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In recent years, Micro and small-scale industries (MSSIs) have been facing significant challenges such as market competition, rapid technological advancements, evolving customer preferences, and resource constraints. To meet production goals with expensive machinery and limited skilled labor, MSSIs often run operations 24/7 with employees working in rotating shifts. Unfortunately, ergonomic concerns are commonly overlooked, leading to issues that impact worker absenteeism and productivity levels. A survey involving 47 MSSIs and 827 workers was conducted to assess the effects of shift work on health and sleep patterns. The questionnaires were designed and distributed among 1497 workers and 827 workers took part in this study and returned the questionnaire (response rate 55.24%). Statistically, the data was analyzed shift wise and Chi-square test was employed to find out whether the shift schedules were associated with various variables. Pearson correlation analysis was applied to explore the complex relationship between the variables and the correlation between each variable and absenteeism before and after the Ergonomic Training Program (ETP). This study reported that ETP helped to mitigate absenteeism by 3.23% and the labor productivity improved by 2.78% (2.875 labor/h). Workers get benefitted from improved health and well-being, reducing the physical and psychological burdens associated with shift work. Overall, both the industry and its employees gain from the application of ergonomic practices.

Abstract This study investigates the synthesis of potato starch elastomers reinforced with silicon dioxide (SiO2) and citric acid as a crosslinking agent to enhance their mechanical and barrier properties. Surface morphology analysis using optical microscopy revealed that pure potato starch films had uneven surfaces. However, higher SiO2 concentrations increased roughness, while citric acid crosslinked films displayed smoother surfaces overall. Water vapor transmission rates (WVTR) indicated that native starch films were highly hydrophilic, while SiO2 incorporation and citric acid crosslinking significantly reduced WVTR of 17% (30% lower than native film), enhancing the barrier properties. Tensile strength testing revealed that citric acid crosslinking increased the tensile strength by 25%, while SiO2 further reinforced the films but decreased elasticity by 15%. SiO2 had little impact on degradation rates, while citric acid crosslinking delayed microbial growth, extending film longevity by 20%. Biocompatibility assays using SiHa, HT-29, and HEK 293 cell lines revealed that the films had varying degrees of cell confluency. Films with both SiO2 and citric acid showed improved confluency (20% higher) compared to films containing only SiO2. However, citric acid alone resulted in the highest confluency (95% viability), suggesting its significant role in biocompatibility. This eco-friendly approach demonstrates substantial advancements in film properties, offering potential applications in diverse biomedical industries.

Exclusive use of Swedish snus is associated with a reduction in associated health risks as compared with cigarette smoking. Similar to Swedish snus but without tobacco, modern oral nicotine pouches are smokeless nicotine products with the potential to offer similar or greater reductions of risks associated with tobacco use. Currently, little is known about the use prevalence of these products in established markets for Swedish snus. In this descriptive study, two market research surveys were conducted in 2019 among 18–64-year-olds in Sweden (n = 7003; male, 51.1%) and Denmark (n = 4402; male, 50.5%) on use of these oral tobacco and nicotine products in order to explore basic user demographics and average daily consumption (ADC) of oral nicotine products. In Sweden, 18.5% of participants reported currently using oral products (17.1% snus; 1.4% nicotine pouch), while only 11.0% smoked cigarettes. In Denmark, by contrast, 20.5% of participants reported currently using cigarettes, whereas 3.2% used oral products (0.8% snus; 2.4% nicotine pouch). More men than women reported using oral products in both countries, and most oral product users were younger than 45 years. The ADC of all oral products was 11.1 pouches/day in Sweden, but only 5.6 pouches/day in Denmark, where nicotine pouch use was predominant. In summary, Swedish snus continues to account for most oral tobacco or nicotine product use in Sweden, but nicotine pouch use has surpassed snus use (2.4% vs. 0.8%) in Denmark. Tobacco users who switch to nicotine pouches may reduce their health risks as compared to continuing tobacco product use, and nicotine pouches can contribute to tobacco harm reduction for the population as a whole.

Abstract Background Carriers of balanced reciprocal translocation are usually phenotypically normal; however, they have an increased risk of producing gametes with chromosomal imbalance through different types of meiotic segregation of the translocation quadrivalent. The genetically imbalanced gametes when they survive can result in embryos with chromosomal abnormalities. Here we report a family with two siblings inheriting partial trisomy for 9p and 18p concurrently resulting from a 3:1 meiotic segregation of a maternal balanced translocation involving chromosome 9q and 18p, and the associated phenotype. The family - case presentation The family was ascertained because of severe congenital anomalies in a newborn male (sibling 1). The karyotype of this patient was 47,XY,+del(9)(q13q34). Cytogenetic analysis revealed that the phenotypically normal mother harbored a balanced translocation 46,XX,t(9;18)(q13;p11.21). Chromosomal microarray analysis (CMA) of the abnormal child detected segmental trisomy for 9p and 18p. In conjunction with conventional cytogenetic results of the mother and CMA results of the affected child, the final karyotype of sibling one was 47,XY,+der(9)t(9;18) (q13;p11.22)dmat. arr[GRCh36] 9p24.3q13(199254_70163189)× 3, 18p11.32p11.22(131491_9640590)× 3; this resulted in segmental duplication of 69.96 Mb on 9pter->q13 and 9.51 Mb on 18p. There was a subsequent birth of a female sibling (sibling two) with multiple anomalies, including dysmorphic facial features, kidney aberration, cardiac defects, and abnormal brain MRI. The G-banded karyotype of this sibling was 47,XX,+del(9)(q13q34). The final karyotype of this sibling after CMA results was 47,XX,+der(9)t(9;18)(q13;p11.22)dmat. arr[GRCh37] 9p24.3p13.1(209020_38763958)× 3; 18p11.32p11.22(146484_9640912)× 3. The apparent discrepancy between the array results of the two siblings is attributed to difference in the design of array chips and genome builds used for these patients (NimbleGen/Roche v2.0 3-plex and GRCh36 for sibling one, and GGXChip + SNP array and GRCh37 of Agilent Technologies for sibling two). There are 182 OMIM genes in the duplicated region of 9p and 33 OMIM genes in the duplicated region of 18p which may have contributed to the clinical features of the affected siblings. Conclusions To our knowledge, we report the first two cases of concurrent partial trisomy 9p and 18p in the same family. This report adds more information about phenotypic effects of these chromosomal copy number gains and supports chromosomal microarray analysis as the standard for precise identification or demarking regions of duplications, particularly when the translocation involves at least one subterminal segment. In view of the recurring infants with congenital anomalies the couple may benefit from prenatal chromosome analysis of future pregnancies or opting to assisted reproductive methods and transferring normal embryos for implantation.

