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Abstract Background Exposure to surgery during medical school is limited. We ran a mentorship scheme pairing students at a medical school with local surgeons to improve undergraduate insight. We evaluated the effectiveness of mentorship in increasing surgical exposure and drivers for students seeking surgical mentorship. Methods 35 surgeons across 7 specialties were recruited and matched with 37 students in years 2–4 for 7 months. Quantitative and qualitative evaluation was done with pre-, mid- and post-scheme questionnaires. Students rated confidence across pursuing a career in surgery, surgical exposure, career insight, understanding the application process, contacts, portfolio development, research knowledge and pursuing extra-curricular activities related to surgery using a 5-point Likert scale. Paired t-tests were performed to measure students’ confidence before and after the scheme. Results Of students that completed all 3 questionnaires (n = 21), conducting research/audit was most frequently selected as a main goal (81.0%), followed by theatre experience (66.7%) and career progression support (28.6%). The number of students that had assisted in theatre increased by 50.0%. Confidence ratings across all domains increased with 7/8 (87.5%) exhibiting a statistically significant improvement (p

Introduction: There is much debate over the best choice of restorative material and the placement method for the most successful treatment. Many teeth that have undergone endodontic treatment may not have enough structure to support a restoration or crown. To improve retention for the restorative material, ferrule may be used. Adhesive techniques have transformed the way we restore teeth after root canal treatment, starting with the shift from using cast post-and-core to using fibre post. The use of fibre-reinforced posts has been found to prevent irreparable root fractures thereby improving the longevity of the treatment. Aim: To compare two different types of aesthetic fibre posts for 12 months. Materials and Methods: A prospective interventional study was carried out in the Department of Prosthodontics, Manav Rachna Dental College (Faridabad) for a period of 12 months from Nov 2022- Oct 2023. Forty participants with single rooted, endodontically treated, maxillary anterior teeth in the age bracket of 15-55 years, both males and females of the north Indian population were included in the study. Teeth were selected where a post-retained crown was indicated and post space was prepared using a piezo reamer drill at 5000 rpm. At least 4 mm of obturation is left in the canal to maintain the apical seal. Furthermore, Zircon-enriched silicon fibre and glass fibre-reinforced posts were cemented into the prepared post space. Metal-ceramic crowns were cemented and baseline periapical radiographs were obtained. At the interval of one month, three months, six months and one year, the patients were evaluated.The Fischer’s exact test was utilised to establish the association between categorical variables and the level of significance (p-value

Abstract Mendelian randomization (MR) is an emerging tool for inferring causality in genetic epidemiology. MR studies suffer bias from weak genetic instrument variables (IVs) and horizontal pleiotropy. We introduce a robust integrative framework strictly adhering with STROBE-MR guidelines to improve causality inference through MR studies. We implemented novel t-statistics-based criteria to improve the reliability of selected IVs followed by various MR methods. Further, we include sensitivity analyses to remove horizontal-pleiotropy bias. For functional validation, we perform enrichment analysis of identified causal SNPs. We demonstrate effectiveness of our proposed approach on 5 different MR datasets selected from diverse populations. Our pipeline outperforms its counterpart MR analyses using default parameters on these datasets. Notably, we found a significant association between total cholesterol and coronary artery disease (P = 1.16 × 10−71) in a single-sample dataset using our pipeline. Contrarily, this same association was deemed ambiguous while using default parameters. Moreover, in a two-sample dataset, we uncover 13 new causal SNPs with enhanced statistical significance (P = 1.06 × 10−11) for liver-iron-content and liver-cell-carcinoma. Likewise, these SNPs remained undetected using the default parameters (P = 7.58 × 10−4). Furthermore, our analysis confirmed previously known pathways, such as hyperlipidemia in heart diseases and gene ME1 in liver cancer. In conclusion, we propose a robust and powerful framework to infer causality across diverse populations and easily adaptable to different diseases.

Wide-Awake Local Anesthesia No Tourniquet (WALANT) offers a cost-effective alternative to general anesthesia (GA) for wound debridement, improving patient safety, surgical accessibility, and cost-efficiency. This study explores WALANT’s cost-effectiveness and patient outcomes in a resource-limited setting. The patient, E.M., a 27-year-old woman, presented with left upper limb swelling, which began a week after Implanon device removal at another facility. Upon admission, she displayed severe sepsis symptoms, including a blood pressure of 100/58 mmHg, a heart rate of 144 beats per minute, a respiratory rate of 24 breaths per minute, and a temperature of 39.2℃. Her left upper limb showed swelling, redness, and shininess, leading to a diagnosis of necrotizing fasciitis with septic shock. Initially, wound debridement was conducted under GA. However, the patient’s choice to undergo WALANT for her second debridement saved her 89.1% of the cost of performing debridement under GA. This cost reduction significantly benefited the uninsured patient, alleviating the financial burden and also achieved a favorable patient outcome within the constraints of a resource-limited setting.

Introduction Hidradenitis suppurativa (HS) is a multifactorial chronic inflammatory follicular disorder affecting apocrine gland-bearing areas of the body. We conducted an observational study to assess the ultrasonography (USG) findings in suspected HS patients at a tertiary care center in North India over 6 months.

Background Encapsulated pancreatic fluid collection (PFC) is a requisite for endoscopic drainage procedures. The 4-week threshold for defining walled-off necrosis does not capture the dynamic process of encapsulation. We aim to investigate the changes in the wall characteristics of PFC in acute necrotizing pancreatitis (ANP) by comparing baseline contrast-enhanced computed tomography (CECT) with follow-up CT scans.

AIM: To investigate clinical outcomes in adults with type 2 diabetes (T2D) after insulin degludec/insulin aspart (IDegAsp) treatment in a real-world setting. Methods: The 26 weeks study involved 1102 adults with T2D who were either initiated with or switched to IDegAsp according to local practice in six countries. It was an open-label, non-interventional study. The primary endpoint was the change in glycosylated haemoglobin (HbA1c) levels from baseline to the end of study (EOS). Results: From India, 185 adults participated in this study with mean age of 58.1 (10.3) years and 14.4 (8.1) years of mean duration of T2D. Mean HbA1c decreased from 9.8% (1.8) at baseline to 8.2% (0.1) at the EOS; change in HbA1c from baseline [95% CI]: -1.6% (0.1) [-1.8; -1.4], P < 0.0001. There was a significant reduction in mean fasting plasma glucose (FPG) level from 190.0 (65.8) mg/dl at baseline to 141.9 (4.3) mg/dl at EOS; change in FPG from baseline [95% CI]: -52.2 (4.3) mg/dl [-60.7; -43.7], P < 0.0001. There was a numerical reduction in resource utilization related to diabetes and its complications and hypoglycaemic episodes. From baseline to EOS, the participants with outpatient visits (72 to 32) and workdays missed (2 to 0) decreased. Additionally, the number of patient-reported non-severe hypoglycaemic (47 to 8) and severe hypoglycaemic (4 to 1) episodes decreased as well. Conclusion: Initiation or switching to IDegAsp led to improvement in glycaemic control in real-world population of Indian adults with T2D. This was accompanied by a numerical reduction in resource utilization and patient-reported hypoglycaemia. Clinical trial registration: NCT04042441

