Search

Introduction Being on a waiting list for elective (planned) cardiac surgery can be physically and psychologically challenging for patients. Research suggests that stress associated with waiting for surgery is dependent on different individual and contextual factors. However, most data on patients’ experiences of waiting for surgery and preferences for waiting list management derives from non-cardiac clinical populations. The aim of the current study is to explore patients’ experiences of being on a waiting list for elective cardiac surgery, and their views on how the waiting experience could be improved in the future. This work will inform the patient management strategy during the waiting period for surgery across the four major hospitals in London directly involved in this study, and potentially beyond by transferring learning to other services.Methods and analysis This is a mixed-methods study that will collect quantitative and qualitative data using a cross-sectional online survey. Patients who are on waiting lists for elective surgery across four major cardiac surgery departments in London hospitals, and are at least 18 years old, will be invited by their healthcare team via text message or letter to complete the survey. The target sample size of non-randomly selected participants will be 268. Bivariable and multivariable regression models will be used to assess associations between survey items measuring the impact of the cardiac condition on specific life domains (eg, daily activities, social and family relationships, hobbies, sexual life), anxiety and depression symptoms as measured by the Patient Health Questionnaire-4 and survey items evaluating experiences of health services. Data on experience and preferences for improvements to the waiting experience will be analysed with qualitative content analysis using an inductive approach.Ethics and dissemination This study was reviewed and granted ethical approval by the East of England—East Cambridge Research Ethics Committee. Findings from this study will be disseminated through peer-reviewed journals, a research website and social media and with an online event engaging patients, members of the public, healthcare professionals and other relevant stakeholders.Trial registration numb NCT05996640

Arti Gupta,1 Mounika Kollimarla,1 Venkatashiva Reddy B,1 Yusuf Noorani Shaik,2 Rakesh Kakkar,3 Rajeev Aravindakshan1 1Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India; 2ICDS Project, Guntur, Andhra Pradesh, India; 3Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, IndiaCorrespondence: Arti Gupta, Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India, Tel +91-9013902976, Email guptaarti2003@gmail.comIntroduction: Anemia is a serious public health issue in India, especially among women, adolescent girls, and young children. Tribal people reside mostly in remote underserved regions with little or no basic civic amenities which makes them a highly vulnerable group of Indians. The study aimed to identify unknown risk factors for anemia among tribal lactating mothers.Methodology: It was a mixed method prospective cohort study for 10 months carried out among 340 scheduled tribes (ST) mothers in 10 clusters in Guntur district, Andhra Pradesh, India. Data collection using a questionnaire, 24 hours dietary recall, anthropometric measurement, and hemoglobin estimation was done. Weekly local recipe talk in the mother’s kitchen, informal group discussions, was conducted for 12 weeks after baseline data collection. The audio and video tapes of the weekly local recipe talk in the mothers kitchen were transcribed verbatim and then translated into English. The individual responses were grouped as barriers related to acceptability, availability, accessibility, use and utilization, appropriateness, and nutrition environment.Results: A total of 340 mothers were enrolled initially of which 315 mothers were studied in an end-line survey with an attrition rate of 7.3%. Over 80% mothers belonged to Yerukula, Yenadis, Lambadi/Sugali tribes, respectively. A total of 345 weekly local mother kitchen recipe talks were conducted in 10 clusters. In the present study, only few mothers mentioned food accessibility and availability issues. Surprisingly, lack of skill to cook the commonly consumed local food item among Indian mothers were recorded. Lack of time for cooking, lack of knowledge of nutritious benefits of food, and use of ready to eat food were other important key findings.Conclusion: The study documents initiation of transition of the tribal lactating mothers towards urbanization. The lack of knowledge of cooking, coupled with lifestyles of urban areas exposes the early aged, poor, low literate mothers to the trap of anemia.Keywords: anemia, lactating mothers, dietary, iron, tribes