Ashwagandha (Withania somnifera L. Dunal) is an Ayurvedic medicinal herb that has been known for its therapeutic properties for millennia. Ashwagandha contains several bioactive compounds, including withanolides, alkaloids, and saponins. They make ashwagandha a potent adaptogen and a versatile herb that can maintain optimal health and overall well-being. Ashwagandha reduces stress and anxiety, as well as boosts the immune system. Its anti-inflammatory properties treat arthritis, asthma, diabetes, and inflammatory bowel disease. Ashwagandha produces an immunomodulatory effect on natural killer cells, lymphocytes, and leukemia cells. It enhances the activity of natural killer cells, increases lymphocyte function, and induces apoptosis in leukemia cells. However, its mechanism of action still remains understudied. Ashwagandha has an impact on COVID-19: phytochemical withanone blocks or weakens the interaction between S-protein and Angiotensin-converting enzyme 2. Withanoside V and somniferine inhibit viral transcription and replication caused by SARSCoV-2 Mpro. This review explores the potential utilization of ashwagandha in the food industry, i.e., its safety and toxicity, as well as the mechanism behind its immunomodulatory effect.

Evaluating the reduced-risk potential of novel tobacco and nicotine products, as compared to cigarettes, requires consideration not only of individual risk but also the impact on the population as a whole. Where the reduction in health risk for smokers who switch to the product instead of continuing to smoke, but also the product’s potential effects and rate of uptake among non-smokers must be taken into account.

Providing data on usage patterns is key to assessing the reduced-risk potential of novel tobacco and nicotine products as compared to conventional cigarettes at a population level. A pilot cross-sectional survey was conducted in 2018 across 3 areas of Japan (Tokyo, Osaka, and Sendai) to assess tobacco and nicotine product use after the introduction of Heated Tobacco Products (HTPs). Following successful completion of the pilot study, two nationwide cross-sectional surveys were conducted using the general population in Japan to assess use patterns after the introduction of HTPs. The first (Wave 1) was conducted in 2019, and the second in 2020. In Wave 2, the concern of this publication, additional population-level data was obtained on use patterns and behaviour relating to tobacco and nicotine products in Japan. Eligible participants were Japanese residents, aged 20 years or older who consented to complete the survey. A 3-stage probability sampling method was applied that was geographically stratified by street blocks proportionate to population density. Respondents self-reported patterns of product use and reasons for HTP use. Complete responses were available from 5307 individuals, of whom 889 (16.7%) were current users, 1012 (19.1%) were former users, and 3407 (64.2%) were never users of tobacco products (weighted respondent totals). Of current tobacco users, 63.5% smoked cigarettes exclusively and 17.9% used HTPs exclusively. HTP dual use in combination with conventional cigarettes was 12.7%. The remaining 5.9% of users were categorised as poly users (i.e., use of 2 or more tobacco products). The most common reasons reported for HTP use were perceived reduction in harm to others and self - compared to cigarettes. These findings are consistent across pilot and Wave 1 conducted in Japan as part of this survey programme. Cigarettes were still the most frequent tobacco product used (13.4% in the pilot to 15.5% in Wave 1) within the general population, the usage prevalence for HTPs (5.3% to 5.4%) being considerable in comparison to other tobacco or nicotine-containing products like cigars, cigarillos, pipe, kiseru, and oral tobacco, where usage prevalence was close to zero. As with the previous Waves, no gateway effect (use of non-traditional combustible tobacco use – such as e-cigarettes and in this case HTP use – leading to subsequent tobacco smoking) was observed in this study.

Shefali Thanawala,1 Rajat Shah,2 Krishnaraju Venkata Alluri,3 Kiran Bhupathiraju,4 Nandlal Prasad,5 Yash Agarwal6 1Medical Science and Research Department, Nutriventia Limited, Mumbai, Maharashtra, 400069, India; 2Executive Management, Nutriventia Limited, Mumbai, Maharashtra, 400069, India; 3Pharmacology and Clinical Research, Laila Nutraceuticals, Vijayawada, Andhra Pradesh, 520010, India; 4Research & Development, Laila Nutraceuticals, Vijayawada, Andhra Pradesh, 520010, India; 5Department of Orthopedics, Bajarang Memorial Fracture Accidental and Surgical Center, Varanasi, Uttar Pradesh, 221003, India; 6Department of Orthopedics, Sri Ram Ortho and Physio Rehab Centre, Varanasi, Uttar Pradesh, 221007, IndiaCorrespondence: Shefali Thanawala, Medical Science and Research Department, Unit 703 & 704, 7 th Floor Solaris One Premises Co-Operative Society Limited, N.S. Phadke Marg, Andheri (East), Nutriventia Limited, Mumbai, 400069, Maharashtra, India, Tel +912269113721, Email shefali@nutriventia.comPurpose: Turmeric extract is a well-known nutraceutical ingredient recognized for its benefits in managing musculoskeletal health. This study evaluated the efficacy and safety of a novel low-dose water-dispersible turmeric extract containing 60% natural curcuminoids (WDTE60N) in participants with mild-to-moderate knee osteoarthritis.Patients and Methods: This double-blind, randomized, placebo-controlled trial was conducted at two orthopedic centers in Uttar Pradesh, India (July 2023–November 2023). Participants aged 45– 75 years with unilateral or bilateral OA of the knee for > 3 months were randomized in 1:1 ratio to receive WDTE60N (250 mg) or placebo capsules once daily for three months. Study endpoints included assessment of changes from baseline to day 90 in pain intensity (visual analog scale [VAS], knee injury and osteoarthritis outcome score [KOOS]), inflammatory biomarkers, and safety profile. Data were analyzed using independent t-test, chi-square test, and analysis of co-variance test.Results: In total, 139 participants (WDTE60N, n = 70; placebo, n = 69) with mean age and BMI of 56.35 years and 23.89 kg/m2, respectively, were included. The mean reduction (95% CI) in VAS score from baseline to day 90 was significantly higher in the WDTE60N group than in the placebo group (14.41 [13.08, 15.75] vs 6.02 [5.00, 7.05]; p < 0.0001). In the WDTE60N group, the mean change in VAS scores was significantly reduced from as early as day 07 (p = 0.0076), which continued until day 90 (p < 0.0001), compared to the placebo group. Improvement in the mean KOOS scores (baseline-Day 90) was evident, with significantly higher mean scores for each domain (pain, symptoms, activities of daily living, function in sport and recreation, and knee-related quality of life [QoL]) on Day 90 in the WDTE60N group than in the placebo group (p < 0.05). Inflammatory biomarkers (hsCRP, TNF-α, IL-6, and IL-1β) were significantly reduced from baseline to day 90 in the WDTE60N group compared to the placebo group (p < 0.0001). Four mild adverse events were reported during the study period.Conclusion: Supplementation with the low-dose water-dispersible turmeric extract containing 60% natural curcuminoids for three months was safe and effective in alleviating pain, improving functional status and quality of life and reducing inflammation in participants with mild-to-moderate knee osteoarthritis.CTRI Registration Number: CTRI/2023/07/055411Keywords: curcuminoids, inflammatory biomarkers, KOOS, pain, QoL, visual analog scale

