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Coronal emission exhibited by the chromospherically active binaries is important to understand the underlying mechanism. We report the X-ray spectral studies of an RS CVn source CF Tuc using XMM-Newton archival data. The light curve was found to be steady with no flaring activity and the source was in a quiescent X-ray emission state. The source spectrum can be explained by a three-component thin plasma model with temperatures ∼ 0.26 keV, ∼ 1.01 keV, and ∼ 2.14 keV using EPIC MOS and pn data. We found that the source exhibits low abundance Z = 0.1−0.2 Z ⊙ , well in agreement with previous studies. Based on the RGS spectral fits of OVII triplets, we estimated the temperature to be about 1−2 × 106 K and density n e = 1−2 × 1010 cm−3 of the coronal emission region during the quiescent state. [ABSTRACT FROM AUTHOR]

The manufacturing economy of a nation has to be competent and sustainable to develop technology, generate employment opportunities, serve customers with innovative products at competitive prices, provide best quality and services, and participate in global trade to boost the world economy. Adoption of new technology is important for firms to remain successful and achieve sustainable competitive advantage in the production and distribution of goods/services. The purpose of this study is to explore the critical success factors (CSFs) affecting the adoption of Additive Manufacturing (AM) in mainstream manufacturing in enhancing supply chain competitiveness and sustainability. As a methodological contribution, this research uses a mixed methods' approach. An Exploratory Factor Analysis (EFA) derives five CSFs: ' customized production with speed'; ' sustainable production'; 'f lexible manufacturing system (FMS) for complex products'; ' standardization in AM industry'; and ' digital skills & infrastructure'. The Analytical Hierarchic Process (AHP) shows the weights of factors. TOPSIS (Technique for order of preference by similarity to ideal solution) ranks the four manufacturing enterprises based on EFA factors. Decision Making Trial and Evaluation Laboratory (DEMATEL) establishes the cause-effect relationship among factors. This study finds that 'c ustomized production with speed' is the most influential causal factor and 's ustainable production' the main effect factor. AM adoption helps industrial sectors in advancing with new technologies, advanced materials, and organizational structures so as to enhance the competitiveness and sustainability of manufacturing supply chains. It has a great potential to reconfigure supply chain (SC) structures in such a way that sustainable competitive advantage is achieved with less lead time and negligible adverse impact on the environment. [ABSTRACT FROM AUTHOR]

Background & objectives: Polyethylene terephthalate (PET) graft, designed and developed at our institute for vascular reconstruction, is porous to promote optimal incorporation and neointima formation, requiring pre-clotting or biomodification by sealing the pores before implantation. The objective of this study was to characterize, test and perform preclinical evaluation of hydrogel (alginate dialdehyde cross-linked gelatin) sealed fluoropassivated PET vascular prosthesis in pig model, so as to avoid pre-clotting, for its safety and efficacy before employing the indigenous and less expensive graft for clinical use. Methods: Hydrogel sealed, fluoropassivated PET vascular prosthesis were tested for haemocompatibility and toxicity followed by small animal toxicology tests and in vivo experiments in pigs receiving implantation at thoracic aorta. All 33 animals received test as well as control grafts with a plan for phased explantation at 2, 12 and 26 weeks. All animals underwent completion angiogram at the end of procedure as well as before graft explantation. Results: Haemocompatibility tests for haemolysis and toxicity tests showed no adverse events in tested mice and rabbits. Completion angiogram showed intact anastamosis and patent graft in each animal in post-operative period and at explantation. Gross and histopathological examination showed wellencapsulated grafts, clean glistening neointima and no evidence of thrombus in both test and control grafts. Interpretation & conclusions: Hydrogel sealed, fluoropassivated PET vascular prosthesis was found non-toxic, haemocompatible and remained patent in in vivo studies at planned intervals. [ABSTRACT FROM AUTHOR]

Women entrepreneur has exceptional capabilities and proficiencies such as innovative and creative orientation, leadership qualities, self and social awareness, ability to identify opportunities, risk taking capacity equipped with ability to commercialize resources through the production of goods and services to meet the present market needs. The study explores the factors essential for the sustainable development of a holistic conceptual framework of competency development and thereby promoting women entrepreneurship. In-depth interviews of seven women entrepreneurs (WEs) from selected regions of Uttar Pradesh and Uttarakhand, India, were conducted for collecting data and information through open-ended questionnaire. During the review and analysis of cases, it has observed that personal, social and environmental factors have affected the development of entrepreneurial learning and competencies that are crucial for the success of women social entrepreneurs. The study findings would facilitate policy makers in for effective campaigning, encouragement and motivation of WEs besides policy bringing desired policy reforms. [ABSTRACT FROM AUTHOR]

