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Introduction: Conservative and surgical approach timeline in post-operative spondylodiscitis (POS) following lumbar disc herniation (LDH) surgery is ill defined, and patients have a protracted recovery phase with social, psychological, and financial implications. Materials and methods: Retrospective analysis of patients operated by transforaminal lumbar interbody fusion (TLIF) in POS was done. Confirmed clinico-radiological diagnosed POS cases, not responding within three to four weeks were included. Normalisation of CRP and radiological stable reconstruction was assessed for objective clearance of POS and bony union. Results: Ninety-five patients were included in the study with minimum follow-up period of two years. The mean age was 51.63±13.63 years. There were organisms cultured in 55 patients (57.89%). The ODI improvement of the patients was noted to improve from 88.71±5.3 to 20.80±9.7 (8 weeks) and was incremental at 2 years follow-up (10.12±6.41) and maintained further at final follow-up at 9±4.3. Bony union achieved in all with stable reconstruction. The resumption of activities of daily living (ADL) was quick (15.90±8.20 days) and job (3.67±1.31 months) was achieved in all the patients. In poor outcomes, two patients didn’t respond, and one patient died due to uncontrolled infection. Conclusion: Early diagnosis and intervention is the key to effective management of POS. Utilisation of aggressive TLIF yields faster ADL resumption.

Study Design Retrospective observational study. Purpose This study aimed to evaluate the utility of cervical dynamic magnetic resonance imaging (dMRI) in the assessment of cervical canal stenosis. Overview of Literature Cervical spondylotic myelopathy has been intricately linked to both static and dynamic narrowing of the cervical spinal canal. Traditional MRI with the neck in a neutral position fails to identify the dynamic changes and may lead to misdiagnosis. Cervical dMRI is a promising tool for evaluating cervical myelopathy, enabling clinicians to assess spinal cord compression, segmental instability, and alterations in range of motion, often missed on conventional imaging. Methods A retrospective analysis was conducted on 369 patients with symptoms of cervical myelopathy assessed using cervical dMRI. After assessing the subaxial cervical spine at each disc level (C3–T1), significant changes in the degree of central canal stenosis were determined. The appearance and extent of hyperintense lesions on T2-weighted sequences were also noted. Results Overall, 653/1,845 (35.39%) disc levels showed an increase in stenosis grade on extension MRI, with 168/653 (25.72%) and 180/653 (27.56%) disc levels changing from grades 0/1 to grades 2 and 3, respectively. Moreover, 120/369 (32.52%) patients showed a mean increase of 1.55±0.75 levels of compression on extension MRI when compared to neutral MRI. A fresh-appearing hyperintense lesion was observed in 79 (4.28%) disc levels on flexion MRI, which was not visualized on neutral MRI. Conclusions Cervical dMRI may help surgeons plan for surgery, discuss the prognosis with the patient, and safeguard themselves from medico-legal issues arising from improper or missed diagnosis and treatment.

Abstract Background During coronavirus pandemic, an unpredictable pile of biomedical waste (BMW) gathers at the top. India produces 710 tonnes of biomedical waste daily. The contribution of COVID-19 related biomedical waste was 126 tonnes per day in first wave of the pandemic. BMW's rapid growth is putting a strain on current waste management facilities, especially in developing countries. A sudden boost in biomedical waste needs rapid and proper segregation and disposal methods to avoid future consequences. Main body of the abstract From literatures and statistical data available on Central Pollution Control Board (CPCB) it shows that India lags behind in large-scale sorting, collection, careful storage, transfer and disposal of bio waste. India has its own guidelines set by the CPCB to ensure the safe disposal of biomedical waste during diagnosis, treatment and quarantine of COVID-19 patients. Although there are strict guidelines for bio-waste management, many hospitals in the process of implementing them often dispose of waste in inappropriate, chaotic and indiscriminate ways due to negligence or laziness. Often, due to poor separation practices, hospital waste is mixed with general waste, resulting in harmful overall waste flow. Waste disposal handlers are not safe due to their exposure to various health risks and inadequate training in waste management. The present review sheds light on guidelines, measures, and challenges related to biomedical waste management. Short conclusion Improper waste separation leads to improper waste disposal. Waste generation and management issues are causing daily problems as they have a profound impact on the dramatically changing global environment, including air, water and soil pollution. In addition, BMW's daily production and its processing are inversely proportional. This situation suggests that India will soon be drowning in its own garbage. The focus of this review is on the generation and disposal of biomedical waste. Based on a review of the literature, this evaluation provides a comparative picture of the current status of waste generation, national waste management strategies, and some measures to contribute to waste management and avoid future disasters.

