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Objective : The ABO and Rh blood type systems are linked to a wide range of illnesses, including bacterial, viral, infectious, and malignant conditions. According to several research, COVID-19 predisposition and ABO blood types are related. The objective of the study is to determine the prevalence of the ABO blood group and its association with Covid disease and outcome. Materials and Methods: It is a retrospective and observational cross-sectional study done at the Department of Transfusion Medicine, from January 2021 to December 2021. A total of 504 Covid positive patients admitted during that period were analysed with their laboratory parameters and blood group types. Chi-square test was used to evaluate the data and find the relationship between blood types. Results: 504 admitted patients who were hospitalised during the research period were included. Among these, 216 belonged to blood type O, whereas 111 belonged to blood group A, 149 to blood group B, 28 to blood group AB. The prevalence of blood group O was higher and group AB had a low risk. There were 88 critical care unit patients, their length of critical care unit admission and blood types did not differ significantly. Conclusion: Our study suggests that blood group AB may be protective and that blood group O may be more susceptible to the disease, but that neither of these factors impact the progression of the illness or the likelihood of death. Keywords: ABO blood group, Severity, Covid 19

Background: India has the highest tuberculosis (TB) burden in the world and account for nearly one-fourth of the global burden of TB. Although the Indian government provides a basic national health service, an increasingly large number of health-care interactions in India are with the physicians in the private sector. Objective: The objective is to study the TB diagnostic practices among private medical practitioners and to determine the association of diagnostic practices with socio-demographic factors, the Revised National Tuberculosis Control Programme (RNTCP) training status, and professional/academic qualification of private medical practitioners. Materials and Methods: The current study was a cross-sectional study conducted in the urban areas of Nalgonda district between October 2015 and September 2017. The study included all medical general practitioners (GP) and all specialists practicing internal medicine, chest medicine, and pediatrics, registered with the Indian Medical Association (IMA) branches and had a private practice in the study area. The study included 101 private medical practitioners from three IMA branches. The data on diagnostic practices of TB and RNTCP training status were collected by an interview using a pretested semi-structured questionnaire. The data analysis was done using Statistical Package for Social Sciences (SPSS) 19th version. Results: The majority of study participants in this study were GP, while specialists constituted a smaller portion. Most of these private medical practitioners opted sputum smear examination as their second preferred investigation after a chest X-ray. For the diagnosis of pulmonary TB, majority of the private practitioners preferred both sputum smears examination and chest X-ray. The private medical practitioners who had received the RNTCP training were employing sputum smear microscopy as a diagnostic tool and were also aware about notification of TB. Conclusions: Overreliance on chest X-ray as the investigation of choice to diagnose pulmonary TB and for follow-up. Training in RNTCP has a positive impact on practicing standard diagnostic practices, treatment, and referral practices on private medical practitioners.

Abstract Background The authors had previously developed AnaVu, a low-resource 3D visualization tool for stereoscopic/monoscopic projection of 3D models generated from pre-segmented MRI neuroimaging data. However, its utility in neuroanatomical education compared to conventional methods (specifically whether the stereoscopic or monoscopic mode is more effective) is still unclear. Methods A three-limb randomized controlled trial was designed. A sample (n = 152) from the 2022 cohort of MBBS students at Government Medical College, Thiruvananthapuram (GMCT), was randomly selected from those who gave informed consent. After a one-hour introductory lecture on brainstem anatomy and a dissection session, students were randomized to three groups (S – Stereo; M – Mono and C – Control). S was given a 20-min demonstration on the brainstem lesson module in AnaVu in stereoscopic mode. M was given the same demonstration, but in monoscopic mode. The C group was taught using white-board drawn diagrams. Pre-intervention and post-intervention tests for four domains (basic recall, analytical, radiological anatomy and diagram-based questions) were conducted before and after the intervention. Cognitive loads were measured using a pre-validated tool. The groups were then swapped -S→ M, M →S and C→S, and they were asked to compare the modes. Results For basic recall questions, there was a statistically significant increase in the pre/post-intervention score difference of the S group when compared to the M group [p = 0.03; post hoc analysis, Bonferroni corrections applied] and the C group [p = 0.001; ANOVA test; post hoc analysis, Bonferroni corrections applied]. For radiological anatomy questions, the difference was significantly higher for S compared to C [p