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

Background: The status of cancer care in Bihar is in elementary stages, with limited knowledge of epidemiology and insufficient comprehensive cancer care centers. State Cancer Institute (SCI) of Bihar is actively working to address these gaps by continuously upgrading its facilities and services. Objectives: The present article aims to define the problem and conduct a situational analysis for strengthening cancer care services in Bihar through the expansion and integration of services at SCI, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna. Materials and Methods: A problem statement was initially developed following a comprehensive review of the literature from January 2023 to September 2023, with an updated review conducted in August 2024. Full-text articles containing the keywords “cancer,” “incidence,” and “Bihar” were searched on PubMed and manually screened for relevance based on titles and abstracts. Additional information was collected through Google searches of public domain websites and newspaper portals, and relevant articles were also identified through a manual review of references. Furthermore, a situational analysis was conducted using SWOT analysis and power-interest matrix to identify and evaluate the stakeholders. Results: Accurate cancer incidence data for Bihar are lacking. Almost half of the estimated new cancer cases seem to be registered within the state, while the rest remain unaccounted. Presently, there are only eight comprehensive cancer centers operational in the state. The SWOT analysis highlighted opportunities for SCI based on inherent strengths, while limited manpower and inadequate collaborations were identified as critical weaknesses. Key stakeholders were identified as the crucial players in mitigating threats and supporting positive policy and financial frameworks. Conclusion: Properly addressing the needs of stakeholders and fully utilizing available opportunities are essential for strengthening healthcare services in the state. The SCI could play a vital role in the process. The article also provides background on devising strategies to address the current cancer care needs of the state.

Abstract Background The posterior ethmoid sinuses have a complex anatomy and a highly variable normal structure. The posterior ethmoid Onodi cell needs careful assessment because of its proximity to the optic nerve and the internal carotid artery canal. Recognising the distinctions is essential for optimal pre-op preparation. Sphenoid sinus surgery can now be performed without worrying about compromising vital structures like the internal carotid artery or optic nerve. Preoperative radiological assessment is a quick and easy way to check for ethmoid cell pneumatisation differences. Aim and objectives To determine the pneumatisation patterns of Onodi cells among the North-East Indian population using 16-slice multidetector computed tomography (MDCT). Results Nine-hundred MDCT paranasal sinuses were analysed over a period of 0–2 years, out of which 220 cases showed the presence of Onodi cell. Type I were 89 cases (40.45%, CI 32.00–48.90), Type II were 128 cases (58.18%, CI 49.72–66.63), and 3 cases with Type III cell (1.36%, CI 0.18–2.54). Conclusion The most prevalent pneumatisation pattern is Type II. The pneumatisation patterns of Onodi cells can be best detected and evaluated by multiplanar MDCT imaging. Sinus surgeons need a firm grasp of pneumatisation patterns to avoid damaging the optic nerve and internal carotid artery canal during operations.

Abstract Bionanofertilizers are promising eco-friendly alternative to chemical fertilizers, leveraging nanotechnology and biotechnology to enhance nutrient uptake by plants and improve soil health. They consist of nanoscale materials and beneficial microorganisms, offering benefits such as enhanced seed germination, improved soil quality, increased nutrient use efficiency, and pesticide residue degradation, ultimately leading to improved crop productivity. Bionanofertilizers are designed for targeted delivery of nutrients, controlled release, and minimizing environmental pollutants, making them a sustainable option for agriculture. These fertilizers also have the potential to enhance plant growth, provide disease resistance, and contribute to sustainable farming practices. The development of bionanofertilizers addresses the adverse environmental impact of chemical fertilizers, offering a safer and productive means of fertilization for agricultural practices. This review provides substantial evidence supporting the potential of bionanofertilizers in revolutionizing agricultural practices, offering eco-friendly and sustainable solutions for crop management and soil health.

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

Abstract Cancer ranks as the second leading cause of mortality worldwide, prompting extensive investigations into factors contributing to its development. Among these factors, genetic variations, known as genotypic polymorphisms, have been identified as significant influencers in the susceptibility to various types of cancer. Recent research has focused on exploring the connection between polymorphisms in the Long Non-coding RNA HOTAIR and cancer risk. However, the results from these studies have been inconsistent, leading to ambiguity and controversy. To address this uncertainty, we conducted a systematic analysis by gathering relevant studies from PubMed, EMBASE, and Google Scholar. Specifically, we focused on three well-studied polymorphisms within the HOTAIR lncRNA (HOTAIR rs920778 C > T, HOTAIR rs1899663 G > T, HOTAIR rs4759314 A > G) and their association with cancer risk. Our meta-analysis included data from 48 case–control studies involving 42,321 cases and 54,137 controls. The results of our updated meta-analysis revealed a significant correlation between HOTAIR rs1899663 G > T and HOTAIR rs4759314 A > G polymorphisms and overall cancer risk, particularly in the homozygous and recessive genetic models. Subgroup analysis further revealed that these associations were notably pronounced in the Asian population but not observed in the Iranian population. Furthermore, our findings underscore the potential of HOTAIR polymorphisms as diagnostic markers for overall cancer risk, particularly in gynecological cancers, precisely, HOTAIR rs1899663 G > T polymorphism in breast cancer. In conclusion, our systematic analysis provides compelling evidence that Long Non-coding RNA HOTAIR polymorphisms are linked to cancer risk, particularly in certain populations and cancer types, suggesting their potential clinical relevance as diagnostic indicators.

This study investigates the epidemiology of subclinical mastitis, focusing on prevalence, risk factors, bacterial pathogens, virulence factors, antimicrobial sensitivity, and detection of methicillinresistant Staphylococcus aureus (MRSA) bacterial isolates in organized and unorganized dairy farms of Kamrup and adjoining districts of Assam. The overall prevalence of bovine subclinical mastitis was found to be 43.81% using the California Mastitis Test (CMT). Risk factor analysis revealed that age-wise, the highest prevalence was noted in the 4-6 years age group (51.95%) and at 4th lactation (60.40%). Significant associations were found between mastitis prevalence and various factors including age, breed, lactation number, stage of lactation, quarter-wise distribution, farm type, management system, and season. A total of 185 bacterial isolates were obtained, predominantly Staphylococcus spp. (143), with notable occurrences of Streptococcus spp. (22), Escherichia coli (14), and Enterococcus faecalis (6). Staphylococcus aureus emerged as the primary etiological agent, with 81.82% of isolates producing coagulase and 45.45% producing hemolysin, while 54.0% of Staphylococcus aureus isolates tested positive for the protein A (spa) gene. Antimicrobial sensitivity testing revealed enrofloxacin, gentamicin, and ceftriaxone as the most effective antibiotics, with penicillin-G demonstrating the least efficacy. Methicillin resistance was detected in 11.96% of Staphylococcus aureus isolates phenotypically and in 2.56% genotypically (mecA) revealing the emergence of MRSA which is important from a public health point of view. These findings highlight the prevalence of subclinical mastitis, the predominance of Staphylococcus aureus as the causative agent, and the emergence of antimicrobial resistance, which warrants effective control measures and antimicrobial management in dairy farming practices.

