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The current recommendations by Indian experts who are focused on the challenges in the management of patients with acute coronary syndrome (ACS) in rural areas, due to limited catheterization (CATH) lab facilities and interventional cardiologist coverage across the country, are described. 120 cardiologist experts drafted recommendations during ten advisory board meetings conducted from April to May 2022. Experts framed statements based on experience, collective clinical judgment from practical experience, and available scientific evidence regarding ACS. The consensus positioned fondaparinux as highly useful in non-CATH-lab-based hospitals for patients diagnosed with non-ST elevation acute coronary syndrome (NSTE-ACS) and ST elevation acute coronary syndrome (STE-ACS) patients who cannot be shifted to percutaneous coronary intervention (PCI)-capable centres, or for patients who are thrombolysed at peripheral centres. [ABSTRACT FROM AUTHOR]

Congenital hemolytic anemia (CHA) especially hemoglobinopathies is quite prevalent in certain ethnic groups in India and commonly seen in pediatric age group. Adult presentations are being seen due to better treatment options and increased life span. This study was conducted to determine the clinical profile, laboratory parameters, transfusion requirements, and transfusion-related infectious complications of adult patients with CHA. A total of 84 patients of CHA aged more than 12 years were enrolled and studied over 18 months period. 63% patients were males with mean age of 19.98±4.99 SD years and maximum (57%) in the age group of 13-20 years. Family history of CHA was present in 19 (22.61%) patients and consanguinity in 16 (19.04%) cases which were statistically significant (P<0.05). Easy fatigability (76.19%) was the most common symptom followed by dyspnea on exertion (36.19%), whereas pallor (98.80%) was the commonest finding on examination followed by spleenomegaly (40.47%). The mean average (mean±SD) values for hemoglobin was 7.37±1.23gm/dl, Red blood cell count was 4.71±0.44 million/µL, Mean Corpuscular Volume was 77±5.05 fL, Mean Corpuscular Hemoglobin concentration was 33±1.38 g/dl, Mean Corpuscular Hemoglobin was 23±1.22 pg and mean Mentzer's index was 16.59±2.24. The most common type of CHA in our study was ß thalassemia major (58%), followed by ß thalassemia intermedia (17%) and Sickle cell homozygous (13%). 45% of CHA patients required monthly transfusion (p <0.05) especially sickle cell homozygous (90%) and thalassemia major (65%) patients. 24 (28.57%) patients were Hepatitis C virus-positive and 1 was HIV virus-positive. Among adult patients with CHA, ß thalassemia major, intermedia and sickle cell anemia were predominant diagnoses. Consanguinity played a role in one-fifth of patients. A majority of the patients had monthly blood transfusion requirements. The high prevalence of hepatitis C virus infection is a major concern. [ABSTRACT FROM AUTHOR]

Background: Molecular tests in solid tumours for targeted therapies call for the need to ensure precision testing. To accomplish this participation in the External Quality Assessment Program (EQAS) is required. This evaluates the consistency of diagnostic testing procedures and offers guidance for improving quality. Outbreak of COVID-19 pandemic led to worldwide lockdown and disruption of healthcare services including participation in EQAS.The present study describes the extended scope of EQAS offered byMPQAP (Molecular Pathology Quality Assurance Program), the first proficiency test provider for solid tumor diagnostics in India. The study surveys the preparedness of molecular testing laboratories in routine diagnostics and participation for quality assessment scheme. Methods: A documented guideline for measures and precautions to be carried by testing laboratories in performing routine diagnostic tests during the lockdown period were charted and distributed to all MPQAP participant centres. A survey was conducted for MPQAP participants to check whether laboratories were involved in COVID-19 testing and to evaluate the impact of lockdown on the operations of diagnostics procedures. From the acquired response of the survey, 2 cycles out of initially proposed 11 cycles were executed with transformed approach using digital tools and image interpretation modules. Findings: Out of 25 solid tumour testing laboratories registered as participants, 15 consented to participate in survey. The summary of survey conveyed the impact of COVID-19onroutine operations of diagnostics tests such as shortcomings in inventory and human resource management. Thirteen participants showed active willingness and consented to participate in EQAS test scheme. Interpretations: The survey findings and assessment of EQAS cycles endorsed the quality testing procedures carried by participating laboratories throughout the lockdown. It highlighted the utility of EQAS participation during pandemic along with emphasis on safety measures for continual improvement in quality of diagnostic services. [ABSTRACT FROM AUTHOR]

