Displaying publications 1 - 20 of 55 in total

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  1. Agarwal A, Singh S, Agarwal S, Gupta S
    Malays Orthop J, 2018 Nov;12(3):31-37.
    PMID: 30555644 DOI: 10.5704/MOJ.1811.007
    Introduction: Early diagnosis of osteoarticular tuberculosis (OATB) is essential to prevent significant functional disability. There is no single test for diagnosis. Despite an array of investigations available, definitive diagnosis at early stage before starting antitubercular drugs is still a challenge. Materials and Methods: A cross sectional study was carried out between February 2016 and October 2017. All children less than 18 years of age with suspected osteoarticular tuberculosis were included. The cases were subjected to simple needle aspiration from whichever site was accessible. Multiple sample aspirations were done at site of involvement. Smears were prepared from the aspirated material. Results: Ziehl-Neelsen staining for Acid Fast Bacilli (AFB) showed deep pink red rods under light microscopy. Features suggestive of tuberculosis can be seen by May-Grünwald-Giemsa (MGG) staining. Auramine-O staining method of detecting AFB under fluorescent microscope shows the bacilli as greenish yellow slender curved rods in dark background. Fluorescent microscopy has higher sensitivity and comparable specificity. In our study, microbiological confirmation of OATB could be done in 100% cases where the lesion could be accessed for aspiration. The molecular techniques are relatively more expensive and not available everywhere. Conclusion: Meticulous search for AFB in a well stained smear using three different staining methods provides a direct evidence of infection over costly imaging especially in poor patients seen in resource limited settings.
  2. Soni A, Kansay R, Gupta S, Malhotra A
    Malays Orthop J, 2019 Mar;13(1):57-59.
    PMID: 31001387 DOI: 10.5704/MOJ.1903.014
    Femoral condyle fracture in coronal plane, also known as Hoffa fracture, is a rare fracture. Non-union of Hoffa fracture is even rarer. We present a case of fibrous nonunion of a Hoffa fracture in which the fractured fragment, though not freely movable, led to painful walking. Since the fragment was un-displaced and non-movable we fixed the fractured fragment in situ. Patient regained full range of motion of the knee and was asymptomatic on follow-up.
  3. Krishna A, Garg S, Gupta S, Bansal H
    Malays Orthop J, 2021 Jul;15(2):143-150.
    PMID: 34429835 DOI: 10.5704/MOJ.2107.021
    Introduction: To evaluate the trends of C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) in the first three weeks after uncomplicated total hip (THR) and total knee (TKR) arthroplasty/replacement in the Indian population and to compare it with available literature.

    Materials and methods: A total of 90 patients were enrolled for this prospective study, of which 30 were unilateral THR, 30 were unilateral TKR (U/L TKR) and 30 were simultaneous bilateral TKR (B/L TKR). Serum CRP and ESR were measured on the day before surgery and post-operatively on day 1st, 2nd, 3rd, 7th, 12th, and at the end of 3rd week.

    Results: CRP showed a peak at day 2nd with normalisation to pre-operative value by the end of 3rd week. While ESR showed a peak on day 3rd and continued to remain elevated even at end of 3rd week post-operatively. Both mean CRP and ESR values were higher in THR patients followed by in B/L TKR and then in U/L TKR patients.

    Conclusion: CRP persists to be the best acute phase reactant in the early post-operative phase with a relatively typical pattern as compared to ESR. CRP values peak at post-operative day 2nd and then show a gradual decline. However, its normalisation to pre-operative baseline values may vary among different groups of population.

