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Objective: This prospective, double-blind, randomized study aimed to compare the effects of dexmedetomidine and fentanyl on the latency and amplitude of transcranial motor evoked potentials (TcMEPs) under propofol-based total intravenous anaesthesia (TIVA) in spine surgery. Secondarily, intraoperative hemodynamics, total propofol consumption, recovery profile, and surgical field quality were compared. Methods: TcMEP amplitude and latency recordings of bilateral abductor pollicis brevis and abductor hallucis muscles posted for elective lumbar spine surgery under TcMEP monitoring randomly divided into two study groups. Throughout the surgery, TIVA was administered using intravenous propofol (100-150 µg kg-1 min-1) and dexmedetomidine (0.5-0.7 µg kg-1 h-1) in group D and intravenous propofol (100-150 µg kg-1 min-1) and fentanyl (1 µg kg-1 h-1) in group F. TcMEPs were recorded at various time points during the surgery. Immediately after extubation recovery from anaesthesia was noted. Additionally, hemodynamic parameters, total propofol consumption, and surgical field quality were assessed. Results: Latency and amplitude were comparable between the groups. Time to extubation was significantly longer in group D, but the mean (standard deviation) duration of stay in recovery was shorter in group D [47.55 (7.51) 95% confidence interval (CI) (44.863-50.237)] (P=0.046). Total propofol consumption was reduced in group D [220 (38) 95% CI (206.402-233.598)] (P=0.025) and surgical field condition was better in group D. Conclusions: Dexmedetomidine and fentanyl do not have any effect on TcMEP amplitude and latency. However, dexmedetomidine provides the additional advantage of reduced total propofol consumption, shorter stay in recovery, and better surgical field quality.

Background : When applying lung-protective ventilation, fluid responsiveness cannot be predicted by pulse pressure variation (PPV) or stroke volume variation (SVV). Functional hemodynamic testing may help address this limitation. This study examined whether changes in dynamic indices such as PPV and SVV, induced by tidal volume challenge (TVC), can reliably predict fluid responsiveness in patients undergoing renal transplantation who receive lung-protective ventilation. Methods : This nonrandomized interventional study included renal transplant recipients with end-stage renal disease. Patients received ventilation with a 6 mL/kg tidal volume (TV), and the FloTrac system was attached for continuous hemodynamic monitoring. Participants were classified as responders or nonresponders based on whether fluid challenge increased the stroke volume index by more than 10%. Results : The analysis included 36 patients, of whom 19 (52.8%) were responders and 17 (47.2%) were nonresponders. Among responders, the mean ΔPPV6-8 (calculated as PPV at a TV of 8 mL/kg predicted body weight [PBW] minus that at 6 mL/kg PBW) was 3.32±0.75 and ΔSVV6-8 was 2.58±0.77, compared to 0.82±0.53 and 0.70±0.92 for nonresponders, respectively. ΔPPV6-8 exhibited an area under the curve (AUC) of 0.97 (95% confidence interval [CI], 0.93–1.00; P≤0.001), with an optimal cutoff value of 1.5, sensitivity of 94.7%, and specificity of 94.1%. ΔSVV6-8 displayed an AUC of 0.93 (95% CI, 0.84–1.00; P≤0.001) at the same cutoff value of 1.5, with a sensitivity of 94.7% and a specificity of 76.5%. Conclusion : s: TVC-induced changes in PPV and SVV are predictive of fluid responsiveness in renal transplant recipients who receive intraoperative lung-protective ventilation.

