Gestational diabetes mellitus - need for universal screening - a clinical study in a tertiary care centre

Background: To study the prevalence of gestational diabetes mellitus among antenatal mothers and to assess the importance of universal screening to detect gestational diabetes mellitus (GDM).Methods: A total of 300 antenatal women irrespective of gestational age were screened for GDM at their antenatal visit during the period of January 2020 to June 2020. All women were screened with 75gm oral glucose load irrespective of last meal followed by blood glucose estimation by glucose oxidase peroxidase method 2 hours following glucose load. A cut-off of 140mg/dl or more were labelled as gestational diabetes mellitus as per DIPSI guidelines.Results: Out of 300 antenatal women tested, 24 women (8%) were positive for gestational diabetes mellitus. During the first, second and third trimesters 12.5%, 33.33% and 54.17% were diagnosed with gestational diabetes mellitus respectively. The number of gestational diabetes mellitus patients for the age groups ≤20 years, 21-25 years, 26-30 years and >30 years are 2 (8.33%), 3 (12.5%), 8 (33.33%) and 11 (45.83%) respectively. The number of pregnant women tested positive for gestational diabetes mellitus with BMI ≤18.5, 18.6-24.9, 25-29.9 and 30-35 are 2 (8.33%), 4(16.67%), 8(33.33%) and 10(41.67%) respectively.Conclusions: Prevalence of GDM in our study is 8%. About 29.16% of GDM did not have any risk factors. This emphasizes the importance of universal screening for GDM of all pregnant women irrespective of gestational age. There is an increased association of GDM with age, BMI, family history and parity according to our study

A REVIEW OF MERELY POLYMERIC NANOPARTICLES IN RECENT DRUG DELIVERY SYSTEM

Synthetic, semi-synthetic, and natural polymers make up the colloidal formations of polymeric nanoparticles. Because of their large surface area and nanoscale size, nanoparticles have unique physical and chemical capabilities. Their distinct size, shape, and structure influence their optical characteristics, reactivity, durability, and other attributes. Supercritical fluids, in which the fluid retains a single-phase regardless of pressure, are environmentally beneficial. It is in a state of minor criticality. Because the precipitate is solvent-free, this method is environmentally friendly. Due to their qualities, they are good candidates for various commercial and marital uses, including catalysis, imaging, pharmaceutical applications, energy-based research, and ecological applications. This review provides a supercritical fluid technology-based polymeric nanoparticles overview of various forms uses, synthesis, properties, and forthcoming prospects

Mechanismen des cAMP-vermittelten Schaltens in Hyperpolerisation-aktivierten zyklischen Nukleotid-gesteuerten Kanälen

HCN channels are activated by hyperpolarizing-voltages and modulated by the binding of cAMP. They are tetrameric channels and the four subunits are arranged as homotetramers or heterotetramers. Each subunit of the channel consists of four structural domains: the HCN domain, the voltage-sensing domain (VSD), the C-linker (CL) domain and the cyclic nucleotide-binding domain (CNBD). The cryo-EM structure of human HCN1 (hHCN1) suggests that a small portion of the CL is in a proximate distance to the residues of the respective opposite subunits. Previous studies have shown the functional importance of diverse interactions of adjacent subunits. This work focuses on characterizing the opposite subunit interactions. The results herein show that the residue K464 of the CL contacts the residue M155 of the HCN domain of the respective opposite subunit. These contacts are essential in close state stabilization of the channel by mediating the opposite subunit interactions. The experimental mutant K464E shows a destabilization of closed state and mimics the phenotype of a cAMP-bound wild-type channel. Such a phenotype shows a relief of auto-inhibition posed by the tetrameric CL-CNBD, as also observed in wild-type cAMP bound phenotype. Furthermore, the loss of auto-inhibition increases the apparent affinity of cAMP binding. The results from this work are in excellent agreement with already published crystal structures and the MD simulations performed by the collaborators. In conclusion, the data here show that the interactions between opposite subunits are essential in HCN channel gating. These interactions play a significant role in maintaining the auto-inhibitory property of the channel. Both binding of cAMP and mutagenesis, disrupt these opposite subunit interactions and cause a weakening of auto-inhibition, leading to enhanced activation of the channel