  4. Saurabh CK, Gupta S, Variyar PS
    J Food Sci Technol, 2018 Jun;55(6):1982-1992.
    PMID: 29892098 DOI: 10.1007/s13197-018-3112-3
    The objective of this study was to develop biodegradable active film to improve the shelf-life of minimally processed fresh-produce. Guar gum (GG) based films with improved properties were fabricated by employing tween-80 (0.88%) as emulsifier, nanoclay (13.9%) as reinforcement, beeswax (1.21%) for hydrophobicity, glycerol (3.07%) as plasticizer, and grape pomace extract (5%) as active ingredient (%w/w of GG). Active films had a tensile strength of 122 MPa and water vapor transmission rate of 69 gm-2d-1. Films demonstrated significant antimicrobial activity against Escherichia coli, Staphylococcus aureus, Bacillus cereus, and Salmonella Typhimurium. The 2 kGy irradiated minimally processed pomegranate arils packed in film demonstrated a shelf-life of 12 days as compared to 4 days for unirradiated samples. The observed improvement in shelf-life was due to a radiation-induced release of antimicrobial volatiles from active films as confirmed by headspace analysis using GC-MS. Suitability of active films for food irradiation applications is thus demonstrated.
  5. Deka L, Gupta S, Gupta R, Gupta K, Kaur CJ, Singh S S
    Malays J Pathol, 2017 Apr;39(1):33-37.
    PMID: 28413203
    BACKGROUND: Fine needle aspiration cytology (FNAC) is a reliable and reproducible diagnostic technique for thyroid lesions with certain limitations. Computed morphometric methods have been introduced with a view to improve the diagnostic yield of thyroid aspirates. However, a review of the existing literature revealed conflicting reports regarding morphometric parameters in thyroid neoplasms.

    MATERIALS AND METHODS: This study included 50 cases of thyroid lesions (20 cases of colloid goitre, 15 of follicular adenoma, 5 of follicular carcinoma and 10 papillary carcinomas). Digital images of cytologic smears of these cases were captured using a dedicated photomicrography system and nuclear profiles traced manually. With self-designed image analysis software, nuclear morphometric measurements, including texture analysis, were performed. Discriminant analysis was performed including the morphometric parameters and percentage of correctly classified nuclei noted.

    RESULTS: Nuclear morphometry parameters showed that papillary thyroid carcinoma had the highest perimeter, area, radius and elongation factor compared to other thyroid lesions. Discriminant analysis revealed that altogether 77.9% of cells could be correctly classified to their lesion category based on the nuclear morphometric and textural parameters. Of the neoplastic cases, 84.5% of cells of follicular neoplasms and 72.5% of papillary carcinoma were classified to the respective category.

    CONCLUSION: Nuclear morphometry, including texture analysis, can assist in the cytologic diagnosis of thyroid lesions, considering the high degree of accuracy of classification. Further studies and methodological refinements can achieve higher accuracy.

  6. Arora S, Verma M, Gupta SR, Urs AB, Dhakad MS, Kaur R
    Biotech Histochem, 2016 May;91(4):237-41.
    PMID: 26984382 DOI: 10.3109/10520295.2015.1127425
    We investigated the prevalence and phenotypic variation of Candida species in oral lichen planus (OLP) and the therapeutic implications of our findings. Eighty patients with clinically and histopathologically confirmed cases of OLP (64 non-erosive, 16 erosive) and a control group of 80 healthy individuals with no predisposing factors for oral candidiasis were examined for evidence of Candida infection. Oral swabs and smears were obtained for cytology and culture. Identification, speciation and antifungal susceptibility tests of Candida isolates were performed using an automated microbial identification system. Fifty percent of erosive OLP cases, 28% of non-erosive cases and none of the controls showed evidence of Candida. Candida albicans was found predominantly in non-erosive OLP, while other Candida species were predominate in erosive OLP. Non-Candida albicans isolates (C. glabrata, C. krusei) were resistant to the commonly used antifungals, clotrimazole and fluconazole. Candida infection is common in cases of OLP. We recommend antifungal sensitivity testing prior to antifungal therapy for the erosive form of OLP.
  7. Gupta S, Mishra KP, Kumar B, Singh SB, Ganju L
    J Ethnopharmacol, 2020 Oct 28;261:113022.
    PMID: 32569719 DOI: 10.1016/j.jep.2020.113022
    ETHNOPHARMACOLOGICAL RELEVANCE: Traditional plant-derived medicines have enabled the mankind in curing the wide spectrum of diseases throughout the ages. Andrographis paniculata (Burm.f.) Nees, is one of the traditional plant used as a folk medicine for the management of inflammation, arthritis, viral-bacterial infections and other ailments in India, China, Malaysia and other South-East Asian countries. Its major bioactive compound; andrographolide, a diterpenoid, also exerts cytoprotective properties and is reported to be effective in neuroprotection, hepatoprotection, etc. AIM: The study is aimed to explore the role of andrographolide in treatment of complete freund's adjuvant (CFA) induced arthritis.

