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Abstract: Medical Thoracoscopy (MT) is commonly performed by respiratory physicians for diagnostic as well as therapeutic purposes. The aim of the study was to provide evidence-based information regarding all aspects of MT, both as a diagnostic tool and therapeutic aid for pulmonologists across India. The consensus-based guidelines were formulated based on a multistep process using a set of 31 questions. A systematic search of published randomized controlled clinical trials, open labelled studies, case reports and guidelines from electronic databases, like PubMed, EmBase and Cochrane, was performed. The modified grade system was used (1, 2, 3 or usual practice point) to classify the quality of available evidence. Then, a multitude of factors were taken into account, such as volume of evidence, applicability and practicality for implementation to the target population and then strength of recommendation was finalized. MT helps to improve diagnosis and patient management, with reduced risk of post procedure complications. Trainees should perform at least 20 medical thoracoscopy procedures. The diagnostic yield of both rigid and semirigid techniques is comparable. Sterile-graded talc is the ideal agent for chemical pleurodesis. The consensus statement will help pulmonologists to adopt best evidence-based practices during MT for diagnostic and therapeutic purposes., (Copyright © 2024 Copyright: © 2024 Indian Chest Society.)

Conversion of carbon-rich waste biomass into valuable products is an environmentally sustainable method. This study accentuates the synthesis of novel SnO 2 QDs@g-C 3 N 4 /biochar using low-cost sawdust by applying the pyrolysis method. Morphology, structure, and composition of the synthesized SnO 2 QDs@g-C 3 N 4 /biochar nanocomposite were characterized using SEM (scanning electron microscope), TEM (transmission electron microscope), XRD (X-ray diffraction), XPS (X-ray photoelectron spectroscopy), FT-IR (infrared spectroscopy) and PL (photoluminescence) spectroscopy. The average diameter of the SnO 2 QDs was measured from TEM and found to be 6.79 nm. Optical properties of the as-synthesized SnO 2 QDs@g-C 3 N 4 /biochar were characterized using UV-visible spectroscopy. The direct band gap of synthesized SnO 2 QDs@g-C 3 N 4 /biochar nanocomposite was calculated from Tauc's plot and found to be 2.0 eV. The fabricated SnO 2 QDs@g-C 3 N 4 /biochar photocatalyst exhibited outstanding photocatalytic degradation efficiency for the removal of Rose Bengal (RB) and Methylene Blue (MB) dye through the Advanced Oxidation Process (AOP). The synthesized photocatalyst showed a degradation efficiency of 95.67% for the removal of RB under optimum conditions of 0.3 mL H 2 O 2 , photocatalyst dosage of only 0.06 gL -1 , and 15 ppm initial RB concentration within 80 min, and 94.5% for the removal of MB dye with 0.5 mL of H 2 O 2 , 0.08 gL -1 of the fabricated photocatalyst and 6 ppm of initial MB concentration within 120 min. The photodegradation pathway followed the pseudo-first-order reaction kinetics with a rate constant of 0.00268 min -1 and 0.00163 min -1 for RB and MB respectively. The photocatalyst can be reused up to the 4 th cycle with 80% efficiency., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The synthesis of dihydropyridone derivatives has been reported by ring rearrangement of pyrans using iodine and formic acid as a catalyst separately. Dihydropyridones were crystallized subjected for single-crystal X-ray crystallography to acquire their structural parameters. The different non-covalent interactions involved within the supramolecular systems were studied and validated using Hirshfeld surface plot analysis. N-H⋅⋅⋅O interactions between the lactam group dominate. Still, other non-covalent interactions such as C-H⋅⋅⋅N, C-H⋅⋅⋅O, C-H⋅⋅⋅C, N-H⋅⋅⋅N, C-H⋅⋅⋅π, and lone pair⋅⋅⋅π systems act as the driving force in facilitating the self-assembly of the dihydropyridone supramolecules. The synthesized compounds were analyzed by in vitro techniques using human lung adenocarcinoma (A549) to evaluate their cytotoxic activities. Ethyl 4-(4-chlorophenyl)-5-cyano-2-methyl-6-oxo-1,4,5,6- tetrahydropyridine-3-carboxylate has shown the highest cytotoxicity among all the synthesized compounds. Molecular recognition properties of the dihydropyridone compounds were also studied, employing molecular docking tools to gain insight into the binding mode inside the allosteric binding pocket of the Eg5 protein through non-covalent interactions., (© 2023 Wiley-VCH GmbH.)

