Abstract Introduction As 30 to 50% of deep venous thrombosis (DVT) cases remain idiopathic, an increased focus on hematologic variables may therefore reveal novel correlates of DVT. Very few studies have investigated the association of hematological parameters with DVT and the causal relationship between them is still to be elucidated. Therefore, we aimed to investigate the association between serial values of hematologic variables and DVT. Methods Complete blood count parameters were serially measured at baseline and then at approximately 3-month intervals for 12 months in 152 adults with the first episode of DVT and 152 age- and sex-matched controls. The odds ratio (OR) with the 95% confidence interval (95%CI) was calculated as a measure of association between hematological parameters and DVT. Results The red cell distribution width (RDW) was the only hematologic variable which showed an independent and consistent association with DVT at all time points (multivariable-adjusted OR [95%CI] 3.38 [1.28 - 8.91] at baseline, 2.24 [0.85 - 5.92] at 3 months and 2.12 [0.81 - 5.55] at 12 months for RDW > 14.0%). This association was higher for provoked DVT than unprovoked DVT and for DVT plus pulmonary embolism than DVT alone. No significant correlation was found between the high RDW and classical thrombotic risk factors, except malignancy. Conclusions We demonstrated an independent and consistent association of the high RDW with the first episode of DVT in adult patients. The study was probably underpowered to evaluate the association between the high RDW and recurrent DVT. Further large studies with long follow-up are needed to confirm this association. 50 (DVT idiopathic elucidated Therefore 3month month 1 15 age sexmatched sex matched controls (OR 95 95%CI 95CI CI (95%CI (RDW multivariableadjusted multivariable adjusted [95%CI 338 38 3.3 1.28 128 28 [1.2 8.91 891 8 91 224 2 24 2.2 0.85 085 0 85 [0.8 5.92 592 5 92 212 2.1 0.81 081 81 5.55 555 55 14.0%. 140 14.0% . 14 14.0%) alone factors malignancy patients followup follow up 9 33 3. 1.2 [1. 8.9 89 22 2. 0.8 08 [0. 5.9 59 21 5.5 14.0 1. [1 8. 0. [0 5. 14. [

Abstract Chocolate is a delectable sweet enjoyed all over the world. Made from dried cocoa beans, through the process of roasting, grinding, and conching, chocolate is known for its taste and flavor. Although the sugar content of chocolate is limiting its reach to the health-conscious population, chocolate is endowed with immense medicinal benefits. The major ingredient of chocolate, cocoa, Theobroma cacao L., is a plant known as the “Food of the Gods” due to the abundance of polyphenols present in it. Processing conditions and parameters affect the polyphenol stability. Roasting process conditions affect the polyphenols of cocoa beans, especially the epicatechin and procyanidin. The variety of cocoa beans, quality and presence of fat, sugar, emulsifiers, drying time, and temperature are the important influencing factors affecting the polyphenol content of chocolate. Chocolate possesses antioxidant, antidiabetic, anticancer, anti–inflammatory, and good mood food properties but it is also shown to be prebiotic and helps in alleviating the symptoms of Alzheimer’s and heart disease. The functional properties of chocolate can be enhanced by the addition of certain foods/ functional ingredients. This paper reviews the role of chocolate as a functional food, the effect of processing on polyphenols, and the recent developments in improving the functional properties of chocolates through fortification. world beans roasting grinding conching flavor healthconscious health conscious population benefits L L. Food Gods stability procyanidin fat emulsifiers time antioxidant antidiabetic anticancer antiinflammatory anti inflammatory anti–inflammatory Alzheimers Alzheimer s disease foods ingredients fortification

