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   Table of Contents - Current issue
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April-June 2021
Volume 5 | Issue 2
Page Nos. 105-234

Online since Wednesday, June 16, 2021

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REVIEW ARTICLES  

Vaccine in response to COVID-19: Recent developments, challenges, and a way out Highly accessed article p. 105
Sameer Quazi
DOI:10.4103/bbrj.bbrj_166_20  
Severe acute respiratory syndrome coronavirus 2 proved to be disastrous as it affected a large population in the period of a few months. As the virus took hold in the world, health experts paced efforts to solve the unknown nature of this threat. Besides finding short-term and sudden relief, scientists directed their efforts to provide a long-term solution for an ensuing pandemic that influenced all areas of life in unprecedented ways. The subject matter of this research involves exploring the relevant literature regarding passive immunity in fight against the virus. It is expected that different vaccine platforms such as traditional recombinant protein, macromolecule DNA and mRNA, and nonreplicating and replicating viral vectors could be helpful if utilized properly. This article is going to discuss all these platforms and recent developments regarding the formulation of the vaccine. It is going to highlight the need for the production and distribution of the medicines along with challenges that are present in this task. The facts involving social, political, and economic aftermath would also be discussed in the current research. There is no doubt that biotechnology is going to provide a sound foundation to fight with upcoming health-related challenges. Along with the exploration of this fact, the article is going to prove a case for effective collaboration among all stakeholders such as government, academia, health sector, and civil society. The mechanism of collaboration would produce safety and efficacy data with the help of many volunteers, to speed up the distribution of multiple vaccine platforms to fight against COVID-19 and to strive for a better future.
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A review on Coronavirus Disease and potentially active drugs targeting Coronavirus Highly accessed article p. 110
Tarawanti Verma, Manish Sinha, Bansal Nitin, Shyam Raj Yadav, Kamal Shah, Nagendra Singh Chauhan
DOI:10.4103/bbrj.bbrj_14_21  
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus with single positive-strand RNA, having glycoproteins projection on envelopes so reveals a halo-like appearance or corona. Coronavirus is of four types: (1) α-coronavirus (α-COV); (2) β-coronavirus (β-COV); (3) δ-coronavirus (δ-COV); and (4) γ-coronavirus (γ-COV) and belongs to family Coronaviridae and subfamily Coronavirinae. Coronaviruses are the normal pathogens that cause broad band of gastrointestinal and respiratory diseases in domestic as well as wild animals such as pigs, birds, and rodents. Coronavirus is highly infectious in case of elders for mortality rate. The elder peoples are at 2-fold higher risk as compared to the younger population and the greater part of the population dying from coronavirus disease (COVID-19) is male. The virus enters into the body by the mouth, eyes, or nose, then particles march inside of the body by different pathways and affect vital organs in severe ways such as liver, heart muscle, blood vessels, kidneys, central nervous system, etc. Right now, the only solution to avoid COVID-19 infection is “precautions.” Different companies of different countries at different steps are in race to develop effective medicines for treatment and management of the same. Here, in this review, we tried to give an overview of all about SARS-CoV-2, COVID-19 infection, pathophysiology, mechanisms, and various treatment trials.
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Disinfectants in the arena of COVID-19 p. 121
Kamal Shah, Sumit Chhabra, Nagendra Singh Chauhan
DOI:10.4103/bbrj.bbrj_16_21  
Currently, a disease name as corona (COVID-19) has become a serious problem around the globe. As of December 2020, the disease has spread to over 213 countries and territories around the world and 2 international conveyances, with over 79,850,900 confirmed cases and over 1,751,705 deaths. The ailment (COVID-19) is instigated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CoV impacts on the respiratory tract and causes infection that may be minor or deadly. Several studies reveal that coronavirus can remain live on nonliving surfaces (glass, metal, or plastic) for up to 9 days, but it may be denatured with many disinfectants having alcohol, benzalkonium chloride, sodium hypochlorite, etc., within 1 min. As we know, there is no fruitful therapy or medication for COVID-19 so early precaution and prevention is the only solution to break the chain of coronavirus. By using different types of disinfectants, we can inhibit the growth of this novel corona disease.