Background : ABO-incompatible (ABOi) kidney transplantation poses significant challenges in achieving successful outcomes. This study aimed to investigate the impact of various interventions and techniques on improving the success rates of ABOi kidney transplantation. Methods : We conducted a retrospective observational analysis of patients who underwent ABOi kidney transplantation from November 2012 to March 2023. The study included a total of 105 patients. We collected and analyzed data on patient demographics, preoperative assessments, surgical details, and postoperative outcomes. Results : The mean ages of the donors and recipients were 50.52±10.32 and 36.63±11.61 years, respectively. The majority of recipients were male (81.9%), while most donors were female (89.5%). The most common blood group among recipients was O (69.5%), and among donors, it was B (46.7%). The median durations of chronic kidney disease and dialysis were 12 months (interquartile range [IQR], 7–28 months) and 6 months (IQR, 2–12 months), respectively. Baseline antibody titers (anti-A and anti-B) ranged from 64.0 to 256.0, while on the day of surgery, they were ≤8. Perioperative complications included hypotension (10.5%), acute tubular necrosis (5.7%), delayed graft function (3.8%), and reexploration (3.8%) due to hematoma. Conclusion : s: ABOi kidney transplantation is a viable option for recipients lacking available donors with an ABO-compatible match. Perioperative concerns, including hypoalbuminemia, heightened risk of infections, coagulopathies, aseptic precautions, and immunological surveillance, must be carefully addressed.

Background: Although deep brain stimulation (DBS) has established uses for patients with movement disorders and epilepsy, it is under consideration for a wide range of neurologic and neuropsychiatric conditions. Objective: To review successful and unsuccessful DBS clinical trials and identify factors associated with early trial termination. Methods: The ClinicalTrials.gov database was screened for all studies related to DBS. Information regarding condition of interest, study aim, trial design, trial success, and, if applicable, reason for failure was collected. Trials were compared and logistic regression was utilized to identify independent factors associated with trial termination. Results: Of 325 identified trials, 79.7% were successful and 20.3% unsuccessful. Patient recruitment, sponsor decision, and device issues were the most cited reasons for termination. 242 trials (74.5%) were interventional with 78.1% successful. There was a statistically significant difference between successful and unsuccessful trials in number of funding sources (p = 0.0375). NIH funding was associated with successful trials while utilization of other funding sources (academic institutions and community organizations) was associated with unsuccessful trials. 83 trials (25.5%) were observational with 84.0% successful; there were no statistically significant differences between successful and unsuccessful observational trials. Conclusion: One in five clinical trials for DBS were found to be unsuccessful, most commonly due to patient recruitment difficulties. The source of funding was the only factor associated with trial success. As DBS research continues to grow, understanding the current state of clinical trials will help design successful future studies, thereby minimizing futile expenditures of time, cost, and patient engagement.

Background: Oxidative stress can occur in iron deficiency anemia (IDA), causing cellular injury. The primary objective of the study was to assess serum malondialdehyde (MDA), protein carbonyl as oxidants and glutathione reductase catalase, superoxide dismutase (SOD), and vitamin C levels as antioxidants in patients with IDA and healthy controls; and secondary objectives were to observe the levels among the mild, moderate and severe category of IDA and their correlations with serum iron and ferritin. Material and methods: Fifty-five patients of IDA and 50 healthy controls were enrolled. Diagnosis of IDA was made based on the cut-off values of low hemoglobin as per age, serum iron

Introduction: The current approach to assessing bradykinesia in Parkinson’s Disease relies on the Unified Parkinson’s Disease Rating Scale (UPDRS), which is a numeric scale. Inertial sensors offer the ability to probe subcomponents of bradykinesia: motor speed, amplitude, and rhythm. Thus, we sought to investigate the differential effects of high-frequency compared to low-frequency subthalamic nucleus (STN) deep brain stimulation (DBS) on these quantified facets of bradykinesia. Methods: We recruited advanced Parkinson’s Disease subjects with a chronic bilateral subthalamic nucleus (STN) DBS implantation to a single-blind stimulation trial where each combination of medication state (OFF/ON), electrode contacts, and stimulation frequency (60 Hz/180 Hz) was assessed. The Kinesia One sensor system was used to measure upper limb bradykinesia. For each stimulation trial, subjects performed extremity motor tasks. Sensor data were recorded continuously. We identified STN DBS parameters that were associated with improved upper extremity bradykinesia symptoms using a mixed linear regression model. Results: We recruited 22 subjects (6 females) for this study. The 180 Hz STN DBS (compared to the 60 Hz STN DBS) and dopaminergic medications improved all subcomponents of upper extremity bradykinesia (motor speed, amplitude, and rhythm). For the motor rhythm subcomponent of bradykinesia, ventral contacts yielded improved symptom improvement compared to dorsal contacts. Conclusion: The differential impact of high- and low-frequency STN DBS on the symptoms of bradykinesia may advise programming for these patients but warrants further investigation. Wearable sensors represent a valuable addition to the armamentarium that furthers our ability to conduct objective, quantitative clinical assessments.

