Child nutrition and the poor nutritional status of children remain a major public health challenge in many low-resource settings despite significant efforts by public authorities. The World Health Organization (WHO) recommends the weight-for-length z-score, the weight-for-height z-score, and mid-upper arm circumference (MUAC) as screening standards for severe acute malnutrition (SAM). Despite nutritional deficiencies and anomalies, numerous community-based predictors contribute to the establishment of malnutrition (moderate and severe). The present work will help policymakers and clinicians to look after the determinants of SAM. The present study aimed to determine the World Health Organization (WHO) growth standards and confounder predictors of moderate and severe acute malnutrition among children aged 6–60 months in a resource-constrained community setting. A cross-sectional study was performed among children aged 6–60 months within a resource-constrained community setting. The anthropometric measurements were performed using MUAC and weight-for-length z-score and weight-for-height z-score, with values <-3 recommended by the WHO as the standard. Bivariate analysis was used to identify predictive variables and risk factors for severe, acute, and moderate malnutrition. Of 301 children, 8.97

In recent times, microplastics (MPs) pollution has become a growing concern across the globe. MPs are easily transferred and ubiquitously found in ambient air. These MPs in the air can act as carriers for several toxic pollutants and exposure to MPs could lead to pulmonary diseases in humans. Polyethylene terephthalate (PET) is one of the most abundant airborne MPs in the ambient environements and nylon 66 is one of the most abundant MPs found in microenvironments. However, there are no studies reported for the quantification of airborne PET and nylon 66 microplastics present in inhalable fraction of ambient fine particulate matter. This study describes the methods optimized for the quantification of PET microplastics and nylon 66 microplastics bound to aiborne PM2.5 using LC-MS/MS. Teflon and Quartz fiber filters were tested for extraction efficiency in measuring the mass concentrations of airborne PET MPs and nylon 66 MPs. Teflon filters have shown good recovery (80 % – 120 %) compared to Quartz filters. Using the optimized methods, a pilot study was carried out at Delhi, the National Capital of India and Mohali, a suburban city in Northwest Indo-Gangetic Plain (NWIGP) for the determination of mass concentrations of PET MPs present in airborne inhalable fraction of ambient PM2.5 and a pilot study was carried out to measure the mass concentrations of nylon 66 microplastics present in the inhalable fraction of particulate matter collected in a shopping complex. Observed maximum mass concentrations of PET MPs in airborne PM2.5 at Delhi and Mohali are 135.2 ng m-3 and 158.0 ng m-3, respectively. The observed mass concentrations of nylon 66 MPs in the microenvironment in this study are in the range of 0.30 ng m-3 to 4.37 ng m-3.

BACKGROUND Childhood malnutrition contributes over half of the childhood mortality around the world, predominantly in South-Asian and sub-Saharan countries. AIM To summarize the childhood malnutrition epidemiology along with the comorbid factors associated with it and its management within the community. METHODS The data collection process involved conducting a comprehensive search using specific keywords such as child nutrition disorders and India with Boolean operators. The search was conducted in the Scopus and PubMed electronic databases. RESULTS Inadequate energy consumption initiates pathological alterations in the form of growth retardation, fat, visceral, and muscle loss, a reduction in basal metabolic rate, and a significant reduction in total energy expenditure. It has become evident that malnutrition shows an increased prevalence and incidence rate, despite available guidelines for the management of malnutrition. CONCLUSION Malnutrition can be a major player in the establishment of severe infections that result in significant post discharge mortalities in children. Future trials are required to fill the prime gaps in knowledge regarding the identification of other contributory factors in the pathogenesis of malnutrition and post-discharge infection. New biomarkers for early detection of malnutrition should be the priority of the scientific community for the early management of malnutrition.