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The effects of topical application of melatonin on periodontal Disease in diabetic patients p. 129
Rocco Franco, Manuele Basili, Michele Miranda, Michele Basilicata, Patrizio Bollero
DOI:10.4103/bbrj.bbrj_34_21  
Periodontal disease is a chronic disease, affects the supporting tissues of the tooth. The clinical manifestation varies from gingivitis to periodontitis. Periodontal disease is caused by bacterial infection that release toxins. The imbalance between oxidants and antioxidants determines the progression of periodontal disease. Melatonin (MEL), (N-acetyl-5-methoxytrittamine) is a hormone in the human body. Its production takes place in various organs including the retina, gastrointestinal tract, bone marrow, leukocytes, lymphocytes, skin, and principally pineal gland. Its main function is the regulation of the circadian and seasonal rhythm, body weight, reproduction, bone metabolism, and tumor growth. An important function of melatonin is the ability to reduce oxidative stress. The aim of this review is to evaluate the necessary effects on melatonin on the progression of periodontal disease and diabetes. The purpose of this review is to answer to the following questions using a PICO method (P: patient problem/population; I: intervention; C: comparison; O: outcome): (1) Can adding melatonin in diabetic and periodontal patients lead to improved periodontal health? (2) Does melatonin also affect the control of blood sugar levels in the diabetic patient? The study was conducted utilizing the main scientific databases (PubMed, MEDLINE, and WEB of SCIENCE). The time window considered for the electronic search was from March 1, 2007, to March 1, 2020. The following inclusion criterion was used: articles in English, human studies and clinical trials. Two independent people search with the same keywords all article and select the article founding. The risk of bias in this phase is solved by an independent author that conduct the same search. We can hypothesize that melatonin may indirectly help control blood sugar levels. Further studies will be needed to evaluate a direct healing effect of melatonin on diabetes.
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ORIGINAL ARTICLES Top

Prevalence of severe acute respiratory syndrome Coronavirus-2 among the young people and association between diabetes, hypertension, and severe acute respiratory syndrome Coronavirus-2 p. 134
Aklima Akter, Nafisa Tabassum, Arifur Rahman
DOI:10.4103/bbrj.bbrj_220_20  
Background: The corona virus disease-2019 (COVID-19) or corona pandemic is an outgoing pandemic caused by coronavirus 2019 (COVID-19) caused by the transmission of severe acute respiratory syndrome coronavirus-2. It was first identified in Wuhan, China, and the first COVID-19 case in Bangladesh was on March 7, 2020. A retrospective research was conducted on Brahmanbaria Medical College with COVID-19-suspected patients to understand the current situation of COVID-19 in Brahmanbaria. Methods: A total 752 oropharyngeal and nasopharyngeal swab samples were collected from COVID-19 suspected patients and reverse transcriptase–polymerase chain reaction test was run to identify the positive cases. Results: We found 28.5% (n = 214) of positive cases among which 22.9% (n = 49) were diabetes mellitus patients and 20.5% (n = 46) were hypertension patients too. Conclusion: A total of 214 (28.5%) COVID-19 positive confirmed cases among 752 COVID-19-suspected peoples were found. The most common age group of COVID-19 patients was between 31 and 40 years, which is a matter of great concern as these patients develop different postcorona syndromes such as weakness, breathlessness, and muscles pains and cannot go back to their normal daily life as before.
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Pathological evaluation of osteolytic bone lesions: A 7-year experience in a tertiary care center in West Bengal, India p. 139
Parul Jain, Senjuti Dasgupta, Nirmal Kumar Bhattacharyya
DOI:10.4103/bbrj.bbrj_10_21  
Background: The purpose of our study was to evaluate the osteolytic lesions of bone reported at the department of pathology in a tertiary care hospital in West Bengal. Materials and Methods: We performed a retrospective study over a period of 7 years from February 2013 to January 2020. Entirely osteosclerotic lesions were excluded from our study. The lesions were classified as nonneoplastic lesions, benign lesions, tumor like lesions and malignant lesions. Results: Over 7 years, 147 cases of osteolytic lesions of bone were reported. Of these, 36.1% were malignant lesions. The most common sites of osteolytic lesions were the femur (n = 46), tibia (n = 24), and humerus (n = 20). The most frequent histological diagnosis was of giant cell tumor (GCT) (n = 31), followed by chronic osteomyelitis (n = 19) and osteosarcoma (n = 17). The most frequent benign neoplasm was GCT and osteosarcoma was the predominant malignant lesion. Relatively uncommon lesions like adamantinoma were also reported. Conclusions: Malignant neoplasms are the most common osteolytic lesions. Bones of the extremities are the most frequent sites of involvement by both benign and malignant tumors. In addition to radiological correlation, a thorough knowledge of the age, sex, site of the common bone lesions is required for a correct histopathological diagnosis so that proper treatment can be instituted. Most of these lesions do not require immunohistochemistry for diagnosis. The possibility of rare tumors presenting at a given age and at a particular site is to be considered.
