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Introduction: Pregnancy causes significant vascular and cutaneous changes in a woman’s body. Preeclampsia is one of the life-threatening conditions associated with high blood pressure and proteinuria after the 20th week of pregnancy. It can cause placental hypoperfusion and placental insufficiency, leading to foetal defects or, in severe cases, foetal loss, which can be prevented by early diagnosis and treatment. There are many ways to observe and study the microcirculation non invasively the safest and most accessible method is nailfold capillaroscopy. Nail-fold Video Capillaroscopy (NVC) is a hand-held digital microscope used to observe the microcirculation at the nailfold of the hands. Thus, comparing the capillary status with healthy subjects will help establish an early diagnosis and manage cases to prevent further complications in the mother and newborn. Need of the Study: The pathophysiology states that preeclampsia is related to systemic endothelial dysfunction, causing the release of Tumour Necrosis Factor (TNF) alpha, a proinflammatory mediator, leading to hypoxia of the placenta and the loss of endothelial cell-lined capillaries. Thus, there is a need to find if there is an established correlation in association of decreased Capillary Density (CD) in individuals with preeclampsia. Although evidence supporting a link between decreased CD and preeclampsia is limited, timely assessment and prevention are crucial. Nailfold capillaroscopy, an accessible and non invasive imaging method, holds promising calibre for understanding microvascular changes in preeclampsia. This could facilitate post-conception monitoring and early interventions to identify and address circulatory issues in affected women with preeclampsia. Aim: To study and compare the nailfold capillary changes in women diagnosed with preeclampsia and women having normal and uneventful pregnancies. Materials and Methods: A comparative cross-sectional study will be done in the Outpatient Department (OPD) and Inpatient Department (IPD) of Obstetrics and Gynaecology and the Outpatient Department of Dermatology at AVBRH Sawangi Meghe, Wardha, Maharashtra, India, from March 2023 to March 2025. A total of 150 pregnant women will be considered in the study, with 75 women being normal pregnant women (controls) and 75 pregnant women diagnosed with preeclampsia (cases). In order to confirm the gestational age of the patients, fundal height and abdominal circumference measurements will be taken. Demographic data, Basal Metabolic Index (BMI), weight gain during pregnancy, laboratory reports including Complete Blood Count (CBC), coagulation profile (Prothrombin Time, International Normalised Ratio, Activated Partial Thromboplastin Time), liver function tests, kidney function tests, urine examinations, and serial ultrasonography reports available for the patients will be noted. Pre-examination blood pressure will be recorded and compared with the baseline to confirm the status of preeclampsia after obtaining written consent from the patients. Nailfold capillaroscopy will be performed using a (Dinolite -AF4115ZT) dermoscope equipped with a 200X magnification, high-resolution lens in a non polarised light setting with oil immersion as a fluid coupling. The observations will be used to interpret the results of the study. Results will be calculated for finding differences between the two comparative groups of cases and controls at a p-value of ≤0.05.

Reflection-type photoplethysmography (PPG) pulse sensors used in wearable smart watches, true wireless stereo, etc., have been recently considered a key component for monitoring biological signals such as heart rate, SPO3, and blood pressure. Typically, the optical front end (OFE) of these PPG sensors is heterogeneously configured and packaged with light sources and receiver chips. In this paper, a novel quarter-annulus photodetector (NQAPD) with identical inner and outer radii of curvature has been developed using a plasma dicing process to realize a ring-type OFE receiver, which maximizes manufacturing efficiency and increases the detector collection area by 36.7% compared to the rectangular PD. The fabricated NQAPD exhibits a high quantum efficiency of over 90% in the wavelength of 500 nm to 740 nm and the highest quantum efficiency of 95% with a responsivity of 0.41 A/W at the wavelength of 530 nm. Also, the NQAPD is shown to increase the SNR of the PPG signal by 5 to 7.6 dB compared to the eight rectangular PDs. Thus, reflective PPG sensors constructed with NQAPD can be applied to various wearable devices requiring low power consumption, high performance, and cost-effectiveness. [ABSTRACT FROM AUTHOR]

In Asian population, bimaxillary protrusion is a prevalent malocclusion characterised by protruding and proclined upper and lower incisors, as well as increased lip procumbence. A 25-year-old female patient presented with a chief complaint of forwardly placed teeth and bimaxillary protrusion and required fixed mechanotherapy with all four 1st premolar extractions. The patient also desired that the treatment be completed in a short period of time. Since sliding or loop mechanics alone take longer to close extraction spaces, authors chose Micro-osteoperforation (MOP), a minimally invasive procedure used to accelerate orthodontic tooth movement. MOP involves drilling or perforating distal to the canine for en-mass retraction, causing the alveolar bone to release inflammatory cells that accelerate tooth movement. This non invasive technique was used for the treatment. The average rate of tooth movement in each quadrant was 1.7 mm per month. Taking the procedure into account, the patient reported no side-effects during or after drilling, but mild discomfort was felt. The entire space closure took four months. At the end of space closure, a Class I molar and canine relationship was preserved with normal overbite and overjet, with very minimal anchorage loss on the molars. An extraoral improvement in profile from convex to straight was seen. The treatment was completed within 14 months. The novelty of MOP includes faster treatment times and less discomfort during orthodontic treatment. However, like any medical procedure, MOP does carry some risks, such as infection or damage to surrounding teeth or gums. It is important to discuss the risks and benefits of MOP with your orthodontist before deciding whether to undergo the procedure.