    MATERIALS AND METHODS: The influx of immune cells, release of pro-inflammatory cytokines and subsequent accumulation of synovial fluid (swelling) and pain manifest into the disease. The present study used CFA induced Balb/c mice model and treated them intraperitoneally with andrographolide and dexamethasone (used as a positive control) on alternate days for six days. After 6 days, blood and peritoneal macrophages were collected to evaluate the expression of various arthritic markers and paw edema was measured on all days.

    RESULTS: The in vitro and ex vivo experiments showed that andrographolide treated animal group had reduced paw edema, cell cytotoxicity and nitric oxide production than dexamethasone treated animal group. Further, the study revealed the mechanistic role of andrographolide in treatment of arthritis by suppressing battery of molecules like COX-2, NF-κB, p-p38, CD40, TNF-α, IL-1β and IL-6 involved in arthritis.

    CONCLUSION: The study showed the potent anti-arthritic effects of andrographolide and warrants further investigations on andrographolide for the development of safe and effective anti-arthritic drug.

  8. Agarwal A, Sharma R, Durairajanayagam D, Cui Z, Ayaz A, Gupta S, et al.
    Urology, 2015 Mar;85(3):580-8.
    PMID: 25733269 DOI: 10.1016/j.urology.2014.11.030
    To compare the sperm protein profile between infertile men with unilateral varicocele and infertile men with bilateral varicocele.
  9. Gupta S, Parolia A, Jain A, Kundabala M, Mohan M, de Moraes Porto IC
    J Indian Soc Pedod Prev Dent, 2015 Jul-Sep;33(3):245-9.
    PMID: 26156281 DOI: 10.4103/0970-4388.160402
    The aim of this in vitro study was an attempt to investigate the effect of different surface treatments on the bond strength between pre-existing composite and repair composite resin.
  10. Prabha R, Singh DP, Gupta S, Gupta VK, El-Enshasy HA, Verma MK
    Microorganisms, 2019 Nov 23;7(12).
    PMID: 31771141 DOI: 10.3390/microorganisms7120608
    Multifunctionalities linked with the microbial communities associated with the millet crop rhizosphere has remained unexplored. In this study, we are analyzing microbial communities inhabiting rhizosphere of kodo millet and their associated functions and its impact over plant growth and survival. Metagenomics of Paspalum scrobiculatum L.(kodo millet) rhizopshere revealed taxonomic communities with functional capabilities linked to support growth and development of the plants under nutrient-deprived, semi-arid and dry biotic conditions. Among 65 taxonomically diverse phyla identified in the rhizobiome, Actinobacteria were the most abundant followed by the Proteobacteria. Functions identified for different genes/proteins led to revelations that multifunctional rhizobiome performs several metabolic functions including carbon fixation, nitrogen, phosphorus, sulfur, iron and aromatic compound metabolism, stress response, secondary metabolite synthesis and virulence, disease, and defense. Abundance of genes linked with N, P, S, Fe and aromatic compound metabolism and phytohormone synthesis-along with other prominent functions-clearly justifies growth, development, and survival of the plants under nutrient deprived dry environment conditions. The dominance of actinobacteria, the known antibiotic producing communities shows that the kodo rhizobiome possesses metabolic capabilities to defend themselves against biotic stresses. The study opens avenues to revisit multi-functionalities of the crop rhizosphere for establishing link between taxonomic abundance and targeted functions that help plant growth and development in stressed and nutrient deprived soil conditions. It further helps in understanding the role of rhizosphere microbiome in adaptation and survival of plants in harsh abiotic conditions.
  11. Goud EVSS, Gulati S, Agrawal A, Pani P, Nishant K, Pattnaik SJ, et al.
    J Family Med Prim Care, 2021 Nov;10(11):4247-4252.
    PMID: 35136797 DOI: 10.4103/jfmpc.jfmpc_885_21
    Background: Down syndrome which is also known as "trisomy 21" is the commonest chromosomal defect that has been associated with intellectual disability or impairment. Clinically, it has been characterized by the generalized presence of hypotonic musculature, variety of neurobiological alterations, numerous respiratory diseases, and significantly higher risk of developing infection along with various dental abnormalities and oro-facial dysmorphological changes. Periodontal diseases are the most prominent oral health issue among individuals diagnosed with Down Syndrome.

