observed to be the shaft of the femur (40.5 %), and the most common type of implants which broke were locking intramedullary nails (62.1 %). The factors responsible for breakage of implants were observed to be: retrauma, failure of compliance with advice about ambulation, absence of union at fracture sites, and persistent infection. Out study shows the importance of educating patients properly about physiotherapy and rehabilitation protocols.

5 illus, 2 tables, 24 ref

044743   THAKUR S, SAXENA A K, BHATNAGAR A (Ophthalmology Dep , Dr Mohan Lal Memorial Gandhi Eye Hospital, Mumbai? 400 088, Maharashtra, Email: snehamthakur@gmail.com) : Central corneal thickness: Important considerate in ophthalmic clinic. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 90-4.

The aim of this study was to evaluate the relationship of central corneal thickness (CCT) with age, sex, refractive status, and keratometry (KM). In our cross‑sectional study, 1000 eyes of 500 patients from the outpatient department were randomly selected between July 2014 and December 2015. CCT was measured with a Humphrey ultrasonic pachymeter. Horizontal and vertical curvatures of the cornea were measured with a Bausch and Lomb keratometer, and its mean was calculated. Refractive state was measured with a Priestley‑Smith retinoscope and converted to spherical equivalent (SE). The patients were divided into three age groups(GroupA[16–30 years], Group B [31–45 years], and Group C [46–60 years]), and the data were analyzed statistically by the Statistical Package for the Social Sciences programme. The mean SE, KM, and CCT of the patients under the study were (‑) 0.47 ± 2.26, 43.79 ± 1.18D, and 528.41 ± 19.1 µm. The mean CCT was higher in age Group C (46–60 years) than other groups (P = 0.008), but we found that an increase in age has no impact on CCT after regression analysis. CCT was not affected by sex (p = 0.168). The mean CCT for myopic patients was 522.87 ± 18.03 µm, which was less compared to 536.39 ± 17.753 µm in hypermetropic patients (p ≤ 0.001). Positive correlation was found between CCT and SE (r = 0.520, P ≤ 0.001). KM showed negative correlation with CCT (r = −0.288, p ≤ 0.001). From our study, we concluded that CCT was related to age, refractive status, and KM, but not to sex.

4 tables, 24 ref

044742   BRIJEETHA V, FERNANDES J E, IDICULLA J (Medicine Dep, MAGJ Hospital, Ernakulum, Kerala, Email: jonitaeve@yahoo.com) : Prediction of lipohypertrophy in patients with diabetes mellitus. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 86-9.

Lipohypertrophy (LH) may result in variable absorption of insulin and affect glycemic control. This study aimed to study the risk factors and prevalence of lipohypertrophy in diabetic patients at a tertiary hospital in South India. 206 patients with diabetes mellitus aged over 18 years of age, on insulin therapy for over two years, were included in this study conducted at St Johns Medical Hospital to explore the prevalence and risk factors for development of lipohypertrophy. Demographics, duration of diabetes and insulin therapy, type of needles used, times of reuse, injection technique was recorded. The injection sites were inspected meticulously for the presence of lipohypertrophy.  66 patients (32 %) were found to have LH of which 62 had Type 2 diabetes and 4 had Type 1 diabetes. The median duration of diabetes was 15 years (IQR 10-20) and was higher in the group with LH (P=0.000). The duration of insulin therapy was 10 years (IQR 5-10.5) and was significantly higher in the group with LH (P=0.000). The commonest site for insulin injection was the abdomen and it was associated with LH (P=0.000).Patients reusing the needles over 6 times and those who failed to rotate injection sites had the highest frequency of LH(P=0.000). Patients on long term insulin should be advised against the reuse of needles to save on cost of therapy in view of increased risk of LH and glycemic variability. Physicians must reinforce proper insulin injection technique periodically and document lipohypertrophy if present.

2 tables, 17 ref

044741   PATOND A, NARANG R (Microbiology Dep, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, Email: rahulnarang@mgims.ac.in) : A low cost ingenious approach for ultraviolet decontamination of N95 filtering face-piece respirators to deal with dwindling supply during the covid-19 pandemic. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 80-5.

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus‑2 is rapidly evolving and hospitals are facing the issue of shortage of personal protective equipment (PPE) due to stringent requirements of PPE use. For reuse of N95 filtering face‑piece respirators (N95FFR), we prepared an ingenious cabinet with ultraviolet light C (UV‑C) using scarce material available during the lockdown period. Since like many other microbiology laboratories in medical colleges, we did not have access to viruses, we could not test our product with them. We thus tested the efficacy of the cabinet to decontaminate material using 0.5 McFarland standard broth of Escherichia coli 25922. The broth was exposed to UV‑C inside the cabinet for 15 and 30 minutes in Petri dishes, with and without lids. The broth was subcultured on nutrient agar plates, both pre and post exposure. We also could not test integrity and static charge of the respirators; we relied on CDC data on the same. It was observed that there was at least 4 log reduction (99.99 %) in the number of viable E. coli on exposure to UV-C for 15 as well as 30 minutes. The plates with glass lids on did not show any reduction in number of viable bacilli. The reduction in number of E. coli was taken as surrogate marker for the reduction of ssRNA viruses. UV‑C inside an ingeniously made cabinet can be used to decontaminate N95 FFR in exceptional circumstances of reduced supply under lockdown conditions of a pandemic.

10 illus, 22 ref

044741   PATOND A, NARANG R (Microbiology Dep, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, Email: rahulnarang@mgims.ac.in) : A low cost ingenious approach for ultraviolet decontamination of N95 filtering face-piece respirators to deal with dwindling supply during the covid-19 pandemic. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 80-5.