Background : When applying lung-protective ventilation, fluid responsiveness cannot be predicted by pulse pressure variation (PPV) or stroke volume variation (SVV). Functional hemodynamic testing may help address this limitation. This study examined whether changes in dynamic indices such as PPV and SVV, induced by tidal volume challenge (TVC), can reliably predict fluid responsiveness in patients undergoing renal transplantation who receive lung-protective ventilation. Methods : This nonrandomized interventional study included renal transplant recipients with end-stage renal disease. Patients received ventilation with a 6 mL/kg tidal volume (TV), and the FloTrac system was attached for continuous hemodynamic monitoring. Participants were classified as responders or nonresponders based on whether fluid challenge increased the stroke volume index by more than 10%. Results : The analysis included 36 patients, of whom 19 (52.8%) were responders and 17 (47.2%) were nonresponders. Among responders, the mean ΔPPV6-8 (calculated as PPV at a TV of 8 mL/kg predicted body weight [PBW] minus that at 6 mL/kg PBW) was 3.32±0.75 and ΔSVV6-8 was 2.58±0.77, compared to 0.82±0.53 and 0.70±0.92 for nonresponders, respectively. ΔPPV6-8 exhibited an area under the curve (AUC) of 0.97 (95% confidence interval [CI], 0.93–1.00; P≤0.001), with an optimal cutoff value of 1.5, sensitivity of 94.7%, and specificity of 94.1%. ΔSVV6-8 displayed an AUC of 0.93 (95% CI, 0.84–1.00; P≤0.001) at the same cutoff value of 1.5, with a sensitivity of 94.7% and a specificity of 76.5%. Conclusion : s: TVC-induced changes in PPV and SVV are predictive of fluid responsiveness in renal transplant recipients who receive intraoperative lung-protective ventilation.

Abstract Biopolymers currently utilized as substitutes for synthetic polymers in photonics applications are predominantly confined to linear optical color responses. Herein we expand their applications in non-linear optics by integrating with triplet-triplet annihilation photon upconversion crystals. A photon upconverting biomaterial is prepared by cultivating Pd(II) meso-tetraphenyl tetrabenzoporphine: 9,10-diphenyl anthracene (sensitizer: annihilator) crystals on bacterial cellulose hydrogel that serves both as host and template for the crystallization of photon upconversion chromophores. Coating with gelatin improves the material’s optical transparency by adjusting the refractive indices. The prepared material shows an upconversion of 633 nm red light to 443 nm blue light, indicated by quadratic to linear dependence on excitation power density (non-linearly). Notably, components of this material are physically dis-assembled to retrieve 66 ± 1% of annihilator, at the end of life. Whereas, the residual clean biomass is subjected to biodegradation, showcasing the sustainability of the developed photonics material.

As digital content increasingly moves away from free access, microtransactions may provide an alternative. There is a need for research on microtransactions as a general digital content payment mechanism. Businesses can capitalize on this technological advancement by expanding their paid digital content offerings without resorting to subscription-based services. This study examines a taxonomy for microtransactions based on consumer buying behavior, presents business models for microtransaction payment processing, and examines issues with its implementation. Data collected from 180 consumers were analyzed using quantitative and qualitative analyses to assess the receptiveness and perception of microtransactions. The results indicate that consumers are receptive to the concept of microtransactions and are willing to spend on five distinct digital content categories. This study concludes with a discussion of issues that consumers foresee with digital content microtransactions and implications for interested businesses.

Abstract Electrolysis of D2O may be used as a portable neutron source with numerous applications without the complexity of huge reactor operations. Herein, we report reproducible fast neutron generation by electrolysis of D2O using palladium cathode and platinum anode, which was detected with diamond detector, gas filled 3He detectors after thermalisation with high density polythene, as well as novel epoxy resin and CR-39 detectors. Notably, a highly reproducible neutron generation at electrochemical surfaces of palladium electrode was observed and signature transmutation via Pd (d, n) Ag was corroborated. This was further explained using a theoretical model based on second order quantum perturbation theory.

Abstract Naringin, a flavonoid, exhibits diverse therapeutic properties and has been proven to exert cytotoxic effects on cancer cells. Nevertheless, the precise mechanism of naringin maintaining its cytotoxic effect on glioblastoma (GBM) remains unknown. Thus, the current study aimed to establish a plausible cellular mechanism for Naringin’s inhibition of GBM. We employed various system biology techniques to forecast the primary targets, including gene ontology and cluster analysis, KEGG enrichment pathway estimation, molecular docking, MD (molecular dynamic) simulation and MMPBSA analysis. Glioblastoma target sequences were obtained via DisGeNet and Therapeutic Target Prediction, aligned with naringin targets, and analyzed for gene enrichment and ontology. Gene enrichment analysis identified the top ten hub genes. Further, molecular docking was conducted on all identified targets. For molecular dynamics modelling, we selected the two complexes that exhibited the most docking affinity and the two most prominent genes of the hub identified through analysis of the enrichment of genes. The PARP1 and ALB1 signalling pathways were found to be the main regulated routes. Naringin exhibited the highest binding potential of − 12.90 kcal/mol with PARP1 (4ZZZ), followed by ABL1 (2ABL), with naringin showing a − 8.4 kcal/mol binding score, as determined by molecular docking. The molecular dynamic approach and MM-PBSA investigation along with PCA study revealed that the complex of Naringin, with 4ZZZ (PARP1) and, 2ABL (ABL1), are highly stable compared to that of imatinib and talazoparib. Analyses of the signalling pathway suggested that naringin may have anticancer effects against GBM by influencing the protein PARP and ALB1 levels. Cytotoxicity assay was performed on two different glioblastoma cell lines C6 and U87MG cells. Naringin demonstrates a higher cytotoxic potency against U87MG human glioblastoma cells compared to C6 rat glioma cells.

Abstract A detailed computational investigation was conducted to explore the dynamics of high-speed free slurry jets, with a focus on how variations in abrasive size and concentration affect their behavior. The study yielded several significant observations: Firstly, it was observed that slurry jets containing larger particles exhibited notably higher average velocities, attributed to their inherent self-similar characteristics. Specifically, at the far field of the jet, slurry jets with larger particle sizes demonstrated a 15% increase in velocity compared to those with smaller particles. Additionally, an analysis of turbulent intensity revealed that beyond a certain axial distance (x/D = 10), turbulence levels progressively increased. However, intriguingly, for slurry jets with a high concentration (Co = 15%), there was a notable decrease (28%) in turbulent intensity compared to water jets, indicating a complex interplay between particle size and concentration. Secondly, the study found that as the concentration of particles in the slurry jet increased, there was a corresponding rise in the bulk temperature of the jet. This phenomenon was primarily attributed to the heightened thermal conductivity resulting from the increased density of particles in the water. Furthermore, an examination of the Nusselt number revealed interesting trends. While the Nusselt number exhibited a peak near the nozzle exit, indicative of enhanced heat transfer in this region, it showed a decremental trend along the axial direction of the jet, attributable to jet divergence. In summary, the computational analysis provided valuable insights into the behavior of high-speed slurry jets, highlighting the intricate relationships between abrasive size, concentration, velocity distribution, and thermal characteristics. These findings contribute to a deeper understanding of slurry jet dynamics and have significant implications for various industrial applications.

