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Background: Pazopanib hydrochloride (PZB) is a protein kinase inhibitor approved by the United States Food and Drug Administration and European agencies for the treatment of renal cell carcinoma and other renal malignancies. However, it exhibits poor aqueous solubility and inconsistent oral drug absorption. In this regard, the current research work entails the development and evaluation of the extrudates of pazopanib hydrochloride by the hot-melt extrusion (HME) technique for solubility enhancement and augmenting oral bioavailability. Results: Solid dispersion of the drug was prepared using polymers such as Kollidon VA64, hydroxypropylmethylcellulose (HPMC), Eudragit EPO, and Affinisol 15LV in a 1:2 ratio by the HME process through a lab-scale 18 mm extruder. Systematic optimization of the formulation variables was carried out with the help of custom screening design (JMP Software by SAS, Version 14.0) to study the impact of polymer type and plasticizer level on the quality of extrudate processability by measuring the torque value, appearance, and disintegration time as the responses. The polymer blends containing Kollidon VA64 and Affinisol 15LV resulted in respective clear transparent extrudates, while Eudragit EPO and HPMC extrudates were found to be opaque white and brownish, respectively. Furthermore, evaluation of the impact of process parameters such as screw rpm and barrel temperature was measured using a definitive screening design on the extrude appearance, torque, disintegration time, and dissolution profile. Based on the statistical outcomes, it can be concluded that barrel temperature has a significant impact on torque, disintegration time, and dissolution at 30 min, while screw speed has an insignificant impact on the response variables. Affinisol extrudates showed less moisture uptake and faster dissolution in comparison to Kollidon VA64 extrudates. Affinisol extrudates were evaluated for polymorphic stability up to a 3-month accelerated condition and found no recrystallization. PZB–Extrudates using the Affinisol polymer (Test formulation A) revealed significantly higher bioavailability (AUC) in comparison to the free Pazopanib drug and marketed formulation. [ABSTRACT FROM AUTHOR]

Local estrogen therapy has been explored as an alternative to conventional testosterone therapy in children requiring urethroplasty for hypospadias. Our objective is to evaluate if preoperative estrogen stimulation reduces post-urethroplasty complications and enhances penile dimensions. A systematic search was conducted on various databases, selecting only randomized controlled trials (RCTs) that tested estrogen on hypospadias patients under 18 years. Articles underwent sorting following PRISMA guidelines and bias risk was assessed using the JBI clinical appraisal tool for RCTs. Out of 607 screened records, 10 underwent full-text review, and 4 randomized controlled trials (RCTs) were selected for analysis. The total patient cohort across studies was 387 with 174 in the estrogen group. All studies utilized topical estrogen, but in different formulations and timings. Prudence is necessary for interpreting results due to variations in formulation, timing, and hypospadias type across studies. Limited by a small number of studies and outcome presentation non-uniformity, the review suggests no change in penile dimensions or postoperative complications with topical estrogen. Further research is needed to explore wound-healing properties of estrogen in hypospadias through animal and human studies. Registration and protocol: Registered in Prospero CRD42024502183. [ABSTRACT FROM AUTHOR]

This study seeks to understand the challenges encountered by qualitative researchers while investigating sensitive topics. We make a valuable contribution to the existing literature on researcher well-being and the mitigation of potential adverse incidents during data collection in studies on sensitive topics. The researchers maintained a comprehensive diary while conducting a study on the sensitive topic of work-family conflict among Indian working women. The analysis of these diary entries revealed three primary categories of challenges: (a) emotional challenges encompassing emotional sustenance, self-awareness, the element of care, building rapport, reciprocity, breaking the connection, preparing for exit, and researcher exhaustion; (b) methodological challenges, including data recording and interview location; (c) ethical challenges, such as confidentiality and guilt; and (d) other challenges, such as establishing credibility as a mainstream researcher in academics. This study aims to raise awareness about the challenges that qualitative researchers face, offering insights into potential dilemmas and explaining how reflexivity, self-disclosure, reciprocity, and a well-planned exit strategy can assist in navigating and addressing researcher biases. [ABSTRACT FROM AUTHOR]

Background: Before the early 2000s, the sexually transmitted infection lymphogranuloma venereum (LGV) was rare in high-income countries. Initially, most cases in these countries were among symptomatic men who have sex with men (MSM) living with HIV. In the context of widespread HIV preexposure prophylaxis (PrEP), LGV's epidemiology may be changing. We aimed to characterize the epidemiology and clinical presentation of LGV in the PrEP era. Methods: Aretrospective chart reviewwas performed on all LGVcases occurring between November 2004 to October 2022 in British Columbia (BC), Canada. Cases were stratified by having occurred before (2004-2017) or after widespread PrEP availability in BC (2018-2022). Annual rates and test positivity percentages were calculated. Bivariate logistic regression was performed to identify drivers of asymptomatic infection in the PrEP era. Results: Among 545 cases identified, 205 (37.6%) occurred pre-PrEP and 340 (62.4%) occurred during the PrEP era. Most cases were among MSM (97.2%). The estimated rate of LGV has doubled from 2018 to 2022, reaching 1535.2 cases per 100,000 PrEP users. Most PrEP-era cases were among HIV-negative individuals (65.3%), particularly those on PrEP (72.6%). Cases in the PrEP era were often asymptomatic compared with pre-PrEP (38.6% vs. 19.3%; P < 0.001). Users of PrEP were more likely to experience asymptomatic infection compared with HIV-negative PrEP nonusers (odds ratio, 2.07; 95% confidence interval, 1.07-3.99). Conclusions: In the context of increased asymptomatic testing, LGV may be increasing in BC. Most infections now occur among HIV-negative MSM. A high proportion of infections are asymptomatic. [ABSTRACT FROM AUTHOR]

Laparoscopic cholecystectomy for benign gallbladder diseases is being practised as a day-care procedure in many centres around the world. This has been justified in view of the low rate of adverse events or complications following the surgery. There is a lack of uniform protocol for hospital admission and duration of hospital stay for elective laparoscopic cholecystectomy especially in developing countries in remote areas. The purpose of this study was to find out the possibility whether it was safe and feasible to discharge elective laparoscopic cholecystectomy patients as day-care (6 h) in a centre like ours where there is no dedicated unit for ambulatory surgery. It is a retrospective analysis of prospectively collected data. The study was conducted in the Department of general surgery in a rural healthcare setup. The suitability for discharge was assessed at 6 h after surgery. All patients were re-evaluated the following morning to rule out any negative outcomes that might have resulted from being released from the hospital at 6 h post-surgery. Total of 145 patients underwent elective laparoscopic cholecystectomy during the said period. The mean age is 39.6 years. Out of 145, 125 (86%) patients were dischargeable according to the modified Alderete score at 6 h. Duration of surgery (p-value-0.001), occurrence of postoperative nausea and vomiting (p-value-.002), critical view of safety visibility (p-value-.03) and need for foley's catheterization (p < 0.001) have significant associations with suitability for discharge at 6 h. Elective laparoscopic cholecystectomy surgery as a day-care procedure has its own advantages. According to the modified Alderete score, most of the patients in our study who were eligible for discharge after six hours did not experience any difficulties while they were hospitalised, making them candidates for same-day discharge. However, case selection should take care of patient and logistic factors. [ABSTRACT FROM AUTHOR]