    Aim: The objective of the present prevalence analysis was to study the implications of Down's syndrome on oral health status among patients.

    Materials and Methods: This was a descriptive and cross-sectional prevalence analysis conducted within a duration of 1 year. A total of 100 children diagnosed with Down syndrome (aged between 5 and 16 years) were selected as the study sample. Inclusion criteria were (a) cytogenetic positive trisomy 21, (b) cooperative behavior, and (c) written informed consent obtained from the legal care-takers. Exclusion criteria were (a) any debilitating form of systemic diseases, (b) any other disability, and (c) extremely uncooperative children. The gingival health status was assessed using gingival index (GI) [Loe and Silness], calculus index (CI) [Ramfjord], and plaque index (PI) [Silness and Loe]. Information involving the practice of oral hygiene maintenance, diet plans, and parental educational status was derived from each parent. Based upon their intelligence quotient (I. Q.) values, the subjects were classified into three groups: a) mild (I. Q. level = 50 to 70), b) moderate (I. Q. level = 35 to 50), and c) severe (I. Q. level ≤35). Statistical analysis was performed using the statistical software tool Statistical Package for Social Sciences (SPSS) version 20.0. Qualitative data were recorded as frequencies, and percentages and quantitative data were recorded as mean and standard deviation values. All categorical outcomes were analyzed by means of the Chi-square test. The quantitative outcomes of Calculus Index, Gingival Index, and Plaque Index were analyzed by either student's t-test or one-way analysis of variance (ANOVA). Significance was set at a cut-off value of P < 0.05.

    Results: Down syndromic children between 12 and 16 years were reported to have statistically significant higher Calculus Index, Gingival Index, and Plaque Index values in comparison with younger age syndromic children (P < 0.01). Those with severe mental retardation had significantly higher Plaque Index (P < 0.001) and Gingival Index (P < 0.04) values when compared with those with mild and moderate mental retardation. No significant difference in comparing Calculus Index was noted.

    Conclusion: Higher age group children with Down syndrome require close monitoring by parents for assisting in maintaining oral hygiene practices just as in younger age group children.

  12. Satyavert, Gupta S, Choudhury H, Jacob S, Nair AB, Dhanawat M, et al.
    Pharmacol Rep, 2021 Dec;73(6):1734-1743.
    PMID: 34283375 DOI: 10.1007/s43440-021-00312-5
    BACKGROUND: Curcumin, a natural polyphenol from Curcuma longa, is known to possess diversified pharmacological roles including anti-inflammatory, antioxidant, antiproliferative and antiangiogenic properties; however, its bioavailability is severely limited due to its poor solubility, poor absorption, rapid metabolism, and significant elimination. Hydrazinocurcumin (HZC), a novel analogue of curcumin has been reported to overcome the limitations of curcumin and also possesses multiple pharmacological activities. The present study aimed to evaluate the unexplored pharmacokinetic profile of this agent in experimental rats.

    METHODS: Drug formulations were administered to the experimental animals via oral, intravenous and intraperitoneal routes. Blood samples were collected at different pre-determined time intervals to determine the pharmacokinetic parameters. To understand the biodistribution profile of HCZ, tissue samples were isolated from different groups of Sprague-Dawley rats at different time points. The pharmacokinetic parameters of HZC were evaluated after administration through oral (100 mg/kg), intraperitoneal (100 mg/kg) and intravenous (10 mg/kg) routes.