Introduction: India is a major contributor to both maternal and neonatal death worldwide. Majority of these fatalities can be averted by adequate utilization of Antenatal care (ANC) services. Large scale surveys like National Family Health Survey follow hieratical characters in which subjects within the clusters are often correlated. The ordinary logistic model ignores this correlation and provide compromised estimate of effect size of predictors. Multilevel model that incorporates correlation is the appropriate method. Aim: To demonstrate the adequacy of multilevel logistic model over ordinary logistic model in hieratical data sets with ANC visits >4 and delivery assisted by Skilled Birth Attendant (SBA). Materials and Methods: This retrospective, cross-sectional study was conducted at the Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India, from October 2021 to March 2022. The data of 174607 women, who delivered the children within five years, obtained using cluster sampling, from country wide survey during 20th January 2015 to 4th December 2016 (India’s National Family Health Survey-IV) was used. Firstly, the model adequacy of ordinary and multilevel logistic models was evaluated for ANC >4 visits and delivery assisted by SBA, the same data set of fourth round National Family Health Survey by considering the outcomes;. Thereafter, predictors of late or no registration of pregnancy were identified using three level logistic model. Results: Because of high Variance Partition Coefficients (VPC) at state and district levels, the multilevel model applied on components ANC >4 visits and delivery assisted by SBA suggested better accuracy of the multilevel logistic model (-2Log L=189334 for ANC >4 visits and 141148 for delivery assisted by SBA) than the ordinary logistic model (-2Log L=220268 for ANC >4 visits and 151978 for delivery assisted by SBA). For the late (registration in third trimester of pregnancy) or no registration of pregnancy, each predictor was found significantly associated in which the most important were women’s education, child birth order, caste and wealth quintile. Conclusion: The present study concluded that multilevel logistic model in clustered design data was useful instead of individual level for more precise estimate of effect size of the predictors.

Objectives: TikTok is a social media platform that has gained popularity and become a powerful engine to disseminate public health and medical information. To date, no study has characterized the qualities of popular TikTok videos related to neurosurgery, or assessed biases in the content of these videos. Methods: The TikTok web browser application was queried using “#neurosurgery” to identify neurosurgery-related videos. The top 100 videos meeting inclusion criteria were analyzed and video characteristics determined. Bias was assessed by the DISCERN scoring system using 3 independent reviewers. A Kruskal–Wallis H test was used to correlate video popularity with video characteristics and to correlate bias with creator and video type. Results: The 100 videos evaluated totaled 8.8 million likes, 104,718 comments, and 100,856 shares. The oldest video was posted February 2020 and the most recent March 2022. Videos were most commonly entertaining (n = 64, 64%), and educational (n = 46, 46%). Video popularity was associated with videos that aimed to entertain, and least associated with videos depicting neurosurgery lifestyle. Low DISCERN scores, indicating more biased content, were seen across the neurosurgical content with the entertaining video category demonstrating the highest bias. Conclusions: Neurosurgical content on TikTok contains a high degree of bias across all creator and video types. Entertaining videos are associated with the highest numbers of likes but also the greatest bias. These data may be used to guide institutions and neurosurgeons to grow interest in the field of neurosurgery and disseminate unbiased information while expanding their social media presence.

