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Abstract Amidst the global sanitation challenges of water pollution, waterborne diseases, and the alarming presence of pathogens in disinfected water, microalgal technology has emerged as a viable alternative for wastewater treatment. Recently, the ability of microalgae to remove pathogens from wastewater has been highlighted. However, a critical knowledge gap exists regarding microalgae-mediated pathogen removal mechanisms. The present study uncovers the intricate mechanisms of Chlorella pyrenoidosa-mediated Escherichia coli removal from sewage. Microalgae-induced pH increase was identified as the most crucial mechanism, followed by photooxidation and attachment, mediated by the hydroxyl group. Longer photoperiods or ultraviolet irradiation produced high oxidative stress, promoting microalgal exopolysaccharides’ production and increasing pathogen entrapment. The knowledge of crucial removal mechanisms can be harnessed for the development of more efficient, innovative, and scalable microalgal systems. Such improved systems offer a sustainable solution to address water-related issues by improving wastewater treatment, increasing access to clean water, and reducing the transmission risk of waterborne diseases.

Abstract Introduction India has committed to the Sustainable Development Goals (SDGs) 2030 principle of “Leave No One Behind”, which seeks to reduce disparities and vulnerabilities. The dearth of data on the oral health conditions of children with intellectual and developmental (IDD) disabilities in India is significant. Our systematic review intended to collate and synthesise data on the oral health status of children with IDD. Methods Online electronic databases such as PubMed-MEDLINE, Embase, and Scopus were searched using appropriate keywords from the earliest available data until 31st March 2024, with no language restriction. Cross-sectional studies conducted amongst individuals below 18 years of age with intellectual, or developmental disabilities, in India were included. Quality assessment and meta-analysis using a random-effects model for variables reported from four or more studies and a prediction interval was calculated. Results Out of 2388 studies, a total of 15 studies were included. Our study showed that 91% (95% [confidence interval] CI: 0.80–0.96) of IDD children use toothbrushes regularly. However, poor oral hygiene was found among 38% (95% CI = 0.21–0.59) of IDD children. The pooled prevalence of dental caries among children was found to be 64% (95% CI: 0.45–0.79). Periodontal disease was reported in only one study among 54.20% of IDD children. Conclusions Our findings suggest that despite brushing regularly the incidence of caries and poor oral hygiene in children with IDD is high. Flexible, tailored interventions that go beyond a uniform approach must be implemented to effectively address oral health requirements of children with IDD. Specific Health Programmes should be established for their preventive oral care.

Abstract Background Reconstruction of maxillofacial defects is challenging due to the region’s complex anatomy. During the COVID-19 era, many patients lost their maxilla and chewing efficiency as a result of Mucormycosis. In such cases, custom-designed implants offer a graftless solution for seemingly hopeless situations. This case report aims at miraculous dental transformation utilizing the Patient Specific Implant (PSI) approach. Case Presentation A 64-year-old male patient presented to the Prosthodontics Department with the chief complaint of missing teeth. He had been struggling with chewing for two years due to a post-mucormycotic maxillary jaw. A CT scan was obtained to evaluate and investigate the affected site. After a comprehensive diagnosis, the treatment of choice was a patient-specific implant decided using 3D printing technology. Reconstructing maxillofacial defects poses significant challenges due to the region’s intricate anatomy, as well as its aesthetic and functional implications. The use of pre-formed alloplastic implants and autogenous grafts often leads to complications such as resorption, infection, and displacement. However, recent technological advances have made it possible to fabricate customized patient-specific implants (PSIs) through computer modeling, offering new opportunities for reconstructive surgery. Conclusion This case report demonstrates the dental management of post-mucormycotic patients with specially designed implants, customized according to the availability and anatomy of the bone in the entire head region. The absence of complications during follow-up, conducted at 15, 30, 45, and 90 days, and subsequently monthly for two years, highlights the success of this approach. Evaluation parameters included infection, soft tissue recovery, wound separation, masticatory efficiency, stability of the prosthesis, and aesthetic outcomes. The positive outcomes observed at follow-up appointments emphasize the viability and effectiveness of patient-specific implants in addressing maxillary defects caused by post-mucormycosis.

Abstract Introduction The Global Adult Tobacco Survey (GATS) shows a drop in tobacco use worldwide. Despite the drop, there still continues to be a significant number of tobacco users in India. Research on tobacco use among young persons is commonly prioritised in India, while studies on tobacco use among middle-aged (45–59 years) and elderly (≥ 60 years) adults are noticeably lacking. We have conducted this study with objective to estimate the distribution, determinants and socioeconomic inequalities of smoking (SM) and smokeless tobacco (SLT) consumption across Indian states and union territories. Methods This study was based on 66,606 participants aged ≥ 45 years using Longitudinal Aging Study in India (LASI)-1 (2017–2018) data. Distribution of tobacco consumption (any form, smoking (SM), smokeless (SLT) and both) was documented as per Indian states and union territories with spatial distribution by Indian map. Demographic, socioeconomic, health related and behavioural determinants were established using nested multilevel regression modelling. Socioeconomic disparities were documented using concentration curve. P-value

Abstract Background Transcript variants and protein isoforms are central to unique tissue functions and maintenance of homeostasis, in addition to being associated with aberrant states such as cancer, where their crosstalk with the mutated tumor suppressor p53 may contribute to genomic instability and chromosomal rearrangements. We previously identified several novel splice variants in ovarian cancer RNA-sequencing datasets; herein, we aimed to elucidate the biological effects of the Integrin Subunit Beta 8 variant (termed pITGB8-205). Methods Resolution of the full-length sequence of pITGB8-205 through rapid amplification of cDNA ends (RACE-PCR). Cell cycle analysis and karyotype studies were performed to further explore genomic instability. RNA-seq and proteomics analyses were used to identify the differential expression of the genes. Results This full-length study revealed a unique 5’ sequence in pITGB8-205 that differed from the reported ITGB8-205 sequence, suggesting differential regulation of this novel transcript. Under a p53 mutant background, overexpression of pITGB8-205 triggered genetic instability reminiscent of oncogene-induced replicative stress with extensive abnormal mitoses and chromosomal and nuclear aberrations indicative of chromosomal instability, leading to near whole-genome duplication that imposes energy stress on cellular resources. Micronuclei and aneuploidy are striking features of pITGB8-205-overexpressing p53-mutant cells but are not enhanced in p53 wild-type (WT) cells. RNA-seq and proteomics analyses further suggested that p53 inactivation in ovarian cancer provides a permissive intracellular molecular niche for pITGB8-205 to mediate its effects on genomic instability. This observation is pivotal considering that most high-grade serous ovarian carcinoma (HGSC) tumors express mutant p53. The resulting aneuploid clones with enhanced self-renewal and survival capabilities disrupt clonal dominance under stress yet maintain a balance between replicative stress and prosurvival advantages. Conclusion pITGB8-205-overexpressing clones sustain ovarian tumor cell survival, achieve homeostasis and are formidable opponents of therapy.

