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Optimal cell spreading and interplay of vascular smooth muscle cells (VSMC), inflammatory cells, and cell adhesion molecules (CAM) are critical for progressive atherosclerosis and cardiovascular complications. The role of vitronectin (VTN), a major cell attachment glycoprotein, in the pathogenesis of atherosclerosis remains elusive. In this study, we attempt to examine the pathological role of VTN in arterial plaque progression and inflammation. We found that, relative expression analysis of VTN from the liver of Apolipoprotein E (ApoE) Knockout mice revealed that atherosclerotic progression induced by feeding mice with high cholesterol diet (HCD) causes a significant downregulation of VTN mRNA as well as protein after 60 days. Promoter assay confirmed that cholesterol modulates the expression of VTN by influencing its promoter. Mimicking VTN reduction with siRNA in HCD fed ApoE Knockout mice, accelerated athero‐inflammation with an increase in NF‐kB, ICAM‐1, and VCAM‐1 at the site of the plaque along with upregulation of inflammatory proteins like MCP‐1 and IL‐1β in the plasma. Also, matrix metalloprotease (MMP)‐9 and MMP‐12 expression were increased and collagen content was decreased in the plaque, in VTN deficient condition. This might pose a challenge to plaque integrity. Human subjects with acute coronary syndrome or having risk factors of atherosclerosis have lower levels of VTN compared to healthy controls suggesting a clinical significance of plasma VTN in the pathophysiology of coronary artery disease. We establish that, VTN plays a pivotal role in cholesterol‐driven atherosclerosis and aortic inflammation and might be a useful indicator for atherosclerotic plaque burden and stability.

Solar energy is the centre of attention and major need of the world. The advancement in the photovoltaic devices plays the key role in the path of solar energy applications. The progress in the perovskite solar cell technologies in the direction of their theoretical power conversion efficiency necessitates elusive control above the carrier dynamics all over the whole device. In the present investigation, a comparative study via SCAPS simulation has been done for the optimization of the device in the light of high power conversion efficiency of organic–inorganic perovskite-based photovoltaic solar cells. Perovskite absorber layers CH3NH3PbI3 and CH3NH3SnI3 are sandwiched in between the TiO2 as electron transport layer (ETL) and spiro-OMeTAD as hole transport layer (HTL) to design the hetrostructures for the simulation. We have achieved enhancement in the power conversion efficiencies of both the devices as compared to the reported experimental and theoretical studies previously.

Lead free and environment friendly, light absorbing material is in high demand for the photovoltaic perovskite solar cell devices. The double perovskite La2NiMnO6 have the centre of attention for this demand. The present review is focused to discuss briefly the progress and challenges in the structural and magnetic properties of La2NiMnO6 in bulk, nano and thin film phases. The structural changes of La2NiMnO6 are highly interesting and have the direct correlation with the magnetic properties. On the basis of these transformations in the structure, efforts have been made to discuss several scientific progresses into technical novelties. This short review article is critically dedicated on reviewing the progresses, openings, and upcoming challenges in perovskite solar cell devices.

The control on magnetization via applied electric field is the centre of attention in multiferroic materials for the achievement of technological device applications. The bismuth ferrite (BiFeO3) is best multiferroic material which has the ferroelectric as well as weak magnetic nature simultaneously in the single phase near the room temperature. There are many unsolved problems in the path of the actual device applications of multiferroic BiFeO3 (BFO) due to the transformation of several scientific progresses into technical innovations. So, there is a need to solve these complications via focused research movements, which may convert this useful material into actual device applications. This review article is mainly concentrated on look over the recent advances on technological achievements and challenges in BFO via the magnetoelectric coupling and presents the latest devices achievements.

The Indian Society of Gastroenterology (ISG) felt the need to organize a consensus on Helicobacter pylori (H. pylori) infection and to update the current management of H. pylori infection; hence, ISG constituted the ISG's Task Force on Helicobacter pylori. The Task Force on H. pylori undertook an exercise to produce consensus statements on H. pylori infection. Twenty-five experts from different parts of India, including gastroenterologists, pathologists, surgeons, epidemiologists, pediatricians, and microbiologists participated in the meeting. The participants were allocated to one of following sections for the meeting: Epidemiology of H. pylori infection in India and H. pylori associated conditions; diagnosis; treatment and retreatment; H. pylori and gastric cancer, and H. pylori prevention/public health. Each group reviewed all published literature on H. pylori infection with special reference to the Indian scenario and prepared appropriate statements on different aspects for voting and consensus development. This consensus, which was produced through a modified Delphi process including two rounds of face-to-face meetings, reflects our current understanding and recommendations for the diagnosis and management of H. pylori infection. These consensus should serve as a reference for not only guiding treatment of H. pylori infection but also to guide future research on the subject.

Introduction: Patient satisfaction is a psychological concept which is considered as a judgment of individuals regarding any object or event after gathering some experiences over time. It is one of the established yardsticks to measure the success of the services. Objectives: 1. To assess the level of inpatient satisfaction on hospital services. 2. To find out the determinants of inpatient satisfaction on hospital services. Method: It was a cross-sectional study conducted over a period of four months at VIMSAR, a tertiary care hospital in Odisha in eastern India. A total of 164 patients were enrolled in the study from the five most occupied indoor departments who were administered a pre-tested semi-structured standardised questionnaire by face to face interview method. Results: Majority (77.44%) of respondents were in the age group of 21-60 years. The sample consisted of 65.24 % males and 43.9% were from lower socio-economic class. Patient satisfaction level was found to be relatively low (~80%) for the service domains like housekeeping, general services and ancillary services. Fields like front desk services, medical care, nursing care and laboratory services enjoyed a better satisfaction score (~90%). Binary logistic regression analysis reflected age and socio-economic class to be the negative determinants of the level of satisfaction. Conclusion: About two thirds of the inpatients were satisfied with the services availed at the tertiary care hospital in the five specialities. There is scope of improvement in the areas like housekeeping, ancillary care and general care. Socio-demographic characteristics like age and socioeconomic class inversely related to inpatient satisfaction on hospital services.

Frequency control is the key factor in a renewable energy-based microgrid system. The inherent dynamics and low inertia of most power generating units of microgrids lead to frequency oscillations i...