Microplastics (MPs) in the air are one of the major concerns due to their possible health risks. In addition, airborne microplastics act as a carrier for several toxic air pollutants and cause carcinogenic, mutagenic and teratogenic effects. Nylon 66 is one of the most abundant MPs in the microenvironments. In this study, we report an optimized method for the quantification of nylon 66 MPs present in the fine particulate matter (PM2.5) using high-performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS). The optimized method exhibited excellent linearity, recovery rates, intraday and interday precision and sensitivity. The optimized method was deployed to carry out a pilot study to measure the mass concentrations of nylon 66 microplastics present in the inhalable fraction of particulate matter collected in a shopping complex. The observed mass concentrations of nylon 66 MPs in this study are in the range from 0.30 ng m-3 to 4.37 ng m-3. This study demonstrates the presence of inhalable fraction of nylon 66 MPs in the indoor environment and their mass concentrations were determined using HPLC-MS/MS.

Oral glucose tolerance test (OGTT) and glycated haemoglobin (HbA1c) have many limitations in diagnosing prediabetes. Glycated albumin (GA) estimation can be a potential tool for its early diagnosis. The present study aims to analyze the diagnostic efficacy of GA to identify prediabetes. Prediabetics (n = 406) and healthy (n = 406) subjects were included. OGTT was used as the diagnostic standard for identifying prediabetes. HbA1c was estimated in a Bio-Rad D-10 analyzer based on the High-Performance Liquid Chromatography (HPLC) method. GA was measured using the enzyme-linked immunosorbent assay (ELISA) technique and was expressed as a percent of total albumin. Total albumin was measured by the modified bromocresol Purple (BCP) dye-binding method in Siemen’s autoanalyzer. HbA1c (5.83 ± 0.57

Methionine synthase reductase (MTRR) gene involved in the signaling for production of enzyme called methionine synthase reductase that use for the synthesis of methionine, which further used in DNA replication and repair. Genetic variation in MTRR gene may alter the susceptibility of developing urinary bladder cancer. The present study undertaken to identify the contribution of genetic polymorphisms in the MTRR gene on the selected polymorphic sites including c.66A>G and c.524C>T towards urinary bladder cancer risk. Direct-DNA sequencing method was applied for the observation of genotyping distribution of MTRR c.66A>G and c.524C>T polymorphisms in 232 histopathological confirmed cases of transitional cell carcinoma (TCC) of urinary bladder cancer and 250 age-, sex- and ethnicity-matched cancer free controls. With significant difference (p = 0.05) of genotype analysis further corresponding Odds ratio (OR) and 95% confidence interval (CI) were calculated. Multivariable logistic regression analysis was applied for adjusting significant confounder variables. Haploview software (version 4.2) was used to perform pairwise Linkage Disequilibrium (LD) analysis. Age (p = 0.01), Habit of smoking (p = 0.05), tobacco consumption (p = 0.001) and diet (p = 0.02) were significantly differed between cases and controls. Both the MTRR substitution showed higher risk of developing urinary bladder cancer (p = <0.001), although this effect alters in multivariable logistic regression analysis in a protective association for both the substitution. No LD observed between the c.66A>G and c.524C>T substitutions. In conclusion, MTRR c.66A>G and c.524C>T substitutions showed a joint effect with the other associated risk factors. Further studies with a greater number of subjects of different ethnicity and polymorphisms are recommended for the better understanding urinary bladder cancer etiology and to screen the population who are at higher risk of developing urinary bladder cancer.