This article argues that while India is preparing for the contingency of a two-front war against China and Pakistan, its procurement and arms production policies make it problematic for the Indian Air Force (IAF) and Indian Navy (IN) to meet these challenges. IAF doctrine is not aligned to its current capabilities and is, therefore, largely speculative. Further, due to budgetary shortfalls in its modernization efforts, the IAF will find it difficult to fulfill its stated doctrinal role against China or Pakistan. On the other hand, the Indian Navy's doctrine is better aligned with its objectives and capabilities. The IN can carry out its doctrine of sea control against the Pakistani Navy, but will have to adopt a sea denial posture against China because of the rapid growth of the PLA Navy's force and capabilities. Given their slow pace of modernization, neither service will be able to decisively counter the Chinese military. [ABSTRACT FROM AUTHOR]

Due to their ability to wipe out pathogens, botanical medicines have been historically used to effectively combat severe ailments throughout time immemorial. Furthermore, owing to the limitations of current medical approaches, investigators have begun looking into generating fresh formulations that have enhanced antioxidant and antimicrobial capabilities. These activities of combination generated from the fruit and seed of medicinal plants were collected in this investigation from different geographical areas for determining antioxidant and antimicrobial activity. One of the medicinal plants, i.e., Zanthoxylum armatum, belongs to the family Rutaceae and has medicinal values as mentioned in the literature. The objective of our study is to analyse the antimicrobial and antioxidant potential of formulations (fruits and seeds with different proportions) from district Bageshwar (location Shama Dura) against specific pathogens. In order to achieve the objective, fruits and seeds of Zanthoxylum armatum were examined through Fourier-transform infrared spectroscopy (FTIR) and estimated in vitro for their synergistic antibacterial potential against three pathogenic microorganisms: Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus using disc-diffusion assays. In addition, antioxidant activity was also performed using 2,2-diphenylpicrylhydrazyl (DPPH) and estimating its phenolic and total flavonoid content. The results of these studies showed that the maximum zone of inhibition was observed in formulation (40:60; 9-11 mm), whereas the least was observed in formulation (20:80; 3-4 mm) against different bacterial strains. In addition, the formulated samples of fruit and seed combinations may have shown higher antioxidant activity (86.37%), total phenolic (416.2 mg GAE/g) and total flavonoid (166.4 mg rutin/g) content. In contrast, FTIR was used to detect the presence of functional groups in the formulated fruit and seed of Zanthoxylum armatum. According to the aforesaid finding, the formulation shows strong antibacterial and antioxidant action without compromising cell viability. [ABSTRACT FROM AUTHOR]

Environmental variation has a significant impact on how organisms, including cyanobacteria, respond physiologically and biochemically. Salinity and ultraviolet radiation (UVR)-induced variations in the photopigments of the rice-field cyanobacterium Nostochopsis lobatus HKAR-21 and its photosynthetic performance was studied. We observed that excessive energy dissipation after UVR is mostly caused by Non-Photochemical Quenching (NPQ), whereas photochemical quenching is important for preventing photoinhibition. These findings suggest that ROS production may play an important role in the UVR-induced injury. To reduce ROS-induced oxidative stress, Nostochopsis lobatus HKAR-21 induces the effective antioxidant systems, which includes different antioxidant compounds like carotenoids and enzymes such as superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and ascorbate peroxidase (APX). The study indicates that Nostochopsis lobatus HKAR-21 exposed to photosynthetically active radiation + UV-A + UV-B (PAB) and PAB + NaCl (PABN) had significantly reduced photosynthetic efficiency. Furthermore, maximum ROS was detected in PAB exposed cyanobacterial cells. The induction of lipid peroxidation (LPO) has been investigated to evaluate the impact of UVR on the cyanobacterial membrane in addition to enzymatic defensive systems. The maximal LPO level was found in PABN treated cells. Based on the findings of this research, it was concluded that salinity and UVR had collegial effects on the major macromolecular components of the rice-field cyanobacterium Nostochopsis lobatus HKAR-21. [ABSTRACT FROM AUTHOR]

The aim of the present study is to investigate the effect of synthesis routes on phase evolution, microstructure, change in ionic state and their co‐relation with electrochemical charge storage, and magnetic properties of novel (CuNiFeMnCo)3O4 high entropy spinel oxide (HESO). We successfully synthesized novel (CuNiFeMnCo)3O4 HESO through two different synthesis methods, that is, sol‐gel and reverse coprecipitation methods abbreviated as SA‐1 and SA‐2, respectively. The XRD analysis for both samples reveals the formation of inverse spinel phase (space group Fd‐3m) with the lattice constant of 8.3602 and 8.2502 Å for SA‐1 and SA‐2, respectively. The sample synthesized through the sol‐gel method possessed porous morphology, whereas the sample synthesized through the reverse coprecipitation method had spherical particles. The x‐ray photoelectron spectroscopy confirmed the presence of +2 and +3 ionic states for Fe, Ni, and Co, while Cu has a + 2 state and Mn exist in +3 and +4 states for both the synthesized samples. The ionic states of all cations remain invariant irrespective of the synthesis methods. However, the concentration of oxygen vacancy is significantly different for samples synthesized through different routes. Both the HESO electrodes show the electrochemical double‐layer capacitive type behavior in 2 M KOH electrolytic solution. The value of maximum specific capacitance is 38.46 and 34.24 F/g at a scan rate of 5 mV/s for SA‐1 and SA‐2, respectively. Moreover, the electrodes have capacity retention of 90 and 99% for 1000 cycles at a scan rate of 50 mV/s for SA‐1 and SA‐2, respectively. The magnetic property of the synthesized HESO samples was also investigated, and the found values of magnetization and coercivity are 1.79 emu/g and 54.9 Oe and 8.5 emu/g and 67.69 Oe for SA‐1 and SA‐2, respectively. [ABSTRACT FROM AUTHOR]

The novel (CuNiZnAlFe)3O4 type nanocrystalline High Entropy Oxide (HEO) was synthesized through the sol‐gel method with combustion at 350°C for 1 h duration. The XRD analysis reveals the formation of inverse spinel [B(AB)O4] type phase indexed with the space group of Fd‐3 m confirmed through the Rietveld Refinement of the XRD data. The lattice constant for the synthesized spinel phase was found to be 8.2453°A. The Scanning Electron Microscope of the synthesized HEO confirms the flakes‐like morphology with porous microstructure. The Energy Dispersive X‐ray (EDX) analysis and elemental mapping confirm the homogeneous distribution of the cations over the selected region. It was found that Fe and Ni are in the +3 and +2 states, other cations, Cu and Zn, are in the +2 states, and Al is in the +3 confirmed through the X‐ray photoelectron Spectroscopy. The electrochemical performance was studied in three electrodes in a 2 M KOH aqueous electrolyte. The specific capacitance value was 2.02, 1.58, 1.24, 1.06, 0.87, 0.71, and 0.65 F/g at scan rates of 5, 10, 20, 30, 50, 80, and 100 mV/s, respectively. The low value of specific capacitance was observed due to the stable ionic structure of the inverse spinel phase. The magnetization behavior of the sample is also investigated. The M‐H loop of the (CuNiZnAlFe)3O4 HEO sample exhibits a ferrimagnetic nature. [ABSTRACT FROM AUTHOR]