Agriculture has always been affected by intractable pests. Conventional agriculture still relies on the use of several pesticides to control various pests to ensure the yield of the crop and to feed a constantly growing population. To reduce the pest menace, the fatuous behavior of people as well as a natural proclivity towards the use of pesticides in a non-judicious manner, has caused several ecological backlashes such as secondary pest outbreak, pest resurgence and non-target organism's exploitation. Effects of pesticides on non-target organisms area worldwide concern and contention are the basis for most legislation regarding usage of specific pesticides. Pesticides, besides their effect on pests, would also affect several beneficial non-targets. The effect of pesticides could be lethal and may prove catastrophic or sublethal and stimulate the growth and development of non targeted biota's. Hence, this review approaches well-analyzed hindsight regarding the effect of pesticides on the natural enemies as well as other non-target organisms present in the rice agroecosystem.

This paper will focus on linguistic constructions involving intensional emotive predicates in order to assess the computational complexity of such constructions based on the features of intensional elements in such constructions. It will be first shown that linguistic constructions vary as a function of the nature of intensional elements involved in such constructions. The important insights derived from these facts will be then carried forward for an exploration of the computational complexity of intensional emotive constructions which can be seen to co-vary in complexity scales with the number of intensional elements or features of intensional elements. Possible ramifications emanating from this for the cognitive tractability of semantic contents and for natural language processing will be offered at the end of the paper.

Epilepsia partialis continua (EPC) is a rare form of status epilepticus and often refractory to antiepileptic drugs (AEDs). Persistent seizure activity may increase pro-inflammatory biomarkers locally, which may respond to adjunctive corticosteroid treatment, especially in central nervous system (CNS) infections. We report four children with refractory EPC and the effect of adjunctive corticosteroid in controlling EPC. The duration of EPC ranged between 3 days and 7 months. One patient had secondary generalized convulsive status epilepticus. Cranial computed tomography/magnetic resonance imaging was abnormal in three out of four patients; revealing old infarction in one, tuberculoma in one, and neurocysticercosis in one. Electroencephalography revealed spike and sharp wave discharges on the corresponding cerebral hemisphere. The EPC was refractory to 2-6 AEDs. Following corticosteroid treatment, EPC remitted in two patients with CNS infection, and those with infarction and cryptogenic EPC converted to discrete seizures. In AED-resistant EPC, a short course of corticosteroid may be helpful.

Farmers’ health and the environment are prime priorities for any agrarian economy. In India, almost 90% of the pesticides are used in rice, cotton, and vegetables. Nevertheless, factors associated with farmers’ behavior in pesticide use are lacking. This study assessed Indian rice farmers’ intention to use pesticides, by applying a modified version of the theory of planned behavior with knowledge of pesticide use and moral norms as additional constructs. The study is marshaled by the primary data collected from 480 rice growers of Odisha region, India through a multi-stage random sampling. The majority of the farmers showed positive attitudes towards pesticide use, relatively high levels of subjective norms, and almost neutral levels of moral norms. On the contrary, the majority of the farmers exhibited quite low levels of perceived behavioral control and knowledge of safe pesticide use. A significant positive correlation was established between intention and the variables attitudes, subjective norms, moral norms, perceived behavioral control, and knowledge. Knowledge was the most significant variable in controlling subjective norms, moral norms, and intention, while subjective norms and moral norms also played a crucial role in intention. Findings highlight the crucial role of knowledge, subjective norms, and moral norms in intention to use pesticides. Policy initiatives need to be implemented in the study area for judicious pesticide use, including integration of scientific knowledge about pesticide use with farmers’ traditional pest management and establishment of a strong link between rice farmers and extension experts, who can encourage ‘pesticide-free’ farming through proper certification programs.

BACKGROUND Though epilepsy remains a significant problem for children and adolescents in our country, studies delineating the clinical profile and response to treatment in childhood epilepsy are lacking. The current study was carried out for obtaining a baseline profile and to predict the response to treatment in childhood epilepsy in India that may be helpful in planning management strategies from a public health point of view. METHODS Patients with clinical suggestion of active epilepsy (N = 141) from one month to 12 years, were enrolled into the study over a period of 1 year (February 2010 to January 2011) from the out-patient department and epilepsy clinic of Bangur Institute of Neurology. Detailed history was taken along with neurological examination. Electroencephalography (EEG) and neuroimaging (MRI / CT scan) were done on all patients. Each patient included in the study was kept in followup for a period of 6 months and their response to the treatment was recorded. RESULTS About 48.9 % (N = 69) patients had localisation related epilepsy while the rest had generalised epilepsy. Of those with generalised epilepsy, generalised tonicclonic seizures (GTCS) was by far the most common type. Of those with focal EEG activity, the highest proportion (50 %), were localised to the temporal lobe. Symptomatic aetiology accounted for 59.6 % (N = 84) of the patients. 20.6 % (N = 29) had poor response to treatment at 6 months follow-up. Abnormal neuroimaging (OR = 6.708) and abnormal EEG (OR = 6.357) were effective factors in predicting poor response to treatment. CONCLUSIONS Our study highlights the need to link specialised epilepsy services with primary health centres for early detection and treatment. EEG is an essential cost-effective modality in determining seizure localisation and response to treatment. KEYWORDS Paediatric, Epilepsy, Clinical Profile, Response to Treatment

To compare the efficacy of intravenous acetaminophen and intravenous diclofenac sodium in the management of skeletal vaso-occlusive crisis among children with sickle cell disease. Single blind randomized controlled trial. Tertiary care hospital. 104 children with sickle cell disease and skeletal vaso-occlusive crisis. Intravenous acetaminophen at 10mg/kg/dose 8 hourly and intravenous diclofenac sodium at 1mg/kg/dose 8 hourly in 1:1 ratio. Reduction in pain score (50%), number of doses needed to relieve pain after 24 hours of drug administration and decrease in pain score at 1 hour. A 50% reduction in pain score was seen in 35 (77.3%) and 10 (21.7%) children among acetaminophen and diclofenac sodium groups respectively (RR, 95% CI 3.6; 2.02–6.33, P< 0.001). The mean (SD) fall in pain score at 1 hour was significantly higher among intervention arm as compared to control arm [1.51 (0.5) and 1.06 (0.5); P