From its inception, plenty of anticancer agents and gene therapies have been developed to account for cancer treatment. Despite this, the effectiveness of these therapies is flawed by toxic effects and failure to efficiently reach the target site. In this shade, novel drug delivery systems with advanced theranostic approaches have become a prerequisite in the domain of nanomedicines and nanotherapeutics. Despite this, the challenges associated with drug delivery have been urged to be discovered in the area of “drug delivery” intended for the delivery of drug to a targeted site for enhancement in clinical results. To deal with these issues, attachment of ligands that offer the selective targeting of active moiety in cancer therapy. In this present review, we have discussed the polydopamine (PDA) surface-modified nanocarriers for improved anticancer activity. In brief, methods for cancer treatment, challenges in cancer drug delivery, and approaches for targeted delivery of anticancer drugs have been described. Afterward, PDA in drug targeting and surface modification has been disclosed that including the significance and mechanism of PDA coating along with functionalization, toxicity, and cellular uptake of polymeric nanoparticles-polymerized dopamine (NPs-pD). Finally, the conclusion and prospects of PDA surface-modified nanocarriers have been discussed in detail. Importantly, the adaptability and flexibility of dopamine polymerization is playing a central role in functionalized nanoparticulate drug carriers in cancer treatment. Predominantly, multifunctionality present on the PDA surface and possible secondary modification approaches offer the potential for delivery of nanocarriers to target cancer cells very selectively and efficiently.

In order to design a reactor, kinetics of degradation of polycarbonate/CaCO3 composites was investigated here by thermogravimetric analysis (TGA), applying model-free and modelistic methods together, to obtain E, A, ΔS*, ΔH* and ΔG* (kinetic parameters). The system was tested with all the mechanisms available using non-isothermal modelistic method (Coats-Redfern). This approach allowed choosing the models, which are otherwise difficult to decide upon simply based on regression fit methods. The mechanism proposed was a simple nth order. Application of artificial neural network supported in designing a neural network could lead to a quick determination of kinetic parameters.

Increase in resistance of antibiotic against P. aeruginosa, the antibiotic treatment therapy fail to exterminate the infection. The approach of new strategy is must to deal with multidrug resistant P. aeruginosa. In the present study total 300 isolates from different clinical samples (Urine, Blood, Sputum, and Pus) were studied for isolation, identification and analysis of resistance pattern against 22 antibiotics. Total 5 most resistant isolates (U004, P017, P078, U105, and U237) were screened to search for synergistic approach of Coriandrum sativum extract prepared by both Soxhlet method and Maceration process in different solvents; petroleum ether, chloroform, acetone, methanol and water. Encouraging results were obtained where HDME extract could synergise the activity of total 8 antibiotics that are; MZ, CPZ, CTX, PB, LE, DOR, AZ and CAZ. Thus the present study provides and landmark approach to deal with multidrug resistant P. aeruginosa by synergistic action of antibiotic and Coriandrum sativum extract.

5-Aminolevulinic acid (5-ALA) is a naturally occurring nonprotein amino acid licensed as an optical imaging agent for the treatment of gliomas. In recent years, 5-ALA has been shown to possess anti-inflammatory and immunoregulatory properties through upregulation of heme oxygenase-1 via enhancement of porphyrin, indicating that it may be beneficial for the treatment of inflammatory conditions. This study systematically examines 5-ALA for use in inflammatory bowel disease (IBD). Firstly, the ex vivo colonic stability and permeability of 5-ALA was assessed using human and mouse fluid and tissue. Secondly, the in vivo efficacy of 5-ALA, in the presence of sodium ferrous citrate, was investigated via the oral and intracolonic route in an acute DSS colitis mouse model of IBD. Results showed that 5-ALA was stable in mouse and human colon fluid, as well as in colon tissue. 5-ALA showed more tissue restricted pharmacokinetics when exposed to human colonic tissue. In vivo dosing demonstrated significantly improved colonic inflammation, increased local heme oxygenase-1 levels, and decreased concentrations of proinflammatory cytokines TNF-α, IL-6, and IL-1β in both plasma and colonic tissue. These effects were superior to that measured concurrently with established anti-inflammatory treatments, ciclosporin and 5-aminosalicylic acid (mesalazine). As such, 5-ALA represents a promising addition to the IBD armamentarium, with potential for targeted colonic delivery.