In Asian population, bimaxillary protrusion is a prevalent malocclusion characterised by protruding and proclined upper and lower incisors, as well as increased lip procumbence. A 25-year-old female patient presented with a chief complaint of forwardly placed teeth and bimaxillary protrusion and required fixed mechanotherapy with all four 1st premolar extractions. The patient also desired that the treatment be completed in a short period of time. Since sliding or loop mechanics alone take longer to close extraction spaces, authors chose Micro-osteoperforation (MOP), a minimally invasive procedure used to accelerate orthodontic tooth movement. MOP involves drilling or perforating distal to the canine for en-mass retraction, causing the alveolar bone to release inflammatory cells that accelerate tooth movement. This non invasive technique was used for the treatment. The average rate of tooth movement in each quadrant was 1.7 mm per month. Taking the procedure into account, the patient reported no side-effects during or after drilling, but mild discomfort was felt. The entire space closure took four months. At the end of space closure, a Class I molar and canine relationship was preserved with normal overbite and overjet, with very minimal anchorage loss on the molars. An extraoral improvement in profile from convex to straight was seen. The treatment was completed within 14 months. The novelty of MOP includes faster treatment times and less discomfort during orthodontic treatment. However, like any medical procedure, MOP does carry some risks, such as infection or damage to surrounding teeth or gums. It is important to discuss the risks and benefits of MOP with your orthodontist before deciding whether to undergo the procedure. [ABSTRACT FROM AUTHOR]

Reflection-type photoplethysmography (PPG) pulse sensors used in wearable smart watches, true wireless stereo, etc., have been recently considered a key component for monitoring biological signals such as heart rate, SPO3, and blood pressure. Typically, the optical front end (OFE) of these PPG sensors is heterogeneously configured and packaged with light sources and receiver chips. In this paper, a novel quarter-annulus photodetector (NQAPD) with identical inner and outer radii of curvature has been developed using a plasma dicing process to realize a ring-type OFE receiver, which maximizes manufacturing efficiency and increases the detector collection area by 36.7% compared to the rectangular PD. The fabricated NQAPD exhibits a high quantum efficiency of over 90% in the wavelength of 500 nm to 740 nm and the highest quantum efficiency of 95% with a responsivity of 0.41 A/W at the wavelength of 530 nm. Also, the NQAPD is shown to increase the SNR of the PPG signal by 5 to 7.6 dB compared to the eight rectangular PDs. Thus, reflective PPG sensors constructed with NQAPD can be applied to various wearable devices requiring low power consumption, high performance, and cost-effectiveness.

Background: Non alcoholic fatty liver disease (NAFLD) is the most common liver disease involving about 25% of the world’s population. Liver biopsy is the current gold standard for the diagnosis and assessment of the severity of hepatic steatosis. However, because of its invasive nature and the risk of complications, many non invasive imaging modalities and laboratory markers were evaluated for the assessment of the hepatic steatosis. Objectives: To evaluate the diagnostic performance of noninvasive indices to predict NAFLD in Egyptian patients. Patients and methods: A cross-sectional study was conducted in a series of adult asymptomatic subjects. NAFLD was diagnosed in 100 cases by ultrasonography for whom controlled attenuation parameters (CAP) examination was done. General, anthropometric and biochemical data were collected. Fatty liver indexes (FLI), Zhejiang University index (ZJU) and hepatic steatosis index (HSI) were calculated. Roc curve analysis was used to detect the optimal cutoff of different models that predict steatosis. Results: The area under the receiver operating characteristic (AUROC) curve of the FLI, ZJU index, and HSI was 0.999, 0.929, and 0.898, respectively. The (AUROC) curve of the FLI and ZJU index were significantly higher than that of HSI (P=0.0001 and P=0.001, respectively). The optimal cut off values for the FLI, ZJU index, and HSIwere 30, 40.3, and 39.6, respectively. Conclusion: FLI, ZJU and HSI could be accurate and applicable tools for the noninvasive diagnosis of NAFLD in Egyptian patients.