Abstract Background The drug volume to be used in caudal in pediatric patients has remained an unmet issue since long. We determined the minimum drug volume required to reach T10 level in pediatric patients using ultrasonography and compared it with the already established volume by Armitage formula. Aim To determine the minimum effective caudal local anesthetic dose using ultrasound guidance. Methods Study was performed at two centres and at each centre, 50 pediatric patients (Total 100 patients), aged 1 to 3 years, undergoing below umbilical surgeries were included and randomised into two groups of 25 each (Total 50) to receive ultrasound guided drug volume vs. Armitage formula based volume. The volume required to reach T10 level was assessed with ultrasound in one group. Also, maximum height achieved, cutaneous level achieved after 15 min, FLACC scores 30 min post extubation and parental satisfaction scores were noted. Results The mean drug volume required to reach T10 level in Group U was 0.755 ± 0.053 ml/kg with a P value

Background: Lower respiratory tract infection (LRTI) is the most common infection causing significant mortality with a 3–5% death rate in adults. The emerging nature of antimicrobial resistance to pathogens makes its treatment more challenging and complicated for physicians. Aims and Objectives: The study was designed to obtain a comprehensive insight into the microbial profile and resistance patterns of the isolated pathogens in LRTI in a tertiary care hospital in Kolkata. Materials and Methods: The cross-sectional observational study was carried out in the Microbiology Department of N.R.S Medical College from January to December 2021. Specimens collected from 782 clinically suspected LRTI cases were processed as per standard laboratory protocol following clinical and laboratory standard Institute guidelines. Results: Out of 782 respiratory samples, 47.83% showed significant bacterial growth. The major risk factor was found to be type II diabetes mellitus (47.44%) followed by chronic obstructive pulmonary disease (36.57%) and smoking (21.35%). 85.56% growth was monomicrobial and Gram-negative organisms (88.50%) predominated. Klebsiella pneumoniae (36.90%) was the most predominant Gram-negative bacilli followed by Pseudomonas aeruginosa (17.11%) and Acinetobacter species (13.90%). Staphylococcus aureus was the predominant Gram-positive isolate (7.49%). Gram-negative organisms showed the highest resistance to penicillin and cephalosporins, whereas the lowest resistance in carbapenems. Piperacillin/tazobactam and levofloxacin showed good susceptibility. Linezolid was the most susceptible antimicrobial followed by vancomycin in the case of Gram-positive organisms. Extended-spectrum β-lactamase was detected as the mechanism of resistance in 31.12% of cases and carbapenemase was detected in 19.64% of cases. Conclusion: Increasing antimicrobial resistance and varied bacterial etiology make it necessary to develop appropriate antibiotic policy and implement antimicrobial stewardship for effective and prompt therapy.

Abstract Limiting global warming requires the effective implementation of energy mitigation measures by individual countries. However, the consequences of the timing of these efforts on the technical feasibility of adhering to cumulative carbon budgets—which determines future global warming—are underexplored. Moreover, existing national studies on carbon budgets either overlook integrated sectoral interactions, path dependencies, or comprehensive demand-side strategies. To address this, we analyse Ireland’s mitigation pathways under equal per-capita carbon budgets using an energy systems optimisation model. Our findings reveal that delayed mitigation brings forward the need for a net-zero target by five years, risks carbon lock-in and stranded assets, increase reliance on carbon dioxide removal technologies and leads to higher long-term mitigation costs. To keep the Paris Agreement targets, countries must set and meet accelerated mid-term mitigation goals and address energy demand.

Study Design Retrospective cohort study. Purpose To determine the incidence and success of three-column osteotomies (3COs) performed in primary and revision adult spine deformity (ASD) corrective surgeries. Overview of Literature 3COs are often required to correct severe, rigid ASD presentations. However, controversy remains on the utility of 3COs, particularly in primary surgery. Methods Patients ASD having 2-year data were included and divided into 3CO and non-3CO (remaining ASD cohort) groups. For the subanalysis, patients were stratified based on whether they were undergoing primary (P3CO) or revision (R3CO) surgery. Multivariate analysis controlling for age, Charlson comorbidity index, body mass index, baseline pelvic incidence–lumbar lordosis, and fused levels evaluated the complication rates and radiographic and patient-reported outcomes between the 3CO and non-3CO groups. Results Of the 436 patients included, 20% had 3COs. 3COs were performed in 16% of P3COs and 51% of R3COs. Both 3CO groups had greater severity in deformity and disability at baseline; however, only R3COs improved more than non-3COs. Despite greater segmental correction, 3COs had much lower rates of aligning in the lumbar distribution index (LDI), higher mechanical complications, and more reoperations when performed below L3. When comparing P3COs and R3COs, baseline lumbopelvic and global alignments, as well as disability, were different. The R3CO group had greater clinical improvements and global correction (both p

OpenAI’s ChatGPT (Generative Pre-trained Transformer) is a chatbot that answers questions and performs writing tasks in a conversational tone. Within months of release, multiple sectors are contemplating the varied applications of this chatbot, including medicine, education, and research, all of which are involved in medical communication and scientific publishing. Medical writers and academics use several artificial intelligence (AI) tools and software for research, literature survey, data analyses, referencing, and writing. There are benefits of using different AI tools in medical writing. However, using chatbots for medical communications pose some major concerns such as potential inaccuracies, data bias, security, and ethical issues. Perceived incorrect notions also limit their use. Moreover, ChatGPT can also be challenging if used incorrectly and for irrelevant tasks. If used appropriately, ChatGPT will not only upgrade the knowledge of the medical writer but also save time and energy that could be directed toward more creative and analytical areas requiring expert skill sets. This review introduces chatbots, outlines the progress in ChatGPT research, elaborates the potential uses of ChatGPT in medical communications along with its challenges and limitations, and proposes future research perspectives. It aims to provide guidance for doctors, researchers, and medical writers on the uses of ChatGPT in medical communications.

Background The present study aimed to compare the efficacy, safety, and cost-effectiveness of quick penetrating solution (QPS) heparin, QPS diclofenac, and heparin gel in the prevention of superficial thrombophlebitis (ST). Materials and Methods This randomized controlled trial was conducted after approval from the Institutional Ethics Committee and registration to Clinical Trial Registry of India. Patients of 18–60 years age, American Society of Anesthesiologists I/II, and who needed venous cannulation for at least 72 h were included in the study. Patients were randomly divided into three groups receiving study drugs (heparin gel, QPS heparin, and QPS diclofenac) every 8 hourly for a period of 72 h. Venous cannulation site was graded using the Visual Infusion Phlebitis Scale. Patients developing no ST, mean time to reach ST Grade 1 and 2, prevention of ST probability, and cost-effectiveness of interventions during the study period were assessed. Results Out of 219 included patients, development of no ST in the study groups at 72 h of treatment were heparin gel (11%), QPS heparin (9.6%), and QPS diclofenac (2.7%). The mean time (hours) to develop any grade ST in the study arms was heparin gel (36.2 [11.9]), QPS heparin (40.0 [13.4]), and QPS diclofenac (37.0 [13.2]). The Kaplan–Meier analysis did not reveal significant differences for the prevention of any grade ST or severe ST in three treatment arms. The average cost-effectiveness ratio for preventing thrombophlebitis was 14.2 in heparin gel-, 13.2 in QPS heparin-, and 95.6 in QPS diclofenac-treated patients. Conclusion Based on efficacy, safety, and cost-effectiveness, heparin gel or QPS heparin can be used to prevent ST due to intravenous cannulation in surgical patients. QPS diclofenac is not a cost-effective option to prevent ST.