Resistance spot welding (RSW) has revolutionized automotive industries since early 1970s for its mechanical assemblies. To date one mechanical assembly out five is welded using spot welding technology in various industries and stainless steel became very popular among common materials. As such this research paper analyses the spot weld growth on 304 austenitic stainless steels with 2mm sample sheets. The growth of a spot weld is primarily determined by its parameters such as current, weld time, electrode tip and force. However other factors such as electrode deformations, corrosions, dissimilar materials and material properties are also affect the weld growth. This paper is intended to analyze only the effects of nuggets growth due to the current and weld time increment with constant force and unchanged electrode tips. A JPC 75kVA spot welder was used to accomplish it and the welded samples were undergone tensile test, hardness test and metallurgical test to characterize the formation of weld nuggets.

The resistance spot welding process is accomplished by forcing huge amounts of current flow from the upper electrode tip through the base metals to the lower electrode tip, or vice versa or in both directions. A weld joint is established between the metal sheets through fusion, resulting in a strong bond between the sheets without occupying additional space. The growth of the weld nugget (bond between sheets) is therefore determined from the welding current density; sufficient time for current delivery; reasonable electrode pressing force; and the area provided for current delivery (electrode tip). The welding current and weld time control the root penetration, while the electrode pressing force and electrode tips successfully accomplish the connection during the welding process. Although the welding current and weld time cause the heat generation at the areas concerned (electrode tip area), the electrode tips’ diameter and electrode pressing forces also directly influence the welding process. In this research truncated-electrode deformation and mushrooming effects are observed, which result in the welded areas being inconsistent due to the expulsion. The copper to chromium ratio is varied from the tip to the end of the electrode whilst the welding process is repeated. The welding heat affects the electrode and the electrode itself influences the shape of the weld geometry.

A sound weld from spot welding is what most manufacturers desire and prefer for mechanical assemblies in their systems. The robustness is mainly attributed to the joining mechanism of mechanical parts. This paper focuses on the effect of parametric changes for dissimilar joints using 304 austenitic stainless steel and carbon steel of two different thicknesses. A pneumatic-based spot welder was used to accomplish the entire welding process. The parameters varied during the experiments are the welding current and welding time, while the electrode pressing force and electrode tip size are kept constant. The welding process began from a poor weld and moved on to a better weld by increasing the process parameters. However, this study is limited to the basic parametric variation to find the optimum parametric setup for 1 and 2 mm base metals. The welded specimens are subjected to tensile, hardness and metallurgical tests to characterise the spot weld growth for both thicknesses.

Objectives: The saliva was first analyzed for the presence of anti-A and anti-B hemagglutinins in 1928. However, it was not been utilized as evidence in criminal investigations because of insufficient techniques available at that time. Hence, the present study was designed to evaluate feasibility of ABO group in medicolegal cases by determining the efficacy and accuracy of ABO blood group determination from saliva and to determine the pattern of antigen secretion in saliva in family members. Methods: A total of 200 subjects (101 males and 99 females) studied. Out of these. 100 subjects were taken at random (sample I) and 100 subjects were taken from 25 families (sample I0. The blood group of each subject was determined from saliva by absorption-inhibition method. Results: The present study showed that 83% subjects are secretors of antigen in saliva. If the subject was secretor, one of his/her parents was essentially a secretor. If both parents were secretor both the children in the family were secretors. Conclusion Results can be utilized for identification of subjects, ruling out identification, determination of inheritance in medicolegal cases.

Papillon-Lefevre syndrome (PLS) is a rare autosomal recessive heterogeneous trait which is characterized by erythematous palmoplantar hyperkeratosis, early-onset periodontitis, and associated calcification of dura mater. The etiology of PLS is multifactorial with genetic, immunological, and microbial factors playing a role in etiopathogenesis. Recently identified genetic defect in PLS has been mapped to chromosome 11q14–q21, which involves mutations of cathepsin C. This paper presents a report of 2 cases of Papillon-lefevre syndrome in which diagnosis is based on clinical presentation and genetic mapping.

The periodontal researchers and clinicians, in an effort to develop effective regenerative therapies, have sought to understand key events involved in the regeneration of periodontium. Polypeptide growth factors are a class of natural biological mediators which regulate key cellular events in tissue repair. Platelet-derived growth factor (PDGF) is the most thoroughly studied growth factor in periodontal regeneration. The present case series evaluate the effectiveness of platelet-derived growth factor (rh-PDGF-BB) in combination with beta-tricalcium phosphate (β-TCP) to achieve periodontal regeneration in 3 infrabony defects.