Subacute Sclerosing Panencephalitis (SSPE) is a very rare and deadly complication of measles infection, with its incidence being signicantly higher in developing countries. Our retrospective analysis of four patients highlights another ominous trend of this deadly disease, i.e, early age at onset leading to a rapid progress of symptoms. Four patients, presenting to the pediatrics department of a tertiary care hospital of eastern India, from February 2020 To December 2020, diagnosed as SSPE, by the modied Dyken's criterion, were analyzed. Paired CSF and serum samples were taken from all the patients and were analyzed for measles-specic IgG in serum (dilution 1:404) & CSF (dilution 1:2) using measles specic IgG ELISA (Enzyme-linked immunosorbent assay) kit. All the patients were under 6 years of age with a mean latency period of 2.5 years. All had contracted measles infection before receiving the scheduled rst dose of vaccine at 9 months of age. Treatment was initiated according to the institutional protocol, keeping in mind the affordability. However, follow-up of the patients reected the rapid progression of the disease. High morbidity and mortality is associated with SSPE in developing countries like India, where treatment availability and affordability becomes a major issue. In order to prevent this disease, it is necessary to prevent measles infection. Recent studies have recorded early disappearance of maternal measles-specic antibodies thus pointing towards the need to vaccinate early. Our case series emphasizes the need to revamp the current vaccination strategies in India with particular focus on re-scheduling the rst dose to 6 months of age.

This observational cross-sectional Study was done in the Institute of Cardiovascular Sciences in R. G. Kar Medical College and Hospital from February, 2015 to December 2016. Atotal of 220 hypertensive patients were included through simple random sample selection. Patients who full the inclusion and exclusion criteria were enrolled for the study after getting written informed consent. This study was carried out using the echocardiogram as the gold standard for the diagnosis of LVH. The new score proposed here, of which cutoff for the diagnosis of LVH was arbitrarily set at 2800mm-ms, is easily applicable in clinical practice and presented the best correlation with the LVMI, when compared to some classic electrocardiographic criteria.

The synovial sarcoma is a malignant soft-tissue tumor that most commonly occurs in the extremities of young adults. The chest wall’s primary synovial sarcoma is extremely rare, and only a few cases of the synovial sarcomas of the chest wall and pleura have been reported. Surgery is the mainstay of the treatment with adjuvant chemotherapy, and radiotherapy plays a significant role, especially in the larger tumors. Here, we report a very rare case of the synovial sarcoma of the anterior chest wall in a middle-aged gentleman and discuss the management and poor outcome despite the aggressive treatment.

The chiral behavior of the macroscopic and nanoscopic objects is ubiquitous. In the last ten years, the research on chiral inorganic nanomaterials has witnessed tremendous growth due to their shape, size, crystal facets-controlled unparalleled physical, chemical, optoelectronic, and bio-compatibility features. Due to the quantum confinement, the chiral nanomaterials exhibit high anisotropy factors, and therefore there has been an upsurge in research activities related to chiroptical and (bio)recognition properties of optically active inorganic nanomaterials. Advancement in synthesis and characterization technologies has made it possible to prepare more and more complex multi-functional materials. Inorganic nanoparticles exhibit fascinating semiconducting or metallic behavior and when combined with chirality, another degree of freedom over achiral systems, their usability in various devices enhances drastically. In this Review, we discuss different chemical routes to transfer chirality from intrinsic chiral systems into achiral nanomaterials for optoelectronics and bio-applications, in the light of recent experimental findings. However, to date, imprinting chirality, device fabrication, scalability, long-term stability, and reproducibility remain challenging tasks that need to be addressed. As the synthesis and growth mechanisms of chiral inorganic systems could be found in literature, here we shed light only on the complimentary metal-oxides semiconductors (CMOS), and bio-compatibility of either intrinsic or imprinted chiral nanomaterials and their potential application in next-generation chiroptical devices. We also discuss feasible strategies to resolve existing issues related to the integration into devices and their operational aspects.

Most of automotive and aerospace industries use journal bearing as support for rotating elements. It is because of such bearings exhibits prolonged material life and has better performance. In this research, material modeling and numerical simulation of an elliptic bore journal bearing with isotropic roughness is carried out for load carrying capacity (LCC) using finite difference method. The LCC is a governing parameter, which decides the bearing material and its implication for a particular bearing application. Load is evaluated by integrating the hydrodynamic pressure over bearing area. Subsequently, it is observed that bearing load depends on eccentricity(e), Non-circularity (G), L/D ratio (β) and roughness parameter (Y) due to which there is a complex effect of all these parameters on bearing performance and therefore on material selection. A grey based Taguchi optimization model is developed with four factors at two levels, to find the best combination of bearing parameters on the LCC. Optimized load carrying is achieved at e2-G1-β2-Y1 condition. The isothermal and the thermal non-dimensional loads are 7.0605 and 3.3 respectively in this condition.

Introduction: Tobacco is the leading causative factor for both oral potentially malignant disorders and oral cancer. Tobacco use is higher among lower income population. Low-income population of India are majorly employed as industrial workers. The aim of this study is to estimate the prevalence of oral lesions associated with tobacco related habits among industrial workers. Materials and Methods: Cross-sectional epidemiological investigation was conducted among 1000 industrial workers using simple random sampling technique. Information on patient demographics, tobacco related (smoke and smokeless) and other deleterious habits, and clinical examination details were recorded in a structured format. The data were analyzed using Statistical Package for Social Sciences version 20.0. Results were tabulated using frequency distribution and mean with a standard deviation. Multiple logistical regression was used to analyze oral lesions by different variables. Results: Among the 1000 industrial workers screened, smoking habit was observed in 13.20%, while 86.8% were using smokeless tobacco. The prevalence of tobacco related oral lesions among individuals with smoke/smokeless tobacco habit was 13.8%. The study documented tobacco related oral lesions such as leukoplakia (6.5%), oral submucous fibrosis (2%), smoker’s palate (2.7%), tobacco related pigmentation (1.9%), erythroplakia (0.3%), and oral squamous cell carcinoma (0.2%). Conclusion: The study documented potentially malignant disorders and oral cancer among users with tobacco related habits. The results also revealed that higher prevalence of potentially malignant disorders over oral cancer. Thus, preventive programs for early detection of oral precancer and oral cancer such as tobacco cessation, tobacco counselling programs are emphasized for industrial workers.