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Studies on antistress activity of Curculigo Orchioides gaertn p. 145
Nagendra Singh Chauhan, Kamal Shah, Prashant Kumar Gupta
DOI:10.4103/bbrj.bbrj_12_21  
The aim of this study was to evaluate the antistress activity of rhizomes ethanolic extract of Curculigo orchioides Gaertn in vivo, using mice with stress-induced injury. The effect of Curculigo orchioides on motor coordination, spontaneous locomotor activity, immobility time, and analgesia was evaluated in mice using standard procedure. The ethanolic extract of Curculigo orchioides at dose levels, i.e., 100 and 200 mg/kg shows pronounced antistress activity evidenced by reduced immobility time in forced swimming and tail test. It also improved motor coordination and enhanced analgesic effect compared to standard diazepam. The Curculigo orchioides was found to be a antistress activity.
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Immunohistochemical subtypes of non-hodgkin lymphomas with special emphasis on diffuse large B-cell lymphoma: An epidemiological study in a tertiary care center of Eastern India p. 149
Gaurav Pal, Senjuti Dasgupta, Uma Banerjee
DOI:10.4103/bbrj.bbrj_33_21  
Background: Non-Hodgkin lymphoma (NHL) is a heterogeneous disease with respect to etiology, morphology, immunohistochemistry, and prognosis. Diffuse large B-cell lymphoma (DLBCL) is categorized into two subtypes – germinal center B-cell like (GCB) and activated B-cell like, based on the stage of B-cell differentiation. The epidemiologic profile of NHL varies from one place to another. The aim of the present study was to delineate the frequencies of different types of NHL including subtypes of DLBCL in a tertiary care center. Another objective was to determine if there is any correlation between different subtypes of DLBCL and clinicopathological parameters. Materials and Methods: Immunohistochemical (IHC) examination was done on paraffin blocks of patients diagnosed as NHL by histopathological examination. The patient details, type of NHL including subtype of cases of DLBCL, diagnosed by IHC, were recorded. Results: The mean age of the study population of 62 patients was 53 ± 14.5 years. Forty patients (65%) were male and 22 (35%) were female. The majority (56, 90%) of the NHLs were of B-cell type. DLBCL was the most common B-cell lymphoma (23, 41%). GCB subtype (12, 21%) of DLBCL was slightly more frequent than non-GCB type (11, 20%). The correlation between subtypes of DLBCL and clinicopathological parameters was not statistically significant. Peripheral T-cell lymphoma was the most common type of T-cell lymphoma. Most of the NHLs presented with nodal involvement (38, 61%). Conclusion: The heterogeneity of NHLs in different parts of the country makes it necessary to undertake epidemiological studies so that patient care may be improved.
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Detection of mecA and staphylococcal cassette chromosome mec gene isolated from Northeast Part of Karnataka Staphylococcus aureus isolates p. 155
Vivek Kulkarni, Vijay M Kumbar, Ajay Kumar Oli, Rahul Kambar, Channappa T Shivannavar, YM Jayaraj
DOI:10.4103/bbrj.bbrj_35_21  
Background: Methicillin- resistant Staphylococcus aureus (MRSA) strains are predominantly significant because they are leading healthcare- associated infections worldwide and even majorly emerged as community associated infections. Methods: A total of 40 S. aureus isolates were collected from Navodaya Institute of Medical Sciences, Raichur Institute of Medical Sciences, and Mid Tech Diagnostic Laboratory, Raichur, and analyzed for mecA, Panton–Valentine leukocidin (PVL), and staphylococcal cassette chromosome mec (SCCmec) typing by gradient and Multiplex polymerase chain reaction (PCR). Results: Out of 40 S. aureus isolates, 7 (17.8%) were resistant and 33 (82.8%) were sensitive for methicillin antibiotic. The seven isolates showed positive for Vancomycin /cefoxitin Ezy MIC strip and oxacillin antibiotic MIC was ≥ 8μg/ml respectively PCR detection has revealed, seven isolates were positive for mecA and SCCmec typing, but none of the isolates has shown positive for PVL genes. The study shows the presence of SCCmec Type II and III was confirmed by multiplex PCR in hospital-acquired MRSA isolate and mecA gene positive of seven strains of MRSA Conclusion: The study demonstrated high specificity and positive prediction of the detection of MRSA from clinical samples.