Introduction and aims The demographic and clinical profile and dynamics of real-time polymerase chain reaction (RT-PCR) in coronavirus disease 2019 (COVID-19) patients are not well understood. The study aimed to analyze the demographic, clinical, and RT-PCR profiles of COVID-19 patients. Methodology The study was a retrospective, observational study conducted at a COVID-19 care facility, and the study period was from April 2020 to March 2021. Patients with laboratory-confirmed COVID-19 by real-time polymerase chain reaction (RT-PCR) were enrolled in the study. Patients with incomplete details or with only single PCR tests were excluded. Demographic and clinical details and the results of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR collected at different time points were retrieved from the records. The statistical software Minitab version 17.1.0 package (Minitab, LLC, State College, PA, USA) and Rstudio version 1.3.959 (Rstudio, Boston, MA, USA) were used for the statistical analysis. Results The mean duration from symptom onset to the last positive RT-PCR was 14.2 ± 4.2 days. The proportions of positive RT-PCR tests were 100%, 40.6%, 7.5%, and 0% at the end of the first, second, third, and fourth weeks of illness. The median duration of days to first negative RT-PCR in the asymptomatic patients was 8 ± 4 days, and 88.2% of asymptomatic patients were RT-PCR-negative within 14 days. A total of 16 symptomatic patients had prolonged positive test results even after three weeks of symptom onset. Older patients were associated with prolonged RT-PCR positivity. Conclusion This study revealed that the average period of RT-PCR positivity from the onset of symptoms is >2 weeks in symptomatic COVID-19 patients. Prolonged observation in the elderly population and repeat RT-PCR before discharge or discontinuation of quarantine is required., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Dutta et al.)

It is important to evaluate the media's health coverage of Indigenous communities both because these communities have been hit very hard by health inequities, and because misinformation can negatively affect the future health of Indian Country. This study takes the unique angle of examining both Indigenous and non-Indigenous ("mainstream") news publications to evaluate information gaps in health, health policy, and health efficacy coverage. The Indigenous media examined, which covered 14 times more health stories than mainstream media, highlighted health issues in Indian Country through the lens of resilience by using framing to emphasize unequal power, while at the same time providing depth and specificity. Instead of putting Indigenous health stories into historical and cultural context, mainstream media focused on the lack of resources and the chronic struggle of Indigenous communities. Mainstream media often only covered the topic once per outlet; however, those outlets with connections to Indigenous communities did provide more balanced coverage. Instead of promoting change, most mainstream media stories blamed Indigenous people for their situation and offered a doom trajectory for tribes hit hardest by health disparities. This study reveals how embedded framing and mediatization direct non-Native readers' attention away from the systemic deprivation of support to U.S. Indigenous tribes that was guaranteed to them by the U.S. government in tribal agreements. The implications for journalism and policy are discussed.

As COVID-19 surged in 2020, non-Indigenous media had a chronic disease of its own: sparse pandemic news from Indian Country. Within this inadequate coverage, there was an erasure of sources: Indigenous women were missing. This study evaluates the role of gender in U.S. Indigenous news coverage during the early stage of the COVID-19 pandemic. In a qualitative thematic textual analysis, 161 Indigenous media news articles were analyzed to examine gendered news coverage themes from the time the United States instituted a nationwide quarantine until the autumn of 2020. U.S. Indigenous media amplified voices of the Indigenous women on the COVID-19 frontlines. This study focuses on Indigenous media as the benchmark for telling ethical diverse Indigenous community-focused stories, illustrating how women's voices led media coverage and amplified issues. U.S. tribes are often matriarchal. As Europeans wielded disease and genocide as extermination tactics on these communities, women's voices served as medicine to guide narratives to community solutions and healing. As such, this study seeks to add to current theoretical understanding of how Indigenous women's roles were portrayed in COVID-19 coverage., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

In this article, for the analysis of Covid-19 progression in India, we present new insights to formulate a data-driven epidemic model and approximation algorithm using the real data on infection, recovery and death cases with respect to weather in the view of mathematical variables., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 The Author(s).)