Background: Health can be defined as more than an absence or lack of disease. It is generally related to personal, physical, social, along with spiritual wellness. However, the importance of good health is comparable with a progressive physical and cognitive limitations due to aging and hence, its clear definition is not possible. Hence, most of the important aims or goals in aging are unrelated to finding a cure but rather toward achieving an optimal function. Thus, a healthy aging process that encompasses physical, mental, psychological, and spiritual well-being is always much desired. Aim and Objectives: The aim and objective of this study is to assess the oral health status and degree of cognitive impairment along with dementia, if present. Materials and Methods: This is a prospective and cross-sectional analysis comprising of 300 study participants of which 150 are males while 150 are females. Cognitive ability is assessed using the Standardized Mini-Mental State Examination (SMMSE) scoring test. A score value lesser than or equal to 23 is considered as low, whereas a score of 24 and above represents normal cognitive abilities. Subjects with low score are selected for the study. Oral health status is assessed by examining a) total numbers of teeth present; b) presence or absence of denture use; and c) capacity for masticatory or chewing ability (recorded as yes or no). Demographic variables parameters include age, gender, and presence of smoking habit. Clinical parameters or variables are analyzed by employing the independent t-test and Chi-square test. Pearson's correlation analysis is used to test a correlation between impairment of cognitive capacity, oral health status, masticatory capability, and use of dentures, if present. Two-tailed t-test is used to derive a P value for significance. Results: The total numbers of teeth present are significantly correlated with a lower SMMSE score (R = + 0.56; P = 0.03) while a significant association is noted between ability for mastication and lower SMMSE score (P = 0.05). Conclusion: This study concluded that loss of cognition or dementia is closely related to a poor oral health status.

Carbon nanotubes (CNTs) have been synthesized by a simple and efficient pyrolysis technique, and composites of CNTs with PEDOT:PSS, and with P3HT:PCBM blend have been prepared by a modest solution treatment. Bulk heterojunction organic photovoltaic cell (OPVC) has been fabricated by spin coating technique with configuration ITO/PEDOT:PSS/P3HT:PCBM/Al to serve as reference OPVC. Three more OPVCs have been fabricated by the same procedure, the first one with CNTs/PEDOT:PSS composite replacing PEDOT:PSS, second one with CNTs/P3HT:PCBM composite replacing P3HT:PCBM blend, and the third one with both replacements. The performances of all the OPVCs at room temperature have been compared and CNTs have been observed to cause extraordinary increment in the power conversion efficiency (PCE) as well as other electrical parameters of all the devices depending on the layer in which they have been incorporated. To extend the study for understanding further advantages of CNTs incorporation in fighting against degradation, all the fabricated OPVCs have been exposed to open atmosphere and their electrical properties have been measured at room temperature in regular intervals. Encouragingly positive outcomes have been attained, demonstrating not only a well maintained enhancement in the PCE, but also a considerably improved device stability. The best performing OPVC has achieved 24% more PCE and 67% more lifetime in open atmosphere than the reference device, which clearly does indicate the significance of applications of filler CNTs to improve not only the performance but also the stability of OPVCs.

OBJECTIVE: Quantitation of mechanical properties of a novel locking compression plate (LCP) for bovine tibia. STUDY DESIGN: Prospective in vitro study. SAMPLE POPULATION: Adult Murrah buffalo (250‐350 kg) tibiae. METHODS: Forty tibiae were randomly assigned to five treatment groups (n = 8/group): intact bone and bone constructs with a standard nonlocking plate, single LCP, double LCP, and novel LCP. During implant application, a mid‐diaphyseal, oblique osteotomy was performed in all constructs, which were subsequently tested in axial compression (n = 4 each) or three‐point craniocaudal bending (n = 4 each). Novel LCP alone (n = 4) was tested only in bending. Stiffness, yield load, ultimate failure load, and bending moment were determined from the load deformation curves and compared among different treatment groups (P

The research paper addresses a robust tilt fuzzy cascade (TDF(1+TI)) controller for frequency regulation of an islanded AC microgrid under different uncertainties. The proposed microgrid is modelle...

Objective: Supraflex (Sahajanand Medical Technologies Pvt. Ltd, Surat, India) is the latest generation of biodegradable polymer-coated sirolimus-eluting coronary stent designed on ultra-thin (60 µm) cobalt–chromium platform with flexible “S-link.” The present study was designed to establish the safety and clinical performance of Supraflex in real-world Indian patients with coronary artery disease. Methods: The study included 839 consecutive patients with coronary artery disease who were implanted with Supraflex from January 2014 to August 2017 at six different tertiary care centers in India. Follow-up was performed at 30 days, 6 months, and 12 months after the index procedure. The primary end-point of the study was the incidence of major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) at the 12-month follow-up. The occurrence of stent thrombosis was analyzed as safety end-point. Results: A total of 1025 lesions were treated by implantation of 1098 Supraflex stents. At the 12-month follow-up, MACE was 4.92%, including 7 (0.86%) cardiac deaths, 16 (1.97%) MI, and 17 (2.09%) TLR. Only three incidences of stent thrombosis were found at the 12-month follow-up. Conclusion: The study results showed excellent safety and clinical effectiveness of Supraflex in a high proportion of high-risk real-world Indian patients with coronary artery disease. (Anatol J Cardiol 2020; 24: 364-9)

Purpose Fingertip injuries are common in the industrial and factory workers as well as in the domestic settings. Loss of pulp hampers daily life activities. Functional and aesthetic aspects are important in fingertip reconstruction. The bone is usually exposed along with soft tissue loss. Therefore to reconstruct the pulp flap with adequate bulk is required. Methods We are reporting a case series of 12 patients with the injury over the volar aspect of distal phalanx of the index or middle finger. In all cases laterally based thenar flap was chosen. The flap donor site was closed primarily in most of cases, while 4 patients required skin graft. The flap was detached in between 2-3 weeks. Functional assessment was done using static and dynamic 2-point discrimination and range of motion at each joint. The aesthetic outcome was assessed through questionnaire. The results were analyzed using the unpaired t-test (SSPS version 21). Results Partial necrosis occurred in 2 cases while rest of flaps survived successfully. Static 2-point discrimination ranged from 6-10 mm with mean 8.6 mm and dynamic 2-point discrimination ranged from 8-10 mm with mean 8.9 mm. Mean satisfaction score was (4.0±0.55). Conclusion Thenar flap is a good choice for reconstruction of the finger pulp as it provides the bulk with good functional and aesthetic outcome.

