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Topical sunscreens decrease the quantity of ultraviolet (UV) light from the sun reaching the skin by either blocking or scattering it and help protect the skin from dyspigmentation, photoaging, DNA damage, and photocarcinogenesis, especially in photosensitive individuals. The significant role played by visible light and infrared light in skin pigmentation and photoaging has been recognized in recent years. The majority of broad-spectrum sunscreens protect against UV-B (290–320nm) and UV-A (320–400nm) radiation. Allergic reactions to sunscreens were relatively uncommon compared to their widespread use in the last more than four decades. With growing awareness of problems associated with excessive sunlight exposure, their use has increased exponentially, especially that of cosmetics and other personal grooming products containing UV filters. In recent years, sunscreen agents have been commonly identified as causing allergic contact dermatitis and photodermatitis. Thus, allergic contact dermatitis, photo-irritation, photo-allergenicity, and photo-toxicity (acute/subacute effects) are of immediate concern in the assessment of topical sunscreens for their optimal use. Sunscreen chemicals such as p-aminobenzoic acid (PABA) and PABA esters, the cinnamates, benzophenones, oxybenzone, and dibenzoylmethane that absorb UV radiation are common contact sensitizers capable of producing both allergic contact dermatitis and photodermatitis. The excipients in sunscreen formulations by themselves may also cause allergic reactions. Herein, we review potential allergens, clinical evaluation, and management aspects of topical sunscreen contact sensitivity for their optimal use in clinical practice.

Background: Skin conditions form a major bulk of diseases in the community. With a disproportionately low number of dermatologists in the country, and a greatly unequal distribution between urban versus rural areas, ineffective treatment and mismanagement of skin conditions are, however, commonplace. Objective: To develop standard treatment workflows (STWs) for certain skin diseases for use by clinicians at primary, secondary, and tertiary care centers. Methodology: Seven members, from various academic institutes across the country, were selected for formulation of the STWs. They were provided logistic and technical support by the ICMR, Department of Health Research (DHR), and WHO India office. Multiple rounds of online and physical discussions were performed to identify topics that would be most useful in the management of skin diseases for the health care personnel (HCP) and subsequently to frame the STW content. Results: The selected diseases included acne and rosacea, alopecia, bacterial skin infections, cutaneous adverse drug reactions, dermatophytosis, eczema/dermatitis, immunobullous dermatoses, psoriasis, scabies, varicella and herpes, vitiligo, and urticaria. There was one separate module on rational use of topical corticosteroids. The STWs for these conditions have been finalised and are available as physical posters in health centers and can also be accessed online and through mobile applications. Conclusion: Thirteen STW modules have been prepared with a view to optimize management of skin diseases at various levels of health care system of the country.

Objectives: Evaluation of effectiveness of bioactive glass, self-assembling peptide (P11-4), and arginine bicarbonate remineralizing agents on simulated carious lesion. Material and Methods: This research was conducted using 40 human premolar teeth that had just been removed. Remineralization of demineralized teeth was carried out three times a day for 14 days for 5 minutes using the appropriate remineralizing agents (Group A: calcium sodium phosphosilicate (bioactive glass), Group B: self-assembling peptide (P11-4), Group C: arginine bicarbonate remineralizing agents, and control group: Group D: deionized water). Using the Vickers hardness number, the degree of demineralization and remineralization was assessed. Results: In every group, there was a drop in microhardness from the baseline to demineralization. In all three test groups, the shift in microhardness values from demineralization to remineralization was shown to be statistically significant. Conclusion: Higher remineralizing capacity was found in bioactive glass and self-assembling peptide (P11-4), which can be employed therapeutically to treat early carious lesions.

Objectives: Comparative assessment of effectiveness of topical coconut cream, pomegranate, and Tacrolimus 0.1% in treatment of oral lichen planus (OLP) lesion. Materials and Methods: Thirty patients with histologically confirmed symptomatic OLP exhibiting gingival manifestation were included in this investigation. Group A received topical coconut cream, Group B received pomegranate, and Group C received topical tacrolimus 0.1% ointment. The participants were split into these three groups. For six months, the participants were told to use topical medicines twice a day. For the purpose of monitoring any relapse, the patients were summoned back one, three, and six months after the therapy was stopped. Result: Both the extent of the lesion and the burning sensation/pain were significantly reduced in all groups of participants. Conclusion: The size of the lesion and the burning feeling were significantly reduced when using coconut cream. For the treatment of OLP, tacrolimus, coconut cream, and pomegranates are viable topical pharmaceutical alternatives.

Abstract The interaction between nitrogen (N), phosphorus (P), and potassium (K) fertilizers significantly impacts the uptake of micronutrients in corn, influencing their availability in soil and uptake by plants. Understanding the interaction of macro‐ and micronutrients is a prerequisite to targeting nutrient balance in crop production. Therefore, a 2‐year field experiment was conducted to determine the effect of NPK fertilization on micronutrient uptake of rain‐fed corn (Zea mays L.). A randomized complete block design was employed with 12 treatments replicated three times. Different combinations of N, P, and K fertilizer rates were investigated for micronutrient concentration and uptake in rain‐fed corn. Findings revealed the order of nutrient accumulation in corn plants: iron (Fe) > manganese (Mn) > zinc (Zn) > copper (Cu). Nitrogen application influenced nutrient concentrations and uptake. Increasing N rates increased micronutrient concentrations in corn grain, except for Cu. Interestingly, Cu content in grains exhibited no correlation with nutrient supply, biomass, or other concentrations. As the N application rate increased, micronutrient content increased at early growth stage and physiological maturity. Phosphorus application showed negligible impact on grain micronutrient concentration and uptake. However, K application notably increased Mn, Fe, and Cu uptake in grains. This study underscores the need to consider not only grain yield but also nutritional quality when determining optimal NPK rates in rain‐fed corn cultivation.