Abstract Introduction Cancer-associated thrombosis is a leading cause of morbidity and mortality in malignancy patients. Prophylactic anticoagulation is under-utilized and the cost of low-molecular-weight heparin (LMWH) and direct oral anticoagulants is a major barrier in developing countries. Material and methods A retrospective analysis was performed of all cancer-associated thrombosis patients attending the thrombosis clinic at a tertiary-level referral hospital based in North India between 2011 and 2015. Patient demographics and disease-related parameters were collected and analyzed. Results A total of 771 patients attended the thrombosis clinic during study period, of which 64 cases were malignancy-associated. Of these, 56% of the patients were female and 20% were bedridden. The median age was 48.5 years, adenocarcinoma (48%) being the most common histological subtype. Gynecological malignancies (30%) were the most common malignancies, followed by genitourinary (11%) malignancies. Most of the cases occurred during first year of diagnosis (51%), and only 14% occurred after 3 years. Most of the patients were on combined treatment. Almost 40% of the patients developed thrombosis within 30 days of surgical treatment. Lower limb thrombosis was the most commonly seen type (56%), while abdominal and pulmonary thrombosis were both seen in 5%. Patients were managed with LMWH and vitamin K antagonists (84.3%) and only 6.25% with LMWH alone. Direct oral anticoagulants were not commonly used during the study period. Discussion At the hospital studied, most of the cases occurred early in the disease course. Postoperative prophylaxis could have contributed towards reducing thrombosis in the peri-operative period. Early suspicion and prompt treatment can improve quality of life in such patients. Cancerassociated Cancer associated underutilized under utilized lowmolecularweight low molecular weight (LMWH countries cancerassociated cancer tertiarylevel tertiary level 201 2015 diseaserelated related analyzed 77 period 6 malignancyassociated. malignancyassociated associated. malignancy-associated these 56 20 bedridden 485 48 5 48. years 48% (48% subtype 30% (30% 11% 11 (11% 51%, 51 51% , (51%) 14 40 56%, (56%) 5% 84.3% 843 84 (84.3% 625 25 6.25 alone studied course perioperative peri operative 7 2 4 (48 (30 1 (11 (51% (56% 84.3 8 (84.3 62 6.2 (4 (3 (1 (51 (56 84. (84. 6. ( (5 (84 (8

Abstract Introduction Coronavirus disease 2019 (COVID-19) is adversely affecting the mental health of patients infected with the virus and the psychological impact on recovered COVID-19 patients is unclear. Objectives The study aimed to assess posttraumatic stress disorder (PTSD) and depression among COVID-19 patients after recovery from the disease. Methods This cross-sectional study was conducted from November 9, 2020, to December 23, 2020. The study used a telemedicine model to enroll recovered COVID-19 patients from a database of patients provided by the health authorities. The National Stressful Events Survey PTSD Short Scale (NSESSS) for adults was used to assess PTSD symptoms and the Patient Health Questionnaire (PHQ-9) was used to assess depression. Results The study enrolled 503 recovered COVID-19 patients with a mean age of 41.90 years. The majority were asymptomatic (64.6%), while 21.5% had had moderate to severe forms of the disease. Prevalence rates of PTSD symptoms and depression were 56.9 and 29% respectively. COVID-19 patients with severe forms of the disease were significantly more affected by PTSD symptoms (vs. mild, odds ratio [OR] = 18.7, 95%confidence interval [CI] 9.9-35.5) and depression (vs. mild, OR = 19.8, 95% CI 9.9-39.5). Similarly, patients who required oxygen or ventilator support reported significantly higher rates of PTSD symptoms (vs. managed at home, OR = 17.4, 95% CI 8.3-36.4) and depression (vs. managed at home, OR = 22.0, 95% CI 10.1-47.7). Conclusion This study reports that recovered COVID-19 patients suffered from a significant amount of depression and experienced significant PTSD symptoms. It will help with addressing a major psychological concern among the recovered subjects. 201 COVID19 COVID 19 (COVID-19 COVID-1 unclear (PTSD crosssectional cross sectional 9 2020 23 authorities NSESSS (NSESSS PHQ9 PHQ (PHQ-9 50 4190 41 90 41.9 years 64.6%, 646 64.6% , 64 6 (64.6%) 215 21 5 21.5 569 56 56. 29 respectively vs. vs (vs mild [OR 187 18 7 18.7 95confidence confidence 95 [CI 9.935.5 99355 9.9 35.5 35 9.9-35.5 198 8 19.8 9.939.5. 99395 39.5 . 39 9.9-39.5) Similarly home 174 17 4 17.4 8.336.4 83364 8.3 36.4 3 36 8.3-36.4 220 22 0 22.0 10.147.7. 101477 10.1 47.7 10 1 47 10.1-47.7) subjects 20 COVID1 (COVID-1 COVID- 202 2 (PHQ- 419 41. 64.6 (64.6% 21. 18. 935 9.935. 9935 99 9. 355 35. 9.9-35. 19. 939 9.939.5 9939 395 39. 9.9-39.5 17. 336 8.336. 8336 83 8. 364 36. 8.3-36. 22. 147 10.147.7 10147 101 10. 477 47. 10.1-47.7 (COVID- (PHQ 64. (64.6 93 9.935 993 9.9-35 9.939. 9.9-39. 33 8.336 833 8.3-36 14 10.147. 1014 10.1-47. (COVID (64. 9.93 9.9-3 9.939 9.9-39 8.33 8.3-3 10.147 10.1-47 (64 9.9- 8.3- 10.14 10.1-4 (6 10.1- (