Background: Portal hypertension is a major consequence of cirrhosis and is responsible for its most severe complications, including ascites, bleeding from gastro-oesophageal varices and encephalopathy. Measuring HVPG is very ideal to diagnosis and to grade severity. But the drawback of this procedure is its invasiveness leading to complications. So, a simple, routinely available, cost effective method for severity assessment of portal hypertension would be attractive. Methodology: It was a cross sectional study which included patients diagnosed as Chronic liver disease attending to the OPD as well as in-patients. Results: This study included a total of 100 subjects who had esophageal varices secondary to liver cirrhosis with portal hypertension. Majority of the patients were in the age group of 36 to 45 years (31%) with mean age of study subjects being 47.43 with male preponderance (87%). A statistically significant association was found for splenic size and esophageal variceal grading. 57% of the patients had splenomegaly between 13-15cm size of which 22 % had grade 3 esophageal varices followed grade 1 varices who constituted 17%. 20% of the patients had spleen size >15cm. Conclusion: Ultrasonographic measurement of spleen size > 13 cm can be considered as non-invasive predictor of presence of esophageal varices and grading in patients with Cirrhosis with portal hypertension along with other measurements like portal vein diameter and platelet count. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus is defined as a clinically and genetically diverse cluster of illnesses involving conflict in carbohydrate and protein metabolism. Periodontitis is a complex condition with several causes. The interaction between these two conditions appears to be cyclical as well as bidirectional. Gingival crevicular blood obtained through routine periodontal oral assessment could be utilised for blood glucose estimation. Aim: To examine the efficacy of gingival crevicular blood elicited during routine periodontal probing, as a reliable source for screening of diabetes mellitus, and to compare it with finger capillary blood and venous capillary blood in chronic periodontitis patients. Materials and Methods: This cross-sectional, in-vivo, clinical study was conducted in the Department of Periodontology at Karnavati School of Dentistry, Gandhinagar, Gujarat, India, from January 2021 to January 2022. The study included 50 patients, who were diagnosed with chronic periodontitis in the age range ≥30 years, and met the inclusion and exclusion criteria. A prior detailed history was compiled. The clinical parameters recorded were sulcus bleeding index, plaque index, gingival index, probing pocket depth, and clinical attachment level. Each patient's blood samples were collected from three different sites, Gingival Crevicular Blood (GCB) collected from gingival crevice, Finger Capillary Blood (FCB) collected from finger bed and and Venous Capillary Blood (VCB) collected from forearm for determining the blood glucose levels. Glucose levels were compared by oneway Analysis of Variance (ANOVA). Karl Pearson's correlation was used for the comparison. Statistical Package for Social Sciences (SPSS) version 26.0 was used for statistical analysis and p-value ≤0.05 was considered as statistically significant. Results: The mean Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) was 5.5±0.61 mm and 6.76±0.82 mm, respectively. The mean Plaque Index (PI) and Gingival Index (GI) score was 1.41±0.25 and 1.45±0.21, respectively. The mean GCB, FCB, and VCB glucose level of the subjects were 171.58±85.63 mg/dL, 179.14±80.31 mg/dL and 186.96±87.57 mg/dL, respectively. There was no statistical difference seen among the three methods, thus, either of the methods can be used for measuring blood glucose levels for screening of diabetes mellitus in chronic periodontitis patients (p-value=0.66). Posistive correlation between FCB and VCB (r-value=0.976, p-value <0.001). VCB and GCB, when correlated showed strong positive and highly statistically significant results (r-value=0.934, p-value <0.001). Similarly, GCB and FCB showed a positive correlation (r-value=0.920, p-value <0.001) which was statistically highly significant. Conclusion: The results suggested that, the efficacy of gingival crevicular blood when compared with finger capillary blood and venous capillary blood glucose levels showed positive correlation, suggesting either can be used in dental clinics for diabetic screening purpose without any extra invasive procedures. [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy causes significant vascular and cutaneous changes in a woman's body. Preeclampsia is one of the life-threatening conditions associated with high blood pressure and proteinuria after the 20th week of pregnancy. It can cause placental hypoperfusion and placental insufficiency, leading to foetal defects or, in severe cases, foetal loss, which can be prevented by early diagnosis and treatment. There are many ways to observe and study the microcirculation non invasively the safest and most accessible method is nailfold capillaroscopy. Nail-fold Video Capillaroscopy (NVC) is a handheld digital microscope used to observe the microcirculation at the nailfold of the hands. Thus, comparing the capillary status with healthy subjects will help establish an early diagnosis and manage cases to prevent further complications in the mother and newborn. Need of the Study: The pathophysiology states that preeclampsia is related to systemic endothelial dysfunction, causing the release of Tumour Necrosis Factor (TNF) alpha, a proinflammatory mediator, leading to hypoxia of the placenta and the loss of endothelial cell-lined capillaries. Thus, there is a need to find if there is an established correlation in association of decreased Capillary Density (CD) in individuals with preeclampsia. Although evidence supporting a link between decreased CD and preeclampsia is limited, timely assessment and prevention are crucial. Nailfold capillaroscopy, an accessible and non invasive imaging method, holds promising calibre for understanding microvascular changes in preeclampsia. This could facilitate post-conception monitoring and early interventions to identify and address circulatory issues in affected women with preeclampsia. Aim: To study and compare the nailfold capillary changes in women diagnosed with preeclampsia and women having normal and uneventful pregnancies. Materials and Methods: A comparative cross-sectional study will be done in the Outpatient Department (OPD) and Inpatient Department (IPD) of Obstetrics and Gynaecology and the Outpatient Department of Dermatology at AVBRH Sawangi Meghe, Wardha, Maharashtra, India, from March 2023 to March 2025. A total of 150 pregnant women will be considered in the study, with 75 women being normal pregnant women (controls) and 75 pregnant women diagnosed with preeclampsia (cases). In order to confirm the gestational age of the patients, fundal height and abdominal circumference measurements will be taken. Demographic data, Basal Metabolic Index (BMI), weight gain during pregnancy, laboratory reports including Complete Blood Count (CBC), coagulation profile (Prothrombin Time, International Normalised Ratio, Activated Partial Thromboplastin Time), liver function tests, kidney function tests, urine examinations, and serial ultrasonography reports available for the patients will be noted. Pre-examination blood pressure will be recorded and compared with the baseline to confirm the status of preeclampsia after obtaining written consent from the patients. Nailfold capillaroscopy will be performed using a (Dinolite -AF4115ZT) dermoscope equipped with a 200X magnification, high-resolution lens in a non polarised light setting with oil immersion as a fluid coupling. The observations will be used to interpret the results of the study. Results will be calculated for finding differences between the two comparative groups of cases and controls at a p-value of =0.05. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus is defined as a clinically and genetically diverse cluster of illnesses involving conflict in carbohydrate and protein metabolism. Periodontitis is a complex condition with several causes. The interaction between these two conditions appears to be cyclical as well as bidirectional. Gingival crevicular blood obtained through routine periodontal oral assessment could be utilised for blood glucose estimation. Aim: To examine the efficacy of gingival crevicular blood elicited during routine periodontal probing, as a reliable source for screening of diabetes mellitus, and to compare it with finger capillary blood and venous capillary blood in chronic periodontitis patients. Materials and Methods: This cross-sectional, in-vivo, clinical study was conducted in the Department of Periodontology at Karnavati School of Dentistry, Gandhinagar, Gujarat, India, from January 2021 to January 2022. The study included 50 patients, who were diagnosed with chronic periodontitis in the age range ≥30 years, and met the inclusion and exclusion criteria. A prior detailed history was compiled. The clinical parameters recorded were sulcus bleeding index, plaque index, gingival index, probing pocket depth, and clinical attachment level. Each patient’s blood samples were collected from three different sites, Gingival Crevicular Blood (GCB) collected from gingival crevice, Finger Capillary Blood (FCB) collected from finger bed and and Venous Capillary Blood (VCB) collected from forearm for determining the blood glucose levels. Glucose levels were compared by one-way Analysis of Variance (ANOVA). Karl Pearson’s correlation was used for the comparison. Statistical Package for Social Sciences (SPSS) version 26.0 was used for statistical analysis and p-value ≤0.05 was considered as statistically significant. Results: The mean Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) was 5.5±0.61 mm and 6.76±0.82 mm, respectively. The mean Plaque Index (PI) and Gingival Index (GI) score was 1.41±0.25 and 1.45±0.21, respectively. The mean GCB, FCB, and VCB glucose level of the subjects were 171.58±85.63 mg/dL, 179.14±80.31 mg/dL and 186.96±87.57 mg/dL, respectively. There was no statistical difference seen among the three methods, thus, either of the methods can be used for measuring blood glucose levels for screening of diabetes mellitus in chronic periodontitis patients (p-value=0.66). Posistive correlation between FCB and VCB (r-value=0.976, p-value