Objective: Deep brain stimulation (DBS) allows for direct electrical stimulation of neural circuitry and recording of local field potentials (LFPs). A bibliometric analysis can be implemented to identify studies that have shaped a research field and influenced future study; however, no such analysis investigating the implementation of LFPs in DBS has been performed. The objective of the present study was to identify the most highly cited articles pertaining to DBS LFPs to identify and evaluate the research that has contributed the most to this growing field. Methods: The Science Citation Index of the Web of Science was implemented to identify the top 84 most cited articles pertaining to DBS LFPs. Information regarding the publication, including author information and study aims, was extracted. Results: The most highly cited articles had had a mean of 109 citations and had been published between 2002 and 2019, with a mode in 2016. The articles had predominantly investigated the subthalamic nucleus (68% of clinical studies) in humans (83.8% of clinical studies). The studies of humans had recruited a mean of 12.5 subjects. Most of the identified articles (56.0%) had reported class III clinical evidence. Conclusions: The implementation of DBS LFPs is a novel field that is rapidly growing. However, a need exists for more studies with larger patient cohorts and more randomized controlled trials to further elucidate the benefits of this technology. These results will allow for the identification and recognition of the most influential studies pertaining to DBS LFPs, appreciation of the current and future research trends, and inform us regarding areas warranting further investigation.

Introduction: Gallbladder Cancer (GBC) is highly fatal due to late-stage diagnosis and poor prognosis. Women are more prone to GBC than men. Imbalanced nutrient intake is cited as a risk factor for GBC. Association of nutrients with GBC incidence assessed using 24-hour recall method may mislead as food intake is altered in disease condition. The Food Frequency Questionnaire (FFQ) method that assesses usual nutrient intake pattern would be a better approach. Aim: To evaluate the association of macro and micronutrients in women with GBC using the FFQ method. Materials and Methods: This case-control study was carried out at a tertiary care hospital of Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India, from September 2018 to August 2019. A total of 82 women with GBC, aged 40 years and above, considered as cases and 164 healthy controls were included in the study. Data was collected regarding food intake, following the FFQ method, which included breakfast, lunch, dinner, and other extra intakes. Macro and micronutrients were computed using a raw database of food. A multivariate statistical approach was adopted as the nutrients were correlated. Results: The mean age of the controls (45.7±10.1 years) was significantly lower than the GBC cases (55.2±11.0 years). Preponderance in both cases and controls was of Hindus, rural and Other Backward Class (OBC) women. Illiterate patients were more than twice than the controls. Intake of 12 nutrients i.e., protein, fat, phosphorus, zinc, manganese, and carotene were higher and of calcium, potassium, selenium, vitamin-C, vitamin-E, and fibre were lower in cases than the controls. These 12 nutrients completely separated cases and controls. However, zinc, manganese, potassium, and fibre whose contributions were lowest when ignored, the separation ability to cases and controls remained the same as of 12 nutrients. Conclusion: Protein, fat, phosphorus, carotene, calcium, selenium, vitamin-C and vitamin-E, were found to be associated with GBC risk. Therefore, further understanding the role of nutrients in bringing about the right intervention to reduce the incidence of GBC is needed.

The world’s health in 2020 was in the grip of the COVID-19 pandemic and its adverse consequences and is still continuing in 2021. Most countries have been locked down or going through different forms of lockdown to prevent the transmission of the infectious virus SARS-CoV-2. To date, there is no specific treatment or vaccination preventive measures. World Health Organization has approved few vaccines for emergency use. Still, the emergence of mutations within SARS-CoV has put forward challenges for vaccine developers. Whether infectious or non-infectious, all diseases have an inflammatory aspect to alarm the body system along with an anti-inflammatory counterbalance mechanism to minimize harmful effects whether through immune modulation or antioxidant reserves. An approach to counteract the novel disease, COVID19, was also sought in enhancing the anti-inflammatory aspect, at the level of prevention and at the level of treatment. One of the methodologies was the recommendation of micronutrient Vitamin D whose immune-modulatory role has been well appreciated in many disease conditions. This short review aims to explore the relationship between vitamin D status through susceptibility and clinical outcomes of COVID-19.