Introduction: Platelets play an important role in cardiovascular disease mainly in the development of acute thrombotic events. Elevated platelet indices have been proposed as a risk factor for acute coronary syndrome (ACS). It remains uncertain whether increased platelet indices are the result or the cause of ACS. Aim and Objective: This study aimed to correlate mean platelet volume (MPV) and platelet aggregation response to know the functional status of platelets based on their size. Materials and Methods: A total of 50 patients with ST-segment elevation ACS (STE-ACS) or non-ST-segment elevation ACS (NSTE-ACS) were included and their MPV was measured and platelet aggregometry was performed. Patients were divided into two groups, patients with MPV ≤9.1 fl as group 1 and those with MPV >9.1 fl as group 2. The mean maximum platelet aggregation response (MMPAR) with ADP, Collagen, and Epinephrine, of both the groups, were compared. MMPAR to ADP, Collagen, and Epinephrine in group 1 was 74.47%, 66.13%, and 72.9%, respectively, and in group 2, 72.94%, 59.97%, and 72.43%, respectively. There was no statistically significant difference in the MMPAR to ADP, Collagen, and Epinephrine among the two groups. Conclusion: Increased MPV does not indicate the platelets are hyperreactive. An increase in MPV may be because of the increased release of immature platelets from bone marrow as there is increased consumption of platelets at the site of thrombus formation in ACS.

Introduction: Peripheral neuropathy is common in clinical practice, with a reported prevalence of 2.4% in the general population. There are numerous aetiologies for peripheral neuropathy like diabetes, ischaemia, vasculitis, inflammatory demyelinating disorders, nutritional deficiencies, paraproteinemic disorders, paraneoplastic syndromes, toxic exposures, and hereditary neuropathies. An exhaustive haematological, biochemical, and serological work-up, cerebrospinal fluid evaluation, electrodiagnostic tests, and nerve biopsy are required when overlapping clinical features present a diagnostic challenge. Aim: To analyse the histopathological characteristics of nerve biopsies in individuals with peripheral neuropathy. Materials and methods: This cross-sectional study was conducted in the Department of Pathology at Kasturba Medical College from January 2011 to December 2016. Nerve biopsies received in the Department of Pathology, Kasturba Medical College and Hospitals in the Ambedkar Circle and Attavar area, as well as at Government Wenlock Hospital, Mangaluru, Karnataka, India were studied. Clinical and laboratory data were collected from biopsy requisition forms and patient case records from the aforementioned hospitals. Results were presented in numbers and percentages. Results: A total of 134 nerve biopsies were included in the study. The age range of all cases studied was 7-86 years, with a mean age of 51.8 years. The study population consisted of 63.4% males and 36.6% females, resulting in a male-to-female ratio of 1.7:1. Vasculitic Neuropathy (VN) accounted for 38.1% cases, followed by chronic inflammatory neuropathies (21.7%) and Diabetic Neuropathy (DN) (12.6%). Other diagnosis included ischaemic neuropathy (6.7%), Hereditary Motor and Sensory Neuropathy (HMSN) (3.7%), subacute inflammatory demyelinating neuropathy (3.0%), as well as two cases each of Hansen’s neuritis, amyloid neuropathy, and acute inflammatory demyelinating neuropathy (1.5% each). One case of toxic neuropathy (0.7%) was identified, while 9.0% of cases displayed histological features that were either non specific or not characteristic of any specific diagnosis. Conclusion: Vasculitic neuropathy was found to be the most common aetiology of peripheral neuropathy, followed by Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and DN. The histopathological examination of nerve biopsies is a useful tool in distinguishing between diseases with overlapping clinical features, confirming or excluding vasculitis, and diagnosing hereditary conditions in settings where genetic testing is unavailable or unaffordable.