Introduction: Cranio-sacral Therapy (CST) is a non invasive method which can help patients with migraine. Reviews are needed to explore the effectiveness of the same and also the most effective treatment frequency and duration need to be recommend. Aim: To evaluate the effectiveness of CST in managing pain and migraine attack frequency among migraineurs. Methodology: Relevant articles were identified by searching major databases (PubMed, Physiotherapy Evidence Database, Cochrane Library) published between 2000 and 2023 on adult participants who received CST with a history of migraine for atleast one year. The focus was to find whether effectiveness of CST was superior to sham interventions in participants with migraines. A standardised approach was used to assess the quality and potential biases within each study using Physiotherapy Evidence Database (PEDro) scale and robvis tool, followed by an evaluation of the overall strength of the evidence using a recognised framework. Results: The present search identified 38 studies, of which only 5 trials met the strict criteria for inclusion in this review. These studies consistently showed that CST was more effective than sham therapy in reducing both migraine frequency and pain intensity. Additionally, the results suggested that CST may not only decrease migraine frequency but also improve overall quality of life. Conclusion: CST is a gentle and safe approach and can be a valuable complementary therapy that may help reduce both the frequency and intensity of migraine episodes compared to other interventions. Implications: It's crucial to seek treatment from a qualified craniosacral therapist for optimal safety and effectiveness. [ABSTRACT FROM AUTHOR]

