સૌરાષ્ટ્રમાં થયેલી રચનાત્મક અને દલિતોધ્ધારની પ્રવૃત્તિઓ (ઇ.સ. ૧૯૨૦ - ૧૯૬૦)

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A Synthetic Approach Towards Bioactive Molecules and Related Studies

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Study of amniotic fluid index and its pregnancy outcome

Background: Amniotic fluid is vital to the well-being of the fetus. Severe oligohydramnios and polyhydramnios are associated with increased maternal morbidity and perinatal morbidity and mortality.Methods: This was prospective observational study conducted at tertiary teaching institute from July 2012 to July 2013. Total 200 patients were included in the study. On the basis of amniotic fluid index (AFI), patients were categorized in 3 groups, Normal AFI (8-24 cm), oligohydramnios (AFI = 25 cm). Results were analysed in the form of incidence, mode of delivery and perinatal outcome which includes preterm, low birth weight, still births, NICU admissions and neonatal deaths in all the 3 groups.Results: Out of 200 patients, there was 150 cases of normal AFI, 39 cases of oligohydramnios and 11 cases of polyhydramnios. Incidence of oligohydramnios was 4.1% and polyhydramnios was 1.1%. PIH was the most common etiological factor found in oligohydramnios (30.7%) and in polyhydramnios congenital anomalies (36.3%) followed by idiopathic cause (27.2%) was most common. Incidence of caesarean section was 58.9% in oligohydarmnios and 17.3% in normal AFI group. Incidence of NICU admission was 25.6% in oligohydramnios and 50% in polyhydramnios group in comparison to 9.3% in normal AFI group.Conclusions: Amniotic fluid index is an important part of antepartum fetal surveillance. Abnormalities of AFI are associated with high perinatal morbidity and mortality and maternal morbidity

Unravelling the potentialities of tocilizumab for the development of a potential immunotherapeutic regimen against COVID-19—A narrative review

The severity of COVID-19 (coronavirus disease 2019) disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been associated with hyperinflammation induced by excessive release of a range of cytokines and chemokines. Among a plethora of cytokines, interleukin-6 (IL-6) plays a pivotal role in the immunopathology of SARS-CoV-2 infection as IL-6 has been proposed to initiate hypersecretion of cytokines by activating the Janus kinases-signal transducer and activator of transcription (JAK-STAT) pathway. Hence, targeting IL-6 and its receptor can be an appropriate therapeutic strategy to treat SARS-CoV-2 infection. However, tocilizumab (TCZ) is a well-known monoclonal antibody for its anti-inflammatory activities. TCZ has been designed to bind two different IL-6 receptors, viz., membrane-bound and soluble receptors. As an antagonist of IL-6 receptors, TCZ inhibits the JAK-STAT signaling pathway, which is essential for the transcriptional activation of cytokines-producing genes.Hence, the inhibition of IL-6 receptors can substantially reduce hyperinflammation, a key characteristic of severely infected patients with SARS-CoV-2 infection. TCZ has much promise in terms of treating SARS-CoV-2-related hyperinflammation, acute respiratory distress syndrome, and multiple organ damage. Hence, TCZ has been proposed as a potential therapeutic drug for treating COVID-19 disease. However, several discrepancies still exist, such as a well-defined molecular mechanism, efficacy, and safety parameters. In this context, various databases, including Medline, ResearchGate, PubMed, Science Direct, Scopus, and Google Scholar, were explored employing keywords such as “Cytokine storm”, “COVID-19”, “hyper inflammation”, “IL-6”, “TCZ”, and “SARS-COV-2” up to May 2021. The authors independently collected and evaluated research papers for inclusion in the current review, relying on their relatedness to the main theme of the literature review. So, this narrative review aims to provide updated information about the molecular mechanism, efficacy, and safety of TCZ in the treatment of COVID-19. However,several contradictions and challenges associated with TCZ use in the treatment of severely infected patients with COVID-19 have also been discussed

Kinetic cross-modal correspondences and felt (e)motion in a novel set of musical stimuli

Embodied music cognition predicts that our understanding of human-made sounds relates to our experience of making the same or similar movements and sounds, which involves imitation of the source of visual and auditory information. This embodiment of sound may lead to numerous kinetic cross-modal correspondences (CMCs). This article investigates music experience in participants with a non-professionally trained music background across three musical dimensions: Contour (Ascending, Descending, Flat), Vertical Density (Low, Medium, High), and Note Pattern (Binary, Ternary, Quaternary). In order that stimuli should reflect contemporary musical usage yet be subject to a high degree of experimental control, 27 ten-second digital piano tracks were created in collaboration with a film composer. In Study 1, participants were asked to rate the stimuli for perceived Direction, Rotation, Movement, and Emotional and Physical Involvement. We test the effects of these factors in terms of the following theories: general and vocal embodied responses to music, the Ecological Theory of Rotating Sounds, and the Shared Affective Motion Experience model of emotion induction. Results for Study 1 were consistent with theories of general and vocal embodied responses to music, as well as with theories of embodied emotional contagion in music. Study 1 also revealed potential confounds in the stimuli, which were further investigated in Study 2 with a new set of participants rating the stimuli for perceived Pitch, Loudness, and Speed. Results for Study 2 served to dissociate intrinsic features of the stimuli from CMCs. Taken together, the two studies reveal a range of embodied CMCs. Although there are limitations to a perceptual study such as this, these stimuli stand to benefit future research in further investigating the embodiment of musical motion

