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Abstract Background Alzheimer's disease (AD) is marked by cognitive decline along with the presence of mental symptoms, most notably psychosis. Although antipsychotic drugs are commonly recommended to treat these symptoms, there is ongoing discussion on the safety and effectiveness of these drugs in AD patients. The therapeutic management of Alzheimer’s disease-related psychosis (ARP) is hampered by its limited therapy options, determining the precise brain regions in Alzheimer’s patients with understanding of the neurological substrates implicated in ARP. While new therapies including brexpiprazole and atypical antipsychotics present promising therapeutic choices, practical implementation and potential upcoming therapies approaches is discussed along with mechanism-based understanding of different neurotransmitters with pharmaceutical therapies. Our objective is to contribute to more efficient and individualized treatment approaches by offering a thorough resource for medical professionals and researchers working in the field of managing and researching psychosis associated with AD. Results The examination containing new data supporting newer therapeutic approaches that target receptors and providing better safety and effectiveness characteristics. This study point out gaps in our existing understanding and make recommendations for future research, emphasizing the necessity of clinical trials created especially for psychotic Alzheimer’s patients. Secondly, the neurochemical and neuropathological bases of ARP, with a focus on changes in the dopamine, serotonin, and glutamate systems of neurotransmitters are also described in detail. Different pharmacodynamics antipsychotic medications are covered in later sections of this paper, with an emphasis on how these medications' interactions with certain neurotransmitter receptors may affect their therapeutic efficacy and side-effects profile. Conclusion The review article summarizes the most recent findings regarding the contribution of neurotransmitter receptors to the effectiveness of antipsychotic drugs in the management of ADP. We provide a thorough overview of second-generation (atypical) antipsychotics, emphasizing how their unique affinity for neurotransmitter receptors influences their clinical application in psychosis associated with AD. The difficulties of treating Alzheimer’s with antipsychotics are also covered in this study, including the potential for cognitive impairment to worsen, the emergence of extrapyramidal symptoms, and other unfavorable effects. New approaches to studying and treating ARP including neuroinflammation-targeting medicines, transcranial magnetic stimulation (TMS), cerebrospinal fluid (CSF) biomarkers, and muscarinic acetylcholine receptor (mAChR) agonists like xanomeline. Reducing psychosis through treatment options could be improved by knowledge of N-methyl-D-aspartate glutamate receptors (NMDAR) hypofunction processes in gamma-aminobutyric acid (GABAergic) neurons.

Wastewater surveillance (WS) has been used globally as a complementary tool to monitor the spread of coronavirus disease 2019 (COVID-19) throughout the pandemic. However, a concern about the appropriateness of WS in low- and middle-income countries (LMICs) exists due to low sewer coverage and expensive viral concentration methods. In this study, influent wastewater samples (n = 63) collected from two wastewater treatment plants (WWTPs) of the Kathmandu Valley between March 2021 and February 2022 were concentrated using the economical skimmed-milk flocculation method (SMFM). The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was tested by qPCR using assays that target the nucleocapsid (N) and envelope (E) genes. Overall, 84% (53/63) of the total samples were positive for SARS-CoV-2 according to at least one of the tested assays, with concentrations ranging from 3.5 to 8.3 log10 gene copies/L, indicating the effectiveness of the SMFM. No correlation was observed between the total number of COVID-19 cases and SARS-CoV-2 RNA concentrations in wastewater collected from the two WWTPs (p > 0.05). This finding cautions the prediction of future COVID-19 waves and the estimation of the number of COVID-19 cases based on wastewater concentration in settings with low sewer coverage by WWTPs. Future studies on WS in LMICs are recommended to be conducted by downscaling to sewer drainage, targeting a limited number of houses. Overall, this study supports the notion that SMFM can be an excellent economical virus-concentrating method for WS of COVID-19 in LMICs.

Splenic abscess is a rare complication of thalassemia major. It has a high mortality due to delay in diagnosis and treatment. Medical treatment alone is insufficient and splenectomy is considered to be a gold standard for splenic abscesses. In this paper, we report a 22-year-old thalassaemic male with splenic abscess. He presented with moderate pain in left hypochondrium and tender splenomegaly. The diagnosis was confirmed by ultrasonography and computerized tomography scan and histopathology.

