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Cauliflower (Brassica oleracea var. botrytis) is a crucial cash crop predominantly consumed as a vegetable. High-yielding varieties are favored to maximize productivity and income, but they require substantial nutrients, leading to heavy reliance on chemical fertilizers and pesticides. This practice poses health risks and causes environmental pollution. Adequate nutrient availability, particularly for phosphorus (P) and nitrogen (N), is essential for optimal cauliflower growth. Phosphate-solubilizing bacteria (PSB) enhance P availability by solubilizing insoluble phosphates, whereas nitrogen-fixing microbes (NFM) convert atmospheric nitrogen into usable forms. These microbial inoculants are eco-friendly alternatives to chemical fertilizers, which promote nutrient availability and plant growth. The purpose of this study was to separate, identify, and describe PSB from the soil of the cauliflower rhizosphere in the Uttar Pradesh district of Lucknow, Unnao, and Kanpur. Selected PSB isolates were screened, characterized using 16S rRNA, and evaluated for their phosphate solubilization capacity at different phosphorus concentrations. The results showed increased phosphate solubilization up to 72 h, with tricalcium phosphate (TCP) solubilized most effectively at 500 ppm and rock phosphate (RP) or bone meal (BM) at 250 ppm. Bacillus pumilus exhibited the highest phosphate solubilization ability. This research highlights the potential of PSB and NFM as sustainable solutions for reducing chemical fertilizer dependency, enhancing soil fertility, and promoting cauliflower growth, thereby offering a promising approach to sustainable agriculture.

Background: Diabetes mellitus significantly impacts long-term cardiovascular disease, increasing elderly mortality and morbidity. Half of elderly diabetics are asymptomatic, with vague symptoms. Insulin resistance (IR) and pancreatic beta-cell dysfunction are central to diabetes pathophysiology. Gender differences in IR and beta-cell function are increasingly recognized in diabetes research. Methods: In 18-month observational cross-sectional study focusing on elderly patients (60+) done at tertiary hospital in North India included 32 diabetic and 32 healthy controls. Fasting blood sample of eligible subjects were sent for hemogram, hemoglobin A1c (HBA1c), blood glucose, and insulin. IR and beta-cell function were calculated using the homeostasis model assessment (HOMA) model and analyzed using SPSS, with P < 0.05. Results: The mean age of participants was 67.77 years and the average duration of having diabetes was 5.11 years. Median HOMA IR was significantly higher in cases compared to controls (4.23 vs 0.89, P < 0.05), while HOMA β was comparable. HOMA IR decreased with longer diabetes duration, with a more rapid decline in female subjects compared to males. Subgroup analysis showed IR increased with age and was higher in females. Conclusion: Our research highlights gender-based differences in IR in the geriatric age group. Elderly women had higher IR compared to men. These findings are significant in understanding gender-specific metabolic differences and tailoring interventions. Further research with a larger sample size is warranted to corroborate these findings. Clinical Implication: This study addresses the gap in research on IR and beta-cell function in the elderly, particularly in India. This research can be compared with past studies on other age groups, aiding in the development of tailored diabetes treatments and improving therapeutic strategies for the elderly.

Abstract In computer vision, image dehazing is a low-level task that employs algorithms to analyze and remove haze from images, resulting in haze-free visuals. The aim of Salient Object Detection (SOD) is to locate the most visually prominent areas in images. However, most SOD techniques applied to visible images struggle in complex scenarios characterized by similarities between the foreground and background, cluttered backgrounds, adverse weather conditions, and low lighting. Identifying objects in hazy images is challenging due to the degradation of visibility caused by atmospheric conditions, leading to diminished visibility and reduced contrast. This paper introduces an innovative approach called Dehaze-SOD, a unique integrated model that addresses two vital tasks: dehazing and salient object detection. The key novelty of Dehaze-SOD lies in its dual functionality, seamlessly integrating dehazing and salient object identification into a unified framework. This is achieved using a conditional Generative Adversarial Network (cGAN) comprising two distinct subnetworks: one for image dehazing and another for salient object detection. The first module, designed with residual blocks, Dark Channel Prior (DCP), total variation, and the multiscale Retinex algorithm, processes the input hazy images. The second module employs an enhanced EfficientNet architecture with added attention mechanisms and pixel-wise refinement to further improve the dehazing process. The outputs from these subnetworks are combined to produce dehazed images, which are then fed into our proposed encoder–decoder framework for salient object detection. The cGAN is trained with two modules working together: the generator aims to produce haze-free images, whereas the discriminator distinguishes between the generated haze-free images and real haze-free images. Dehaze-SOD demonstrates superior performance compared to state-of-the-art dehazing methods in terms of color fidelity, visibility enhancement, and haze removal. The proposed method effectively produces high-quality, haze-free images from various hazy inputs and accurately detects salient objects within them. This makes Dehaze-SOD a promising tool for improving salient object detection in challenging hazy conditions. The effectiveness of our approach has been validated using benchmark evaluation metrics such as mean absolute error (MAE), peak signal-to-noise ratio (PSNR), and structural similarity index measure (SSIM).

Abstract Accurate reservoir characterization is necessary to effectively monitor, manage, and increase production. A seismic inversion methodology using a genetic algorithm (GA) and particle swarm optimization (PSO) technique is proposed in this study to characterize the reservoir both qualitatively and quantitatively. It is usually difficult and expensive to map deeper reservoirs in exploratory operations when using conventional approaches for reservoir characterization hence inversion based on advanced technique (GA and PSO) is proposed in this study. The main goal is to use GA and PSO to significantly lower the fitness (error) function between real seismic data and modeled synthetic data, which will allow us to estimate subsurface properties and accurately characterize the reservoir. Both techniques estimate subsurface properties in a comparable manner. Consequently, a qualitative and quantitative comparison is conducted between these two algorithms. Using two synthetic data and one real data from the Blackfoot field in Canada, the study examined subsurface acoustic impedance and porosity in the inter-well zone. Porosity and acoustic impedance are layer features, but seismic data is an interface property, hence these characteristics provide more useful and applicable reservoir information. The inverted results aid in the understanding of seismic data by providing incredibly high-resolution images of the subsurface. Both the GA and the PSO algorithms deliver outstanding results for both simulated and real data. The inverted section accurately delineated a high porosity zone ( $$>20\%$$ > 20 % ) that supported the high seismic amplitude anomaly by having a low acoustic impedance (6000–8500 m/s $$*$$ ∗ g/cc). This unusual zone is categorized as a reservoir (sand channel) and is located in the 1040–1065 ms time range. In this inversion process, after 400 iterations, the fitness error falls from 1 to 0.88 using GA optimization, compared to 1 to 0.25 using PSO. The convergence time for GA is 670,680 s, but the convergence time for PSO optimization is 356,400 s, showing that the former requires $$88\%$$ 88 % more time than the latter.