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

A tactical key management infrastructure for mobile ad hoc networks

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Neuropharmacological evaluation and HPTLC fingerprint profile of phytocompound-enriched chloroform fraction of methanolic extract of Lagenaria siceraria (Molina) Standley fruits – a potent Asian ethno-medicinal vegetable plant

Introduction: Lagenaria siceraria (Molina) Standley (Cucurbitaceae) is a traditional vegetable plant, popularly known as bottle gourd (English) and lauki (Hindi). It is a climbing herb characterized with a number of therapeutic properties. Traditionally Lagenaria siceraria (LS) fruits were used for their cardioprotective, hepatoprotective, diuretic, and purgative effects, but there is very little scientific data available on its neuroprotective potential. Aims: The present study aimed to assess the neuropharmacological profile of the sterol-enriched chloroform fraction of methanolic extract of Lagenaria siceraria fruits in animal experimental models. Materials and methods: Neuropharmacological screening was conducted in specific reported animal models. Adult Wistar albino rats were subjected to behaviour despair test and elevated plus maze test. Thiopental-induced sedation, locomotor activity, and rota rod test were conducted on Swiss albino mice. Similarly, pentylenetetrazole-induced convulsions and maximal electroshock-induced seizures in Swiss albino mice were performed to evaluate the anti-epileptic potential. Results: The results of the study demonstrated that the anxiolytic activity of phytocompound-enriched chloroform fraction of methanolic extract of Lagenaria siceraria fruits (100, 200, and 400 mg/kg per os) was characterized by increased time spent in and increased number of entries into the open arms of the elevated plus maze prototype as compared to the control group (p<0.001). Chloroform fraction (100-400 mg/kg, p.o.) showed the dose-dependent significant reduction in duration of immobility (p<0.001) in the behaviour despair test. Similarly, the chloroform fraction was found to exert a significant reduction in motor co-ordination (p<0.001) and prolongation of thiopental-induced sleeping time (p<0.001) during the animal studies. Moreover, the test fraction significantly increased (p<0.001) the onset of myoclonic seizures in pentylenetetrazole-induced convulsions model as well as in the maximal electroshock-induced seizures model at all three dose levels selected. Interestingly, the chloroform fraction neither produced any overt motor dysfunction nor any kind of extra pyramidal symptoms in any of the animal models during pharmacological screening. Preliminary phytochemical screening of the fraction showed presence of saponins, phytosterols, terpenoids, fats, and trace amount of polyphenolic compounds. HPTLC fingerprinting analysis was also carried out. Conclusions: This is the first study exploring the neuroprotective potential of Lagenaria siceraria fruits by showing the anxiolytic, anti-depressant, sedative, and anti-epileptic-like activities, confirming the traditional claims. Future prospectus and investigations will give emphasis on isolation of the bioactive phytocompounds and their precise mechanisms involved in the neuroprotective activities

Study of fetomaternal outcome in second stage caesarean section

Background: The incidence of second stage caesarean section is more in developing countries. Caesarean sections done at full cervical dilatation with impacted fetal head are difficult and associated with an increased incidence of maternal and fetal complications.Methods: This was prospective observational study conducted at a tertiary teaching institute. All second stage caesarean sections performed between September 2017 to August 2018 were analysed in terms of incidence, indications of caesarean-section, intra-operative  and postoperative complications, maternal and fetal outcome.Results: During the study period there were total 7270 deliveries. Out of this 1884 deliveries were done by caesarean section. Out of them 50 were 2nd stage caesarean sections contributing to 2.65% of total sections. Patwardhan method was used in 50% cases for deliveryof deeply engaged head. Intra-operative complications were higher in terms of atonic pph (8%), extension of uterine incision (16%), in 3 cases bladder injury was noticed. Obstetric hysterectomy was required  in 4% cases. 14% cases had postoperative febrile illness and 8% cases had wound infection. 44% babies required NICU admissions and neonatal death was 18%.Conclusions: Caesarean section in the 2nd stage of labour is associated with significantly increased maternal morbidity. Neonatal morbidity and mortality also increases. A proper judgement is required by a skilled obstetrician to take a decision for caesarean section at full cervical dilatation