The current research work explores the production of silver nanoparticles using aqueous extracts of Delonix regia (Boj. ex Hook.) Raf. (Angiosperms; Fabaceae) shoots for the bioreduction of Ag metal and its antimicrobial activity. Fourier transform infrared spectroscopy (FTIR), Zeta potential, ultraviolet-visible spectroscopy, scanning electron microscopy (SEM), and X-ray diffraction (XRD) have been used to evaluate the produced silver nanoparticles (AgNPs). Both antibacterial and antifungal activity were examined against bacterial and fungal pathogens, viz., Escherichia coli and Bacillus subtilis, and fungal strains, viz., Fusarium oxysporum and Aspergillus niger. The presence of silver nanoparticles was observed by the color change, i.e., from pale yellow to dark brown. The zeta potential observed for the produced nanoparticle is -18mv. The SEM and XRD revealed the size of synthesized AgNPs, i.e., 35nm and SEM size lies in the range of 40-60 nm. UV-visible absorption spectra were found at wavelength 425 nm. The synthesized nanoparticles are cost-efficient and could be an alternative procedure for the peculiar production of nanoparticles and also act as potential antimicrobial agents.

Uterine hemangioma is a rare benign tumour and can be congenital or acquired. Acquired is associated with physical changes such as tissue injury, hypoxia, endometrial curettage, increased blood volume during pregnancy and hormonal alterations. Uterine hemangiomas are found incidentally, remain asymptomatic and may present with bleeding per vaginum. Only 73 cases of uterine, cervical, vaginal and fallopian tube hemangiomas are described in the literature. In this report we describe additional two cases of uterine hemangioma.

Carbonation is one of the significant durability properties of cement mortar. Conventional mortar is generally made up of cement and sand, but blended mortar is formed by partial substitution of cement with certain pozzolanic materials. Consumption of industrial-by-products in developing of mortar is a footstep towards economic and sustainable construction and it also results in probable reduction of excessive carbon footprint and simultaneously deals with major environmental problems i.e., safe disposal of industrial by-products, reduction of pollution by dropping the amount of Portland Cement (PC) and lowering the exploitation of natural resources. The studies investigating carbonation resistance of mortar blended with industrial-by-products are uncommon till date. The current literature reviews the carbonation resistance of blended mortar made with incorporation of various industrial by-products (namely- silica fume-SF, fly ash-FA, ground granulated blast furnace slag-GGBS, coal bottom ash-CBA etc.). Out of all industrial by-products blended mortars containing SF exhibit highest carbonation resistance followed by FA, GGBS and CBA. The carbonation depth has been decreased up-to the range of 10% with the incorporation of various industrial mortars. Based on the existing trends, the current area requires more devotion as significant number of investigations has favoured the use of aforesaid by-products as partial replacement of PC in refining carbonation resistance.

Environmental surveillance of rivers and wastewater for SARS-CoV-2 detection has been explored as an innovative way to surveil the pandemic. This study estimated the economic costs of conducting wastewater-based environmental surveillance for SARS-CoV-2 to inform decision making if countries consider continuing these efforts. We estimated the cost of two SARS-CoV-2 environmental surveillance pilot studies conducted in Blantyre, Malawi, and Kathmandu, Nepal. The cost estimation accounted for the consumables, equipment, and human resource time costs used for environmental surveillance from sample selection until pathogen detection and overhead costs for the projects. Costs are reported in 2021 US$ and reported as costs per month, per sample and person per year. The estimated costs for environmental surveillance range from $6,175 to $8,272 per month (Blantyre site) and $16,756 to $30,050 (Kathmandu site). The number of samples processed per month ranged from 84 to 336 at the Blantyre site and 96 to 250 at the Kathmandu site. Consumables costs are variable costs influenced by the number of samples processed and are a large share of the monthly costs for ES (ranging from 39% to 72%). The relatively higher costs per month for the Kathmandu site were attributable to the higher allocation of dedicated human resources and equipment to environmental surveillance for SARS-CoV-2 compared to the Blantyre site where these resources were shared with other activities. The average cost per sample ranged from $25 to $74 (Blantyre) and $120 to $175 (Kathmandu). There were associated economies of scale for human resources and equipment costs with increased sample processing and sharing of resources with other activities. The cost per person in the catchment area per year ranged from $0.07 to $0.10 in Blantyre and $0.07 to $0.13 in Kathmandu. Environmental surveillance may be a low-cost early warning signal for SARS-CoV-2 that can complement other SARS-CoV2 monitoring efforts.