Background: Child nutrition and poor nutritional prominence of children is still a major public health threat to underdeveloped and developing countries despite stone breaking efforts of public authorities. World Health Organization (WHO) recommends weight for length z-score and weight of height Z score <-3 and mid-upper arm circumference (MUAC) as screening standards for severe acute malnutrition (SAM). Despite nutritional deficiencies and anomalies, numerous community-based predictors contribute to the establishment of malnutrition (moderate and severe).ObjectivesThe present study aimed to determine the World Health Organization (WHO) growth standards and confounder predictors of moderate and severe acute malnutrition among children aged between 6 to 60 months in a resource-deprived community setting.Methods: A cross-sectional study was performed among children aged between 6 to 59 months within a resource-deprived community setting. The anthropometric measurements were performed using MUAC and weight for length z-score and weight of height Z score <-3 recommended standard of WHO. Bivariate analysis was used to determine the predictive variables and risk factors in the occurrence of severe acute, acute and moderate malnutrition.Results: Out of 301 children, 8.97%, 10.96%, and 18.93% presented the class of severe acute, moderate and acute malnutrition with a higher number of male children with malnutrition. Bivariate analysis showed that malnutrition (severe acute, moderate and acute) was significantly associated with gender (Odds Ratio: 5.321; 95% Confidence Interval [CI]: 2.210 to 13.25 and Risk Ratio: 3.370 Confidence Interval [CI]: 1.773 to 6.275). Children from slum households (OR: 2.00; 95% CI: 0.336 to 22.16 and RR: 1.867; 95% CI: 0.398 to 10.75) were two times more likely to be severely malnourished. Higher odds of SAM were found among parents who consumed tobacco (OR: 6.508; 95% CI: 1.672 to 28.47 and RR: 5.565; 95% CI: 1.548 to 20.95).Conclusions: The findings of the present study showed that gender, household type, tobacco consumption by parents, family monthly income, anaemia and the status of antenatal care of mothers received during pregnancy were the major predictors of severe acute malnutrition. The study was conducted in a resource-deprived region and to reduce the prevalence and causes of malnutrition, food safety and guarantee schemes should be strictly monitored along with delivering education awareness within the community, especially to mothers in a family.Funding Information: This work was supported by the Indian Council of Medical Research New Delhi (Extramural Project Sanction No.)Declaration of Interests: The authors declare that they have no competing interests.Ethics Approval Statement: Not applicable.

The novel coronavirus severe acute respiratory syndrome-CoV-2 (SARS-CoV-2) is responsible for COVID-19 infection. The COVID-19 pandemic represents one of the worst global threats in the 21st century since World War II. This pandemic has led to a worldwide economic recession and crisis due to lockdown. Biomedical researchers, pharmaceutical companies, and premier institutes throughout the world are claiming that new clinical trials are in progress. During the severe phase of this disease, mechanical ventilators are used to assist in the management of outcomes; however, their use can lead to the development of pneumonia. In this context, mesenchymal stem cell (MSC)-derived exosomes can serve as an immunomodulation treatment for COVID-19 patients. Exosomes possess anti-inflammatory, pro-angiogenic, and immunomodulatory properties that can be explored in an effort to improve the outcomes of SARS-CoV-2-infected patients. Currently, only one ongoing clinical trial (NCT04276987) is specifically exploring the use of MSC-derived exosomes as a therapy to treat SARS-CoV-2-associated pneumonia. The purpose of this review is to provide insights of using exosomes derived from mesenchymal stem cells in management of the co-morbidities associated with SARS-CoV-2-infected persons in direction of improving their health outcome. There is limited knowledge of using exosomes in SARS-CoV-2; the clinicians and researchers should exploit exosomes as therapeutic regime.

Background: The COVID-19 pandemic adversely hit India and its economy recently and is associated with the increasing uncertainty among the mental health status of health care workers. When the World Health Organization focus has mostly on testing and finding a vaccine, healthcare workers are passing with a myriad of mental health problems. The present study decided to conduct an online survey for assessing health status. Aims and Objective: To assess the health of healthcare workers engaged in SARS-CoV-2 duties. Methods: From 4th July 2020 to 4th October 2020 an online Google Form, a survey was conducted among healthcare workers. The survey collected data on socio-demographic and health variables especially during COVID-19 duties in the form of questionnaires. Results: There were a total of 196 responses from different provinces of India collected. The mean age of the respondents was around 41 years with 62.3% males and 37.7% females. The study showed that most HCWs showed a change in the sleeping habit. Conclusions: The present study concluded that there is a need for holistic interventions among health care workers and more systematic and longitudinal evaluations of mental health status further needed. Keywords: SARS-CoV-2; Health; Health care workers; COVID-19; Mental Health; Stress.