Background: In vitiligo, there is a significant decrease in melanocytes and melanin. The decrease in melanin causes oxidative stress, with a chance of causing metabolic syndrome. Hence, there is a need to look for metabolic syndrome in vitiligo. Aim and Objectives: To estimate the prevalence of metabolic syndrome in vitiligo patients and to evaluate the relationship between the severity and progression of vitiligo and metabolic syndrome. Materials and Methods: A hospital-based cross-sectional study was conducted on 178 vitiligo cases and 178 controls who were age- and sex-matched. The type of vitiligo, stability by vitiligo disease activity score (VIDA), and severity by vitiligo area severity index (VASI) were noted. The waist circumference, blood pressure, fasting lipid profile, and fasting blood sugar were measured for cases and controls. Metabolic syndrome was diagnosed based on Harmonization Asian criteria. Results: The mean age in cases was 34.38 years, and in controls, it was 35.67 years. The majority were females in both cases (52.2%) and controls (55.6%). Most have a VIDA score of 2+ (41.6%). The mean VASI score was 2.54. The percentage of metabolic syndrome was higher in cases (36%) compared to controls (24.2%) (P = 0.015). The mean age was lower in vitiligo cases with metabolic syndrome (38.83 years) compared to controls with metabolic syndrome (43.14 years). Metabolic syndrome was more frequent in the vitiligo vulgaris type (48.9%) than in acral and segmental vitiligo. Metabolic syndrome was more common in patients with high VIDA (45%) and VASI (52.3%) scores compared to patients with low VIDA (25%) and VASI (27.3%) scores. Limitation: It is a hospital-based study, so controls were not from the general population. Conclusion: The prevalence of metabolic syndrome was higher in vitiligo patients compared to controls, and it was higher in patients with active and severe disease. Screening and close monitoring of vitiligo patients help in the early diagnosis of metabolic syndrome and reduce the risk of cardiovascular disease.

We studied five patients who presented with complaints of swelling of the sternoclavicular joint (SCJ), with pain and restriction of shoulder movements in some. There was no clinical or imaging evidence of pulmonary involvement in any of these patients. The diagnosis of SCJ tuberculosis (TB) was ascertained by histopathological evidence (n = 2), by Xpert MTB/RIF (n = 1) and based on clinical presentation and response to anti-TB treatment (n = 2). On follow-up, all patients had responded well to anti-TB treatment. TB should be considered in the differential diagnosis in patients presenting with subacute/chronic SCJ arthritis, with or without pulmonary involvement, especially in high TB burden countries.

Background: Infective endocarditis (IE) involving tricuspid valve is rarely reported in children. Common etiological organisms of IE include Staphylococci, viridans group Streptococci, and Enterococci. Other less frequent organisms include Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella (HACEK) group, and Candida, accounting for 1% of cases. We describe the rare case scenario of tricuspid valve endocarditis caused by an unusual pathogen. Clinical Description: An 8-year-old girl presented with complaints of cough, shortness of breath, and intermittent fever for the past 2 months. Since 10 days before presentation, the fever had become high grade, continuous, and associated with chills and rigors. As per parents, the child had incidentally been detected with some congenital heart disease (CHD) at 3 months of age, documents being unavailable, child remaining asymptomatic till this presentation, without any medications. On examination, the child was malnourished with pallor, Grade 3 clubbing, tachypnea, and tachycardia. Auscultation revealed bilateral basal crepitations and a pansystolic murmur of Grade 4 in tricuspid area. Management and Outcome: Along with routine investigations, a two-dimensional echocardiography was done which revealed perimembranous ventricular septal defect with left-to-right shunt, tricuspid valve vegetations with anterior tricuspid leaflet prolapse with ruptured chordea, severe tricuspid regurgitation, and thickened aortic valve with good biventricular function. Blood culture showed growth of Streptococcus sinensis. The child was treated with oxygen, diuretics, and intravenous ciprofloxacin and gentamicin according to antibiotic sensitivity pattern. The child became hemodynamically stable and symptomatically improved after 3 weeks of treatment. Conclusion: This case creates awareness regarding an usual pathogen – S. sinensis as an etiological agent of IE, involving an unusual site – the tricuspid valve, in a child with CHD.

The GALEX Nearby Young Star Search (GALNYSS) yielded the identification of more than 2000 late-type stars that, based on their ultraviolet and infrared colors and pre-Gaia proper motions, are potentially of age

Abstract Background and Aim Celiac disease (CD) was shown to be associated with increased risk of developing acute pancreatitis (AP). There is a paucity of literature critically analyzing the association of CD with AP outcomes. We aimed to evaluate the impact of CD on outcomes and complications of AP in recent years. Methods A population‐based analysis was performed using the National Inpatient Sample (NIS) between 2016 and 2019. Multivariable logistic regression was conducted to identify the independent impact of CD on AP outcomes while controlling for demographics and comorbidities and all patients refined diagnosis‐related groups (APR‐DRG) risk of severity subclass. Results From 2016 to 2019, a total of 2 253 730 inpatients with AP were identified, of which 4640 (0.2%) had CD. On multivariable analysis, while controlling for demographics, comorbidities, and severity of illness, CD patients had significantly decreased odds for mortality (OR = 0.387), pseudocyst formation (OR = 0.786), sepsis (OR = 0.707), respiratory failure (OR = 0.806), acute kidney injury (AKI) (OR = 0.804), and myocardial infarction (OR = 0.217), (P