Abstract Trifluoromethyl arenes (Ar–CF3) are amongst the commonly encountered fluorinated substructures in pharmaceutical, agrochemical, and material sciences. However, predominant methods to access Ar–CF3 possess several limitations, including harsh conditions, lack of availability of substrates, and poor regioselectivity, which combined restrict access to desirable highly functionalized Ar–CF3-containing compounds. To expand the scope of accessible Ar–CF3-based molecules, we present an orthogonal deoxyfluoroalkylation/aromatization approach that exploits readily accessible and programable cyclohexan(en)one substrates, which undergo a reliable 1,2-addition reaction with the Ruppert-Prakash reagent (TMSCF3) followed by aromatization to deliver highly functionalized Ar–CF3 compounds in a one/two-pot sequence. This general strategy enables access to highly substituted Ar–CF3-containing molecules that are difficult, expensive, and/or impossible to access by current synthetic methods.

Introduction: Selecting a correct shade is the key to success of any prosthesis, especially in the aesthetic zone. Variations of shade in a single tooth or the polychromatic nature of a tooth can impose greater challenges in shade matching. Therefore, it would be best if it is taught during the undergraduate course in dental schools. Aim: To evaluate the knowledge and shade matching skills among dental undergraduate students with and without training in three different clinical conditions. Materials and Methods: This post-test only quasi-experimental study was conducted with 377 undergraduate students of Indian origin studying in a dental teaching institute. The students were divided into two groups based upon their clinical training in shade matching: Group I (trained, n=197) and Group II (untrained, n=180). Three different patients, in terms of their shade complexity, were presented to both the groups and their shade matching ability was assessed. The results were subjected to statistical analysis using the Chi-square test and one-way Analysis of Variance (ANOVA). Results: Statistical analysis showed that the mean correct scores of the trained students were significantly higher than those of the untrained students (p=0.0001) in all three patients. There was a statistically significant difference (p=0.0001), as the trained group was better able to identify the correct or clinically acceptable shade compared to the untrained group in all three cases. Conclusion: The study concluded that training significantly improved the shade matching ability of dental undergraduate students in clinical conditions presenting varied complexities.

Hospitalized patients on mechanical ventilation are at high-risk of developing ventilator-associated pneumonia (VAP), making early and accurate diagnosis essential for the best possible treatment outcomes. This review examined various laboratory techniques, such as aerobic cultures, Gram’s stain, and molecular techniques, to assess how well they diagnose VAP. We have done search strategies using Google Scholar, Medline Complete, and PubMed. Extensive statistical tools were utilized to examine studies and evaluate the diagnostic accuracy of laboratory results. Multiplex PCR was superior to Gram’s stain and culture methods in terms of sensitivity (92%) and specificity (86%). On the other hand, Gram’s stain showed the highest specificity (78.9%) and the lowest sensitivity (74.6%). The results of semi-quantitative, quantitative, enrichment culture showed a lower specificity (75.97%) but a moderate sensitivity (78.5%). The most accurate diagnostic approach for VAP, according to a meta-analysis, was multiplex PCR-based testing, closely followed by culture methods. Beyond separate tests, multiplex PCR, culture, and Gram’s stain combination increased sensitivity. Prompt and precise VAP diagnosis is essential for efficient treatment. With possible improvements through combination diagnostic techniques, multiplex PCR remains the most accurate diagnostic tool. However, more investigation is necessary to improve and certify VAP diagnostic instruments.

Abstract Background Neurodegenerative disorders (NDs), primarily affecting the elderly, are marked by complex pathophysiological processes and are projected to become the second leading cause of death. Parkinson’s disease (PD), one of the most common NDs, is characterized by motor impairments due to reduced dopamine levels in the substantia nigra (SN), a crucial midbrain region involved in motor control and reward mechanisms. PD also impacts cognitive functions, potentially leading to depression and sleep disturbances. Recent research highlights the importance of MAO-B inhibitors in PD management, as these enzymes play a critical role in regulating neurotransmitter levels by catalyzing the oxidative deamination of intracellular amines and monoamine neurotransmitters. Result Computational virtual screening of several quinoline-based ligands against the target protein MAO-B (PDB ID: 1OJA) was performed using molecular docking simulation and ADMET studies to identify promising inhibitors for neurodegenerative disease treatment. The most active hit, Compound PA001, exhibited a MolDock score of − 207.76 kcal/mol. Subsequent investigation of 6-methoxy-2-(4-phenylpiperazin-1-yl)quinoline (Compound PA001) using molecular dynamics (MD) simulations with GROMACS revealed potent inhibition and significant interactions at key active site residues. MD simulations confirmed the stability of the Compound PA001-MAO-B complex under physiological conditions. Additionally, ADMET analysis demonstrated that Compound PA001 possesses favorable drug-like properties, including absorption, distribution, metabolism, excretion, and toxicity profiles. These findings underscore 6-methoxy-2-(4-phenylpiperazin-1-yl)quinoline (Compound PA001) as a promising candidate for developing new MAO-B inhibitors to treat neurodegenerative diseases. Conclusion The research highlighted 6-methoxy-2-(4-phenylpiperazin-1-yl)quinoline (Compound PA001) as a promising MAO-B inhibitor, exhibiting strong binding affinity, stability, and desirable drug-like characteristics for the treatment of neurodegenerative diseases. Among the top ten molecules, Compound PA001 was selected for molecular dynamics (MD) simulation using GROMACS. The compound showed potent inhibition, significant interactions with key active site residues, and stable complex formation under physiological conditions. ADMET analysis further confirmed its favorable pharmacokinetic profile.

Abstract Background Nasal packs are central to nasal surgeries. Primarily, these packs function by controlling bleeding, modulating pain and reducing adhesions postsurgery. However, the major setback of the currently used conventional nasal packs is the unbearable pain the patient undergoes upon removal of these packs. To overcome this shortcoming a variety of biodegradable packs have emerged. This study was aimed at evaluating the safety, efficacy and tolerability of VELNEZ nasal packs. VELNEZ, a patented Datt Mediproducts Pvt. Ltd. nasal pack, is one of its kind biodegradable composite that fragments within a few days of application. Methods Eighty patients were included in an open label, interventional, single arm clinical study using clinical endpoints to investigate the safety and efficacy of nasal pack VELNEZ. The patients were questioned using a visual analog scale from discharge day to 28th postoperative day (9 follow‐up visits) at regular intervals. The standardized questionnaires for hemorrhage control, relief from postoperative pain, moderate obstruction, and pain were used. Results A total of 76 patients were enrolled in the study and 74 patients completed the study. VELNEZ nasal pack played a significant role in controlling hemorrhage and reducing postoperative pain. The average hemorrhage control time was 7.49 ± 3.90 min with only 34.24% of population complaining of pain on the sixth day of surgery (follow‐up 4). Forteen days postsurgery only 10.95% of subject population complained of postoperative pain. This biodegradable composite has an average fragmentation time of 4.7 days in the nasal cavity. In addition, this study did not observe any postoperative adverse events or serious adverse events. Conclusion VELNEZ, a fragmentable nasal pack, is comfortable, safe, and effective against postsurgery bleeding and pain.