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus‑2 is rapidly evolving and hospitals are facing the issue of shortage of personal protective equipment (PPE) due to stringent requirements of PPE use. For reuse of N95 filtering face‑piece respirators (N95FFR), we prepared an ingenious cabinet with ultraviolet light C (UV‑C) using scarce material available during the lockdown period. Since like many other microbiology laboratories in medical colleges, we did not have access to viruses, we could not test our product with them. We thus tested the efficacy of the cabinet to decontaminate material using 0.5 McFarland standard broth of Escherichia coli 25922. The broth was exposed to UV‑C inside the cabinet for 15 and 30 minutes in Petri dishes, with and without lids. The broth was subcultured on nutrient agar plates, both pre and post exposure. We also could not test integrity and static charge of the respirators; we relied on CDC data on the same. It was observed that there was at least 4 log reduction (99.99 %) in the number of viable E. coli on exposure to UV-C for 15 as well as 30 minutes. The plates with glass lids on did not show any reduction in number of viable bacilli. The reduction in number of E. coli was taken as surrogate marker for the reduction of ssRNA viruses. UV‑C inside an ingeniously made cabinet can be used to decontaminate N95 FFR in exceptional circumstances of reduced supply under lockdown conditions of a pandemic.

10 illus, 22 ref

044740   DUTTA S, ROY S, ROY S (Home Science Dep, Calcutta Univ, Kolkata? 700 027, West Bengal, Email: soumam_dutta@yahoo.com) : Functional foods for mental health promotion. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 72-9.

Mental health problems and morbidities are increasing day by day. The etiology of mental health disorders is extremely complex and encompasses a range of genetic, dietary, emotional, and social as well as lifestyle factors. Finding adequate therapeutic and preventive strategies for mental health promotion is a great challenge. India is a country which is famous for its flora and fauna, many of which possess functional and medicinal properties. This article summarizes the mental health role of some selected functional foods of Indian origin, namely, brahmi (Bacopa monnieri), ashwagandha (Withania somnifera), turmeric (Curcuma longa), garlic (Allium sativum), and pumpkin seeds (Cucurbita maxima). Relevant article searches were conducted in PubMed, Google Scholar, and Google to identify the scientific articles highlighting the role of the functional foods on various mental health problems such as neurodegeneration, Alzheimer’s disease, Parkinson’s disease, depression, epilepsy, stress, and anxiety. The eligible articles were reviewed to gather information. These functional foods were found to be highly beneficial in treating and preventing mental health disorders mainly due to their antioxidant and anti‑inflammatory properties as well as their ability to prevent mitochondrial dysfunction and degrade abnormal protein aggregates. These functional foods were also found to be effective in the improvement of the activities of various neurotransmitters such as acetylcholine and monoamines. These foods can be incorporated into the diet as well as can be used to develop drugs and nutraceuticals for treating various psychiatric problems.

2 tables, 99 ref

044739   HUIDROM S, BEG M A (Pharmacology Dep, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, Email: sangeeta44@rediffmail.com) : Dysbiosis of gut microbiota and human diseases. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 66-71.

Gut microbiota of humans harbour a complex and dynamic community of more than 100 trillion beneficial microbes. Recent advances in tools and techniques of microbial analysis have made it possible to understand better the important role played by gut microbiota in the human body. The composition of gut microbiota depends on many factors, such as the mode of delivery of the baby, environmental conditions, antibiotic usage, age, and diet. Homeostasis of gut microbiota is important for maintaining good health as it influences human nutrition, metabolism, and immune function, while dysbiosis of the gut microbiota is associated with various gastrointestinal and metabolic disorders, such as inflammatory bowel disease, obesity, type 2 diabetes, colon cancer, and dysregulation of the immune system. Clinical evidences have shown that diseases caused by imbalance gut microbiota can be treated by probiotics. However, more research work is required to get insightful knowledge of what kind of particular microbes and underlying molecular mechanisms are responsible for a particular disease.

85 ref

044738   GUPTA O P (Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, Email: opgupta@mgims.ac.in) : Sarcopenia: A review. J Mahatma Gandhi Inst Med Sci 2020, 25(2), 62-5.

Sarcopenia is the process of loss of skeletal muscle mass. It has recently been recognized as a separate entity, and there is very little awareness about it among health professionals. Sarcopenia is a geriatric condition where there is an age‑related primary loss of muscle mass, although it has now been recognized to begin early in life. In general, loss of muscle mass occurs secondary to chronic illness, malignancy, or drugs, particularly long‑term steroid therapy and cytotoxic drugs. Aging itself may cause sarcopenia, especially in inactive individuals who have a sedentary lifestyle. There is a decrease in muscle mass with increase in intra‑ and intermuscular adipose tissue. Besides epigenetic factors, malnutrition, chronic inflammation (raised cytokine levels of interleukin (IL)‑1, IL‑6, and tumor necrosis factor‑alpha), and changes at hormonal and mitochondrial level are responsible for the poor muscle growth and loss of muscle mass and strength and thereby affect the performance of activities of daily living. Diagnosis of sarcopenia can be made by simple clinical tests which detect loss of muscle mass and strength. Loss of muscle mass can be confirmed with the help of computed tomography, magnetic resonance imaging, and ultrasonography. Exercise and improvement of nutrition are the mainstays of treatment. So far, no specific drug is available for the treatment of sarcopenia, though some age‑old drugs such as metformin and anabolic steroids have been tried with variable results. Some new molecules have shown positive results in experimental animals and are in various phases of clinical trials.

2 illus, 19 ref