Abstract Background Neisseria gonorrhoeae (Ng) causes the sexually transmitted disease gonorrhoea. There are no vaccines and infections are treated principally with antibiotics. However, gonococci rapidly develop resistance to every antibiotic class used and there is a need for developing new antimicrobial treatments. In this study we focused on two gonococcal enzymes as potential antimicrobial targets, namely the serine protease L,D-carboxypeptidase LdcA (NgO1274/NEIS1546) and the lytic transglycosylase LtgD (NgO0626/NEIS1212). To identify compounds that could interact with these enzymes as potential antimicrobials, we used the AtomNet virtual high-throughput screening technology. We then did a computational modelling study to examine the interactions of the most bioactive compounds with their target enzymes. The identified compounds were tested against gonococci to determine minimum inhibitory and bactericidal concentrations (MIC/MBC), specificity, and compound toxicity in vitro. Results AtomNet identified 74 compounds that could potentially interact with Ng-LdcA and 84 compounds that could potentially interact with Ng-LtgD. Through MIC and MBC assays, we selected the three best performing compounds for both enzymes. Compound 16 was the most active against Ng-LdcA, with a MIC50 value

Abstract Sewage metagenomics has risen to prominence in urban population surveillance of pathogens and antimicrobial resistance (AMR). Unknown species with similarity to known genomes cause database bias in reference-based metagenomics. To improve surveillance, we seek to recover sewage genomes and develop a quantification and correlation workflow for these genomes and AMR over time. We use longitudinal sewage sampling in seven treatment plants from five major European cities to explore the utility of catch-all sequencing of these population-level samples. Using metagenomic assembly methods, we recover 2332 metagenome-assembled genomes (MAGs) from prokaryotic species, 1334 of which were previously undescribed. These genomes account for ~69% of sequenced DNA and provide insight into sewage microbial dynamics. Rotterdam (Netherlands) and Copenhagen (Denmark) show strong seasonal microbial community shifts, while Bologna, Rome, (Italy) and Budapest (Hungary) have occasional blooms of Pseudomonas-dominated communities, accounting for up to ~95% of sample DNA. Seasonal shifts and blooms present challenges for effective sewage surveillance. We find that bacteria of known shared origin, like human gut microbiota, form communities, suggesting the potential for source-attributing novel species and their ARGs through network community analysis. This could significantly improve AMR tracking in urban environments.

Context: Metabolic syndrome (MetS) raises the chance of cerebrovascular accidents and cardiovascular illness in type 2 diabetes mellitus (T2DM) individuals. Early identification of MetS allows for suitable prophylactic and treatment strategies to reduce the risks. Aim: To estimate the prevalence of MetS and its risk factors in T2DM individuals. Settings and Design: This cross-sectional study investigated MetS and its component’s prevalence among newly diagnosed T2DM at the tertiary care hospital. Methods and Material: The study was conducted from January 2022 to December 2022 and included 300 participants above 18 years, with most being men (55%, 165), and using the World Health Organization (WHO) STEPS questionnaire for assessing selected risk factors. Along with blood glucose, different components of MetS were assessed, that is serum triglyceride (TG) level, serum high-density lipoprotein (HDL) level, blood pressure (BP) and waist circumference (WC), as per the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. Statistical Analysis Used: Data analysis includes mean and standard deviation (SD) for numerical variables with an unpaired t-test to compare means and percentage and proportions for categorical variables with the Chi-square test for the associations. Multivariate logistic regression was used for assessing the predictors of MetS Results: The prevalence of components of MetS, that is obesity, hypertension (HTN), TG and HDL components, was 64.0% (192), 45.7% (137), 46.0% (138) and 30% (90), respectively. Overall, MetS was 57% (170). Moderate activity of 150 min/week, sitting/reclining, WC, diastolic BP, TG and HDL had a significant association with MetS Conclusions: MetS was highly associated with newly diagnosed T2DM with obesity being the most common component.

Objectives: Mycoplasma pneumoniae (M. pneumoniae) continues to pose a significant disease burden on global public health as a respiratory pathogen. The antimicrobial resistance among M. pneumoniae strains has complicated the outbreak control efforts, emphasizing the need for robust surveillance systems and effective antimicrobial stewardship programs. Design: This review comprehensively investigates studies stemming from previous outbreaks to emphasize the multifaceted nature of M. pneumoniae infections, encompassing epidemiological dynamics, diagnostic innovations, antibiotic resistance, and therapeutic challenges. Results: We explored the spectrum of clinical manifestations associated with M. pneumoniae infections, emphasizing the continuum of disease severity and the challenges in gradating it accurately. Artificial intelligence and machine learning have emerged as promising tools in M. pneumoniae diagnostics, offering enhanced accuracy and efficiency in identifying infections. However, their integration into clinical practice presents hurdles that need to be addressed. Further, we elucidate the pivotal role of pharmacological interventions in controlling and treating M. pneumoniae infections as the efficacy of existing therapies is jeopardized by evolving resistance mechanisms. Conclusion: Lessons learned from previous outbreaks underscore the importance of adaptive treatment strategies and proactive management approaches. Addressing these complexities demands a holistic approach integrating advanced technologies, genomic surveillance, and adaptive clinical strategies to effectively combat this pathogen.

Background: Diabetes mellitus (DM) is a common metabolic disorder affecting insulin secretion, insulin sensitivity, or both, resulting in hyperglycemia. As it progresses, almost all systems including cardiovascular, nervous, renal, etc. are involved eventually manifesting as several health-related complications. As all the systems of the human body work in harmony with each other, development of insulin resistance, dyslipidemia, and setting in of chronic inflammatory states evidenced by the rise in inflammatory markers are interrelated. Aims and Objectives: The aim of this study was to establish the correlation of the inflammatory markers, serum ferritin and high sensitivity C-reactive protein (hs-CRP), with glycated hemoglobin (HbA1c) and dyslipidemia in patients of type 2 DM. Materials and Methods: The present cross-sectional study was carried out in the Department of Biochemistry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand. A total of 80 male patients of type 2 DM aged between 40 and 60 years with blood HbA1c level of more than 6.5% were included in the study. Results: The inflammatory markers hs-CRP and ferritin were found to be positively correlated with HbA1c, triglycerides, total cholesterol, and low-density lipoprotein-cholesterol but negatively correlated with high-density lipoprotein-cholesterol. Conclusion: Estimation of serum ferritin and hs-CRP can detect the ongoing inflammatory and free radical-mediated damages in diabetic patients at an early period before the development of diabetic-related complications such as atherosclerosis and myocardial infarction.

Background The field of radiology relies on accurate interpretation of medical images for effective diagnosis and patient care. Recent advancements in artificial intelligence (AI) and natural language processing have sparked interest in exploring the potential of AI models in assisting radiologists. However, limited research has been conducted to assess the performance of AI models in radiology case interpretation, particularly in comparison to human experts.

The severity of COVID-19 is linked to excessive inflammation. Neutrophils represent a critical arm of the innate immune response and are major mediators of inflammation, but their role in COVID-19 pathophysiology remains poorly understood. We conducted transcriptomic profiling of neutrophils obtained from patients with mild and severe COVID-19, as well as from SARS-CoV-2 infected mice, in comparison to non-infected healthy controls. In addition, we investigated the inflammasome formation potential in neutrophils from patients and mice upon SARS-CoV-2 infection. Transcriptomic analysis of polymorphonuclear cells (PMNs), consisting mainly of mature neutrophils, revealed a striking type I interferon (IFN-I) gene signature in severe COVID-19 patients, contrasting with mild COVID-19 and healthy controls. Notably, low-density granulocytes (LDGs) from severe COVID-19 patients exhibited an immature neutrophil phenotype and lacked this IFN-I signature. Moreover, PMNs from severe COVID-19 patients showed heightened nigericin-induced caspase1 activation, but reduced responsiveness to exogenous inflammasome priming. Furthermore, IFN-I emerged as a priming stimulus for neutrophil inflammasomes. These findings suggest a potential role for neutrophil inflammasomes in driving inflammation during severe COVID-19. Altogether, these findings open promising avenues for targeted therapeutic interventions to mitigate the pathological processes associated with the disease.