    RESULTS: Significantly (p 

  13. Paudel K, Gupta S, Gautam K, Wickersham JA, Khati A, Azwa I, et al.
    J Community Health, 2023 Jun;48(3):513-521.
    PMID: 36732459 DOI: 10.1007/s10900-023-01195-8
    The recent approval of long-acting injectable cabotegravir (CAB-LA) as PrEP for HIV prevention could be an attractive alternative for MSM, particularly among those who face barriers to adherence using the oral pill. This study reports on the awareness of long-acting injectable PrEP (LAI-PrEP) and factors associated with interest in LAI-PrEP use among a nationwide sample of MSM in Malaysia. An online cross-sectional survey was conducted between August and September 2021 to explore perspectives on PrEP modalities among Malaysian MSM (N = 870). Convenience sampling was used to recruit participants using ads on two platforms hornet and facebook. While only 9.1% of the study participants were aware of LAI-PrEP, the majority had heard of oral PrEP (80.9%). After giving a description of it, a large majority (86.6%) expressed interest in using it if made accessible. Those who had a prior history of HIV testing (aOR = 1.9; 95% CI = 1.2-3.2) were more likely to use LAI-PrEP. Interestingly, despite the concerns related to potential high cost (aOR = 3.4; 95% CI = 2.1-5.5) and long-term side effects (aOR = 1.9; 95% CI = 1.2-3.1), the majority of the participants were interested in using LAI-PrEP. Those who were afraid of (or disliked) syringes were less interested in using it (aOR = 0.2; 95% CI; 0.1-0.4). In the recent context that LAI-PrEP was shown to be safe and effective at preventing HIV, our results indicate its potential relevance as an additional PrEP option that could accelerate the uptake and scale-up of PrEP. However, it is crucial to conduct future research urgently to improve the understanding of strategies that could enhance the accessibility, acceptability, and affordability of LAI-PrEP for MSM in low- and middle-income countries, including Malaysia.
  14. Mohd J, Bhat NA, Lone ZA, Bhat TA, Afzal T, Dev B, et al.
    Malays Orthop J, 2023 Jul;17(2):49-56.
    PMID: 37583530 DOI: 10.5704/MOJ.2307.008
    INTRODUCTION: Open tendoachilles injuries are rare and associated with significant soft tissues complications. The objective of the present study was to assess the clinical outcome and safety of a simple and minimally invasive technique, with a goal to assess if it may help minimise flap and wound related complications in open tendoachilles injuries.

    MATERIALS AND METHODS: This prospective study of four years duration included 20 patients with open tendoachilles injuries managed with a simple minimally invasive tunnel technique. The primary outcome variable was occurrence of a major soft tissue complication. The secondary outcome variables included functional outcome measured using AOFAS Ankle hind foot score, re-rupture of tendoachilles and need for revision surgery.

    RESULTS: None of the patients in the present series developed a serious soft tissue complication. Based upon the AOFAS hind foot scoring system, good to excellent outcome was achieved in 19 (95%) patients. All the patients were able to perform tip toe walking at six months post-surgery. None of the patients had a re-rupture of the tendoachilles and no patient needed a revision surgery. The complications encountered include thickening of the tendon at the repair site (15%), superficial wound infection (5%), stitch granuloma (5%) and hypertrophic scar (5%).

    CONCLUSION: This technique seems to be promising in reducing the soft tissue complications associated with the surgical management of open tendoachilles injuries. Most patients had a good final clinical outcome. The technique is safe, simple and reproducible. However, further randomised control studies with a larger sample size assessing the technique are recommended.

  15. Rajani AM, Shah UA, Mittal A, Gupta S, Garg R, Rajani AA, et al.
    Malays Orthop J, 2023 Jul;17(2):13-20.
    PMID: 37583526 DOI: 10.5704/MOJ.2307.003
    INTRODUCTION: The preferred management of medial meniscus tears has notably moved from meniscectomies towards repair. With a higher volume of meniscal repairs being done all across the world with every passing day, the lack of an objective and definitive sign suggesting the adequacy of its repair is daunting. The purpose of our study was to introduce a unique and novel arthroscopic sign formed after adequate repair of the medial meniscus, the AMR (Adequacy of Medial meniscus Repair) sign. We hypothesised that it is not only the objective end point for repair, but can also form the indicator for excellent clinical, functional, and radiological outcome even in the long term.

