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Parkinson’s disease (PD) is a neurodegenerative disorder that affects the brain–gut axis, manifesting through both motor dysfunction and nonmotor symptoms. While several factors contribute to PD, the precise cause remains unknown. Research studies suggest that an altered gut microbiota (GM) plays a key role in PD pathophysiology. Gut dysbiosis compromises the integrity of the intestinal epithelium, increasing gastrointestinal permeability. This, in turn, activates the innate immune system, leading to systemic inflammation, whereas the adaptive immune system responds to bacterial proteins through cross-reactivity with human antigens. The altered GM promotes the accumulation of alpha-synuclein fibrils in the intestinal neural plexus, which are then transported to the central nervous system, driving the core pathological process of PD. This review focuses on the connection between gut dysbiosis, PD pathology, and current microbial-based therapeutic interventions. Furthermore, research into innovative approaches to modulate the GM and reinforce gut epithelial integrity is crucial to halting or slowing PD progression.

Abstract Background Recent research has revealed that today’s older adults report more sleep problems than their predecessors, a trend compounded by expanding social stratification. As such, this study examined the demographic, socioeconomic, and health correlates of sleep quality and sleep duration among community-dwelling older adults in India. Methods The current study sample draws on data from 7118 respondents aged 50 years and over participating in the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE) wave-2 dataset. Sleep quality (good, moderate, and poor) and sleep duration (in hours and minutes) were self-reported. Adjusted multivariable logistic regression models were employed to examine the associations between sleep quality and sleep duration and several demographic, socioeconomic, and health indicators. Results A total of 12.84% and 36.1% of older adults reported long (> 8 h) and short (

Abstract There has been an increasing focus on the interplay between physical frailty and cognitive impairment, as both conditions pose significant risks for life-threatening health complications and are receiving considerable attention in global geriatric health initiatives. A recent consensus introduces “cognitive frailty,” denoting the co-existence of physical frailty and cognitive impairment without dementia. This study aims to ascertain the prevalence of cognitive frailty and investigate the factors contributing to gender differentials of cognitive frailty among older adults in India. This study has used the data from the nationally representative survey Longitudinal Ageing Study in India 2017–18. This study included a sample of 13,946 males and 14,989 females aged 60 and above. Descriptive and bivariate analyses were conducted. A proportion test was employed to assess gender disparities and determine the statistical significance of risk factors. Furthermore, multivariate decomposition analysis was performed to identify the extent to which various covariates contribute to explaining the gender differences observed in cognitive frailty. The overall prevalence of cognitive frailty was 4.4%. There was a significant gender difference in cognitive frailty among older adults in India (Difference: 4.3%; p-value

Abstract Background In India, more than half of the newborns experience delayed breastfeeding, and non-exclusive breastfeeding is practiced in 63% of babies below the age of six months. The goal of this study is to investigate the extent to which external environment, demographic and socioeconomic, pregnancy and birthing characteristics, as well as utilization of maternal care services, are associated with delayed initiation and non-exclusive breastfeeding among children in India. Methods Data was gathered from the fifth round of the National Family Health Survey (NFHS), which was conducted in 2019-21. This study used information on 85,037 singleton infants aged 0–23 months and 22,750 singleton infants aged 0–5 months. Delayed initiation of breastfeeding and non-exclusive breastfeeding was used as outcome variables in this study. Unadjusted and adjusted multivariable binary logistic regression was performed to analyse the association of delayed breastfeeding and non-exclusive breastfeeding with selected background characteristics. Results Factors significantly associated with increased risks of delayed initiation of breastfeeding included infants from in the central region (OR 2.19; 95% CI 2.09, 2.29), mothers in the 20 to 29 years age group at the time of childbirth (OR 1.02; 95% CI 0.98, 1.05), caesarean deliveries (OR 1.97; 95% CI 1.90, 2.05). The likelihoods for non-exclusive breastfeeding significantly increased among children belonging to the richest household status (OR 1.30; 95% CI 1.17, 1.45), mothers who had less than nine months of pregnancy period (OR 1.15; 95% CI 1.06, 1.25), and mothers who gave birth in non-health facility (OR 1.17; 95% CI 1.05, 1.31). Conclusions The connections between several different categories of factors and non-exclusive breastfeeding and delayed breastfeeding initiation show the need for comprehensive public health programmes using a multi-sectoral approach to promote breastfeeding behaviours in India.