Agricultural soils are an important source of greenhouse gas nitrous oxide (N 2 O) emission. The comprehensive effects of nitrogen fertilizer management on N 2 O emission from paddy fields of India have not been evaluated under field conditions. A 2-year field study was conducted to evaluate the effect of different nitrogen fertilizers, namely, conventional fertilizer (NPK), starch-coated urea (SCU), neem-coated urea (NCU), and normal urea alone (NUA) on soil quality, grain yield, and N 2 O emission from rice field. Gas samples were collected from the field at weekly intervals by static chamber technique and analyzed in a gas chromatograph. During the crop-growing season, the application of NPK resulted in the highest cumulative N 2 O emission (2.49 kg N 2 O-N ha -1 ) followed by NUA (2.34 kg N 2 O-N ha -1 ), NCU (2.20 kg N 2 O-N ha -1 ), and SCU (1.97 kg N 2 O-N ha -1 ). As against the application of conventional fertilizer (NPK), the application of SCU and NCU reduced the total N 2 O emission by 21% and 12%, respectively (p < 0.05), during the rice-growing period. The results indicate a good correlation of N 2 O emissions with soil organic carbon, soil mineral nitrogen, and urease activity (p < 0.05) at different stages of crop growth. Application of SCU significantly increased the rice grain productivity by 12%, 10%, and 3% over NPK (control), NCU, and NUA respectively without affecting the soil quality and nutrient status. The use of SCU improved the nitrogen use efficiency (NUE) and was the effective substitute for conventional fertilizer in terms of reducing N 2 O emissions from tropical rice paddy.

Background: The purpose of this study was to evaluate prognostic factors, locoregional control, and survival in locally advanced bucco-alveolar complex cancers., Methods: A retrospective review of 83 patients treated between January 2009 and December 2012 with bucco-alveolar complex cancers was conducted. All patients had surgery and adjuvant radiotherapy with intensity-modulated radiotherapy (IMRT) with/without concurrent chemotherapy. Survival analysis was performed using Kaplan-Meier and multivariable Cox regression model., Results: On univariate and multivariate analysis, perineural invasion (PNI) was found to be an independent adverse risk factor. Patients with PNI-positive disease had significantly worse 2-year disease-free survival (DFS), locoregional failure free survival, and overall survival (OS) as compared to patients with PNI-negative disease (P < 0. 001, 0.001 and < 0. 001) respectively., Conclusion: Compared with patients with PNI-negative disease, patients with PNI-positive disease had much worse outcome despite aggressive adjuvant treatment. It warrants escalation of therapy and modification in radiation portals to cover neural pathways in patients with PNI-positive disease., (© 2017 Wiley Periodicals, Inc.)

Circulating megakaryocytic cells abound in chronic myeloid leukemia (CML) seen in India and uniquely provide a setting for observing megakaryocytic maturation in the peripheral blood, a milieu not native to megakaryocytes. Peripheral blood megakaryocytic cells were studied in 324 cases of CML (235 chronic, 65 accelerated and 24 blastic phases). Two maturation themes were evident. Megakaryocytic blasts, especially in some cases of blast crisis, precociously make a foray into platelet formation and end up producing huge agranular or poorly granular cytoplasmic lobulated masses, that break off and come to lie in the circulation. This evidence of unsuccessful effort may exist, in a considerably attenuated form in chronic phase, alongside of the second major theme of megakaryocytic maturation centered around the familiar micromegakaryocyte, characteristic of the chronic phase. This cell is regarded as dysplastic, but produces morphologically normal platelets. The possibility that this occurs via a hitherto unstudied alternative path of platelet maturation that plays out in the peripheral blood, and the contrasting disorderly premature attempt of blasts to form platelets, represent exciting maturation processes that need further study. Our observations fortuitously constitute a revisit of the insightful exposition on the subject by George Minot nearly a century ago., (Copyright © 2016 Elsevier Inc. All rights reserved.)

We introduce the notion of weighted A-statistical convergence of a sequence, where A represents the nonnegative regular matrix. We also prove the Korovkin approximation theorem by using the notion of weighted A-statistical convergence. Further, we give a rate of weighted A-statistical convergence and apply the classical Bernstein polynomial to construct an illustrative example in support of our result.

Clear cell myoepithelioma arising from the minor salivary glands of hard palate is a rare entity. Most of the cases of palatal myoepitheliomas reported so far are either plasmacytoid or spindle cell type. Our literature search revealed only one case report of clear cell myoepithelioma of the palate. We report a case in a 21-year-old female who presented to us with a non-ulcerating, painless firm swell.ing of the left side of the hard palate. The tumor was excised with a healthy rim of surrounding tissue. Immunohistochemistry was performed on formalin-fixed and paraffin-embedded tissue with a panel of immunohistochemical markers. Tumor cells showed positivity for S100, cytokeratin and Muscle specific actin. Histological and immunohistochemical analyses revealed the tumor to be a myoepithelioma of the clear cell variety.