Background and Objectives: The impact of chronic pancreatitis (CP) on quality of life (QOL) of children is not well established. Our objective was to evaluate the QOL, identify contributing factors, and determine the prevalence of anxiety and depression in children with CP in India., Methods: Children (8-18y old) with CP were prospectively enrolled across three pediatric gastroenterology centres in India. QOL was assessed using the pediatric QOL inventory (PedsQL 4.0) scale, administered to both children and their parents. Anxiety and depression was studied using the Revised Children's Anxiety and Depression Scale (RCADS 25). Contributing factors were identified using binary logistic regression analysis. The data was compared against published QOL data in healthy Indian children., Results: 121 children with CP (boys-57.9 %, age at QOL-14 ± 3.2years) were enrolled. A majority (82.7 %) had pain and advanced disease (Cambridge grade IV- 63.6 %). Children with CP had poorer QOL compared to controls (total score 74.6 ± 16 vs. 87.5 ± 11.1, p < 0.0001). QOL scores were similar across centres. Older children were similar to younger ones, except for a poorer emotional QOL. Taking QOL < -2 standard deviation (SD) of controls, ∼35 % had poor physical (50.9 ± 11.9) and 20 % had poor psychosocial (PS) QOL score (52.1 ± 7.2). On analysis, presence of pain and lower socio-economic status (SES) adversely affected both physical and PS-QOL. Additionally, girls had poorer PS-QOL than boys (Odds ratio 3.1, 95%CI:1.23-7.31). Anxiety and depression were uncommon (2,1.6 %)., Conclusions: Patients with CP had impaired physical and psycho-social QOL. Presence of pain and lower SES adversely affected QOL. Psychiatric comorbidities were uncommon., Competing Interests: Declaration of competing interest All authors declare no conflict of interest., (Copyright © 2024 IAP and EPC. Published by Elsevier B.V. All rights reserved.)

Background: Risk scoring systems are required to allow accurate prognostication, compare outcomes of surgery, and allow patients to make informed decisions about their health. This prospective study compares the p-POSSUM (Portsmouth Modification to Physiological and Operative Severity Score for Enumeration of Mortality), Mannheim Peritonitis Index, and Jabalpur Peritonitis Index for their utility in predicting mortality in patients with peritonitis., Methods: Perioperative data was collected from 235 patients with secondary peritonitis and used to calculate p-POSSUM, MPI, and JPI scores. The accuracy of the 3 scores was compared using receiver operator characteristic curves., Results: p-POSSUM and Mannheim Peritonitis Index were similar in their accuracy with area under the curve (AUC) values of 0.756 and 0.757. Jabalpur Peritonitis Index had an AUC of 0.665., Conclusion: p-POSSUM and Mannheim Peritonitis Index can be used to predict mortality in patients with secondary peritonitis. Jabalpur Peritonitis Index is not suited for this purpose. Further studies are required to improve the diagnostic performance of p-POSSUM and MPI in patients with secondary peritonitis., (© 2023. The Author(s).)

Background: Erythrodermic psoriasis is an acute inflammatory condition presenting as erythema and scaling involving more than 90% of body surface area in patients with a history of psoriasis vulgaris. If not treated promptly, metabolic complications and infections due to acute skin failure can cause significant morbidity and mortality in this condition. Interleukin-17 (IL-17) is considered to be the key player in initiating the inflammatory cascade in psoriasis. IL-17 blockers have been successfully used in the management of psoriasis vulgaris. However, its use in unstable erythrodermic psoriasis is limited to isolated case reports., Methods: We hereby report an observational study of nine patients of unstable psoriatic erythroderma successfully managed with injection secukinumab and followed up over the next 24 months., Results: Nine patients were managed during the study period, and a successful outcome was noted in all the patients. The Psoriasis Area and Severity Index response rate improved by at least 75% from baseline in 33.3% (3⁄9) at week 4 and improved to 88.9% (8⁄9) at week 12. None of the patients had a recurrence of erythroderma till 24 months of followup., Conclusion: The study concluded that secukinumab is quick, safe, and efficient in psoriatic erythroderma, and there was no relapse of erythroderma in any of the patients in the 24 months of followup., Competing Interests: The authors have none to declare., (© 2021 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.)