Introduction: Alcohol dependence syndrome (ADS) is a significant health problem all over the world. Alcohol-dependent individuals have a high prevalence of psychiatric comorbidities and nonadaptive personality traits that may influence the pathogenesis, treatment outcome, clinical course, and relapse of ADS. Aim: The aim of this study was to assess the personality traits and psychiatric comorbidities of alcohol-dependent patients and to determine the association of personality traits with psychiatric comorbidities in ADS. Methodology: An observational study was conducted on 100 patients of ADS from Acharya Vinoba Bhave Rural Hospital, Sawangi Wardha, Maharashtra. They were assessed through semi-structured sociodemographic pro forma, Mini-International Neuropsychiatric Interview PLUS, and 16 Personality Factor Inventory. Results: Most of the patients scored high on personality traits such as dominance (67%), warmth (56%), sensitivity (70%), social boldness (56%), openness to change (65%), vigilance (77%), and perfectionism (52%) while they scored low on factors privateness (50%) and liveliness (35%). The prevalence of psychiatric comorbidity was found to be 49%, with mood disorders (21%) being the most common diagnosis. Personality factors dominance (0.0001) and social boldness (0.042) were significantly associated with psychiatric comorbidities with P < 0.05. Conclusion: The personality traits and psychiatric comorbidity need to be addressed at the time of management to improve outcome.

This manuscript aims to investigate the welding characteristics, bead profile, structural integrity and corrosion behavior of low-carbon steel and Monel grade 400 dissimilar joints. The structures were developed using advanced welding technique, gas tungsten constricted arc welding, with Mo-based filler wire. Dissimilar metals after welding have been tested for internal inspection using X-ray radiography and confirmed to be free from all welding defects. Corrosion tests were carried out at various zones of weldment and characterized in a 3.5 wt% NaCl solution at 10 mV/s scan rate. The welding characteristics have been studied by conducting various tests including Vickers hardness, tensile and impact test. To reveal the structural integrity and perform chemical composition analysis of constricted arc weldment, OM/SEM techniques were used. Corrosion rate at steel interface is lower than that at the Monel 400 interface by 9.7% due to the less accumulation of heat. Uniform grain distribution and structural homogeneity were also observed along the weld zone due to constricted arc and controlled heat input.

This study examines the impact of both constant and pulsed current on the tensile characteristics, micro-hardness of weld surface, and metallurgical properties of the Inconel 718 and SS316L weldments. The Tungsten Inert Gas (TIG) welding process utilized two distinct arc modes to combine incompatible metals. The pulse frequency was systematically adjusted within the range of 2 Hz–6 Hz in order to investigate its impact on the welding parameters. A tensile test was performed using a universal testing equipment under various temperature conditions, including room temperature and an elevated temperature of 350 °C. When the samples were welded at a frequency of 4 Hz, both the Ultimate Tensile Strength (UTS) and Yield Strength (YS) were greater compared to when the samples were welded at 2 Hz, 6 Hz, or a continuous arc mode. Furthermore, it was noted that the YS-to-UTS ratio was higher for the weldments produced at 4 Hz pulse frequency. The UTS of current and pulsed (4 Hz) modes at a temperature of 350 °C were determined to be 505 and 524 MPa, respectively. Pulse welding demonstrated a higher hardness number compared to steady welding due to the regulated rate of heat. The TIG weldments of Inconel 718 and SS316L demonstrated superior mechanical and metallurgical qualities when exposed to elevated temperatures. The practical implications of these findings are relevant to the fabrication of turbine discs and shafts.

The high spatial resolution data presents a problem when it comes to mapping and identifying distinct tree species based on the characteristics of their canopies. The deep learning Semantic Segmentation approach based on U-Network (U-Net.) artificial intelligence model that we provide here can recognize, and map Azadirachta indica trees canopy cover. This method trains its model by making use of image chips and labels of the item being segmented. The new testing images processed for multiple stages of pixel level of convolution and pooling operations. The sampling methods allow increase to make complete to make the recognized object on the image. The model’s ability to identify items based on canopy shape, structure, and pixel data makes it very useful for mapping and recognizing a single tree species as well as several tree species. The model validation results indicated an accuracy of 84–89 percent, which is regarded to be rather good. Based on ground census data, the overall accuracy of identification is 89 percent, F1 score 0.91–0.94, while the complete tree canopy validation (Intersection to Union) for canopy matching area is 0.79–0.89. The method has the potential to be utilised for identification, mapping of tree canopy. The approach has the potential to be used for important research initiatives i.e tree censuses and the identification and mapping of crop plant identification. The deep learning model used as inferences for automatization of the identification of the tree species helps to resolve identification and mapping based complex problems in agro-forestry allied fields.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of the gastrointestinal (GI) tract (1% to 2% of GI malignant tumors). They are most commonly located in the stomach (50 to 60%) and rarely in the small intestine (20-25% of all cases). The hallmark of most GISTs is their positivity for KIT (CD117) and DOG-1. Intussusception occurs rarely in adults with an incidence of approximately 2-3 per 1L per year. It represents 5% of all intussusceptions and is the cause of 1% of all intestinal obstructions. Ileocolic intussusception in adults is a unique variant in which most cases have a malignant lead point. In our case, we report an elderly patient presenting with intestinal obstruction, and imaging showed ileocecal intussusception with a solid nodular growth arising from the ileum. On exploration, the tumor was intraluminal arising from the ileum with ileocecal intussusception. Adhering to oncological principles, a right hemicolectomy was performed. The final pathologic diagnosis indicated the GIST of the ileum. Immunohistochemistry (IHC) showed CD117 negative and DOG-1 positive. Bowel obstruction due to intussusception in adults is rare. GIST in the ileum causing intussusception is unusual with a poorer prognosis than other GISTs. Intussusception in adults obstructing with small intestinal GIST which is CD117 negative makes it interesting and even rare. The diagnosis of intussusception and GISTs causing obstruction in adults is delicate, and timely surgical treatment can be vital. Given a high risk of malignancy, primary surgical resection using oncologic principles presents the best option in this scenario.

Background: Hirayama disease (HD) is a rare benign type of cervical cord myelopathy occurring commonly in young males as unilateral or bilateral asymmetrical amyotrophy of the hand and forearm muscles in C8–T1 distribution. Magnetic resonance imaging (MRI) is the best technique for the evaluation and imaging of this entity. Materials and Methods: This is a retrospective review of cervical magnetic resonance images of patients that were taken for clinically suspected and diagnosed HD on 3T MRI in postcontrast neutral and flexion (30°–40°) positions from July 2019 to January 2024 at Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly. Results: Fourteen patients included in the study were males less than 34 years of age. MRI findings of cord atrophy in the lower cervical region/cervico-dorsal junction, abnormal cervical curvature, loss of attachment of the dorsal dural sac and subjacent laminae with anterior displacement, and a prominent intense enhancing posterior epidural space were observed in all 14 patients. The minimum anteroposterior cord diameters in the neutral and flexion positions were 2.9 and 2.8 mm, respectively (mean thickness of laminodural space on flexion – 5.2 mm). Other MRI findings showed variable representations. Conclusions: Flexion-position MRI has emerged as the gold standard for establishing and validating the diagnosis of HD in clinically suspected cases and should be an essential part of the protocol for the screening of clinically suspected cases of HD to aid in early treatment and therapeutic intervention. Complimentary newer sequences such as the Three-dimensional (3D)-Constructive interference in Steady State (CISS)/Fast Imaging Employing Steady-state Acquisition Cycled Phases (FIESTA-C) may reinforce better appreciation of epidural flow voids.