Introduction Similar presenting manifestations in early phase and lack of awareness of aetiology of acute febrile illness (AFI) are major challenges in management of AFI. Material and Methods This was a retrospective observational cross-sectional study conducted in the Department of Microbiology, NRS Medical College, from 1 July 2022 to 30 June 2023 in serologically diagnosed febrile patients attending the outpatient department or admitted. Clinical and epidemiological data and laboratory parameters were recorded in a pretested structured questionnaire study tool, and collected data were analysed on MS-Excel sheets with various charts and tables. Results A total of 1711 serologically diagnosed febrile patients showed preponderance of dengue (38.3%), followed by leptospirosis (25%), scrub typhus (23.9%), malaria (12.6%), and enteric fever (1.92%). A majority of cases were male, less than 40 years of age, and from the rural population (73.2%), except in malaria (urban = 79.6%). The mean duration of fever was 9 days. Febrile cases were recorded maximum during the monsoon and postmonsoon periods (66.5%). The common manifestations are fever, headache (46.2%), pain abdomen (7.8%), nausea, and vomiting (9.4%). Thrombocytopenia with bleeding manifestation was higher in dengue (18%) cases. Mortality in dengue cases was recorded with multiorgan dysfunction syndrome (MODS). Scrub typhus cases showed seizure (8.3%) and altered sensorium (5%) due to fatal meningoencephalitis. Fatality in leptospirosis was mostly due to acute kidney injury (29.5%) and Weil’s disease (4.4%). Conclusion Misdiagnosis or incorrect diagnosis and delay in initiation of appropriate treatment results in increased morbidity and mortality in AFI. Determination of epidemiological features and clinical manifestations of AFI along with timely correct diagnosis will benefit clinicians in proper treatment initiation, thereby reducing morbidity and mortality.

Abstract Sensing limitations have impeded knowledge about how individual predator-prey interactions build to organized multi-species group behaviour across an ecosystem. Population densities of overlapping interacting oceanic fish predator and prey species, however, can be instantaneously distinguished and quantified from roughly the elemental individual to spatial scales spanning thousands of square kilometres by wide-area multispectral underwater-acoustic sensing, as shown here. This enables fundamental mechanisms behind large-scale ordered predator-prey interactions to be investigated. Critical population densities that transition random individual behaviour to ordered group behaviour are found to rapidly propagate to form vast adversarial prey and predator shoals of capelin and surrounding cod in the Barents Sea Arctic ecosystem for these keystone species. This leads to a sudden major shift in predator-prey balance. Only a small change in local behaviour triggers the shift due to an unstable equilibrium. Such unstable equilibria and associated balance shifts at predation hotspots are often overlooked as blind spots in present ocean ecosystem monitoring and assessment due to use of highly undersampled spatio-temporal sampling methods.

Abstract Background Salmonella, a foodborne pathogen, possesses a type I-E clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR associated (Cas) system. We investigated the system’s role in regulating Salmonella virulence by deleting the CRISPR arrays and Cas operon. Results Our study demonstrates invasion and proliferation defects of CRISPR-Cas knockout strains in intestinal epithelial cells and macrophages owing to the repression of invasion and virulence genes. However, proliferation defects were not observed in the Gp91phox−/− macrophages, suggesting the system’s role in the pathogens’ antioxidant defense. We deduced that the CRISPR-Cas system positively regulates H2O2 importer (OmpW), catalase (katG), peroxidase (ahpC), and superoxide dismutase (soda and sodCI), thereby protecting the cells from oxidative radicals. The knockout strains were attenuated in in-vivo infection models (Caenorhabditis elegans and BALB/c mice) due to hypersensitivity against antimicrobial peptides, complement proteins, and oxidative stress. The attenuation in virulence was attributed to the suppression of LPS modifying (pmr) genes, antioxidant genes, master regulators, and effectors of the SPI-1 (invasion) and SPI-2 (proliferation) islands in knockout strains. The regulation could be attributed to the partial complementarity of the CRISPR spacers with these genes. Conclusions Overall, our study extends our understanding of the role of the CRISPR-Cas system in Salmonella pathogenesis and its virulence determinants.

Introduction: There is a wide range of pathological lesions that can involve the urinary bladder, such as congenital anomalies, inflammatory conditions, metaplastic lesions and tumours which are responsible for significant morbidity and mortality worldwide. Broadly, bladder lesions are categorised as neoplastic and non neoplastic. Some urothelial lesions have mixed features or a tendency to transform into urothelial carcinoma such as metaplastic lesions, inverted papillomas, atypical papillary hyperplasia, Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) and urothelial dysplasia. They are grouped as grey zone lesions. Identifying the malignant nature of grey zone lesions is difficult to identify by histopathological examination. Pathologists are trying to differentiate and classify bladder tumours using Immunohistochemical (IHC) markers such as Cytokeratin (CK) 20, CK-7, p53, Ki-67, etc., to help oncologists take proper decisions regarding patient management. Aim: To study the histopathological lesions of urinary bladder tumours and diagnose the malignant nature of grey zone lesions using IHC marker CK 20. Materials and Methods: This cross-sectional study of urinary bladder lesions was conducted in the Department of Pathology of Subharti Medical College, Meerut, Uttar Pradesh, India between December 2012 and October 2014. A total of 87 patients with urological complaints were selected for the study. Data related to age, sex, clinical symptoms and personal habits were noted on a working proforma. Biopsy materials were processed and stained with Haematoxylin and Eosin (H&E) for histopathological examination. The intensity of the reaction was determined in different fields, ranging from negative (0) to intense (3). Data thus obtained were analysed and presented in this paper. Results: Out of 87 cases of urinary bladder lesions, 47 (54.02%) were neoplastic, 26 (29.88%) non neoplastic and 14 (16.09%) grey zone lesions. They were more common in males, particularly in the 7th and 6th decades of life, i.e., 27 (31.03%) and 22 (25.28%) respectively. The most common histopathological finding in non neoplastic lesions was inflammatory conditions seen in 21 (80.76%) cases; Papillary urothelial carcinoma-low-grade in 26 (55.31%) cases of neoplastic lesions and PUNLMP in 8 (57.14%) cases of grey zone lesions. The result was positive with CK 20 in 5 (62.5%) cases of PUNLMP, 1 (100%) urothelial dysplasia, and 1 (100%) poorly differentiated tumour tissues but negative in 3 (37.5%) cases of PUNLMP, 2 (100%) of Adenocarcinoma and 1 (100%) case of Nested Variant of Urothelial Carcinoma (NVUC). Conclusion: CK 20 is a good IHC marker for determining the malignant nature of tissues in grey zone lesions. The results will be more reliable when used together with other markers.

A new species of Merismomorpha Girault, 1913, M. ulleungensis Tselikh, Rasplus & Ku, sp. nov., is described and illustrated from the Palaearctic region (Russian Far East and South Korea). An updated diagnosis of the genus is given, as well as a comparison to the closely related genus Pterosemopsis Girault, 1917.

Abstract 5-Fluorouracil (5-FU) is the leading chemotherapeutic drug used to treat hepatocellular carcinoma, one of the major cancer diseases after atherosclerosis. Because of chemo-resistance, the success rate of treatment declines with time due to continuous drug exposure. Though autophagy induction is majorly responsible for acquired resistance, the exact role of this evolutionary conserved mechanism is unknown in cancer cell survival and suppression. The usual practice involves the combinatorial use of chemotherapeutic drugs with autophagy inhibitors like Chloroquine and Bafilomycin A, while neglecting the side effects caused by autophagy impairment in healthy cells. Starvation is a well-known physiological inducer of autophagy. In this study, by caloric modulation, we tried to circumvent the resistance imposed by prolonged drug exposure and investigated the effect of 5-FU in nutrient-sufficient and deficient conditions. Our findings show a substantial correlation between autophagy and increased cancer cell death in the presence of 5-FU, with negligible effects on normal cells. Experimental data revealed that nutritional deprivation augmented cell death in the presence of 5-FU through mitochondrial membrane damage and excessive reactive oxygen species (ROS) production, initiating apoptosis. Lipidation study also unveiled that under such combinatorial treatment cellular metabolism shifts from glucose to lipid biosynthesis. Overall, our experimental findings suggest that nutritional deprivation in combination with chemotherapeutic medication can be a new effective strategy to control hepatocellular carcinoma.