Abstract To address food and nutrition security in the face of burgeoning global populations and erratic climatic conditions there is a need to include nutrient dense, climatic resilient but neglected indigenous fruit trees in agrifood systems. Here we present the draft genome sequence of Kei Apple, Dovyalis afra, a neglected indigenous African fruit tree with untapped potential to contribute to nutrient security and improved livelihoods. Our long-read-based genome assembly comprises 440 Mbp sequence across 1190 contigs with a N50 and L50 of 13.3 Mbp and 11, respectively. We also annotated the genome and identified 27,449 protein-coding genes. Our genome assembly provides a valuable resource for unlocking the food security and nutraceutical potential of Kei apple.

Biting midges (Culicoides spp.) are important vectors of several insect borne arboviruses but are underrepresented in terms of availability of high-resolution genomic resources. We assembled and annotated complete mitochondrial genomes for two Culicoides species, namely C. brevitarsis and C. imicola which are proven vectors for Bluetongue Virus (BTV). We used both long read and short read sequencing technologies to assemble the circular genomes. The genome sizes are 17,100 bp and 17,031 bp, respectively, all comprising 37 genes, including 13 protein, 22 tRNA, two rRNA coding genes, and one non-coding AT rich control region. The gene organizations and orientations are comparable to other available Culicoides mitogenomes, except for a translocation of ND2 and six tRNA genes in both C. brevitarsis and C. imicola. Eleven protein-coding genes encode a full TAA stop codon, while two (ND5, COX3) are completed by mRNA polyadenylation. Phylogenetic analysis of the mitogenomes showed C. brevitarsis and C. imicola form a monophyletic group. The sequences of these mitogenomes contribute to a baseline of molecular tools for diagnostics and surveillance for use by World Organisation for Animal Health (WOAH) reference laboratories for monitoring vectors of emerging diseases.

Abstract The recent economic recession has reportedly worsened food insecurity in Sri Lanka. We assessed food insecurity and its impact on the growth of children aged 6–59 months through a community-based, descriptive, cross-sectional study conducted in 2022. Food insecurity was measured using the Household Food Insecurity Access Scale, and anthropometric measurements (weight, length/height) were taken using standard techniques. Weight faltering was defined as inadequate or no weight gain (flattening) or a drop in weight gain, based on the trajectory of the weight curve over two points six months apart. Additionally, food insecurity, stunting, and wasting during crisis were compared with pre-crisis data. The study included 832 children, with half of the households experiencing moderate to severe food insecurity. One-fifth of the children showed growth faltering during the crisis, and 8.9% of those with growth faltering crossed one centile line (0.67 SD). Among children facing food insecurity, the rate of growth faltering had doubled, with the residential sector (i.e., estate) tripling the risk of weight faltering. The rates of food insecurity and growth issues were notably higher during the crisis compared to pre-crisis data. This study highlights the worsening food insecurity and its significant impact on growth faltering in children under five during the 2022 economic recession.

Nevus Sebaceous of Jadassohan (NSJ) is a hamartoma that presents as a cutaneous lesion, which can be considered an overgrowth of sebaceous glands, hair follicles, and other epidermal structures. Although it is usually a benign condition, the lesion is capable of producing secondary neoplasms, both benign and infrequently, malignant. This case report discusses a 21-year-old male patient who presented with a lesion on the forehead, manifesting as a pilonidal sinus due to the presence of a tuft of hair at the end of the sinus tract following childhood trauma. The presence of a sinus tract with hair growth in the glabellar region is a rare and diagnostically challenging presentation of NSJ. This case highlights the complexities of managing such chronic wounds and the potential complications arising from trauma.

Persistent Right Umbilical Vein (PRUV) is a developmental abnormality of the vascular system that occurs during embryonic development when the right umbilical vein remains open while the left umbilical vein becomes atretic. PRUV presents in two forms: the extrahepatic variety, which is less prevalent but more often associated with complications, and the intrahepatic type, which is the most common (90-95%). A Single Umbilical Artery (SUA) occurs when there is only one umbilical artery in the cord, and it is associated with an increased risk of various abnormalities, including cardiovascular defects. Hereby, the authors present a case report of a 32-year-old primigravida, approximately 20.3 weeks into her pregnancy, underwent an anomaly scan that revealed a two-vessel umbilical cord, showing an SUA and a PRUV in one of the foetuses, while both foetuses demonstrated normal intrauterine growth. PRUV in foetuses is linked to preterm births, oligohydramnios, and intrauterine growth restriction. It can also lead to gastrointestinal malformations, various cardiac anomalies, skeletal malformations, urinary tract anomalies, and SUA defects. Therefore, prenatal diagnosis of PRUV is essential.

Abstract Introduction Interim analysis of the long-term safety and effectiveness of canakinumab, at a patient level, in the mevalonate kinase deficiency/hyperimmunoglobulin-D syndrome (MKD/HIDS) cohort of the RELIANCE registry. Methods From June 2018, the RELIANCE registry enrolled paediatric (aged ≥ 2 years) and adult patients (aged ≥ 18 years) with MKD/HIDS who were receiving canakinumab as part of their routine medical care. Safety, physician- and patient-reported measures of disease activity and dosing patterns were evaluated at baseline and every 6 months until end-of-study visit. Results At the analysis cut-off date of December 2022, eight patients with MKD/HIDS were enrolled. Five (62.5%) were children (

Background: After periodontal therapy, metrics such as pocket probing depth and clinical attachment level are typically measured, but patient-centered outcomes are often overlooked. It is important to enhance the evaluation of flap surgery outcomes with a questionnaire that gauges the quality of life in patients, postprocedure. The questionnaire for patient-based outcomes following periodontal therapy (QPBOPT) includes 14 items that investigate the potential observations and expectations of patients following periodontal treatment. Materials and Methods: A cross-sectional observational study was conducted with 51 patients who had received periodontal flap surgery. The QPBOPT was administered 3 months after the treatment, and the collected data were then subjected to statistical analysis. Results: All patients (100%) reported a decrease in bleeding gums, and 96% noticed an improvement in bad breath following surgery. Nevertheless, 68.6% of patients were discontented with the positioning of their gums, whereas 76.5% continued to experience sensitivity after the procedure. Conclusion: Significant improvements were seen in most dimensions except for the position of gums and sensitivity from the patient’s perspective. Hence, there is a need to address both the esthetic expectations of the patient and the hypersensitivity following flap surgery.