Pancreatic cancer continues to be a deadly disease because of its delayed diagnosis and aggressive tumor biology. Oncogenes and risk factors are being reported to influence the signaling pathways involved in pancreatic embryogenesis leading to pancreatic cancer genesis. Although studies using rodent models have yielded insightful information, the scarcity of human pancreatic tissue has made it difficult to comprehend how the human pancreas develops. Transcription factors like IPF1/PDX1, HLXB9, PBX1, MEIS, Islet-1, and signaling pathways, including Hedgehog, TGF-β, and Notch, are directing pancreatic organogenesis. Any derangements in the above pathways may lead to pancreatic cancer. TP53: and CDKN2A are tumor suppressor genes, and the mutations in TP53 and somatic loss of CDKN2A are the drivers of pancreatic cancer. This review clarifies the complex signaling mechanism involved in pancreatic cancer, the same signaling pathways in pancreas development, the current therapeutic approach targeting signaling molecules, and the mechanism of action of risk factors in promoting pancreatic cancer.

Recent research shows that Conditional Generative Adversarial Networks (cGANs) are effective for Salient Object Detection (SOD), a challenging computer vision task that mimics the way human vision focuses on important parts of an image. However, implementing cGANs for this task has presented several complexities, including instability during training with skip connections, weak generators, and difficulty in capturing context information for challenging images. These challenges are particularly evident when dealing with input images containing small salient objects against complex backgrounds, underscoring the need for careful design and tuning of cGANs to ensure accurate segmentation and detection of salient objects. To address these issues, we propose an innovative method for SOD using a cGAN framework. Our method utilizes encoder-decoder framework as the generator component for cGAN, enhancing the feature extraction process and facilitating accurate segmentation of the salient objects. We incorporate Wasserstein-1 distance within the cGAN training process to improve the accuracy of finding the salient objects and stabilize the training process. Additionally, our enhanced model efficiently captures intricate saliency cues by leveraging the spatial attention gate with global average pooling and regularization. The introduction of global average pooling layers in the encoder and decoder paths enhances the network's global perception and fine-grained detail capture, while the channel attention mechanism, facilitated by dense layers, dynamically modulates feature maps to amplify saliency cues. The generated saliency maps are evaluated by the discriminator for authenticity and gives feedback to enhance the generator's ability to generate high-resolution saliency maps. By iteratively training the discriminator and generator networks, the model achieves improved results in finding the salient object. We trained and validated our model using large-scale benchmark datasets commonly used for salient object detection, namely DUTS, ECSSD, and DUT-OMRON. Our approach was evaluated using standard performance metrics on these datasets. Precision, recall, MAE and Fβ score metrics are used to evaluate performance. Our method achieved the lowest MAE values: 0.0292 on the ECSSD dataset, 0.033 on the DUTS-TE dataset, and 0.0439 on the challenging and complex DUT-OMRON dataset, compared to other state-of-the-art methods. Our proposed method demonstrates significant improvements in salient object detection, highlighting its potential benefits for real-life applications.

Neisseria gonorrhoeae is the causative agent of the sexually transmitted disease gonorrhea. The increasing prevalence of this disease worldwide, the rise of antibiotic-resistant strains, and the difficulties in treatment necessitate the development of a vaccine, highlighting the significance of preventative measures to control and eradicate the infection. Currently, there is no widely available vaccine, partly due to the bacterium’s ability to evade natural immunity and the limited research investment in gonorrhea compared to other diseases. To identify distinct vaccine candidates, we chose to focus on the uncharacterized, hypothetical proteins (HPs) as our initial approach. Using the in silico method, we first carried out a comprehensive assessment of hypothetical proteins of Neisseria gonorrhoeae, encompassing assessments of physicochemical properties, cellular localization, secretary pathways, transmembrane regions, antigenicity, toxicity, and prediction of B-cell and T-cell epitopes, among other analyses. Detailed analysis of all HPs resulted in the functional annotation of twenty proteins with a great degree of confidence. Further, using the immuno-informatics approach, the prediction pipeline identified one CD8+ restricted T-cell epitope, seven linear B-cell epitopes, and seven conformational B-cell epitopes as putative epitope-based peptide vaccine candidates which certainly require further validation in laboratory settings. The study accentuates the promise of functional annotation and immuno-informatics in the systematic design of epitope-based peptide vaccines targeting Neisseria gonorrhoeae.

Introduction: Gastrointestinal neuropathies are frequently found in diabetic patients. The pathogenesis of diabetic gastroparesis (DG) is multifactorial. The usual treatment for DG includes dietary modifications, prokinetic and antiemetic agents. There is increasing demand for more effective medicines to treat DG. The current study was conducted on the Pistacia lentiscus stem extract to add to the armamentarium of DG treatment and to find the efficacy of P. lentiscus plant extract (mastic gum) in comparison to levosulpiride in DG for improvement in gastroparesis symptoms and gastric emptying scintigraphy (GES) in a single centric double-blind non-inferiority randomised control trial. Methods: Thirty-eight individuals were recruited and equally randomised into two study groups based on Gastroparesis Cardinal Symptom Index (GCSI) score and TC99 Radionuclide GES, mastic gum group and levosulpiride group. Both pre and post-intervention (8 weeks) GCSI scores were calculated, GES was performed to quantify the improvement in gastric emptying. Power analysis was performed using G*POWER software version 3.1.9.7 and data analysis using SPSS 23.0, variables measured in mean ± standard deviation (SD). Various statistical tests were used such as independent t-test, Chi-square test or Fisher's exact test, Wilcox Mann–Whitney test, analysis of variance (ANOVA) test, and posthoc pairwise tests. Results: The mastic gum is found effective in the improvement of 4 h gastric emptying percentage from the mean (SD) 76.60 (± 9.96) to mean (SD) 97.20 (2.17)% (P < 0.001). Mastic gum has the property of HbA1c reduction, which is more significant than that of levosulpiride (P = 0.044). Mastic gum also had significant Low density lipoprotein (LDL) (mg/dL) levels reduction, (P < 0.001), compared to levosupiride. An absolute increase was observed in haemoglobin (HB) level in mastic gum at a 2-month mean (SD) of 1.03 (0.77) (g/dL) (P-value

Background The most crucial step in the management of type 2 diabetes is identifying its pathogenesis and progression. Fat accumulation in the pancreas and decreased parenchymal volume can influence pancreatic function due to insulin resistance or β-cell dysfunction. This study aims to find out the difference in pancreatic volume and fat content by using contrast-enhanced computed tomography (CECT) between normal subjects and patients with different durations of type 2 diabetes mellitus (T2DM).