Random Characterization of Design Automation Algorithms

Randomly generated Directed Acyclic Graphs (DAGs) can be used to generate various kinds of EDA test data. For example, they can be used to characterize channel routing algorithms. This paper uses such data to characterize the relative performance of a number of different channel routing algorithms, with the aim of determining those factors that have the most effect on routing performance. Our studies show very little difference in the algorithms studied. Factors that have been considered to provide performance improvements are shown to be unimportant, and in some cases even detrimental to average routing performance. This study suggests that “well known” algorithms are not really well known at all, and that more extensive data is needed to characterize the algorithms that we use every day. 1

Multidisciplinary Management of a Fractured Premolar: A Case Report with Followup

The general dental practitioner must consider orthodontic extrusion of a tooth when a subgingival defect, such as, crown fracture occurs before prosthetic rehabilitation, especially in the aesthetic zone. Extrusion enables the root portion to be elevated which exposes sound tooth structure for placement of restorative margins. This case report describes the multidisciplinary management of a fractured upper first premolar in a general dental practice. The forced orthodontic eruption is achieved by an endodontic attachment and sectional fixed appliance with an offset placed in the wire. The ability to extrude premolars with this method is complicated by heavy occlusal forces, occlusal interferences, and short clinical crown length. The tooth was restored with a titanium post, composite core, and porcelain fused to metal crown. The entire course of treatment was carried out under National Health Scheme, UK and as a part of vocational training. The 21 months followup showed no change in occlusal contacts or gingival level

A REVIEW NOVEL CORONAVIRUS

Coronaviruses (CoVs), incorporated positive-sense RNA diseases, are depicted by the club-like spikes that adventure from their surface, an abnormally huge RNA genome, and a specific replication technique. CoVs cause a selection of diseases in mammals and birds ranging from enteritis in cows and pigs and upper respiratory sickness in chickens too possibly deadly human respiratory diseases. Here, we provide a quick presentation to CoVs talking about their replication and pathogenicity, and current avoidance and treatment techniques. We likewise mention the episodes of the profoundly pathogenic severe acute respiratory syndrome CoV (SARS-CoV) and thus the recently identify Middle Eastern respiratory syndrome CoV (MERS-CoV)

Targeting autophagy with small molecules for cancer therapy

Autophagy is a conserved lysosomal-dependent catabolic process that maintains the cellular homeostasis by recycling misfolded proteins and damaged organelles. It involves a series of ordered events (initiation, nucleation, elongation, lysosomal fusion and degradation) that are tightly regulated/controlled by diverse cell signals and stress. It is like a double-edged sword that can play either a protective or destructive role in cancer, by pro-survival or apoptotic cues. Recently, modulating autophagy by pharmacological agents has become an attractive strategy to treat cancer. Currently, a number of small molecules that inhibit autophagy initiation (e.g., ULK kinase inhibitors), nucleation (e.g., Vps34 inhibitors), elongation (e.g., ATG4 inhibitors) and lysosome fusion (e.g., chloroquine, hydroxyl chloroquine, etc.) are reported in pre-clinical and clinical study. Also a number of small molecules reported to induce autophagy by targeting mammalian target of rapamycin (e.g., rapamycin analogs) or adenosine 5’-monophosphate-activated protein kinase (e.g., sulforaphane). The study results suggest that many potential “druggable” targets exist in the autophagy pathway that could be harnessed for developing new cancer therapeutics. In this review, we discuss the reported autophagy modulators (inhibitors and inducers), their molecular mode of action and their applications in cancer therapy

Self-reported Medication Adherence in Schizophrenia and Bipolar Disorder Patients during COVID-19 Pandemic in a COVID Care Hospital: A Cross-sectional Study