To assess the clinical utility of pre-pregnancy planning among female patients with rheumatic diseases attending a targeted pregnancy and rheumatic diseases clinic. We conducted a retrospective review using data collected via chart review of female patients with rheumatic diseases seen at the Pregnancy and Rheumatic Diseases Clinic at the Mary Pack Arthritis Centre in Vancouver, Canada, between January 2017 and July 2020. Patients were categorized according to an initial presentation at the clinic as (1) pregnant without pre-pregnancy planning; and (2) not pregnant with pre-pregnancy planning. The latter group was further categorized according to whether they had contraindications to pregnancy. Pregnancy outcomes were extracted from electronic medical records and analyzed using descriptive statistics. Our study included 230 female patients with rheumatic diseases. At the initial clinical presentation, 86 were pregnant and 144 were planning to become pregnant and presenting for pre-pregnancy planning. Compared to patients without pre-pregnancy planning, patients who received pregnancy planning experienced fewer prenatal disease flares (61.3% [38/62] vs. 22.6% [7/31]; p < 0.001), fewer medication changes during pregnancy (46.4% [39/84] vs. 18.9% [10/53]; p = 0.002), and improved disease control in the first trimester of pregnancy (p = 0.018). There were no statistically significant differences in the frequency of adverse pregnancy or fetal outcomes between patients with and without pre-pregnancy planning. Evaluation of patient outcomes suggests that pre-pregnancy planning may support early assessment of high-risk pregnancy status; therein, allowing healthcare providers to identify and manage risk factors for adverse pregnancy outcomes among patients living with rheumatic diseases. [ABSTRACT FROM AUTHOR]

Nanofluids are thermoelectric substance with a greater thermal transmission effectiveness than traditional thermal fluids. Nanofluid's specific heat capacity (SHC) is a crucial thermophysical parameter since it controls the fluid's heat transfer coefficient. Surprisingly few research investigations have been done on the prognostic modelling of the specific heat capacity of fusion nanofluids, despite the fact that numerous experiments have been conducted on the heat transfer capacitance of blended nanofluids. This study focuses on the use of algorithms based on machine learning procedures (MLP) to estimate the SHC of blended nanofluids. Numerous numbers of hybrid nanofluids are investigated in this investigation. Total of 984 samples of hybrid nanofluids for specific heat capacity has been collected from nine experimental research papers. Various MLP techniques were utilized in this analysis, including extreme boost gradient boost regression (XGB), support vector regression augmented with a genetic algorithm (support vector regression [SVR]‐genetic algorithm [GA]), grid search optimized based gradient boost regression algorithm (GBR) (GBR‐GSO), and voting ensemble procedure (VE). The obtained correlation coefficients of the SVR‐GA, XGB, VE and GBR‐GSO models for the testing dataset are 98.43%, 96.29%, 94.4% and 96.55% respectively. The SVR‐GA model showed a better predictive accuracy relative to other ML models. This SVR‐GA anticipated model could be used for quick and reliable prediction of the SHC of blended nanofluids which reduces the burden associated with experimental measurement possible future work includes applying a machine‐learning strategy to the problem of determining the diffusivity of hybrid nanofluids. [ABSTRACT FROM AUTHOR]

Derivatives of BODIPY are popular fluorophores due to their synthetic feasibility, structural rigidity, high quantum yield, and tunable spectroscopic properties. While the characteristic absorption maximum of BODIPY is at 2.5 eV, combinations of functional groups and substitution sites can shift the peak position by ±1 eV. Time-dependent long-range corrected hybrid density functional methods can model the lowest excitation energies offering a semi-quantitative precision of ±0.3 eV. Alas, the chemical space of BODIPYs stemming from combinatorial introduction of—even a few dozen—substituents is too large for brute-force high-throughput modeling. To navigate this vast space, we select 77 412 molecules and train a kernel-based quantum machine learning model providing < 2 % hold-out error. Further reuse of the results presented here to navigate the entire BODIPY universe comprising over 253 giga (253 × 109) molecules is demonstrated by inverse-designing candidates with desired target excitation energies. [ABSTRACT FROM AUTHOR]

The process of identifying a person using their facial traits is referred to as face recognition, and it is a form of biometric identification. The use of facial recognition might range from that of an entertainment tool to one of a security tool. Even while other forms of biometric identification, such as fingerprints and iris scans, are reliable, they require the active participation of an individual. As a result, criminals cannot rely on them as the most reliable means of verification. When a criminal database, which stores the individual details of a criminal, and facial recognition technology are brought together, it can identify a criminal who is depicted in an image or seen in a video feed. Not only does a criminal recognition system needs to have a high level of accuracy, but it also needs to be able to adapt to significant changes in lighting, occlusion, aging, expressions, and other factors. In this study, they were analyzed and compared with the many methods of face detection and face recognition, such as HAAR cascades, local binary patterns histogram, support vector machines, convolutional neural networks, and ResNet-34. These methods include a variety of different approaches to recognizing faces. An analysis of these strategies is also conducted and then put into practice to those that seem to be the most effective for the designed criminal recognition system. In addition to that, a variety of uses of this criminal recognition in the real world are also discussed. [ABSTRACT FROM AUTHOR]

An algorithm for a three-dimensional fine-grid block encompassing a moving solid body using a multi-relaxation time model of the lattice Boltzmann method is proposed and developed. In this numerical framework, a geometry-conforming fine block shifts a coarse lattice unit as the object translates by same amount. The effective utilization of higher-order spatial interpolation has been demonstrated in place of the commonly used low-order temporal interpolation in traditional grid refinement techniques within the lattice Boltzmann method. The successful application of this method has been showcased through three distinct cases: the settling of a solid sphere in a fluid tank under the influence of gravity, hovering motion of an elliptic airfoil, and the "clap and fling" motion of an insect wing. In this regard, various interpolation schemes based on the location of nodes in the overlapping zones of fine and coarse block are discussed. In addition, two cases were evaluated, case 1 where distributions are interpolated and case 2 where macroscopic variables are directly interpolated. It was observed that both interpolations gave same computational accuracy for low Reynolds number [ ∼ O ( 10 2) ]. However, as Re is increased [ ∼ O ( 10 3) ], direct interpolation of macroscopic variables proved erroneous and resulted in a large deviation in fluid forces and is not recommended. The geometry-conforming dynamic mesh refinement results in a substantial decrease in computation time, approximately 90%, along with a memory reduction of about 80% compared to the fully refined counterpart. [ABSTRACT FROM AUTHOR]