Aim: TCF7L2 gene is believed to increase the risk of T2DM by its effects on insulin secretion. However, the exact mechanism of this enhanced risk is not clearly known. While TCF7L2 gene has been shown to affect lipid metabolism, these effects have remained largely unexplored in the context of diabetes risk., Methods: Postprandial lipid responses to a standardized fat challenge test were performed in 620 Asian Indian subjects (310 with NGT and 310 with T2DM/prediabetes) and compared between the risk and wild genotypes of the rs7903146 TCF7L2 gene. In 30 subjects scheduled to undergo abdominal surgery (10 each with NGT, Prediabetes and T2DM), adipocyte TCF7L2 gene expression was also performed by real time qPCR and confirmed by protein expression in western blot., Results: T allele of rs7903146 TCF7L2 gene was confirmed as the risk allele for T2DM (OR=1.8(1.2-2.74), p=0.005). TT+CT genotypes of rs7903146 TCF7L2 gene showed significantly higher 4hrTg (p<0.01), TgAUC (p<0.01), peakTg (p<0.01) as well as higher postprandial plasma glucose (p=.006) levels and HOMA-IR (p=0.03) and significantly lower adiponectin levels (p=0.02) as compared to CC genotype. The expression of TCF7L2 gene in VAT was 11-fold higher in prediabetes group as compared to NGT (P<0.01) and 5.7-fold higher in T2DM group as compared to NGT group(P=0.003) and was significantly associated with PPTg and glucose levels., Conclusion: There is significant PPTg dysmetabolism associated with the risk allele of rs7903146 polymorphism as well as adipocyte expression of TCF7L2 gene. Significant upregulation of TCF7L2 gene expression in VAT that correlates with PPTg and glycaemia is also seen in Asian Indians with glucose intolerance. Modulation of PPTg metabolism by TCF7L2 gene and the resultant PPHTg may be a novel mechanism that contributes to its diabetes risk in them., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Madhu, Mishra, Mannar, Aslam, Banerjee and Agrawal.)

The cattle and buffalo farm practices have been adopted differently by farmers in India but the infestation of ectoparasites including louse has been advocated in high population of animals across the country. The aim of this study was to identify the louse morphologically and determine the in vitro efficacy of the insecticides deltamethrin, cypermethrin and flumethrin against the buffalo louse, Haematopinus tuberculatus. The present research work was conducted using lice collected from organized buffalo dairy farms of Mhow block, Indore district of Madhya Pradesh, India. The adult's lice were collected from heavily infested regions of the body and tail of buffaloes. Some of the collected adult's lice were preserved for morphological identification in 70% alcohol. Briefly, in vitro treated surface bioassay utilizing a cloth rectangle that allows lice to move freely has been used. The concentrations were prepared as 30, 60, 90 and 120 ppm for deltamethrin and flumethrin, whereas for cypermethrin, 100, 200, 300 and 400 ppm concentrations were prepared in distilled water. The 600 μl of each concentration was spread evenly over a cloth rectangle held in the bottom of a Petri plate. Ten adult lice were used for each concentration in triplicate (n = 30) and the same is maintained for control. The vitality of the louse was assessed at various intervals: 30, 60, 120, 180 and 240 min. The lousicidal efficacy was determined by using in vitro bioassays with deltamethrin, cypermethrin and flumethrin. It is observed that as the concentration of insecticides increases with exposure time, mortality of lice is also increased. The current study reveals that cypermethrin and flumethrin were effective in their recommended doses but in the case of deltamethrin, the lice showed a low level of resistance. Furthermore, this type of study on buffalo louse has not conducted in Mhow region of Madhya Pradesh where heavy infestation of lice occurs on buffalo., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: There are no accepted guidelines for the closure of laparotomy incisions in patients of peritonitis. As these patients differ from the patients undergoing elective abdominal surgery, the same recommendations for closure may not be applicable in both groups., Aim: To compare wound outcome parameters following closure of the laparotomy incision with absorbable and non-absorbable suture material using the continuous and interrupted techniques in patients of peritonitis., Method: A single blinded randomised controlled trial using Polygalactin-910 and Polypropylene, number 1 sutures, to close midline vertical incisions, placed in continuous and interrupted manner, was performed on 174 patients. Patients were randomised into four groups: Group A (Polygalactin-910 continuous suturing, n=40), B (Polygalactin-910 interrupted suturing, n=47), C (Polypropylene continuous suturing, n=45) and D (Polypropylene interrupted suturing, n=42). The incidence of wound infection, dehiscence, suture sinus formation and incisional hernia was recorded. Patients were followed up for a period of four years. Statistical analysis involved the chi-square and Fisher's exact tests. A 'p' value of <0.05 was considered significant., Results: The study included 139 male and 35 female patients between the ages of 10 and 75 years. The incidence of wound infection (p=0.656), dehiscence (p=0.997), and incisional hernia (p=0.930) at 3 months and four years (p= 0.910) was not statistically significant. There was no sinus formation in groups A and B, however 2 patients of group C and 6 patients of group D did develop suture sinus (p=0.003)., Conclusion: Suture material and technique of closure does not influence wound outcome in patients of peritonitis except for a significantly lower incidence of sinus formation when non-absorbable sutures are used.