Abstract Future changes in solar radiation and rising temperatures will likely reduce global solar photovoltaic potential, but advancing photovoltaic technologies could counteract these effects. We investigate the potential of photovoltaic to satisfy energy demands given climate change and technological development. We find that conventional photovoltaic will require 0.5 to 1.2% of global land area to meet projected energy demands by 2085 without accounting for climate change effects. When considering climate impacts, this requirement increases to 0.7–1.5% of the global land area. However, utilising advanced photovoltaic technologies can reduce this area to 0.3–1.2%, effectively mitigating climate impacts. Regional climate change impacts vary substantially, resulting in photovoltaic potential decreases of up to 3% in Latin America and the Caribbean, and by up to 8% in South Asia. Our results suggest that technology-driven increases in future global photovoltaic energy production can more than compensate for the climate related reductions.

Abstract Background This paper aimed to explore the palliative care (PC) needs and barriers to access among cancer patients in a rural region of North India with a high cancer burden. Methods A Participatory action research (PAR) approach was employed. Situational assessment, community sensitization workshops (CSWs) and door-to-door surveys were planned, conducted and developed over three PAR cycles. A parallel convergent mixed-methods approach was adopted wherein the quantitative data from door-to-door surveys and qualitative data from CSWs and investigator field notes were collected and analyzed to provide a comprehensive understanding of PC needs and barriers to access. Descriptive statistics and thematic analysis were used. Results A total of 27 CSWs involving 526 stakeholders were conducted. A total of 256 cancer patients were assessed for PC needs and symptom burden using the Supportive and Palliative Care Indicators (SPICT-4ALL) and the Edmonton Symptom Assessment System (ESAS) tool, respectively. Based on the SPICT assessment, all patients (n = 256) satisfied general and/or cancer-specific indicators for PC. The majority (56.6%) had ≥ one moderate-severe symptom, with the most common symptoms being tiredness, pain and loss of appetite. Analysis of qualitative findings generated three themes: unmet needs, burden of caregiving, and barriers and challenges. Cancer affected all domains of patients’ and their families’ lives, contributing to biopsychosocial suffering. Social stigma, discrimination, sympathizing attitudes and lack of emotional and material support contributed to psychosocial suffering among cancer patients and their caregivers. Lack of awareness, nearby healthcare facilities, transportation, essential medicines, trained manpower and education in PC, collusion, fear of social discrimination, faulty perceptions and misconceptions about cancer made access to PC difficult. Conclusions The study emphasize the need for and provide a roadmap for developing context-specific and culturally appropriate CBPC services to address the identified challenges and needs. The findings point towards education of CHWs in PC; improving community awareness about cancer, PC, government support schemes; ensuring an uninterrupted supply of essential medicines; and developing active linkages within the community and with NGOs to address the financial, transportation, educational, vocational and other social needs as some of the strategies to ensure holistic CBPC services. Trial registration Clinical Trial Registry of India (CTRI/2023/04/051357).

Introduction: For a dentist, it is a matter of concern to restore the original luster or glaze on a Monolithic Zirconia (MZ) restoration after clinical adjustments. For a long time, the gold standard for surface restoration was reglazing; however, with advancements in technology, new polishing kits optimised for zirconia have become available for chairside polishing. Aim: To examine the effects of grinding, reglazing, and polishing techniques on the surface roughness and flexural strength of MZ specimens. Materials and Methods: This in-vitro study was conducted in the Department of Prosthodontics at MM College of Dental Sceiences and Research in Mullana, Haryana, India from April to December 2019 and 32 specimens of MZ, each measuring 20 mm × 5 mm × 3 mm, were fabricated and divided into four groups, with each group consisting of eight specimens. Group C was considered the Control group. Specimens in Group G were only Ground, specimens in Group GR were Ground and Reglazed, and specimens in Group GP were Ground and Polished using a zirconia polishing kit. All specimens were then analysed for surface roughness and flexural strength using a profilometer and a Universal Testing Machine (UTM), respectively. Statistical analysis was performed using Analysis of Variance (ANOVA), Honest Significant Test (HSD) post-hoc test, Pearson’s correlation, and other methods using International Business Machine (IBM) Statistics version 25.0 (Armonk, USA). Results: The surface roughness (Ra) of the control group (C) was 0.4403 μm, followed by the Polished Group (GP) at 0.656 μm and the Reglazed Group (GR) at 0.809 μm. The difference between the polished (GP) and reglazed (GR) groups, was statistically insignificant (p=0.53). There was a statistically significant increase in flexural strength in the reglazed samples (GR) when compared to the polished samples (GP). No significant correlation (p=0.58 and r=-0.1) was found between surface roughness and flexural strength. Conclusion: Chairside polishing can be an effective alternative to reglazing for restoring the surface finish of MZ. Additionally, polishing increases the strength of zirconia after adjustments.

Abstract Background Alpha-1 adrenergic receptor antagonists (α1-ARAs) are frequently used in treatment of Hypertension and symptomatic benign prostatic hypertrophy (BPH). Numerous studies have demonstrated the association between α1-ARAs like Tamsulosin and increased surgical risks for patients undergoing cataract surgery. This study aims to identify and study the effects of α1-ARAs on iris parameters and the subsequent operative challenges encountered during cataract surgery. Methods A cross-sectional, prospective study involving 30 patients on α1-ARAs planned for cataract surgery and equal number of age and sex matched controls were subjected to evaluation of changes on iris parameters and subsequent challenges in cataract surgery. Results The study group had statistically significant lesser pupil diameter. Iris thickness at sphincter muscle region (SMR) was similar between groups (P = 0.53). Significantly lower values of iris thickness at dilator muscle region (DMR) found in treated subjects (P =

Abstract The use of enzymes in the production of food products is an ancient practice. Microbes provide several enzymes that are involved in improving the taste, texture, as well as aroma of food items, offering several benefits to the food industry. Subsequently, the ease of availability of these microbial enzymes has increased their utilization in the food industry. This cost-effectiveness and ease of commercial-scale production make enzymes ideal tools for various industrial uses. Microbial enzymes are utilized in processing food products such as those associated with the brewery, dairy and bakery industries. In addition, the nutritional value, color, aroma and texture of food products can be improved by using microbial enzymes. With the progress in technology, several novel enzymes in various applications of the food and beverages industry have been developed and demand is constantly increasing. The present review provides a comparative narrative of the applications of some of the predominating enzymes, such as phytases, lipases, lactases, pectinases, and laccases, commonly used as processing aids in the food industry. Graphical Abstract

Objective: To assess the knowledge, attitude, and compliance with standard precautions among medical students in a tertiary care hospital in Jharkhand, India. Methods: A total of 280 medical students, including phase I and phase II MBBS students, participated in the study. Phase I comprised an introduction to standard precautions in four-hour classes while the Phase II comprised of 8 hours of theory and three skill assessments on standard precautions according to the CBME curriculum and pandemic module. A structured validated questionnaire was used to collect data on the student's knowledge, attitude, and practice related to standard precautions. The questionnaire included items assessing various aspects of standard precautions, and scoring criteria were used to evaluate student performance. The overall level of knowledge, attitude, and practice was classified as poor (