Churg–Strauss syndrome, also known as eosinophilic granulomatosis, is one of the antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis associated with asthma and peripheral eosinophilia. Here, we present a case of a 50-year-old male, known asthmatic presenting with cough, dyspnea, fever, and lower limb purpura. On evaluation found to have perinuclear ANCA positivity; a nerve conduction study showed mononeuritis multiplex, and he was diagnosed with Churg–Straus syndrome.

Background and Aim: Food item that has little nutritive value, high fat, and sugar content with little to no fiber content is labeled as junk food. The objective of the study is to assess the patterns of consumption of junk food among young adults and to explore the reasons for junk food consumption among young adults. Materials and Methods: Mixed method study consisting of quantitative phase involving interviews with 116 students from a Medical College using a semi-structured, validated questionnaire circulated through Google Forms followed by an depth interview of 10 participants for qualitative phase. Results: In the study, it was observed that (62.2%) eat junk food during snack time. Students staying with friends (35.3%) consumed more junk food compared to the ones staying with family (13.8%). The most common reasons for junk food consumption were its good taste (77.6%) and (68.1%) convenience. It is observed that maximum consumption of junk food is seen when meeting their friends (70.7%) and on special occasions (61.2%). French fries (69.8%) were the most common junk food consumed although (76.7%) felt that junk food is unhealthy. The qualitative interview also supported the findings that the most common reasons for junk food consumption were craving, inexpensive, taste, and poor taste of hostel food. Conclusion: The above study concluded that majority of the students consumed junk food when staying with friends and due to its good taste and convenience and to spend quality time with their family and on special occasions. Participants were aware that junk food is unhealthy but consume it because it is delicious while being pocket friendly.

Background: High-value care emphasizes services offering significant health benefits, aligning with patient preferences while minimizing costs and interventions of little benefit. This approach is increasingly vital in a healthcare environment constrained by finite resources and rising costs. Large Language Models (LLMs) like Generative Pretrained transformer-4 (GPT-4), with their vast data processing capabilities, offer a promising avenue for supporting healthcare providers in making evidence-based, high-value care decisions. Aims: This study aims to evaluate the performance of OpenAI’s GPT-4 in providing responses to high-value care clinical scenarios within internal medicine, assessing its accuracy, relevance, and reasoning against established medical guidelines and literature. Materials and Methods: An observational study was conducted using MKSAP-19’s high-value care questions, comparing GPT-4’s responses to the correct answers based on established studies, trials, and guidelines. The study did not involve real patient data, circumventing the need for Institutional Review Board (IRB) approval. Performance metrics focused on the accuracy, relevance, and consistency of GPT-4’s answers. Results: GPT-4 demonstrated a 74.4% accuracy rate (32 out of 43 questions) across a range of high-value care clinical scenarios, including image-based questions. Errors made by GPT-4 were similar to those by medical residents using MKSAP-19, suggesting areas for model improvement and potential educational applications. The study detailed GPT-4’s decision-making pattern, emphasizing its clinical reasoning capabilities. Conclusion: The findings suggest that GPT-4 can significantly support high-value care in internal medicine by providing accurate, evidence-based responses to complex clinical scenarios. Despite its limitations, including a 25.6% error rate and the scope of its training data, GPT-4’s performance indicates its potential as both a clinical and educational tool in healthcare.

Aeromonas hydrophila is a Gram-negative bacterium that has been linked to serious illnesses in both humans and animals. The presence of hemolysin, a virulence factor, is critical in the development of A. hydrophila-related illnesses. As a result, precise and timely detection of the hemolysin gene is critical for efficient diagnosis and prevention of many illnesses. The PCR is used in this study to detect the hemolysin gene of A. hydrophila in a novel, fast, and highly sensitive one-step technique. Specific primers were constructed to amplify a conserved area within the hemolysin gene to achieve both specificity as well as sensitivity. The PCR assay was rigorously optimized, taking temperature, primer concentration, and reaction time into account, in order to maximize the efficiency and reliability of this method. In conclusion, this method’s simplicity, sensitivity, and specificity make it highly promising for regular diagnostic applications. Its application would allow for the early detection of A. hydrophila infections, allowing for more effective treatment and control methods.