Dental implants are now considered as a predictable treatment modality for the oral rehabilitation of partially or fully edentulous patients. Recently emphasis has changed towards achieving a predictable esthetic success. Creating aesthetically successful implant-supported restoration in the anterior region of oral cavity depends on the presence of interimplant papilla when multiple implants are used. The present paper reports a case of interimplant papilla reconstruction in esthetic zone of maxilla during one stage early loading multiple implant procedure using demineralized freeze dried bone allograft block fixed by titanium screw.

Delivery of orally compromised therapeutic drug molecules to the systemic circulation via buccal route has gained a significant interest in recent past. Bioadhesive polymers play a major role in designing such buccal dosage forms, as they help in adhesion of designed delivery system to mucosal membrane and also prolong release of drug from delivery system. In the present study, HPMC (release retarding polymer) and mannitol (diluent and pore former) were used to prepare bioadhesive and controlled release buccal discs of buspirone hydrochloride (BS) by direct compression method. Compatibility of BS with various excipients used during the study was assessed using DSC and FTIR techniques. Effect of mannitol and HPMC on drug release and bioadhesive strength was studied using a 32 factorial design. The drug release rate from delivery system decreased with increasing levels of HPMC in formulations. However, bioadhesive strength of formulations increased with increasing proportion of HPMC in buccal discs. Increased levels of mannitol resulted in faster rate of drug release and rapid in vitro uptake of water due to the formation of channels in the matrix. Pharmacokinetic studies of designed bioadhesive buccal discs in rabbits demonstrated a 10-fold increase in bioavailability in comparison with oral bioavailability of buspirone reported. [ABSTRACT FROM AUTHOR]

Abstract: Creep testing of notched cross-weld specimens was carried out at 873K temperature and 300MPa stress to study the effect of notch on creep properties of 316 L (N) SS weld joint. Various stress states were achieved by changing the notch profile. It was observed that, multiaxial state of stress developed during creep had a decisive role in creep life and the deformation mechanism. Thus, presence of notch and its consequences on creep life of the specimen prompted to offer exact solutions to explain the creep behavior. Notch strengthening effect is reported in the present investigation. Single mode of fracture was observed and fractures were located at the notch root. The transformation of δ-ferrite to sigma phase during creep exposure for about 2700 to 6200h had resulted in ductile fracture in weld metal. [Copyright &y& Elsevier]

Abstract: The present work focuses on testing of 316 L (N) steel in which varying degrees of multiaxiality are introduced with variation in the stress intensity factor, Kt. The specimens were tested under varying notch geometries at 873K and 300MPa. The stress distributions from the notch root to center of the specimen are explained with Finite Element Modeling calculations simulated later with ANSYS software. Correlation of the stress distribution with microstructural features is attempted to evaluate stress offloading due to multiaxiality. [Copyright &y& Elsevier]

Background: Lapis judaicus, or Jews stone (Badarashma), has been used in treating kidney and bladder stones since ancient times by Ayurvedic and Unani medicinal practitioners. A limited number of studies have been carried out using Ayurvedic preparations derived from gems or precious stones that were used traditionally. In Ayurveda, Rasa Shastra includes the fabrication of Bhasmas and Pishti. Objective: This study aimed to prepare and characterize Badarashma Pishti formulation (Lapis judaicus microparticles) and investigate its structural and thermal properties. Materials and methods: The microparticles were prepared by subjecting purified powder of Lapis judaicus to a wet levigation (Bhavana) process. Characterizations were done using Fourier transform infrared spectroscopy (FTIR), Differential scanning calorimetry (DSC), thermo-gravimetry analysis (TGA), energy-dispersive X-ray (EDAX) spectroscopy, X-ray diffraction (XRD), and scanning electron microscopy (SEM) analysis. Physicochemical characterization, elemental analysis, particle size distribution study, and identification of heavy metals were also performed. Results: A standard operating procedure was developed to formulate Badarashma Pishti. The obtained microparticles were irregularly shaped with a size of 4.290 ± 0.472 μm, confirmed in SEM images. The FTIR and XRD of prepared Badarashma Pishti samples revealed the presence of calcite, quartz, and aragonite minerals. The results of EDAX also confirmed the presence of Ca, Mg, O, and Si elements. Conclusion: The proposed study results reveal great insights for determining the authenticity, purity, and standardization parameters of inorganic mineral drugs, proving to be a useful delivery system for treating renal calculi.