Background: Our study explores the role of bats as reservoirs of coronaviruses. Methods: We conducted virological screening of bats hibernating in military bunkers at the Natura 2000 site “Nietoperek” in Western Poland collecting oral and anal swab samples from 138 bats across six species to apply a combination of pan-coronavirus and SARS-CoV-2 specific PCR assays. Results: Only one anal swab tested positive for coronavirus. No SARS-CoV-2 was detected in any of the samples. The low prevalence of coronavirus in the studied colony contrasts with higher rates found in other regions and may be influenced by hibernation. Conclusions: Hibernating bats may show a low prevalence of coronavirus, potentially due to the hibernation process itself. This finding indicates that hibernating bats may not be the most optimal subjects for screening zoonotic pathogens. However, biomonitoring of bats for emerging and reemerging diseases is recommended for comprehensive epidemiological insights.

Nanoparticles of Zn2SiAl2O4 infused with Dy3+ were produced through a traditional co-precipitation approach. We investigated the particles' structural attributes and physical characteristics using tools such as X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), UV–Vis absorption spectroscopy, and photoluminescence (PL) spectrometry. The XRD outcomes validated the crystalline nature of the nanoparticles and showed the effective replacement of Dy3+ ions in the place of Zn2+ ions within the matrix and with increasing Dy concentration from 0.5 % to 1.25 %, the crystallite size decreased from 84 nm to 53 nm. The SEM visuals offered clarity on the shape, dimension, and spread of these particles. FTIR analysis further confirmed the composition and structure of the nanoparticles by identifying the chemical bonds and functional groups. UV–visible absorption spectroscopy revealed increase in the optical energy bandgap from 4.45 eV to 4.55 eV with increasing Dy3+ content, indicating potential for optical applications. The photoluminescence spectrometry results featured a prominent transition at approximately 646 nm, suggest that the phosphor has the capability to function as a vivid yellow light emitter and demonstrate their potential for application in optoelectronics, photonics, and luminescent materials.

Abstract Background Noncommunicable diseases (NCDs) contribute significantly to global morbidity and mortality, with cancer being one of the leading causes. In this prospective observational study, we aimed to investigate the prevalence and impact of endocrine disorders, specifically diabetes and thyroid dysfunction, in patients with advanced metastatic cancer undergoing cancer‐directed therapy. Methods Over 15 months, we recruited 100 histologically proven advanced metastatic cancer patients from the Department of Medical Oncology Haematology, All India Institute of Medical Sciences, Rishikesh, and conducted institutional‐based prospective observational study. All participants over 18 years of age, treatment‐naive, and potential candidates for systemic chemotherapy with an expected clinical survival of at least 6 months were included in the study. Patients with prior therapy, secondary neoplasms, and those unable to complete 3 months of palliative chemotherapy were excluded. Patients were assessed for diabetes and thyroid function at presentation, after 3 and 6 months of cancer‐directed standard therapy. These data were analyzed, processed, and presented as results. Results The mean age of participants was 50.45 years, with a near‐equal distribution of males and females. At baseline, 10% of the study population had preexisting endocrine disorders (2% hypothyroidism, 8% diabetes). By the end of 6 months, the prevalence increased to 18%, with females being more affected. Notably, the prevalence of new‐onset endocrine disorders during cancer‐directed therapy was only 3% for diabetes and 4% for thyroid dysfunction. Conclusion Analysis of sociodemographic and cancer‐related characteristics showed no significant association with changes in diabetic and thyroid status at 3 and 6 months. However, substance use, particularly smoking, was associated with an increased risk of diabetes development (p

ABSTRACTIn response to the ongoing COVID-19 pandemic, the quest for coronavirus inhibitors has inspired research on a variety of small proteins beyond conventional antibodies, including robust single-domain antibody fragments, i.e., “nanobodies.” Here, we explore the potential of nanobody engineering in the development of antivirals and diagnostic tools. Through fusion of nanobody domains that target distinct binding sites, we engineered multimodular nanobody constructs that neutralize wild-type SARS-CoV-2 and the Alpha and Delta variants at high potency, with IC50 values as low as 50 pM. Despite simultaneous binding to distinct epitopes, Beta and Omicron variants were more resistant to neutralization by the multimodular nanobodies, which highlights the importance of accounting for antigenic drift in the design of biologics. To further explore the applications of nanobody engineering in outbreak management, we present an assay based on fusions of nanobodies with fragments of NanoLuc luciferase that can detect sub-nanomolar quantities of the SARS-CoV-2 spike protein in a single step. Our work showcases the potential of nanobody engineering to combat emerging infectious diseases.IMPORTANCENanobodies, small protein binders derived from the camelid antibody, are highly potent inhibitors of respiratory viruses that offer several advantages over conventional antibodies as candidates for specific therapies, including high stability and low production costs. In this work, we leverage the unique properties of nanobodies and apply them as building blocks for new therapeutic and diagnostic tools. We report ultra-potent SARS-CoV-2 inhibition by engineered nanobodies comprising multiple modules in structure-guided combinations and develop nanobodies that carry signal molecules, allowing rapid detection of the SARS-CoV-2 spike protein. Our results highlight the potential of engineered nanobodies in the development of effective countermeasures, both therapeutic and diagnostic, to manage outbreaks of emerging viruses.

The present study was undertaken to explore the antimicrobial potential of cow urine distillate (gomutra ark) against pathogenic microorganisms of medical and veterinary significance. Cow urine distillates (CUDs) were prepared from fresh cow urine of three Indian breeds viz. Sahiwal, Tharparkar, and Vrindavani. CUDs obtained from two goshalas and one commercially available CUD were also tested for antimicrobial activity for comparison. Minimal inhibitory concentration (MIC) of CUD, antimicrobial activity of concentrated CUD, bacteriostatic and bactericidal potential as well as vapor phase activity were also determined. FT-IR and GC-MS analysis of the selected CUDs was performed to detect the surface functional groups and chemical composition. No antimicrobial activity was detected in the CUDs by disc diffusion and agar well diffusion methods. However, antimicrobial activity was observed in the microtitre Plate (MTP) assay as evidenced by inhibition of visible growth (turbidity) or measuring optical density (OD595). CUDs prepared from indigenous cows (Sahiwal and Tharparkar) exhibited superior antimicrobial activity compared to CUDs from crossbred cows (Vrindavani) or commercial CUDs. In general, CUDs were bactericidal for Gram-negative bacteria but bacteriostatic for Gram-positive bacteria. The MIC of CUDs was found to be in the range of 1:4 to 1:8 dilution. The concentrated CUDs exhibited a relatively lesser antimicrobial effect. CUDs exhibited antifungal activity against Candida albicans and Malassezia furfur. CUDs also exhibited antimicrobial activity in the vapor phase. FT-IR spectra of selected CUDs exhibited bending vibrations at 1633.5 cm-1 due to N-H groups resembling N-H bonding in the structure of urea and stretching vibrations at 3330. 10 cm-1 due to C-H group. GC-MS analysis of selected CUDs exhibited many compounds that may be responsible for the antimicrobial activity. The results of the study confirm the antimicrobial potential of CUD as reported in ancient literature.