Exosomes are nano-vesicles of endosomal origin inherited with characteristics of drug delivery and cargo loading. Exosomes offer a diverse range of opportunities that can be exploited in the treatment of various diseases post-functionalization. This membrane engineering is recently being used in the management of bacteria-associated diabetic foot ulcers (DFUs). Diabetes mellitus (DM) is among the most crippling disease of society with a large share of its imposing economic burden. DM in a chronic state is associated with the development of micro- and macrovascular complications. DFU is among the diabetic microvascular complications with the consequent occurrence of diabetic peripheral neuropathy. Mesenchymal stromal cell (MSC)-derived exosomes post-tailoring hold promise to accelerate the diabetic wound repair in DFU associated with bacterial inhabitant. These exosomes promote the antibacterial properties with regenerative activity by loading bioactive molecules like growth factors, nucleic acids, and proteins, and non-bioactive substances like antibiotics. Functionalization of MSC-derived exosomes is mediated by various physical, chemical, and biological processes that effectively load the desired cargo into the exosomes for targeted delivery at specific bacterial DFUs and wound. The present study focused on the application of the cargo-loaded exosomes in the treatment of DFU and also emphasizes the different approaches for loading the desired cargo/drug inside exosomes. However, more studies and clinical trials are needed in the domain to explore this membrane engineering.

SARS-CoV-2–infected patients are reported to show immunocompromised behavior that gives rise to a wide variety of complications due to impaired innate immune response, cytokine storm, and thrombo-inflammation. Prolonged use of steroids, diabetes mellitus, and diabetic ketoacidosis (DKA) are some of the factors responsible for the growth of Mucorales in such immunocompromised patients and, thus, can lead to a life-threatening condition referred to as mucormycosis. Therefore, an early diagnosis and cell-based management cosis is the need of the hour to help affected patients overcome this severe condition. In addition, extended exposure to antifungal drugs/therapeutics is found to initiate hormonal and neurological complications. More recently, mesenchymal stem cells (MSCs) have been used to exhibit immunomodulatory function and proven to be beneficial in a clinical cell-based regenerative approach. The immunomodulation ability of MSCs in mucormycosis patient boosts the immunity by the release of chemotactic proteins. MSC-based therapy in mucormycosis along with the combination of short-term antifungal drugs can be utilized as a prospective approach for mucormycosis treatment with promising outcomes. However, preclinical and in mucormyIn mucormycosis, the hyphae of clinical trials are needed to establish the precise mechanism of MSCs in mucormycosis treatment.

Background: Urinary bladder is an organ which incessantly exposed to carcinogenic substances and may cause chronic inflammation may subsequently lead to tumorigenesis. The functional regulatory polymorphisms of TNF-alpha gene modulate its control of inflammation and other major functions that may eventually lead to tumorigenesis. Objective: To analyze the link between three genetic polymorphisms of TNF-alpha gene including -863C > A, -308 G > A and - 238 G > A and the risk of developing UBC in Indian population. Methods: Direct DNA sequencing method was performed for the assessment of genotyping of TNF-alpha gene polymorphisms in the blood samples of histopathologically confirmed 232 cases of UBC compared to cancer free 250 controls. We have conducted meta-analysis investigating the association between TNF-alpha -308 G > A polymorphism and the risk of UBC by using available data from six studies (including the present data), comprising 1397 cases and 1722 controls. Results: Dominant model of -863C > A showed 2.33 fold higher risk of UBC in cases as compared to controls (p = 0.00003; OR = 2.33, 95%CI 1.56-3.47) while contrary, recessive model showed a significant protective effect (p = 0.03; OR = 0.45, 95%CI 0.23-0.91). Other polymorphism -238 G > A and - 308 G > A did not reveal significant association with UBC risk. Meta-analysis study did not show any significant association with the risk of UBC development (OR = 1.01, 95%CI 0.84-1.23; p = 0.88) with the fixed effect model (OR = 1.01, 95%CI 0.84-1.23; p = 0.88) random effect model. Conclusion: Overall, the results suggest that TNF-alpha -863C > A polymorphism has been found to significantly influence the risk of UBC. Further researches are needed to understand its potential role on UBC risk.

