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The etoxazole metabolite R13, systematic name 4-(4-tert-butyl-2-ethoxyphenyl)-2-(2,6-difluorophenyl)oxazole (C21H21F2NO2), results from the oxidation of etoxazole, a chitin synthesis inhibitor belonging to the oxazoline class, widely used as an insecticide/acaricide since 1998. The structure of R13 features a central oxazole ring with attached 2,6-difluorophenyl and 4-t-butyl-2-ethoxyphenyl moieties. The overall conformation gives dihedral angles between these rings and the oxazole of 24.91 (5)° (with difluorophenyl) and 15.30 (6)° (with t-butyl-ethoxyphenyl), indicating an overall deviation from planarity. Additionally, torsion angles of the ethoxy and t-butyl groups define the orientation of these substituents relative to their benzene ring. In the crystal packing, no significant hydrogen bonds are present, but a Hirshfeld surface analysis highlights weak intermolecular contacts leading to π–π-stacked dimers linked by weak C—H...N contacts. The packing analysis confirms that most intermolecular interactions involve hydrogen atoms.

This study presents the synthesis, crystal structure, and a Hirshfeld-surface analysis of the bioactive compound 5-methyl-1H-pyrazol-3-yl 4-nitrobenzenesulfonate(C10H9N3O5S), a pyrazole derivative with pharmacological potential. Pyrazoles are known for diverse bioactivities, and recent research emphasizes their role as a ‘privileged structure’ in drug design. Here, the asymmetric unit of the title compound contains two distinct molecules, A and B, exhibiting differences in conformation resulting from variation in key torsion angles. These distinctions influence the molecular orientation and intermolecular interactions, with strong N—H...N and N—H...O hydrogen bonds forming a centrosymmetric tetramer stabilized by π–π stacking. Hirshfeld surface analysis readily confirms differing intermolecular contacts for A and B, primarily involving hydrogen atoms and differences in their close contacts to nitrogen and oxygen. This study offers further insight into the molecular architecture and potential interactions of pyrazole-based drug candidates.

Abstract Retinal degeneration is a progressive condition that affects the retina, the light-sensitive layer, and deteriorates the inner retinal cells that encompass retinal pigment epithelium, photoreceptors, and ganglion cells that are essential for eyesight. Multiple factors including aging, genetic factors, oxidative stress, inflammation, and environmental factors can contribute to retinal degeneration. Retinal degeneration is seen predominantly in Age-related Macular degeneration, Diabetic retinopathy, Glaucoma, and Retinitis pigmentosa that contribute to the leading cause of vision loss. The search for potential and effective therapeutic interventions in the management of retinal degeneration has led to increased interest in dietary supplements, particularly those rich in antioxidant properties. Dietary supplements have been proposed as an ideal source for preventing retinal degeneration, especially supplements containing significant levels of antioxidants that help to reduce the damage to retinal cells. Notably, dietary interventions with carotenoids, flavonoids, alkaloids, amino acids, fatty acids, vitamins, and minerals have shown positive effects in both preclinical and clinical studies by preserving the retinal structure, revitalizing retinal health, delaying disease progression, and improving visual function. To explore this topic further, a systematic search strategy was employed in recent studies that are focused on cell lines, animal models, and human subjects. Ultimately, this review highlights the potential of dietary supplements that should be used as adjunctive therapies alongside comprehensive medical management, aiming to maximize their potential benefits in treating and preventing retinal degeneration.

Sweet’s syndrome is a reactive dermatosis which usually presents as edematous papules and plaques, and very rarely vesicles. It is seen to be associated with various conditions such as autoimmune diseases, malignancy, infections, and drugs. Malignancy associated with Sweet’s syndrome is known to occur anytime during the course of the disease and also after treatment. Very rarely, it is seen during radiation therapy. Here, we are presenting a case of Sweet’s syndrome in a postsurgery and chemotherapy patient with breast carcinoma during radiation therapy.