The excitement of watching a seed sprout into a flourishing plant is a joy for all who cultivate their own urban gardens. Many think of soil as a mere support for those plants, a substance that anchors them into the ground. However, soil is a dynamic and life-sustaining medium that nourishes plants. There is a complex ecosystem beneath the soil surface, composed of minerals, organic matter, water, air, and countless microorganisms. Understanding soil fertility is vital to plant growth. This publication is written for individuals tending to lawns, shrubs, trees, or flowers in urban settings. It introduces essential terms of soil fertility, explains the role of soil properties in supporting healthy plants, and familiarizes readers with methods to enhance soil fertility within the context of urban settings. It also serves as a guide to empower non-farmers and urban residents, offering insights into plant nutrient requirements and the principles of effective nutritional care.

Cutis Verticis Gyrata (CVG) is an uncommon condition, often classified as primary (idiopathic) or secondary to other diseases or syndromes. Its pathogenesis remains poorly understood, and its association with genetic syndromes is particularly rare. Noonan and Turner syndromes are distinct genetic disorders with characteristic phenotypes and multiple systemic involvements. This report aims to highlight the diagnostic complexities when CVG presents in the backdrop of these syndromes. A 38 years old patient was presented with chief complaints of receding hairline, dropping eyelids, cerebral deformations with deep furrows and thickened dermis. On the basis of patient's complaints, Noonan or turner syndrome was considered as possible diagnosis. This particular report presents a case of patient suffering from CVG having history of noonan and turner syndrome. With the detailed MRI, histology etc. CVG was finally confirmed. The novelty of this case lies in its rarity, diagnostic complexity, and the need for a multidisciplinary approach to unravel and manage the intersecting conditions. It contributes valuable insights to the existing medical literature, enhancing our understanding of the interplay between dermatological and genetic conditions. Patients with Noonan and turner syndrome exhibit clinical signs and symptoms that are strikingly similar to those of CVG, suggesting that this presents a significant diagnostic problem. An unfavorable outcome could arise from delayed or incorrect diagnosis. Because of this, it is recommended that healthcare fraternities should include uncommon illnesses like CVG as differential diagnosis. Considering CVG in differential diagnosis is crucial for early identification, accurate diagnosis, and comprehensive management. It ensures that associated systemic and genetic conditions are not overlooked and that patients receive holistic and personalized care.

People with disabilities often experience worse health outcomes than ordinary people because of multiple barriers to accessing healthcare. These inequalities are particularly exposed during the pandemic, indicating an urgent need to strengthen health systems, so that they are inclusive and responsive to the needs of these people during crises. These people are particularly affected by changes in routine services because of diversion of healthcare staff and facilities to respond to the pandemic, e.g., rehabilitation and medications. The combination of these factors substantially imparts negative impacts on their functioning and well-being. Health services research can help address the challenges of maintaining continuity of care during crises as well as addressing systematic inequalities in the health sector that marginalize people with disabilities even during noncrisis times. Therefore, research is needed to understand the health service design and to identify strategies to maximize active participation from this population.

Introduction: The Emergency Department (ED) is the point of first contact for any critically ill patient needing immediate medical attention. EDs use a triage system which ensures people who are critically ill are treated first. Turnaround Time (TAT) for the ED is taken as the time from the patient’s arrival in the ED to either their hospitalisation or discharge. Aim: To estimate the TAT of patients in the ED at a tertiary care teaching hospital. Materials and Methods: This cross-sectional study was conducted from August 1 to August 31, 2022, at the ED of Himalayan Hospital, Dehradun, Uttarakhand, India. A sample size of 300 patients were selected using a simple random sampling technique. Data were collected by direct observation using a data collection sheet. Timings were recorded with the help of a stopwatch. Statistical analysis was performed using the data analysis tool in Microsoft Excel and Statistical Package for Social Sciences (SPSS) version 23.0. Pearson coefficient of correlation (r-value) and p-value were calculated. The level of statistical significance was set at 5% (p-value

The whitefly, Bemisia tabaci Gennadius (Hemiptera: Aleyrodidae), is a significant pest affecting pulse crops in north India, particularly soybean [Glycine max (L.) Merr.]. The study was carried out during the rainy (kharif) seasons of 2018 and 2019 at Punjab Agricultural University, Ludhiana, Punjab to investigate whitefly populations across 8 soybean genotypes. The study revealed that genotypes SL 1074 and SL 1028 had the lowest whitefly infestations, while DS 3105 exhibited high susceptibility. Whitefly populations, peaking at different stages, were positively correlated with temperature and relative humidity and negatively with rainfall. Significant variations in whitefly population densities were observed across different genotypes and canopy levels, with higher populations in the upper and middle canopies. The avoidable yield losses were estimated in three cultivars recommended for cultivation by the Punjab Agricultural University, with losses ranging from 18.12–27.28%. The insecticide thiamethoxam was effective initially, but whitefly populations increased three weeks after the spraying. Unprotected plots exhibited higher whitefly populations and greater yield losses. Negative correlations were found between whitefly populations and yield parameters, particularly with 100-seed weight. This study underscores the importance of cultivating resistant soybean varieties like SL 1074 and SL 1028 to manage B. tabaci and minimize yield losses.