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The effect of 16 Arg/Gly β2–adrenergic receptors gene polymorphism on pulmonary function in asthmatic children treated with nebulized salbutamol p. 161
Ayat Sahib Mohammed, Haidar Abdul Amir Najim Abood, Aqeel Mahdi Hussein
DOI:10.4103/bbrj.bbrj_36_21  
Background: The β2-adrenergic receptor gene is a typical candidate for the study of genetic polymorphism, the biological relevance, and clinical consequences of polymorphisms. Many patients with asthma do not respond to β2-agonist; in addition, a wide interindividual variability in pharmacological response exists, likely because of the interaction between clinical, environmental, and genetic factors. Methods: A total of 80 asthmatic children, including 55 males and 25 females with acute attacks ages range between 5 and 18 years, attended the Respiratory Clinic at Karbala Pediatric Hospital, allele-specific polymerase chain reaction was performed to determine SNP of β2-adrenergic receptor gene at nucleic acid 46 (16 amino acid position). Results: Asthmatic children having GG genotype showed significant increase (P < 0.05) in all the recorded lung function parameter (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC], FEV1/FVC and FEV1% predicted) after treatment with nebulized salbutamol while those having AA and AG genotypes showed significant (increase) improvement (P < 0.05) only in FEV1, FVC, and FEV1% predicted after treatment with nebulized salbutamol and showed no significant increase (P > 0.05) in FEV1/FVC ratio after treatment with nebulized salbutamol, patients having GG genotype of 16Arg/Gly SNP showed highest change (increase) in FEV1 (204.44 ± 175.35) ml and in FEV1% predicted (15.22 ± 14.75) % after treatment with nebulized salbutamol in compared with other genotypes groups, although this change is not statistically significant (P > 0.05). Conclusion: Asthmatic children having GG (Gly16Gly) genotype showed better improvement in lung function after nebulized salbutamol in compared with those having AA (Arg16Arg) and those having heterozygous AG (Arg16Gly) during mild-to-moderate acute asthma attacks.
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Evaluation of contact-wear behavior of lithium disilicate glass ceramic materials; In vitro study p. 166
Efe Çetin Yilmaz, Recep Sadeler
DOI:10.4103/bbrj.bbrj_37_21  
Background: The purpose of this work is to evaluation of contact-wear behavior of lithium disilicate glass ceramic materials under in vitro chewing tests. Methods: Eight specimens of each ceramic materials were exposed contact-wear tests using a computer-controlled chewing simulator (1.2 Hz 50 N bite force loads, 120.000 mechanical cycles, constantly 37 °C temperature immersed in distill water. Al2O3 balls of 6 mm in diameter were used for each chewing test. The mean volume loss of all ceramic specimens after the contact-wear tests was determined with use 3D profilometer. In addition to a random specimen was selected from each test group and scanning electron microscopy (SEM) images were taken for analysis of wear tracks. Results: As a result, the ceramic materials tested in this study showed similar wear behaviors after 120.000 chewing tests. Conclusions: However, it was observed that more particles were carried on the wear surface and occurred micro cracks of the IPS e.max ceramic material. These micro cracks can be the continuation of cracks that occur subsurface of ceramic material.