Shilajit is an ancient herbal medicine from India with many uses. It is a viscous material prominently present in the Himalayan and Hindukush rocks of the Indian region. The formation due to plant decompostion with time. Herbs assosciated to the stones reveals about composition of Shilajit. Primary objective is to create GCMS/MS and LC-analysis techniques for separating the phytochemicals and complete profiling of volatile and non-volatile metabolites found in Shilajit. Accordingly, an attempt was undertaken to develop a method for standardisation and, subsequently, certification inorganic content and purity of shilajit in various indian regions S-01, S-02, S-03, S-04, and S-05. Thus, an effort was made to create a fundamental technique for standardization and, consequently, authentication of shilajit that was acquired from various geographical locations.Trace metal concentrations were measured using ICP OES in mg Kg−1 for each sample. These elements included As, Pb, Cd, Ag, Al, B, Ba, Cr, Cu, Fe, Mn, Ni, Sb, Se, Zn, P, Ca, K, Mg, and Na. ICP OES analysis observed the significant concentration of Ca and K, in S-01 (102631 and 26779), S-02 (13529.25 and 36866.35), S-03 (8170.84 and 37989.10), S-04 (9616.37 and 18843.77), and S-05 (4992.10 and 2120.64), appropriately. By measuring the DPPH radical scavenging activity were assessed for their antioxidant activities of the S-01, S-02, S-03, S-04, and S-05 samples: 12.316 ± 0.561 %, 13.144 ± 2.884 %, 15.105 ± 1.421 %, 19.683 ± 2.013 %, and 0.0724 ± 1.045 %, respectively. Concurrently, TPC studies on Shilajit found between 10 and 150 mg g−1 wt Similarly, shilajit’s TFC was analysed with geographically. TFC were found in mg QCE/g of wt of S-01 12.56, S-02 5.56, S-03.48, S-04 49.23, and S-05 5809 each respectively. The phytochemicals protocatechuic acid and hippuric were tested for in silico anti-inflammatory and antihyperglycemic activity of acid, which need to be explored in-vivo applications.

Abstract Agro-waste is the outcome of the under-utilization of bioresources and a lack of knowledge to re-use this waste in proper ways or a circular economy approach. In the Indian medicinal system, the root of Cyperus scariosus (CS) is used at a large scale due to their vital medicinal properties. Unfortunately, the aerial part of CS is treated as agro-waste and is an under-utilized bioresource. Due to a lack of knowledge, CS is treated as a weed. This present study is the first ever attempt to explore CS leaves as medicinally and a nutrient rich source. To determine the food and nutritional values of the neglected part of Cyperus scariosus R.Br. (CS), i.e. CS leaves, phytochemicals and metal ions of CS were quantified by newly developed HPLC and ICPOES-based methods. The content of the phytochemicals observed in HPLC analysis for caffeic acid, catechin, epicatechin, trans-p-coumaric acid, and trans-ferulic acid was 10.51, 276.15, 279.09, 70.53, and 36.83 µg/g, respectively. In GC–MS/MS analysis, fatty acids including linolenic acid, phytol, palmitic acid, etc. were identified. In ICPOES analysis, the significant content of Na, K, Ca, Cu, Fe, Mg, Mn, and Zn was observed. The TPC and TFC of the CS leaves was 17.933 mg GAE eq./g and 130.767 mg QCE eq./g along with an IC50 value of 2.78 mg/mL in the DPPH assay and better antacid activity was measured than the standard (CaCO3). The methanolic extract of CS leaves showed anti-microbial activity against Staphylococcus aureus (15 ± 2 mm), Pseudomonas aeruginosa (12 ± 2 mm) and Escherichia coli (10 ± 2 mm). In silico studies confirmed the in vitro results obtained from the antioxidant, antiacid, and anti-microbial studies. In addition, in silico studies revealed the anti-cancerous and anti-inflammatory potential of the CS leaves. This study, thus, demonstrated the medicinal significance of the under-utilized part of CS and the conversion of agro-waste into mankind activity as a pharmaceutical potent material. Consequently, the present study highlighted that CS leaves have medicinal importance with good nutritional utility and have a large potential in the pharmaceutical industry along with improving bio-valorization and the environment.