The global food supply heavily depends on utilizing fertilizers to meet production goals. The adverse impacts of traditional fertilization practices on the environment have necessitated the exploration of new alternatives in the form of smart fertilizer technologies (SFTs). This review seeks to categorize SFTs, which are slow and controlled-release Fertilizers (SCRFs), nano fertilizers, and biological fertilizers, and describes their operational principles. It examines the environmental implications of conventional fertilizers and outlines the attributes of SFTs that effectively address these concerns. The findings demonstrate a pronounced environmental advantage of SFTs, including enhanced crop yields, minimized nutrient loss, improved nutrient use efficiency, and reduced greenhouse gas (GHG) emissions. Nevertheless, amidst these benefits, the challenges and constraints associated with these technologies, such as production expenses and potential environmental impacts of specific components, are also discussed. A comparative assessment of these SFTs emphasizes the importance of a balanced approach, considering three crucial factors: efficiency, environmental safety, and cost-effectiveness. While no single SFT achieves optimal balance across these dimensions, integrating multiple fertilizer technologies may help mitigate individual drawbacks. Also, financial and cost-to-benefit analyses are essential to gauge their applicability across diverse cropping environments. Future perspectives shed light on emerging SFTs and innovative approaches to overcome prevailing challenges and cultivate a more impactful role in fostering sustainable agriculture.

Objective: This study aimed to describe real-world patient and physician characteristics, rearranged during transfection (RET) mutation testing and results, treatment patterns and patient-reported outcomes (PROs) in advanced or metastatic medullary thyroid cancer (aMTC) across five populous European countries. Methods: Cross-sectional physician and patient surveys were used to collect quantitative and qualitative data in France, Germany, Italy, Spain and the UK from July to December 2020, prior to the introduction of selective RET inhibitors in Europe. Physicians completed patient record forms and a survey about their specialty and practice site. Patients were asked to provide PRO data using four validated instruments, including the EuroQol 5 Dimension (EQ-5D) questionnaire. Results: The physician-reported sample included 275 patients with aMTC, including 79 patients with RET mutation-positive disease; median age was 60 and 56 years, respectively. Overall, 75% were tested for RET mutation (35% germline only, 21% somatic only and 44% both). Common physician-cited barriers to RET mutation testing included high cost, difficulty accessing the latest tests and time delay for results. First-line systemic therapy (most commonly vandetanib or cabozantinib) was prescribed for 69% of patients overall and 82% of the RET mutation-positive subgroup. Second-line therapy was prescribed for 12% of patients who received first-line therapy; most patients remained on first-line therapy at data capture. PROs revealed a substantial disease/treatment burden. Conclusion: Patients with aMTC report a substantial disease/treatment burden. Outcomes could be improved by identifying patients eligible for treatment with selective RET inhibitors through more optimal RET mutation testing.

Lead (Pb) is known to cause neurological changes, but antioxidants, chelators, and anti-inflammatory agents mitigates Pb toxicity. Previously, we reported antioxidant and anti-inflammatory effects of 3-hydroxy-3′,4′,5′-trimethoxyflavone (HTMF) derived from Ocimum basilicum L. leaves. This research investigates the neuroprotective properties of HTMF against Pb induced neurotoxicity in rats. Rats were orally administered lead acetate (100 mg/kg) daily for 30 days to induce neurotoxicity, then treated with HTMF (5 and 10 mg/kg) 30 min after Pb exposure. Cognitive and motor functions and brain biochemical parameters were determined to understand HTMF’s mechanism of action. Pb exposure impaired cognition and motor skills, elevated Pb levels, TBARS, TNF-α, IL-6 and MAO A & B, and reduced GSH levels in the brain. HTMF treatment significantly improved memory, motor deficits, and metabolic abnormalities induced by Pb, attributed to its chelating, antioxidative, anti-inflammatory, and monoaminergic modulating properties, suggesting its potential as a therapeutic agent for metal-induced brain injuries.

Abstract Background Titanium is a commonly used material for dental implants owing to its excellent biocompatibility, strength-to-weight ratio, corrosion resistance, lightweight nature, hypoallergenic properties, and ability to promote tissue adhesion. However, alternative materials, such as titanium alloys (Ti–Al-2 V) and zirconia, are available for dental implant applications. This study discusses the application of Density Functional Theory (DFT) in evaluating dental implant materials' mechanical properties and structural stability, with a specific focus on titanium (Ti) metal. It also discusses the electronic band structures, dynamic stability, and surface properties. Furthermore, it presents the mechanical properties of Ti metal, Ti–Al-2 V alloy, and zirconia, including the stiffness matrices, average properties, and elastic moduli. This research comprehensively studies Ti metal's mechanical properties, structural stability, and surface properties for dental implants. Methods We used computational techniques, such as the CASTEP code based on DFT, GGA within the PBE scheme for evaluating electronic exchange–correlation energy, and the BFGS minimization scheme for geometry optimization. The results provide insights into the structural properties of Ti, Ti–Al-2 V, and zirconia, including their crystal structures, space groups, and atomic positions. Elastic properties, Fermi surface analysis, and phonon studies were conducted to evaluate the tensile strength, yield strength, ductility, elastic modulus, Poisson's ratio, hardness, fatigue resistance, and corrosion resistance. Results The findings were compared with those of Ti–Al-2 V and zirconia to assess the advantages and limitations of each material for dental implant applications. This study demonstrates the application of DFT in evaluating dental implant materials, focusing on titanium, and provides valuable insights into their mechanical properties, structural stability, and surface characteristics. Conclusions The findings of this study contribute to the understanding of dental implant material behavior and aid in the design of improved materials with long-term biocompatibility and stability in the oral environment.