In the past decades to meet the increases in population demand, farmers have utilized huge amount of agrochemicals to increase the crop production. However, in the present era, there is an awareness regarding the adverse consequences posed by the agrochemicals to human health and the environment. Such concerns are driving the search for more environmentally friendly methods to control plant disease that will contribute to the goal of sustainability in agriculture. Plant growth promoting rhizobacteria (PGPR) are found to be a potential alternative to chemical pesticides with an ability to antagonize and prevent plant disease. Fluorescent pseudomonads are one of the common PGPR which have received much attention in recent years as biocontrol agent. Fluorescent pseudomonads are known for its production of diverse microbial metabolites including antibiotics, siderophores and volatile compounds such as HCN. Moreover, it also possesses plant growth-promoting traits such as nitrogen fixation, phosphate solubilization, iron chelation, and phytohormone production. Hence, this chapter will give an importance and overview of the Fluorescent pseudomonads as a potential biostimulant for sustainable crop production.

The pandemic COVID-19 has tremendously affected the food industry, particularly, the restaurants and other food vendors (FVs) that serve ready-to-eat foods. These food industries have been badly hit not only because of the lock down, imposed for COVID-19 containment, but also because of the consumer’s concern for food safety. To revive the processed food industry, it is necessary to win back the consumer’s confidence, which in turn requires a number of steps to be taken by both the policy makers and the food business operators. In this context, the present article describes how the maintenance of hygiene at places of food production would be important for the food industry in the COVID-19 regime. It has recommendations that could be useful for both food safety regulators and food business operators.

Background: Febrile convulsions are the most common provoked seizures affecting children. Low magnesium level leads to cell and membrane excitability thereby causing seizures. Objective: The objective of the study was to determine the role of serum sodium, calcium, magnesium, and zinc in children with simple febrile seizures (SFSs). Materials and Methods: This was a case–control study done in children admitted in the pediatric ward. Children with SFSs were taken as cases while children with fever but without seizures served as controls. After obtaining informed consent, details of each child were recorded, which included age, sex, seizure details (duration, type), nature of the febrile illness, and history of febrile seizures (FSs). Estimation of serum sodium, zinc, magnesium, and calcium was done. Results: The present study included 120 subjects, out of which 60 were cases and 60 were controls. The male-to-female ratio was 2:1. In our study, there was no significant difference in the levels of calcium, magnesium, and zinc in cases with FSs and controls. Although the serum zinc levels were in the normal range, majority of the children with SFS had serum zinc levels toward the lower range of normal which was statistically highly significant. Conclusion: Our study found that SFSs occurred more frequently in boys. The levels of serum calcium and magnesium were normal and did not correlate with SFS. Low serum zinc level had a direct correlation with SFS, although this level was within the defined normal range.

The present manuscript highlights on the frequency regulation of an islanded AC micro-grid under different uncertainties. The advancement in battery-operated vehicles (electric vehicles) keeps envi...

The paper proposes to use an improved Grey Wolf Optimization (GWO) optimized Fractional Order (FO) based type-II fuzzy controller for frequency regulation of an AC microgrid in presence of plug-in electric vehicles. The AC microgrid comprises various renewable-based energy sources such as wind turbine generator (WTG), photovoltaic cell (PV), microturbine (MT), aqua electrolyzer based fuel cell (FC) and diesel engine generator (DEG) along with various storage devices (ESD) like battery energy storage (BES), flywheel energy storage (FES) and electric vehicles (EV). The uncertain nature of solar, wind technologies and load demand makes the system more complicated and introduces the frequency oscillations in the system. It is highly needed to establish power balance among generation by designing an appropriate controller for frequency regulation. This paper proposes a robust fractional order type-II fuzzy PID (FO-T2-FPID) where the parameters of the FO-T2-FPID controllers are optimized by suggesting an improved GWO (I-GWO) algorithm. To demonstrate the capability of proposed I-GWO algorithm few comparative analyses have been performed over particle swarm optimization (PSO) and grey wolf optimization (GWO) algorithm. It is also observed that for the same FO-T2-FPID controller structure, the percentage improvement in the objective function (ITAE) under load uncertainty by I-GWO compared to GWO and PSO are 29.74% and 65.94% respectively. Finally, it is conferred that proposed I-GWO optimized FO-T2-FPID controller significantly improves microgrid dynamic performance under various operational conditions.

Background: Vitamin D status in sickle cell children (SC) has been widely discussed and its effect on clinical profile among SC is currently highly debatable. Objective: The objective of this study was to determine the clinical outcomes in terms of morbidities for Vitamin D supplementation among Vitamin D deficiency (VDD) SC. Materials and Methods: A total of 428 children as per predefined inclusion and exclusion criteria were enrolled in this present prospective study, after receiving written informed parental consent. Patients were supplemented with Vitamin D according to their serum status and followed up at 3 subsequent visits (0, 6, and 12 weeks). All the relevant statistics were done by SPSS v 25.0 (IBM, New York). Results: A total of 428 diagnosed cases of sickle cell anemia were enrolled, from which 272 (63.6%) were male and 156 (36.4%) were female, and 393 cases were found to be VDD (92%). The mean age of the study population was 88.39 (46.27) months. Vitamin D supplementation was significantly associated with decrease in number of vaso-occlusive crisis, duration of hospitalization, and duration of pain hours (p

The levels of vitamin D have an important effect on bone mass in young and old. Hypovitaminosis D adversely affects calcium metabolism, osteoblastic activity, matrix ossification, bone remodeling, and hence bone density. Objective: The present study was conducted to determine the status of serum 25(OH)D and BMD of healthy adult men in Manipur and also to find out the relationship of 25(OH)D level with BMD. Methods: A cross-sectional study was conducted in Department of Physiology in collaboration with the Department of Physical Medicine & Rehabilitation, Regional Institute of Medical Sciences (RIMS), Imphal from October 2014 to September 2016. 100 Healthy adult males in Manipur in the age group 18-35years and ≥50years were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. The serum 25-OH vitamin D level was estimated by using an enzyme immunoassay (EIA) kit (IDS immunodiagnostic systems, United Kingdom). The BMD of lumbar spine was determined using enCORE – based X-ray bone densitometer (Lunar Prodigy advance, GE Medical Systems, USA) which is based on DEXA scan. Results: The present study revealed that the majority of subjects with insufficiency of 25(OH)D had low bone mass, whereas all the subjects with 25(OH)D deficiency had BMD readings consistent with osteopenia or osteoporosis in both the age groups. This study also showed a positive correlation between BMD and 25(OH)D in most subjects, particularly in the groups with insufficiency or deficiency of 25(OH)D.Conclusion: In conclusion, the study shows a positive relationship between the serum 25 (OH) D concentrations and BMD. Keywords: Serum 25(OH)D; Bone mineral density (BMD); Enzyme immunoassay (EIA).

