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ObjectivesNeurologic manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, COVID-19) infection are common and varied. The objective of this report was to describe clinicopathologic findings of rare acute ascending necrotizing myelitis (ANM) and briefly summarize similar COVID-19–associated longitudinally extended transverse myelitis cases.MethodsWe described the clinical presentation, disease course, diagnostic workup, therapeutic measures, and pathologic findings of ANM associated with COVID-19 infection.ResultsA 31-year-old previously healthy woman developed a longitudinally extensive lower thoracic myelopathy 3 weeks after COVID-19 infection. The thoracic spinal cord lesion extended to cervical level in 1 week and to the lower medullary level in 2 more weeks. Thoracic laminectomy at T5-T6 level and cord biopsy revealed necrobiotic changes without viral particles or microglial nodules. The clinical deficit stabilized after immunomodulatory and eculizumab therapies.DiscussionCOVID-19 infection can cause ANM. It adds to the spectrum of reported cases of COVID-19 –associated encephalitis and myelitis.

Emerging concern about the emergence of antimicrobial resistance has limited the use of antibiotics in calves. Hence, there is a need to find suitable alternatives to antibiotics to manage gastrointestinal infections in neonatal calves. The objective of the present study was to develop a probiotic of calf-origin for its potential application in calf nutrition. Accordingly, 69 lactic acid bacteria (LAB) strains were isolated from faeces of newborn calves, out of which 10 strains were short-listed for further in vitro testing based on the aggregation time and cell surface hydrophobicity. The results of acid-, bile- and phenol-tolerance tests indicated that out of the ten strains, the isolate CPN60 had better resistance to these adverse conditions likely to be encountered in the gastrointestinal tract. The isolate also showed an optimal ability to produce biofilm. Further assessments reiterated its superiority in terms of co-aggregation and antagonistic activity against pathogenic strains of Escherichia coli. Subsequently, the isolate was identified through 16S rRNA sequencing and sequence homology and designated as Ligilactobacillus salivarius CPN60. The candidate probiotic was evaluated in vivo using 48 male (5 weeks old) Wistar rats, divided into two equal groups viz. control (CON) and probiotic (PRO). During the 4-weeks feeding trial, the PRO group rats were gavaged with one mL culture of L. salivarius CPN60 equivalent to 108 CFU/rat. The in vivo trial results indicated better nutrient utilization efficiency and growth performance (p

Background Common mental disorders (CMD) are among the largest contributors to global maternal morbidity and mortality. Although research on perinatal mental health in India has grown in recent years, important evidence gaps remain, especially regarding CMD. Our study aims to improve understanding of CMD among perinatal and non-perinatal women of reproductive age across two settings in India: Bangalore (Karnataka) and Tanda (Himachal Pradesh). Methods The study is embedded within the Maternal and Perinatal Health Research Collaboration India (MaatHRI). This mixed-methods observational study comprises three consecutive phases: (i) focus group discussions and individual interviews to explore women’s knowledge and seek feedback on CMD screening tools; (ii) validation of CMD screening tools; and (iii) prospective cohort study to identify CMD incidence, prevalence and risk factors among perinatal and non-perinatal women. Results of the three phases will be analyzed using inductive thematic analysis, psychometric analysis and multivariable regression analysis, respectively. Conclusion Improving understanding, detection and management of CMD among women is key to improving women’s health and promoting gender equality. This study will provide evidence of CMD screening tools for perinatal and non-perinatal women in two diverse Indian settings, produce data on CMD prevalence, incidence and risk factors and enhance understanding of the specific contribution of the perinatal state to CMD.