RESUMEN En general, los programas de control de la hipertensión son costo-eficaces, incluso en los países de ingresos bajos y medios. Aun así, es poco probable que los gobiernos nacionales y la sociedad civil apoyen los programas de control de la hipertensión a menos que se demuestre su valor en términos de beneficios para la salud pública, impacto presupuestario y valor de la inversión para el contexto individual del país. La Organización Mundial de la Salud (OMS) y la Organización Panamericana de la Salud (OPS) implementaron la iniciativa HEARTS, un enfoque mundial estandarizado y simplificado para el control de la hipertensión, que incluye los medicamentos antihipertensivos y los dispositivos de medición de la presión arterial de preferencia. El objetivo de este estudio es informar sobre los estudios en el ámbito de la economía de la salud relativos al costo de las medidas de control de la hipertensión previstas en HEARTS (especialmente, de los medicamentos), la costo-efectividad y el impacto presupuestario, así como describir los modelos matemáticos diseñados para traducir los datos de este programa en un enfoque óptimo para la prestación y el financiamiento de los servicios de atención de la hipertensión, especialmente en países de ingresos medianos y bajos. Los primeros resultados indican que las intervenciones de HEARTS para el control de la hipertensión son de bajo costo o costo-eficaces, que el conjunto de medidas HEARTS es asequible, a un precio que oscila entre US$ 18 y US$ 44 al año por paciente tratado, y que los medicamentos antihipertensivos podrían tener un precio lo suficientemente bajo como para alcanzar un estándar medio mundial de <US$ 5 por paciente al año en el sector público. Estos datos del ámbito de la economía de la salud serán argumentos convincentes para que los gobiernos se involucren en los programas de control de la hipertensión a escala nacional y les brinden apoyo financiero.

RESUMO Geralmente, os programas de controle de hipertensão são custo-efetivos, inclusive em países de baixa e média renda, mas os governos dos países e a sociedade civil provavelmente não apoiarão tais programas a menos que demonstrem valor em termos de benefícios à saúde pública, impacto orçamentário e retorno sobre o investimento no contexto individual do país. A Organização Mundial da Saúde (OMS) e a Organização Pan-Americana da Saúde (OPAS) criaram a Global HEARTS, uma abordagem padrão e simplificada ao controle da hipertensão arterial, que inclui medicamentos anti-hipertensivos preferidos e dispositivos para aferição da pressão arterial preferidos. O objetivo deste estudo é relatar os estudos de economia em saúde que analisaram o custo (especialmente custos de medicamentos), custo-benefício e impacto orçamentário do pacote HEARTS para controle da hipertensão e descrever modelos matemáticos elaborados para traduzir os dados do programa de controle de hipertensão em uma abordagem ideal para a prestação e financiamento de serviços de atenção às pessoas com hipertensão, especialmente em países de baixa e média renda. Os primeiros resultados sugerem que as intervenções HEARTS para controle da hipertensão são de baixo custo ou custo-efetivas, que o pacote HEARTS é acessível (custando de US$ 18 a 44 por pessoa tratada por ano) e que o preço dos medicamentos anti-hipertensivos poderia ser baixo o suficiente para atingir uma média global de <US$ 18 por paciente por ano no setor público. Estas evidências do campo da economia em saúde serão um argumento convincente para que os governos se responsabilizem por programas de controle de hipertensão em escala nacional e os dotem de recursos financeiros.

ABSTRACT Generally, hypertension control programs are cost-effective, including in low- and middle-income countries, but country governments and civil society are not likely to support hypertension control programs unless value is demonstrated in terms of public health benefits, budget impact, and value-for-investment for the individual country context. The World Health Organization (WHO) and the Pan American Health Organization (PAHO) established a standard, simplified Global HEARTS approach to hypertension control, including preferred antihypertensive medicines and blood pressure measurement devices. The objective of this study is to report on health economic studies of HEARTS hypertension control package cost (especially medication costs), cost-effectiveness, and budget impact and describe mathematical models designed to translate hypertension control program data into the optimal approach to hypertension care service delivery and financing, especially in low- and middle-income countries. Early results suggest that HEARTS hypertension control interventions are either cost-saving or cost-effective, that the HEARTS package is affordable at between US$ 18-44 per person treated per year, and that antihypertensive medicines could be priced low enough to reach a global standard of an average <US$ 5 per patient per year in the public sector. This health economic evidence will make a compelling case for government ownership and financial support for national scale hypertension control programs.