Background: Depression, a multi-dimensional disorder adversely affects the interpersonal, social and occupational spheres of students’ life. It is the 11th leading cause of global disease burden. Aims and Objectives: To assess the prevalence of depressive symptoms among various professional course students including medical, dental, and engineering students in Patna, Bihar. Materials and Methods: The present investigation was a questionnaire-based cross-sectional descriptive study. A total of 3,100 students attending government and private medical, dental, and engineering colleges in Patna were approached during the course of this study. Students were briefed about the study and questionnaire. BDI-II (Beck's Depression Inventory-II) was administered to the students and they were instructed to fill it. Beck's scores were recorded and a descriptive analysis performed. Results: 2798 students out of 3,100 responded positively to the survey by completely filling out the form. The overall response rate was 90.25%. The overall prevalence of depressive symptoms was found to be 47.78%. Of the three streams, students belonging to the engineering stream (40.28%) showed a maximum prevalence of depressive symptoms followed by dental (38.50%) and medical students (34.74%). Conclusion: Our study showed an alarming prevalence of depression among professional course seeking students. This multi-dimensional disorder continues to affect student's performance and professionalism, thus, extending its negative impact to the community at large. This may carry out later in their lives, thus leaving a long-term negative impact. Considering the high rate of depressive symptoms, establishing a unit or facility to identify or diagnose it at an early stage and providing psychological support to students is recommended.

COVID-19 viruses are primarily transmitted between people via respiratory droplets generated from an infected person while coughing, sneezing, exhaling or close contact. Hence, the use of masks are part of prevention and control measures to limit the spread of COVID-19. A comprehensive study on various materials used in masks is required. The filtration efficiency of cotton masks increases with increase in thread count and number of layers, but breathability is affected and therefore a risk for longer durations. Cotton-based masks have filtration efficiency ranging from 5% to 80% depending on the number of layers. Combinations of different hybrid fabric materials and design have an efficiency ranging from 37% to 97%. Bio-cellulose, which is derived from cellulosic biomass by synthesis techniques involving various physical and chemical processes followed by refining techniques, possesses remarkable properties including biodegradability, biocompatibility, low toxicity, etc., making it the most suitable mask material. Masks made of bio-cellulose have an important property of hydrophilicity which makes it adhere to the face tightly, giving a cooling effect to the face. Use of nanocellulose masks can help attaining filtration efficiency up to 99.9980–99.9995% along with other desirable properties. Hence, there is an immediate need to address the issues and challenges of mask materials and work towards the design and development of low cost masks to overcome these shortcomings by the researchers and manufacturers.

Introduction: Tonsillitis is widespread among children and has serious poststreptococcal complications, and both the patients and the otolaryngology surgeon have to face the question on what is the role and benefit of using long-acting penicillin and whether it is an alternative method of treatment to surgery? This study was carried out to evaluate the effectiveness of tonsillectomy compared with long-acting penicillin in the treatment of recurrent tonsillitis, comparing their effects on the levels of the antistreptolysin O titer (ASOT) and erythrocyte sedimentation rate (ESR). Methods: This study was carried out as a prospective study. A total of 100 Children were chosen for this study. Subjects fulfilling the inclusion criteria like , Age of 5–15 years , Children suffering from recurrent tonsillitis with signs of chronic tonsillitis: inequality in the size of the tonsils, enlarged cervical lymph nodes, and pus in the tonsillar crypts 6 , Severe attacks of tonsillitis: seven times in 1 year or five times in each of 2 years, or three times in each of 3 years & An ASOT of greater than 400 IU/ml and an ESR of greater than 30 ml/1 at 1/2 h 10,11.were selected by simple random sampling method. Results : The frequencies of occurrence of fever, cough, obstructive sleep apnea, unequal tonsil size, and pus in the tonsillar crypts were 80% , 51 % , 4% , 52% , and 48 %, respectively. Effect of tonsillectomy versus the effect of long-acting penicillin on ASOT, we found that the levels after 3 months were lower in patients who were treated by tonsillectomy than in those who were treated with long-acting penicillin; the difference between both the groups was found to be statistically significant. Conclusion: This study presents important insight into the alternate treatment regimens of Recurrent Tonsillitis in rural children. This study demonstrates that the first line of treatment of recurrent chronic tonsillitis is tonsillectomy, as it is both clinically effective and cost-effective for children and that the second line of treatment is long-acting penicillin with long-term follow-up, and in patients, have contraindications for surgery such as bleeding diathesis.

Patients with the chronic obstructive pulmonary disease have ongoing systemic inflammation, which can be assessed by measuring serum C- reactive protein. Objective: To explore whether CRP could be used as an independent predictor of disease outcome in COPD. Methods: A cross-sectional study was conducted among 50 COPD patients attending Respiratory Medicine outpatient services in the Regional Institute of Medical Sciences (RIMS), Imphal from January 2015 to September 2016. Patients aged 18-67 were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. Computerized Spirometer Helios 401 was the instrument used to measure lung volumes and capacities. BeneSpheraTM CRP Latex Slide test kit was used to estimate serum c-reactive protein. Results and observation: The present study was conducted on fifty COPD patients in which serum CRP level showed positive correlation with COPD (p=0.002) but serum CRP level with spirometric parameters showed significant negative correlation;FEV1 (r=-0.451, p=0.001), FEV1/FVC (r=-0.617, p