Near peer learning is an educational practice in which children interact with their peers or friends attain educational objectives. In simpler terms children involved in this type of learning are seniors and juniors of the same school or college. Learners are more comfortable and relaxed, and ready to learn when teacher is their peer, whom they know and understand. At the same time, it develops communication skill, leadership skills and confidence of public dealings in the teacher peer. In recent days, near peer teaching and learning becoming popular as learning methodology in schools and colleges. It involves students exposed to similar circumstances, from same educational programme, but at different levels. Research question of the study is ‘Is Near Peer learning effective on improving knowledge and habit making regarding prevention of waterborne diseases among primary school children?’ This study was carried out systematically to assess the effectiveness of structured Near Peer learning, where a senior student teaches regarding prevention of waterborne diseases to junior students. Here the subject selected for structured near peer learning is “prevention of waterborne diseases”. Elder children of age group 13-14 years taught their near peers of age group 9-10 years, regarding prevention of waterborne diseases with special attention on improving personal hygiene and hand hygiene. The researcher assessed the effectiveness of structured Near peer learning regarding prevention of water borne diseases, in increasing the knowledge and improving the habits related to Personal hygiene and Hand washing, among primary school children. An evaluative research approach with one group pre test post test design was adopted. In the study, 4 students of 13-14 years age group were selected and researcher taught them regarding prevention of waterborne diseases. 40 primary school children of age group 9-12 years, constituting both boys and girls were also selected through convenient sampling technique. Then one elder child taught 10 younger children regarding same. Pretest and post test done. The questionnaire used were, demographic proforma, knowledge questionnaire, and checklist. Mean pretest was 9.925 and mean post test knowledge was 15.6 Mean pretest for practice was 33.5 and mean post test for practice was 42.07. Hand washing mean pretest practice score was 7.075 and post test was 10.095. There was significant association between pre test scores regarding knowledge and practice and education of child, occupation of father and age of child. P_value

Computerization is becoming famous step by step because of various benefits. Till now the current advancement shows that the mechanization framework is overseen by messages, messages or a few different applications. This paper gives a thought of involving IoT for observing and controlling home machines by means of the World Wide Web through remote medium or Wi-Fi. The thought given in this paper targets controlling home machines through detecting the movement of the human body by involving a Raspberry Pi as a server framework, PIR sensor for detecting movement of the human body and convey in AWS cloud stage so the framework is open with the movement of the human body just, with NodeMCU. Raspberry Pi known as a Single Board Computer (SBC) is proposed in this paper to accomplish these objectives. PIR sensor identifies a person moving around, which can recognize levels of infrared radiation. A web or an android application is utilized by the clients to carefully guide these frameworks. This framework can utilize a large group of specialized strategies like Wi-Fi, GSM, Bluetooth, ZigBee. Distinctive controlling gadgets and designs can be found in existing frameworks. Such frameworks have been tracked down currently in many spots for a wide assortment of uses. This paper presents a review of every such framework.

The writers describe a case of big ovarian mucinous cystadenocarcinoma aggravating a young pregnancy in a young woman. Ovarian mucinous adenocarcinoma is an uncommon type of ovarian tumour that develops from the ovary's surface epithelium.A 25-year-old woman with abdominal distension presented to the hospital 9 days after giving birth. USG findings reveal a massive solid cystic mass beginning from the pelvis and extending up to the epigastrium, measuring 36 x 14 cm.MRI pelvis shows a heterogeneous hyperintense solid cystic mass lesion with a bunch of grapes appearance in the intraperitoneal space, extending cranially up to the epigastrium and caudally into the pelvis, causing anterior uterus displacement. Also, the bowel loops are displaced to the back. The lesion is cystic with a solid component and multiple internal echoes for the most part.

Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive neurodegenerative disease resulting in death in 2 to 4 years in most cases. There are several clinical subtypes of ALS depending on the degree of upper and lower motor neuron involvement, and recognition of these subtypes is important because certain subtypes have better prognosis. Without a reliable biomarker, ALS is a clinical diagnosis supported by laboratory investigations. The etiology of ALS remains unknown. However, mutations in certain genes cause ALS in about 5–8% of cases and understanding molecular pathogenetic pathways in these cases may pave a way for effective therapies. There is currently no cure or meaningfully effective therapy for ALS. Supportive and palliative measures in multidisciplinary ALS clinics are exceedingly important to maintain and improve the quality of life in patients with ALS. This chapter summarizes the clinical features and management of ALS.