ABSTRACT Introduction: Idiopathic steroid resistant nephrotic syndrome (SRNS) has variable outcomes in children. The primary objective of the present study was to assess the cumulative remission rate and the secondary objectives were to assess factors affecting the remission status, kidney function survival, and adverse effects of medications. Methods: One hundred fourteen patients with SRNS were included. Calcineurin inhibitor-based treatment protocol along with prednisolone and angiotensin-converting enzyme inhibitor were used, and patients were followed over 5 years. Results: Median age was 4.5 years; 53.5% of cases were between 1 to 5 years of age. Sixty-two patients (54.4%) were at initial stage and 52 (45.6%) were at a late SRNS stage. Median eGFRcr was 83.5 mL/min/1.73m2 at presentation. Of the 110 patients, 63 (57.3%) achieved remission [complete remission 30 (27.3%), partial remission 33 (30%)], and 47 (42.7%) had no remission. Kidney function survival was 87.3% and 14 cases (12.7%) had progression to CKD (G3-8, G4-3, G5-1, and G5D-2). Median duration of follow up was 36 months (IQR 24, 60). Age of onset, cyclosporine/tacrolimus, eGFRcr, and histopathology (MCD/FSGS) did not affect remission. Similarly, remission status in addition to age of onset, drug protocol, and histopathology did not significantly affect kidney function during a period of 5 years. Hypertension, cushingoid facies, short stature, cataract, and obesity were observed in 37.7, 29.8, 25.5, 17.5, and 0.7% of cases, respectively. Conclusion: About half of the cases achieved remission. Age of onset of disease, cyclosporine/tacrolimus use, and histopathological lesion neither affected remission status nor short-term kidney function survival in SRNS.

Introduction: One of the stringent assumptions about covariates in the Cox hazard and Logistic regression modelling is that they should be independent. Incorporating correlated covariates as such into the model might distort the precision of the estimates due to multicollinearity. One way to deal with multicollinearity is by using Principal Component Analysis (PCA) technique. Aim: To demonstrate the application of PCA in dealing with correlated covariates while modelling time to event and case-control study data. Materials and Methods: This study was conducted at Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India, from February 2021 to January 2022. Two datasets were used for the demonstration i.e., data relates to a time to event outcome and a case-control study with binary outcome in which lipids were the correlated covariates. Three sets of Cox regression models were used to demonstrate change in hazard ratios with 95% Confidence Intervals (CI) for evaluating the effect of intervention at a different time of lipid measurement. Model I has evaluated treatment/Body Mass Index (BMI) effect on the outcome by ignoring the effect of lipid parameters. Model II has evaluated treatment/BMI effect on the outcome by incorporating lipid variables but ignoring multicollinearity. Model III has evaluated treatment/ BMI effect on the outcome by incorporating lipid variables through principal component analysis and thus adjusting for multicollinearity. Similarly, a logistic regression model was performed by using the same three sets of models to evaluate the effect of exposure (BMI). The comparability of lipids between the two groups for both datasets was tested using Hotelling’s T-squared statistic. Results: The lipids measured at 12th, 24th and 36th months between the two groups in the first data set as well as between cases and controls in the second data set were statistically significant. In the first dataset, at baseline, the Hazard Ratio’s (HR’s) were statistically similar irrespective of the models used; while decreasing successively with narrowing 95% CI’s as moving from model I to model III for the lipid measured at 12th, 24th and 36th months. Further, at 24th and 36th months, the HR in model-III found to be significant. In the second data set, the Odds Ratio (OR) were significant for all the three models and it was almost similar for model I and II but in model III it was elevated. Conclusion: The multicollinearity issue should be properly addressed before including correlated covariates in the Cox regression hazard and Logistic regression model. The PCA technique would be a favourable method.