Introduction: Fluid cytology and the examination of malignant cells play an important role in the treatment of critical cases. The Department of Pathology (Cytopathology laboratory) receives samples for fluid cytology and examines malignant cells, reporting the White Blood Cell (WBC) count in the received fluid and the morphological findings of the cells examined on smears. Degeneration of cells in these body fluid samples, especially if the samples are not stored under proper conditions, is a common problem faced by many laboratories. Even overnight storage (12 hours) of these body fluids at temperatures of 4-8ºC (domestic refrigerators) may still cause some degree of degenerative changes. This becomes problematic in cytopathological reporting of body fluids, particularly when the samples are limited in amount or are from areas that cannot be re-aspirated {e.g., Cerebrospinal Fluid (CSF)}. While alcohol is a common fixative used for cell fixation in cytopathology, it is rarely used for fixing cells in fluid samples. Aim: To test the usage of absolute alcohol as a fixative in body fluid samples received in the cytopathology laboratory, which have been stored for 12 hours at two temperatures: room temperature and 4-8ºC. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology at Subharti Medical College, Meerut, Uttar Pradesh, India. The study was conducted over the periods of two months, from February 2022 to March 2022. A total of 100 body fluid samples (including CSF, ascitic fluid, pleural fluids, etc.) sent for routine workup to the cytopathology laboratory were included in the study. Each body fluid sample (1 mL) was taken in two test tubes, and four drops of 100% (absolute) alcohol were added to both test tubes. The mixture of body fluid and absolute alcohol was then gently shaken, and one set of test tubes was kept at room temperature while the other set was kept at 4-8ºC. The data was tabulated in an MS Excel worksheet, and basic statistical analysis was performed. Results: The age range of cases whose samples were analysed was from one-week-old neonates to 65-year-old adults. The total number of fluid samples was 100, including 42 CSF samples, 23 ascitic fluid samples, 18 pleural fluid samples, and 17 Bronchoalveolar Lavage (BAL) fluid samples. Out of the 42 CSF samples, 15 showed preservation of morphology when the alcohol-body fluid mixture was kept at room temperature, while 22 cases showed preservation of the same mixture at 4-8ºC. Some samples showed no preservation (5 CSF), the reasons for which are discussed below. All the examined body fluids showed better preservation with alcohol at 4-8ºC. Conclusion: The addition of absolute alcohol as a fixative in fluids helps preserve the cytomorphological features of cells and provides better preservation for the diagnosis of fluid samples.

Introduction: Rotator cuff tears are common musculoskeletal injuries, often associated with fatty degeneration (FD) of the rotator cuff muscles. While MRI has been the gold standard for assessing FD, dual-energy CT (DECT) shows promise in providing quantitative measurements. This study aims to compare FD quantification using DECT and MRI fat fraction values in patients with rotator cuff tears. Materials and Methods: Thirty patients diagnosed with rotator cuff tears underwent DECT and MRI scans for FD assessment. Imaging parameters and techniques were standardized for both modalities. Fat fraction values were obtained using region-of-interest (ROI) analysis. Results: The mean age of participants was 55.73 ± 10.16 years, with a majority classified as Goutallier stage 1. Significant differences were observed between fat fraction values measured by DECT and MRI. The ICC revealed moderate reliability (0.549, p

Introduction: Dengue Fever (DF) poses a critical public health threat in tropical regions, displaying a spectrum of manifestations without distinct diagnostic hallmarks. Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) are useful biomarkers of inflammation and prognostic markers in various diseases. The inflammation that occurs in dengue is due to the exaggerated response of the immune system. Aim: To assess the utility value of NLR and PLR as prognostic markers for dengue severity. Materials and Methods: A cross-sectional study was conducted on 99 admitted Dengue patients. Patients were grouped into three categories: DF, Dengue Haemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS). Various parameters of Complete Blood Count (CBC), NLR, and PLR were compared among the groups using Analysis of Variance (ANOVA) test (p-value