Sentiment analysis is used to conclude the approach of a consumer with respect to some topic. Sentimental analysis, a sub discipline within data mining and computational linguistics, refers to the methodology for mining, understanding the opinions expressed by the consumer in various forms like forums, forms blogs etc. The goal of sentiment analysis is to identify emotional states in online text. We Know human’s learns from past knowledge and machines follows instructions given by humans. But what if humans can prepare the machines from the past data and to put output to work much faster well that what is machine learning is it’s not about learning it’s also about understanding. So we will learn about analysis of sentiments using machine learning techniques

Background: The SARS-CoV-2 pandemic in India has adversely affected many aspects of population health. We need detailed evidence of the impact on reproductive health in India so that lessons can be learnt. Methods: Hospital-based repeated monthly survey of nine severe maternal complications and death in 15 hospitals across five states in India covering a total of 202,986 hospital births, December-2018 through to May-2021. We calculated incidence rates (with 95% Confidence Intervals (CIs)) per 1000 hospital births, case-fatality and rate ratios (RR) with 95% CIs. Linear regression was used to examine the association between the Government Response Stringency Index (GRSI) for India and changes in hospital births, incidence and case-fatality. Results: There was a significant decrease in hospital births per month during the pandemic period with a 4.8% decrease per 10% increase in the GRSI scores (p

An in ovo study on the effect of the administration of a combination of nucleosides (25, 50, and 100 mg/egg) on hatchability, growth performance, energy metabolizability, and intestinal morphology in broilers was carried out. Four hundred eighty (480) fertile eggs were divided into four groups (in four replicates each having 30 eggs). On the 18th days of incubation of the eggs, candling was carried out and the fertile eggs were selected and given one of the four in ovo administrations. Group one served as control and was injected with phosphate-buffered saline (PBS). The other groups were given in ovo administration of nucleosides (25, 50, and 100 mg/egg) at 100 μl through the yolk sac route, and chicks of respective groups were hatched out. Among the experimental groups, the hatchability was comparable; however, the hatchability was affected in the group injected with a higher level of nucleosides at 100 mg/egg. The hatched out chicks from higher doses of nucleosides (50 and 100 mg) had higher body weight (BW) (P < 0.05) than the control. Higher energy metabolizability (%) was observed in nucleoside-injected groups. Plasma protein concentration was higher in groups administered with nucleosides (50 and 100 mg). Histologically, the intestinal villi length was maximum in 100 mg-injected group followed by 50 and 25 mg. Relative expression of homeobox (Cdx) in the jejunum was significantly (P < 0.05) upregulated in all the injected groups at 3, 7, and 14 days of age. Nucleoside-administered groups had better performance, energy metabolizability, and intestinal morphology. Among the experimental groups, the administration of nucleosides at 50 mg/egg resulted in higher growth performance, plasma protein, intestinal surface, and villi development in broiler chickens.

The present study investigates the performance of two-bed adsorption refrigeration system for various types of activated carbon–ammonia pairs by employing steady-state thermodynamic model. Two performance parameters, namely coefficient of performance (COP) and specific cooling effect (SCE), are evaluated and compared for different types of activated carbon particles under various working conditions. The control parameters to depict variable working conditions are chosen to be maximum desorption temperature, minimum adsorption temperature, condensation pressure and evaporation pressure. A simple thermodynamic model has been developed to obtain the cycle analysis. Heats of adsorption and desorption are estimated using the Clausius–Clapeyron equation, while the Dubinin-Astakhov (D-A) adsorption model has been used to correlate concentration of ammonia (W) in the adsorber/desorber bed with respect to pressure (P) and temperature (T) under equilibrium condition. The theoretical analysis shows that activated carbon–ammonia adsorption refrigeration system can achieve COP of 1.4 and SCE of 240 kJ/kg at maximum and minimum bed temperature of 185 ℃ and 22 ℃, respectively, for compact AS12 activated carbon ammonia pair. The result of this simulation will provide convenient guidelines for the design of a two-bed continuous type basic adsorption refrigeration cycle.