Abstract: The durability of imported timber is a matter of growing concern in the tropical Indian climate, with their refractory nature further adding to the woes with respect to further processing. In the present study, the effect of microwave pre-treatment, exposure time and initial wood moisture content on retention, treatability and cross-sectional anatomical properties of Tectona grandis and Southern yellow pine imported from Ghana and South America were evaluated. Water based preservative copper chrome borate (CCB) of 2 % concentration was used for the study. The experimental study in combination with dip-diffusion method returned with significant improvement in retention of about 5-6 folds more than the control sets in Southern yellow pine and Tectona grandis. Another set of Southern yellow pine and Tectona grandis samples were further treated using a full cell pressure method after microwave, without initial vacuum, which showed similar trends with a 3-4 folds increase in retention over controls. Both experiments returned with significant improvement in the treatability class of Tectona grandis and Southern yellow pine. The anatomical analysis was performed using a light microscope with 5 and 10x magnifications on treated and untreated samples of both Tectona grandis and Southern yellow pine. The outcome of the anatomical study exhibited improvement in vessel diameters in the treated samples of Tectona grandis with a reduction in the degree of occlusion by the presence of tyloses. For Southern yellow pine, checks on micro level and cracks on macro level appeared along with the ray cells and the diameter of the resin canals was substantially expanded which ascertains that microwave pre-treatment ameliorated the flow of fluids in the wood microstructure which improved permeability and resulted in better uptake and penetration.

Abstract Background: Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal symptoms, primarily attributed to sensitization of somatosensory system carrying pain. Few reports have investigated the impact of fibromyalgia symptoms on cognition, corticomotor excitability, sleepiness, and the sleep quality — all of which can deteriorate the quality of life in fibromyalgia. However, the existing reports are underpowered and have conflicting directions of findings, limiting their generalizability. Therefore, the present study was designed to compare measures of cognition, corticomotor excitability, sleepiness, and sleep quality using standardized instruments in the recruited patients of fibromyalgia with pain-free controls. Methods: Diagnosed cases of fibromyalgia were recruited from the Rheumatology department for the cross-sectional, case-control study. Cognition (Mini-Mental State Examination, Stroop color-word task), corticomotor excitability (Resting motor threshold, Motor evoked potential amplitude), daytime sleepiness (Epworth sleepiness scale), and sleep quality (Pittsburgh sleep quality index) were studied according to the standard procedure. Results: Thirty-four patients of fibromyalgia and 30 pain-free controls were recruited for the study. Patients of fibromyalgia showed decreased cognitive scores (p = 0.05), lowered accuracy in Stroop color-word task (for color: 0.02, for word: 0.01), and prolonged reaction time (< 0.01, < 0.01). Excessive daytime sleepiness in patients were found (< 0.01) and worsened sleep quality (< 0.01) were found. Parameters of corticomotor excitability were comparable between patients of fibromyalgia and pain-free controls. Conclusions: Patients of fibromyalgia made more errors, had significantly increased reaction time for cognitive tasks, marked daytime sleepiness, and impaired quality of sleep. Future treatment strategies may include cognitive deficits and sleep disturbances as an integral part of fibromyalgia management.

Abstract Objectives Fibromyalgia Syndrome (FMS), is a chronic pain disorder with poorly understood pathophysiology. In recent years, repetitive transcranial magnetic stimulation (rTMS) has been recommended for pain relief in various chronic pain disorders. The objective of the present research was to study the effect of low frequency rTMS over the right dorsolateral prefrontal cortex (DLPFC) on pain status in FMS. Methods Ninety diagnosed cases of FMS were randomized into Sham-rTMS and Real-rTMS groups. Real rTMS (1 Hz/1200 pulses/8 trains/90% resting motor threshold) was delivered over the right DLPFC for 5 consecutive days/week for 4 weeks. Pain was assessed by subjective and objective methods along with oxidative stress markers. Patients were followed up for 6 months (post-rTMS;15 days, 3 months and 6 months). Results In Real-rTMS group, average pain ratings and associated symptoms showed significant improvement post rTMS. The beneficial effects of rTMS lasted up to 6 months in the follow-up phase. In Sham-rTMS group, no significant change in pain ratings was observed. Conclusion Right DLPFC rTMS can significantly reduce pain and associated symptoms of FMS probably through targeting spinal pain circuits and top-down pain modulation . Trial registration: Ref No: CTRI/2013/12/004228.