Multidisciplinary Research Unit, MoHFW, GSVM Medical College, Kanpur, U.P, India, 208001. Department of Microbiology, College of Basic Sciences and Humanities, GBPUA &T, Pantnagar, Uttarakhand, India, 263145. Department of Anatomy and Cell Biology, College of Medicine, Gachon University, Seongnam-si, Gyeonggi-do, South Korea. School of Public Health, Poornima University, Vatika Rd, Sitapura, Jaipur, Rajasthan 303905. Department of Medicine, Christian Medical College, Ludhiana, Punjab 141008. Former Professor of Endocrinology, Rajiv Gandhi Centre for Diabetes and Endocrinology, JN Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, India, 202002. Address correspondence to: Prashant Tripathi, e-mail: mru.gsvm@gmail.com; alokalig@gmail.com

Objective: It has been explored that Vitamin D play role in various non-skeletal disorders including Diabetes Mellitus. The present study was designed with the aim to assess association among control, pre-diabetic and diabetic with vitamin D and association between lipid profile and vitamin D. Materials and Methods: A total of 109 subjects were recruited for the cross-sectional study including 37 as control, 41 pre-diabetic and 31 diabetic. A clinical examination was done for all the groups including fasting samples (12hrs) for lipid parameters, serum 25 (OH) vitamin D level and (HbA1/C). Results: It was found that in control subjects 37.9% have the sufficient vitamin D3 level whereas 17.1% subjects in pre-diabetic, 16.6% in diabetic with good glycemic control and no subject was found to have sufficient vitamin D3 level in diabetic with poor glycemic control. The mean vitamin D3 levels was highest in control i.e. -26.53±11.99 ng/ml followed by 20.23±4.12ng/ml in pre-diabetics,19.07±8.01ng/ml in diabetics with good glycemic control and 12.92±6.77ng/ml in diabetics with poor glycemic control. HBA1/c and serum vitamin D3level share a significant association (P-value< 0.01).Total cholesterol (P-value< 0.0), serum triglyceride (P-value< 0.01), serum LDL cholesterol (P-value< 0.01) and serum VLDL (P-value< 0.01) had inverse association with vitamin D levels. HDL cholesterol has no effect with vitamin D. Conclusion: The present study showed vitamin D3 deficiency as a risk factor for worsening glycemic control and dyslipidemia.

Vitamin D plays an important role in glucose tolerance by stimulating insulin secretion and evidences suggest a contradictory result on the association between vitamin D status and risk of developing gestational diabetes mellitus (GDM). The present updated meta-analysis has been undertaken to find out the joined effect of vitamin D status on the risk of effect GDM considering previously published articles. Data were collected through literature search using electronic databases to retrieve relevant published research articles using various combinations of the following keywords, "vitamin D," "vitamin D deficiency," "cholecalciferol," "25-hydroxyvitamin D," "25(OH) D," "gestational diabetes mellitus," and "GDM." A total of 36 studies including 7,596 GDM cases and 23,377 non-GDM controls were involved in this study. Overall, pooled meta-analysis showed that pregnant women diagnosed with GDM have 18% higher risk of GDM risk when compared with controls [odds ratio (OR) = 1.18, 95% confidence interval (CI) 1.10–1.25; P = 0.00] with high heterogeneity (I2 = 73.29). The mean difference was also significantly different between cases and controls (OR = −0.18, 95% CI − 0.22 to − 0.14; P = 0.00). Subgroup analysis showed significant results with age more than 30 years, Asian and European regions, and case–control, cross-sectional, and nested case–control study design. Low concentration of vitamin D is associated with the development of GDM. Although in future more studies especially systematically designed clinical trials based on vitamin D supplementation with large sample size on different population are needed to elucidate the exact concentration of vitamin D during pregnancy as well as before and after pregnancy.