Soils and sediments from the Savannah River Site (SRS), located in the USA are known to have a long history of co-contamination with radionuclides (mainly uranium) and heavy metals. To better understand the bacterial taxonomic and genomic characteristic of the SRS soil habitat, shotgun metagenomes were obtained from three different levels of contaminated soil—high, medium, and low. Sequences were then assembled and annotated to generate metagenome-assembled genomes (MAGs) using toolkits within the nf-core/mag. The initial analysis resulted in a total of 254 MAGs. After bin refinement and de-replication, 55 MAGs which met the quality standard with a completeness > 75% and contamination < 25%, accounting for 21.67% of all the MAGs, were reconstructed. Further refinement with completeness > 90% and contamination < 10% yielded 24 MAGs (18 from the winter season and 6 from the summer season) spanning 6 bacterial phyla, predominantly Actinomycetota, Proteobacteriota, Bacteroidota, and Cyanobacteria. Overall, the Arthrobacter MAG was found to be robust for further analysis, with over 1749 genes putatively involved in the crucial metabolism of elements viz. nitrogen, phosphorous, and sulfur, and 598 genes encoding enzymes for the resistance of metals including cadmium, zinc, chromium, arsenic, and copper. In summary, this project enhances our understanding of genes conferring resistance to heavy metals in uranium-contaminated soils.

This study investigated the impact of a mixture of six endophytic bacterial strains isolated from cucumber plants on the growth and microbiome diversity of six cucumber traditional varieties and hybrids. Six bacterial species were isolated and identified by 16 s rRNA sequencing. All the bacteria showed plant growth promoting traits. Bacillus tequilensis showed 80 % inhibition of the mycelia growth of Fusarium oxysporum f.sp. cucumarinum (Foc). Mixed culture of all the bacteria was prepared and applied back to the varieties and hybrids of cucumber plants through seed soaking. Plant growth characteristics indicated that the treated plants showed increased plant growth in terms of plant height, number of leaves, vine length, male:female flower ratio, number of fruits and fruit length. Bacteria treated plants of hybrid HiVeg Chitra recorded 19 cm increase in vine length compared to control plants. The matataxonomic analysis of leaf samples by Illumina sequencing highlighted a diverse bacterial community shift in treated plants, with significant increases in genera like Bacillus and Staphylococcus. The core microbiome analysis identified key genera such as Bacillus, Staphylococcus, Sphingomonas, Methylobacterium, etc that could be pivotal in plant growth promotion. Bacillus and Staphylococcus showed increased abundance in treated varieties, correlating with the observed in plant growth parameters thus indicating their role in growth promotion of cucumber plants. Endophytic bacterial species identified from cucumber plants when re-applied by seed soaking, they promote the plant growth by modulating the microbiome. The bacterial species identified in the study could be potential candidates as microbial bioinputs for cucumber cultivation.

Introduction Comprehensive oral care is a service centered around the patient, and individuals who need it the most often face limited access. Patient perception acts as a guide for enhancing quality, ensuring patients’ future intent to utilize the services and facilitating recommendations to others. The present study aimed to assess the patients’ perception of comprehensive dental services availed at a Primary Health Center (PHC). Methods This qualitative study was based on a phenomenological interpretive approach, and judgment sampling method was employed. A validated interview guide, developed from relevant literature was employed in the local language to conduct interviews among adults visiting the PHC, gathering their views regarding the services provided. The interviews were audio recorded on a digital voice recorder, and files were password protected. Content saturation guided the determination of the final number of participants interviewed. After translating and transcribing the interviews, thematic analysis and coding were performed using ATLAS. ti 23 for Windows. Results A total of 12 participants were included in the study, following data saturation. Among them, there were 8(66.7%) female and 4(33.3%) male participants. Ten overarching main themes were discerned through the assigned codes, including positive views, neutral views, negative views, previous dental clinics visited, previous experience with dental treatment, treatments sought at the center, referrals, source of information about the dental center, subsequent visits and suggestions for improvement. Conclusions The findings of this study revealed a positive patient perception of the comprehensive dental services offered at the PHC. Through insightful interviews, various strengths, and areas for improvement regarding the center and care provision were identified. These insights provide valuable suggestions that can be applied to elevate the utilization of dental services, ensuring continuous improvement in patient care.