Type of study: Original Research. Aims: To comparatively evaluate the effect of different premedication agents on the efficacy of 4% Articaine in teeth with symptomatic irreversible pulpitis. Materials and methods: The primary objective of our study is to evaluate the effect of premedication agents on efficacy of Articaine as an oral anesthetic. Our secondary objective is to comparatively evaluate the efficacy of Diclofenac patch, Ibuprofen tablet, Paracetamol tablet and Placebo as a premedication agent. Patients with 25–40 years age, no systemic disease, no history of medication for that complaint, with pain on Heft Parker Visual Analog Scale between 55 mm and 170 mm (VAS), no tenderness on percussion, cold test and EPT negative- Positive, giving proper consent, coming to the Department of Conservative Dentistry and Endodontics were allowed to participate. The exclusion criteria include the following- Non-vital teeth, pregnant and lactating women, allergic to Articaine and NSAIDs, active systemic disease, immune-compromised patients, taken analgesics in last 24 h, root fractures, restoration extending to pulp10 and periapical pathologies (except periodontal ligament widening).Preoperatively pain was recorded using Heft Parker VAS (Visual Analog Scale). Cold testing, palpation, percussion and EPT were carried out. 40 patients having symptomatic irreversible pulpitis were randomly divided into 4 groups: group 1 Placebo (n = 10), group 2-Diclofenac patch (n = 10), group-3 Ibuprofen tablets (n = 10), group 4-Paracetamol tablets (n = 10). After 1 h of premedication, all patients were administered IANB injection using 4% Articaine (Septanest with adrenaline 1/100000, Septodont, France) containing epinephrine 1:100000. 15 mins after administration of IANB, patients were asked about symptomatic numbness and was tested with Endo frost and EPT and Outcome was recorded. If lip numbness was present, Electric Pulp Testing and Cold Test give negative result then endodontic access opening was performed and pain was recorded using visual analog scale. The study was conducted for a period of 1.5 years. Results: During the access cavity preparation only 1 subject in the Group III reported pain while in other groups none of the subjects reported pain of any type. When the intergroup comparison was made of intensity of pain 15 min after LA and during access cavity preparation, the difference between the groups was statistically non-significant when analyzed using One Way ANOVA. The intragroup comparison between three time intervals revealed significant reduction in the pain scores from the pre-treatment levels in all the four groups. Conclusions: The results of the study showed that there is no significant effect of different premedication agents on the efficacy of 4% Articaine in teeth with symptomatic irreversible pulpitis.

Abstract Background Cognitive impairment (CoI) is a significant risk factor for ill-health status among the older adults and a major burden on public health. This study unearths the degree of socioeconomic inequalities and assesses the determinants of CoI among the older adults in India. Methods Data on cognitive impairment of older adults aged 60 + years (n = 31,646) gathered in a nationally representative Longitudinal Ageing Study in India (2017–18) was analyzed through STATA with a significance level of 5%. Binary logistic regression, the concentration index, concentration curve, and Shapley decomposition analysis were performed to assess the socioeconomic inequalities and the determinants of CoI. Results Sixteen percent of the older adults had CoI. Females (OR = 1.88, 95% CI = 1.70–2.09), those aged 80 plus years (OR = 3.98, 95%CI = 3.56–4.44), from ST (OR = 2.65, 95%CI = 2.32–3.02), with perceived poor health (OR = 1.61,95%CI = 1.45–1.79), with depression (OR = 1.32, 95%CI = 1.21–1.43), with no schooling (OR = 16.46, 95%CI = 11.31–23.97) with 1 + ADL (OR = 1.43, 95%CI = 1.31–1.57) and 1 + IADL (OR = 1.30, 95%CI = 1.19–1.41) had higher odds of CoI than their respective counterparts. Older adults from urban areas (OR = 0.63, 95%CI = 0.57–0.70), higher income groups (OR = 0.61, 95%CI = 0.53- 0.70) and higher education level with sources of financial support (OR = 0.68, 95%CI = 0.61- 0.76) less likely to experience CoI. Economic inequalities exist in the distribution of CoI-the poorest being the most disadvantaged (concentration index value = -0.118). Conclusions There are socioeconomic-related inequalities in CoI among the older adults. The socioeconomically vulnerable older adults, including those illiterates, with poor economic status, women, not-in-union, the older, and those without social support, are more likely to develop CoI. The results suggest awareness generation and more customized policies and programs to reduce the socioeconomic inequalities in CoI among the older adults in India. The improved mental health of the older adults will contribute to achieving Sustainable Development Goals, including Goal 3 on guaranteeing good health and well-being for all.