This study aimed to determine the duration of the process of spermatogenesis in adult Javan langurs (Trachypithecus auratus) by measuring levels of the hormone testosterone and luteinizing hormone (LH), as one of the efforts to increase the success of mating this endemic animals. Two Javan langurs aged 3-5-year-old, named Luki and Moses were taken their feces for 30 days. Feces extraction process used PBS with a ratio of 1: 9, while the measurement of hormone levels used Monkey Luteinizing Hormone ELISA BT Lab brand with Cat.No E0052MK for LH and Cat No E0008MK for testosterone. Hormone consentration data was a graph with fluctuating patterns which are then analyzed descriptively. The results of this study were the concentration of the hormone testosterone is in the range of 4.81 ng / gram of feces to 15.08 ng / gram of feces. While LH level is in the range of 12.59 mIU/gram to 26.24 mIU/gram. In conclusion, we could estimated that the duration of the spermatogenesis cycle every month in langur Luki occurs for 14 days, while Langur Moses for 10 days.

Objective: To compare the efficacy of continuous positive airway pressure (CPAP) versus usual care for prehospital patients with severe respiratory distress.Methods: We conducted a parallel group, individual patient, non-blinded randomised controlled trial in Western Australia between March 2016 and December 2018. Eligible patients were aged ≥40 years with acute severe respiratory distress of non-traumatic origin and unresponsive to initial treatments by emergency medical service (EMS) paramedics. Patients were randomised (1:1) to usual care or usual care plus CPAP. The primary outcomes were change in dyspnoea score and change in RR at ED arrival, and hospital length of stay.Results: 708 patients were randomly assigned (opaque sealed envelope) to usual care (n=346) or CPAP (n=362). Compared with usual care, patients randomised to CPAP had a greater reduction in dyspnoea scores (usual care -1.0, IQR -3.0 to 0.0 vs CPAP -3.5, IQR -5.2 to -2.0), median difference -2.0 (95% CI -2.5 to -1.6); and RR (usual care -4.0, IQR -9.0 to 0.0 min-1 vs CPAP -8.0, IQR -14.0 to -4.0 min-1), median difference -4.0 (95% CI -5.0 to -4.0) min-1. There was no difference in hospital length of stay (usual care 4.2, IQR 2.1 to 7.8 days vs CPAP 4.8, IQR 2.5 to 7.9 days) for the n=624 cases admitted to hospital, median difference 0.36 (95% CI -0.17 to 0.90).Conclusions: The use of prehospital CPAP by EMS paramedics reduced dyspnoea and tachypnoea in patients with acute respiratory distress but did not impact hospital length of stay.Trial Registration Number: ACTRN12615001180505. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) has become the most common liver alteration worldwide. It encompasses a spectrum of disorders that range from simple steatosis to a progressive form, defined non-alcoholic steatohepatitis (NASH), that can lead to advanced fibrosis and eventually cirrhosis and hepatocellular carcinoma. On liver histology, NASH is characterized by the concomitant presence of significant fat accumulation and inflammatory reaction with hepatocellular injury. Until now, liver biopsy is still required to differentiate simple steatosis from NASH and evaluate the degree of liver fibrosis. Unfortunately, this technique has well-known limitations, including invasiveness and expensiveness. Moreover, it may be biased by sampling error and intra- or inter-observed variability. Furthermore, due to the increasing prevalence of NAFLD worldwide, to program a systematic screening with liver biopsy is not imaginable. In recent years, different techniques were developed and validated with the aim of non-invasively identifying NASH and assess liver fibrosis degrees. The non-invasive tests range from simple blood-tests analyses to composite scores and complex imaging techniques. Nevertheless, even if they could represent cost-effective strategies for diagnosing NASH, advanced fibrosis and cirrhosis, their accuracy and consequent usefulness are to be discussed. With this aim, in this review the authors summarize the current state of non-invasive assessment of NAFLD. In particular, in addition to the well-established tests, the authors describe the future perspectives in this field, reporting the latest tests based on OMICS, gut-miocrobioma and micro-RNAs. Finally, the authors provide an accurate assessment of how these non-invasive tools perform in clinical practice depending on the clinical context, with the aim of giving the clinicians a useful tool to try to resolve the diagnostic conundrum of NAFLD.