Background: Diabetic cardiomyopathy, which involves both the right and left ventricles, progresses from a preclinical stage to overt heart failure. Detection of this entity at a preclinical stage could be crucial in intervening to halt its progression to overt heart failure. There is a paucity of literature on subclinical RV dysfunction in diabetic patients, and it is even rarer in the Indian literature. Our study intended to study this clinical entity through an echocardiographic assessment of asymptomatic patients. Objectives: This was a cross-sectional observational analytic study, comparing subclinical RV dysfunction in diabetic and non-diabetic subjects by using echocardiography as a primary objective, while the secondary objective of the study was to find out the correlation between RV dysfunction and the duration of diabetes mellitus and HbA1C levels. Methods: Conventional echocardiography with tissue Doppler imaging (TDI) was used to measure nine different echocardiographic parameters in the diabetic and non-diabetic groups. All probable causes of RV dysfunction were excluded before enrolling the patients in the study. Unpaired t-test was used to compare the parameters between the two groups, and multivariate regression analysis was done taking into consideration age, duration of diabetes, and HbA1C levels as the independent variables, and echocardiographic parameters as the dependent variables. Results: Out of the nine different echocardiographic parameters, Tricuspid annular plane systolic excursion (TAPSE), RV end diastolic diameter (RVEDD), Tricuspid peak late diastolic velocity (A), E/A ratio, RV basal segment peak myocardial systolic velocity (Sm), RV basal segment peak early diastolic velocity (Em), RV basal segment peak late diastolic velocity (Am), and E/Em ratio showed statistically significant differences between the two groups. These results show the presence of subclinical RV dysfunction in diabetic patients. TAPSE and E/A ratio showed a significant correlation with the duration of diabetes, while Em showed a significant correlation with HbA1C. Conclusion: Diabetes mellitus is associated with subclinical systolic as well as diastolic RV dysfunction. In addition to helping identify people at high risk, the early recognition of RV dysfunction gives us a window of opportunity to take action and slow down the disease's course. This study emphasizes that the early identification of RV diastolic as well as systolic dysfunction in asymptomatic Type 2 diabetic patients can be a helpful tool in halting the progression of disease from subclinical to frank clinical cases, thereby preventing the morbidity and mortality associated with heart failure. Hence, it adds value to the pre-existing literature.

Cutaneous leishmaniasis is one of the most commonly diagnosed dermatological condition in travel medicine after diarrhoeal diseases and febrile status. The disease is transmitted by Phlebotomus and Lutzomyia sandflies. It appears in various clinical forms, the most common of which is a painless ulcer with raised edges, usually present on exposed parts of the body on the side where the insect bite occurred. Annually, over a million new cutaneous leishmaniasis (CL) cases are reported globally. We present two cases of affliction, the first occurring in Patient 1, who attempted treatment through the Kambo cleanse in South America, which is considered a toxic, even life-threatening, procedure. It involves the subcutaneous application of a substance dangerous to humans derived from the surface mucus of a frog. Patient 2 applied caustic ointments, a fruitarian diet, and hyperbaric oxygen therapy in a private setting. After initial therapeutic failures caused by the patients’ unconventional treatment ideas, the causal treatment effect was satisfactory, demonstrating the efficacy of these treatments in resolving the infection when applied appropriately. Despite the typical CL presentation in both patients, their self-treatment course was unusual. It is worth noting that alternative, sometimes harmful, self-treatment initiatives by patients may be surprising and ineffective. Promoting knowledge about tropical diseases among travellers and medical staff is crucial to improving treatment outcomes.

Solar panel efficiency is significantly influenced by its operating temperature. Recent advancements in emerging renewable energy alternatives have enabled photovoltaic (PV) module installation over water bodies, leveraging their increased efficiency and associated benefits. This paper examines the operational performance of solar panels placed over water bodies, comparing them to ground-mounted solar PV installations. Regression models for panel temperature are developed based on experimental setups at BITS Pilani, India. Developed regression models, including linear, quadratic, and exponential, are utilized to predict the operating temperature of solar PV installations above water bodies. These models incorporated parameters such as ambient temperature, solar insolation, wind velocity, water temperature, and humidity. Among these, the one-degree regression models with three parameters outperformed the models with four or five parameters with a prediction error of 5.5 °C. Notably, the study found that the annual energy output estimates from the best model had an error margin of less than 0.2% compared to recorded data. Research indicates that solar PV panels over water bodies produce approximately 2.59% more annual energy output than ground-mounted systems. The newly developed regression models provide a predictive tool for estimating the operating temperature of solar PV installations above water bodies, using only three meteorological parameters: ambient temperature, solar insolation, and wind velocity, for accurate temperature prediction.

Background: It is pertinent to objectively assess the severity of diabetic gastroparesis and tailor treatment accordingly. The current study was planned to document gastroparesis by gastric emptying scintigraphy (GES) objectively and see the effect of medications and diet control on clinical and GES after four weeks. Methods: A prospective, open-label randomized trial was conducted in the Department of Internal Medicine at a tertiary care teaching hospital over twelve months. Type 2 diabetic patients aged 18-65 years diagnosed with a case of delayed gastric emptying by gastric scintigraphy were included. All baseline GSCI was recorded, and then they were allotted to 3 groups – Group-1 (Levosulpiride 25mg once daily), group-2 (Cinitapride 1mg thrice daily), and Group-3 (Waitlisted control) by block randomization and followed-up weekly till four weeks. After four weeks duration, if not improved clinically, then Group-3 on diet and diabetic control only, were randomized into Levosulpiride 25mg once daily (Group 1), and Cinitapride 1mg Thrice daily (Group 2) for the next four weeks. Results: Forty confirmed cases with diabetic gastroparesis documented by Gastroparesis Symptom Cardinal Index (GCSI) scoring and later by Scintigraphy (GES) were included in this study. However, there was no statistically significant difference between the Levosulpiride and Cinitapride groups when all symptoms were taken into account. Levosulpiride was significantly more effective than Cinitapride in improving individual symptoms like nausea, vomiting, stomach fullness, and early satiety. Conclusion: Levosulpiride is better than Cinitapride in improving the symptoms of diabetic gastroparesis but no significant effect on gastric scintigraphy.

Introduction: Age-related deficits such as malnutrition, functional reliance, and cognitive decline also occur in older women, as they are typically weaker and have many co-morbid conditions like diabetes or cardiac illness. These prognostic factors might predict overall survival and progression-free survival. Aim: To analyse the management outcomes of elderly patients with cervical carcinoma treated with radiotherapy and brachytherapy. Materials and Methods: A retrospective observational study was conducted in the Department of Radiation Oncology at Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India. Medical records were collected from 876 patients with cervical cancer who had been treated with radiotherapy or combined radiotherapy and chemotherapy from January 2009 to December 2021. A total of 876 patients presented with cervical cancer in the Outpatient Department (OPD), and 20 patients meeting the inclusion criteria were selected. Patients diagnosed with cervical cancer, Federation International Federation of Gynaecology and Obstetrics (FIGO) stage IB to IVA, aged equal to or greater than 80 years old, and Eastern Cooperative Oncology Group (ECOG) performance status I to III were considered for inclusion. Categorical variables were expressed as counts and percentages. The following clinicopathological characteristics of the study population were examined: FIGO staging, including stage IB to stage IVA, histopathological features of adenocarcinoma, squamous carcinoma, or adenosquamous carcinoma, doses of radiotherapy and brachytherapy, overall survival, disease-free survival, and the patient’s current status (alive or dead) was determined. If death occurred, the cause of death was determined. The Kaplan-Meier approach was used to analyse overall survival and disease-free survival in the study population using XLSTAT statistical software. Results: The study population was age standardised, with 18 patients (90%) falling between the ages of 80 and 85, and 2 patients (10%) falling between the ages of 86 and 90. A total of 12 patients (60%) belonged to ECOG PS II. A total of 19 (95%) patients had histologically confirmed squamous cell carcinoma. 75% of the population was in a locally advanced stage (stage III-IVA). The overall survival (in months) was 65.58 months, which was statistically significant (p