    MATERIALS AND METHODS: This was a multicentric, prospective study initiated by the corresponding author, and the findings validated subsequently by the other authors. Overall, it included 804 patients of isolated medial meniscus tear operated with arthroscopic all-inside technique between January 2014 and December 2017. Patients were segregated into three groups based on whether an S-shaped curve in the free, inner edge of the medial meniscus sign was formed post-repair, lost after further tightening, or not formed upon subjective completion of repair. All the patients were followed-up and evaluated based of medial joint line tenderness, McMurray's test for medial meniscus, IKDC score, WOMET score, and radiologically using an MRI at the terminal follow-up.

    RESULTS: The mean terminal follow-up was 42.34±4.54 months. There was significant (p<0.01) improvement in all patients at the terminal follow-up post-surgery, irrespective of the group. The group in which AMR sign was formed and maintained showed a significantly better functional outcome on terminal follow-up as well as lower failure rates compared to the other two groups.

    CONCLUSION: AMR sign is an S-shaped fold at the inner, free edge of medial meniscus, formed after an adequate repair of isolated medial meniscus tear, as viewed on arthroscopy. It is an objective sign denoting regained integrity of the collagen architecture of the medial meniscus following repair. It is also a reliable indicator of excellent long term functional, clinical, and radiological outcome and also lower failure rates in patients after arthroscopic medial meniscus repair.

  16. Zahoor F, Hussin FA, Isyaku UB, Gupta S, Khanday FA, Chattopadhyay A, et al.
    Discov Nano, 2023 Mar 09;18(1):36.
    PMID: 37382679 DOI: 10.1186/s11671-023-03775-y
    The modern-day computing technologies are continuously undergoing a rapid changing landscape; thus, the demands of new memory types are growing that will be fast, energy efficient and durable. The limited scaling capabilities of the conventional memory technologies are pushing the limits of data-intense applications beyond the scope of silicon-based complementary metal oxide semiconductors (CMOS). Resistive random access memory (RRAM) is one of the most suitable emerging memory technologies candidates that have demonstrated potential to replace state-of-the-art integrated electronic devices for advanced computing and digital and analog circuit applications including neuromorphic networks. RRAM has grown in prominence in the recent years due to its simple structure, long retention, high operating speed, ultra-low-power operation capabilities, ability to scale to lower dimensions without affecting the device performance and the possibility of three-dimensional integration for high-density applications. Over the past few years, research has shown RRAM as one of the most suitable candidates for designing efficient, intelligent and secure computing system in the post-CMOS era. In this manuscript, the journey and the device engineering of RRAM with a special focus on the resistive switching mechanism are detailed. This review also focuses on the RRAM based on two-dimensional (2D) materials, as 2D materials offer unique electrical, chemical, mechanical and physical properties owing to their ultrathin, flexible and multilayer structure. Finally, the applications of RRAM in the field of neuromorphic computing are presented.
  17. Gupta S, Vellanki VK, Shetty VK, Kushwah S, Goyal G, Chandra SM
    J Clin Diagn Res, 2015 Jan;9(1):ZC09-11.
    PMID: 25738077 DOI: 10.7860/JCDR/2015/11463.5386
    AIMS: To compare the shear bond strength of nanocomposites to dentin using three different types of adhesive systems; and to test few specimens under Scanning Electron Microscope (SEM) for analysing whether the bond failure is adhesive or cohesive.

    MATERIALS AND METHODS: Sixty human premolar teeth were selected and were randomly grouped, with 20 specimens in each group: group 1 - fluoride releasing dentin bonding agent; group 2 - antibacterial containing dentin bonding agent; and group 3 - one step conventional self etch adhesive. Each group was treated with its respective bonding agents, composite resin build up was done, and shear bond strengths were tested using Instron Universal testing machine. Few of the specimens were tested under SEM.

    RESULTS: The results were statistically analysed using One-way ANOVA and paired t-test. It was observed that group 3 has the highest shear bond strength followed by group 2, and then group 1. Adhesive failures and mixed failures were most frequent types of failures as seen under SEM.