Iron Deficiency Anaemia (IDA) is the most prevalent form of anaemia, affecting 24.8% of the global population. An examination of the complete blood count (CBC) is performed to determine general health and the presence of illnesses. Accurate and timely diagnosis of IDA is essential for proper treatment, yet traditional methods can be time-consuming and costly. This study uses machine learning and computer vision techniques for the automatic identification of hypochromic microcytes from Peripheral Blood Smear (PBS) images to improve IDA diagnosis. Two approaches were implemented: first, a ResNet50 model was used to classify PBS images as Normal or IDA; second, the YOLOv7 object detection model was employed to localize hypochromic microcytes within the images. The YOLOv7 model was tested on 17 images containing 425 instances of hypochromic microcytes and demonstrated superior performance, achieving a test mean Average Precision (mAP) of 89% with faster inference times than ResNet50. By providing localized detection of hypochromic microcytes, YOLOv7 enhances diagnostic accuracy and speed compared to image-level classification. This study highlights the potential of object detection models for improving automated anaemia diagnosis, with implications for faster and more cost-effective healthcare solutions.

Abstract Background The difficulty in understanding speech becomes worse in the presence of background noise for individuals with sensorineural hearing loss. Speech-in-noise tests help to assess this difficulty. Previously, the Tulu sentence lists have been assessed for their equivalency to measure speech recognition threshold in noise among individuals with normal hearing. The present study aimed to determine the equivalence and test–retest reliability of Tulu sentence lists for measuring speech recognition threshold in noise among individuals with sensorineural hearing loss. Results The SNR-50 was measured for 13 sentence lists in 20 Tulu-speaking individuals with mild to moderate sensorineural hearing loss. Retesting was done by administering all lists to eight participants after an average of 25.25 days (SD = 19.44). Friedman test was administered to check for the list equivalency. Intraclass correlation coefficient was measured to assess test–retest reliability. A regression analysis was performed to understand the influence of pure-tone average on SNR-50. A Kruskal–Wallis test was administered to check the statistical significance of the SNR-50 obtained across different configurations and degrees of hearing loss. Nine of the 13 Tulu sentence lists (lists 2, 4, 5, 6, 9, 10, 11, 12, and 13) were equivalent in individuals with sensorineural hearing loss. The mean SNR-50 for these nine lists was 1.13 dB (SD = 2.04 dB). The test–retest reliability was moderate (ICC = 0.727). The regression analysis showed that a pure-tone average accounted for 24.7% of the variance in SNR-50 data (p = 0.026). Individuals with mild to moderate hearing loss obtained the worst SNR-50, followed by mild and high-frequency hearing loss. Conclusion Nine Tulu sentence lists are equivalent and reliable and can be used to measure speech recognition threshold in noise among individuals with sensorineural hearing loss who are Tulu speakers.

Background: Securing and maintaining a patent airway for the conduct of general anesthesia are a major concern for an anesthesiologist. Unanticipated difficult intubation in anesthetized patients is the main cause of morbidity or mortality. Several predictors are proposed to anticipate difficult tracheal intubation, but no predictor is found to be 100% accurate. Acromio-axillo-suprasternal notch index (AASI) is a recent addition to the list of predictors. Aims and Objectives: The current study compared the usefulness of AASI and thyromental height test (TMHT) as predictors of difficult visualization of larynx (DVL). Materials and Methods: Following approval by the Institutional Ethics Committee and CTRI registration, written informed consent was taken. The study was conducted on 300 patients aged 18–65 years belonging to American Society of Anesthesiologists’ physical status I and II, with modified Mallampati (MMP) Scores of 1 and 2, over a period of 6 months. Preoperatively all patient’s airway was evaluated using AASI and TMHT. The DVL during direct laryngoscopy was noted as assessed by Cormack and Lehane grading. We compared the sensitivity and specificity for DVL with regard to AASI and TMHT. Results: The incidence of unanticipated DVL was 14%. The sensitivity, specificity, positive predictive value, and negative predictive value of AASI were 86.4%, 38.1%, 89.6%, and 31.4%, respectively, and for TMHT, they were 94.6%, 4.8%, 85.9%, and 12.5%, respectively. Pearson correlation coefficient was r = −0.068 (P=0.243) when AASI was compared with TMHT. Conclusion: AASI was found to be less sensitive when compared to TMHT and there was statistically no significant correlation between the two parameters to predict the DVL.