Abstract Background Ticks carry microbes, some of which are pathogenic for humans and animals. To assess this One Health challenge, 342 ticks were collected from pet dogs and cats at 10 veterinary clinics in Finland as part of the European project “Protect Our Future Too”. Methods The tick species were identified, and ticks were screened with quantitative PCR (qPCR) for tick-borne pathogens, including Borrelia burgdorferi sensu lato, Borrelia miyamotoi, Ehrlichia canis, Anaplasma spp., Candidatus Neoehrlichia mikurensis, tick-borne encephalitis virus (TBEV), and Babesia spp. For comparison, a subset of tick DNA (20 qPCR-positive samples) was analysed with 16S next-generation sequencing (NGS). Results Most ticks were Ixodes ricinus (289, 84.5%), followed by Ixodes persulcatus (51, 14.9%). One hybrid tick (I. ricinus/I. persulcatus, 0.3%) and one Rhipicephalus sanguineus tick (0.3%) were identified. We found one or more of the analysed pathogens in 17% (59/342) of the ticks. The most prevalent pathogen was B. burgdorferi s.l. (36, 10.5%), followed by Anaplasma phagocytophilum (12, 3.5%), B. miyamotoi (5, 1.5%), Babesia venatorum (4, 1.2%), and TBEV (1, 0.3%). Candidatus Neoehrlichia mikurensis DNA was amplified from three (0.9%) ticks. Ehrlichia canis was not detected. In the 16S NGS, six samples produced enough reads for the analysis. In these six samples, we confirmed all the positive qPCR findings of Borrelia spp. and Ca. N. mikurensis. Conclusions The high prevalence of pathogenic microorganisms in the ticks of this study emphasizes the importance of awareness of ticks and tick-borne diseases and prevention. Furthermore, the results show that veterinary surveillance can facilitate early detection of tick-borne pathogens and new tick species and draw attention to possible co-infections that should be considered both in symptomatic humans and animals after tick bites. Graphical Abstract

We report a sequencing protocol and 121-kb poxvirus sequence from a clinical sample from a horse in Finland with dermatitis. Based on phylogenetic analyses, the virus is a novel parapoxvirus associated with a recent epidemic; previous data suggest zoonotic potential. Increased awareness of this virus and specific diagnostic protocols are needed.

Background Radiology is among India's top five speciality choices pursued by meritorious medical graduates. With the advent of the subspecialization degree courses, fellowships, the requirement of senior residency as faculty eligibility criteria, and the lucrative option of private practice, the final-year postgraduates are given opportunities to choose from but with little guidance on what and how to choose. This study aims to analyze the views of the final-year radiology postgraduate residents in India regarding their understanding of how to proceed in their professional life with options available. Materials and Methods A cross-sectional, questionnaire-based study was conducted online via Google forms distributed via email and social media platforms. The questionnaire was prepared after going through previous literature, video blogs, and media available on the Internet and was further validated for content. Results About half (48%) of them wished to pursue higher studies in the form of Doctorate of Medicine (DM) degree courses or fellowships. Almost three-quarters of the participants preferred short-term subspecialization via fellowships over 3-year DM courses (28%). Regarding clinical practice, 61.9% preferred to take up senior residency, while slightly over one-third (35.7%) expressed their will to move on to private practice. Conclusion A relative conundrum was observed in the decision to take up senior residency or private practice or to go for DM but had to pursue a fellowship due to limited choice in topics and seats available in the country for subspecialization.

The present investigation was undertaken at the Hybrid Rice plot of TCA, Dholi, and Muzaffarpur, and molecular analysis was conducted in the Molecular Laboratory of Postgraduate Dept. of Genetics & Plant Breeding, RPCAU, and Bihar to generate heterosis studies for 18 traits and molecular characterization using SSR markers. The experimental material comprised 31 three-line rice hybrids and 3 commercial checks evaluated in the RBD design. Among the tested varieties, Rajendra Sweta performed best in terms of grain yield per plant. Two rice hybrid genotypes, namely, IR68897A × KMR-3R and Rajendra-3A × RRR–4, exhibited superior standard heterosis over all three tests for trait grain yield per plant. By utilizing 12 primer pairs, a total of 33 shared alleles and 13 unique alleles were produced as amplified products. Among the 12 primers, seven primers were found to be comparatively informative for all nineteen hybrids and eleven parents. Only five primers, namely, MRG2894, RM515, RM520, RM538, and RM555, were able to confirm the hybridity (F1) with the respective parental lines.

This study proposes an integrated framework for successfully implementing collaboration strategies in supply chain (SC) management using a fuzzy decision-making trial and evaluation laboratory (DEMATEL) and multi-criteria decision-making (MCDM) approach. The study analyses and measures the successful possibility of SC collaboration implementation in small and medium enterprises (SMEs). The fuzzy DEMATEL is used to evaluate the weight of each criterion, and fuzzy MCDM is used to assess the possible success rates of the collaboration strategies. The result shows that top management support and commitment, SC strategic planning, information sharing, goal congruence, organizational compatibility, and decision synchronization are major factors responsible for SC collaboration success in SMEs. This study helps predict the effectiveness of collaboration strategies and indicates remedial activities in the existing collaborative environment by undertaking corrective actions and measures to increase implementation success.

Abiotic and biotic factors have considerable impact on the plasticity of plant functional traits, which influences forest structure and productivity; however, their inter-relationships have not been quantified for fragmented tropical dry forest (TDF) ecosystems. We asked the following questions: (1) what are the variations in the plasticity of functional traits due to soil moisture availability in TDF fragments? (2) what are the roles of soil nutrients and forest disturbances in influencing variations in the plasticity of functional traits in the TDF fragments? and (3) how do the variations in the plasticity of functional traits influence the structure and productivity of TDF fragments? Based on linear mixed-effects results, we observed significant variations among tree species for soil moisture content (SMC) under the canopy and selected functional traits across forest fragments. We categorized tree species across fragments by principal component analysis (PCA) and hierarchical clustering on principal components (HCPC) analyses into three functional types, viz., low wood density high deciduous (LWHD), high wood density medium deciduous (HWMD), and high wood density low deciduous (HWLD). Assemblage of functional traits suggested that the LWHD functional type exhibits a drought-avoiding strategy, whereas HWMD and HWLD adopt a drought-tolerant strategy. Our study showed that the variations in functional trait plasticity and the structural attributes of trees in the three functional types exhibit contrasting affinity with SMC, soil nutrients, and disturbances, although the LWHD functional type was comparatively more influenced by soil resources and disturbances compared to HWMD and HWLD along the declining SMC and edge distance gradients. Plasticity in functional traits for the LWHD functional type exhibited greater variations in traits associated with the conservation of water and resources, whereas for HWMD and HWLD, the traits exhibiting greater plasticity were linked with higher productivity and water transport. The cumulative influence of SMC, disturbances, and functional trait variations was also visible in the relative abundance of functional types in large and small sized fragments. Our analysis further revealed the critical differences in the responses of functional trait plasticity of the coexisting tree species in TDF, which suggests that important deciduous endemic species with drought-avoiding strategies might be prone to strategic exclusion under expected rises in anthropogenic disturbances, habitat fragmentation, and resource limitations.