Introduction: Being diagnosed with breast cancer or receiving surgery, radiation or chemotherapy as a treatment modality in itself is seen as a traumatic experience for many women. This emotional distress is in turn associated with reduced quality of life and can pose a negative influence on compliance with treatment. Ultimately leading to an elevated risk of mortality which is also seen as the sixth vital sign in cancer care. Aim & Objectives: The purpose of our study is to estimate the prevalence of depression and anxiety in breast cancer patients and their correlation with socio-demographic factors. Materials and Methods: A cohort of 140 breast cancer patients registered in the Department of Radiation Oncology, SMS medical College, Jaipur from January 2022 to December 2022 were recruited and interviewed with a structured questionnaire including socio-clinical and demographic factors and PHQ-2 and GAD-2 scales. Results: Prevalence of depression among patients were 37.9% (53/140) and almost one third (33.6%, 47/140) of cases had anxiety. Around two thirds (69.3%, 97/140) cases had stage III breast cancer, followed by stage II in 23 (16.4%) cases and 20 (14.3%) cases had IV stage breast cancer. The place of residence, educational status, employment status, accompanying person and marital status emerged as significant predictors of depression risk, while age group, marital status and financial status were found to have statistically significant association with elevated anxiety symptoms. Conclusion: This study shows that prevalence of anxiety and depression in breast cancer patients is high and patients from rural areas, single, low monthly income, younger age group and low education level were more prone. Therefore, special care and support and often referral to psychiatry department may be required in such group of patients.

Background: COVID-19 pandemic has been a source of emerging public health problems for the past few years. Due to its contagious nature, health care professionals especially dentists, incorporated various modifications in their practices to prevent themselves and their patients from the risk of getting infected. Objective: The present study aims to assess whether dental professionals are still continuing with those modifications in practice in current times. Materials and Methods: The present study was conducted on 415 subjects after getting due approval from concerned authorities and consent from the subjects. Systematic random sampling methodology was employed for selection for study sample. The study employed a self-constructed questionnaire which was divided into 2 parts and information regarding demographic profile, practice modifications and safety protocols was gathered from subjects. Statistical analysis was conducted using Chi-square test and multiple regression analysis. Results: Only 8.6% of subjects were currently continuing with their all previous practice modifications. A vast majority of subjects (83.8%) were not deferring treatment of patients showing suspicious symptoms. Approximately 89% of subjects were not sanitizing the operating area at the end of the working day. More than two-thirds (76.4%) of the subjects stated that the pandemic was over. Female gender (OR:1.67) and high level of education (OR:2.45) had an important effect on the continuation of practice modifications. Conclusion: Very few subjects were adhering to all practice modifications previously incorporated. Dental professionals should not let their guard down even if COVID-19 cases have reduced considerably. The information collected will be useful for the dental community and further studies should be carried out.

Objective:Pyeloplasty involves the surgical reconstruction of the pelviureteric junction (PUJ) to drain the urine. We compared the surgical outcomes of open and laparoscopic pyeloplasty (LP) in PUJ obstruction in pediatric patients.Materials and Methods:A simple randomized, prospective, comparative trial was conducted at two tertiary care centers in North India, from Jan 2015 to Dec 2019, with a follow-up to Dec 2020. A total of 110 patients were included in the study, out of which 52 underwent LP, and 58 were offered open pyeloplasty (OP).Results:The mean operative time in the OP and LP groups was 100 min (80-140 min) and 170 min (120-240 min), respectively. The mean blood loss in the OP and LP groups was 15 mL and 10 mL. In the OP group, pre-operative mean split renal function was 33.5% (19-40%), which increased to 40.5% (27-46%) postoperatively. In the LP group, pre-operative mean split renal function was 35% (23-39%), which increased to 45.5% (30-48%) post-operatively after one year at the first follow-up scan. The mean number of analgesic doses administered was 12 (range 9-15 doses) in the OP group and 9 (range 7-12 doses) in the LP group.Conclusion:LP and OP showed no significant differences except for operative time. The analgesic requirement was higher in the OP group without being statistically significant. Both techniques were equally effective, and any procedure being superior to others in all respects is ill-founded and must be viewed with an unbiased approach.

Introduction: The Outpatient Department (OPD) holds significant relevance in modern medical care and serves as the “Shop Window” of the hospital. Waiting time serves as a crucial indicator of the quality of OPD services provided by the hospital, as it greatly affects patient satisfaction. Radiation oncology is a clinical specialty that focuses on administering radiation therapy to cancer patients, who seek consultation in the radiation oncology OPD. Aim: To estimate the waiting time and consultation duration for patients in the OPD of radiation oncology at a tertiary care teaching hospital. Materials and Methods: This cross-sectional study was conducted from August 1 to August 31, 2022, at the Cancer Research Institute of Himalayan Hospital, which is the affiliated hospital of the Himalayan Institute of Medical Sciences under the aegis of Swami Rama Himalayan University, Dehradun, Uttarakhand, India. A total sample size of 300 patients was selected using the simple random sampling technique. Data was collected through direct observation using a data collection sheet. Statistical analysis was performed using the data analysis tool in Microsoft Excel and Statistical Package for Social Sciences version 23.0. Pearson coefficient of correlation (r) and p-value were calculated. Results: The results were analysed based on demographic details, days of the week, patients seen per consultation room, new and follow-up patients, and patient arrival time in the OPD. The majority of patients attending the OPD were in the age group of 50-69 years (60.6%). A total of 256 patients (85%) were follow-up patients. Analysis of the patient arrival pattern revealed that the highest number of patients, 200 (66.7%), arrived between 8:30 AM and 10:30 AM. The overall mean waiting time was estimated to be 50.43±0.030 minutes, and the mean consultation time was estimated to be 9.53±0.004 minutes. The Pearson coefficient of correlation between the two variables was calculated, revealing a positive correlation with ‘r’ value=0.14 and a statistically significant p-value=0.014 (