Introduction: Citrobacter species play a significant role in causing hospital-acquired infections, especially those affecting the urinary and respiratory systems, and they are commonly present in faeces. Healthcare systems are facing a major challenge due to the rise of antibiotic-resistant Gram-negative infections resistant to antibiotics. Aim: To identify the genotypic characterisation of the resistant gene blaTEM-1 in Citrobacter spp. obtained from a range of clinical samples. This investigation seeks to provide insights into the patterns of antibiotic resistance exhibited by these bacteria. Materials and Methods: This cross-sectional study was conducted between August 2021 and February 2022. Preliminary examinations included screening as well as confirmatory tests for Extended Spectrum Beta Lactamase (ESBL) production, which were confirmed by the combination disk method and double disc synergy test. Genotypic detection of the blaTEM-1 gene was done using the Polymerase Chain Reaction (PCR) technique. Demographic parameters like gender and age were assessed. Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) Software version 21.0. Results: Citrobacter koseri (66 isolates, 54.5%) was found to be the predominant species among the Citrobacter spp., followed by Citrobacter freundii (55 isolates, 45.5%). Urine samples were the primary source of Citrobacter spp. isolates, comprising 52 isolates (43%) of the total. In this study, the prevalence of ESBL producers was reported to be 49 isolates (77.8%) identified as ESBL producers. Tigecycline demonstrated a 100% effectiveness rate, followed by Piperacillin-Tazobactam (96% sensitivity) and Amikacin (95% sensitivity). Out of the 20 Citrobacter spp. isolates that tested positive for ESBL, 15 isolates (75%) were found to be positive for blaTEM-1. Conclusion: The results of this study provide insight into the changing patterns of antibiotic resistance in Citrobacter spp., with particular emphasis on ESBL profiles. Thus, it is imperative to implement intervention techniques to reduce the ongoing selection and spread of these more resistant bacteria, as well as efficient infection-control measures to manage epidemics. These results advance the comprehension of antibiotic resistance patterns and guide initiatives to combat the increasing threat of antibiotic resistance.

Background: Type 2 Diabetes Mellitus (T2DM) is one of the most prevalent Non Communicable Diseases (NCD) in Nepal. Nutrition plays a significant role in creating barriers to the development of NCDs like diabetes. The main objective of this study is to identify the factors that influence the dietary behaviors and practices among T2DM patients. Methods: The study used quantitative method and a cross-sectional research design. The study was carried out in two centers: one in diabetes and another in thyroid care centers at the Lalitpur district, Nepal. A survey questionnaire based on Pender Health Promotion Model (PHPM) was developed, piloted, and administrated directly to 450 T2DM patients aged 40–65. Validity and reliability of the tools was ensured through reviewing panel of experts and using the coefficient and Cronbach's alpha test, respectively. Three sorts of statistical analysis; univariate, bivariate, and multivariate analysis were done using SPSS version 25. Results: Respondents belonged to a joint family, no alcohol consumption, positive attitude towards a healthy diet (P

Women from low- and middle-income countries face challenges in accessing and utilising quality healthcare. Technologies can aid in overcoming these challenges and the present scoping review is aimed at summarising the range of technologies used by women and assessing their role in enabling Indian women to learn about and access healthcare services. We conducted a comprehensive search from the date of inception of database till 2022 in PubMed and Google Scholar. Data was extracted from 43 studies and were thematically analysed. The range of technologies used by Indian women included integrated voice response system, short message services, audio–visual aids, telephone calls and mobile applications operated by health workers. Majority of the studies were community-based (79.1%), from five states (60.5%), done in rural settings (58.1%) and with interventional design (48.8%). Maternal and child health has been the major focus of studies, with lesser representation in domains of non-communicable and communicable diseases. The review also summarised barriers related to using technology – from health system and participant perspective. Technology-based interventions are enabling women to improve awareness about and accessibility to healthcare in India. Imparting digital literacy and scaling up technology use are potential solutions to scale-up healthcare access among women in India.