The incidence of hepatic tuberculosis is increasing with the resurgence of tuberculosis due to the emergence of multi drug resistant strains and to an increased prevalence of human immune-deficiency virus infection. In contrast, isolated tuberculous liver abscess (TLA) is extremely uncommon with a prevalence of 0.34% in patients with hepatic tuberculosis. We describe a case of isolated TLA in a 32-year-old immune-competent man, who presented with a painless lump in the right posterior chest wall. Fine needle aspiration revealed acid fast bacilli (AFB), computed tomogram of the thorax showed a hepatic abscess in the segments 6 and 7 communicating with the posterior chest wall. The presentation of TLA may be atypical and diagnosis remains elusive unless hepatic involvement is revealed by imaging and AFB is demonstrated in the aspirated pus or necrotic material. Open drainage of the superficial component of the abscess along with antituberculosis treatment resulted in the resolution of the abscess.

The aetiology of rectal stricture is varied, with malignancy being the commonest cause. We report the case of a 26-year-old man, from the state of Bihar, India, who presented with features of large bowel obstruction. Investigations revealed a rectal stricture. Biopsy from the affected site demonstrated non-specific inflammation. An anterior resection was carried out as it was not possible to convincingly rule out malignancy. Histopathological examination of the resected specimen reaffirmed the nonspecific inflammation. This case illustrates that long stricture of rectum my have a benign cause.

Cysts of the greater tuberosity can be a normal finding independent of age and concurrent rotator cuff tear. The presence of a large greater tuberosity cyst can present a challenge at the time of rotator cuff repair. We present a 1-step arthroscopic technique to address these defects at the time of rotator cuff repair using a synthetic graft (OsteoBiologics, San Antonio, TX) originally designed to address osteoarticular defects. With the viewing portal established laterally, a portal allowing perpendicular access to the cyst is established. The cyst is thoroughly debrided, and a drill sleeve is then introduced perpendicular to the surrounding bone, serving as a guide for the matching drill to create a circular socket. A correspondingly sized TruFit BGS cylindrical implant (OsteoBiologics) is then implanted by use of the included instrumentation. The scaffold is placed flush with the surrounding bone. Because our arthroscopic rotator cuff protocol uses a tension-band technique with placement of suture anchors distal and lateral to the rotator cuff footprint, we are subsequently able to proceed with routine rotator cuff repair.

Gangrene of Meckel's diverticulum is uncommon and its pre-operative diagnosis is difficult. We report three cases with different presentations--simulating acute appendicitis, intestinal obstruction, and strangulation of the bowel.

Appendicular inflammation can present as a discharging fistula on the abdominal wall. This faecal fistula can be difficult to diagnose even with the assistance of advanced radiological techniques. Many pathological conditions of the appendix can present as appendico-cutaneous fistulae, and these have been defined to be distinct from those external appendicular fistulae that follow appendicectomy for acute appendicitis. Appendico-cutaneous fistula is a rare disease, and we could retrieve only 16 cases from a (Pubmed) search. An exploratory laparotomy is the gold standard for confirmation of this rare condition and, simultaneously, it allows treatment by appendicectomy and excision of the fistulous tract. We report and discuss one such case that we managed.

Malignant phyllodes tumor of prostate is described in a 78 year old man. He had symptoms of prostatism since six months before developing acute urinary retention, which was relieved by suprapubic cystostomy. Transabdominal ultrasonography showed a few hypoechoic areas in a 120 gm prostate. Serum prostate specific antigen was 2.7 ng/ml. Transrectal trucut biopsy was inconclusive. With a diagnosis of benign hyperplasia of prostate. Transvesical prostatectomy was performed. Postoperative biopsy showed phyllodes tumor of the prostate with metastastic deposits in the anterior abdominal wall. He received chemotherapy with Vincristine, Mitomycin C, Adriamycin and Cisplatin every 21st day for six cycles in addition to orchiectomy. Routine follow up by transabdominal ultrasound at ten months showed space occupying lesions in the liver. Patient succumbed to his disease a few days later.

Liver function and histology were studied in 62 patients undergoing elective cholecystectomy. Data from 50 of the cases was subsequently analyzed. Liver function was assessed by biochemical parameters and histological examination of intraoperatively obtained core and wedge liver biopsy. There were no complications associated with the procedure of liver biopsy. Seventy-eight percent of liver biopsies showed some form of abnormality, the commonest being mild portal tract infiltration. Eighteen percent of patients had severe histological abnormalities. Fourteen percent of bile samples were infected. No correlation was found among age, symptom duration, liver function tests, and histological appearance. Biliary infection was associated with a significant incidence of fatty change and inflammatory cell infiltration of parenchyma. We observed a high rate of abnormal liver histology of unknown clinical significance in patients of calculous cholecystitis. These changes are not reflected in commonly performed tests of liver function. Intraoperative liver biopsy is a safe and sensitive method to detect liver abnormalities.