Background: Oxidized low-density lipoprotein (ox-LDL) has been implicated in both coronary artery disease and retinal vein occlusion (RVO) because of atherosclerosis. However, there is no study to show the prevalence of ox-LDL in RVO till date. Aims and Objectives: This study aimed to find the prevalence of ox-LDL in RVO in a population of West Bengal. Materials and Methods: A 2-year prospective cross-sectional study of consecutive, unrelated adult patients, with a diagnosis of RVO, attending the outpatient department in a Medical College, was taken up for study. A pilot study was done to determine the expected prevalence of ox-LDL. Sample size was calculated based on the formula ... n= d2 z2pq (z=1.96, d=0.04, p=0.196, q=0.804, n=minimum sample size). ox-LDL was measured in a total of 512 subjects who were selected based on the inclusion and exclusion criteria. Results: In this study, 272 males (aged 50 ± 7.2 years) and 240 females (aged 46 ± 7.7 years) with RVO were screened for ox-LDL. Elevated ox-LDL levels were found in 142 patients out of 512 participants in this study (27.7%). Moreover, 102 cases (19.9%) were found to have both raised LDL and ox-LDL, whereas 40 RVO cases (7.8%) had only elevated ox-LDL among the study participants. 71.8% of 142 RVO cases with elevated ox-LDL levels also had raised LDL levels, whereas remaining 28.2% had normal LDL cholesterol levels. Conclusion: It is high time to look beyond the traditional lipid parameters such as ox-LDL cholesterol levels as a risk factor of RVO. This study proved that ox-LDL cholesterol is highly prevalent in RVO cases. Thereby, proper screening of ox-LDL is a must as a tool for risk reduction of RVO cases, especially in a population with normal LDL cholesterol levels. [ABSTRACT FROM AUTHOR]

Tecoma stans (Fam. Bignoniaceae) is also popularly known as yellow bells and yellow trumpet bush in vernacular terminology. Limited and variable data are available from the literature regarding the quantification of luteolin, apigenin and chrysoeriol, which are considered as the most active pharmacological active constituents. High-performance liquid chromatography–photodiode array detection has been developed for the determination of the bioactive flavonoids, luteolin, apigenin and chrysoeriol, from the methanolic extract of the leaves of T. stans. A column packed with a pentafluorophenyl-based stationary phase was used for the separation of the analytes under gradient elution. The detection wavelength was 345 nm. The validation of the method as per the International Council on Harmonisation (ICH) guidelines (ICH 2005) for linearity, accuracy and precision was investigated and found within limits specified by the ICH guidelines. The method was linear over with a good regression coefficient of more than 0.99. The limit of detection of the method was 0.68, 2.97 and 1.76 μg/mL for luteolin, apigenin and chrysoeriol, respectively. In conclusion, a reliable and reproducible method was devised that can be used for the estimation of the said components from T. stans. [ABSTRACT FROM AUTHOR]

Aim and objectives The aim of this study is to propose a new clinical classification for gynecomastia management based on our experience. Introduction We believe that the prevalent gynecomastia classifications need to be more detailed. Several key aspects that we noticed have either been incompletely represented or not mentioned at all, leaving them unclassified. Materials and Methods This study was conducted at the authors' center over 24 months from May 2020 to May 2022, and included 1,571 patients who were classified and treated as per our new classifications and small iterations were done to strengthen the classification. Results We were able to better classify our patients and previously unclassified situations. Skin sagging or a potential for skin sagging and puffy nipples were managed better. This classification allowed recommendation of each step of the procedure, resulting in high patient satisfaction, as all problem areas were sorted and outcome that was explained to them preoperatively was clearly visible postoperatively. Conclusion The new clinical classification for gynecomastia is a simple, clinical, straightforward, comprehensive, grading system, the use of which has helped the authors and the team in achieving precise and predictable results while ensuring patient satisfaction. [ABSTRACT FROM AUTHOR]

Isolated urogenital sinus is a rare anomaly. These cases may have high confluence which adds complexity to surgical correction. There are controversies regarding timing and techniques of management. We present a case report on managing such a case in an infant with bladder outlet obstruction and pyocolpos. [ABSTRACT FROM AUTHOR]

Background: Females having a large proportion of gallbladder carcinoma (GBC) and a higher incidence of gallstones pointed toward the role of sex hormones in GBC development. In this study, we evaluated the expression of Estrogen receptor (ER), Progesterone receptor (PR), and Her2/neu and their correlation with tumor markers and clinicopathological parameters in the GBC. Methods: A total of 50 patients of GBC and 42 patients in control group undergoing surgery for other conditions were taken. The patient's biopsy sample's paraffin block was tested for ER, PR, and Her2/neu expression by immunohistochemistry. Results: ER and PR had no significant expression in GBC and control group, but Her2/neu had 16% expression in GBC, significantly associated with the degree of differentiation with 62.5% (n-5) being well-differentiated; 75% of Her2/neu positive were in stages III and IV. Her2/neu did not correlate with tumor markers despite expression. Conclusions: Her2/neu amplification is a small step in validating that option so it could be included in the treatment and prognostication of GBC. [ABSTRACT FROM AUTHOR]

Storage is a challenging issue that cuts across distribution, delivery, and safe end-uses of hydrogen as fuel. All the fuel cell vehicles are equipped with inefficient and unsafe high-pressure hydrogen cylinders. It is well known that storing such a highly flammable gas at high pressure is not safe. Only hydrogen can be stored safely as a form of metal hydrides, and all the investigated metal hydrides are inefficient in one way or another. Four essential hydrogen parameters for solid-state storage for fuel cell applications are high volumetric storage capacity, excellent heat transfer, and recharge time and feasible charging discharging temperatures. The available metal tanks have good gravimetric storage capacity but did not satisfy the prescribed criterion for good volumetric capacity necessary for mobile applications. Recently, some promising reports are published on the hydrogen storage properties of newly discovered High Entropy Alloys (HEAs). HEAs provide vast composition selection freedom for the formation of favorable simple solid solution phase for hydrogen storage. The four core effects of these alloys may also play a vital role in hydrogen storage properties. Here we reviewed and summarized the published results on hydrogen storage properties of HEAs to date. We underlined different essential aspects for the future development of HEAs as hydrogen storage materials. This review article discusses and describes the perspectives of HEAs in regards to the hydrogen storage applications of these alloys and will provide insight into the future development of hydrogen storage HEAs. • Provide detailed, information on the different aspects of hydrogen storage properties of HEAs. • Discuss basic properties (definition and core effects) of HEAs regarding hydrogen storage properties. • Discuss benefits of HEAs over conventional alloys in regards to HS properties. • Underlined different aspects that have importance on the future development of hydrogen storage HEAs for applications. [ABSTRACT FROM AUTHOR]