Early Childhood Caries (ECC) is a condition associated with nearly 123 risk factors. Among all the risk factors, enamel defects or enamel hypoplasia (ED/EH) has been shown to be the primary risk factor. ED/EH comprises the earliest changes that manifest on newly erupted primary tooth surfaces soon after its eruption. ED/EH appears as white lines or patches, either as demarcated or diffuse opacities on the enamel surface. It is often observed on the labial and buccal surfaces of the newly erupted primary maxillary incisors. A simple self-report tool for mothers/caretakers, healthcare professionals, and primary care workers to diagnose early changes in ECC may facilitate early diagnosis. The MAAC chart was developed to prevent ECC in children with cleft lip and palate. These charts, primarily developed to educate parents, caregivers, healthcare professionals, and primary health care providers, illustrate the variations in ED/EH on the enamel surface (demarcated and diffuse opacities on various maxillary teeth) as a collage of pictures organized as incisors and canines. This paper describes a novel and simple, tool called ‘MAAC charts’ providing guidance on early signs of Early childhood caries (ECC) for health professionals, parents and caretakers. MAAC charts can be useful for Pediatric dentists while providing anticipatory guidance during early first dental visits in their office. Pediatric dentists can suggest paediatricians to use these MAAC charts, in vaccinations clinics and various in/out patient settings to provide oral health related anticipatory guidance. Pediatric dentists can use these MAAC charts in large scale public health campaigns focused on preventing ECC.

Background: Tuberculosis (TB) continues to be a major cause of morbidity and mortality worldwide. The main strategy to fight the pandemic is the development of rapid, accurate diagnostic tests, which helps to reduce the time for initiation of therapy. In 2010, WHO recommended the use of Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) (G4), which is a cartridge-based semi-automated nucleic acid amplification test (NAAT) as a primary test with an aim to improve the detection of MTB. Later on, to improve the diagnostic efficacy, the new and improved cartridges called Xpert Ultra were introduced in 2017. MATERIALS AND METHODS: One thousand and sixty-nine clinical samples were utilized for the study for microscopy, culture, and NAATs (Xpert MTB/RIF G4 and Ultra). The samples were randomly allocated. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated while assuming trace results as positive and negative in two separate scenarios. Results: The sensitivity of Xpert MTB/RIF Ultra cartridge was higher (100%) than Xpert MTB/RIF G4 cartridge (95.23%) and the specificity of Ultra cartridge was lower (71.79%) when compared to G4 cartridge (91.63%). However, the specificity of Xpert Ultra cartridge improved by reclassifying the “trace” interpretation as negative (89.1%). The NPV was 100% and 99.09% for Xpert Ultra cartridge and the Xpert G4 cartridge, respectively, and did not change by reclassifying the “trace” interpretation as negative. In contrast, the PPV varied greatly between the two tests, 26.66% for Xpert Ultra cartridge and 66.66% for Xpert G4 cartridge. The PPV of Xpert Ultra cartridge was improved to 48.48% by including “trace” samples in the negative pool. Conclusion: Xpert Ultra and G4 shows good performance as a first line diagnostic test. Caution should be exercised when interpreting ‘trace’ results in a country like India without parallel confirmatory tests like microscopy and culture. Data is limited on this newly incorporated value assigned in the automated report. Conducting further studies on results interpreted as ‘trace’ will help in improving the guidelines and as well as utilisation of such tests.

Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC) is a rare histological subtype of pancreatic ductal adenocarcinoma according to the World Health Organization classification of digestive system tumors. This subtype is exceptionally uncommon, accounting for less than 1% of pancreatic malignant tumors. This paper presents a rare case of a 62-year-old female patient diagnosed with UC-OGC. The patient initially presented with symptoms, including epigastric pain and the presence of an abdominal mass, which led to further investigation and the eventual diagnosis of this unusual and challenging form of pancreatic cancer.

AIMS: The aim of the study was to assess preoperative radiographic parameters predictive of cervical deformity (CD) autocorrection in patients undergoing thoracolumbar deformity (ASD) surgery. This was a retrospective cohort study. Methods: Inclusion criteria were operative ASD patients with complete baseline (BL) and 2-year radiographic data. Patients with cervical fusion during index surgery, revision involving cervical fusion, and those who developed proximal junctional kyphosis by 2-year postoperative were excluded from the study. If patients met CD criteria at BL but not at 6 weeks or 2 years postoperatively, they were considered autocorrected (AC). Descriptive and univariate analysis, binominal logistic regression, and multivariable backward stepwise regression. Results: Two hundred and twenty ASD patients were included. 51.4% of patients had preoperative CD. By 6-week postoperative, 32.7% achieved AC. At 2 years, 24.8% of preoperative CD patients obtained AC. 2-year AC patients had lower BL sacral slope, lumbar lordosis (LL), T1 slope, cervical lordosis (CL), and C2-T3, and T2-T12 kyphosis (all P < 0.05). Patients with BL-unmatched Roussouly types are corrected postoperatively and are more likely to experience autocorrection at 1 year (45.2% vs. 19.0%; P = 0.042) and at 2 years (31% vs. 4.8%; P = 0.018). Multivariable analysis revealed that patients with BL-mismatched Roussouly types were corrected postoperatively and showed a significant increase in likelihood of AC at 1 year (odds ratio [OR]: 18.72; P = 0.029) and 2 years (OR: 8.5; P = 0.047). Similarly, BL LL (OR: 0.772; P = 0.003) and CL (OR: 0.829; P = 0.005) exhibited significant predictive value for autocorrection at 1 year and 2 years (OR: 0.927; P = 0.004 | OR: 0.942; P = 0.039; respectively). Conclusions: Autocorrection is more likely in patients with postoperatively corrected Roussouly types, those with lower BL cervical, and LL. Given these findings, it may not be necessary to routinely extend reconstruction into the cervical spine for ASD patients with similar characteristics to those in this study.

Introduction: An aging population is associated with an increased risk of cognitive decline. Sleep duration, both excess and deficiency, is a risk factor for cognitive impairment. Therefore, this study was conducted to assess the relationship between sleep duration and cognition in the Indian population. Methods: This study was a secondary analysis of the first wave of the Longitudinal Aging Study in India (LASI) conducted across India in all 34 states and union territories. Sleep duration was calculated using sleep and wake times, whereas cognition was measured as a composite cognitive index. Both univariable and multivariable linear regressions were performed on the composite cognitive score. Subgroup analyses were conducted based on sex and age groups (45-59 years and ≥60 years). Results: The median (IQR) cognition score was 25 (20-30). A sleep duration of ≤4 hours was associated with a decrease in cognition status of 1.15 points (1.57-0.72), and a sleep duration of ≥9 hours was associated with a decrease of 0.93 points (1.25-0.60). Subgroup analysis revealed that this relationship remained consistent across both genders and both age groups. Conclusion: Both long and short durations of sleep were seen to be associated with a decrease in cognition scores among Indian adults, in both sexes and both age groups. Thus, proper sleep duration can help in the prevention of declining cognition as one ages and the development of dementia.