Abstract The biomedical industries have recently shown a great deal of interest in the study of flexible wireless devices. Wearable antennas are vital in medical applications as they enable continuous, real-time monitoring of patient health. In this context, a circular-shaped two-slot flexible ultra-wideband microstrip antenna is presented for use in the medical field. An inexpensive, lightweight flexible foam substrate material of 2 mm thickness with dielectric constant 1.07 and copper foil of 50 microns for patch is proposed in the fabrication of antenna. This paper presents a circularly shaped antenna of size $$48\times 36 {\text{mm}}^{2}$$ 48 × 36 mm 2 with patch radius of 12 mm and detailed analysis of bending, on-body and SAR with actual measurement. A good matching is observed between measured and simulated results with the bandwidth of 10 GHz over the ultra-wideband operating frequencies of 3.1–10.7 GHz. The slot and stub added into geometry has resulted into the total gain of 4.7 dB, with good impedance matching. An extensive SAR analysis for 1 and 10 g tissue has been carried out with average SAR of 0.0215 W/kg and 0.0138 W/kg respectively and found below the safety limit as prescribed by IEEE.

Abstract Background Long-read technologies from Pacific Biosciences (PacBio) and Oxford Nanopore Technologies (ONT) have transformed genomics research by providing diverse data types like HiFi, Duplex, and ultra-long ONT. Despite recent strides in achieving haplotype-phased gapless genome assemblies using long-read technologies, concerns persist regarding the representation of genetic diversity, prompting the development of pangenome references. However, pangenome studies face challenges related to data types, volumes, and cost considerations for each assembled genome, while striving to maintain sensitivity. The absence of comprehensive guidance on optimal data selection exacerbates these challenges. Results Our study evaluates recommended data types and volumes required to establish a robust de novo genome assembly pipeline for population-level pangenome projects, extensively examining performance between ONT’s Duplex and PacBio HiFi datasets in the context of achieving high-quality phased genomes with enhanced contiguity and completeness. The results show that achieving chromosome-level haplotype-resolved assembly requires 20 × high-quality long reads such as PacBio HiFi or ONT Duplex, combined with 15–20 × of ultra-long ONT per haplotype and 10 × of long-range data such as Omni-C or Hi-C. High-quality long reads from both platforms yield assemblies with comparable contiguity, with HiFi excelling in phasing accuracies, while Duplex generates more T2T contigs. Conclusion Our study provides insights into optimal data types and volumes for robust de novo genome assembly in population-level pangenome projects. Reassessing the recommended data types and volumes in this study and aligning them with practical economic limitations are vital to the pangenome research community, contributing to their efforts and pushing genomic studies with broader impacts.

Abstract Background Prolonged therapy, hepatic damage, and the development of drug resistance are the limitations of doxycycline and rifampicin in the treatment of brucellosis. This study was designed to assess the effect of solid lipid nanoparticles (SLNs) encapsulation of these antimicrobials against brucella. SLNs were prepared by a double emulsion method and characterized for entrapment efficiency, particle size distribution, drug release, infrared spectroscopy, differential scanning calorimetry, and scanning electron microscopy. The encapsulated formulations were tested for stability, safety, and in vitro antimicrobial assay on brucella and brucella-infected mice models. Results The particle size, polydispersity index and zeta potential of doxycycline encapsulated SLN size were 443.6 ± 3.03 nm, 0.858 ± 0.00, and + 26.5 ± 1.87 mV, respectively. The rifampicin SLN showed particle size, polydispersity index, and zeta potential of 348.7 ± 3.35 nm, 0.234 ± 0.00, and + 22.9 ± 1.59 mV. The entrapment efficiency of doxycycline and rifampicin encapsulated SLN was 98% and 96%, respectively. The drug-loaded SLN retained the biophysical properties, drug loading, and entrapment efficiency after storage at 4 °C as well as 25 °C for 6 months. The Fourier transform infrared spectroscopy depicted effective encapsulation and the Differential scanning colorimetry thermogram revealed a negative interaction of drug and polymer. Drug release parameters were fitted well with the Korsmeyer–Peppas and Hixson–Crowell model (R2 ≥ .09). The MIC findings showed a reduction in MIC values of SLN-encapsulated rifampicin; whereas, doxycycline did not show any changes. The MBC value for free and SLN-encapsulated doxycycline and rifampicin did not show changes. SLN encapsulation did not show any cytotoxicity on murine macrophage cell line RAW 264.76 for both drugs. Doxycycline and rifampicin significantly reduced the CFU of B. abortus compared to the free drug (P > 0.05), resulting in less damage to the liver and kidneys. Conclusions The present study concludes that SLN encapsulation of doxycycline and rifampicin would be safe and effective for the prolonged treatment regimen against Brucella infection. Graphical abstract

Abstract Acute myeloid leukemia (AML) with RUNX1::CBFA2T2 fusion is rare with largely unknown clinicopathological features and genomic characterization. We present one such case of AML transformed from JAK2 V617F mutated primary myelofibrosis and review the literature on this topic. The immunophenotype and the landscape of cooperative gene alterations in AML with RUNX1::CBFA2T2 resemble those of AML with RUNX1::RUNX1T1, including expression of CD19, cooperative gene alterations in signaling pathway (JAK2), epigenetic/chromatin and cell cycle regulation (TET2, SMC3, and CDKN2A/B), and additional chromosomal abnormalities (trisomies 8 and 15). This case study provides insights into the pathogenesis of this rare subtype of AML.