    CONCLUSION: Addition of antimicrobial agent decreases the bond strength of dentin bonding agent and addition of fluoride further decreases the bond strength. From SEM results it can be concluded that the zone of failure could not be defined and also that the failure mode was independent of the dentin bonding agent used.

  18. Gupta S, Bharatha A, Cohall D, Rahman S, Haque M, Azim Majumder MA
    Cureus, 2024 Mar;16(3):e55468.
    PMID: 38440201 DOI: 10.7759/cureus.55468
    Aerobic exercise is a widely adopted practice, not solely for enhancing fitness and reducing the risk of various diseases but also for its ability to uplift mood and aid in addressing depression and anxiety disorders. Within the scope of this narrative review, we seek to consolidate current insights into the endocannabinoid-mediated regulation of stress and the brain's reward mechanism resulting from engaging in aerobic exercise. A comprehensive search was conducted across Medline, SPORTDiscus, Pubmed, and Scopus, encompassing data available until November 30, 2023. This review indicates that a bout of aerobic exercise, particularly of moderate intensity, markedly augments circulating levels of endocannabinoids - N-arachidonoyl-ethanolamine (AEA) and 2-acylglycerol (2-AG), that significantly contributes to mood elevation and reducing stress in healthy individuals.  The current understanding of how aerobic exercise impacts mental health and mood improvement is still unclear. Moderate and high-intensity aerobic exercise modulates stress through a negative feedback mechanism targeting both the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system, thereby facilitating stress regulation crucial role in endocannabinoid synthesis, ultimately culminating in the orchestration of negative feedback across multiple tiers of the HPA axis, coupled with its influence over cortical and subcortical brain structures. The endocannabinoid has been observed to govern the release of neurotransmitters from diverse neuronal populations, implying a universal mechanism that fine-tunes neuronal activity and consequently modulates both emotional and stress-related responses. Endocannabinoids further assume a pivotal function within brain reward mechanisms, primarily mediated by CB1 receptors distributed across diverse cerebral centers. Notably, these endocannabinoids partake in natural reward processes, as exemplified in aerobic exercise, by synergizing with the dopaminergic reward system. The genesis of this reward pathway can be traced to the ventral tegmental area, with dopamine neurons predominantly projecting to the nucleus accumbens, thereby inciting dopamine release in response to rewarding stimuli.
  19. Majumder MAA, Gaur U, Singh K, Kandamaran L, Gupta S, Haque M, et al.
    World J Radiol, 2021 Nov 28;13(11):354-370.
    PMID: 34904050 DOI: 10.4329/wjr.v13.i11.354
    Radiology education and training is of paramount clinical importance given the prominence of medical imaging utilization in effective clinical practice. The incorporation of basic radiology in the medical curriculum has continued to evolve, focusing on teaching image interpretation skills, the appropriate ordering of radiological investigations, judicious use of ionizing radiation, and providing exposure to interventional radiology. Advancements in radiology have been driven by the digital revolution, which has, in turn, had a positive impact on radiology education and training. Upon the advent of the corona virus disease 2019 (COVID-19) pandemic, many training institutions and hospitals adhered to directives which advised rescheduling of non-urgent outpatient appointments. This inevitably impacted the workflow of the radiology department, which resulted in the reduction of clinical in-person case reviews and consultations, as well as in-person teaching sessions. Several medical schools and research centers completely suspended face-to-face academic activity. This led to challenges for medical teachers to complete the radiology syllabus while ensuring that teaching activities continued safely and effectively. As a result, online teaching platforms have virtually replaced didactic face-to-face lectures. Radiology educators also sought other strategies to incorporate interactive teaching sessions while adopting the e-learning approach, as they were cognizant of the limitations that this may have on students' clinical expertise. Migration to online methods to review live cases, journal clubs, simulation-based training, clinical interaction, and radiology examination protocolling are a few examples of successfully addressing the limitations in reduced clinical exposure. In this review paper, we discuss (1) The impact of the COVID-19 pandemic on radiology education, training, and practice; (2) Challenges and strategies involved in delivering online radiology education for undergraduates and postgraduates during the COVID-19 pandemic; and (3) Difference between the implementation of radiology education during the COVID-19 pandemic and pre-COVID-19 era.
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