Justification: When developmental dysplasia of the hip (DDH) is diagnosed during infancy, conservative management is often successful, with good long-term outcomes. In India, DDH is often not diagnosed until walking age and there are limited guidelines for its screening. Process: A multidisciplinary Expert Group consisting of members of the Paediatric Orthopaedic Society of India, Indian Academy of Pediatrics, National Neonatology Forum of India, Indian Radiological and Imaging Association, Indian Federation of Ultrasound in Medicine and Biology, Federation of Obstetric and Gynaecological Societies of India, and Indian Orthopaedic Association worked collaboratively to develop surveillance guidelines for DDH. Objectives: To enhance the early detection rate of DDH in India through development and implementation of a standardized surveillance care pathway, thus reducing the burden of late-presenting DDH. Recommendations: Routine clinical hip examinations must be performed on all infants at birth and during immunization visits at these approximate time points: 6, 10, and 14 weeks; 6, 9, 12, 15, and 18 months of age. Assessments include Ortolani and Barlow tests for infants <14 weeks; limited hip abduction and leg length discrepancy for infants >14 weeks; and evaluation of limp in walking children. If clinical examination is abnormal or inconclusive, referral to orthopedics for further evaluation and management is recommended. In infants younger than 6 weeks with positive Barlow test but negative Ortolani test, hip ultrasound is recommended at 6 weeks of age. Infants must also be screened for DDH risk factors: breech presentation, family history of DDH, unsafe hip swaddling, and hip instability at any previous clinical examination. In infants with risk factors but normal clinical examination, further evaluation should include ultrasound taken no earlier than 6 weeks of age for infants younger than 14 weeks, ultrasound or X-ray for infants 14 weeks to 6 months of age, and X-ray for infants older than 6 months. Referral to an orthopedic surgeon is recommended if radiological tests are abnormal. [ABSTRACT FROM AUTHOR]

In today's competitive world it is very important for any working professional to stay relevant and keep growing. It is also very challenging for our management students to match the requirements of their potential recruiters along with living up to their own expectations from their respective careers. In smaller towns of India, the female MBA students often get affected by certain other factors such as family influence, relocation constraints and the opinion of family members and others about a particular job. Any career choice made by these students without considering these factors can result in unsuccessful careers or early career switches which are often not taken well by prospective recruiters. Understanding the probable impact of these factors on the career choice of female MBA students can not only help them in better decision making for their career choice this can also help their faculties, career counselors and mentors to guide them for a suitable career option. Thus this paper the authors tried to understand the various factors which affect the career choice among female MBA students and to find out whether the demographic profiles of the students affect their career choice. The results drawn from the study can be used by the B-Schools to accordingly guide the female students in finding right careers as per their career choices. A self-designed questionnaire was used in the study and the responses were taken from female students who are currently pursuing their MBA degree from reputed MBA institutes from Madhya Pradesh. Mean, ANOVA and t-test were used for the analysis of the data. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the safety and efficacy of favipiravir, which is prescribed for the treatment of patients with mild-to-moderate coronavirus disease 2019 (COVID-19) in India. Patients and Methods: This was a prospective, open-label, multicenter, single-arm postmarketing study conducted in India. Patients with mild-to-moderate COVID-19 received favipiravir (3600 mg [1800 mg orally twice daily] on the first day, followed by 800 mg orally twice daily, up to a maximum of 14 days) as a part of their treatment. The primary endpoints were to evaluate the safety of favipiravir by assessing the number of adverse events (AEs) and treatment-related AEs. The secondary endpoints were to evaluate the efficacy of favipiravir by assessing time to clinical cure, rate of clinical cure, time to pyrexia resolution, rate of oxygen requirement, and all-cause mortality. Results: A total of 1083 patients were enrolled in this study from December 2020 to June 2021. Adverse events were reported in 129 patients (11.9%), 116 (10.7%) of whom had mild AEs. Dose modification or withdrawal of favipiravir treatment was reported in four patients (0.37%). The median time to clinical cure and pyrexia resolution was 7 and 4 days, respectively. A total of 1036 patients (95.8%) exhibited clinical cure by day 14. Oxygen support was required by 15 patients (1.4%). One death was reported, which was unrelated to favipiravir. Conclusion: In the real-world setting, favipiravir was well-tolerated, and no new safety signals were detected. [ABSTRACT FROM AUTHOR]