Background: Diabetes mellitus (DM) is a clinical syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin. It is a leading cause of mortality and morbidity in adults worldwide, posing serious medical, socioeconomic, and rehabilitation problems. Rapid diagnosis plays an important role in the management of DM. Gama glutamyl transferase (GGT) is an example of one of these biomarkers. Aims and Objectives: The aim of the study was to study the correlation of GGT in Type 2 DM patients. Materials and Methods: The present cross-sectional study was carried out in the Department of Biochemistry, B.J. government Medical College and Sassoon General Hospital Pune, Maharashtra. The study period was from December 2015 to June 2017. A total of 70 newly diagnosed Type 2 DM patient aged between 40 and 60 years with blood glucose level more than 126 mg/dL in fasting and more than 200 mg/dL post-prandial were included in the study. Results: The mean GGT in control group was 26.5 U/L and in diabetic group was 58.5 U/L. The GGT values were significantly raised in diabetic (case group) as compared to control group (P

Kimura disease is an uncommon disease entity that typically involves the lymph nodes predominantly in the head and neck region together with frequent involvement of salivary glands. Very few cases of it have been reported in literature globally, and in the context of India, it is even rare. Early suspicion of Kimura disease may prevent the patient from unnecessary invasive diagnostic tests. We present a case scenario of a 35 years old female, from a hilly area who presented with painless neck swelling for 3 months that was followed by fever, new onset pain at the site of neck swelling, and skin rashes. Diagnosis of Kimura disease was made based on histopathological findings aided by peripheral eosinophilia and elevated serum Immunoglobulin E (IgE) levels. Following the diagnosis, the patient was treated with a short course of oral steroids which produced an excellent response with a consequent decrease in the size of lymph nodes and resolution of the skin rashes.

In the present study, we addressed the imperative for potent anticancer agents through Wedelia chinensis, a medicinal plant abundant in the robust antihepatotoxic and antitumor compound wedelolactone. Hindrances in conventional propagation methods due to cross-pollination and habitat degradation prompted us to pioneer in vitro rapid multiplication using plant tissue culture. Optimal outcomes were attained employing Murashige and Skoog (MS) medium supplemented with Indole-3-butyric acid (IBA) (0.5 mg/L) and Kinetin (KN) (5.0 mg/L), yielding 97.67% shoot regeneration and 81.67% rooting from nodal explants. Transplanted plantlets exhibited a 92% survival rate. We established a wedelolactone extraction protocol using toluene:ethyl acetate:formic acid (5:4:1) for High-performance thin-layer chromatography (HPTLC) analysis, trailblazing wedelolactone quantification and 2C DNA analysis in W. chinensis via flow cytometry. Experiments under heavy metal stress with CuSO4 unveiled physiological responses, with peak wedelolactone content [193.90 μg/g dry weight (dw)] in vitro at 75 μM CuSO4, surpassing in vivo levels (89.95 μg/g dw) by 116%. By pioneering successful in vitro rapid multiplication and enhanced wedelolactone content, we bridge a critical gap in the conservation and production of this medicinal plant. Our findings not only offer a sustainable means of propagation but also present a viable strategy for elevating the yield of potent bioactive molecules like wedelolactone, holding immense promise for the development of novel therapeutic interventions and addressing the pressing healthcare challenges of our time.

This review highlights the scope for integrating green nanoparticle-based drug-delivery systems with Ayurveda and presents a compelling opportunity to bridge ancient healing wisdom with modern scientific advancements by bringing forward the recent advancements in the field of Ayurveda and nanomedicine. Combining the principles of Ayurveda with green nanoparticles offers an eco-friendly approach to drug delivery, aligning with Ayurvedic emphasis on natural remedies and sustainable practices. This convergence could lead to the development of envi-ronmentally conscious therapeutic solutions. The potential for enhanced therapeutic efficacy through targeted delivery of Ayurvedic bioactive compounds using green nanoparticles holds promise. This could potentially optimize treatment outcomes and reduce side effects, aligning with Ayurveda’s holistic approach to healing. By encapsulating Ayurvedic ingredients within green nanoparticles, the bioavailability and stability of herbal compounds can be addressed, po-tentially unlocking their full therapeutic potential. This aligns with Ayurvedic teachings on opti-mal absorption and assimilation of remedies. The personalized and targeted approach of Ayur-veda, combined with the precision of green nanoparticle-based drug delivery, could usher in a new era of individualized medicine. This convergence represents a powerful example of how the synergy between traditional knowledge and scientific progress can drive transformative ad-vancements in medicine.

Pheochromocytoma is a rare neuroendocrine tumor presenting with a classical triad of symptoms. In 10% of the cases, the presentation can be atypical, and the diagnosis is often missed for several years. Most common neurological manifestations are haemorrhage, seizures, etc., but pheochromocytoma crisis presenting as delirium has been infrequently reported. We present a case of a middle-aged female who presented with hypertensive emergency and an acute confusional state. Other causes of delirium were ruled out in the patient and a timely diagnosis of pheochromocytoma was made with CT abdomen showed a large right suprarenal mass which was confirmed on 123I-MIBG scan and supported by elevated plasma metanephrines. She responded to alpha and beta blockers following which her blood pressure spikes were controlled, and subsequently, her sensorium improved significantly. Patient underwent surgical resection of the tumor and was followed up after 2 weeks with her blood pressure controlled without any medications. Conclusion: A high degree of clinical suspicion is essential in such rare presentations of pheochromocytoma. Early diagnosis, adequate preoperative preoperative stabilization followed by a definitive surgical excision offers a complete cure to such patients.

Abstract Background Ultrasound imaging of optic sheath nerve diameter [ONSD] is reported to reflect changes consistent with intracranial pressure changes seen in traumatic brain injury and also in documented serum hyponatremia. We hypothesized that hyponatremia and hypervolemia seen during trans urethral resection of prostate [TURP] surgery may also have some association with different ONSD readings from the baseline perioperatively, resulting in early detection of TURP syndrome. In this prospective observational study, 50 adult male patients scheduled for TURP surgery meeting inclusion criteria were included and the ONSD measurements were serially recorded perioperatively. Patients with measurements ≥ 5.2 mm with either clinical symptoms or electrolyte changes suggested TURP syndrome were taken as true positive. Results The sensitivity, specificity, area under the curve, positive predictive, and negative predictive value at 95%CI of ONSD for early detection of TURP syndrome was {100% [15.81 to 100.00%], 91.67% [80.02 to 97.68%], 0.96 [0.86 to 0.99%], 33.33% [4.33 to 77.72%], 100% [91.96 to 100.00%]} with a diagnostic accuracy of 95.83%. In univariate logistic regressions, the duration of surgery had a positive association with TURP syndrome [odd ratio 1.066, β coefficient 0.064, p = 0.015]. In multivariate logistic regression, we could not validate the association between these factors and TURP syndrome [p > 0.050]. Conclusions The ONSD measurements have good diagnostic accuracy for detecting TURP syndrome, but we advocate more multi-centric studies with large sample sizes to validate this association in the multivariate regression model.