Background: Shyonaka (Oroxylum indicum Vent) is widely used in Ayurveda and in ethnomedical practice for the treatment of inflammation, pain, diarrhea, non-healing ulcers, and cancer. Owing to the high prevalence of Epstein-Barr virus (EBV) infection in Nasopharyngeal carcinoma (NPC) patients, simultaneous targeting of proteins involved in both EBV replication and NPC proliferation might help to manage the disease effectively. Objectives: This study is designed to identify potential dual targeting inhibitors from Oroxylum indicum having the potential to inhibit both EBV and NPC. This study also attempted quantitative analysis of Shyonaka Bark Decoction (SBD) to confirm the presence of Baicalein and Chrysin which are predominant marker compounds of Shyonaka. Methodology: The HPLC analysis of stem bark and root bark of Oroxylum indicum was done to estimate the presence of marker compounds Baicalein and Chrysalin. The in-silico analysis included ADMET analysis followed by molecular docking of known compounds from Oroxylum indicum (retrieved from IMPPAT database) onto the target proteins of EBV (BHRF1, NEC1, dUTPase, Uracil DNA glycosylase) and NPC (COX-2, EGFR, and MDM2) using DOCK6 tool. Further validations were done using the molecular dynamics simulations of top screened molecules onto the selected target proteins using AMBER20 package and their corresponding MMGBSA binding free-energy values were calculated. Results: The molecular docking revealed that the key molecules from the plant, scutellarein 7-rutinoside (S7R), scutellarin (SCU) and 6-hydroxyluteolin, Baicalein and 5,7-Dihydroxy-2-phenyl-6-[3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxychromen-4-one (57D) are effectively intervening with the target proteins of EBV, one of the key causative factors of NPC and the NPC specific targets which have the potential to reduce tumor size and other consequences of NPC. The molecular dynamics simulations of S7R, Baicalein and 57D, Baicalein with MDM-2 protein and dUTPase protein, respectively, showed stable interactions between them which were further assessed by the binding energy calculations. Conclusion: Overall, the in-silico evaluation of these phytochemicals with target proteins indicates their potential to inhibit both EBV and NPC which needs further in-vitro and in-vivo validations.

Abstract The primary approaches to treat cancerous diseases include drug treatment, surgical procedures, biotherapy, and radiation therapy. Chemotherapy has been the primary treatment for cancer for a long time, but its main drawback is that it kills cancerous cells along with healthy ones, leading to deadly adverse health effects. However, genitourinary cancer has become a concern in recent years as it is more common in middle-aged people. So, researchers are trying to find possible therapeutic options from natural small molecules due to the many drawbacks associated with chemotherapy and other radiation-based therapies. Plenty of research was conducted regarding genitourinary cancer to determine the promising role of natural small molecules. So, this review focused on natural small molecules along with their potential therapeutic targets in the case of genitourinary cancers such as prostate cancer, renal cancer, bladder cancer, testicular cancer, and so on. Also, this review states some ongoing or completed clinical evidence in this regard.

Introduction: Among all face masks, N95 masks have been recommended for medical professionals involved mainly in patients with severe respiratory illnesses. Studies showing a decrease in peripheral oxygen saturation (SpO2 ) and an increase in heart rate after N95 mask usage have already created panic/ concern among medical professionals. On the contrary, a few studies have shown no such negative impact of N95 mask usage, thereby urging scientific communities to investigate/ explore these contrasting results. Aim: To study the effect of wearing an N95 mask continuously for three hours on SpO2 and heart rate specifically in Indian medical professionals. Materials and Methods: This was a quasi-experimental study conducted for a period of 2 months from June 15, 2022, to August 15, 2022, at Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India, with a total of 105 healthy Indian medical professionals aged 18-40 years (55 males, 50 females) (12 study participants dropped from the study midway). In each participant, SpO2 and heart rate were recorded first without a mask (M0) and then with a mask (M3) after three hours of routine work in the hospital. Using Mystat statistical software (version 12.0), results were expressed as mean±Standard Deviation (SD), and Student’s paired t-test was used to compare the pairs of means. Results: Among the 105 eligible participants, 93 successfully completed the study, whereas 12 participants were excluded (dropout rate=11.42%). The study included 55 males (52.38%) and 50 females (47.61%) with an age range of 18-40 years and a mean age of 30.2±6.4 years. The SpO2 levels statistically showed a highly significant decrease after three hours of wearing an N95 mask (96.5±0.83% in M0 vs. 93.98±0.6% in M3). Similarly, the heart rate statistically showed a highly significant increase after three hours of using an N95 mask (73.45±3.6 in M0 vs. 89.6±6.1 beats/min in M3). Conclusion: The authors highlighted lower SpO2 levels and an increase in heart rate after three hours of N95 mask usage specifically in Indian medical professionals and thereby appeal to develop/upgrade the N95 mask by lowering its humidity, thermal stress, and breathing resistance.