Introduction: Age at menarche is said to be a risk factor for Gallbladder Cancer (GBC). The available research about the association of age at menarche with GBC, by taking a cut-off age of 13 years, is neither uniform nor consistent and at best inconclusive. Aim: To evaluate the association between age at menarche and the risk of GBC, based on cut-off age of 13 years and treating age at menarche as a continuous variable. Materials and Methods: A hospital based case-control study was conducted on 92 female patients and 92 female controls. The data was collected from the Department of Surgical Oncology, Sir Sunderlal (SS) Hospital, Banaras Hindu University, Varanasi, Uttar Pradesh, India during the period of October 2018 to June 2019. Logistic regression analysis was performed and Adjusted Odds Ratio (AOR) with its 95% CI (Confidence Interval) was obtained. Results: In the present study, the mean age of GBC cases and control were 56.84±8.74 years and 51.21±6.37 years, respectively. With the reference category of menarche age, the females with menarche age >13 years were insignificantly at lower risk of incidence of GBC (AOR=0.569; 95% CI: 0.263-1.233). But when age at menarche was considered as a continuous variable; the AOR was significantly lower among females found decreasing with increasing age at menarche (AOR=0.798; 95% CI: 0.666-0.955). Conclusion: This exercise indicates, using a reference category of continuous measurements obtained result may be inconclusive with an influence of subjective decision making so it is suggested to prefer the recorded discrete continuous value for the analysis procedure.

[2 + 2] cycloaddition of alkynes with alkenes would normally require UV light irradiation. Here, the authors report an alkyne–alkene [2 + 2] cycloaddition based on visible light energy transfer photocatalysis, both inter- and intramolecularly, to afford cyclobutenes and 1,3-dienes.

Introduction: The high prevalence of Low Birth Weight (LBW) due to Preterm Birth (PTB) and Intrauterine Growth Restriction (IGUR) still persists a challenge in India. This happens due to poor and infrequent utilisation of Antenatal Care (ANC) service. Aim: To assess the difference of PTB and LBW newborns in mothers, who availed ANC at a tertiary care hospital against those who availed ANC at other healthcare facility. Materials and Methods: This cross-sectional study was conducted at Gynaecology Department in Sir Sundarlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India and 1858 mothers and their newborn were analysed. The data was obtained from the delivery register maintained at the Labour Room of the Department. The age of the mother, place where ANC services availed, birth weight of the newborn and the gestational age were recorded on a master chart. The newborn were considered LBW, if birth weight was

Background: Preoperative anxiety plays a critical role in post-operative pain response and other outcomes. Melatonin is a naturally secreted hormone which has anxiolytic, sedative, and analgesic properties. Pregabalin, analogue of gabapentin which has property of anxiolytic and analgesic effects. Materials and Methods: Total 96 patients undergoing total hip arthroplasty, divided into 3 groups of 32 each and were given placebo (group I), melatonin 6 mg (group II), and pregabalin 150 mg (group III). Anxiety level, postoperative pain score, sedation level and duration as well as characteristics of spinal anaesthesia were assessed with other vital parameters. Results: Group I showed an increment in the anxiety score from baseline whereas in group II and group III, there was a decline in pre-operative anxiety score from baseline at all the periods of observation and more significantly in group III. Visual analogue scale (VAS) score and total dose of rescue analgesia were highest in group I, but group II and group III were comparable to each other. However, the durations of spinal anaesthesia and motor blockade showed a statistically significant difference with maximum duration in group III followed by II and then I. The level of sedation among the three groups were comparable at all the periods of observation. Conclusions: Pregabalin was found better for perioperative anxiolysis, post-operative analgesia and for prolongation of duration of spinal anaesthesia when compared to melatonin.

Abstract Introduction: Treatment of nephrotic syndrome with corticosteroid can cause several side- effects including behavioral abnormalities. The objectives of the study were to observe the proportion of non-relapsers having persistence of behavioral abnormalities after completion of treatment of initial episode and compare the abnormalities with relapsers, and to determine risk factors for persistence. Methods: Seventy-five children with a first episode of idiopathic nephrotic syndrome and 60 normal children were rated by parents for behavioral problems using the Child Behavior Checklist. The Parenting Stress Index was also evaluated. The children were rated before treatment and 12 and 36 weeks after. Results: Both relapsers and non-relapsers showed abnormalities in internalizing and externalizing domains at 12 weeks of steroid therapy. Non-relapsers had abnormal scores in the internalizing domain in 63.5 % and externalizing domain in 48.1% of cases at 36 weeks. Relapsers had abnormal scores in all the three behavior domains, but a significantly higher proportion of relapsers had abnormal scores regarding total behavior (65.2% vs 28.8%, p