Asbestos has been classified as a human carcinogen, and exposure may increase the risk of diseases associated with impaired respiratory function. As the range of health effects and airborne concentrations that result in health effects across asbestos-related natural mineral fiber types are not fully understood, the National Institute of Environmental Health Sciences has established a series of research studies to characterize hazards of natural mineral fibers after inhalation exposure. This paper presents the method development work of this research project. A prototype nose-only exposure system was fabricated to explore the feasibility of generating natural mineral fiber aerosol for in vivo inhalation toxicity studies. The prototype system consisted of a slide bar aerosol generator, a distribution/delivery system and an exposure carousel. Characterization tests conducted using Libby Amphibole 2007 (LA 2007) demonstrated the prototype system delivered stable and controllable aerosol concentration to the exposure carousel. Transmission electron microscopy (TEM) analysis of aerosol samples collected at the exposure port showed the average fiber length and width were comparable to the bulk LA 2007. TEM coupled with energy dispersive spectrometry (EDS) and selected area electron diffraction (SAED) analysis further confirmed fibers from the aerosol samples were consistent with the bulk LA 2007 chemically and physically. Characterization of the prototype system demonstrated feasibility of generating LA 2007 fiber aerosols appropriate for in vivo inhalation toxicity studies. The methods developed in this study are suitable to apply to a multiple-carousel exposure system for a rat inhalation toxicity testing using LA 2007. [ABSTRACT FROM AUTHOR]

Exposure to asbestos is associated with malignant and nonmalignant respiratory disease. To strengthen the scientific basis for risk assessment on fibers, the National Institute of Environmental Health Sciences (NIEHS) has initiated a series of studies to address fundamental questions on the toxicology of naturally occurring asbestos and related mineral fibers after inhalation exposure. A prototype nose-only exposure system was previously developed and validated. The prototype system was expanded to a large-scale exposure system in this study for conducting subsequent in vivo rodent inhalation studies of Libby amphibole (LA) 2007, selected as a model fiber. The exposure system consisting of six exposure carousels was able to independently deliver stable LA 2007 aerosol to individual carousels at target concentrations of 0 (control group), 0.1, 0.3, 1, 3, or 10 mg/m3. A single aerosol generator was used to provide aerosol to all carousels to ensure that exposure atmospheres were chemically and physically similar, with aerosol concentration as the only major variable among the carousels. Transmission electron microscopy (TEM) coupled with energy dispersive spectrometry (EDS) and selected area electron diffraction (SAED) analysis of aerosol samples collected at the exposure ports indicated the fiber dimensions, chemical composition, and mineralogy were equivalent across exposure carousels and were comparable to the bulk LA 2007 material. The exposure system developed is ready for use in conducting nose-only inhalation toxicity studies of LA 2007 in rats. The exposure system is anticipated to have applicability for the inhalation toxicity evaluation of other natural mineral fibers of concern. [ABSTRACT FROM AUTHOR]

Background: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome associated with phosphaturic mesenchymal tumors (PMTs). Localization of the causative tumor in these cases is an arduous task since the culprit lesions are usually small, slow-growing, and can be located almost anywhere from head to toe. Purpose: To describe the morphological characteristics of histologically proven PMTs on various radiological modalities. Material and Methods: After institutional ethical approval, this retrospective study analyzed 20 cases with a histopathological evidence of PMT. Various imaging characteristics of the tumors on available computed tomography (CT) and magnetic resonance imaging (MRI) scans were evaluated. Descriptive statistical analyses were conducted. Results: The tumors were located in diverse locations: lower extremities (n = 10); head and neck (n = 5); vertebral column (n = 3); pelvis (n = 1); and upper extremities (n = 1). Bone lesions seen on CT had variable morphology: sclerotic (n = 3/8, 37.5%); lytic (n = 3/8, 37.5%), and both lytic and sclerotic (n = 2/8, 25%) with presence of narrow zone of transition in all cases (n = 8/8) and amorphous internal matrix calcifications in 25% of cases (n = 2/8). Of the tumors, 68.4% (n = 13/19) were hypointense on T1 and all of them showed hyperintense signal on T2-weighted and STIR images (n = 19/19) and contrast enhancement (n = 16/16). Of the tumors, 66.7% (n = 6/9) showed restricted diffusion. DOTANOC PET/CT showed tumor uptake in all cases (n = 8/8). Conclusion: PMTs may have variable and non-specific tumor appearances on various imaging modalities. However, in an appropriate clinical scenario and a background of suggestive biochemical work-up, the radiologist should keep a high index of suspicion. [ABSTRACT FROM AUTHOR]

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, the virus kept developing and mutating into different variants over time, which also gained increased transmissibility and spread in populations at a higher pace, culminating in successive waves of COVID-19 cases. The scientific community has developed vaccines and antiviral agents against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease. Realizing that growing SARS-CoV-2 variations significantly impact the efficacy of antiviral therapies and vaccines, we summarize the appearance and attributes of SARS-CoV-2 variants for future perspectives in drug design, providing up-to-date insights for developing therapeutic agents targeting the variants. The Omicron variant is among the most mutated form; its strong transmissibility and immune resistance capacity have prompted international worry. Most mutation sites currently being studied are in the BCOV_S1_CTD of the S protein. Despite this, several hurdles remain, such as developing vaccination and pharmacological treatment efficacies for emerging mutants of SARS-CoV-2 strains. In this review, we present an updated viewpoint on the current issues faced by the emergence of various SARS-CoV-2 variants. Furthermore, we discuss the clinical studies conducted to assist the development and dissemination of vaccines, small molecule therapeutics, and therapeutic antibodies having broad-spectrum action against SARS-CoV-2 strains. [ABSTRACT FROM AUTHOR]

Background: Oxidized low-density lipoprotein (ox-LDL) has been implicated in atherosclerotic cardiovascular disease. Arteriolosclerosis is an important causative factor for retinal vein occlusion (RVO). Till, date there is dearth of literature on ox-LDL and RVO. Aims and Objectives: The objectives of this study were to see whether ox-LDL cholesterol is an independent risk factor in RVO with normal lipid profile. Materials and Methods: Lipid profiles and ox-LDL levels were assayed in 122 adult unilateral RVO cases and 142 age and sex matched controls in this 1 year old case–control study. Results: ox-LDL cholesterol levels were significantly elevated in RVO cases than controls (54.5±6.1 in cases vs. 36.6±5.6 in controls, P<0.01), although serum lipid profiles were normal in both cases and controls. Conclusion: The ox-LDL-induced atherosclerosis may be responsible for the retinal venous occlusion in absence of other risk factors. Hence, screening for ox-LDL in RVO patients should be worth considering especially in patients with normal lipid profiles. [ABSTRACT FROM AUTHOR]

Ultraviolet radiation (UVR) has been scientifically proven to cause skin disorders such as sunburn, skin cancer and the symptoms of chronic exposure. Natural sun screening compounds have recently gained tremendous attention from the cosmetic and cosmeceutical sectors for treating skin disorders such as hyperpigmentation and aging. A wide range of natural UV-absorbing compounds have been used to replace or reduce the number of synthetic sunscreen molecules. One of the primary causes of photoaging is DNA damage, mainly caused by UVR. Photoprotection provided by traditional sunscreens is purely preventative and has no efficacy after DNA damage has been initiated. As a result, the quest for DNA-repair mechanisms that block, reverse, or postpone pathologic processes in UV-exposed skin has stimulated anti-photoaging research and methods to increase the effectiveness of traditional sunscreens. This review summarizes many natural compounds from microalgae, lichens, and plants that have demonstrated potential photoprotection effects against UV radiation-induced skin damage. Furthermore, it offers an overview of current breakthroughs in DNA-repair enzymes utilized in sunscreens and their influence on photoaging. [ABSTRACT FROM AUTHOR]