Aim: The aim of our study was to study and compare the impact and efficacy of medical nutrition therapy (MNT) with that of the standard nutrition therapy(SNT) in children diagnosed with Severe thiness in the age group of 5-10 years and diagnosed as severely thin. Study Design: It was a prospective comparative study, conducted over a period of 18 months at the Nutrition Rehabilitation, Research and Training Centre (NRRTC) associated with a tertiary care hospital in India. Methods and Materials: A total of 113 children in the age group of 5 to 10 years with severe thinness were enrolled and divided into 2 groups-58 were placed in the MNT group and 55 in the SNT group for a period of 8 weeks. The children in both groups received MNT and SNT diet over the said period of 8 weeks. Primary outcome variables were weight gain and body mass index (BMI) (i.e., change in nutritional status). Results: At the end of 8 weeks, the rate of weight gain (gm/ kg/day) was significantly greater in the MNT group, that is, 2.35 gm/kg/day as compared with the SNT group, that is, 0.73 gm/kg/day, and the change in nutritional status was significantly better in the MNT group (p < 0.001) with 62.1% achieving normal nutritional status, 32.8% remaining thin, and 5.2% remaining severely thin as compared to the SNT group in which 9.1% achieved normal nutritional status, 65.5% remained thin, and 25.5% remained severely thin. Conclusion: To conclude, MNT is superior to SNT for the treatment of severe thinness (ST). [ABSTRACT FROM AUTHOR]

Summary: Equine babesiosis in India has always been a severe and life‐threatening disease attributed to infection with Theileria equi and Babesia caballi. These organisms are not host‐specific, as both T. equi and B. caballi are reported in dogs. Likewise, Babesia canis canis and Babesia canis rossi, the common causative agents in canines, have also been identified in horses. However, no molecular evidence of Babesia gibsoni has been reported in horses in India. A 5‐year‐old Thoroughbred gelding residing in Bengaluru showed signs of recurrent intermittent fever, inappetence, poor performance, anaemia and depression. A regular complete blood count and biochemical profile were done, however, the results were unresponsive to treatment interventions. The blood sample was submitted for screening equine haemoprotozoans using polymerase chain reaction. The current blood sample was screened for haemoprotozoans. The sample was positive for B. gibsoni and was confirmed by sequencing. Basic Local Alignment Search Tool (BLAST) search against GenBank revealed the highest similarity (95.17%, Accession No. MN385430.1) with B. gibsoni 18s rRNA partial sequence. [ABSTRACT FROM AUTHOR]

Naturally-occurring membranes in the xylem tissue of gymnosperm sapwood enable its use as an abundantly-available material to construct filters, with potential to facilitate access to safe drinking water in resource-constrained settings. However, the material's behavior as a filter is poorly understood, and challenges such as short shelf life have not been addressed. Here, we characterize the operational attributes of xylem filters and show that the material exhibits a highly non-linear dependence of flow resistance on thickness upon drying, and a tendency for self-blocking. We develop guidelines for the design and fabrication of xylem filters, demonstrate gravity-operated filters with shelf life >2 years, and show that the filters can provide >3 log removal of E. coli, MS-2 phage, and rotavirus from synthetic test waters and coliform bacteria from contaminated spring, tap, and ground waters. Through interviews and workshops in India, we use a user-centric approach to design a prototype filtration device with daily- to weekly-replaceable xylem filters, and uncover indicators of social acceptance of xylem as a natural water filter. Our work enhances the understanding of xylem as a filtration material, and opens opportunities for engineering a diverse range of low-cost, biodegradable xylem-based filtration products on a global scale. Gymnosperm sapwood is an abundantly available material to construct water filters but the material's behaviour as a filter is poorly understood and challenges such as short shelf live have not been addressed. Here, the authors develop guidelines for the design and fabrication of xylem filters and demonstrate gravity-operated filters with a shelf life of more than two years for the removal of contaminants from spring, tap and ground water. [ABSTRACT FROM AUTHOR]