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Identification of a subpopulation of chemoresistant cancer cells with adult stem cell properties and embryonic transcription factors in oral squamous cell carcinoma p. 170
Mahaboob Vali Shaik, Munni Shaik, G Subramanyam, G Rajasekhar
DOI:10.4103/bbrj.bbrj_55_21  
Background: In South-central Asia, oral cancer ranks among the three most common types of cancer. India alone accounts for 86% of the total oral cancer figures globally. Cancer stem cells (CSCs) are thought to give rise to differentiated tumor cells and to predict tumor recurrence and metastases. This study designed to characterize the CSCs derived from oral squamous cell carcinoma and its identification of correlation with embryonic transcriptional potential. Materials and Methods: Tumor (microscopically ~80% of their areas occupied by tumor cells) and normal counterpart (normal paired noncancerous matched tissue) samples from each histologically confirmed cases of oral squamous cell carcinoma (OSCC) were undertaken in this study. Isolation of stem cells using anti-CD133-positive selection. Expression levels of stem cell surface markers were assessed by flow cytometer. The immunoprofile of these markers was correlated with sex-determining region Y-box 2 (SOX-2), octamer-binding transcription factor 4 (OCT4), and NANOG. The tissue samples of OSCC were studied to identify the localization pattern for CSCs using fluorescence microscopy. Results: Histologically, SOX-2 expression has been identified at all zones exhibiting dysplasia. Isolated CD133+ cells showed differential expression pattern with embryonic transcription factors in tumor cells but not in normal counterpart, which depicts their cancer stemness. Flow cytometry analysis exhibited that SOX-2/OCT4/CD44+with CD133 positive stemness in OSCC malignant tissues was identified to be the best marker for OSCC prediction of the disease. Conclusion: The isolated subpopulation CD133+ cells possess the characteristics of both stem cells and malignant tumors. The findings show that elevated levels of CD133 lead to OSCC invasiveness and metastasis, associated with the upregulation of embryonic and stemness markers. Hence, these tumors may be controlled by restricting the expression of CD133, CD44, OCT4, and SOX2 or by disrupting the molecular pathways that are altered in CSCs.
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Detection of Epstein–Barr virus in prostate tissue from prostatic cancer patients in Iraq p. 180
Anwar Abd Hashim Al-Ramahy
DOI:10.4103/bbrj.bbrj_57_21  
Introduction: The prostatic tumor was the third form of cancer in males being more than 55 years of age, after the pulmonary and colon cancer. The prostate infected by many viruses causing repeated or chronic inflammation or enhance carcinogenesis. The aim of this study was to determine the presence and prevalence of Epstein–Barr virus (EBV) in the prostate tissue of patients with prostate cancer. Methods: Prostate tissue samples were collected from paraffin embedding block of 70 patients diagnosed with EBV from archives of AL-Sadder Hospital in AL-Najaf City and some archives of private histopathology laboratories from January 2016 to the December of the same year. We investigated the presence of EBV DNA by using the polymerase chain reaction (PCR). Results: The sample size was 60 patients and 10 as controls. The present study shows that 7/60 prostatic patients have EBV. Five patients of them have a malignancy prostatic tumor and only two with a benign prostatic tumor. On the other hand, there are 53/60 prostatic patients without EBV. Conclusions: EBV gene sequences were identified in benign and prostate cancer specimens. These sequences were located in the nuclei of prostate epithelial cells. The presence of EBV gene sequences in some of the benign and malignant prostate specimens is particularly noteworthy because of recent experimental evidence demonstrating that EBV can increase the proliferation of cultured cervical cells.
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Atherogenic index of plasma: A novel biomarker and lipid indices in young myocardial infarction patients p. 184
Pradeep Kumar Dabla, Shikha Sharma, Kumar Saurabh, Ishit Chauhan, MP Girish, Mohit Dayal Gupta
DOI:10.4103/bbrj.bbrj_58_21  
Background: Cardiovascular diseases (CVDs) have become the leading cause of death among Indian population. It has been directly linked to hypercholesterolemia, particularly elevated plasma low-density lipoprotein-cholesterol (LDL-C) levels and low plasma high-density lipoprotein-cholesterol (HDL-C) levels. The lipid tetrad index (LTI) and lipid pentad index (LPI) have been recently described as a new form of assessment of lipid profiles. Hence, the present study was undertaken to evaluate the role of atherogenic index of plasma (AIP) and other lipid indices such as LTI and LPI in young myocardial infarction (MI) patients from North India.Methods: The present cross-sectional study was conducted in the Department of Biochemistry and Cardiology at GB Pant Institute of Postgraduate Medical Education and Research, New Delhi. A total of 240 individuals were included in the study in which 135 were patients of ST-elevation MI of the age 15–45 years, along with 105 age-matched controls