Abstract Amidst the global food shortage and the global climate change challenge, there is an urgent need to double food production by 2050. However, the modern crop production methods, including the use of fertilizers and pesticides, have adverse environmental consequences, exacerbating the climate crisis. To address this challenge, a transition to sustainable agriculture is imperative that can harmonize the issue. Biostimulants offer an eco‐friendly solution, especially bacterial biostimulants centred on plant growth‐promoting rhizobacteria (PGPRs). These biostimulants hold the promise of offering environmentally sustainable solutions to enhance crop productivity. The adoption of PGPR‐based biostimulants in agriculture has gained significant momentum in agricultural research. PGPRs enhance plant growth through multifaceted mechanisms. This review delves into the various modes of action employed by PGPRs to improve plant growth, including their impact on nutrient availability (such as nitrogen fixation and mineral solubilization) and stress mitigation. In addition, the practical implication of PGPR strains in field research has been discussed extensively. Besides, the review outlines the roadmap for commercializing PGPR‐based biostimulants and discusses the associated challenges and limitations. A balanced perspective on the practical implementation of PGPRs in modern agriculture is presented. Exploration of future strategies and directions rounds out the review, emphasizing the necessity of a comprehensive approach to address research gaps and unlock the full potential of PGPR‐based biostimulants for sustainable agriculture. In conclusion, this review underscores the applicability of PGPR‐based biostimulants as an innovative solution to address the current food crisis in the context of climate change.

The purpose of this publication is to inform cotton producers, Extension agents, crop advisors, and consultants about the role, deficiency, and management of potassium in cotton production. Written by Kulpreet Singh, Hardeep Singh, Peter Omara, Nkem J. Nwosu, Jennifer Bearden, Ravinder Singh, and Lakesh K. Sharma, and published by the UF/IFAS Agronomy Department, January 2024.

A conventional linear programming model (LPM) for feed formulation of lactating cattle will overlook the variation in feed components. LPM only considers the mean composition of feed values, regardless of variations, the confidence in satisfying the nutrient need falls to 50%. Whereas the stochastic model (SM), which takes into account both the mean and variation of feed composition and provides 90-99% confidence in meeting the nutrient need. In present work, we have proposed SM for least-cost feed formulation of lactating cattle where the variation in the composition of nutrients like crude protein (CP), Calcium (Ca) and Phosphorus (P) in the feedstuff are considered. Data provided by the National Research Council (2001) are the basis for the current analysis. These SMs are resolved using M.S. Excel's Generalized Reduced Gradient (GRG) nonlinear and LINGO's Nonlinear solver, and the results are compared to LPM; the feed formulated by SM (90 % and 99 %) has the lowest cost when compared to LPM. Nutrients estimated by LPM, SM by GRG nonlinear, and SM by Nonlinear solver utilized for feed formulation had no significant differences as (p>0.05). When compared to LPM, the stochastic model is a better technique, particularly when dealing with nutrient variation.

Abstract Despite the high burden of mental disorders in low- and middle-income countries (LMICs), less than 25% of those in need have access to appropriate services, in part due to a scarcity of locally relevant, evidence-based interventions and models of care. To address this gap, researchers from India and the United States and the Indian Council of Medical Research (ICMR) collaboratively developed a “Grantathon” model to provide mentored research training to 24 new principal investigators (PIs). This included a week-long didactic training, a customized web-based data entry/analysis system and a National Coordination Unit (NCU) to support PIs and track process objectives. Outcome objectives were assessed via scholarly output including publications, awards received and subsequent grants that were leveraged. Multiple mentorship strategies including collaborative problem-solving approaches were used to foster single-centre and multicentre research. Flexible, approachable and engaged support from mentors helped PIs overcome research barriers, and the NCU addressed local policy and day-to-day challenges through informal monthly review meetings. Bi-annual formal review presentations by all PIs continued through the COVID-19 pandemic, enabling interim results reporting and scientific review, also serving to reinforce accountability. To date, more than 33 publications, 47 scientific presentations, 12 awards, two measurement tools, five intervention manuals and eight research grants have been generated in an open-access environment. The Grantathon is a successful model for building research capacity and improving mental health research in India that could be adopted for use in other LMICs.

Background: Cervical carcinoma is the fourth most common cancer and leading cause of cancer related deaths in women worldwide. Brachytherapy is an important part in the treatment of cervical cancer. Delivering HDR Intracavitary Brachytherapy in the Covid-19 era is challenging. Objective: To compare the dosimetry and treatment outcomes between two fractionation schedules of 9Gy in 2 fractions v/s 7Gy in 3 fractions of high dose rate Brachytherapy in patients with locally advanced carcinoma cervix. Methods: A randomized observational study was carried out on 80 histopathologically proven squamous cell carcinoma patients of cervix. All patients were treated with EBRT 50Gy in 25 fractions over a period of 5 weeks (2Gy/#) with concurrent weekly cisplatin 30mg/m2. After assessing fitness for brachytherapy, patients in the study arm received HDR intracavitary brachytherapy in 9Gy for 2 fractions v/s 7Gy for 3 fractions in the control arm. Results: The median time of follow-up was 14 months for the study (range 7 – 20 months). Local control rate was 89.75% for study arm and 92.30% for control arm. One year disease free survival in the study arm was 76.92% as compared to 74.35% in the control arm. Median disease-free survival was better in the study arm (14 months v/s 12 months) with a trend of significant benefit. Rectal and bladder toxicities were comparable in both the arms. Median dose to ICRU bladder and rectal point, and EQD2 dose in both arms were not found to be statistically significant. Conclusion: Both the regimes were found to be safe. Disease response and toxicities were also similar in both the arms. There was a better patient compliance with 9Gy for 2 fractions schedule in view of lesser number of fractions resulting in less hospital visit in the Covid-19 pandemic.