Ecotourism is a growing arena of tourism industry and is a potential tool for sustainable development. This study focuses identifying potentials of ecotourism in Tinjure-Milke-Jaljale (TMJ) area in Eastern Nepal via assessing flow of tourists, purpose for visits, major natural attractions, physical infrastructures and human resources available in the region. Direct interviews were conducted with respondents purposively selected from 50 households using structured questionnaires. Demographic variables and visit purpose were expressed in numbers and percentage using MS-Excel soft ware. A descriptive analysis was performed for the natural features, human resource, physical infrastructures and cultural entities which were collected using standard checklist. Results showed that TMJ was visited by approximately 1, 00,000 internal and 600 international tourists throughout the year in 2018.Th e main purpose of visit to TMJ was to adhere the beauty of rhododendron or landscape followed by religious, study and recreational purposes respectively. While 80% percent of the respondents were aware of the need towards biodiversity conservation focusing Rhododendron forests which listed as a major attraction in the region and 78% agreed to impacts of tourism the area, 75% were unfamiliar with the concept ecotourism. The region with more than 80% forest coverage harbors natural and cultural attractions such as Deurali Bhulke picnic spot, Rock and Rhododendron Garden, Basantapur Botanical garden and view Tower, Tinjure Dada Pathivara Temple, Gupha Pokhari, Singhabahini Devi Temple, Gaunkhuridham, Siddhakali, Sabhapokhari. The present natural and culturally important areas in TMJ show good prospects for ecotourism. However, a detailed study focusing number of seasonal flow of tourists and services provided addressing visitor’s perception is seen important to improve ecotourism.

Background: Transfusion therapy in patients with thalassemia major needs to address the common questions such as what should be the optimal hemoglobin (Hb) level for effective transfusion and how do transfusion requirements affect the success of iron chelation therapy. Objective: The objective of the study was to evaluate iron overload and adequacy of packed red blood cells (PRBCs) transfusion in children with thalassemia major along with the correlation of serum ferritin level with transfusional iron load and pre?transfusion Hb level. Materials and Methods: This single?center retroprospective observational study was carried out in thalassemia day care center of tertiary care hospital for 1 year over 32 transfusion?dependent ??thalassemic patients up to 18 years of age. Data including pre?transfusion hemoglobin level, number and volume of PRBC transfused, and serum ferritin level for 1 year were analyzed, and annual transfusion iron load was calculated. Correlation of serum ferritin level with transfusional iron load and pre?transfusion Hb level was determined using Pearson coefficient (r) and p-value. Results: The mean pre?transfusion hemoglobin level was 6.4±0.23 g%. The average number and volume of PRBCs transfused in a year were 12.5±3.02 and 112 ml/kg, respectively, with the average annual transfusional iron load of 121.3 mg/kg ±28.9 or 0.3 mg/kg/day. A significant positive (r=0.4184, p=0.017) correlation was observed between serum ferritin level and transfusional iron load with the mean serum ferritin level of 1744±604.6 ng/ml. Negative correlation was observed between serum ferritin and pre?transfusion Hb level (r=?0.2624 and p=0.1537). Conclusion: All patients were undertransfused and this undertransfusion further leads to more accumulation of iron in the body through increased absorption of dietary iron as a result of anemia and ineffective erythropoiesis.

Introduction: Diabetes mellitus (DM) is an important public health problem, where patients do not present with any pulmonary complaints because of large vascular and ventilatory reserve. As obesity is regarded as one of the risk factors leading to diabetes, the present study will try to determine the effect of body mass index (BMI) on pulmonary system. Aim: The present study is aimed to find out the effect of BMI on pulmonary function tests (PFTs) among diabetic patients. Materials and Methods: The study was undertaken in the departments of Physiology and Medicine to determine the effect of BMI on PFTs. Thirty (30) known diabetic patients were recruited from medicine OPD on the basis of guidelines according to American Diabetes Association (ADA) and they were divided into two groups based on their BMI. PFTs were performed using computerized spirometer. Data were entered and analyzed using independent student’s t-test. Results: Patients with higher BMI have reduced values of Forced Vital Capacity (FVC), Forced Expiratory Volume in 1st sec (FEV1), FEV1/FVC, Forced Expiratory Flow in between 25%-75% (FEF25-75%) compared to those with lower BMI, whereas with higher BMI, Peak Expiratory Flow Rate (PEFR) was increased. The differences in FEV1, PEFR and FEF25%-75% values among the two groups were found to be significant (p-values are 0.003, 0.05 and 0.026 respectively). Conclusion: Increased BMI can have detrimental effects on pulmonary functions among diabetics. So, early awareness about body weight and prevention strategy would be important steps towards making a diabetes free nation. Keywords: Body Mass Index (BMI), Diabetes Mellitus, Pulmonary Function Tests (PFTs).

Aim: This study aimed to evaluate concurrent laparoscopic totally extraperitoneal (TEP) inguinal hernia repair and transurethral resection of the prostate (TURP) with determination of outcomes. Materials and Methods: This retrospective study was conducted at our hospital, from June 2011 to June 2020. Over 9 years, 17 patients with co-existing uncomplicated unilateral or bilateral inguinal hernia (primary/recurrent) and significant benign prostatic hypertrophy were operated in the same sitting. The following outcomes were compared: duration of the surgery, conversion to open hernia surgery, intraoperative and post-operative complications, duration of hospital stay, recurrence, time taken to resume normal activity and cost of the treatment. Results: This study included 17 patients with a mean age of 65 years (range of 50–87 years). The average time taken for the surgery was 115 min with no conversion to open hernia repair. The mean post-operative stay was 3.7 days. There were four patients (23.5%) with seromas identified at day 10, only two remained at 6 weeks and none at 12 weeks. None had significant bleeding intraoperatively or postoperatively. There was no superficial or deep wound infection (including mesh infection). There was no recurrence of inguinal hernia. Two patients (11.7%) developed post-TURP urethral stricture and underwent cystoscopic stricturoplasty, 3 and 2.5 months after the initial procedure. The time taken to resume normal activity was 7 (±1) days. The hospital cost is reduced by 25% as compared to the sum of costs when both the operations are done separately. Conclusion: Concurrent TEP inguinal hernia repair and TURP is a practical, safe and cost-effective procedure.