Background/objectives: Obesity and bone diseases have increased substantially worldwide in the last three decades, particularly among older adults. This study assesses the association between obesity and bone disease among older adults in India. Methods: The data from the Longitudinal Ageing Study in India (LASI) was considered for analysis. A total of 65,173 individuals above the age of 45 years were analyzed. The descriptive statistics, multivariable logistic regression and mediation analysis are done to analyse the determinants of obesity and bone diseases. Results: Sixteen percent of the older adults in India had bone diseases. Females (OR = 1.453, 95%CI = 1.254,1.684) with obesity (OR = 1.571, 95%CI = 1.344,1.837), those aged more than 70 years (OR = 1.834, 95% CI = 1.540,2.184), not in union, from SC category, from rural areas, consumed tobacco (OR = 1.269, 95%CI = 1.209, 1.331) and alcohol (OR = 0.902, 95%CI = 0.867, 0.950), and with no physical activity (OR = 1.228, 95%CI = 1.087, 1.387) in daily life had higher risks of bone diseases. The results of the mediation analysis showed the relationship between bone disease and overweight/obesity was significantly mediated by the three modifiable risk factors: alcohol intake, smoking, and physical activity. Conclusion: The association between obesity and bone disease was found to be statistically significant in this study. Women, not-in-union, the older, and those without any education, those have lack of health awareness are more likely to develop bone-related issues in their later life. Research investigating the relationship between obesity and bone health has the potential to identify novel targets for the treatment of bone-related illnesses, such as osteoporosis, fractures, and rheumatoid arthritis.

Introduction: Cleaning and shaping of sophisticated root canal system plays an important role in the success of endodontic treatment. In addition to root canal instrumentation, irrigation also becomes a crucial aspect in the effective disinfection of root canal system. The chemical substances like acids, chelating agents, alkaline solutions, Sodium Hypochlorite (NaOCl), oxidative agents, and normal saline are used as root canal irrigants. But each irrigant has its own limitations. With the advent of novel materials and techniques, the search for the optimal root canal irrigant still continues. Aim: To evaluate and compare the antimicrobial effectiveness of various root canal irrigant solutions such as combination of 5.25% NaOCl and 2% Chlorhexidine gluconate, 2% Chlorhexidine gluconate, Miswak extract and normal saline for root canal irrigation. Materials and Methods: In this prospective observational study was conducted from February 2021 to April 2021, on 10 patients with persistent endodontic infection on single rooted teeth. After obtaining access to the root canals, paper points were inserted and the soaked paper points were placed immediately in a microtube with two mL of Reduced Transport Fluid (RTF) to obtain the bacterial suspension. The sensitivity of gram negative anerobic bacteria and E.faecalis to different irrigants was assessed with disc diffusion test and bacterial load was evaluated with Colony Forming Unit (CFU) assay. The study was analysed statistically using Kruskal-Wallis test and Dunn test (post-hoc test). Result: The results of disk diffusion method showed that the zone of inhibition for 2% chlorhexidine gluconate was 29 mm for gram negative anerobic bacteria and 22 mm for E.faecalis, and the zone of inhibition for Miswak extract was 8 mm for gram negative anerobic bacteria and 10 mm for E.faecalis. Gram negative anerobic bacteria on the culture plates treated with Miswak extract had 6.41 CFU/mL, and E.faecalis had 5.21 CFU/mL. Gram negative anerobic bacteria on the culture plates treated with normal saline had a CFU/mL of 6.77, and E.faecalis had a CFU/mL of 5.77. The antibacterial activity of miswak extract was lower than that of other irrigants. The normal saline lacked any antimicrobial qualities. Conclusion: The antibacterial effectiveness of the combination of 5.25% NaOCl and 2% Chlorhexidine gluconate was found to be higher than, 2% Chlorhexidine gluconate, Miswak extract and normal saline for root canal irrigation. A combination of 5.25% NaOCl and 2% Chlorhexidine gluconate can be used as a better choice over the other three irrigants.