The deformation and displacement phenomena of liquid droplets from solid substrates are important in sub-surface processes such as enhanced oil recovery, chemical processing, and others, where the velocity of the continuous fluid is a key parameter. In the present work, a pioneering mathematical model equation for the minimum fluid velocity at which perturbation development begins, termed the 'critical velocity of perturbation' that is associated with the elongated part of a droplet and water has been developed using viscous potential flow analysis. Furthermore, the deformation and detachment of large (2 mL and 4 mL) aniline droplets, small (120 μ L) aniline droplet and small (5 μ L and 40 μ L) iso-quinoline droplets in close channels have been experimentally investigated in the verification of the proposed mathematical model equation. The developed model equation was successfully verified. Tails were formed, and the droplet partially detached when the continuous fluid velocity exceeded the critical velocity of perturbation. This study will aid in enhancing process efficiency and lowering operational costs in the field of liquid recovery and associated process industries. [ABSTRACT FROM AUTHOR]

Background Structured reporting has the advantages of reducing ambiguity in written radiology reports with greater uniformity and comparability of reports amongst different institutes. It has multiple facets: structured format, structured content, and standardized language. While structured reporting initiative has been used in various radiology subspecialties such as oncology, cardiothoracic, abdominal and interventional radiology; skeletal dysplasia is a domain that remains largely untouched by this concept. Purpose To evaluate the impact of structured reporting in skeletal dysplasia. Methods and Materials This was an ethically approved pragmatic clinical trial. A defined number (75) of clinically diagnosed and/or genetically confirmed skeletal dysplasia radiographs were evaluated by two radiologists (reader A and reader B) with 5-and 7-years' experience in general radiology, respectively. A pre-defined structured reporting format for skeletal dysplasia was used as an interventional tool. Both the readers interpreted the radiographs before and after the training session. In addition to diagnosis, diagnostic confidence was noted using a semiquantitative scale. Improvement in diagnostic accuracy and diagnostic confidence after training were assessed. McNemar's test was used to assess the statistical significance of difference in proportion of correct diagnoses in pre- and post-education phases. An interrater reliability analysis using the Kappa statistic was performed to determine interobserver agreement between readers both in pre- and post-education phases. Results In the post-education phase, the proportion of accurate diagnosis improved from 48% (36/75) to 64% (48/75) for reader A, and from 44% (33/75) to 60% (45/75) for reader B as compared with the pre-education phase. Amongst the cases with a correct radiologic diagnosis, an increase in diagnostic confidence was noted in 18 cases for reader A, and 15 cases for reader B. In none of the cases, there was a reduction in diagnostic confidence after training. A McNemar's test determined that there was a statistically significant difference in the proportion of correct diagnoses in pre- and post-education phases, p < 0.001. The interobserver agreement between the readers was found to increase from Kappa = 0.33 (p = 0.004) using non-structured reporting in pre-education phase to Kappa = 0.46 (p < 0.001) using structured reporting in the post-education phase. Conclusion A structured reporting of skeletal survey can improve accuracy and confidence in diagnosing skeletal dysplasia. [ABSTRACT FROM AUTHOR]

The new coronavirus (COVID-19) infection, first detected in Wuhan, China in 2019 has become a pandemic that has spread to nearly every country in the world. Through October 11, 2021, more than 23 billion confirmed cases and 4.8 million fatalities were reported globally. The bulk of individuals afflicted in India during the first wave were elderly persons. The second wave, however, resulted in more severe diseases and mortality in even younger age groups due to mutations in the wild virus. Symptoms may range from being asymptomatic to fatal acute respiratory distress syndrome (ARDS). In addition to respiratory symptoms, patients may present with gastrointestinal symptoms such as stomach pain, vomiting, loose stools, or mesenteric vein thrombosis. The frequency of patients presenting with thromboembolic symptoms has recently increased. According to certain studies, the prevalence of venous thromboembolism among hospitalized patients ranges from 9 to 25%. It was also shown that the incidence is significantly greater among critically sick patients, with a prevalence of 21–31%. Although the exact origin of thromboembolism is unknown, it is considered to be produced by several altered pathways that manifest as pulmonary embolism, myocardial infarction, stroke, limb gangrene, and acute mesenteric ischemia. Acute mesenteric ischemia (AMI) is becoming an increasingly prevalent cause of acute surgical abdomen in both intensive care unit (ICU) and emergency room (ER) patients. Mesenteric ischemia should be evaluated in situations with unexplained stomach discomfort. In suspected situations, appropriate imaging techniques and early intervention, either non-surgical or surgical, are necessary to avert mortality. The purpose of this article is to look at the data on acute mesenteric ischemia in people infected with COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Pancreatic neuroendocrine tumours (pNETs) have an excellent long-term survival after resection, but are associated with a high recurrence rate. Identification of prognostic factors affecting recurrences would enable identifying subgroup of patients at higher risk of recurrences, who may benefit from more aggressive treatment. Methods: A retrospective analysis of prospectively maintained database of patients undergoing pancreatectomy with curative intent for grade I and II pNETs between July 2007 and June 2021 was performed. Perioperative and long-term outcomes were analysed. Results: A total of 68 resected patients of pNETs were included in this analysis. Fifty-two patients (76.47%) underwent pancreaticoduodenectomy, 10 (14.7%) patients had distal pancreatectomy, and 2 (2.9%) patients underwent median pancreatectomy, while enucleation was performed in 4 patients (5.8%). The overall major morbidity (Clavien-Dindo III/IV) and mortality rates were 33.82% and 2.94%, respectively. At a median follow-up period of 48 months, 22 (32.35%) patients had disease recurrence. The 5-year overall survival and 5-year recurrence-free survival (RFS) rates were 90.2% and 60.8%, respectively. While OS was unaffected by different prognostic factors, multivariate analysis showed that lymph node involvement, Ki-67 index ≥5%, and presence of perineural invasion (PNI) were independently associated with recurrence. Conclusions: While surgical resection gives excellent overall survival in grade I/II pNETs, lymph node positivity, higher Ki-67 index, and PNI are associated with a high risk for recurrence. Patients with these characteristics should be stratified as high risk and evaluated for more intensive follow-up and aggressive treatment strategies in future prospective studies. [ABSTRACT FROM AUTHOR]