Background: Infertility is commonly defined as the failure of conception after at least twelve months of unprotected intercourse. Factors contributing are both male and female in which unexplained etiology accounts for 51%, male factor 28%, endometriosis 17% and ovulatory disorders 4%.Methods: Prospective, randomized study was conducted at DRRPG medical college, Tanda, Kangra, Himachal Pradesh. In our study, patients were randomized into two groups of 30 each. Women in group A received clomiphene citrate 100mg/day and group B received letrozole 2.5 mg/day from day 3-7 of menstrual cycle. All the patients received human menopausal gonadotropin 75 U given every alternate day from day 5 until HCG administration. Ovulation was triggered with recombinant HCG (5000 IUIM) when the dominant follicles reached 18 mm in diameter. A single IUI was performed 36 hours later. A maximum of four cycles were given.Results: In our study, total number of induction cycles given in group A and B were 120 and 114 respectively. Out of these, 112 and 111 IUI cycles were done in group A and B respectively. A pregnancy rate of 1.66% and 7.87% per IUI cycle was observed in group A and B respectively.Thus it is concluded that the pregnancy rates were significantly higher in letrozole group (30%) in comparison to clomiphene citrate group (6.66%).Conclusions: Aromatase inhibitor letrozole appears to constitute a good alternative to clomiphene citrate in patients with unexplained infertility undergoing gonadotropin-stimulated COS cycles combined with IUI therapy.

In the current digital era, education system has witness tremendous growth in data storage and efficient retrieval. Many Institutes have very huge databases which may be of terabytes of knowledge and information. The complexity of the data is an important issue as educational data consists of structural as well as non-structural type which includes various text editors like node pad, word, PDF files, images, video, etc. The problem lies in proper storage and correct retrieval of this information. Different types of learning platform like Moodle have implemented to integrate the requirement of educators, administrators and learner. Although this type of platforms are indeed a great support of educators, still mining of the large data is required to uncover various interesting patterns and facts for decision making process for the benefits of the students.

The habitat use and seasonal migratory pattern of birds in Ethiopia is less explored as compared to diversity studies. To this end, this study aimed at investigating the patterns of distribution related to seasonality and the effect of habitat characteristics (elevation, slope, and average vegetation height) on habitat use of birds of Wondo Genet Forest Patch. A stratified random sampling design was used to assess the avian fauna across the four dominant habitat types found in the study area: natural forest, wooded grassland, grassland, and agroforestry land. A point transect count was employed to investigate avian species richness and abundance per habitat type per season. Ancillary data, such as elevation above sea level, latitude and longitude, average vegetation height, and percent slope inclination, were recorded with a GPS and clinometers per plot. A total of 33 migratory bird species were recorded from the area, of which 20 species were northern (Palearctic) migrants while 13 were inter‐African migrants. There was a significant difference in the mean abundance of migratory bird species between dry and wet seasons (t = 2.13, p = .038, df = 44). The variation in mean abundance per plot between the dry and wet seasons in the grassland habitat was significant (t = 2.35, p = .051, df = 7). In most habitat types during both dry and wet seasons, omnivore birds were the most abundant. While slope was a good predictor for bird species abundance in the dry season, altitude and average vegetation height accounted more in the wet season. The patch of forest and its surrounding is an important bird area for migratory, endemic, and global threatened species. Hence, it is conservation priority area, and the study suggests that conservation coupled with ecotourism development is needed for its sustainability.

Antibiotics, often supplemented in feed, used as a growth promoter, may cause their residual effect in animal produce and also trigger antibiotic resistance in bacteria, which is of serious concern among swine farming entrepreneurs. As an alternative, supplementing probiotics gained interest in recent years. Lactobacillus being the most commonly used probiotic agent improves growth performance, feed conversion efficiency, nutrient utilization, intestinal microbiota, gut health and regulates immune system in pigs. The characteristics of Lactobacillus spp. and their probiotic effects in swine production are reviewed here under.

Background Cervical cancer is the most common cause of death among women in developing countries. India has the highest age standardized incidence in South Asia at 22. An attempt was made to know the impact of cancer screening programmes in place since 1975 in India, and to do cytological screening in symptomatic women. Material and methods 200 women in the age group of 21–65 years who attended Gynaecology Outdoor Patient Department (OPD) who consented to participate were screened by Pap smear testing. Women who were pregnant, and known or treated case of cancer cervix were excluded from the study. Pap smears were made with conventional method. Results None of the women had Pap smear testing in their life earlier. Only 5% women knew that the tests are available that can detect cervical cancer. All the women were married and in stable marital relationship. Mean age was 38.6 years. Most of the women were parous, had poor socio-economic status and had never used tobacco in any form. Vaginal discharge was the commonest complaint followed by inter-menstrual bleeding. 56% smears were reported as NILM, 32.5% inflammatory, 1.5% had other non-specific findings. ASC-US was in 1%, LSIL in 5.5% and HSIL in 2.5% women. Overall sensitivity and specificity for detection of LSIL were 76.9% and 96.2% and those for detection of HSIL were 66.6% and 97.6%. Conclusions Pap smear is highly sensitive and specific method in detecting pre-cancerous lesions of cervix. Community needs to be enlightened about Pap test through diffuse educational activities.