Describes the role of research and evaluation in the growth, evolution, and impact of developmental television in India. Eleven references are listed. (Author/LLS)

Improved capabilities in microfluidics, electrochemistry, and portable assays have resulted in the development of a wide range of point-of-use sensors intended for environmental, medical, and agricultural applications in resource-limited environments of developing countries. However, these devices are frequently developed without direct interaction with their often-remote intended user base, creating the potential for a disconnect between users' actual needs and those perceived by sensor developers. As different analytical techniques have inherent strengths and limitations, effective measurement solution development requires determination of desired sensor attributes early in the development process. In this work, we present our findings on design priorities for point-of-use microbial water sensors based on fieldwork in rural India, as well as a guide to fieldwork methodologies for determining desired sensor attributes. We utilized group design workshops for initial identification of design priorities, and then conducted choice-based conjoint analysis interviews for quantification of user preferences among these priorities. We found the highest user preference for integrated reporting of contaminant concentration and recommended actions, as well as significant preferences for mostly reusable sensor architectures, same-day results, and combined ingredients. These findings serve as a framework for future microbial sensor development and a guide for fieldwork-based understanding of user needs. [ABSTRACT FROM AUTHOR]

Rationale: Antibacterials are largely prescribed to the intensive care unit (ICU) patients due to high prevalence of infections. However, appropriate use of antibacterials is imperative; since the misuse of antibacterials increases antibacterial resistance and ultimately, it has negative impact on health care and economic system. Hence, continuous antibacterials prescription assessments are very important to judge and improve prescription patterns. The present work was carried out at public and private hospitals to assess the differences in antibacterial prescribing pattern. Methods: The present study was conducted at three public and two private hospitals over the period of 14 months. Demographic and drug use details were captured daily from patients admitted to medical ICUs to assess the World Health Organization indicators. Results: A total of 700 patients were enrolled across the five centers (140 per center), among them 424 were male and 276 were female. Average number of drugs and antibacterials prescribed at public hospitals are significantly higher than the private hospital. However, percentage of antibacterial agents prescribed at public hospitals was significantly lower than the private hospitals (P = 0.0381). Private hospitals had significantly lower percentage of antibacterial agents prescribed by generic name (P < 0.0001). Differences in change of antibacterial agents required were not statistically significantly different (P = 0.1888); however, significant difference was observed in percentage of patients who received antibacterial treatment as per sensitivity pattern (P = 0.0385) between public and private hospitals. Significantly higher mortality was observed in public hospitals compared to private hospitals (<0.0001). Conclusions: More generic prescriptions and more number of prescriptions as per the sensitivity pattern are required at each public and private hospital. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate changes in annual blood transfusion requirements and complications after splenectomy in patients with β-thalassemia.Methods: Forty post-splenectomy β-thalassemic patients aged 8-33 y, receiving regular blood transfusions and chelation therapy were included and non transfusion dependant patients were excluded from this retrospective cross-sectional study. Details about their surgery, transfusion requirements, and platelet levels were recorded on a standard proforma. All patients underwent a B-mode and color-coded duplex sonography of the hepatoportal system during the study period.Results: The average ferritin level in the year prior to the study was 4432 mcg/L (range 480-12,200 mcg/L). The annual blood transfusion requirement in the first year and 5 y post splenectomy [mean ± SD (138.41 ± 90.38 ml/kg/y); (116 ± 41.44 ml/kg/y)] were significantly different from requirements before splenectomy [(mean ± SD) 294.85 ± 226 ml/kg/y; p value <0.001]. There was a significant rise in platelet counts within 24 h post splenectomy with a mean rise of 4,51,000/mm(3) (p value < 0.001). During the follow up period, infections were noted in 50 % of patients, with malaria (18.75 %) being the most common. Doppler study of the portal system in one case showed portal vein thrombosis.Conclusions: A significant sustained fall in annual blood transfusion requirement and a rise in platelet counts occurred post-splenectomy. Increase in annual blood transfusion requirement should be investigated to find the cause. [ABSTRACT FROM AUTHOR]