The global surge in refractive surgeries, particularly among myopic individuals, has elicited concerns regarding potential inaccuracies in the measurement of intraocular pressure (IOP) post surgery, primarily associated with central corneal thinning. The incidence of elevated IOP after intraocular refractive surgeries is higher than expected and is multifactorial. Myopic eyes have a higher susceptibility to both primary and secondary glaucoma. Consequently, meticulous preoperative screening for glaucoma is imperative, coupled with systematic postoperative follow-up and evaluation. This comprehensive review analyses the etiology, mechanisms, and therapeutic strategies for managing elevated IOP following refractive surgery. We propose an algorithm to summarize the causative factors of elevated IOP and formulate effective interventions in these instances.

Anal fistula can be a challenging condition to manage, with complex fistulas presenting even greater difficulties. The primary concerns in treating this condition are a risk of damage to the anal sphincters, which can compromise fecal continence, and refractoriness to treatment, as evidenced by a high recurrence rate. Furthermore, the treatment of complex anal fistula involves several additional challenges. Satisfactory solutions to many of these obstacles remain elusive, and no consensus has been established regarding the available treatment options. In summary, complex anal fistula has no established gold-standard treatment, and the quest for effective therapies continues. This review discusses and highlights groundbreaking advances in the management of complex anal fistula over the past decade.

Abstract Background Transgender people comprise an estimated 0.3–0.5% (25 million) of the global population. The public health agenda focuses on understanding and improving the health and well-being of gender minorities. Transgender (TG) persons often have complex healthcare needs and suffer significant health disparities in multiple arenas. The international literature suggests that this community is at a higher risk of depression, and other mental health problems, including HIV. Many transgender people experience gender dysphoria and seek specific medical needs such as sex reassignment surgeries, implants, hormonal therapies, etc., but are unable to access these services due to financial or social reasons. The objective of this study was to assess the healthcare needs and associated barriers experienced by transgender people in Western Rajasthan. Methodology: A qualitative study was carried out in which multilevel stakeholder interviews were conducted using interview and focus group discussion guides. Data was analyzed using the qualitative thematic analysis technique. Results: Findings reveal that transgender people have expressed their need to access health services for general health needs, including but not limited to mental health, non-communicable diseases, and infectious diseases. Barriers to healthcare services were identified on 3 levels: health system, social and personal. Health system barriers include policy, accessibility, affordability, and acceptability issues. Social factors such as inadequate housing, education, and job opportunities also play an important role in affecting the individual’s health-seeking behavior. The knowledge of healthcare providers in this context was also limited in context of health insurance schemes, package of services available for transgenders and the importance of gender sensitive healthcare. Conclusion: Transgender people expressed the need for mental health services, programs targeting nutritional improvement, gender-affirmation procedures besides regular screening of non-communicable diseases as operational for males and females. Levels of barriers have been identified at various levels ranging from absence of targeted policies to individual behavior.

The sirtuin-1 (SIRT1) gene contains multiple exons that usually undergo alternative splicing. The exclusion of one or more exons causes domain loss in the alternatively spliced isoforms and may change their functions. However, it is not completely established to what extent the loss of a non-catalytic domain could affect its regulatory function. Using muscle cells and SIRT1-knockout cells, we examined the function of the constitutively spliced isoform (SIRT1-v1) versus the alternatively spliced isoforms SIRT1-v2 and SIRT1-v3 that had lost part of the N-terminal region. Our data indicate that partial loss of the N-terminal domains in SIRT1-v2 and SIRT1-v3 attenuated their function. The full-length SIRT1-v1 significantly increased the oxidative phosphorylation and ATP production rate. Furthermore, SIRT1-v1 specifically upregulated the mitochondrial respiratory complex I without affecting the activity of complexes II, III, and IV. Additionally, domain loss affected the regulation of site-specific lysine acetylation in the histone H4 protein, the gene expression of respiratory complex I subunits, and the metabolic balance of oxidative phosphorylation versus glycolysis. Since alternatively spliced isoforms tend to increase with advancing age, the impact of SIRT1 isoforms on mitochondrial respiratory complexes warrants further investigation.

Abstract Electrospinning stands out as a flexible and viable method, presenting designed nanoscale materials with customized properties. This research demonstrates the immobilization of carboxylesterase protein Ha006a, reported for its adequacy in pesticide bioremediation by utilizing the electrospinning strategy. This strategy was utilized to create nanofibers by incorporating variable mixtures of biodegradable and cost-effective polyvinyl alcohol (PVA)-chitosan (CS) nanofiber solution (PVA100, PVA96, PVA94, PVA92 and PVA90). All the mixtures were electrospun at a reliable voltage of 21 kV, maintaining a gap of 12 cm from the nozzle. The Ha006a, sourced from Helicoverpa armigera, was consolidated into the optimized PVA90 polymer mixture. The electrospun nanofibers experienced comprehensive characterization utilizing distinctive microscopy and spectroscopy procedures counting FESEM, TGA, XRD and FTIR. The comparative investigation of the esterase property, ideal parameters and stability of the unbound and bound/immobilized Ha006a was scrutinized. The results uncovered an essential elevation in the ideal conditions of enzyme activity post-immobilization. The PVA-CS control nanofiber and Ha006a-PVA-CS showed a smooth structure, including an average breadth of around 170.5 ± 44.2 and 222.5 ± 66.5 nm, respectively. The enzyme-immobilized nanofibers displayed upgraded stability and comprehensive characterization of the nanofiber, which guaranteed genuineness and reproducibility, contributing to its potential as a potent device for bioremediation applications. This investigation opens the way for the manufacture of pesticide-resistant insect enzyme-based nanofibers, unlocking their potential for assorted applications, counting pesticide remediation and ensuring environmental sustainability.

Abstract An environmentally friendly, versatile multicomponent reaction for synthesizing isoxazol-5-one and pyrazol-3-one derivatives has been developed, utilizing a freshly prepared g-C3N4· OH nanocomposite as a highly efficient catalyst at room temperature in aqueous environment. This innovative approach yielded all the desired products with exceptionally high yields and concise reaction durations. The catalyst was well characterized by FT-IR, XRD, SEM, EDAX, and TGA/DTA studies. Notably, the catalyst demonstrated outstanding recyclability, maintaining its catalytic efficacy over six consecutive cycles without any loss. The sustainability of this methodology was assessed through various eco-friendly parameters, including E-factor and eco-score, confirming its viability as a green synthetic route in organic chemistry. Additionally, the gram-scale synthesis verifies its potential for industrial applications. The ten synthesized compounds were also analyzed via a PASS online tool to check their several pharmacological activities. The study is complemented by in silico molecular docking, pharmacokinetics, and molecular dynamics simulation studies. These studies discover 5D as a potential candidate for drug development, supported by its favorable drug-like properties, ADMET studies, docking interaction, and stable behavior in the protein binding cavity.