Background and Objectives: We previously reported on the impact of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) on the QoL of persons with ME/CFS and their family members. Here, we present the findings of the impact on the QoL of individuals with ME/CFS whose family members did not participate in the survey. Materials and Methods: A prospective multinational online survey was disseminated via patient charities, support groups and social media. Persons with ME/CFS completed the EuroQoL questionnaire (EQ-5D-3L). Results: Data were analysed from 876 participants from 26 countries who reported a health care professional diagnosis of ME/CFS. In total, 742 participants identified as female, 124 male and 10 preferred not to say. The mean age of the participants was 47 years (range 18–82), and the mean time to diagnosis was 14 years. The mean overall health status on a visual analogue scale for people with ME/CFS was 36.4 (100 = best health). People with ME/CFS were most often affected by inability to perform usual activities (n = 852, 97%), followed by pain (n = 809, 92%), impaired mobility (n = 724, 83%), difficulty in self-care (n = 561, 64%) and least often affected by anxiety and depression (n = 540, 62%). Conclusions: The QoL of people with ME/CFS is significantly affected globally. There was no significant difference in quality of life compared with previously published data on those with ME/CFS who did have a family member complete the family member quality of life questionnaire (FROM16). Contrary to popular misconception, anxiety and depression are the least often affected areas in persons with ME/CFS who are most impacted by their inability to perform usual activities.

[This corrects the article DOI: 10.1371/journal.pone.0264956.].

Phosphorus (P) is an indispensable nutrient for agricultural crops, existing in both organic and inorganic forms within the soil matrix. However, its runoff and leaching could potentially pollute the natural water bodies worldwide through eutrophication. Despite the elevated soil P levels indicated by soil tests, the potato crop necessitates substantial P fertilization due to its relatively superficial root structure and short growth period, particularly when compared to longer-cycle agronomic crops such as corn or cotton. This investigation was designed to assess the response of potato tuber yield and quality to incremental P fertilizer applications during the 2021 and 2022 growing seasons. The research was performed in the 2021 growing season across two different agricultural sites at the Hastings Agricultural Extension Center (HAEC), incorporating eight varying rates of Triple Super Phosphate (TSP) (formulation 0-46-0% N–P2O5–K), specifically 0, 28, 56, 84, 112, 140, 168, and 224 ​kg P2O5 ha−1. In the subsequent 2022 season, the study expanded to include three additional sites at HAEC, testing six different TSP levels at 0, 22, 45, 67, 90, and 112 ​kg P2O5 ha−1. A randomized complete block design (RCBD) with four replications was employed throughout the 2021 and 2022 seasons. The cumulative data from 2021 to 2022 indicated that total and marketable yields across all sites increased in response to increasing P rates (p ​

ChAdOx1 nCoV-19 (AZD1222) is a replication-deficient chimpanzee adenovirus vectored vaccine developed by Oxford and AstraZeneca for a disease we all know as Coronavirus, or COVID-19. Ongoing clinical studies reveal that the ChAdOx1 nCoV-19 vaccine has a tolerable safety profile and is effective against symptomatic COVID-19. This vaccine may prove crucial in boosting herd immunity, averting life threatening illness, and relieving the current pandemic. In this mini review, we performed a thorough literature search through PubMed and Google Scholar and reported various case reports associated with complications of the adenovirus-vectored COVID-19 vaccine. Various adverse effects of the ChAdOx1 nCoV-19 vaccine were reported around the globe, which were often serious but rare and developed into life-threatening pathologies such as GBS, thrombocytopenia, demyelinating neuropathies, progressive dementia, cerebral infarction, IgA vasculitis, hemophagocytic lymphohistiocytosis, herpes zoster, cutaneous reactions, and vein thrombosis. These worldwide reported complications, which are usually rare and severe, will aid clinicians in understanding and managing unforeseen situations. There is a need for more research to find out more about these complications and their etiopathogenesis. However, the benefits of these vaccinations for stopping the spread of the outbreak and lowering the fatality rate outweigh the potential risk of the uncommon complications.

Introduction: The knowledge of the effect of sociodemographic and disease-related factors on health-related quality of life (HRQoL) among people living with HIV/AIDS (PLWHA) is important for planning comprehensive health-care services for them. Material and Methods: Two hundred PLWHA on antiretroviral therapy (ART) volunteered to complete a self-reported World Health Organization's Quality of Life‒HIV brief questionnaire (WHOQoL-HIV-BREF) that examines six domains each with four items (physical, psychological, level of independence, social, environmental, and spiritual) with 25 facets and additional 5 facets specific to PLWHA (symptoms of HIV, social inclusion, forgiveness, worries about the future, and death and dying). Results: Only 135 questionnaires from 73 (53.3%) men and 63 (46.7%) women (male: female – 1.14:1) aged 20–82 years (mean ± standard deviation: 42.9 ± 10.5 years) were found complete. Eighty-five (63%) individuals were aged 41–60 years, 78 (57.8%) individuals were matriculates, graduates, or postgraduates, 76 (56.3%) respondents were married, and 38 (28.1%) were widows/widowers. Staying-alone workers comprised 43 (31.8%) individuals. Overall health and HRQoL were rated satisfactory (n = 85.2%) and good/very good (n = 74.8%) by a significantly greater number of individuals (P = 0.001). Pearson's Chi-squared test showed no statistically significant (P > α) associations between good HRQoL and variables such as age >40 years, gender, education, marital status, duration of disease, disclosure of serostatus to family, ART for >3 years, and CD4 >200 cells/mL. Conclusion: Regular ART can result in adequate control of immunosuppression and no comorbidities in a majority of PLWHA, family and social acceptance, and financial security can result in overall good HRQoL in all six domains within the WHOQoL-HIV-BREF. The study is limited by its cross-sectional study design and small sample size.