The stem bark of Salix alba (SA) is extensively used in herbal medicine and nutraceuticals. The non-availability of quality standard available for SA stem bark in the Ayurvedic Pharmacopeia of India (API) leads inability to trace adulteration. In the current study, quality standard of SA stem bark has been developed in the interest of quality control, as per international standards including API parameters. The geographical changes could play a vital role in phytochemicals’ and nutrients’ variations. Hence, the samples from different geolocations and markets were analysed along with the cultivated plant sample. A comprehensive study including identification and authentication by DNA barcoding and pharmacognostic evaluation, physicochemical and phytochemical analysis by HPTLC was carried out. Moreover, a validated HPLC method was developed for the quantification of three phytochemicals (Salicin, Procyanidin B1 and Catechin) for the standardization of SA stem bark. The complete profiling of volatile metabolites and non-volatile metabolites was done by using GC–MS and LC-MS techniques, respectively. In ICP-OES based elemental analysis, heavy metals were observed below permissible limits, and SA stem bark has shown significant amount of essential metal ions like Na, Mg, Ca, Fe, Cu, and Zn. The observed total phenol content (TPC) and total flavonoid content (TFC) for all samples of SA stem bark ranged from 16.69 to 50.30 mg GAE/ g of wt. and 124.57 to 347.76 mg QCE/ g of wt., respectively. In DPPH assay, the observed IC50 values of SA stem bark ranged from 0.58 to 2.08 mg/mL. In antibacterial assay, SA stem bark has shown promising results against S. aureus and B. subtilis strains with inhibition zones of 20 ± 4 mm. Overall, this is first report comprising of advanced quality standard and detailed standardization of SA stem bark with quantification of three important phytochemicals by HPLC along with the quantification of essential metal ions and other in vitro assays. Moreover, the study revealed that the fresh stem bark sample may contain significant content of phytochemicals and antibacterial activity.

Objective Percutaneous transforaminal endoscopic lumbar discectomy (PTELD) is safe and effective. Perioperative or postoperative seizures are a rare complication that can be prevented by promptly identifying prodromal symptoms and signs. This study aimed to identify prodromal symptoms and risk factors of avoidable seizures in patients undergoing PTELD and to quantify irrigation fluid ingression into the epidural space on immediate postoperative magnetic resonance imaging (MRI). Methods This retrospective analysis included patients who underwent PTELD under local anesthesia from February 2018 to June 2022. Surgical records were reviewed to identify patients who developed prodromal symptoms, and immediate postoperative MRI was evaluated for radiological correlations. Results Nine patients developed prodromal symptoms of neck pain (n=6), upper dorsal pain (n=7), headache (n=2), confusion (n=2), visual disturbance (n=1) and hemodynamic alterations (n=4). No patients had seizures. Calcified lumbar disc herniation-associated posterior apophyseal ring fracture, central lumbar disc herniation, obesity, double-level surgery, use of an automated pump, and a large working channel endoscope were associated with an increased fluid flow rate for epidural work and duration of surgery. MRI showed significant epidural fluid collection cranial to the operative level, reaching the thoracolumbar junction, in patients with prodrome, suggesting increased intracranial pressure due to thecal sac compression. Conclusion Prodromal symptoms should be considered a red flag for avoidable seizures. The duration of surgery and infusion fluid flow rate are controllable risk factors during surgery. Risk factors should be kept in mind. The judicious use of automated pumps and larger channel working endoscopes is recommended.