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has made it difficult for patients with Schizophrenia and Bipolar Affective Disorder (BPAD) to receive ongoing care, which has led to non adherence to medication and undesirable health outcomes. Lower treatment adherence in severe mental illness might lead to symptom exacerbation and relapses and might cause a strain on the health system during COVID-19 pandemic. Aim: To assess the treatment adherence in Schizophrenia and BPAD patients during prevailing COVID-19 situation in India. Materials and Methods: This cross-sectional study was conducted among 92 patients with Schizophrenia and BPAD through a questionnaire between January to September 2021 in a COVID-19 care hospital Government Medical College Palakkad/District hospital Palakkad, Kerala, India. Demographic and clinical data, adherence to treatment, along with Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HAM-D). Clinical Global impression (CGI S&I), Work and Social Adjustment Scale (WSAS), Modified COVID Threat Scale (CTS) and Medication Adherence Rating Scale (MARS) were collected. The outcomes included adherence to medication, deterioration of the psychopathology, improvement in severity, social functioning. Descriptive statistics was used to define the sample characteristics and presented as mean and standard deviation and frequency and percentages. Spearman’s Correlation coefficient was used to find the correlation between MARS and other variables: CTS, BPRS, YMRS, HAM-D, CGI and WSAS. Results: A total of 92 patients were interviewed which comprised of 43 patients with Schizophrenia and 49 patients with Bipolar disorder. As assessed by MARS rating scale 19 patients (20.65%) had a MARS score less than six suggesting poor adherence and 73 (79.35%) had MARS score 6 and greater suggesting better adherence to the treatment. This was supported by negative correlation with BPRS, YMRS, HAM-D and CGI-S and CGI-I scales which implies that the COVID-19 pandemic did not hinder the patients to take the medication. The mean MARS score was 7.31±2.11. A total of 37 (40.2%) patients had acute exacerbation of the illness during the COVID-19 related lockdown and 37 (40.2%) had exacerbation during the six months prior to COVID-19 lockdown. There was negative correlation between MARS scores and the CTS but was not statistically significant. Conclusion: Despite the COVID-19 pandemic related restriction, patients with Schizophrenia and BPAD were adherent to the medication and the number of relapses during COVID-19 pandemic was similar to the period before the pandemic. COVID-19 related anxiety didn’t have an impact on medication adherence and relapse in this study

APTAMERS: NANOMATERIALS AS A POTENTIAL AGENT FOR ANTIVIRAL THERAPEUTIC DRUG DELIVERY DEVELOPMENT: A SYSTEMATIC LITERATURE REVIEW

Chemotherapeutic experts have been utilised to cure a variety of disorders, but their practical application is restricted due to their regrettable selectivity and outrageous fundamental optional effects. Short single-stranded DNA or RNA oligonucleotides known as aptamers are released from randomised libraries and have strong propensity and differentiation towards targets like antibodies as well as characterised structures and ties to targets like proteins. They commonly suppress protein interactions while restricting proteins, which may elicit positive effects like threat. Aptamers have recently demonstrated their amazing promise for use in medicines, biosensors, and bioimaging thanks to a number of advantages, such as minimal immunogenicity, simplicity of giant degree blend, low pack to-bunch collection, genuinely substance modification, and programmability.  At any rate, the steady for the most part accomplishment speed of aptamer is far from being brilliant, despite everything needs to overwhelm the gigantic obstruction in propensity, constancy for utilitarian application, explicit illness cell affirmation. The sensible method of controlling the binding execution of aptamers, and dealing with their show in the practical application is of great significance and these single-abandoned DNA or RNA aptamers could outline with astoundingly poisonous chemotherapy drugs, hurts, strong RNAs or different particles as novel aptamer-drug structures, which are prepared to do endlessly out working on the obliging plentifulness and decreasing the critical danger of solutions and have unprecedented possible in living spaces for appointed ailment treatment. In this survey, we have extensively covered and summarised the ongoing improvements in the aptamer-drug structure philosophy for designated drug transport in the assessment methodologies of aptamers for unambiguous disease biomarkers. A modified strategy utilising aptamers could be a reliable system for quick and precise advancement of biopharmaceutics for use in infection-related treatment, especially in light of the enormous advances in modernised thinking for protein and RNA structure conjectures. Additionally, the likelihood of future conception is also summarised