Introduction: Malnutrition adversely affects clinical outcome of hospitalized patients. This observational prospective study was done to assess the prevalence of malnutrition and its grade among patients admitted in a mixed intensive care unit (ICU) of a tertiary care hospital in order to help devise a comprehensive nutrition program for the malnourished., Materials and Methods: A total of 500 sequential patients admitted to the ICU were screened on admission over a year period for malnutrition using the Subjective Global Nutritional Assessment (SGNA) score. Distribution of the degree of malnutrition according to co-morbidities was also documented., Results: Of the total, 198 (39.6%) patients were malnourished, including one patient qualifying as severely malnourished; 68% patients were male, however, there was no statistically significant difference between nutrition status between sexes. Hypertension, diabetes, and cancer were the three most commonly encountered co-morbidities among the malnourished. A total of 86% of all cancer patients admitted were malnourished against only 12% of trauma patients., Conclusion: This study showed that almost two-fifth of the patients admitted were malnourished in this tertiary care hospital and that there is an urgent need to develop a comprehensive nutritional care program in many such Indian ICUs.

Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disorder caused by hypersensitivity to Aspergillus fumigatus which primarily complicates the course of asthma and cystic fibrosis. There is a theoretical possibility that patients with chronic obstructive pulmonary disease (COPD) can also develop Aspergillus hypersensitivity (AH) and/or ABPA. The aim of this prospective case-control study conducted in the Chest Clinic was to evaluate the prevalence of AH/ABPA in patients with COPD. Two hundred subjects with COPD (17, 62, 74, 47; GOLD guidelines stages I&#x2013;IV respectively) and 100 healthy volunteers were screened with an Aspergillus skin test. Patients were said to have AH if they demonstrated immediate cutaneous hyperreactivity to A. fumigatus antigen and those with positive responses were further investigated for ABPA. Of this patient population there were 179 (89.5%) males and 21 (10.5%) females with a mean age of 57.1 in the COPD arm and 88 males and 12 females with a mean age of 52.3 in the control arm. AH was found in 17 (8.5%) patients with COPD as compared to none in the control group. Two (1.0%) COPD patients fulfilled the serologic criteria for the diagnosis of ABPA. On univariate analysis, age of the patient, duration of COPD, smoking index and the COPD severity did not predict the occurrence of AH. On the basis of this study we concluded that AH/ABPA can occur in patients with COPD, and it is probable that COPD could be a predisposing factor for AH/ABPA. The clinical significance of AH and ABPA in COPD remains unclear.

Background: World literature suggests parapharyngeal space lesions account for only 0.5% head and neck tumours and the majority of the minor salivary gland tumours are malignant. The parapharyngeal space is very rare site for this tumour., Case Presentation: Two cases of primary pleomorphic adenomas arising de novo from minor salivary glands in the para pharyngeal space are reported. Review of literature, clinical features, pathology, radiological findings and treatment of these tumours are discussed., Conclusion: Pleomorphic adenoma arising de novo in the parapharyngeal space is of rare occurrence. High index of suspicion and an adequate clearance of the tumour with a cuff of surrounding dispensable normal tissues is the key to successful treatment of such tumours.

Bulky neck nodal disease with involvement of the overlying skin develops large post resection defects with skin loss following extensive neck dissection, that may not be suitable for primary closure. We describe a simple and easy to do procedure for cover of such large post surgical resection neck defects by using the Delto-pectoral flap as a single staged procedure.

This paper describes the use of arrays of horizontally-oriented reservoirs to deliver liquids through microchannels at a constant flow rate over extended periods of time (hours to days). The horizontal orientation maintains a constant hydraulic pressure drop across microfluidic channels even as the volumes of liquids within the reservoirs change over time. For a given channel-reservoir system, the magnitude of the flow velocity depends linearly on the height difference between reservoirs. The simple structure and operation mechanism make this pumping system versatile. A one-inlet-one-outlet system was used to continuously deliver media for perfusion cell culture, and an array of inlet reservoirs coupled to an outlet reservoir via microchannels was used to drive flows of multiple laminar streams. The parallel pumping scheme conveniently generated various smooth and step concentration gradients, and allowed evaluation of the effect of colchicine on myoblasts. Since the reservoir arrays are configured to be compatible with commercialized multichannel pipettors designed for 96 well plate handling, this simple pumping scheme is envisioned to be broadly useful for medium to high throughput microfluidic perfusion cell culture assays, cell migration assays, multiple laminar flow drug tests, and any other applications needing multiple microfluidic streams.