Inflammation is a distinguished clinical manifestation of COVID-19 and type 2 diabetes mellitus (T2DM), often associated with inflammatory dysfunctions, insulin resistance, metabolic dysregulation, and other complications. The present study aims to test the hypothesis that serum concentrations of PAR-1 levels differ between COVID-19 diabetic patients (T2DM) and non-diabetic COVID-19 patients and determine their association with different biochemical parameters and inflammatory biomarkers. T2DM patients with COVID-19 (n = 50) with glycated hemoglobin (HbA1c) levels of (9.23 ± 1.66) and non-diabetic COVID-19 patients (n = 50) with HbA1c levels (4.39 ± 0.57) were recruited in this study. The serum PAR-1 levels (ELISA method) were determined in both groups and correlated with parameters such as age, BMI, inflammatory markers including CRP, interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), D-dimer, homocysteine, and N-terminal pro–B-type natriuretic peptide (NT-proBNP). Demographic variables such as BMI (29.21 ± 3.52 vs. controls 21.30 ± 2.11) and HbA1c (9.23 ± 1.66 vs. controls 4.39 ± 0.57) were found to be statistically elevated in COVID-19 T2DM patients compared to non-diabetic COVID-19 patients. The concentrations of several inflammatory biomarkers and PAR-1 were remarkably increased in the COVID-19 T2DM group when compared with the non-diabetic COVID-19 group. The univariate analysis revealed that increased serum PAR-1 estimations were positively correlated with enhanced HbA1c, BMI, inflammatory cytokines, D-dimer, homocysteine, and NT-proBNP. The findings in the current study suggest that increased levels of serum PAR-1 in the bloodstream could potentially serve as an independent biomarker of inflammation in COVID-19 patients with T2DM.

Abstract The transplacental route of vertical transmission of Hepatitis B Virus (HBV) has been known for over a decade. Here we present evidence which suggest HBV can replicate in placenta. Forty-one HBsAg positive and 10 control pregnant women were enrolled in the study after obtaining informed consent. HBV positives were further divided in the High Viral Load (HVL) Group and Low Viral Load (LVL) Group according to INASL guidelines 2018. The Presence of the HBV DNA and expression of NTCP in the placenta was analyzed by qPCR/RT-qPCR and/or immunohistochemistry (IHC). The presence of cccDNA was assessed using Digital Droplet PCR while the presence of pre-genomic (pg) RNA was assessed through qRT-PCR and sequencing. The presence of HBeAg and HBcAg in the placenta was assessed by IHC. Immunostaining of NTCP, HBeAg and HBcAg on trophoblasts along with the presence of total HBV DNA, cccDNA and pgRNA indicated, that these cells are not only susceptible to HBV infection but may also support viral replication. This is further supported by the finding that trophoblasts of the several HBeAg seronegative samples harbored the HBeAg. Although, we did not find any correlation in NTCP expression and viral markers with viral load indicates placental replication may not aping hepatocytes. The presence of the HBV receptor, NTCP along with the presence of cccDNA, pgRNA, and HBeAg in placenta of HBV infected females without circulating HBeAg suggest that placenta act as a replication host.

Plain Language Summary The Bacillus Calmette–Guérin (BCG) vaccine has been studied previously in several settings, including reducing childhood mortalities due to viral infections and induction of trained immunity and reducing upper respiratory tract infections and pneumonia in older adults. This multi-centre trial has tried to evaluate the efficacy of BCG revaccination in reducing the incidence and severity of COVID-19 infections in adults between 18 and 60 years of age belonging to the high-risk group owing to the presence of comorbidities including diabetes, chronic kidney disease, chronic liver disease and chronic lung diseases. A single dose of BCG vaccine produced significantly high titres of BCG antibodies lasting for six months. While there was no significant reduction in the incidence of COVID-19 infection, there was an 8.4% reduction in the incidence of symptomatic COVID-19 disease at the end of 9 months of follow-up. In addition, there were significantly fewer severe COVID-19 infections requiring hospital stay and oxygen support. However, the overall numbers of severe COVID-19 infections were low. Thus, the study shows that BCG can protect against symptomatic and severe COVID-19 disease. However, it might not reduce the incidence of new infections. The study results are significant for low- and middle-income countries without adequate coverage of primary doses of COVID-19 vaccination, let alone the booster doses. Future studies should evaluate the BCG vaccine’s efficacy as a booster compared with routine COVID-19 vaccine boosters.

Background. The emergence of monkeypox has presented a new challenge for health agencies around the globe. There is significant increase in the number of cases that too in non-endemic countries with more than 18000 cases reported worldwide. Objective. The present study was conducted to assess knowledge and awareness regarding monkeypox among dental professionals. Materials and Method. The present cross-sectional study among 410 subjects who were residing in a northern state of the country. Informed consent was obtained from all the subjects. Study sample was selected on the basis of Systematic random sampling methodology. A self-designed close-ended questionnaire written in English and verified by experts was utilized for the study. The questionnaire was delivered personally to study subjects to collect the required information. Chi-square test and ANOVA were used for statistical analysis. Results. One-fourth (24.8%) of the subjects never heard about monkeypox disease. Negative response was given by 44.8% of subjects regarding resemblance of monkeypox with small pox. Only 31.2% of subjects had knowledge regarding oral manifestations of the disease. High knowledge scores were reported by only 28% of subjects. Higher knowledge levels were significantly related to education level and working profile of study subjects. Online media (Internet) was preferred as the main source to obtain more information by 42.2 of subjects. Conclusion. There was low level of knowledge regarding monkeypox among study subjects. There is an urgent need for dental professionals to keep themselves updated with recent knowledge on new emerging infectious diseases.