Introduction: Cancer is one of the major public health concerns leading to high trends of mortality and morbidity in India. Health-related quality of life (HRQoL) is an indicator of the sense of well-being applicable, which includes all the domains of physical, social, emotional, and functional well-being. The inferences can strengthen the palliative care needs of patients. This study was conducted to assess the HRQoL of patients on anticancer therapy and to measure the perceived palliative care needs amongst diagnosed patients on cancer therapy. Methodology: Mixed method approach was used to assess the objectives of the study. FACT-G questionnaire was used to assess the HRQoL of patients among a sample size of 290 participants for quantitative analysis and 9 for in-depth interviews. Data were generated and analyzed in SPSS version 23. Spearman correlation coefficient was used to test the association between the well-being score and demographic factors. Results: The mean age of the study population was 52.46 ± 13.83 years with 65% females. The mean FACT-G score was 61.1 ± 17.1 with mean domain values of 14.97 (physical well-being), 16.55 (social well-being), 16.21 (emotional well-being) and 13.35 (functional well-being). FACT-G score was significantly associated with education level, type of cancer and type of anticancer therapy. Qualitative themes described pertaining to delayed diagnosis, financial distress, side effects, social isolation (factors worsening QoL) and support, and attitude (factors improving QoL). Conclusion: HRQOL scores were found low in all types of cancer and early referral for palliative care might have a positive effect on the quality of life of cancer patients. Cancer is the leading cause of morbidity and mortality with its profound social and economic consequences leading to impoverishment and societal inequity.

Background and Purpose Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT). Methods The 2016–2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT. Patients with a currently active diagnosis of malignancy (CA-CVT) were then identified. Demographics and comorbidities were compared between CA-CVT and CVT patients. Subgroup analyses explored patients with hematopoietic cancer and non-hematopoietic cancers. Stroke severity and treatment were explored. Inpatient outcomes studied were discharge disposition, length of stay, and mortality. Results Between 2016 and 2019, 6,140 patients had a primary diagnosis code of CVT, and 370 (6.0%) patients had a coexisting malignancy. The most common malignancy was hematopoietic (n=195, 52.7%), followed by central nervous system (n=40, 10.8%), respiratory (n=40, 10.8%), and breast (n=40, 10.8%). These patients tended to be older than non-CA-CVT and were more likely to have coexisting comorbidities. CA-CVT patients had higher severity scores on the International Study of Cerebral Vein and Dural Sinus Thrombosis Risk Score (ISCVT-RS) and increased complications. In a propensity-score matched cohort, there were no differences in inpatient outcomes. Conclusion Malignancy occurs in 6% of patients presenting with CVT and should be considered a potential comorbidity in instances where clear causes of hypercoagulabilty have not been identified. Malignancy was linked to higher mortality rates. Nonetheless, after adjusting for the severity of CVT, the outcomes for inpatients with cancer-associated CVT were comparable to those without cancer, indicating that the increased mortality associated with malignancy is probably due to more severe CVT conditions.

Background: Artificial intelligence (AI) technology is a trailblazer in obtaining critical information in oral observational studies involving forensic medicine. It holds immense potential in forensic odontology. Machine learning’s involvement in our daily lives has doubled. The constructive upgraded mechanism of machine learning involved in exploring lip print patterns is a crucial perspective for future diagnostic studies. Objectives: To illuminate the significance and application of AI technology in forensic odontology, specifically lip print analysis. The cardinal objective is to identify the most effective algorithm for lip print analysis using AI. Methodology: The data for this study were collected by conducting a thorough search of articles published in reputable search engines between January 2010 and January 2024. The QUADAS-2 tool forms an impression of the risk of bias in the selected studies. Search engines such as PubMed, Web of Science, Scopus, and Cochrane were extensively searched for data collection. Results: All studies shortlisted for this review present promising results. Results showed that of all algorithms, VGG16 and VGG19 are better than other algorithms in terms of accuracy, precision, and recall. Conclusion: Our focus in this study is to determine whether AI is efficient in providing results for lip print pattern analysis and standardize an AI network algorithm that works best for it.

Abstract Background Goat milk is gaining popularity as a superior alternative to bovine milk due to its closer resemblance to human milk. Understanding the molecular processes underlying lactation is crucial for improving milk quality and production in goats. However, the genetic mechanisms governing lactation in goats, particularly in indigenous breeds like the Jakhrana, remain largely unexplored. Results In this study, we performed a comprehensive transcriptomic analysis of Jakhrana goat mammary glands during early and late lactation stages. We isolated milk somatic cells and conducted RNA sequencing, followed by transcript quantification and mapping against the ARS1.2 Capra hircus reference assembly. Our analysis identified differentially expressed genes (DEGs) and commonly expressed genes (CEGs) across the lactation phases. Early lactation showed enrichment of genes encoding antimicrobial peptides and lubrication proteins, while late lactation exhibited heightened expression of genes encoding major milk proteins. Additionally, DEG analysis revealed upregulation of pivotal genes, such as the ABC transporter gene MRP4, implicated in modulating milk composition and quality. Conclusion Our findings provide insights into the genetic mechanisms underlying lactation dynamics in the Jakhrana goat. Understanding these mechanisms could help in improving milk production and quality in goats, benefiting both the dairy industry and consumers.

Introduction: Sustainability is the profound and accountable way of using the natural resources, its goal being to prevent their depletion and preserving the ecological balance. An essential prerequisite to accomplish dental practice environmentally friendly. Materials and Methods: The mixed method dual approach study, preliminary in level I a qualitative evaluation of green practices among dental professionals for sustainable ecofriendly dental practice. Questionnaire study performed by 24 item scale among registered dental professionals was performed. Level II Scoping research was blatantly representing via tree map the voids towards environment friendly dental care in evidence-based literature via R Studio programming in statistical graphics. Results: Out of 300 dentists 258 (84.7%) opine optimistically towards environmentally friendly dental practices. Majority 98.7% agree to implement green dental practices, only 58% dentists follow mandatory protocol. Only 9.0% dentists updated with latest innovative methodologies for reducing carbon footprint. Quantitative data envisage 16 articles in PubMed database, spanning 2001 to 2023. There’s a dearth of national research trends in this field. Quality research for promoting sustainable dentistry need escalation. Conclusion: It is inevitable to measure and mitigate the environmental foot print. By implementing 4 R of reduce, reuse, recycle and restore in dental care. Redesigning, exterior to interior, stop disposable, stringent waste management can bring revolution. Sustainable use of dental materials and equipment promoting research for health promotion is need of an hour. Green entrepreneurship in dentistry have the potential to protect ecosystem.

Background: Tuberculosis (TB) is caused due to the infection of Mycobacterium tuberculosis (MTB) and it can infect the various parts of the human body. The disease is highly prevalent and is the second most common cause of death worldwide after COVID-19. Apart from sputum specimen, it is exceedingly difficult to diagnose due to its paucibacillary nature. The current study was intended to evaluate the accuracy of Smart Sure™ MTB and multidrug-resistant-TB (MDR-TB) kits (Genetix Biotech Asia Pvt. Ltd., India) with Xpert ultra and Mycobacterium growth indicator tube (MGIT) culture on nonsputum specimens from TB suspects. Methods: A total of 205 nonsputum specimens were received between October 2023 and May 2024 at Intermediate Reference Laboratory, Department of Medicine, All India Institute of Medical Sciences, New Delhi, India. Xpert ultra and Smart Sure™ MTB and MDR-TB tests were done directly on samples. However, processed specimens were used for MGIT culture and drug-susceptibility testing (DST). Invalid and MGIT contaminated specimens were excluded from the final calculation. Results: Overall, sensitivity and specificity of Smart Sure™ MTB screening kit was 71.59% and 98.28%, respectively, with Xpert ultra and 68.35% and 90.83%, respectively, with MGIT culture. While comparing with both Xpert ultra and MGIT-DST to detect rifampicin (RIF) resistant, Smart Sure™ MDR-TB kits showed sensitivity of 75.0% and 100% of specificity. However, for isoniazid (INH) resistance, Smart Sure™ MDR-TB kits showed 100% of sensitivity and specificity with MGIT-DST. Conclusion: For the detection of MTB and its drug-resistance patterns (RIF and INH) in the specimens other than sputum, Smart Sure™ MTB and MDR-TB kits could play a vital role in TB endemic countries. While comparing the set-ups and skilled staffs, it required almost same as compared with previously approved WHO diagnostics used in resource-limited countries.