Abstract This paper investigates a novel category of probability distributions and a specific member within this category. We have formulated a new family of trigonometric distributions by utilizing the odds ratio derived from the distribution function of a base distribution. This newly devised distribution family termed the “Sine pie-power odd-G family” of distributions, is constructed through a transformation involving the sine function. The paper presents an overview of the fundamental characteristics inherent to this proposed distribution family. Using the Weibull distribution as a base reference, we have introduced a member belonging to the proposed distribution family. This member demonstrates various hazard functions such as j, reverse-j, increasing, decreasing, or bathtub shapes. The paper examines essential statistical attributes of this newly introduced distribution. The estimation of the distribution’s parameters is carried out via the maximum likelihood estimation method. The accuracy of the parameter estimation procedure is validated through Monte Carlo simulations. The outcomes of these simulations reveal a reduction in biases and mean square errors as sample sizes increase, even for small samples. Two sets of real-engineering data are considered to demonstrate the proposed distribution’s applicability. The performance of the suggested distribution is evaluated using some model selection criteria and goodness-of-fit test statistics. Empirical evidence from these evaluations substantiates that the proposed model outperforms six existing models.

Abstract The inter-ionic relationships of groundwater present in a region as well as various chemical and physical factors all have an impact on the geochemistry of groundwater in an aquifer. To assess the factors influencing the geochemical composition of groundwater in the eco-sensitive area of Western Ghats, Kerala, India, various weathering, and ionic indices were analyzed. Results show groundwater ranges from soft to extremely hard and acidic to alkaline, with high Mn and Fe levels. WQI analysis found 7% of samples unfit for drinking due to Fe/Mn contamination in the southeast part of the study area. Main water types are CaHCO3 (46%) and CaMgCl. Geochemical modeling indicates silicate and carbonate weathering, cation exchange, and reverse ion processes influence the aquifer. Groundwater is often supersaturated with iron minerals, saturated with carbonate minerals, and undersaturated with sulfate and chloride minerals. Cluster analysis (CA) revealed that NO3 − and K+ are derived from anthropogenic sources. Principal component analysis (PCA) resulted in three factors. Factor 1 is for geogenic processes, while Factors 2 and 3 imply the anthropogenic and weathering of iron-rich minerals. Hierarchical cluster analysis defines anthropogenic input, silicate and carbonate weathering, and different patterns of mineralization in the groundwater. The study underscores the need for comprehensive management to protect groundwater quality, considering the complex interplay of natural processes and human factors.

An ultrawide stopband lowpass filter is reported using three stepped impedance resonators with high selectivity. The filter extends the stopband frequency range and attenuation, and two quarter-wave open stubs and three circular ground slots are introduced. The lumped and distributed equivalent models are derived and analyzed. The corresponding results are validated experimentally in a fabricated prototype. The prototype lowpass filter has a 3 dB cutoff frequency (fc) of 2.9 GHz, and the stopband is extended up to 35 GHz (12.07fc), with an attenuation level better than 20 dB throughout. The passband-to-stopband transition (3 dB-20 dB) bandwidth is 0.18 GHz, and the roll-off factor is 135 dB/GHz at 30 dB. The insertion loss is 0.3 dB at 1.6 GHz. The normalized circuit size of the proposed filter with respect to the guided wavelength is 0.04.

Introduction: Quality of Life (QoL) has recently become a focus of research in haemophilia, as children with haemophilia miss out on opportunities to reach their full potential during school and later in life. This leads to emotional and behavioural problems, family issues, and a decrease in Health-related Quality of Life (HRQoL). There is very limited data from the state of Madhya Pradesh, India, to assess the QoL in haemophilia patients. Aim: To study the clinical profile of haemophilic children and assess their QoL. Materials and Methods: The present hospital-based cross-sectional study was conducted in the Department of Paediatrics, Gandhi Medical College, Bhopal, Madhya Pradesh, India, from January 2019 to December 2019. A total of 49 children (Institutional incidence), aged from 4-12 years, with factor VIII/IX deficiency who presented in the Paediatric ward of the study Institution for factor transfusion, were included in the study. The study population was divided into two groups with children aged (group ) and children aged 8-12 years (group II). A detailed clinical history was obtained from the accompanying parent/guardian, and QoL was measured using the Haemophilia QoL (Haemo-QoL) questionnaire. Scores achieved in each dimension, as well as, the total score were combined on a scale ranging from 0 to 100. High values indicate high impairment in QoL. The meanings of different scales like Standardised and Transformed Scale Scores (TSS) of Haemo-QoL were analysed using the student’s t-test. Results: In the present study, haemophilia A was more common than haemophilia B. All patients who attended the paediatric ward for factor transfusion were males, with a mean age of 8.37±2.56 years. It was also observed that the proportion of patients who were diagnosed early was significantly higher in the 4-7 years age group compared to the 8-12 years age group of patients (p-value

Abstract The present study focused on the physiological and biochemical aspects of Tricleocarpa fragilis, red seaweed belonging to the phylum Rhodophyta, along the South Andaman coast, with particular attention given to its symbiotic relationships with associated flora and fauna. The physicochemical parameters of the seawater at the sampling station, such as its temperature, pH, and salinity, were meticulously analyzed to determine the optimal harvesting period for T. fragilis. Seaweeds attach to rocks, dead corals, and shells in shallow areas exposed to moderate wave action because of its habitat preferences. Temporal variations in biomass production were estimated, revealing the highest peak in March, which was correlated with optimal seawater conditions, including a temperature of 34 ± 1.1 °C, a pH of 8 ± 0.1, and a salinity of 32 ± 0.8 psu. GC‒MS analysis revealed n-hexadecanoic acid as the dominant compound among the 36 peaks, with major bioactive compounds identified as fatty acids, diterpenes, phenolic compounds, and hydrocarbons. This research not only enhances our understanding of ecological dynamics but also provides valuable insights into the intricate biochemical processes of T. fragilis. The established antimicrobial potential and characterization of bioactive compounds from T. fragilis lay a foundation for possible applications in the pharmaceutical industry and other industries.

Abstract Ribosomes are regulated by evolutionarily conserved ubiquitination/deubiquitination events. We uncover the role of the deubiquitinase OTUD6 in regulating global protein translation through deubiquitination of the RPS7/eS7 subunit on the free 40 S ribosome in vivo in Drosophila. Coimmunoprecipitation and enrichment of monoubiquitinated proteins from catalytically inactive OTUD6 flies reveal RPS7 as the ribosomal substrate. The 40 S protein RACK1 and E3 ligases CNOT4 and RNF10 function upstream of OTUD6 to regulate alkylation stress. OTUD6 interacts with RPS7 specifically on the free 40 S, and not on 43 S/48 S initiation complexes or the translating ribosome. Global protein translation levels are bidirectionally regulated by OTUD6 protein abundance. OTUD6 protein abundance is physiologically regulated in aging and in response to translational and alkylation stress. Thus, OTUD6 may promote translation initiation, the rate limiting step in protein translation, by titering the amount of 40 S ribosome that recycles.