Objective: To identify clinicopathologic and genomic features associated with brain metastasis after resection of lung adenocarcinoma (LUAD) and to evaluate survival after brain metastasis. Methods: Patients who underwent complete resection of stage I-IIIA LUAD between 2011 and 2020 were included. A subset of patients had broad-based panel next-generation sequencing performed on their tumors. Fine-Gray models for the development of brain metastasis were constructed, with death without brain metastasis as a competing risk. Results: A total of 2660 patients were included. The median duration of follow-up was 71 months (95% confidence interval [CI], 69-73 months). The cumulative incidence of brain metastasis at 10 years was 9.8%. Among patients who developed a brain metastasis, the median time from surgery to brain metastasis was 21 months (interquartile range, 10-42 months). Higher maximum standardized uptake value of the primary tumor, neoadjuvant therapy, lymphovascular invasion, and stage III disease were associated with the development of brain metastasis. Among patients who underwent next-generation sequencing, a multivariable analysis identified neoadjuvant therapy, pathologic stage, and TP53 mutations as associated with development of brain metastasis. The median survival after brain metastasis was 18 months (95% CI, 13-24 months). Better performance status, lack of extracranial metastasis, stereotactic radiosurgery, and targeted therapy were associated with better survival after brain metastasis. Conclusions: Brain metastasis is common after complete resection of LUAD and often occurs within 2 years. Markers of aggressive tumor biology, including higher maximum standardized uptake value, lymphovascular invasion, and TP53 mutations, and neoadjuvant therapy are associated with brain metastasis.

Escherichia coli harbors various virulence factors responsible for diarrhea and other diseases in neonatal calves. The antimicrobial resistance (AMR) among the diarrheagenic and non-diarrheagenic E. coli may impose a potential health hazard among the calves and make the antibacterial therapy ineffective. The virulence gene expression among AMR strains plays a crucial role in establishing diarrheal disease with therapeutic complications. This study investigates the diversity of E. coli isolates from neonatal calves. E. coli isolated from the fecal samples were subsequently subjected to pathotyping and virulotyping using the PCR technique. AMR profiling was done by phenotypic and genotypic methods. The ERIC pattern of E. coli pathotypes was compared and correlated with the pattern of AMR and virulence traits. 179 isolates were obtained from 158 fecal samples collected from neonatal calves. Forty-two isolates were pathotypable; predominated by shigatoxigenic E. coli. Seventy-four isolates were ESBL producers. Nineteen isolates were carbapenem resistant and 68 isolates exhibited quinolone resistance. blaAmpC, blaVIM and qnrS were the predominant genes detected among ESBL, carbapenem and quinolone resistance genes, respectively. The present study indicated diverse virulence profiles and the presence of significant ESBL, carbapenem and fluoroquinolone resistance among E. coli pathotypes from calves. The analysis of resistance profiling indicates the risks associated with the indiscriminate antibiotic use among farm animals, which may pose a potential health hazard to livestock owners.

Abstract Cellular target engagement technologies enable quantification of intracellular drug binding; however, simultaneous assessment of drug-associated phenotypes has proven challenging. Here, we present cellular target engagement by accumulation of mutant as a platform that can concomitantly evaluate drug-target interactions and phenotypic responses using conditionally stabilized drug biosensors. We observe that drug-responsive proteotypes are prevalent among reported mutants of known drug targets. Compatible mutants appear to follow structural and biophysical logic that permits intra-protein and paralogous expansion of the biosensor pool. We then apply our method to uncouple target engagement from divergent cellular activities of MutT homolog 1 (MTH1) inhibitors, dissect Nudix hydrolase 15 (NUDT15)-associated thiopurine metabolism with the R139C pharmacogenetic variant, and profile the dynamics of poly(ADP-ribose) polymerase 1/2 (PARP1/2) binding and DNA trapping by PARP inhibitors (PARPi). Further, PARP1-derived biosensors facilitated high-throughput screening for PARP1 binders, as well as multimodal ex vivo analysis and non-invasive tracking of PARPi binding in live animals. This approach can facilitate holistic assessment of drug-target engagement by bridging drug binding events and their biological consequences.

Abstract Background Drug-resistant hypertension affects approximately 9–18% of the United States hypertensive population. Recognized as hypertension that is resistant to three or more medications, drug-resistant hypertension can lead to fatal sequelae, such as heart failure, aortic dissection, and other vast systemic disease. The disruption of the homeostatic mechanisms that stabilize blood pressure can be treated procedurally when medication fails. These procedures include carotid body stimulation, renal denervation, sympathectomies, dorsal root ganglia stimulation, and more recently spinal cord stimulation and have all been utilized in the treatment of drug-resistant hypertension. Methods To identify the clinical trials of neuromodulation in drug-resistant hypertension, a PubMed search was performed that included all original clinical trials of neuromodulation treating drug-resistant hypertension. The 838 articles found were sorted using Covidence to find 33 unique primary clinical trials. There were no methods used to assess risk of bias as a meta-analysis was not feasible due to heterogeneity. Results Renal denervation and carotid body stimulation have both shown promising results with multiple clinical trials, while sympathectomies have mostly been retired due to the irreversible adverse effects caused. Dorsal root ganglion stimulation showed varying success rates. Spinal cord stimulation is a novel treatment of drug-resistant hypertension that shows promising initial results but requires further investigation and prospective studies of the treatment to provide guidelines for future DRH treatment. The limitations of the review are reporting bias and absence of a meta-analysis that compares the treatment modality due to the heterogeneity of reported outcomes. Conclusion Innovation in neuromodulation is necessary to provide alternative avenues of treatment in the face of contraindications for standard treatment. Treatment of drug-resistant hypertension is essential to delay dangerous sequelae. This review’s objective is to summarize the clinical trials for treatment of drug-resistant hypertension following PRISMA guidelines and suggests future directions in the treatment of drug-resistant hypertension.

Periodontal surgery often necessitates the use of a periodontal dressing to protect the surgical site and facilitate healing. Commonly used dressings, such as noneugenol packs, offer some benefits but have significant drawbacks, including plaque accumulation, a sensation of foreignness, and no significant impact on healing enhancement. On the other hand, platelet-rich fibrin (PRF) membranes are rich in growth factors, which can accelerate wound healing and tissue regeneration. However, their use is limited due to the need for suturing to stabilize the membrane. N-butyl cyanoacrylate is a tissue adhesive known for its hemostatic and bacteriostatic properties and effectiveness in moist environments, presenting a potential solution for PRF membrane stabilization without the need for suturing. This case report evaluates the use of PRF membrane in combination with N-butyl cyanoacrylate adhesive as an alternative to traditional noneugenol periodontal dressing.