during the period of July 2019 till December 2019. LTI was calculated as TC*TG*Lp(a)/HDL and LPI as TC*TG*Lp(a)*ApoB/ApoA1. AIP is calculated according to the formula: log (TG/HDL-C). Results: The lipid parameters including total cholesterol, triglyceride, LDL-C, and non-HDL-C were significantly increased in the acute MI cases in comparison to controls. HDL-C was significantly decreased in the cases. Lipoprotein (a), ApoB levels, and ApoB/ApoA1 were also significantly increased in the cases. On the other hand, ApoA1 levels were significantly decreased in the patients. LTI and LPI were significantly increased in the acute MI cases as compared to controls. On correlating lipid parameters with LTI and LPI, a significant positive correlation was observed with all lipid parameters – total cholesterol, triglyceride, LDL-C, Lp(a), and ApoB/ApoA1 except HDL-C which showed a negative correlation with LTI and a nonsignificantly negative correlation with LPI. HDL-C shows a significantly negative correlation with AIP in both cases and controls. Conclusions: This present study has evaluated Role of AIP along with lipid indices such as LTI & LPI which helps in early identification of individuals with higher risk of premature CAD. AIP can be used as a better biomarker than other lipid indices in young MI patients, especially those associated with cardiovascular risk. At present, no Lp(a)-lowering drugs have been approved, hence early identification and intervention to modify risk factor may be helpful in prevention of development of MI in these patients with the help of LTI and LPI levels.
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Assessing liver functions of radiologic technologists exposed chronically to radiation p. 191
Sultan Zaher Alasmari, Mohammed Makkawi, Nasser Shubayr, Gaffar Zaman, Yazeed Alashban, Nashwa Eisa, Hussain Khairy, Fuad Rudiny, Basma Afif
DOI:10.4103/bbrj.bbrj_59_21  
Background: The continued absorption of occupational radiation encounter by radiologic technologists and the potential resulting adverse effects have been a concern to the field for decades. This study investigates the risk factors of developing liver dysfunction among a selected group of radiologic technologists (RTs) to evaluates the correlation between cumulative radiation doses and liver injury. Methods: Only RTs who have been working in the radiology department for more than 10 years were selected for the study. The RTs and control groups were chosen based on several factors: adults, nonalcoholic, non-smoker, and have no history of hypertension or diabetes. A retrospective analysis was performed on the effective cumulative radiation dose for a selected RTs from 2009 to 2019. Fully automated biochemical analyzer was used to evaluate liver function tests. Alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total bilirubin (BiL), direct BiL, indirect BiL, albumin (ALB), total protein (TP), cholesterol (CHOL), triglyceride (TG), high-density lipoprotein (HDL), and glucose (GLUH) were measured. Results: The result showed that the difference in the medians of liver biomarker GGT between control and RTs groups was statistically significant. The median of GGT in RTs group was higher than that of the control group. Conclusions: GGT test is a hallmark of liver function and alteration in GGT level may indicate a hepatic defect. Thus, further investigation in a large cohort to study the association between GGT elevation and chronic radiation exposure is required.
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The Contribution of [18]F-fluoro-2-deoxy-glucose positron emission tomography/computed tomography to the diagnosis and staging of signet-ring cell carcinoma of the stomach p. 196
Selda Yilmaz Tatar, Esra Arslan
DOI:10.4103/bbrj.bbrj_60_21  
Background: Signet ring cell carcinomas (SRCC) have been among the most common histological types of gastric cancer. In recent years, [18]F-fluoro-2-deoxy-glucose positron emission tomography/computed tomography ([18]F-FDG-PET/CT) has been very useful for primary cancer staging and distant metastasis detection. In our study, the aim was to evaluate the diagnostic and predictive level of [18]F-FDG-PET/CT in SRCC. Methods: Ninetytwo patients that underwent [18]F-FDG-PET/CT procedures between 2011 and 2017 for primary staging were included in the study. The clinicopathological features and maximum standard uptake value (SUVmax) of histopathologically defined cancers were determined. Ethical approval was obtained from Istanbul Training and Research Hospital Local Ethics Committee with the date and number 04/08/2017-1048. Results: The mean age of the patients was 58.1 ± 12.2 years. Sixtythree of the patients (75.3%) were male and 29 (24.7%) were female. According to the histopathological classification, the majority of the SRCCs were poorly differentiated and were most frequently localized in the middle and lower parts of the stomach. The mean value of [18]F-FDG uptake by [18]F-FDG-PET/CT in the primary lesions was SUVmax = 9.69 ± 7.58. The mean SUVmax (SUVmax: 7.92) measured in the patient group, 60 years and older, was found to be statistically significantly higher (p = 0.038) than the value measured in the 59 years and younger group (SUVmax: 10.26). There was a statistically significant