Here the authors describe a small antibody-like protein that can prevent infection by diverse SARS-CoV-2 variants in cell culture and in mice that were intranasally treated with this inhibitor before or shortly after being exposed to the virus.

Monkeypox virus was imported into Finland during late May–early June 2022. Intrahost viral genome variation in a sample from 1 patient comprised a major variant with 3 lineage B.1.3–specific mutations and a minor variant with ancestral B.1 nucleotides. Results suggest either ongoing APOBEC3 enzyme–mediated evolution or co-infection.

Background Although gastric reserve volume (GRV) is a surrogate marker of gastrointestinal dysfunction and feeding intolerance, there is ambiguity in its estimation due to problems associated with its measurement. Introduction of point-of-care ultrasound as a tool for anesthetists kindled interest in its use for GRV estimation. Methods In this prospective observational study, we recruited 57 critically ill patients and analyzed 586 samples of GRV obtained by both ultrasonography (USG) and manual aspiration. Results The analysis showed that USG-guided GRV was significantly correlated (r=0.788, P

Background: Diabetes mellitus (DM) can contribute to the development of foot ulcers, a known complication of DM with a high financial and social burden. Achilles tendon (AT) and plantar fascia (PF) are well known to play an important role in foot biomechanics. The present study focuses on the alteration in thickness and stiffness of the AT and PF in Type 2 DM patients compared with the normal controls. Methods: A cross-sectional observational study was conducted with 55 DM patients and 55 healthy volunteers as controls. The thickness of the AT and PF were measured using B-mode ultrasound and stiffness was measured using shear wave elastography. Both the thickness and stiffness in the patient group and controls were compared. The values were also compared with the clinical and demographic profiles of the patients. Results: DM patients had considerably thicker AT and PF than controls (P < 0.05); mean values of AT thickness for DM patients and controls were 5.66 ± 0.54 mm and 4.61 ± 0.39 mm, respectively, and for PF were 2.53 ± 0.51 mm and 1.97 ± 0.19 mm, respectively. Furthermore, the stiffness of AT and PF was significantly (P < 0.05) lower in DM patients compared to controls, suggestive of softening of AT and PF in Type 2 DM patients. Mean values of shear wave velocity for DM patients and controls in AT were 5.53 ± 0.54 m/s and 7.25 ± 0.61 m/s, respectively, and for PF, 4.53 ± 0.89 m/s and 6.28 ± 0.88 m/s, respectively. Conclusion: We conclude that there is softening and thickening of the AT and PF in Type 2 DM patients, which can impair foot biomechanics.

Introduction: The interrelationship of diabetes with mental illness has increased in recent years. Diabetes-related distress is the emotional burden, stress, and worries associated with diabetes, which does not reach the threshold for depressive disorder. A diabetes self-management education (DSME) is a structured educational approach to improve glycemic control and diabetes-related distress. This study aimed to assess the effectiveness of DSME in comparison with usual diabetes care in improving glycemic control and diabetes-related distress. Material and Methods: This is a single-center, parallel randomized controlled trial. A total of 106 participants were recruited for both intervention and control groups with 53 participants each. The control group received only routine outpatient department (OPD) care. The intervention group received DSME in addition to routine OPD care. Diabetes-related distress and HbA1C were assessed after 3 months. The data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 25. Per-protocol analysis was done. Results: Of 127 patients screened, 106 met the eligibility criteria and were randomized. At 3-month follow-up, the reduction in mean HbA1C, fasting blood sugar (FBS), postprandial blood sugar (PPBS), and diabetes distress were significant in the intervention group compared with the control group (p 0.001). The mean HbA1C reduction in the intervention group was significant (mean difference: -1.3, SD: 0.4). The mean DDS had decreased significantly in the intervention group from 2 to 1.2 (mean difference: -0.8, SD: 0.1). Conclusion: The DSME was effective in improving the glycemic control, diabetes-related distress, and self-care among type 2 diabetes (T2DM) mellitus patients.

Background: Chronic kidney disease (CKD) is a global health problem, with a worldwide prevalence of around 9.1 per cent (as of 2017). In India, its prevalence was found to be around 17.2%. There are several risk factors of CKD, out of which the presence of underlying longstanding uncontrolled diabetes mellitus (DM) and hypertension are common. Certain previous studies have tried to assess the level of knowledge, attitudes and practices of such a 'high risk' group for developing CKD but there is a paucity of literature on it. Hence, this study was undertaken to assess these domains in individuals at risk for developing CKD. Patients and Methods: It is an observational cross-sectional study conducted from October 2020 to December 2021 at a tertiary care teaching and referral hospital in India. A total of 215 patients who were at risk of developing CKD, were enrolled and were given a CKD Screening Index questionnaire to fill and scoring was done for all three components-knowledge, attitudes and practices. Results: The mean age was found to be 49.21 ± 13.49 years with a male: female ratio of 1.4:1. Nearly three-a fourth of the patients were having DM while one-fourth of the participants had a previous history of hypertension. The mean scores on the knowledge, attitude and practices scales were found to be 11.80 ± 5.31, 50.18 ± 8.23 and 30.83 ± 7.53 respectively. The study results revealed that the majority of patients had 'low' levels of knowledge scores but 'average' levels of attitude and practice scores. A significant correlation was found amongst knowledge and attitude scores (r = 0.226, P = 0.001), knowledge and practice scores (r = 0.153, P = 0.025) and practice and attitude scores (r = 0.295, P = 0.000) of our patients. Conclusion: There is a need of improving awareness at least amongst the population at risk of getting CKD. Improving knowledge would help in inculcating positive attitudes and healthier practices amongst these, thus delaying the onset of this disease.

Background: The Primary objective of this prospective study is to study the rate of infection, number of days required for formation of healthy granulation tissue, healing of soft tissue injury and number of days of hospital stay and cost effectiveness associated with soft tissue injury treated by Vacuum Assisted closure therapy. Methods: This is a prospective observational study of 30 patients presenting with open musculoskeletal injuries in extremities that required coverage procedures in the department of Orthopaedics, Sri Aurobindo Medical College and PG Institute, Indore. All these patients had undergone wound debridement and fracture fixation. This was followed by application of Vacuum Assisted Closure (VAC). The infection rate analysed by clinical findings and investigations. Assessment of these wound(s) were done on a regular basis by wound bed score. Assessment of rate of granulation was done on every 3rd day. Based on the rate of granulation, definitive surgical intervention (skin grafting, secondary closures and flap cover procedures) was done. The patient was sent home after performing the definitive surgical intervention. Results: The infection rate was low when compared to literature study of conventional dressings. The primary wound coverage can be done earlier wound healing was also faster in patients. Conclusion: This is a simple and low cost method for treating soft tissue injury associated with severe open fractures. It can be done even in peripheral hospitals with low resources. The rate of granulation tissue formation is good with vacuum assisted closure. Also compliance of patient is good in vacuum assisted closure therapy.VAC dressing also provided the wound ready for SSG or flap rotation early as assessed by wound bed score.