Background: Acute appendicitis is a common surgical emergency amongst the paediatric population. Available diagnostic tools are focussed to make a diagnosis of acute appendicitis. A definitive predictive factor for the diagnosis of complicated appendicitis is lacking. Thus, this aims to analyse hyperbilirubinaemia as a predictor of complicated appendicitis amongst the paediatric population.Materials and Methods: A prospective observational study was conducted in a tertiary hospital from November 2018 to October 2019. All children undergoing emergency appendectomy were included in the study. Preoperatively, patients were evaluated clinically, and routine investigations including total and direct serum bilirubin were sent. All patients were grouped as 'simple appendicitis' or 'complicated appendicitis' based on intra-operative and histological findings. Bilirubin level was compared between these groups and analysed.Results: A total of 52 children fulfilling the inclusion criteria were included. The mean age was 13.2 ± 4.2 years, and the male: female ratio was 2.1:1. Thirty-four (65.4%) had simple appendicitis and 18 (34.6%) had complicated appendicitis. Total bilirubin was 23.83 ± 5.94 mmol/L in the complicated appendicitis group and 13.15 ± 3.29 mmol/L in the simple appendicitis group. Direct bilirubin was 5.28 ± 2.22 mmol/L in complicated appendicitis and 2.62 ± 0.83 mmol/L in simple one. Both total and direct bilirubin were significantly high in the complicated group (P < 0.001) compared to the simple appendicitis group. On the Receiver operating curve (ROC), the best cutoff value for total and direct bilirubin was 21 and 5.5 mmol/L, respectively. The sensitivity and specificity of total and direct bilirubin were 72.2%, 100%, and 61.1%, and 85.3%, respectively.Conclusion: It is concluded that hyperbilirubinaemia is a good predictor for paediatric complicated appendicitis. [ABSTRACT FROM AUTHOR]

A biofilm is an aggregation of surface-associated microbial cells that is confined in an extracellular polymeric substance (EPS) matrix. Infections caused by microbes that form biofilms are linked to a variety of animals, including insects and humans. Antibiotics and other antimicrobials can be used to remove or eradicate biofilms in order to treat infections. However, due to biofilm resistance to antibiotics and antimicrobials, clinical observations and experimental research clearly demonstrates that antibiotic and antimicrobial therapies alone are frequently insufficient to completely eradicate biofilm infections. Therefore, it becomes crucial and urgent for clinicians to properly treat biofilm infections with currently available antimicrobials and analyze the results. Numerous biofilm-fighting strategies have been developed as a result of advancements in nanoparticle synthesis with an emphasis on metal oxide np. This review focuses on several therapeutic strategies that are currently being used and also those that could be developed in the future. These strategies aim to address important structural and functional aspects of microbial biofilms as well as biofilms' mechanisms for drug resistance, including the EPS matrix, quorum sensing (QS), and dormant cell targeting. The NPs have demonstrated significant efficacy against bacterial biofilms in a variety of bacterial species. To overcome resistance, treatments such as nanotechnology, quorum sensing, and photodynamic therapy could be used. [ABSTRACT FROM AUTHOR]

BACKGROUND: Persistent infection of high-risk HPVs is known to cause diverse carcinomas, mainly cervical, oropharyngeal, penile, etc. However, efficient treatment is still lacking. OBJECTIVE: Identify and analyze potential therapeutic targets involved in HPV oncogenesis and repurposing drug candidates. METHODS: Integrative analyses were performed on the compendium of 1887 HPV infection-associated or integration-driven disrupted genes cataloged from the Open Targets Platform and HPVbase resource. Potential target genes are prioritized using STRING, Cytoscape, cytoHubba, and MCODE. Gene ontology and KEGG pathway enrichment analysis are performed. Further, TCGA cancer genomic data of CESC and HNSCC is analyzed. Moreover, regulatory networks are also deduced by employing NetworkAnalyst. RESULTS: We have implemented a unique approach for identifying and prioritizing druggable targets and repurposing drug candidates against HPV oncogenesis. Overall, hundred key genes with 44 core targets were prioritized with transcription factors (TFs) and microRNAs (miRNAs) regulators pertinent to HPV pathogenesis. Genomic alteration profiling further substantiated our findings. Among identified druggable targets, TP53, NOTCH1, PIK3CA, EP300, CREBBP, EGFR, ERBB2, PTEN, and FN1 are frequently mutated in CESC and HNSCC. Furthermore, PIK3CA, CCND1, RFC4, KAT5, MYC, PTK2, EGFR, and ERBB2 show significant copy number gain, and FN1, CHEK1, CUL1, EZH2, NRAS, and H2AFX was marked for the substantial copy number loss in both carcinomas. Likewise, under-explored relevant regulators, i.e., TFs (HINFP, ARID3A, NFATC2, NKX3-2, EN1) and miRNAs (has-mir-98-5p, has-mir-24-3p, has-mir-192-5p, has-mir-519d-3p) is also identified. CONCLUSIONS: We have identified potential therapeutic targets, transcriptional and post-transcriptional regulators to explicate HPV pathogenesis as well as potential repurposing drug candidates. This study would aid in biomarker and drug discovery against HPV-mediated carcinoma. [ABSTRACT FROM AUTHOR]

Introduction: Negative pressure wound therapy (NPWT) has been suggested as a gold standard for managing complex wounds and to reduce the time of healing and overall morbidity and mortality of the patient. Aim: We have done a retrospective study to observe the outcome in patients managed with negative pressure wound therapy for varied etiologies. Methods: Patients with complicated wounds including lower limb wounds post-debridement, upper limb wounds post-debridement, postoperative abdominal wound dehiscence, abdominal and chest abscess wounds post-debridement and amputation stumps, managed with negative pressure wound therapy were studied on the basis of wound outcome, total hospital stay, days of NPWT application and pressure and mode of NPWT. Results: A total of 42 patients with complicated wounds were included in the study. Mean hospital stay was 16.2 days and mean NPWT application time was 8.29 days with NPWT being applied on average for 3.91 days post-procedure like debridement or amputation or after wound dehiscence in which debridement was not done. As many as 41.5% of wounds were closed with suturing, 48.8% healed by secondary intention and 9.8% were covered with split-thickness skin grafts. A significant observation was made for lower pressure being used for abdominal wound dehiscence (75 mmHg) compared to other wounds on limbs (mean 98.33 mmHg) (P < 0.001). Re-debridement after the 1st cycle of NPWT was needed in 40% of wounds managed with intermittent mode compared to 6.2% in continuous mode (P = 0.028). Conclusion: NPWT can reduce and manage wound complications with improvement in the quality of life of patients when used at an appropriate time with knowledge of its mechanism and functionality. [ABSTRACT FROM AUTHOR]

In this report, a modified solid-state synthesis technique is optimized to synthesize a single spinel phase for a novel (CuNiTiZnFe) 3 O 4 High Entropy Oxide (HEO) and studied for magnetic behavior. Three different approaches were adopted for the synthesis of pure spinel HEO. In the first approach, The initial mixture of constituent oxides was admixed, and sintered at 1050 °C for 20 h. For the second and third approaches, the mixture of constituent oxides was ball-milled for 2 h, and 10 h separately, followed by sintering at 1050 °C for 20 h. A small amount of undiffused constituent oxide peaks are present in both the first and second approaches. However, the sample synthesis through 10 h milling followed by sintering has single spinel (CuNiTiZnFe) 3 O 4 HEO phase. The single spinel HEO phase formation was confirmed through the le-Bail refinement. The lattice parameter for the well-fitted XRD pattern is 8.415161 A°. Further, the investigation was focused on the magnetic behavior of the single spinel HEO phase. The value of magnetization and coercivity is 16.11 emu/g and 10.66 Oe, respectively. The synthesized HESO has typical ferrimagnetic nature and has the second-highest value of Ms reported so far for HEOs. The ionic states of different cations present in the (CuNiTiZnFe) 3 O 4 HESO were also investigated through X-ray photoelectron Spectroscopy. XPS analysis reveals that Fe and Ni are in the +3 and + 2 states, Cu and Zn are in the +2 states, and Ti is in the +4 states. [ABSTRACT FROM AUTHOR]