Introduction: Dental anxiety negatively affects patients’ oral and overall health. This study explored attitudes and clinical practices of licensed Bihar general dentists who treat patients with dental anxiety. Methods: An anonymous self-administered mail survey was sent to 250 general dentists licensed and practicing in Bihar. Responses to 21 pre-coded questions were analysed. Frequencies were examined; cross-tabs, Chi-Square, and Fischer’s Exact Test were calculated for statements according to dentists’ gender. Alpha was set at p = 0.05. Results: Nearly all respondents treated anxious patients; males were more likely to find it challenging than females. Dentists were most familiar with distraction, although half found Tell-show-do to be an effective tool. Female dentists were more likely than males to be familiar with anxiolytics and find them effective. Conclusion: Overall, Bihar general dentists are most familiar with using distraction and Tell-show-do during appointments for anxious patients. Gender differences exist in attitudes towards anxiolytic use for patients with dental anxiety. Practice Implications: By identifying techniques that are comfortable for patient and practitioner, oral health disparities associated with dental anxiety may be reduced.

Sinus of Valsalva Aneurysms are extremely rare cardiac anomalies.The sinus of Valsalva aneurysm (SVA) is a small dilatation caused by a separation between the aortic media and annulus fibrosus. Its may be either acquired or congenital. The right coronary sinus is most frequently affected. The most common complication being rupture.We present the case of a 12-year old girl with ruptured non-coronary sinus of valsalva aneurysm associated with ventricular septal defect , mitral regurgitation grade II and severe pulmonary hypertension. Echocardiography is sufficient to diagnose SVA, its complications, repercussions, and surgical options. SVA, even if asymptomatic, has potential risks of expansion,rupture, cardiac failure, endocarditis, embolism and sudden death. This justifies surgical correction, with a low mortality rate in both the short- and long-term. KYAMC Journal Vol. 10, No.-4, January 2020, Page 211-213

Patients with moderate to severe dry eyes are often screened at the Dry Eye Clinic to rule out connective tissue diseases. Rheumatoid factor (RF) is one of the screening tools to rule out rheumatoid arthritis (RA). Patients who turn out positive for the RF are often subjected to anti-CCP antibody evaluation for confirmation of disease. This article tries to highlight 3 cases of negative and anti-CCP antibody positive cases which presented to the ophthalmic clinic, unaware of their systemic status. Though RF is the cheapest modality to screen for RA, it is not always a reliable marker. One should order anti-CCP antibody for patients where suspicion is high, despite RF being normal.

Reverse sural flap (RSF) is commonly used for soft tissue reconstruction of distal leg and heel defects. The classic method of flap transfer is the single-staged cutaneous islanded reverse sural flap (SS-RSF). This method is associated with variable flap complications notably the venous congestion. The other form of flap transfer is the two-stage reverse sural flap (TS-RSF), in which the pedicle of the flap is exteriorized in the first stage. Flap division and re-inset are done in the second stage. The aim of this paper is to review the flap outcomes and complications among the SS-RSF and TS-RSF reconstruction of soft tissue defects in the distal leg and heel. This is a retrospective chart review of RSF being operated in a tertiary care hospital. The duration of study was 1.5 years. Twelve RSFs (6 SS-RSF, 6 TS-RSF) were done for soft tissue defects in the distal leg and heel. Wounds of various etiologies (traumatic, chronic, non-healing ulcers) were reviewed. Trauma was the most common etiology with 8 out of 12 (66.7%) patients. Large wounds, donor site damage and patients with peripheral vascular disease were excluded from the study. Five out of six (83.3%) of TS-RSF healed uneventfully. However, 3 out of 6 (50%) of SS-RSF had partial flap necrosis. All complicated flaps healed well subsequently. No donor site complication was found in any of our patients. Pedicle exteriorization in TS-RSF eliminates the element of venous congestion and eventually flaps necrosis. Less technical expertise and minimal morbidity are additional advantages of TS-RSF. Level IV, therapeutic study.

Introduction: Many studies have been done for screening of congenital heart disease (CHD) in the neonatal period utilizing pulse oximetry as a screening tool along with routine clinical assessment, but none of them from our province. Objective: The objective of the study was to find out the diagnostic accuracy of pulse oximeter at three different sites as a screening tool to diagnose CHD among neonates. Methods: A diagnostic study was conducted in neonatal intensive care unit of a tertiary care hospital of Odisha from October 2016 to September 2018 after approval from the Institutional Ethics Committee. Three hundred and seventy-four neonates (both inborn and outborn) with gestational age >34 weeks were included in the study. Oxygen saturation (SpO2) in the right hand (RH), right foot (RF), and left foot (LF) was estimated by pulse oximeter among all participants after 10 min of postnatal life. All the study subjects were evaluated by two-dimensional (2D) echocardiography for the detection of CHDs. All the diagnostic accuracy tests (sensitivity [Sn], specificity [Sp], positive predictive value, negative predictive value, and diagnostic odds ratio) were calculated taking 2D echocardiography as the gold standard with software, and for all statistical purpose, p

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease in which there is developmental absence of connection of all four pulmonary veins with the left atrium. To report a rare case and share our experience in surgery and post-operative management for supracardiac TAPVC. Patient with supracardiac TAPVC with atrial septal defect (ASD) secundum variety with rudimentary patent ductus arteriosus (PDA) underwent rechanneling of pulmonary veins to left atrium (LA) with gluteryldehye treated autologous pericardial patch closure of ASD with ligation of ascending vertical vein and ligation of rudimentary PDA.Post operatively there were no events of pulmonary hypertensive crisis, low cardiac output syndrome, right heart failure or conduction defect were observed and echocardiogram showed adequate pulmonary venous drainage with no residual shunt across the interatrial septum. Marked development in surgical results of TAPVC has been observed in recent years with declining mortality rate from 65% in early sixties to 5% in current surgical scenerio. KYAMC Journal Vol. 10, No.-2, July 2019, Page 118-121

This study sets out to identify the various factors of a health drink product that affects the consumer decision-making process. It aims to determine the relative importance connected to multiple aspects of health drink beverages, such as brand, nutrition content, taste, muscle building, brain boosting, price, ingredients, and country of origin. The paper also aims to identify consumer segments by the relative importance consumers give to various attributes of health drinks. Through examining the literature, the researchers identified various attributes of health drinks, which they analyzed empirically using a choice-based conjoint survey conducted with the help of the internet-based software 1000minds. Cluster analysis was also done to identify different consumer segments. The study identified two consumer segments: brand conscious and value conscious. As the name indicates, the brand-conscious segment gives more importance to a trusted brand, followed by nutrition content and price.