Objective Neonatal jaundice is the most common cause of neonatal morbidity and rehospitalisation in the first week of life, affecting approximately 60% of term and 80% of preterm neonates, with 10% requiring phototherapy to prevent bilirubin-induced neurological dysfunction. Enterohepatic circulation contributes 10%–20% of the body’s bilirubin load, and oral calcium-phosphate can inhibit this process by binding to unconjugated bilirubin and acting as a bilirubin-trapping agent in the gut. This study aimed to evaluate the efficacy of oral calcium phosphate as an adjunct to phototherapy in reducing phototherapy duration, improving bilirubin decline rate and lowering rebound hyperbilirubinaemia incidence.Methods This double-blind, placebo-controlled randomised controlled trial with a 1:1 allocation ratio was conducted in the neonatal intensive care unit of a tertiary care hospital in Eastern India. The investigator and the analyst were blinded to the treatment assignments. Eligible neonates with neonatal jaundice requiring phototherapy as per the ‘American Academy of Pediatrics or ‘National Institute for Health and Care Excellence’ guidelines were enrolled and randomly assigned to receive either oral calcium phosphate or placebo.Results The total duration of phototherapy was significantly lower in the intervention group compared with placebo (18.8±5.63 hours vs 24.3±4.50 hours; mean difference=−5.55 (95% CI −7.82 to −3.28), p

The use of Areca sheath in developing a newer composite material is proposed in this article. The Areca sheath particulates are extracted by pulverizing long sheaths into different sizes of particulates and are reinforced into the epoxy to process the composites. The study evaluated these composites' macroscopic and vibrational properties, revealing that those with coarse particulates demonstrated superior tensile and flexural strengths, impact strength, hardness, and natural frequency. Notably, the coarse epoxy composite with a 10% weight fraction of particulates exhibited tensile strength and modulus values of 24 MPa and 1050 MPa, respectively. These findings suggest that incorporating a 10% weight fraction of coarse Areca sheath particulates into epoxy resin significantly enhances the composite's macroscopic and vibrational properties, making it a promising material for various building applications like Partition panels, Ceiling Panels, and similar applications.

Background: Nonsurgical periodontal therapy results in the formation of a smear layer which inhibits tissue regeneration. Root biomodification (RB) using various agents has been tried for the enhancement of new attachment formation. However, no substantial therapeutic advantages of currently available root conditioning agents have been reported emphasizing the need for additional biologically acceptable agents. Glycolic acid (GA) due to its antimicrobial nature and ability of initiation and proliferation of fibroblasts may potentially modify root surface enabling regeneration. Materials and Methods: Eighty specimens from 40 single-rooted teeth were treated with 17% ethylenediaminetetraacetic acid (EDTA) and 5% GA and scanning electron microscopy analysis was done. The micrographs were examined for the evaluation of smear layer removal, total number of dentinal tubules, total number of patent dentinal tubules, mean diameter and surface area of dentinal tubules, and dentin erosion. Statistical analysis was done using unpaired t-test for intergroup comparison. Results: The efficacy of smear layer removal (P = 0.01) and dentin erosion (P = 0.042) was significantly better in the GA group. Both the groups showed no difference in dentinal tubule-related parameters. Conclusion: GA showed improved RB with greater smear layer removal and lesser dentin erosion, indicating its use as a potent alternative to the conventional EDTA root conditioning.