Purpose: Colistin, which had not been used widely because of nephrotoxicity and neurotoxicity, has gained clinical importance in recent times due to the resurgence of multidrug-resistant Gram-negative bacilli. Very few studies, especially pharmacokinetic studies, have been performed with intravenous colistimethate sodium, and none in India. The aim of our study was to study the single-dose and steady-state pharmacokinetics of colistin in patients with multidrug-resistant Gram-negative bacilli infections. Method: This was a prospective open-label pharmacokinetic study done in an intensive care unit in a tertiary care hospital on 15 critically ill patients with proven multidrug-resistant Gram-negative bacilli infection. Colistimethate sodium was injected as intermittent intravenous infusions in accordance with the recommendations on the package insert. For patients weighing ≥60 kg with a normal renal function or with a creatinine clearance (CL) of between 20 and 50 ml/min, the drug was administered at 2 million international units (MIU) every 8 h; for those with a CL of 10-20 ml/min, the dose was 2 MIU every 12 h. Those patients who weighed <60 kg were administered 50,000 IU/kg/day in three divided doses at 8-h intervals. Both single-dose and steady-state pharmacokinetics of colistin were determined and correlated with clinical outcomes. Results: A wide inter-individual variation was observed in pharmacokinetic parameters. The median (range) of the maximum plasma drug concentration/minimum inhibitory concentration (C/MIC) ratio for Acinetobacter spp. was 13.4 (1.3-40.3) following the administration of a single dose of colistimethate sodium and 26.3 (0.9-64.9) at steady-state. For Pseudomonas spp., these values were 3.18 (1.6-23.1) following the single dose and 3.82 (2.3-10.9) at steady-state. For those patients whose cultures grew Acinetobacter spp., an optimum value of the C/MIC ratio of >8 was achieved in seven of nine patients after the single dose and in seven of eight patients at steady-state. For those patients whose cultures grew Pseudomonas spp, only one patient after the single dose and one patient at steady-state achieved a C/MIC ratio of >8. A significant association was noted between dose and survival, and a trend was observed with patients weighing ≤60 kg (who received 50,000 IU/kg/day instead of 6 MIU/day for those >60 kg) having an increased mortality. Conclusion: The pharmacokinetic parameters of colistin were comparable to those reported in previous studies in critically ill patients. However, the recommended dose may be inadequate to maintain the C/MIC ratio to an optimal level-at least in patients infected with Pseudomonas spp. The dose recommendation should be based only on creatinine clearance and not body weight. [ABSTRACT FROM AUTHOR]

doi: 10.1111/j.1741-2358.2011.00603.x Prevalence of gingival overgrowth among elderly patients under amlodipine therapy at a large Indian teaching hospital Objectives: To determine the prevalence of amlodipine-induced gingival overgrowth (GO) among elderly subjects attending an Indian teaching hospital and find any association with demographic factors, drug variables, oral hygiene status and gingival inflammation. Methods: A cross-sectional pilot study included 157 dentate patients aged 60 years or more, taking Amlodipine for at least 3 months. Data were collected from past medical records and oral examination. Clinical assessment of GO was correlated with patient's age, gender, drug dosage (2.5, 5 or 10 mg/day), duration of drug therapy (3-4, 4-6, 6-12, 12-24 and >24 months) and also with subjects' plaque index and gingival index scores. Results: Eight patients (5.09%) had GO. No statistically significant relation was observed between age ( p = 0.79), gender ( p = 0.56), drug dosage ( p = 0.25) and duration of drug intake ( p = 0.62) and prevalence of GO. GO prevalence related highly significantly ( p < 0.001) with plaque and gingival index scores. Conclusions: Prevalence of amlodipine-associated GO in the sample of elderly Indian patients was noted higher than that previously reported. Plaque and gingival inflammation were highly correlated with this condition, while demographic characteristics and drug dosage did not relate significantly. [ABSTRACT FROM AUTHOR]