Adiantum venustum D. Don (Himalayan or Evergreen maiden hair fern), also known as ‘Hansraj’ in India, is a pteridophytes that grows extensively in tropical and temperate areas. It has been used in traditional medicines to treatment cough, cold, fever, and headache. However, the information available is scarce and scattered. So, the primary goal of this review is to provide complete and updated knowledge about the distribution, morphology, pharmacognostic characteristics, chemistry and biological activities of A. venustum to assess its therapeutic potential and future research opportunities. Different parts of this fern have been extensively used in traditional medicines to treatment diseases from time immemorial. It is a reservoir of active chemical compounds like terpenoids, flavonoids, fatty acids, sterol, carotenoids and others, which possesses antimicrobial, antiviral, antitumor, and anti-analgesic properties. The current review has been designed to provide the upto-date knowledge and perspectives about A. venustum and its potential use as a therapeutic plant. So, researchers should take a keen interest in exploring and isolating new active components, bio-assay their pharmaceutical values and mode of action, and conducting clinical trials to justify their reported studies on human health benefits.

Gairika (red ochre) has a long history of influencing human civilization. Gairika is a rich source of nutrients used for reproductive and brain health. Gairika is mentioned as an antacid drug in Indian Ayurvedic medicine under Laghu Sutashekhara Rasa (LSR). However, a detailed study on LSR has not been reported to date. In the present study, LSR was prepared, and a pharmaceutical SOP (standardization procedure) was reported to obtain batch-to-batch reproducibility. LSR was characterized using FTIR, XRD, SEM-EDX, and TGA analyses. LSR was tested in vitro for its antacid activity. Advanced instrumentation revealed that LSR formation produced symmetrical particles (5–8 µm) with kaolin, kaolinite, quartz, goethite, and hematite, along with the phytoconstituents of Goghrita (clarified cow’s butter), Shunthi, and Nagawalli, as confirmed by GC-MS/MS analysis. The FTIR study revealed the formation of a chelating complex of goethite and hematite along with their phytoconstituents. XRD analysis confirmed the presence of kaolin, kaolinite, quartz, goethite, and hematite. Using in vitro antacid experiments, LSR and Shunthi demonstrated significant antacid activity as compared to antacid drugs and standards in the market, such as CaCO3. The DPPH assay revealed IC50 values of 12.16 ± 1.23 mg/mL, which is 0.0029 of Trolox-equivalent antioxidant activity. The inhibition (18 ± 4 mm) against pathogens (S. aureus, E. coli, P. aeruginosa, and B. subtilis) and the prominent growth of gut microbiota-supported strains (S. boulardii, L. paracasei, and L. plantarum) observed on LSR formulation were indicative of LSR application as a prebiotic. Here, the mechanism of purification and levigation mentioned in the classical literature of LSR was established. Overall, purification of Gairika with cow ghee and levigation with Nagawalli may enhance the solubility, bioavailability, and shelf-life of LSR through hydration and co-crystallization mechanisms. This is the first comprehensive report on the pharmaceutical validation of LSR and its characterization. The results of the present study could contribute to the development and reliable reproduction of LSR and the utility of environmental red ochre as a medicine in combination with Shunthi (Zingiber officinale Roxb.), as prescribed under Indian Ayurvedic medicine.

Context: Cervical disc arthroplasty (CDA) was developed for the treatment of cervical disc disease with the potential advantages of preservation of physiological motion at a discal level, thereby potentially reducing adjacent level stresses and degeneration, which were a known complication of anterior cervical arthrodesis. The objective of this study was the assessment of long-term functional and radiological outcomes overtime in all the patients who underwent CDA from 2011 to 2019 at our institute. Materials and Methods: Forty-eight patients who underwent CDA (2011–2019) with a minimum 2-year follow-up were retrospectively evaluated. The functional outcome included the Visual Analog Score (VAS) and Neck Disability Index (NDI). Radiographs were assessed for range of motion (ROM) at the index surgical level, presence of heterotopic ossification (HO), and adjacent segment degeneration. Results: The mean follow-up was 5.79 ± 2.96 (2.16–11.75) years. Significant improvement (P < 0.05) was observed in the VAS (8.91 ± 2.52 [preoperative] to 0.89 ± 1.27 [follow-up]) and NDI (65.5% ±23.06% [preoperative] to 4.79 ± 3.87 [follow-up]) score. Motion at index level increased significantly from 5.53° preoperatively to 7.47°, and 92% of the implanted segments were still mobile (referring to the threshold of ROM > 3°). HOs are responsible for the fusion of 4/50 (8%) levels at the last follow-up. Distal and proximal adjacent disc degeneration occurred in 36% and 28% of patients, respectively. No migration of the implant was observed on the radiograph. Conclusion: Our study showed favorable clinical outcome of CDA with preservation of ROM at the index surgical level. CDA can be a promising alternative to anterior cervical arthrodesis when properly indicated.