Objective To report the prevalence and risk factors for the fear of falling (FOF) among older individuals living in residential care facilities in India.Design Cross-sectional study.Setting Homes for the aged centres in Hyderabad, India.Participants The study included individuals aged ≥60 years from homes for the aged centres. The participants underwent a comprehensive eye examination in make-shift clinics setup in homes. Trained investigators collected the personal and demographic information of the participants and administered the Patient Health Questionnaire-9 and Hearing Handicap Inventory for Elderly questionnaire in the vernacular language. FOF was assessed using the Short Falls Efficacy Scale. The presence of hearing and visual impairment in the same individual was considered dual sensory impairment (DSI). A multiple logistic regression analysis was done to assess the factors associated with FOF.Primary outcome measure FOF.Results In total, 867 participants were included from 41 homes for the aged centres in the analyses. The mean (±SD) age of the participants was 74.2 (±8.3) years (range 60–96 years). The prevalence of FOF was 56.1% (95% CI 52.7% to 59.4%; n=486). The multivariate analysis showed that those with DSI had eleven times higher odds of reporting FOF than those with no impairment (OR 11.14; 95% CI 3.15 to 41.4.) Similarly, those with moderate depression had seven times higher odds (OR 6.85; 95% CI 3.70 to 12.70), and those with severe depression had eight times higher odds (OR 8.13; 95% CI 3.50 to 18.90) of reporting FOF. A history of falls in the last year was also associated with increased odds for FOF (OR 1.52; 95% CI 1.03 to 2.26).Conclusion FOF is common among older individuals in residential care in India. Depression, falling in the previous year and DSI were strongly associated with FOF. A cross-disciplinary approach may be required to address FOF among the older people in residential care in India.

The South China Sea (SCS) conflict has become a critical factor for regional peace and development with growing geopolitical competition between China and the USA. To face the rising threat of China, the study argues that the balance of power theory is relevant to explain why Vietnam attempts to strengthen strategic alliances with the USA, Russia, EU, and India to balance against the rising threat of China in SCS. However, this theory is not able to explain why Vietnam has a bandwagoning policy toward China at the same time. To fill the gap of the previous studies, this study endeavors to put forward the point that as geopolitical rivalry between the two superpowers, the United States and China, intensifies, Vietnam is put in a predicament of balancing the economic and the political choices against the choices of taking a neutral stand against the assertiveness of China in the SCS. Further, the alternative traditional balance options with ASEAN, and Russia are not sufficiently effective for Vietnam to balance against China since the position of both ASEAN and Russia is much weaker than China. This study also suggests that the support of the USA, EU, and its alliance for Vietnam’s position creates unbearable costs for China’s aggressive behaviors in SCS. By using the mathematical and logical framework, the study suggests that Vietnam tends to adopt a mixed strategy (balancing, bandwagoning, neutrality) in dealing with China’s threats.

Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83–0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.

The Smart City (SC) framework has garnered global recognition for its transformative influence on society through innovative solutions. However, the extensive use of Internet of Things (IoT) devices in SCs raises concerns regarding electronic waste and resource consumption. Addressing this challenge necessitates integrating smart grid systems to safeguard SC residents’ environment and well-being. Accurate air quality prediction is essential for informed societal decisions, safe transportation, and disaster preparedness. This study introduces a novel approach: Towards Cleaner Industries: Smart Cities’ Impact on Predictive Air Quality Management (SPAM). The SPAM model utilizes a bidirectional stacking mechanism of long short-term memory neural networks, considering spatiotemporal correlations to forecast future air pollutant concentrations. Surpassing conventional methods, SPAM model enhances accuracy while reducing computational complexity. Experimental findings demonstrate enhanced efficiency and accuracy, underscoring its practicality in industrial contexts. The SPAM model represents a significant advancement in promoting environmental sustainability within the SC framework.

Purpose: The study aimed to analyze the surgical outcome of manual small incision cataract surgery (MSICS) in patients with pseudoexfoliation syndrome (PXF) and pseudoexfoliation glaucoma (PXG) and compare them with those of controls. Settings and Design: This prospective, observational, and comparative study included 150 cases of PXF with cataracts, 150 cases of PXG with cataracts, and 200 cases of cataracts without PXF as controls. Methods: MSICS was performed in all cases under peribulbar anesthesia. Intraoperative complications, if any, were noted. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), and postoperative complications were recorded at follow-up on day 1, day 7, and after 1 month. Statistical Analysis Used: IBM SPSS 24.0 statistics, SPSS South Asia Pvt Ltd. Results: Lines of improvement in BCVA were significantly better in the control group (8.7 ± 1.7) than that in the PXF (7.5 ± 2.1) and PXG groups (6.4 ± 2.7). IOP significantly decreased from baseline to 1 month postoperatively in the PXG group than in the PXF and control groups (mean difference: 3.8 ± 7.5 mm Hg). Intraoperative iridodialysis and zonular dialysis were significantly high in the PXG group with a proportion of 4 and 20%, respectively. Postoperative choroidal detachment and hyphema, six cases each, were found significantly high in the PXG group. Conclusion: Although the BCVA improvement was less and the complications were high in patients with pseudoexfoliation, especially those with PXG, the reduction in IOP was significant. MSICS can be considered favorably in patients with PXF and PXG, with adequate precautions to manage anticipated complications.