This article is concerned with evaluating the growth performance of states in the Indian Federation. This was sought to be done by estimating growth equations for a group of 19 states in India as well as sub-groups of these states during the period from 1981-1982 to 2004-2005. It has been found that, systematically, the contribution of educational attainment (social sector capital) to the growth process is larger than the contribution of physical capital. An important concern in the article is whether growth regressions estimated for a large group of 19 states can be replicated for smaller sub-groups. The problem of parameter heterogeneity is investigated, and the results of this study show that there is considerable parameter heterogeneity in the growth equations across groups. Rates of convergence estimated in this article also vary from extremely low levels (in the absence of the education variable) to more than 10% (in the presence of the education variable). The results of this study thus point to the great importance of education in improving the growth performance of Indian states. [ABSTRACT FROM AUTHOR]

This paper examines the decentralization process in the state of Maharashtra. Among the states in India, Maharashtra's efforts at decentralization are regarded as a success story. Using cross-section data for 243 urban local governments, the paper examines the flypaper effect, that is, the expenditure stimulus of grants from the state government to the urban governments. The significance of spatial factors has been highlighted in the study. The models have been estimated using spatial econometric techniques. Most of the estimated models show the presence of the flypaper effect. [ABSTRACT FROM AUTHOR]

This article examines decentralization in the state of Maharashtra in India, especially with respect to the functioning of its urban local governments. Using panel data, the article specifically investigates the flypaper effect of grants from the state government to urban local bodies. It also addresses the asymmetry hypothesis, which states that subnational governments respond differently to a reduction in grants than to an increase. Our results demonstrate the presence of the flypaper effect, but evidence regarding the asymmetric response to a reduction in grants is ambiguous. [ABSTRACT FROM AUTHOR]

HIV/AIDS can now be considered a pandemic as it affects all parts of the world. As attentive as scholars have been to the biomedical and epidemiological aspects of the disease, they have been slower to try to understand it as a disease of transnational significations or meanings. This article looks to the ways that the conceptual categories of HIV/AIDS came to India in the biomedical literature, the approaches that the media in the United States and India took in contending with these meanings, and how these categories travel globally in dominant and negotiated realms of discourse. Throughout this analysis, attention is paid to ways that high-risk groupings obscure alternative approaches based on understandings of the dynamics of poverty, history, gender, and culture. Finally, this article argues that critical approaches to science and medicine are essential to help produce a more complex science. [ABSTRACT FROM AUTHOR]

The present case report describes asymptomatic worker working in quartz crushing unit and having crepitations on ausculation in the middle zone of right lung, diagnosed as grade 1/1 silicotic according to ILO Classification of Pneumoconiosis. The patient had elevated levels of SACE and serum Copper. This is the first time that SACE and serum copper levels were measured in a covert case of silicosis particularly in India. [ABSTRACT FROM AUTHOR]

In India approximately 1 million people get burnt every year and most of them are from the lower or middle income strata. Therefore it is obligatory to find out an economic way of treatment for the affected populace. Since use of human skin allograft is the gold standard for the treatment of burn wound, in-house skin banking for a burn unit hospital is prerequisite to make the treatment procedure affordable. Although, there was one skin bank at India till 2009, but it was difficult for a single bank to cover the entire country's need. Looking at the necessities, National Burns Centre (a tertiary burn care centre) along with Rotary International and Euro Skin Bank collaborated and developed an effective cadaveric skin banking model in Mumbai, Maharashtra in 2009. Initial two to three years were formation phase; by the year 2013 the entire system was organized and started running full fledged. The model has also been replicated in other states of India to accommodate the large burn population of the country. This paper therefore, gives a step by step account of how the bank evolved and its present status. [ABSTRACT FROM AUTHOR]