difference between the mean SUVmax of the patients aged 60 and over and under this age group (p = 0.038). A statistically significant difference was found between the group with a positive regional LN and the mean SUVmax calculated between the group with negative regional LN (p = 0.012). A statistically significant difference was found between the group with distant organ metastasis and the negative group (p = 0.008). However, no statistically significant difference was found between tumor diameter, tumor wall thickness, localization of the tumor in the stomach, presence of distant nodal metastasis, and SUVmax calculated for histological gradients of the lesions (p > 0.05). Conclusion: Due to the advances in the diagnosis and treatment of SRCC in recent years, PET/CT may contribute to the diagnosis, staging, and prognosis determination of patients. [18]F-FDG-PET/CT demonstrated high FDG uptake in SRCC lesions. The FDG SUVmax was observed to increase significantly in patients with SRCC diagnosis of regional LN and distant organ metastasis. Studies with larger patient groups are needed to detect locally advanced and metastatic cases in SRCC patients using [18]F-FDG-PET/CT.
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Qualitative and quantitative analysis of protein expression in the caput and cauda regions of the rat epididymis p. 203
Binita Basnet Baruah, Srujana Kola, Lokesh Rukmangadachar, Pradeepkumar Chaturvedi, Srinivasan Alagiri
DOI:10.4103/bbrj.bbrj_61_21  
Background: The aim of this study was to identify the differentially expressed proteins in the sperm isolated from the caput and the cauda region of the rat epididymis. This is the first study on the quantitative nongel-based proteomics to have identified differentially expressed proteins in the cauda epididymal sperm. Material and Methods: This was achieved by isolation of sperm from the caput and the cauda of the rat epididymis followed by the tryptic digestion of the proteins and the resulted peptides were subjected to isobaric tags for relative and absolute quantitation-label and mass spectrometry (MS)/MS analysis. With the help of quantitative proteomics, we have been able to elucidate some of the major proteins involved in the process of sperm maturation. Results: In total, 999 proteins from the spermatozoa of caput and cauda region of the epididymis were identified. We have reported about 10 downregulated proteins and 15 upregulated proteins that have been in the sperm from the cauda region of the epididymis. HongrES1, the membrane of the SERPIN family specifically expressed in the principal cells of the cauda epididymis, have been found to be expressed three-fold higher. Conclusion: This study contributes to the understanding of the importance of different proteins at the different stages of the maturation during the transit of the spermatozoa. The higher and lower expression of different proteins in the epididymal region depicts their roles in priming the spermatozoa for normal fertilizing ability. Thus, the target proteins can be further studied for the possible development of male contraception.
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Acute respiratory distress syndrome and pneumothorax in COVID-19 patients p. 217
Seyed Mohammad Reza Hashemian, Navid Shafigh, Raziyeh Erfani, Batoul Khoundabi, James Miller
DOI:10.4103/bbrj.bbrj_62_21  
Background: Spontaneous pneumothorax is known as a fatal complication in patients with COVID-19. However, the exact pathogenesis of the spontaneous pneumothorax occurrence and its cause remains unknown. Accordingly, the present study examined 30 patients with acute COVID-19-induced respiratory failure who were under biphasic positive airway pressure (BIPAP) and medical ventilator machines. Methods: This study is a retrospective study and was performed on patients with COVID-19-induced acute respiratory failure who were admitted to the intensive care unit. The study population included 30 patients (10 patients with pneumothorax complication and 20 other patients without this complication). All study patient demographic data and device parameters (physiological parameters observed by the device) were collected and compared with each other. Results: Overall, 30 patients with COVID-19 and acute respiratory distress syndrome (ARDS) were selected during the 3 months from April to July 2020, with complications of spontaneous pneumothorax and emphysema detected in the collected chest X-ray images of 10 patients. In general, the results showed that p-plateau and p-peak parameters in the group with pneumothorax were significantly higher than the other group. Alternately, it was observed that static compliance for the group with pneumothorax was significantly lower than the uncomplicated group. Further, the mortality rates obtained were equal to 80% for the group with pneumothorax complication and 55% for the other group. Conclusion: Spontaneous pneumothorax in patients with ARDS and COVID-19 is a rare complication with a high mortality rate that occurs even in patients without intubation and patients undergoing BIPAP. Hence, if low static compliance and high pulmonary pressures are observed for patients, physicians should seek the complication diagnosis and treatment following changes in patients' symptoms.