Introduction: Liver fibrosis is a progressive disorder that if diagnosed early and staged precisely, allows early clinical intervention that may hinder or slow down the progression to end stage decompensated cirrhosis. Grading of hepatic fibrosis is important not only for diagnosis but also for prognostic evaluation, planning appropriate therapy, and follow-up of patients with chronic viral hepatitis. Liver biopsy has been considered the reference standard for grading liver fibrosis. As liver biopsy is invasive and associated with complications, non invasive serological and imaging techniques like Shear Wave Elastography (SWE) and Aminotransferase Platelet Ratio Index (APRI) have come to the spotlight. Aim: To evaluate SWE alone and together with APRI as a reliable alternative to liver biopsy for diagnosing and grading hepatic fibrosis in chronic viral hepatitis. Materials and Methods: This case control study was conducted over a period of 18 months from October 2017 to March 2019, at a tertiary care hospital in New Delhi, India. Total 120 subjects (60 cases of chronic viral hepatitis and 60 case matched healthy volunteers as controls) were enrolled in the study. Biopsy could not be performed in 10 cases so these cases and their matched controls were excluded from the statistical analysis. SWE was performed using a 1-5 MHz curvilinear transducer (Philips iU22x MATRIX). APRI and mean of six SWE measurements (in kilopascals) were calculated for all subjects. The analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: Among all 50 cases of chronic hepatitis who have undergone biopsy, the mean SWE values corresponding to the histopathological grade of fibrosis i.e., F0, F1, F2, F3 and F4 was found to be 4.48±1.05, 7.16±0.75 kPa, 8.08±1.05 kPa, 8.44±0.47 kPa and 16.01±3.78 kPa respectively. The mean APRI values of the cases in F1, F2 and F3 grades showed significant overlap (cut off value between 0.5-1.5). Also, when APRI was used along with SWE, does not have a statistically significant contribution to improve its diagnostic accuracy in liver fibrosis grading. Conclusion: Shear wave elastography has high accuracy in detecting and grading of fibrosis. APRI does not appear to have a significant role in the grading of liver fibrosis however it can be combined with SWE for post-treatment follow-up of chronic viral hepatitis patients thus avoiding the need for repeated biopsy. [ABSTRACT FROM AUTHOR]

Abstract Background Accurate diagnosis of anemia by community workers using a point-of-care device is a challenge. The objective of the study was to establish the diagnostic accuracy of point-of-care devices for detecting anemia in community settings. Methods It was diagnostic accuracy study with cross-sectional design on adult patients attending the outpatient department of rural/ urban health centres of Medical colleges from India. The index tests were HemoCue, TrueHb, Massimo’s device and spectroscopic device, compared against autoanalyzer (gold standard). Accuracy was expressed by sensitivity, specificity, likelihood ratios, predictive values, area under the curve (AUC) and levels of agreement. For the diagnostic accuracy component, 1407 participants were recruited with a minimum of 600 for each device. An additional 200 participants were considered to elucidate the performance of devices in different weather conditions. Results HemoCue and TrueHb performed better than Massimo and spectroscopic devices. Detection of anemia by technicians was similar between TrueHb and HemoCue (AUC 0.92 v/s 0.90, p > 0.05). Community workers performed better with Hemocue for detecting anemia compared to TrueHb (AUC 0.92 v/s 0.90, p

Abstract One of the two missing canvases from L’évidence éternelle of 1954, the one of the feet, has been discovered beneath a small woman portrait painted in 1958, La toile de Pénélope. Indeed, the underlying woman’s feet revealed through the IRR and XRR images leave little doubt about the identity of the hidden composition. All the more so as the canvas dimensions perfectly match with the format ascribed to the feet part in the diagram Magritte made of the 1954 variant of L’évidence éternelle. This paper presents the main results of the material study conducted on La toile de Pénélope by means of non-invasive and complementary imaging and analytical techniques. Furthermore, it proposes a virtual colorized reconstruction of the hidden picture, built on the basis of the XRR and IRR images, the elemental information provided by the MA-XRF analysis, the Raman results and the microscope examination of the painting surface.

Introduction: Liver fibrosis is a progressive disorder that if diagnosed early and staged precisely, allows early clinical intervention that may hinder or slow down the progression to end stage decompensated cirrhosis. Grading of hepatic fibrosis is important not only for diagnosis but also for prognostic evaluation, planning appropriate therapy, and follow-up of patients with chronic viral hepatitis. Liver biopsy has been considered the reference standard for grading liver fibrosis. As liver biopsy is invasive and associated with complications, non invasive serological and imaging techniques like Shear Wave Elastography (SWE) and Aminotransferase Platelet Ratio Index (APRI) have come to the spotlight. Aim: To evaluate SWE alone and together with APRI as a reliable alternative to liver biopsy for diagnosing and grading hepatic fibrosis in chronic viral hepatitis. Materials and Methods: This case control study was conducted over a period of 18 months from October 2017 to March 2019, at a tertiary care hospital in New Delhi, India. Total 120 subjects (60 cases of chronic viral hepatitis and 60 case matched healthy volunteers as controls) were enrolled in the study. Biopsy could not be performed in 10 cases so these cases and their matched controls were excluded from the statistical analysis. SWE was performed using a 1-5 MHz curvilinear transducer (Philips iU22x MATRIX). The APRI and the mean of six SWE measurements (in kilopascals) were calculated for all subjects. The analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: Among all 50 cases of chronic hepatitis who have underwent biopsy, the mean SWE values corresponding to the histopathological grade of fibrosis i.e., F0, F1, F2, F3 and F4 was found to be 4.48±1.05 kPa, 7.16±0.75 kPa, 8.08±1.05 kPa, 8.44±0.47 kPa and 16.01±3.78 kPa, respectively. The mean APRI values of the cases in F1, F2 and F3 grades showed significant overlap (cut off value between 0.5-1.5). Also, when APRI was used along with SWE, does not have a statistically significant contribution to improve its diagnostic accuracy in liver fibrosis grading. Conclusion: Shear wave elastography has high accuracy in detecting and grading of fibrosis. APRI does not appear to have a significant role in the grading of liver fibrosis however it can be combined with SWE for post-treatment follow-up of chronic viral hepatitis patients thus avoiding the need for repeated biopsy.