The leave paste of the plant, Eupatorium glandulosum H. B & K , has been traditionally used to treat cuts and wounds by the tribal community of the Nilgiris district of Tamilnadu, India. The present study was carried out to investigate the wound healing potential of this plant extract and the compound, 1-Tetracosanol, isolated from the ethyl acetate fraction. An in vitro study was designed to compare the viability, migration and apoptosis of the fresh methanolic extract fractions and 1-Tetracosanol using mouse fibroblast NIH3T3 cell lines and human keratinocytes HaCaT cell lines, respectively. 1-Tetracosanol was evaluated for its viability, migration, qPCR analysis, in silico , in vitro and in vivo. 1-Tetracosanol at the concentration of 800, 1600, 3200 μM has significant wound closure of 99% at 24 h. The compound when screened in silico against various wound healing markers, TNF-α, IL-12, IL-18, GM-CSF and MMP-9, revealed high binding energy of −5, 4.9 and −6.4 kcal/mol for TNF-α, IL-18 and MMP-9, respectively. Gene expression and the release of cytokines increased at an early stage of the wound repair. 1-Tetracosanol, at 2% gel showed 97.35 ± 2.06% wound closure at 21st day. 1-Tetracosanol is a good lead for drug development targeted towards wound healing activity and work in this direction is in progress. [Display omitted] • The leaf paste of the plant, Eupatorium glandulosum , is used to treat cuts and wounds by Badagar, Irular and Toda tribal people of the Nilgiris, India. • 1-Tetracosanol isolated from Eupatorium glandulosum shows high binding energy with TNF-alpha, IL-18 and MMP-9. • 1-Tetracosanol has shown to play a predominant role in early stage of wound healing. • 1-Tetracosanol shows potential wound healing activity in vitro and in vivo. [ABSTRACT FROM AUTHOR]

Introduction: Managing choledocholithiasis alongside cholelithiasis has seen significant evolution, presenting options such as single-stage cholecystectomy with common bile duct (CBD) exploration, or a two-stage procedure involving endoscopic retrograde cholangiopancreatography (ERCP) performed before or after cholecystectomy. Evidence from Western settings may not fully capture the unique disease burden and demographic characteristics prevalent in developing countries. Laparoscopic common bile duct exploration (LCBDE) is more commonly performed in the Indian subcontinent compared to Western centers due to limited access to advanced procedures and specialized instrumentation for complex ERCP cases. The high cost and the need for extensive armamentarium in managing failed ERCPs make LCBDE a more feasible option in many Indian centers., Methods: This prospective study, conducted from August 2019 to July 2020 at King George's Medical University, UP, India, included n = 24 patients diagnosed with choledocholithiasis. The operative procedures performed included laparoscopic CBD exploration and cholecystectomy, along with internal endo-biliary drainage. Perioperative outcomes were assessed, and follow-up data were included to monitor any recurrence until 36 months post-surgery., Results: The study population had a mean age of 42.2 years, with 83% (n = of the patients being female). Abdominal pain was the predominant symptom, reported by 91.66% of the patients, followed by nausea/vomiting in 79.20% of cases. The mean CBD diameter observed was consistent with existing literature. The mean operating time was 2.02 h, with primary duct closure taking an average of 13.66 min. Mean blood loss during surgery was 136.25 mL. The average hospital stay was 5.54 days, with the majority of drain removals occurring by the third postoperative day. Complications included fever in 25.0% of the patients and bile leakage in n = 3 out of 24 cases (~12.50%). During the follow-up period, one patient (4.17%) experienced a retained stone., Conclusion: Laparoscopic CBD exploration with primary duct closure and internal biliary drainage appears to be a feasible approach, yielding satisfactory perioperative outcomes. However, further studies are required to firmly establish its superiority over alternative approaches within the Indian context., (© 2024 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)