The present study was carried out to evaluate the efficacy of host specific probiotic on growth performance, diarrhoea scores, intestinal microbiota and gut health of grower-finisher pigs. A feeding trial (180 days) was carried out with 36 early weaned piglets (28 days) divided into three dietary groups (4 replicates of 3 each) viz ., T0 (basal diet alone, control), T1 (basal diet + probiotic of dairy origin, Lactobacillus acidophilus NCDC-15) and T2 (basal diet + probiotic of swine origin, Pediococcus acidilactici strain FT28). The probiotics were fed as fermented feed @200 g/pig/day. At the end of the trial, six pigs from each group were sacrificed to determine the intestinal morphology. Daily feeding of probiotics from weaning to market age showed positive (P E. coli and clostridia population decreased (P P. acidilactici strain FT28 was more effective in decreasing (P L. acidophilus NCDC-15. The villi height (V) and crypt depth (C) was increased (P P. acidilactici strain FT28 was more effective in reducing diarrhoea scores and maintaining acidic environment of gastrointestinal tract (GIT) indicating a synergistic probiotic effect along with gut microbiota for promotion of gut health of the animal.

Background:Thyroid disorder is the second most common endocrine disorder affecting women of reproductive age. The increased prevalence of thyroid dysfunction in pregnancy and the need for proper management to reduce obstetrical and neonatal adverse events led us to collect the baseline data on hypothyroidism in pregnancy in our population. Material and methods: A total of 1203 consecutive pregnant women attending antenatal clinic in our hospital and consented to participate were studied. All women were tested for TSH levels (determined by chemiluminescent enzyme immunoassay) . Women having higher than normal range of TSH (>2.5mIU/L in first trimester and >3.0mIU/L in second trimester were further tested with repeat TSH & T4. Results: 118 (9.8%) were found to be hypothyroid. The mean age of the women was 26.2?3.7years. 21.2% women had history of previous one or more spontaneous abortions, 15.3% had history of infertility. Symptoms of hypothyroidism were present in 33.9% women, 4.2% women had goiter. Mean BMI was 26.1kg/m2. 72.9% were newly diagnosed in current pregnancy and 27.1% were known cases of hypothyroidism. 18.1% women had pregnancy induced hypertension, 11.9% had preterm labor, and 10.2% each had placental abruption and premature rupture of membranes. 7.6% women had intrauterine growth restriction. Caesarean rate was 41.5% of which 54% were for foetal distress. 16% of neonates were admitted to NICU. Conclusions: Based on the results of this study, we recommend universal screening of hypothyroidism in pregnancy for early diagnosis and treatment of this potentially treatable condition complicating pregnancy.

In the current digital era, education system has witness tremendous growth in data storage and efficient retrieval. Many Institutes have very huge databases which may be of terabytes of knowledge and information. The complexity of the data is an important issue as educational data consists of structural as well as non-structural type which includes various text editors like node pad, word, PDF files, images, video, etc. The problem lies in proper storage and correct retrieval of this information. Different types of learning platform like Moodle have implemented to integrate the requirement of educators, administrators and learner. Although this type of platforms are indeed a great support of educators, still mining of the large data is required to uncover various interesting patterns and facts for decision making process for the benefits of the students. In this research work, different data mining classification models are applied to analyse and predict students’ feedback based on their Moodle usage data. The models described in this paper surely assist the educators, decision maker, mentors to early engage with the issues as address by students. In this research, real data from a semester has been experimented and evaluated. To achieve the better classification models, discretization and weight adjustment techniques have also been applied as part of the pre – processing steps. Finally, we conclude that for efficient decision making with the student’s feedback the classifier model must be appropriate in terms of accuracy and other important evaluation measures. Our experiments also shows that by using weight adjustment techniques like information gain and support vector machines improves the performance of classification models.