Background: The present study investigates the effect of an aqueous extract of Anogeissus leiocarpa (AEAL) on normotensive Wistar rats and its chronic antihypertensive effects in L-NAME-induced hypertensive rats by using a non-invasive tail-cuff model. Methods: The effects of AEAL (50mg/kg) and NaCl 0.9% on blood pressure were investigated by daily oral administration in normotensive Wistar rats over four weeks. L-NAME-induced hypertensive rats were produced by L-NAME (40mg/kg) daily oral administration for two weeks. For chronic antihypertensive effects, induced hypertensive rats have received L-NAME in combination with AEAL (10 or 50mg/kg/day) for two following weeks. Results: In normotensive rats, daily administration of AEAL (50mg/kg) has no significant effect on their blood pressure, which was similar to that of the control group. L-NAME's daily oral administration induces a progressive increase in systolic blood pressure (SBP) from 115.8 ± 7.9mmHg to 153.5 ± 4.6mmHg after two weeks, which was maintained to the end of the treatment. In L-NAME-induced hypertensive rats, AEAL (50mg/kg/day) significantly decreases the SPB from 160.0 ± 5.8 mmHg to 108.8 ± 2.7mmHg after only four days of administration. However, the lower dose of AEAL (10mg/kg) also normalized the SBP of L-NAME-induced hypertensive rats but only evident after seven days of administration. Moreover, AEAL does not effect on the serum biochemical parameters (ALAT, ASAT, CREAT, etc.) and any macroscopic adverse effect was detected on the sensible organs involved during hypertension. In the aorta rings from treated rats, AEAL (50mg/kg/day) alone or in combination with L-NAME has enhanced the vasodilation effect of acetylcholine. However, the vasodilation effect of AEAL alone or in association with L-NAME has enhanced the sodium nitroprusside effect in treated rat aorta rings after autopsy. Conclusion: These findings suggest that AEAL affords significant antihypertensive effects against L-NAME-induced hypertensive rats without modification of serum parameters and deleterious effects. [ABSTRACT FROM AUTHOR]

Background: Little is known about optimal fluid therapy for patients with sepsis without shock who present to the ED. In this study, we aimed to quantify the effect of a fluid challenge on non-invasively measured Cardiac Index (CI) in patients presenting with sepsis without shock.Methods: In a prospective cohort study, CI, stroke volume (SV) and systemic vascular resistance (SVR) were measured non-invasively in 30 patients presenting with sepsis without shock to the ED of a large teaching hospital in the Netherlands between May 2018 and March 2019 using the ClearSight system. After baseline measurements were performed, a passive leg raise (PLR) was done to simulate a fluid bolus. Measurements were then repeated 30, 60, 90 and 120 s after PLR. Finally, a standardised 500 mL NaCl 0.9% intravenous bolus was administered after which final measurements were done. Fluid responsiveness was defined as >15% increase in CI after a standardised fluid challenge.Measurements and Main Results: Seven out of 30 (23%) patients demonstrated a >15% increase in CI after PLR and after a 500 mL fluid bolus. Fluid responders had a higher estimated glomerular filtration rate (eGFR) (64 (44-78) vs 37 (23-47), p=0.009) but otherwise similar patient and treatment characteristics as non-responders. Baseline measurements of cardiac output (CO), CI, SV and SVR were unrelated to PLR fluid responsiveness. The change in CI after PLR was strongly positive correlated to the change in CI after a 500 mL NaCl 0.9% fluid bolus (r=0.88, p<0.001).Conclusion: The results of the present study demonstrate that in patients with sepsis in the absence of shock, three out of four patients do not demonstrate a clinically relevant increase in CI after a standardised fluid challenge. Non-invasive CO monitoring in combination with a PLR test has the potential to identify patients who might benefit from fluid resuscitation and may contribute to a better tailored treatment of these patients. [ABSTRACT FROM AUTHOR]

This paper focuses on the Brain Computer Interface (BCI) application and its issues. Further the attempt was made to implement left and right hand movement classification after removal of the artifacts in the acquired signals of the various hand movements.