Recent years have seen a decline in number of barium procedures due to wider availability of cross sectional imaging modalities. Though use of barium esophagography/barium swallow has decreased in day to day clinical practice, it still remains a valuable test for structural and functional evaluation of esophagus. It can be performed as single or double contrast examination or as a multiphasic examination comprising upright double contrast views followed by prone single contrast views. This pictorial essay demonstrates imaging features of various esophageal diseases on barium esophagogram.

ABSTRACT

We report the case of a 44-year-old male patient with bicuspid aortic valve, presenting with hemoptysis. Catheter angiography revealed an abnormal communication between bronchial and pulmonary artery, which remained undetected on computed tomography angiography. Angioembolization was done using polyvinyl alcohol and gelfoam particles. This is the first case in literature describing bronchial arteriovenous malformation associated with bicuspid aortic valve.

Pulmonary tuberculosis (TB) is one of the common causes of life-threatening hemoptysis, particularly in developing countries. Bronchial and pulmonary arteries are the major source of hemoptysis in pulmonary TB. Intercostal artery pseudoaneurysm as a cause of hemoptysis in pulmonary TB is extremely rare, with only a few reported cases. We describe a case of intercostal artery pseudoaneurysm in a patient of pulmonary TB, presenting as massive hemoptysis. Computed tomography bronchial angiography (CTBA) revealed a contrast-filled outpouching in a left upper lobe cavity. Catheter angiography revealed a pseudoaneurysm arising from one of the left intercostal arteries, which was managed subsequently by endovascular embolization. Pseudoaneurysm from visceral arteries is an extremely rare but important cause of massive hemoptysis in pulmonary TB, which if not managed promptly may prove fatal.

Background: Central venous disease is a serious complication in patients undergoing hemodialysis, often presenting with symptoms of venous hypertension. Treatment is aimed to provide symptomatic relief and to maintain hemodialysis access site patency. Aim: To describe our initial experience in the endovascular treatment of central venous stenosis or obstruction in patients undergoing hemodialysis. Settings and Design: This was a retrospective study carried out in a tertiary care center. Study duration was 24 months. Follow-up was variable. Materials and Methods: Eleven patients of chronic renal failure undergoing hemodialysis presented with central vein stenosis or obstruction having ipsilateral vascular access, between July 2012 and July 2014. All the patients underwent endovascular treatment and were analyzed retrospectively. Results and Conclusion: A total of 11 patients (4 male and 7 female) underwent 18 interventions for 13 stenotic segments during a time period of 2 years. Eight stenotic segments were in brachiocephalic vein, three in subclavian vein, and two in axillary veins. The technical success rate for endovascular treatment was 81.8%. Two patients underwent percutaneous transluminal angioplasty (PTA) alone and presented with restenosis later. Balloon angioplasty followed by stenting was done in seven patients, two of which required reintervention during follow-up. We found endovascular treatment safe and effective in treating central venous disease.

Bronchial artery embolization is the treatment of choice for the management of life-threatening massive hemoptysis. Chronic pulmonary thromboembolism (PTE) is one of the rare causes of hemoptysis. Management of hemoptysis in chronic PTE is a point of debate. In this article, we have reported one case of hemoptysis in chronic PTE managed successfully with bronchial artery embolization.

Wrist fractures and dislocations are frequently encountered in the emergency department and can cause significant long-term disability. Imaging plays a crucial role in the evaluation of wrist injuries, with conventional radiography being the first imaging investigation. Cross-sectional imaging is playing an increasingly important role in management of wrist injuries. Computed tomography with 3D and multiplanar reformatting capabilities is in particular useful for detailed evaluation of bony injuries and can provide vital information to orthopaedic surgeons for adequate surgical planning. In this article, we provide a brief review of the normal wrist anatomy, imaging appearance, and various patterns of fractures and dislocations commonly encountered in the emergency department.

Hydatid disease is a zoonosis that can involve almost any organ in the human body. After the liver, the lungs are the most common site for hydatid disease in adults. Imaging plays a pivotal role in the diagnosis of the disease, as clinical features are often nonspecific. Classical radiological signs of pulmonary hydatid cysts have been described in the literature, aiding in the diagnosis of the disease. However, complicated hydatid cysts can prove to be a diagnostic challenge at times due to their atypical imaging features. Radiography is the initial imaging modality. Computed tomography can provide a specific diagnosis in complicated cases. Ultrasound is particularly useful in peripheral lung lesions. The role of magnetic resonance imaging largely remains unexplored.