Background: In clinical setting, to answer a research question, very often more than one outcome variables are used which are statistically correlated. Univariate analysis approach, which is commonly used in such context, violates the assumption of independence for correlated variables, while multivariate approach could give more robust and precise clinical decision by accounting this correlation. This paper is a demonstration of the change in statistical decision in multivariate approach compared to univariate approach in analysing medical data with multiple correlated outcome variables. Method: ology: The data used in this paper was the ACCORD trial data and the variables were Systolic blood pressure (SBP) and Diastolic blood pressure (DBP) which are correlated. The condition of bivariate normality was checked after removing the outliers. We compared the differences in means of SBP and DBP separately between the groups at different follow up time points by univariate approach using unpaired ‘t’ test and thereafter together by bivariate approach using Hotelling ‘T2’. Further the role of varied levels of correlation between SBP and DBP coupled with the variations in sample size in changing the statistical inference has been investigated. Robustness of these results were demonstrated through 1000 samples of simulated data from Accord trial data. Results: The statistical decision regarding difference in means of either SBP or DBP between the two groups at baseline, 12th, 36th and 84th month in both univariate and bivariate approaches were similar. At baseline and 84th month the hypotheses were accepted and at 12th and 36th month the hypotheses were rejected with both the approaches. However at 60th and 72nd month the univariate and multivariate approach results contradicted each other which reflect the significance of correlation in modifying the inference. The analysis results further indicated that varied levels of correlation and sample size too modify the inference in bivariate approach and contradict univariate results. Conclusion: Studies with multiple correlated outcomes, the multivariate approach which accounts this statistical correlation has potential to change statistical decisions and provide more precise results. Hence multivariate approach is recommended in such situations.

Abstract Physical process version of the first law of black hole mechanics relates the change in entropy of a perturbed Killing horizon, between two asymptotic cross sections, to the matter flow into the horizon. Here, we study the mathematical structure of the physical process first law for a general diffeomorphism invariant theory of gravity. We analyze the effect of ambiguities in the Wald’s definition of entropy on the physical process first law. We show that for linearized perturbations, the integrated version of the physical process law, which determines the change of entropy between two asymptotic cross-sections, is independent of these ambiguities. In case of entropy change between two intermediate cross sections of the horizon, we show that it inherits additional contributions, which coincide with the membrane energy associated with the horizon fluid. Using this interpretation, we write down a physical process first law for entropy change between two arbitrary non-stationary cross sections of the horizon for both general relativity and Lanczos-Lovelock gravity.

The study was aimed to examine the effect of supplementation of sodium metavandate (NaVO3) as source of vanadium on DMI intake, growth performance, antioxidant activity, level of mineral in plasma and their balance in male Sahiwal calves. The vanadium content in maize (Zea mays) and bajra (Pennisetum glaucum) grains was 58 ppb and 55 ppb while in berseem (Trifolium alexandrinum) and mustard (Brassica campestris) fodder it was 8.37 and 7.24 ppm, respectively. Male Sahiwal calves (20) of comparable age (6±0.82 months) and body weight (71±8.06 kg) were randomly allotted to 4 different treatments with replication of 5 animals in each. Supplementation was done with 0, 2, 4 and 8 ppm of vanadium in groups T1, T2, T3 and T4, respectively, for 120 days. Blood samples were collected at monthly intervals to examine antioxidant activity in blood, plasma and mineral levels. Feed consumption (DM intake, DM intake% BW) and growth rate did not show any significant effect of vanadium supplementation. Glutathione peroxidase activity was higher in groups T3 and T4 as compared to T1 and T2 whereas, SOD and catalase activity was similar in all the groups. Excretion and absorption patterns of Ca, P, Cu and Fe and their plasma levels were similar in different groups. However, vanadium and Zn balance and their plasma levels increased due to vanadium supplementation. The present study revealed that in growing calves, vanadium supplementation showed enhanced glutathione peroxidise activity, plasma Zn and vanadium levels.