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Green synthesis of silver nanoparticles using Eranthemum Pulchellum (Blue Sage) aqueous leaves extract: Characterization, evaluation of antifungal and antioxidant properties p. 222
Jai Prakash, Himanshu Shekhar, Shyam Raj Yadav, Abhishek Kumar Dwivedy, Vijay Kumar Patel, Shikha Tiwari, Niraj Kumar Vishwakarma
DOI:10.4103/bbrj.bbrj_63_21  
Background: Nanoparticles modulate several physiochemical and biological properties. In this regard, silver nanoparticles (AgNPs) have shown remarkable applications. The present research work comprises green synthesis of AgNPs using aqueous leaves extract of Eranthemum pulchellum and evaluation of its efficacy as antifungal and antioxidant agents. Methods: Synthesized AgNPs have been characterized by Fourier Transforms Infrared (FTIR) Spectroscopy, X-ray diffraction (XRD), transmission electron microscopy (TEM), and ultraviolet-visible spectrophotometry. Qualitative phytochemical analysis of aqueous leaves extract of E. pulchellum and FTIR spectrum of the synthesized AgNPs suggest about the presence of different phytochemicals and functional groups, respectively, which are responsible for reducing silver ions as well as capping and stabilizing synthesized nanoparticles. Results: The wavelength of maximum absorbance of AgNPs solution near to 439 nm indicates the spherical morphology. XRD infers about average crystalline size of the synthesized AgNPs to be ~12 nm. Selected area electron diffraction pattern of the synthesized AgNPs shows four visible diffraction rings corresponding to (111), (200), (220), and (311) set of planes which are attributed to face centered cubic metallic silver. The size and spherical shape of the synthesized AgNPs have been further determined by TEM. The synthesized AgNPs have shown a significant antifungal activity against Aspergillus flavus (AF-LHP-NS7) strain with minimum inhibitory concentration value of 200 μg/mL. The synthesized AgNPs have also shown strong antioxidant efficacy through Azino-bis-3-ethylbenzothiazoline-6-sulfonic acid assay with IC50 value of 462.56 μg/mL. Conclusions: The present study shows a green and facile synthesis of AgNPs. Leaves extract of E. pulchellum has been first time utilized as efficient reductant for the AgNPs synthesis. These AgNPs have shown potent antifungal and antioxidant activity.
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Antifungal efficacy of lauric acid and caprylic acid – Derivatives of virgin coconut oil against Candida albicans p. 229
Satya Tejaswi Akula, A Nagaraja, M Ravikanth, N Govind Raj Kumar, Y Kalyan, D Divya
DOI:10.4103/bbrj.bbrj_65_21  
Background: Candida albicans is the primary causative agent of oral mycotic infections and can be fulminant, especially in immunocompromised individuals, which often necessitates a therapeutic intervention with antifungal drugs. However, with emergence of multidrug-resistant fungi and concomitant intolerance and adverse side effects of antifungal drugs, it is pivotal to find an alternative. One approach is to screen natural compounds which represent a rich source of novel antimicrobial agents. Aim: The present study focused on the pharmacological screening of active ingredients of virgin coconut oil, the medium-chain fatty acids – lauric acid and caprylic acid, for antifungal activity on C. albicans comparatively with those of standard antifungal drugs such as fluconazole and clotrimazole. Methods: The efficacy of lauric acid and caprylic acid against C. albicans was evaluated by using standard protocol of disc diffusion method. It was assessed by the presence or absence of inhibition zones, diameter of inhibition zones (in cm), and minimum inhibitory concentration (MIC) values. Results: Caprylic acid and lauric acid (MCFS) have potential anticandidal activity against C. albicans. Caprylic acid has the highest antifungal potential at MIC of 40μg/ml. Conclusion: Both the natural compounds have shown encouraging antifungal activity in the present study. However, further microbiological and clinical evaluation is essential to consider their utilization for therapeutic purposes.
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