Naveed Ahmed,1 Mohmed Isaqali Karobari,2– 4 Anam Yousaf,5 Roshan Noor Mohamed,6 Sohaib Arshad,7 Syed Nahid Basheer,8 Syed Wali Peeran,9 Tahir Yusuf Noorani,4 Ali A Assiry,10 Abdulaziz S Alharbi,11 Chan Yean Yean1 1Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Malaysia; 2Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia; 3Center for Transdisciplinary Research (CFTR), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai, Tamil Nadu, 600077, India; 4Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, 16150, Malaysia; 5Department of Pathology Laboratory, Pakistan Kidney and Liver Institute & Research Center, Lahore, Pakistan; 6Department of Pediatric Dentistry, Faculty of Dentistry, Taif University, Taif, 21944, Saudi Arabia; 7Periodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia; 8Division of Operative Dentistry, Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia; 9Department of Periodontics, Armed Forces Hospital Jizan, Jizan, Kingdom of Saudi Arabia; 10Preventive Dental Science Department, Faculty of Dentistry, Najran University, Najran, Kingdom of Saudi Arabia; 11Saudi Board of Pediatric Dentistry (SB-PD), King Fahad Military Medical Complex – KFMMC, Dammam, Saudi ArabiaCorrespondence: Mohmed Isaqali Karobari, Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia, Email dr.isaq@gmail.com Chan Yean Yean, Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Malaysia, Email yychan@usm.myAbstract: Introduction: Ginger (Zingiber officinale) has been one of the most commonly consumed herbal medicines for a long time to treat several common diseases. Antibacterial activity, antioxidant properties and many bioactive compounds in ginger have been identified previously, which could be used as an alternative method to treat many infectious diseases.Methods: The current study evaluates ginger’s biochemical profile using qualitative and quantitative analysis and its bioactive potentials using antioxidant and antimicrobial assays against Streptococcus mutans and selective oral microbes. HPLC analysis was performed for the quantitative analysis. DPPH and disc diffusion assays were used for antioxidant and antimicrobial activities. The antimicrobial activity was checked against Streptococcus mutans, Enterococcus faecalis, Staphylococcus spp., and Lactobacillus spp. All solvents were removed by rotary evaporation before testing the dried extracts.Results: The observed IC50 value showed that distilled water extract exhibited the highest antioxidant activity (43.9), followed by ethanol extract (52.4), and the lowest activity was observed in n-butanol extract (91.2) and n-hexane (90.6). Different plant extracts have shown significant antibacterial activity (p = 0.001) against each bacterium. The highest antibacterial activity against tested bacteria was observed in n-hexane, chloroform and ethanol extracts. In comparison, the ethyl acetate, n-butanol and water extracts showed low antibacterial activity.Conclusion: This study emphasizes that Zingiber officinale (Z. officinale) against Gram-positive bacteria is an effective antimicrobial herb. Furthermore, it can be used as a potential natural source of antioxidants. Further studies on the toxicity analysis of ginger are recommended.Keywords: Streptococcus mutans, ginger, dental, oral microbes, herbal medicine, medicinal plants, healthy food

Nariman Shahid,1,2 Alia Erum,1 Muhammad Zaman,3 Ume Ruqia Tulain,1 Qurat-ul-ain Shoaib,3 Abdul Majeed,4 Muhammad F Rasool,4 Imran Imran,5 Sultan Alshehri,6 Behnam Noorani,7 Faleh Alqahtani8 1College of Pharmacy, University of Sargodha, Sargodha, 40100, Pakistan; 2Akhtar Saeed College of Pharmaceutical Sciences, Lahore, 53720, Pakistan; 3Faculty of Pharmacy, University of Central Punjab, Lahore, 54782, Pakistan; 4Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan; 5Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan; 6Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia; 7Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, TX, 79106, USA; 8Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi ArabiaCorrespondence: Muhammad Zaman; Faleh Alqahtani Email dr.mzaman@ucp.edu.pk; afaleh@ksu.edu.saBackground: Ticagrelor (TG), an antiplatelet drug is employed to treat patients with acute coronary syndrome, but its inadequate oral bioavailability due to poor solubility and low permeability restricts its effectiveness.Purpose: This contemporary work was aimed to design a novel pH-sensitive nanocomposite hydrogel (NCH) formulation incorporating thiolated chitosan (TCH) based nanoparticles (NPs) of Ticagrelor (TG), to enhance its oral bioavailability for effectively inhibiting platelet aggregation.Methods: NCHs were prepared by free radical polymerization technique, using variable concentrations of chitosan (CH) as biodegradable polymer, acrylic acid (AA) as a monomer, N,N-methylene bisacrylamide (MBAA) as cross-linker, and potassium persulphate (KPS) as initiator.Results: The optimum hydrogel formulation was selected for fabricating NCHs, considering porosity, sol-gel fraction, swelling studies, drug loading capacity, and TG’s in vitro release as determining factors. Outcomes of the studies have shown that the extent of hydrogel swelling and drug release was comparatively greater at higher pH (7.4). Moreover, an amplifying trend was observed for drug loading and hydrogel swelling by increasing AA content, while it declined by increasing MBAA. The NCHs were evaluated by various physicochemical techniques and the selected formulation was subjected to in vivo bioavailability studies, confirming enhancement of bioavailability as indicated by prolonged half-life and multifold increase in area under the curve (AUC) as compared to pure TG.Conclusion: The results suggest that NCHs demonstrated a pH-responsive, controlled behavior along with enhanced bioavailability. Thus NCHs can be effectively utilized as efficient delivery systems for oral delivery of TG to reduce the risk of myocardial infarction.Keywords: nanocomposite, thiolated chitosan, biodegradable, bioavailability, free radical polymerization