Objectives: To determine the proportion of Phase I MBBS students regretting their choice of joining medical profession; and to assess the reasons for regretting their choice of joining medical profession. Methods: This was a questionnaire based, mixed-methods, cross-sectional study conducted among Phase I medical students pursuing Bachelor of Medicine, Bachelor of Surgery (MBBS) in MCI/NMC recognised institutions across India. Results: In this study involving 1060 Phase I MBBS students, 32.0% regretted their decision to pursue medicine. Factors contributing to regret included societal pressure, demanding nature of education and profession, lack of support systems, negative patient attitudes, and COVID-19 stress. Notably, 53.7% of those regretting cited the pandemic's influence, while 51.3% desired super specialization. Those regretting were more likely to doubt their career choice before joining (58.1%), compared to 21.6% who didn't regret. Additionally, 56.3% of regretful students preferred clinical specialization, and 34.0% had taken education loans. Demographics showed significance in parental medical background (11.2% regretful vs. 7.2% non-regretful with doctor fathers). Qualitative analysis emphasized the need for parental guidance reconsideration and systemic improvements to alleviate stress and enhance support structures within medical education. Conclusion: The findings underscore the complex interplay of personal, environmental, and systemic factors shaping students' perceptions of their chosen profession. To mitigate the negative consequences of regret and promote career satisfaction among medical students, targeted interventions and support services are needed.

Background: Evidence on variation in the information provided to mothers during antenatal and postnatal periods, its influence on breastfeeding awareness, and practice in urban and rural settings of India is scarce. The aim of the study was to assess the variation in mothers experience during pregnancy, delivery, and maternity period across settings and its influence on breastfeeding practices in the first six months of infants’ life. Methods: A community-based analytical cross-sectional study was carried out in urban and rural settings of Coimbatore, Tamil Nadu, among 800 mothers who had delivered between one year and six months before the date of the survey using simple random sampling. Results: The proportion of mothers with less than four antenatal visits were significantly higher in urban areas (urban vs rural, 11.4% vs 6.2%). The mean scores for positive experiences during pregnancy (MD −0.99, 95% CI −1.31 to −0.69), experiences during birth and maternity period (MD −0.59, 95% CI −0.83 to −0.35) were significantly lower in the urban areas compared to rural areas. The prevalence of exclusive breastfeeding was 75.8% and 85.0% in urban and rural areas, respectively. Mothers not satisfied with experiences during delivery and maternity period (OR 1.69, 95% CI 1.18 to 2.42) and from urban areas (OR 1.81, 95% CI 1.27 to 2.59) were at significantly increased risk of nonexclusive breastfeeding. Conclusion: The present study showed that mothers from urban areas were not provided with appropriate, adequate, and timely information by the healthcare providers. It is the need of the hour to train and motivate healthcare providers regarding maternal awareness of antenatal, intranatal, and postnatal care practices including breastfeeding and infant care.

Background: Digitalization in the form of increased Internet use through screen media has also shown its ramification like cyberbullying. They are aggressive acts with the intention or motivation to harm another person through technology. The aim is to study the prevalence of cyberbullying and its association with mental illness in the adolescent age group (15–19 years). Methods: This community-based cross-sectional study was rolled out among adolescents aged 15–19 years. A total of 387 were given a semistructured interviewer-administered questionnaire consisting of general details, cyberbullying victimization, and offending questions, PHQ-9 and GAD-7. Results: The mean (SD) age was 16.8 (1.3) years. More than half (53.2%) were males, and nearly three-fourths (74.4%) were school-going. Around 28.2% reported being cyberbullied at least once in their lifetime. About 7.0% of adolescents were cyberbullied more than once, and 0.8% more than five times in the past 30 days. The most common ways were posting a mean or hurtful picture (31.9%) and the concerned person’s comments (24.2%) online. Multivariable logistic regression analysis found that adolescents attending colleges (AOR 1.9, 95% CI 1.1 to 3.4), using tobacco (AOR 2.5, 95% CI 1.4 to 4.5), and depressed (of any severity, AOR 2.0, 95% CI 1.1 to 4.3) were at significantly increased risk of being cyberbullied (P < 0.05). Conclusion: The prevalence of cyberbullying among adolescents aged 15–19 is notable, with significant associations found between cyberbullying and attending college, tobacco use, and depression. Understanding the correlates of cyberbullying can inform targeted interventions to support mental health and well-being among adolescents.