Introduction: Coeliac Disease (CD) is a systemic immune disorder caused by gluten in genetically susceptible individuals. A serological screening assay for CD has been designed to detect Immunoglobulin A (IgA) and IgG anti-tissue Transglutaminase (a-tTG) and IgA and IgG Deamidated Gliadin Peptide antibodies (a-DGP) simultaneously. The seronegative gap can be closed when these two antigens are combined on a single solid phase. This is primarily because untreated CD children who are negative for antibodies of one of the antigens may exhibit a positive result for the other. Aim: To determine the diagnostic parameters {sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV)} of tTG-IgA and htTG-DGP (Coeliac fusion- a combination of IgA and IgG to human tTG and synthetic DGP) for the diagnosis of CD in clinically symptomatic children. Materials and Methods: This cross-sectional study was conducted at the Paediatric Outpatient Department (OPD) of Santokhba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India from April 2023 to November 2023. The study population comprised 45 children (age >6 months and

Background: Keratoconus is a bilateral, asymmetric, chronic, progressive ectasia of the cornea in which patients experience distorted vision that is usually treated with rigid contact lenses when spectacles no longer provide adequate vision. The aim of the study is to find out the clinical profile and visual outcome of the patient having Keratoconus. Materials and Methods: The hospital based cross sectional study was done at Biratnagar Eye Hospital, Biratnagar. All the diagnosed Keratoconus patients referred from cornea clinic to contact lens clinic for contact lens trial were included in this study between 1stJanuary 2017 to 31st December 2019. Diagnosis was done by using keratometry and pachymetry findings or by using corneal topography findings and slit lamp examination. Results: Total 133 patients were enrolled in the study among them the mean (±SD) age was 20.2 (±6.9) with a minimum of 9 and a maximum of 50 years of age. Most of them were male 89 (67%) and 78 (58.7%) patients were between 16 to 25 years of age group. Most of the eyes had moderate 161 (63.4%) type in which the amount of refractive was high 201 (79%) and RGP contact lens 245 (96.4%) was tried for vision correction. Normal vision (0.0 to 0.5 Log MAR) was found in 255 (96%) of eyes among them 194 (73%) of eyes got better than 0.2 log MAR visual acuity after the contact lens trial. Conclusion: Keratoconus was found mostly in younger male patients and gas permeable contact lenses were most commonly used treatment modality.

Background: Outreach camp is helpful for reducing the prevalence of blindness due to cataracts and refractive error. The objective was to evaluate the visual outcome of cataract surgery among camp patients operated at a high volume center of Eastern Nepal. Materials and Methods: Descriptive cross sectional study design was used. The comprehensive eye screening program was conducted and those having cataracts were referred to base hospital for cataract surgery, patients were reexamined at the base hospital again and a small incision cataract surgery with posterior chamber intraocular lens was implanted at Biratnagar Eye Hospital, Biratnagar and Sagarmatha Choudhary Eye Hospital, Lahan. The pre-operative vision was taken during screening and post-operative vision was taken after one-month by performing refraction by trained personnel. Data were extracted from the hospital record; analysis was done using SPSS version 17.0. Descriptive analysis by using frequency, parent age and association was done by using Chi square test with a P-value

Background: Peptic ulcer perforation is a serious complication which affects 2–10% of peptic ulcer patients. Peptic ulcer perforation presents with an overall mortality of 10% although various authors had reported incidence between 1.3% and 20%. Being a life-threatening complication of peptic ulcer disease, it needs special attention with prompt resuscitation and appropriate surgical management if morbidity and mortality are to be contained. Aims and Objectives: The aim of the study was to the comparative study of Graham’s omentopexy versus modified Graham’s omentopexy in duodenal perforation. Materials and Methods: This prospective and single-center study was done in Birsa Munda, GMC Shahdol Madhya Pradesh from 2021 to 2023 for 2 years of periods. A total of 160 patients divided into two groups-Graham’s omentopexy 80 cases group “A” and modified Graham’s omentopexy 80 cases group “B.” Results: One hundred and forty-six (91%) were male and 14 (9%) were female with M:F Ratio 10:1. Most of the patients were 20–78 years of age in both groups. Post-operative leakage was 7.5% and 1.25%, respectively. Mortality rate in Group A (3.75%) and in Group B (1.25%). The overall mortality rate was 7.14%. In this study, average hospital stay was 12.4 days in Group A and 9.0 days in Group B. Conclusion: This study showed that modified Graham’s patch repair is as effective as Graham’s patch repair in terms of the mean operative time period, the timing of oral feed allow, and mean hospital stay timing.

This is a case of pseudopneumothorax caused by skin fold artifact in chest X-ray. This is important to diagnose as it can lead to inappropriate intervention or radiation exposure as in this case. Human eye’s ability to perceive margin by contrast difference is Mach band effect.

Small bowel lipomas are benign submucosal neoplasm composed mainly of mature adipose tissue. Despite their rare occurrence, lipomas are the second most common benign tumour of the small intestine. These tumours are mostly small in size and remain clinically asymptomatic. However, larger lesions tend to be more symptomatic, presenting with complications such as intussusception, bleeding or obstruction. Definitive surgical or endoscopic intervention is indicated in such symptomatic lipomas. Herein, we describe a rare case of ileal lipoma presenting with ileo-ileal intussusception and a life-threatening haemorrhage that was managed by laparoscopic-assisted ileal resection.

Background/Aims Patients of ulcerative colitis (UC) on follow-up are routinely evaluated by sigmoidoscopy. There is no prospective literature to support this practice. We assessed agreement between sigmoidoscopy and colonoscopy prospectively in patients with disease extent beyond the sigmoid colon. Methods We conducted a prospective observational study at a tertiary care institute for agreement between sigmoidoscopy and colonoscopy. We assessed endoscopic activity using the Mayo Endoscopic Score (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and histological activity using the Nancy Index (NI), Robarts Histopathology Index (RHI), and Simplified Geboes Score (SGS). Results Sigmoidoscopy showed a strong agreement with colonoscopy for MES and UCEIS with a kappa (κ) of 0.96 and 0.94 respectively. The misclassification rate for MES and UCEIS was 3% and 5% respectively. Sigmoidoscopy showed perfect agreement (κ = 1.00) with colonoscopy for assessment of the presence of endoscopic activity in the colon using MES ≥ 1 as activity criteria and strong agreement (κ = 0.93) using MES > 1 as activity criteria. Sigmoidoscopy showed strong agreement with colonoscopy for assessment of the presence of endoscopic activity using UCEIS (κ = 0.92). Strong agreement was observed between sigmoidoscopy and colonoscopy using NI (κ = 0.86), RHI (κ = 1.00), and SGS (κ = 0.92) for the detection of histological activity. The misclassification rate for the detection of histological activity was 2%, 0%, and 1% for NI, RHI, and SGS respectively. Conclusions Sigmoidoscopy showed strong agreement with colonoscopy for endoscopic and histologic disease activity. Sigmoidoscopy is adequate for assessment of disease activity in patients with UC during follow-up evaluation.