Abstract Megaselia scalaris, commonly known as the scuttle fly, is a cosmopolitan species in the family Phoridae. It is an easily cultured fly species that is an emerging model organism in the fields of genetics and developmental biology. Its affinity for carrion and its predictable life cycle makes it useful in the field of forensic science for estimating the post-mortem interval (PMI) of human remains. Cases of human myasis caused by M. scalaris have also been reported in the medical literature. Despite its ubiquitous prevalence and its relevance across multiple fields, its morphology has not been adequately characterized. Here, we report the complete morphological characterization of all lifestages of M. scalaris, ranging from egg to adult. Scanning electron microscopy has enabled us to uncover morphological features and developmental processes that have previously not been reported in the literature. Our data lays the groundwork for future genetic studies: a morphological characterization of the wild type must be performed before mutants displaying different phenotypes can be identified. In this vein, we also report the observation of a acephalic, or 'headless’, adult phenotype whose study could yield insights into the process of cephalogenesis. Finally, all morphological features observed have been compiled into an ’atlas’ that should be of use to all workers in the field.

Background: More than 90 percent of oral cancers are squamous cell carcinomas, making them the most frequent kind of malignant tumor in the oral and maxillofacial area. Oral cancer rates are rising rapidly over the globe. Oral malignant tumors may develop when there is an incongruity between the microbiome and the host. Material & Methods: This prospective study was carried out in microbiology department, SMS Medical College, Jaipur. A total of 200 oral swab samples have been collected 100 for control group and 100 for case group and processed for bacterial identification according to standard microbiological guidelines. Results: Among the 100 samples studied from the oral squamous cell carcinoma patients, Pseudomonas species (n = 45) were the predominant isolate, followed by Klebsiella species (n = 26) and Staphylococcus species (n = 15). Of the 100 samples studied among the control group, Micrococci (24) and Diptheroids (23) is the predominant bacteria isolated. Conclusion: Patients with precancerous lesions had a more varied and abundant oral microbiome compared to those with oral cancer and healthy controls but that there was no difference between the groups in terms of overall microbiota composition. When comparing the oral bacterial profiles of those with cancer and those without, there were clear distinctions. Therefore, bacteria may be used as biomarkers in the diagnosis of oral cancer and as therapeutic targets in its therapy. Keywords: Oral microbial profile, oral pre canceous lesions, Oral pre cancerous lesions

(1) Background: We aimed to investigate the outcomes of human leukocyte antigen (HLA)-incompatible transplantation for patients who received desensitization with intravenous immunoglobulins (IVIg), plasmapheresis, and rituximab. (2) Methods: A comprehensive search of multiple electronic databases to identify studies that utilized desensitization was conducted. The random-effects model was used to calculate the pooled rates and the 95% confidence interval (CI). (3) Results: A total of 1517 studies were initially identified. From these, 16 studies met the inclusion criteria, encompassing 459 patients, with a mean age of 45 years, of whom 40.8% were male. CDC crossmatch was positive in 68.3% (95% CI: 43.5–85.8; I2 87%), and 89.4% (95% CI: 53.4–98.4%; I2 89.8%) underwent living-donor transplantation. The 1-year graft survival pooled rate was 88.9% (95% CI: 84.8–92; I2 0%) and the 5-year graft survival rate was 86.1% (95% CI: 81.2–89.9; I2 0%). The 1-year patient survival rate was 94.2% (95% CI: 91–96.3; I2 0%), and the 5-year patient survival rate was 88.9% (95% CI: 83.5–92.7%; I2 7.7%). The rate of antibody-mediated rejection was 37.7% (95% CI: 25–52.3; I2 80.3%), and the rate of acute cell-mediated rejection was 15.1% (95% CI: 9.1–24; I2 55%). (4) Conclusions: Graft and patient survival are favorable in highly sensitized patients who undergo desensitization using IVIg, plasmapheresis, and rituximab for HLA-incompatible transplantation.