Background & objectives: Scrub typhus is clinically undifferentiated from other aetiologies for acute febrile illness such as enteric fever, dengue, malaria, and leptospirosis. Rapid ELISA tests are being used as an alternative to immunofluorescence assay in tropical countries. Methods: In this study, we compared and evaluated commercially available InBios Scrub Typhus Detect IgM Rapid Test (USA) for diagnosing human scrub typhus infection using archived and prospectively collected samples against the reference standard, InBios Scrub Typhus Detect IgM ELISA (USA). Results: The data analysis of archived samples on rapid test revealed a moderate sensitivity of 53.92% and a specificity of 100%. Meanwhile, prospective serum samples demonstrated higher sensitivity and specificity of 96.4% and 94.6%, respectively. Interpretation & conclusion: The InBios Scrub Typhus Detect IgM rapid test can be a good point-of-care assay during surveillance, outbreak investigations, and case identification.

Abstract Fibrosis is a common outcome of numerous pathologies, including chronic kidney disease (CKD), a progressive renal function deterioration. Current approaches to target activated fibroblasts, key effector contributors to fibrotic tissue remodeling, lack specificity. Here, we report Gucy1α1 as a specific kidney fibroblast marker. Gucy1α1 levels significantly increased over the course of two clinically relevant murine CKD models and directly correlated with established fibrosis markers. Immunofluorescent (IF) imaging showed that Gucy1α1 comprehensively labelled cortical and medullary quiescent and activated fibroblasts in the control kidney and throughout injury progression, respectively. Unlike traditionally used markers platelet derived growth factor receptor beta (Pdgfrβ) and vimentin (Vim), Gucy1α1 did not overlap with off-target populations such as podocytes. Notably, Gucy1α1 labelled kidney fibroblasts in both male and female mice. Furthermore, we observed elevated GUCY1α1 expression in the human fibrotic kidney and lung. Studies in the murine models of cardiac and liver fibrosis revealed Gucy1α1 elevation in activated Pdgfrβ-, Vim- and alpha smooth muscle actin (αSma)-expressing fibroblasts paralleling injury progression and resolution. Overall, we demonstrate Gucy1α1 as an exclusive fibroblast marker in both sexes. Due to its multiorgan translational potential, GUCY1α1 might provide a novel promising strategy to specifically target and mechanistically examine fibroblasts.

Abstract Detecting glucose levels is crucial for diabetes patients as it enables timely and effective management, preventing complications and promoting overall health. In this endeavor, we have designed a novel, affordable point-of-care diagnostic device utilizing microfluidic principles, a smartphone camera, and established laboratory colorimetric methods for accurate glucose estimation. Our proposed microfluidic device comprises layers of adhesive poly-vinyl films stacked on a poly methyl methacrylate (PMMA) base sheet, with micro-channel contours precision-cut using a cutting printer. Employing the gold standard glucose-oxidase/peroxidase reaction on this microfluidic platform, we achieve enzymatic glucose determination. The resulting colored complex, formed by phenol and 4-aminoantipyrine in the presence of hydrogen peroxide generated during glucose oxidation, is captured at various glucose concentrations using a smartphone camera. Raw images are processed and utilized as input data for a 2-D convolutional neural network (CNN) deep learning classifier, demonstrating an impressive 95% overall accuracy against new images. The glucose predictions done by CNN are compared with ISO 15197:2013/2015 gold standard norms. Furthermore, the classifier exhibits outstanding precision, recall, and F1 score of 94%, 93%, and 93%, respectively, as validated through our study, showcasing its exceptional predictive capability. Next, a user-friendly smartphone application named “GLUCOLENS AI” was developed to capture images, perform image processing, and communicate with cloud server containing the CNN classifier. The developed CNN model can be successfully used as a pre-trained model for future glucose concentration predictions.

Abstract The contemporary research article is central to understanding coal structure evaluation and the morphological development impacting its utilization in different applications. Through Mineral Liberation Analysis (MLA) designs high content phyllosilicates minerals and swelling clay minerals were rationalized to provides a novel insight into enhanced coal beneficiation and the benefits of coal by-product re-utilization progressions that encourage safer environments and economic sustainability. This work commences with collection of five (5) different coal samples from the central district region in Botswana, sample characterization deploying Thermogravimetric coal analysis (TGA), x-ray fluorescence spectroscopy (XRF), x-ray diffraction (XRD), scanning electron microscopy (SEM) and the Hardgrove Grindability Index (HGI) test that was directed to quantification of the coal hardness and fracture toughness during milling. The cumulative objective was to understand the correlation that exists between the natural composition of the coal sample and their adaptation and application in various carbonaceous products. A solid connection was thus identified in the sulfur and phosphorus weight percentage inclusions in all the coal materials hence higher significance in sphalerite mineral phases (Zn, Fe) S critically increased the fracture toughness and hardness properties. Moreover, mineral amalgams intrinsic to the coal maceral such as aluminum oxides (Al2O3), silicate (SiO2), calcites (CaO), Iron oxide (Fe2O3), potassium feldspars (K − AlSi3O8), albite (Na − AlSi3O8), and anorthite (Ca − Al2Si2O8) compounds in alkali feldspars were detected in larger quantities. The coal industry has attracted much industrial attention to manufacturing foundations producing cement, ceramic tiles, paving bricks, and material synthesis and will continue to supply other economic sectors in the conceivable future. Graphical Abstract

Introduction: Photodynamic Therapy (PDT) presents a non invasive avenue for treating various infections, including periodontal disease, offering an alternative to mechanical methods like scaling and root planing. Concerns about antibiotic resistance have fueled the exploration of PDT as an antimicrobial therapy. PDT combines low-power lasers with photosensitising drugs to eliminate microorganisms through the generation of cytotoxic reactive oxygen species upon light activation. Aim: To evaluate the scope of PDT and its role in periodontology. Materials and Methods: A comprehensive electronic search was conducted in major medical databases, including Google Scholar, PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Wiley. A total of 43 studies from 2007 to 2023 were selected, focusing on PDT for the treatment of periodontal disease. The review included Randomised Controlled Trials (RCTs), case-control studies, and cohort studies involving human subjects, using Photosensitisers (PSs) or Indocyanine Green (ICG) for subgingival irrigation in chronic periodontitis patients after scaling and root planing, with follow-ups extending over one month. The outcomes measured were Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Plaque Index (PI), and Gingival Index (GI). Results: In present review, after thorough analysis, a total of 21 studies were selected from databases including Google Scholar, PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Wiley. The risk of bias assessment showed high-risk in 1 out of 128 studies (0.59%), low risk in 139 out of 168 studies (82.74%), and unclear risk in 28 out of 168 studies (16.67%). The results indicated significant clinical improvements when PDT was combined with conventional treatments. Conclusion: The PDT in periodontology showcases varied roles, from antimicrobial action to tissue healing and the promotion of periodontal health. Its efficacy as an adjunctive treatment, especially in challenging cases or against resistant microbes, is evident, accentuated by its non invasive nature and minimal adverse effects, making it an appealing option in periodontal care.