Abstract Stevia rebaudiana (Bertoni), commonly known as stevia, is a sought-after natural sweetener, but its conventional propagation methods are slow and inefficient. This study aims to enhance the in vitro culture for stevia by investigating the impact of different Murashige and Skoog (MS) medium salt strengths and plant growth hormones on growth and rebaudioside A content. Apical bud-containing shoot segments were used as explants and cultured on various semi-solid and liquid MS media formulations, incorporating cytokinins (BAP and Kin), auxins (NAA and IAA), and different MS major salt concentrations (MS full, ½ MS, and ¼ MS). Assessments of shoot growth parameters, root formation, and HPLC analysis for rebaudioside A content were conducted. The optimal conditions for in vitro growth was found to be in the ¼ MS + Kin 3 mg/L + NAA 0.1 mg/L (semi-solid) medium, resulting in significantly improved shoot growth and enhanced 30.04% rebaudioside A content. Genetic fidelity of regenerated plants was confirmed using RAPD and ISSR markers. These findings offer valuable insights for optimizing in vitro propagation of stevia and potentially enhancing rebaudioside A content.

Introduction: The thyroid gland and the hypothalamus are closely linked to the cardiovascular system through the Autonomic Nervous System (ANS). The actions of thyroid hormones target the cardiovascular system, affecting homeostasis, which includes contraction, rhythm, blood flow, and peripheral vascular resistance of the myocardium. To assess the function of the ANS that influences the cardiovascular system, Heart Rate Variability (HRV) is an important and increasingly used tool. Aim: To investigate cardiac autonomic changes as assessed by short-term HRV in Subclinical Hypothyroidism (SCH) and to determine whether there is any association between Thyroid Stimulating Hormone (TSH) levels and the Low Frequency/High Frequency (LF/HF) ratio as well as the Standard Deviation of NN intervals (SDNN). Materials and Methods: A cross-sectional analytical study was conducted at R.G. Kar Medical College and Hospital, Kolkata, West Bengal, India from November 2022 to October 2023. Both males and females aged 18-55 years with newly diagnosed SCH (cases, n=50) and healthy individuals (controls, n=50) were included in the study. HRV was recorded using a Physiograph Polyrite-D instrument equipped with bioamplifiers, four channels, and accessories {Record Mangement System (RMS) latest software-version 1.2.5}. The study variables included anthropometric parameters, biochemical parameters (TSH), and HRV parameters such as SDNN and the LF/HF ratio. Relevant data were collected using standard statistical methods, including Statistical Package for Social Sciences (SPSS) version 20.0, unpaired Student’s t-test, and Pearson’s correlation coefficient. Results: The present study found a significant increase in the LF/HF ratio in SCH patients (1.28±0.75) compared to controls (0.90±0.32). There was a significantly lower SDNN value among cases (40.63±21.89) compared to controls (79.86±15.36). No significant changes were observed in Heart Rate (HR), Systolic Blood Pressure (SBP), or Diastolic Blood Pressure (DBP) between cases and controls. The LF/HF ratio and TSH value showed a positive correlation (r=0.09, p=0.57), while SDNN exhibited a negative correlation with TSH value (r=-0.08, p=0.58) among the cases, but neither correlation was statistically significant. Conclusion: The present study concludes that there is a significant change in the LF/HF ratio in newly diagnosed SCH patients. Therefore, the evaluation of short-term HRV can be utilised as a routine screening test for improved medical care.

Introduction: Wound site infiltration with local anaesthetic agents is one of the simplest and safest techniques, improving postoperative analgesia as part of multimodal analgesia following general or regional anaesthesia. Adding an adjuvant to local wound infiltration can provide a longer duration of analgesia with fewer side-effects. Aim: To compare the analgesic efficacy of local wound infiltration with levobupivacaine alone versus a mixture of levobupivacaine and nalbuphine for postoperative pain. Materials and Methods: A double-blind randomised controlled study was conducted on 100 patients in GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India. Patients were American Society of Anaesthesiologists (ASA) I-III, aged 18-70 years, and scheduled for abdominal surgeries. A standard general anaesthetic technique was used. Patients received local site wound infiltration during wound closure. A computer-generated random number was used to randomly divide patients into two groups. Group L received 18 mL of 0.25% levobupivacaine plus 2 mL of 0.9% normal saline (total of 20 mL), while Group LN received 18 mL of 0.25% levobupivacaine plus 2 mL of nalbuphine (20 mg), also totaling 20 mL for wound infiltration. Postoperative rescue analgesia was provided with intravenous injection paracetamol (1 g) on demand or whenever the Numeric Rating Scale (NRS) indicated a score of ≥5. Haemodynamic parameters such as Heart Rate (HR), Systolic Blood Pressure (SBP), and Diastolic Blood Pressure (DBP) were observed at intervals in the Post Anaesthesia Care Unit (PACU) and at 30 minutes, 1 hour, 2 hours, 4 hours, and 6 hours postoperatively. Side-effects of the adjuvant were also recorded. Chi-square tests and Independent t-tests were used to compare data between the two groups. R esults: Demographic data, such as age, weight, height, ASA grade, and gender, were comparable between both groups (p-value>0.05). The total duration of analgesia in group LN was 9.20±0.79 hours, compared to 4.5±0.71 hours in group L (p-value

Introduction: With the increasing demand for aesthetics, the popularity of Vacuum-formed Retainers (VFRs) has been on the rise. Bisphenol-A (BPA) is added to the polymers to make them clear and tough. BPA is identified as an endocrine disruptor linked to developmental defects, infertility, cardiovascular disease and cancer. The release of BPA from various orthodontic materials, including VFRs, has been reported infrequently and with variable results. Aim: To assess the effect of immersing VFRs in distilled water on BPA release in the saliva of patients wearing VFRs. Materials and Methods: This was a single-centre prospective randomised clinical trial. A total of 28 patients aged between 15 and 25 years, who had completed their fixed orthodontic treatment in 2021 at Bharati Vidyapeeth Deemed to be University (BVDU), Dental College and Hospital, Sangli, Maharashtra, India, were selected for this in-vivo study. Patients were randomly divided into two groups. Group I patients received VFRs without immersion in water before delivery, while Group II patients received VFRs that were immersed in distilled water at 37˚C for 24 hours before delivery. Four samples of unstimulated whole saliva were collected across four different time intervals: T0 (before VFR delivery), T1 (after one hour of wearing retainers), T2 (after one week of wearing retainers) and T3 (after three weeks of wearing retainers). These samples were tested for BPA release using HPLC analysis. For numerical continuous data following a normal distribution, intergroup comparison was conducted using a one-way Analysis of Variance (ANOVA) test and intra-group comparisons were performed using a paired t-test. An alpha error of 5% and a power of 80% were maintained, with p

INTRODUCTION: In the hypothalamic-pituitary-gonadotrophin axis, estrogen plays a key role in the regulation of bone maturation and growth plate closure. This study was designed to explore the link between single nucleotide polymorphisms (SNPs) in the estrogen receptor 1 (ESR1) gene with idiopathic short stature (ISS) susceptibility in a North Indian population. METHODS: Four SNPs of ESR1 (rs543650, rs6557177, rs2234693 and rs9340799) were genotyped by Sanger sequencing in ISS patients and controls. Linkage disequilibrium (LD) and haplotyping were done by SNPStat and SHEsisPlus software. The extent of LD was determined by calculating D’ and R2 values in SNP paired combinations. RESULTS: Fifty-two ISS patients were compared with 68 controls. A significant positive association was found between rs6557177 and rs543650 genotype and ISS susceptibility. The frequencies of the rs6557177 CC genotype [p=0.030; odds ratio (OR)=0.13; 95% confidence interval (CI): 0.01-1.10] and rs543650 genotype TT (p=0.043; OR=0.29; 95% CI: 0.09-0.92) were increased in the ISS group compared with controls. However, no significant correlation was observed between clinical parameters of patients and these SNPs. rs543650 showed strong LD with rs2234693 and rs9340799, similarly rs2234693 and rs9340799. DISCUSSION AND CONCLUSION: Our study showed that the CC genotype at rs6557177 and TT genotype at rs543650 of ESR1 constituted a risk factor for developing ISS in North Indian children. These findings may lead to a better understanding of the SNPs associated with ISS susceptibility.