Background: A subtle modification in the genes coding for enzymes responsible for DNA synthesis, DNA repair and methylation can modify their activity, which eventually affects the susceptibility and sensitivity of an individual towards cancer. Methylene-tetrahydrofolate reductase (MTHFR) plays a crucial role in DNA synthesis and methylation reactions and genetic variations in this gene may associate with the cancer susceptibility. The present study analyzed three polymorphisms (c.677C>T, c.1298A>C and c.203G>A) in the MTHFR gene for correlation with the risk of urinary bladder cancer (UBC). Methods: Genotyping of the three polymorphisms was performed in 232 cases and 250 controls by direct DNA sequencing method. For meta-analysis, the relevant data were collected through literature search in “Pubmed”, “ScienceDirect” and “Google Scholar” databases using the keywords,‘methylene-tetrahydrofolatereductase’, ‘MTHFR’, ‘c.677C>T polymorphism’, ‘c.1298A>C polymorphism’ and ‘urinary bladder cancer’ in various combinations. Results: We observed a significant protective association of c.1298A>C with bladder cancer risk, but c.677C>T and c.203G>A were unrelated to the UBC risk. We also undertook a meta-analysis on 4171 cases and 4749 controls for c.677C>T polymorphism and on 3785 cases and 4205 controls for c.1298A>C polymorphism. The meta-analysis revealed a lack of association of these polymorphisms with the UBC risk. Conclusion: MTHFR c.1298A>C substitution is protective against urinary bladder cancer in the study population; however, meta-analysis denied an association at the global level.

Objective: To compare the effects of a combined nutritional-behavioral-exercise intervention therapy on anthropometric measurements, fitness level and carotid intima media thickness in overweight/obese children and adolescents. Design: Longitudinal follow up study. Setting: Children attending OPD in department of pediatrics, LLR & Associated Hospitals and School Camps from Kanpur city. Method: 124 obese children aged 6-18 years were enrolled from OPD and schools. These children were equally divided (62 each) into intervention (cases) versus control group. All cases were given combined nutritional behavioral- exercise intervention therapy for 3 months. After therapy these children were examined at 3 months and again after completion of 12 months. During period of 3 months to 12 months, no further active intervention was provided to cases. These children were compared with age and gender matched obese children, who did not participate in intervention study and served as control. All characteristics of cases and controls were noted before intervention, at 3 months and after 12 months of follow-up and compared by t-test. Additionally, in this study 125 normal children (Not obese or overweight) were also included for cross-sectional analysis of their intima media thickness with overweight and obese children of this study to compare the effect of obesity on vascular system. Results: On statistical analysis after 12 months in cases, body weight ( 2.61±0.132 kg Vs 6.52±1.751 kg), BMI (-0.4125±0.041 kg/m2 Vs 1.473±0.9308 kg/m2), TSF (-1.269±0.0957 cm Vs 2.045±0.9138 cm), waist circumference (-0.9615±0.1350 cm Vs 3.409±1.716 cm), fitness level ( 47.84±2.373 sec Vs -13.93±44.160 sec) and intima media thickness (-0.021±0.0046 mm Vs 0.0238±0.025 mm) have shown the significant improvement (P 0.05) except improvement in fitness level which was statistically significant even after 3 months (P< 0.05). Conclusion: This study demonstrates the long-term (12 months) beneficial effects of a combined nutritional-behavioral-exercise intervention therapy for treatment of childhood obesity. Short-term (3 months) effects may not be significant but long-term effects are encouraging. Weight loss should not be encouraged in every case of obesity. Obesity is a risk factor for early atherosclerotic changes and these changes are reversible with weight control measures.