Waseem Chauhan,1 Mohammad Afzal,1 Zeeba Zaka-ur-Rab,2 Md Salik Noorani3 1Department of Zoology, Aligarh Muslim University, Aligarh, India; 2Department of Pediatrics, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, India; 3Department of Botany, Jamia Hamdard, New Delhi, IndiaCorrespondence: Mohammad AfzalHuman Genetics and Toxicology Laboratory, Department of Zoology, Aligarh Muslim University, Aligarh, IndiaTel +919897839601Email afzal1235@rediffmail.comPurpose: Beta thalassemia is one of the most common inherited disorders in India with heterogenous clinical phenotypes from silent carrier to clinically severe ones. Our study aimed to characterize the mutation spectrum in thalassemia patients who are coming to the hospital for follow-up from the western region of Uttar Pradesh India.Patients and Methods: For the study, a case series of the retrospective bi-centre study was conducted. The patients from two thalassemia centers in the major hospitals (LLRMC Meerut, and JNMC, Aligarh administered by the Ministry of Health and Family Welfare (MoHFW)) in the Western Uttar Pradesh, India were considered for the study. A total of 77 blood samples were obtained from individuals (both related and unrelated) diagnosed with β-thalassemia after their consent. After DNA extraction, HBB gene amplification, mutation-specific polymerase chain reaction and gene sequencing were carried out to analyze the mutations.Results: In this study, seven different types of mutations were reported for the first time in Western Uttar Pradesh, India. A novel frameshift mutation, deletion of 4 nucleotides Codon 66/67 (-AAAG) in exon 2 region, is reported for the first time. IVS 1– 5 (G>C) and Codon 41/42 (-CTTT) are the most frequently reported mutations. The molecular spectrum for these two cases consists of 44 and 42 alleles out of 108 alleles, respectively.Conclusion: A total of 108 β-thalassemia alleles were studied from 46 homozygous and 31 compound heterozygous patients. All the individuals were from 20 districts of the Western Uttar Pradesh, India.Keywords: codon 41/42-CTTT, IVS I-5G>C, beta globin, mutation, beta-thalassemia major

In this paper we prove the existence and uniqueness of coincident (fixed) points for nonlinear mappings of any number of arguments under a (ψ, θ, φ)-weak contraction condition without O-compatibility. The obtained results extend, improve and generalize some well-known results in the literature to be discussed below. Moreover, we present an example to show the efficiency of our results.

Dentigerous cysts are the most common bony lesions of the jaws in children. It is one of the most prevalent types of odontogenic cysts associated with an erupted or developing tooth, particularly the mandibular third molars; the other teeth that are commonly affected are, in order of frequency, the maxillary canines, the maxillary third molars, and rarely the central incisors. Radiographically, the cyst appears as ovoid well-demarcated unilocular radiolucency with a sclerotic border. Careful evaluation of the history and the clinical and radiographical findings help clinicians to currently diagnose the condition, identify the etiological factors, and administer the appropriate treatment.

Provision of infant oral health (IOH) care is a challenging issue in the rural areas of our country due to lack of pedodontists and other dental workforces. To overcome these barriers it is essential to call the medical and other healthcare professionals to provide IOH care in joint collaboration with dental professionals. However, it is unclear to what extent these medical professionals are really aware of preventive strategies and to what extent they impart them. Thus, the present study was designed to begin from the grass-root levels, that is, assessing the baseline knowledge and awareness regarding IOH care among students (dental/medical) and parents (urban/rural). Variation of opinions with inconsistencies were obtained from both medical and/dental students and as well as from both the parental groups. This study calls for further research to evaluate the role of various factors involved in IOH care and to effectively educate all healthcare providers in this area.