Purpose: The purpose of this paper is to test the relationship between the annual income earned by the investors and eight behavioural biases exhibited by the investors such as mental accounting, anchoring, gambler's fallacy, availability, loss aversion, regret aversion, representativeness and overconfidence. Design/methodology/approach: The relationship is derived based on a questionnaire survey conducted on 436 secondary equity investors residing in Chennai, India. Findings: Analysis of variance test was performed on the normalised and non-normalised version of the biases divided in terms of the annual income earned by the investor. The test found that for the significant biases except the overconfidence bias, the investors with higher annual income were less prone to the biases when compared to investors with lower annual income. On the other hand, with respect to the overconfidence bias, the investors with higher annual income were prone to exhibit overconfidence bias when compared to the investors with lower annual income. Correlation analysis showed that the investors with high annual income were more likely to exhibit higher overconfidence bias but lower representativeness, loss aversion, availability and mental accounting biases. Originality/value: A contribution in the financial and economic front which would benefit the financial advisors to now consider the income earned by the clients as an important factor while giving financial advice to the clients and while guiding them about the biases they are prone to exhibit.

ABSTRACT Heavy metal toxicity in plants lead to accumulation of reactive oxygen species (ROS). Antioxidant enzyme system is also not able to revert altered ROS homeostasis. The present study reports the heavy metal induced ROS toxicity by up-regulating the expression of key antioxidant enzyme genes through Brassinosteroids pre-soaking treatment in radish.

Viscosity q and density p of aqueous concentrated perchloric acid 1.0 moldm-3 to 9.0 moldm-3 were measured at 297.65K. The viscosity data were used to calculate the value of A and B-coefficient of Jones-Dole equation. The value of B-coefficient is positive which suggests the strong ion-solvent interaction in aqueous perchloric acid. The three concentration regions of perchloric acid having value of B-coefficient (measure of ion-solvent interaction or structure making capacity) in the order 1.0 to 4.0 moldm-3 < 4.0 to 6.0 moldm-3 < 6.0 to 9.0 moldm-3 has been proposed.

Leishmania donovani is the known causative agent of both cutaneous (CL) and visceral leishmaniasis in Sri Lanka. CL is considered to be under-reported partly due to relatively poor sensitivity and specificity of microscopic diagnosis. We compared robustness of three previously described polymerase chain reaction (PCR) based methods to detectLeishmania DNA in 38 punch biopsy samples from patients presented with suspected lesions in 2010. Both, Leishmaniagenus-specific JW11/JW12 KDNA and LITSR/L5.8S internal transcribed spacer (ITS)1 PCR assays detected 92% (35/38) of the samples whereas a KDNA assay specific forL. donovani (LdF/LdR) detected only 71% (27/38) of samples. All positive samples showed a L. donovani banding pattern upon HaeIII ITS1 PCR-restriction fragment length polymorphism analysis. PCR assay specificity was evaluated in samples containing Mycobacterium tuberculosis, Mycobacterium leprae, and human DNA, and there was no cross-amplification in JW11/JW12 and LITSR/L5.8S PCR assays. The LdF/LdR PCR assay did not amplify M. leprae or human DNA although 500 bp and 700 bp bands were observed in M. tuberculosis samples. In conclusion, it was successfully shown in this study that it is possible to diagnose Sri Lankan CL with high accuracy, to genus and species identification, using Leishmania DNA PCR assays.

Abstract Mutations in the tafazzin (TAZ) gene on chromosome Xq28 are responsible for the Barth syndrome (BTHS) phenotype resulting in a loss of function in the protein tafazzin involved in the transacylation of cardiolipin, an essential mitochondrial phospholipid. TAZ gene was investigated in the proband in our study, who died of dilated cardiomyopathy at 8 months of age, and his family by sequencing to identify the genetic cause of BTHS. Molecular analysis revealed a novel mutation in exon 5 (c.520T>G) of the TAZ gene. This novel mutation c.520T>G, pW174G, was also found in female carriers (mother and grandmother of proband) in the family. Bioinformatic analysis was carried out to examine the effect of mutation in the gene and confirmed the deleterious effect of this single mutation to the protein structure. Protein modeling and 3-dimensional structure of TAZ protein demonstrated the significantly visible changes in mutated protein leading to BTHS phenotype. Prenatal diagnosis in a subsequent pregnancy showed a carrier female, and pregnancy was continued. Child is doing well at 1 year of age.