The carcinoids are the most frequent tumors arising from the appendix, in majority of the cases, these are asymptomatic and are discovered after appendectomy. The lipid-rich carcinoid, also known as clear cell carcinoid; is histologically characterized by the presence of clear vacuoles in the cytoplasm of tumor cells. Only 24 cases of lipid-rich carcinoid of the appendix are described in the English literature, and there is no report of this entity in the Indian literature. In this report we describe a first case of lipid-rich carcinoid of the appendix in India and also present a review of the literature.

Background and Aims: Total knee replacement (TKR) patients experience considerable post-operative pain. We evaluated whether addition of perineural dexmedetomidine to ropivacaine 0.2% in the femoral nerve block would enhance post-operative analgesia in patients undergoing unilateral TKR under spinal anaesthesia. Methods: Fifty patients were allocated randomly to two groups of 25 each. Group D received ropivacaine (0.2%) with dexmedetomidine (1.5 μg/kg), and Group C received ropivacaine (0.2%) with normal saline. Pain scores, time to the first request for analgesia and total consumption of ropivacaine in 48 h, along with haemodynamic parameters and sedation scores, were recorded. Quantitative data were compared using t-test, categorical data using Chi-square or Fisher's exact test and time variables using ANOVA. Results: The mean pain scores were significantly low till 2 h post-operatively in Group D. Time to the first demand for analgesia after initial loading dose was statistically prolonged in Group D, with mean duration of 346.8 ± 240 min, compared to 150 ± 115.2 min in Group C (P = 0.001). Total local anaesthetic consumption was also decreased over 24 and 48 h in Group D (P = 0.001). Haemodynamically, there was no significant variation in heart rate from their baseline mean values in either group (P > 0.05). However, the drop in systolic and mean blood pressure post-surgery was significant till 4 (P = 0.002) and 8 h (P = 0.02), respectively, in Group D. Group D patients were also significantly more sedated till 4 h post-operatively (P < 0.005). Conclusion: Adding dexmedetomidine to ropivacaine 0.2% in the femoral nerve block in patients undergoing unilateral TKR improves the quality and prolongs the duration of post-operative analgesia.

Background: Mobile phones are said to be the new epidemic of this century. The research was carried out to assess the level of mobile phone involvement among the medical students and its determinants. Methodology: It was a cross-sectional study carried out among 150 medical students of Bhavnagar using a tool “Mobile Phone Involvement Questionnaire (MPIQ)”. Results: Out of 150 medical students, 92.7% were highly involved with their mobile phone. Self reported data revealed that 40% often thought about their mobile phone when not using it; 50.4% often interrupt whatever else they are doing where they are contacted on their mobile phone; 78% often feel connected to others when they are using mobile phone; 39.3% often lose track of their mobile phone usage; 38.7% feel distressed by thought of being without their mobile phone and 35.9% often have been unable to reduce their mobile phone use. No association found between mobile phone involvement and age, gender, per-capita income, number of family members, expenditure on the phone or type of mobile plan. Conclusion: Most of the medical students (92.7%) were highly involved with their mobile phone, which was directly correlated with the frequency of their mobile phone usage.

This study looks into people's perceptions in the Delhi-NCR area to investigate the effect of fintech on financial inclusion. FinTech, which offers financial services and products through digital platforms, is a disruptive force in the worldwide financial services industry. Still untapped, though, is its potential to advance financial inclusion--that is, to guarantee that everyone has access to appropriate and reasonably priced financial services. This research seeks to clarify the ways in which FinTech promotes financial inclusion through a descriptive and exploratory study and to offer stakeholders guidance on how to best utilize its potential. Using judgmental and convenient sampling strategies, the study uses a sample of 360 respondents. Results of regression analysis corroborate the findings, which show a substantial relationship between financial inclusion and facilitating and growing the use of FinTech products. The research highlights the significance of Financial Technology in advancing inclusive financial systems, improving disadvantaged communities' access to financial services. FinTech companies, financial institutions, and legislators should all take note of these findings. Businesses can modify their products to target underprivileged communities, and governments can set aside funds to encourage FinTech projects. The report also suggests directions for further investigation, such as cross-regional comparisons and long-term tracking of shifts in FinTech adoption and its effects on financial inclusion. [ABSTRACT FROM AUTHOR]