Aim: Posterior cloacal malformations (PCMs) are distinguished from classical cloacal malformations by the posterior location of the common opening in the perineum. We aim to describe our experience of management of these rare and complex malformations. Methods: This study was a retrospective chart review of all patients with PCM who underwent treatment at Kalawati Saran Children's Hospital (KSCH), New Delhi, and Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, between 2013 and 2021. Individual anatomical variations and their impact on the clinical presentation, management, and final outcome (cosmesis and function) were recorded and analyzed. Results: During the study period, four girls with a median age of 2 (range: 0–5) years presented to us with PCM. Three patients were referred to KSCH as ambiguous genitalia whereas one patient was born at SGPGIMS with an antenatal diagnosis of "urorectal septal defect." On examination, three patients had the urogenital sinus (UGS) opening immediately anterior to the normally located anal opening (2 orifices), whereas one had a single orifice at the normal location of the anus with the UGS opening in the anterior rectal wall. Associated anomalies included: (a) hydrocolpos (n = 3), which was managed by a tube vaginostomy; (b) urethral duplication with dorsal atretic urethra (n = 3); (c) uterine didelphys (n = 1); (d) bilateral grade 5 vesicoureteric reflux (n = 1); and (e) vaginal calculus (n = 1). Total urogenital mobilization (anterior sagittal approach) with feminizing genitoplasty was performed for patients with UGS and normal anus (n = 3). In the patient with a single opening at the normal location of the anus, posterior sagittal ano-recto-urethro-vaginoplasty was performed. At a median follow-up of 24 months, three patients are continent for urine and stool, whereas one patient is yet to be toilet trained. Conclusions: PCMs are unusual complex malformations that necessitate meticulous clinical examination, detailed diagnostic workup, and multistaged surgical management. Management should be tailored as per each individual patient's anatomy and clinical presentation for an optimal outcome. [ABSTRACT FROM AUTHOR]

Background: The orbital structures are ideally suited for ultrasound examination due to their superficial location and cystic composition of the eye. However, orbital ultrasound remains an underutilised modality due to preference for other cross‐sectional modalities in general practice. Aim: In this article, we review the basic principles, clinical uses and technique of orbital ultrasound in peadiatric patients. Materials and methods: The clinical utility of orbital ultrasound in peadiatric patients is demonstrated using selected cases. Results: Ultrasound is useful in the diagnosis of various posterior segment pathologies, especially in conditions causing opacification of light‐conducting media of the eye. It is also beneficial in diagnosing various orbital pathologies, particularly in differentiating solid from cystic lesions. Discussion: The added advantages of its use in children include lack of ionising radiation and reduced requirement of sedation or general anesthesia. Ultrasound is the most practical initial investigation in cases where ophthalmoscopy is limited by opacification of ocular media. The addition of color Doppler on ultrasound can give additional information about the vascularity of the lesion. Conclusion: Use of ultrasound can be streamlined into the workup of various orbital and ocular pathologies either as an initial investigation or as a problem‐solving tool in cases with a diagnostic dilemma on other modalities. [ABSTRACT FROM AUTHOR]

Robotic surgery has changed the landscape of surgery and ushered in a new era of technology-assisted minimally invasive surgery. There is a paradigm shift from traditional open surgeries to minimal access surgery, with robotic surgery being the new standard of care in some surgical fields. This change comes with an unprecedented influx of innovations in technology related to minimal access surgery, robotics and artificial intelligence. Despite the exponential advances in technology, there is a lacuna in the training and credentialling of robotic surgeons. In India, no dedicated training curriculum exists for trainees in robotic surgery. Thus, as robotic surgery continues to develop in India, it is imperative that robust training and credentialing systems are in place to ensure that patient safety and surgical outcomes are not compromised. [ABSTRACT FROM AUTHOR]

The main characteristic feature of diabetes mellitus is the disturbance of carbohydrate, lipid, and protein metabolism, which results in insulin insufficiency and can also lead to insulin resistance. Both the acute and chronic diabetic cases are increasing at an exponential rate, which is also flagged by the World Health Organization (WHO) and the International Diabetes Federation (IDF). Treatment of diabetes mellitus with synthetic drugs often fails to provide desired results and limits its use to symptomatic treatment only. This has resulted in the exploration of alternative medicine, of which herbal treatment is gaining popularity these days. Owing to their safety benefits, treatment compliance, and ability to exhibit effects without disturbing internal homeostasis, research in the field of herbal and ayurvedic treatments has gained importance. Medicinal phytoconstituents include micronutrients, amino acids, proteins, mucilage, critical oils, triterpenoids, saponins, carotenoids, alkaloids, flavonoids, phenolic acids, tannins, and coumarins, which play a dynamic function in the prevention and treatment of diabetes mellitus. Alkaloids found in medicinal plants represent an intriguing potential for the inception of novel approaches to diabetes mellitus therapies. Thus, this review article highlights detailed information on alkaloidal phytoconstituents, which includes sources and structures of alkaloids along with the associated mechanism involved in the management of diabetes mellitus. From the available literature and data presented, it can be concluded that these compounds hold tremendous potential for use as monotherapies or in combination with current treatments, which can result in the development of better efficacy and safety profiles. [ABSTRACT FROM AUTHOR]

Aim: To analyze the outcome of upfront pyeloplasty in kidneys of children with unilateral ureteropelvic junction obstruction (UPJO). Materials and Methods: Thirty-three consecutive cases with split renal function (SRF) of ≤20% on dynamic renal scintigraphy (DRS) underwent upfront pyeloplasty with a nephrostomy tube and trans-anastomotic stent. Outcome was analyzed based on symptomatic relief, nephrostomy output, surgical complications and changes noted in pre-and post-operative findings on renal ultrasound (US), and DRS. Results: The most common symptom was abdominal lump in <5-year age group (79%) and abdominal pain in >5-year age group (93%). Postoperatively, symptoms were relieved in all (100%), parenchymal thickness (PT) on US improved in 82% and SRF improved significantly (>5%) in 75.8% of patients. The improvement was more significant in patients with abdominal lump and large kidneys. The mean nephrostomy output showed an inverse relationship with age at pyeloplasty and a direct correlation with the change in PT and SRF. The degree of improvement in SRF also was inversely related to the age at pyeloplasty with a significantly better outcome in <2-year-age. Although age at pyeloplasty, nephrostomy output and change in PT individually showed significant correlation with change in SRF, multiple regression analysis showed PT as the only significant factor. Conclusion: Upfront pyeloplasty should be the first option in children with poorly functioning kidneys as it has a favorable outcome in almost all the cases with a very low incidence of complications. The degree of improvement in SRF can be predicted by the nephrostomy output and improvement in PT on US. [ABSTRACT FROM AUTHOR]