Abstract Background Groundnut is mainly grown in the semi-arid tropic (SAT) regions worldwide, where abiotic stress like drought is persistent. However, a major research gap exists regarding exploring the genetic and genomic underpinnings of tolerance to drought. In this study, a multi-parent advanced generation inter-cross (MAGIC) population was developed and evaluated for five seasons at two locations for three consecutive years (2018–19, 2019–20 and 2020–21) under drought stress and normal environments. Results Phenotyping data of drought tolerance related traits, combined with the high-quality 10,556 polymorphic SNPs, were used to perform multi-locus model genome-wide association study (GWAS) analysis. We identified 37 significant marker-trait associations (MTAs) (Bonferroni-corrected) accounting, 0.91- 9.82% of the phenotypic variance. Intriguingly, 26 significant MTAs overlap on four chromosomes (Ah03, Ah07, Ah10 and Ah18) (harboring 70% of MTAs), indicating genomic hotspot regions governing drought tolerance traits. Furthermore, important candidate genes associated with leaf senescence (NAC transcription factor), flowering (B3 domain-containing transcription factor, Ulp1 protease family, and Ankyrin repeat-containing protein), involved in chlorophyll biosynthesis (FAR1 DNA-binding domain protein), stomatal regulation (Rop guanine nucleotide exchange factor; Galacturonosyltransferases), and associated with yield traits (Fasciclin-like arabinogalactan protein 11 and Fasciclin-like arabinogalactan protein 21) were found in the vicinity of significant MTAs genomic regions. Conclusion The findings of our investigation have the potential to provide a basis for significant MTAs validation, gene discovery and development of functional markers, which could be employed in genomics-assisted breeding to develop climate-resilient groundnut varieties.

Nanofluids have gained significant attention as a promising solution to several challenges in drilling operations. Nanoparticles, due to their exclusive properties such as high specific surface area, strong adsorption potential, and excellent thermal conductivity, offer significant potential to improve the efficiency and performance of drilling processes. Regardless of the advancements in drilling fluids and techniques that have improved borehole stability, hole cleaning, and extreme operational condition (HTHP) management, limitations still persist. This review discusses a detailed summary of existing research on the application of nanofluids in drilling, exploring their types, properties, and specific uses in areas such as fluid loss control, wellbore stability, and thermal management. It also reports the challenges and future potential of nanotechnology in drilling, including nanoparticle stability, environmental considerations, and cost concerns. By synthesizing current research and highlighting gaps for further study, this review intends to guide researchers and industry professionals in effectively integrating nanofluid usage to optimize drilling practices and support a more sustainable energy future.

Sublingual (SL) buprenorphine has been used as a modality of managing acute postoperative pain in many studies. This systematic review aimed to investigate the safety and efficacy of SL buprenorphine as an analgesic for various surgeries. After registering the protocol with PROSPERO, we searched PubMed, Cochrane Library, and Ovid databases with relevant keywords. The primary outcomes were 24-hour pain scores, and the secondary outcomes were postoperative nausea and vomiting, sedation scores, pruritus, rescue analgesia, and urinary retention. The risk of bias scale was used to identify the quality of evidence. From the 103 articles identified, four randomized-controlled trials fulfilled the inclusion criteria for qualitative analysis. The overall risk of bias was low. Most of the studies showed that the use of SL buprenorphine led to either better or comparable pain scores when compared to a control group with lesser or tolerable adverse events. There was a lot of heterogeneity across the studies in this systematic review in terms of the type of surgery performed, the comparison groups, doses of buprenorphine, and the outcomes that were assessed. Therefore, a quantitative meta-analysis was not performed. The results of this systematic review should be interpreted with caution due to heterogeneity in the methodology. Adequately powered studies with robust methodology should investigate the safety and efficacy of SL buprenorphine when used for postoperative analgesia.

Elisabetta Bugianesi,1 Luca Miele,2,3 Giovanna Donnarumma,4 Katrine Grau,5 Mariarosaria Mancuso,4 Preethy Prasad,5 Andrea Leith,6 Victoria Higgins6 1Division of Gastroenterology, Department of Medical Sciences, University of Torino, AOU Città della Salute e della Scienza, Torino, Italy; 2Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; 3Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy; 4Novo Nordisk SpA, Rome, Italy; 5Novo Nordisk A/S, Søborg, Denmark; 6Adelphi Real World, Bollington, Cheshire, UKCorrespondence: Elisabetta Bugianesi, Email elisabetta.bugianesi@unito.itBackground: Although the estimated prevalence of non-alcoholic steatohepatitis (NASH) in Italy is 4– 6%, little is known about patient characteristics and care pathways.Aim: To describe patient characteristics and management approaches for patients with NASH or suspected NASH in Italy.Methods: Data were drawn from the Adelphi Real World NASH Disease Specific Programme™, a cross-sectional survey of endocrinologists and gastroenterologists in Italy from January to March 2018. Physicians completed questionnaires for their next five consecutively consulting patients with NASH or suspected NASH. Analyses were descriptive.Results: Seventy-six physicians provided data on 380 patients. The mean age was 58.5 ± 11.1 years and the mean body mass index was 31.8 ± 5.5 kg/m2. A total of 231 patients (61%) had no/non-advanced fibrosis as evaluated by liver biopsy or non-invasive tests. Common diagnostic assessments were cholesterol, hemoglobin A1c, absence of viral hepatitis, and alcohol assessment. At diagnosis, 87% (n=322/372) and 45% (n=169/372) of patients received an ultrasound and liver biopsy, respectively. Overall, 88% of patients were referred from primary to secondary care. Obesity (81%) and type 2 diabetes (62%) were the most commonly recorded comorbidities, with 70% of patients having ≥ 3 comorbidities. Vitamin E (13%) and GLP-1 receptor agonists (13%) were the most prescribed guideline-recommended treatments for all patients.Conclusion: Patients with NASH in Italy had high levels of obesity and comorbidities, while diagnosis and treatment frequently were not according to guidelines. Our data show an unmet need for more targeted diagnosis and treatment in Italian patients with NASH, in order to optimize outcomes.Plain language summary: Fat buildup in the liver, known as fatty liver disease, affects around 4-6% of people in Italy, and can lead to complications if left untreated. However, little is known about how doctors manage people with this disease. Fatty liver disease can only be diagnosed by a liver biopsy, but we found this is only performed in 45% of people, making accurate diagnosis difficult. We also found that 28% of people receive a recommended medication. Overall, increasing doctor awareness of fatty liver medical guidelines may help improve the diagnosis and treatment for people living with fatty liver disease in Italy.Keywords: NASH diagnosis, NASH treatment, NASH resource utilization