Abstract Huntington’s disease (HD) is a rare neurodegenerative disease caused due to aggregation of Huntingtin (HTT) protein. This study involves the cloning of 40 DnaJ chaperones from Drosophila, and overexpressing them in yeasts and fly models of HD. Accordingly, DnaJ chaperones were catalogued as enhancers or suppressors based on their growth phenotypes and aggregation properties. 2 of the chaperones that came up as targets were CG5001 and P58IPK. Protein aggregation and slow growth phenotype was rescued in yeasts, S2 cells, and Drosophila transgenic lines of HTT103Q with these overexpressed chaperones. Since DnaJ chaperones have protein sequence similarity across species, they can be used as possible tools to combat the effects of neurodegenerative diseases.

Introduction: Dyslipidaemia is an important risk factor for coronary artery disease. Oxidative damage to plasma lipoproteins ultimately results in the development of atherosclerosis. Since Hydrogen Sulphide (H2S) is a cytoprotective molecule in oxidative stress, decreased H2S levels may be a cause of dyslipidaemia. Aim: To determine the relationship between the serum levels of H2S with serum Triglycerides (TG), Total Cholesterol (TC), and High-density Lipoprotein Cholesterol (HDL-C) in cases of dyslipidaemia. Materials and Methods: A cross-sectional study was conducted between December 2022 and June 2023 in the Departments of Biochemistry and Medicine at KPC Medical College, Jadavpur, Kolkata, West Bengal, India. Serum lipid profile {TC, TGs, HDL-C, and Low-density Lipoprotein Cholesterol (LDL-C) (calculated by Friedewald’s equation)} and serum H2S were measured in 70 cases of dyslipidaemia {according to National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria} aged between 30 to 80 years and compared with an equal number of healthy volunteers as controls. The means of continuous variables were compared by independent t-tests and Mann-Whitney U tests. The Chi-square test was applied to compare gender distribution. Pearson’s and Spearman’s correlation coefficients were calculated for normal and non normal distributions, respectively. Results: The mean age of dyslipidaemic patients (54.54 years±11.19) was significantly (p=0.0017) higher than that of the controls (47.02 years±16.18). Among the 70 cases of dyslipidaemia, 38 participants were male and 32 were female, while among the healthy controls (n=70), 42 participants were male and 28 were female. The serum H2S levels in cases of dyslipidaemia (37.91±6.28 μmol/L) were significantly lower than in the healthy controls (58.52±12.92, p

We report the anesthetic management of a patient presenting with a mobile vocal cord lesion in combination with restricted mouth opening. Fiber-optic laryngoscopy revealed a highly mobile vocal cord lesion, moving in and out of the vocal cords with respiration. A very small tracheal lumen was visible posteriorly during expiration. ASA difficult airway algorithm was applied, and the patient was successfully intubated awake with a # 5 microlaryngeal tube loaded over a pediatric bronchoscope. We aim to highlight the importance of detailed preoperative evaluation, adopting difficult airway algorithms and utilization of devices, with which we have maximum expertise with some modification as the key to avoid airway-related adverse events in such patients.

Orbital foreign bodies are common. A large metallic foreign body involving ipsilateral orbit into the maxillary sinus is potentially vision-threatening. This case report describes a potentially serious incident involving a 49-year-old man who presented with an injury to his right eye with an iron nail while working in a factory. An iron nail penetrating the infraorbital margin of the right eye extended into the maxillary sinus associated with periorbital edema. X-ray showed a metallic foreign body extending from the right eye infraorbital margin into the maxillary sinus. Under local anesthesia, under all aseptic precautions, a linear iron nail measuring 4.5 cm in length was removed from the right orbit without any evidence of damage to vital structures. This case represents one of the largest reported infraorbital metallic (iron nail) foreign bodies, highlighting its rarity and potential danger to vision and overall health.

Target-controlled infusion (TCI) is a novel drug delivery system wherein a microprocessor calculates the rate of drug to be infused based upon the target plasma or effect site concentration set by the operator. It has found its place in the operation theaters and intensive care units (ICUs) for safe administration of intravenous anesthesia and analgosedation using drugs like propofol, dexmedetomidine, opioids, and so on. Operating a TCI device requires the user to have a primitive understanding of drug pharmacokinetics and pharmacodynamics and an awareness of the practical problems that can arise during its administration. Ongoing research supports their usage in other clinical settings and for various other drugs such as antibiotics, vasopressors, and so on. In this article, we review the underlying principles and commonly used drugs for TCI, the practical aspects of its implementation, and the scope of this technology in future. TCI technology is increasingly being used in the field of anesthesiology and critical care due to the myriad advantages it offers when compared to manual infusions. It is, therefore, essential for the reader to understand the relevant principles and practical aspects related to TCI technology, as well as to be aware of the commonly used TCI models.

Background and Aims: Starvation of long duration during third trimester of pregnancy is undesirable as it is associated with accelerated fasting leading to hypoglycemia, raised plasma free fatty acid (FFA) levels, and increased plasma/urinary ketones. Carbohydrate (CHO)-rich drinks given preoperatively may ameliorate these deleterious effects. The enhanced recovery after surgery (ERAS) guidelines for perioperative care recommend that oral CHO fluid supplementation 2 h before cesarean delivery may be offered to nondiabetic pregnant women. The aim of the study was to evaluate the role of preoperative oral CHO loading for the prevention of perioperative ketoacidosis in elective cesarean deliveries. Material and Methods: One hundred and twenty American Society of Anesthesiologists (ASA) II/III parturients undergoing elective cesarean section under subarachnoid block (SAB) were divided into two groups of 60 each after they gave written informed consent. Group A parturients received 400 ml of filtered water 2 h before surgery. Group B parturients received 400 ml of nonparticulate CHO drink 2 h before surgery. The primary outcome was the incidence of ketonuria studied by the dipstick method. Secondary outcomes included hunger and thirst scores, anxiety score, dominant hand grip strength, and the quality of recovery score. Results: The urine ketone levels were positive (+1) in 8.3% parturients in group A and 1.7% parturients in the CHO group (P value- 0.094). The hunger and thirst scores as well as the modified Beck’s anxiety scores were significantly lower in the CHO group (P value- 0.002). Dominant hand grip strength was preserved in both the groups (P value- 0.827). The quality of recovery score was significantly improved in the CHO group (P value- 0.002). No serious adverse effects were noted in either group. Conclusion: Oral CHO drink is safe when administered 2 h before uncomplicated elective cesarean deliveries. It may have a positive influence on a wide range of perioperative markers of clinical outcome.