Abstract Rice metabolomics is widely used for biomarker research in the fields of pharmacology. As a consequence, characterization of the variations of the pigmented and non-pigmented traditional rice varieties of Tamil Nadu is crucial. These varieties possess fatty acids, sugars, terpenoids, plant sterols, phenols, carotenoids and other compounds that plays a major role in achieving sustainable development goal 2 (SDG 2). Gas-chromatography coupled with mass spectrometry was used to profile complete untargeted metabolomics of Kullkar (red colour) and Milagu Samba (white colour) for the first time and a total of 168 metabolites were identified. The metabolite profiles were subjected to data mining processes, including principal component analysis (PCA), Orthogonal Partial Least Square Discrimination Analysis (OPLS-DA) and Heat map analysis. OPLS-DA identified 144 differential metabolites between the 2 rice groups, variable importance in projection (VIP) ≥ 1 and fold change (FC) ≥ 2 or FC ≤ 0.5. Volcano plot (64 down regulated, 80 up regulated) was used to illustrate the differential metabolites. OPLS-DA predictive model showed good fit (R2X = 0.687) and predictability (Q2 = 0.977). The pathway enrichment analysis revealed the presence of three distinct pathways that were enriched. These findings serve as a foundation for further investigation into the function and nutritional significance of both pigmented and non-pigmented rice grains thereby can achieve the SDG 2.

AimTo assess the level of total antioxidant capacity (TAC) in the unstimulated saliva of autism children and normal children. MethodsA total of 60 children participated in the study (autism children—30; normal children—30) in the age-group of 7–14 years, at a Special Needs Children’s Home in Salem district. Both groups were further subdivided into subgroups of 15 children each (caries-free and caries-active). All children were given instructions regarding saliva sample collection, and unstimulated saliva samples were collected in sterile cryovials and transported to the laboratory at 4°C, where the TAC of saliva was evaluated using the spectrophotometric assay. ResultsTAC of autism children was comparable to that of normal children due to personal care and improved diet. TAC was increased in caries-active children when compared to caries-free children in both groups. When comparing the mean values of TAC in caries-active and caries-free children of both groups, it was not statistically significant. So, from the above results, it can be assumed that the diet, age, and caries activity have a definitive influence on the TAC level of saliva. ConclusionPersonal hygiene, diet, age, and caries activity have a definitive influence on the level of TAC in saliva.

Introduction: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Due to the limited understanding of this disease, research has quickly extended towards identifying biomarkers to predict its prognosis and progression. Aim: To explore the impact of albumin infusion on critically ill COVID-19 patients. Materials and Methods: In this retrospective cohort study, a total of 150 severe COVID-19 patients aged 18 to 65 years were enrolled. These patients were categorised into the no albumin infusion group (n=61), consisting of those who did not undergo albumin transfusion during their treatment, and the albumin infusion group (n=89), comprising patients who received albumin transfusion as part of their treatment protocol. Assessments of hospitalisation included the Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation (APACHE-II) scores obtained at baseline and day 5. Unpaired t-tests, Chi-square tests, and paired t-tests were used for analysis. Results: The mean values of Haemoglobin (Hb), eosinophils, Random Blood Sugar (RBS), Mean Corpuscular Volume (MCV), total protein, serum urea, serum bilirubin, Prothrombin Time (PT), International Normalised Ratio (INR), Interleukin 6 (IL-6), Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), and D-dimer exhibited significant differences between the two groups. The average duration of vasopressor usage and Intensive Care Unit (ICU) stay were significantly reduced in the albumin infusion group (3.50±1.55 days and 8.70±4.20 days, respectively) compared to no albumin infusion group (4.33±1.05 days and 12.80±3.43 days, respectively). The albumin infusion group also displayed a lower incidence of Renal Replacement Therapy (RRT) and poorer ICU outcomes. Conclusion: The intravenous administration of albumin did not exhibit a significant impact on mortality. However, albumin transfusion in patients with severe COVID-19 who initially had albumin levels