Cryolipolysis has been marketed as a safe and effective alternative to invasive procedures for reduction of subcutaneous fat and body contouring. Some complications include erythema and paradoxical adipose hyperplasia. We present a case report of bilateral flank lumps post 2 sessions of cryolipolysis. Literature search was performed for "Cool sculpting" AND "adverse effects" OR "Side effects" OR "Complications" OR "cryolipolysis" AND "Fat necrosis". Histopathology slides were also reviewed by a senior consultant pathologist. The mechanism of action of each non-invasive fat reduction modality differs; cryolipolysis works by apoptosis, not necrosis. However, on review of the histopathology slides, necrosis was a predominant feature of the bilateral flank lumps that were excised. This is the first known publication of fat necrosis following cryolipolysis and while fat necrosis is incongruent with known complications, we propose that in persistent lumps following cryolipolysis, fat necrosis should be part of the differential. Level of evidence: Level V, risk/prognostic study. [ABSTRACT FROM AUTHOR]

Background: Accurate diagnosis of anemia by community workers using a point-of-care device is a challenge. The objective of the study was to establish the diagnostic accuracy of point-of-care devices for detecting anemia in community settings.Methods: It was diagnostic accuracy study with cross-sectional design on adult patients attending the outpatient department of rural/ urban health centres of Medical colleges from India. The index tests were HemoCue, TrueHb, Massimo's device and spectroscopic device, compared against autoanalyzer (gold standard). Accuracy was expressed by sensitivity, specificity, likelihood ratios, predictive values, area under the curve (AUC) and levels of agreement. For the diagnostic accuracy component, 1407 participants were recruited with a minimum of 600 for each device. An additional 200 participants were considered to elucidate the performance of devices in different weather conditions.Results: HemoCue and TrueHb performed better than Massimo and spectroscopic devices. Detection of anemia by technicians was similar between TrueHb and HemoCue (AUC 0.92 v/s 0.90, p > 0.05). Community workers performed better with Hemocue for detecting anemia compared to TrueHb (AUC 0.92 v/s 0.90, p < 0.05). For detection of severe anemia, accuracy of TrueHb was significantly better with technicians (AUC 0.91 v/s 0.70; p < 0.05) and community workers (AUC 0.91 v/s 0.73; p < 0.05). HemoCue showed a bias or mean difference (95%CI) of 0.47 g/dl (0.42, 0.52) for all values, and 0.92 g/dl (0.82, 1.03) for severe anemia. For TrueHb, it was - 0.28 g/dl (- 0.37, - 0.20) for all readings, and 0.06 g/dl (- 0.52, 0.63) for severe anemia. TrueHb appeared to be more consistent across different weather conditions, although it overestimated Hb in extreme cold weather conditions.Conclusion: For detection of anemia, True Hb and HemoCue were comparable. For severe anemia, True Hb seemed to be a better and feasible point-of-care device for detecting anemia in the community settings. [ABSTRACT FROM AUTHOR]

Colorectal surgery has witnessed a transformative shift with the advent of minimally invasive techniques, offering patients reduced postoperative discomfort, shorter hospital stays, and accelerated recovery compared to conventional open surgery. This comprehensive review aims to assess the current state of minimally invasive approaches in colorectal surgery, encompassing various techniques such as single-incision laparoscopic surgery, robot-assisted surgery, and conventional laparoscopic surgery. The article meticulously explores the benefits and drawbacks of each technique, delves into the established criteria for their application, delineates cautious circumstances, and analyzes the outcomes of minimally invasive colorectal surgery. Additionally, the integration of virtual reality and augmented reality for surgical planning and training is discussed, shedding light on the future trajectory of this field. Surgeons and researchers striving to enhance patient care and surgical outcomes in colorectal surgery will find this review article an invaluable resource, presenting crucial components of minimally invasive colorectal surgery and paving the way for continued advancements in the field., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Pathak et al.)

Nowadays, large number of anaemia cases can be seen especially in women and children. It is caused due to low haemoglobin level in blood. Mostly conventional methods are used to calculate haemoglobin level. These methods involve pricking of human body with needle and sending blood sample to laboratory for further analysis which results in delay and chances of infection increases. This research work is aimed at designing a instantaneous non invasive small, portable and low cost device to determine hemoglobin value in blood which makes it completely mobile. The prototype is based on transmittance type PPG sensor having LEDs and photo detector. The developed prototype capability for hemoglobin detection is validated on 8 subjects by comparing its results with laboratory type digital calorimeter. As a result, the response of prototype has been proved with mean absolute error of 0.7 having a small bias of 0.1 g/deci litre (g/dl) with all data points lie within 95% limits. This shows good agreement and perfect correlation between developed prototype and standard instrument. [ABSTRACT FROM AUTHOR]