Abstract The study investigated the effect of soilless media (burlap), on the morphological traits and antioxidant activities of microgreens from Brassicaceae, Amaranthaceae, and Linaceae families. The results revealed significant variations were observed in the selected morphological, biochemical composition, and antioxidant capacity of the microgreens. The radish sango and microgreens showed superior morphological characteristics compared to other microgreens. The elemental composition analysis revealed consistent moisture, ash, fat, fiber, and protein content across all families. The results revealed significant variations in the biochemical composition and antioxidant capacity of the microgreens, depending on the growing medium and between microgreens. Notably, microgreens differed in photosynthetic pigment profiles, with flaxseed and cabbage showing the highest chlorophyll content of 26.59 to 27.18 µg/g, FW and carotenoid content in a range of 3.74 to 6.39 µg/g, FW was observed in microgreens. The radish sango and beetroot microgreens exhibited elevated anthocyanin levels of 27.94–28.25 µmol/100 g, FW. Biochemical analysis indicated varying levels of ascorbic acid (177.58 to 256.46 mg/100 g, FW), total glucosinolate content (4.09 to 47.38 µmol/g, FW), phenolic content (131.44 to 298.56 mg GAE/100 g, FW), and flavonoid content (10.94 to 18.14 mg QUE/100 g, FW) were observed in selected microgreens families. Radish sango microgreens demonstrated the highest DPPH (76.82%, FW) and ABTS (88.49%, FW) radical scavenging activities, indicating superior antioxidant potential. The study showed that Brassicaceae microgreens are particularly rich in bioactive and antioxidant properties. Additionally, studies could assess the economic feasibility and scalability of soilless cultivation methods for microgreens to support their inclusion in sustainable agricultural practices and health-promoting diets.

In recent years, the tobacco- and/or nicotine-containing product (TNP) portfolio has expanded to include products such as e-vapor products, heated tobacco products, and nicotine pouches. Although scientific papers and regulatory requirements/recommendations related to the assessment of product use behavior and exposure to product use have been published for these novel TNPs, there is great diversity in the terminology used to characterize and assess these types of products. The aim of this paper is to define the terms and methods used for assessing product use behavior and exposure, with the objective to suggest a uniform application of terms used by scientists working in this field of research. This publication is the work product of a cross-industry work item commissioned by the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA) Product Use Behaviour and Biomarkers Subgroups.

Abstract Background The indoor home environment plays a crucial role in determining the outcome of respiratory diseases, including asthma. Researchers, clinicians, and patients would benefit from self-reported questionnaires to assess indoor home environmental exposures that may impact on respiratory health. Objective To review self-reported instruments for assessing indoor home environmental exposures in asthma patients and to characterise their content, development, and psychometric properties. Design A scoping review was conducted with content assessment. Methods A literature search was conducted in Embase and PubMed using the key words housing quality, questionnaire and asthma and their index terms, covering articles published in English between January 2000 to July 2023. Articles in which questionnaires or single item questions were used to assess indoor home environmental exposures in asthma patients in middle- and high-income countries were included. We excluded articles in which the questionnaire required an interviewer or onsite observations and those conducted in low-income countries. Results We screened 1584 articles to identify 44 studies containing self-reported questionnaires measuring indoor home environmental exposures. 36 studies (82%) were cross sectional, 35 (80%) had a sample size of greater than 1000 participants, and 29 (66%) were conducted in children. Most studies (86%, n = 38) had binary (yes/no) or multiple-choice responses. 25 studies (57%) included a recall period of 12 months. 32 studies (73%) had a response rate of greater than 50%. Dampness, biological exposures (e.g. mould), and second-hand tobacco smoke were the most assessed indoor home environmental exposures. Childhood asthma (54%, n = 24) and asthma symptoms (36%, n = 16) were the most examined asthma related outcomes. The exposure most associated with adverse asthma outcomes was exposure to damp (79%, n = 35). 13 studies (29%) had developed a self-reported instrument by adapting questions from previous studies and almost all instruments (n = 42 studies, 95%) had not been validated. Conclusions The scoping review did not identify a comprehensive, validated self-reported questionnaire for assessing indoor home environmental exposures in patients with asthma. There is need to develop and validate a robust but pragmatic self-reported instrument, incorporating the findings from this review.

Abstract Background Usually non-pathogenic in immunocompetent individuals, mucormycosis is an aggressive, angio-invasive fungus. It is a rare, opportunistic infection belonging to the zygomycete family. The second wave of COVID-19 saw the emergence of a more dangerous and a potentially deadly invasive fungal sinusitis evolving in rhino-cerebral mucormycosis thus compounding and complicating the pandemic. Alarming and exponential rise in the number of cases of rhino-cerebral mucormycosis in India versus the rest of the world when the treatment protocols essentially remained the same needs to be probed scientifically along with its prompt management. Here an attempt has been made to explore this in the study of 50 cases of rhino-cerebral mucormycosis. This study aims to explore the cause and extension of the disease along with its treatment and outcome in 50 cases of post COVID rhino-cerebral mucormycosis. Results This is a retrospective cohort study conducted on 50 patients with post COVID-19 invasive mucormycosis of the paranasal sinuses with extension to surrounding structure visiting Otorhinolaryngology department at Acharya Vinoba Bhave Rural Hospital, Wardha. Among 50 patients, 86% males in 4th to 7th decade with mean age of 51.08 years. Large majority had mild–moderate severity on high-resolution computed tomography thorax with 84% having uncontrolled diabetes and 18% newly diagnosed diabetic cases. Seventy-two percent had history of steroid intake for COVID-19 management. Maxillary sinus was most commonly involved sinus in 94% cases while 32% had commonest extra nasal spread hard palate. Seventy-eight percent of the post operated mucormycosis cases are alive with no recurrence, 8% are alive and had recurrence of the disease while 14% resulted in death. Conclusion Effective management and control of the infection can be achieved with the use of strong antibiotics, oral or systemic antifungal drugs, extensive surgical excision of diseased tissue, and addressing underlying risk factors can effectively manage and control the infection. This approach results in positive outcomes and reduced morbidity compared to the time prior to the COVID-19 pandemic including cases with extensive disease.