Background Arginine:glycine aminotransferase (AGAT) (GATM) deficiency is an autosomal recessive inborn error of creative synthesis. Objective We performed an international survey among physicians known to treat patients with AGAT deficiency, to assess clinical characteristics and long-term outcomes of this ultra-rare condition. Results 16 patients from 8 families of 8 different ethnic backgrounds were included. 1 patient was asymptomatic when diagnosed at age 3 weeks. 15 patients diagnosed between 16 months and 25 years of life had intellectual disability/developmental delay (IDD). 8 patients also had myopathy/proximal muscle weakness. Common biochemical denominators were low/undetectable guanidinoacetate (GAA) concentrations in urine and plasma, and low/undetectable cerebral creatine levels. 3 families had protein truncation/null mutations. The rest had missense and splice mutations. Treatment with creatine monohydrate (100–800 mg/kg/day) resulted in almost complete restoration of brain creatine levels and significant improvement of myopathy. The 2 patients treated since age 4 and 16 months had normal cognitive and behavioral development at age 10 and 11 years. Late treated patients had limited improvement of cognitive functions. Conclusion AGAT deficiency is a treatable intellectual disability. Early diagnosis may prevent IDD and myopathy. Patients with unexplained IDD with and without myopathy should be assessed for AGAT deficiency by determination of urine/plasma GAA and cerebral creatine levels (via brain MRS), and by GATM gene sequencing.

Background: In developing and resource-limited countries alternative screening methods like VIA, VILI, and Pap smear are used in detection of premalignant and malignant lesions of cervix. The aim of our study was to compare the efficacies of VIA, VILI, and Pap smear in detection of premalignant and malignant lesions of cervix.Methods: The study was conducted for a period of one year in the department of obstetrics and gynaecology, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh. Women who attended the outdoor patient department of obstetrics and gynecology were subjected to collection of Pap Smear, VIA followed by VILI and a thorough pelvic examination.Results: Among the 350 women studied, 59 women (16.9%) had abnormal VIA, 64 women (18.2%) had abnormal VILI. On pap smear, 10 women were reported as ASCUS, 11 as L-SIL and 1 as H-SIL. Cervical biopsy was done in 98 women, out of which 70 had one or more abnormality on VIA, VILI, or Pap, and 28 women who had normal results. Sixteen women (16.3%) reported as CIN-1 and 2 women (2.07%) as CIN-3. VIA and VILI had a higher sensitivity as compared to pap. However, pap was more specific. The PPV of pap was also much higher as compared to VIA and VILI, whereas there was no difference in NPV of the three.Conclusions: Authors observed that VIA presented the best sensitivity (88.8%), followed by VILI (83.3%), and Pap (72.2%). Pap smear had the highest specificity of 97.2%. The positive predictive value of Pap was higher as compared to VIA and VILI, whereas there was no difference in NPV of the three. VIA and VILI have good sensitivity, with reasonable specificity and because of their cost effectiveness and ease of availability, these can be an alternative screening modality for cervical cancer screening.

Background: “Communication with patients” is an important skill needed for every physician in their clinical practice. These soft skills are required in dealing with patients at every step which include history taking from the patients, explaining them the diagnosis, the prognosis of the disease with associated complications. Dealing with empathy, taking informed consent, explaining the operative procedure and the complications associated with surgery, the art of breaking bad news are the mandatory skills for a good clinician. Labouring women like other patients also require special attention and empathy. So, the residents working in labor room need commitment to develop these soft skills in order to improve the labor room experience of expectant mothers. Objective of this study was to analyse role of a formal training in labor room communication skills among post graduate students of the department of obstetrics and gynecology.Methods: Faculty and students’ sensitization was done after approval from institutional ‘ethics committee’ for conducting this study. Pre-workshop assessment of residents for communication skills attitude and effective communication was done through ‘communication skill attitude scale’ (CSAS) and ‘GAP-KALAMAZOO scale’. Workshop for communication skills on the framework of Calgary Cambridge patient interview model and online teaching of students through what’s app videos, role-play demonstrations was followed by reassessment of the residents through above used scales.Results: Results depicted both improvements in attitude and effective communication skills among residents. 100% of the students were convinced and opined that good communication skills necessary for perfect clinical practice.Conclusions: The skill to communicate with patients is a fine art and needs to be mastered to be a good clinician. A formal training in effective communication skills is absolutely necessary to bring professionalism in medical practice.