Background: Present study compares two high-dose-rate intracavitary brachytherapy (ICBT) planning methods using two-dimensional orthogonal radiography and three-dimensional computed tomography (3D-CT) with regard to dose to target volume and organs at risk (OAR) in carcinoma cervix. Methodology: ICBT plans for 22-patients were compared using 2D planning and three-dimensional computed tomography (3D-CT) planning techniques. 2D treatment plans were generated using 2D-orthogonal images and dose was prescribed at Point A while 3D-CT plans were generated using 3D-CT images after contouring target volume and organs at risk. In 2D planning rectal and bladder doses were assessed as per ICRU-38 and in 3D planning, 0.1cc, 0.2cc, 0.5cc and 1cc doses of bladder and rectum were evaluated. Doses to target and organ at risks (rectum and bladder) were compared for each planning method. Results: Mean dose received by D90, D95 and D100 was 8.05±1.59Gy, 7.19±1.43Gy and 4.79±0.93Gy respectively. ICRU bladder and rectal point doses were 5.19±1.36Gy and 5.03±0.36Gy respectively. Mean dose received by bladder D0.1cc, D0.2cc, D1cc, D2cc and D5cc was 2.38±0.80, 2.22±.75, 1.85±0.64, 1.51±0.64 and 1.29±.49 times higher than ICRU bladder reference point dose. Similarly mean dose received by rectum D0.1cc, D0.2cc, D1cc, D2cc and D5cc was 1.49±0.27, 1.43±.25, 1.25±0.23, 1.09±0.21 and 0.93±.21 times higher than ICRU rectal reference point dose. Conclusion: This study demonstrates suboptimal target coverage and underestimation of dose to OAR by 2-dimensional radiography when actual dose estimation was done by 3-dimensional brachytherapy planning for the same brachytherapy session.

Purpose of study: To evaluate the efficacy and safety of oral pilocarpine concomitantly with radiation treatment for the prevention of radiation induced xerostomia in Head and Neck cancer patients. Material and methods: A prospective randomized study was carried out on 60 histopathological proven squamous cell cancer patients of Head and neck region. All patients received a total radiation dose of 66Gy /33 fraction/6.2 weeks (2Gy/fraction, 5 days/ week) on Telecobalt machine with or without concurrent chemotherapy. The concurrent chemotherapy eligible patients received, weekly chemotherapy courses using cisplatin 30 mg/m2. Patients in the study group received oral pilocarpine 5.0 mg three times a day starting 3 days prior to start of radiotherapy and continued for 3 months post radiotherapy. Patients were evaluated on subjective basis based on Zimmerman Questionnaire and EORTC QLQ HN 35. The statistical analysis was done by Paired sample T test. Results: The average Zimmerman Xerostomia score for all parameters combined was as follows: First assessment -100mm vs 100mm; Second assessment -50mm vs 45mm; Third assessment -59mm vs 52mm; Fourth assessment -64mm vs 57mm, Fifth assessment -71mm vs 68. As per QLQ-HN 35 questionnaire used for assessment of quality of life of patients in both groups, we observed that better scores were obtained in the pilocarpine group in comparison to control group. Conclusion: In the present study, the effectiveness of Pilocarpine given during and 3 months post radiotherapy was observed in terms of better compliance during radiation treatment. Most of the patients had less subjective symptoms with lesser grades of toxicities observed during various phases of assessment post RT.

Abstract Patients with acute‐on‐chronic liver failure (ACLF) have a high probability of developing systemic inflammation and sepsis due to immune dysregulation. Fifty‐nine patients with ACLF (12 without and 19 with systemic inflammation, and 28 with sepsis) were serially monitored for clinical and immunological changes at baseline, 6 hours, 24 hours, day 3, and day 7 following hospitalization. Ten healthy controls were also included. At all time points, soluble plasma factors and monocyte functions were studied. Patients with ACLF and systemic inflammation showed higher interleukin (IL)–6, vascular endothelial growth factor‐a, monocyte chemoattractant protein 1, and macrophage inflammatory protein 1β than patients with no systemic inflammation. Patients with ACLF with sepsis had raised (p

This article aims to inform cotton producers, Extension agents, crop advisors, and consultants about the role and management approaches of plant growth regulators in cotton production. Written by Kulpreet Singh, Hardeep Singh, Libbie Johnson, Ethan Carter, Lakesh Sharma, and Ravinder Singh, and published by the UF/IFAS Agronomy Department, May 2023.

Omicron, the new ‘Variant of Concern’ of SARS-CoV-2, is rapidly evolving into new sub-variants or sub-lineages (BA.1, BA.2 etc.). These sub-variants have higher transmissibility, decreased vaccine effectiveness and increased risk of reinfection. As a result, many nations across the globe are reporting surge in infections which is a matter of concern. Understanding Omicron and its sub-variants is vital for development of public health policy and preventing disease transmission. The present paper throws a spotlight on the newly detected sub-variants of Omicron as reported in ongoing researches which are available only in pre-print form and also the importance of a booster dose of the vaccine. Information regarding recent research on a new nasal vaccine formulation, which may be effective against the new variants, is also highlighted in the paper.

Luminescent optical concentrators are thin films containing fluorescent dyes that enable light collection over a wide field of view without the need to track the path of the Sun. However, a disadvantage when using luminescent concentrators is that the performance is often impeded by surface losses through these films. Liquid-crystal (LC) hosts are attractive for luminescent concentrators, as they impart, at the very least, an orientational ordering to the transition dipole moment of the dyes dispersed within these films. This enables the directivity of both the absorption and emission and can reduce surface losses by, for example, adopting the homeotropic alignment of the LC director. This article reviews the developments and applications of LCs to luminescent optical concentrators and describes the strategies that have been introduced to further combat losses by decoupling the absorption and emission processes through Förster energy transfer, the approaches employed to enhance the chemical structures of the dyes, and the methods of using alternative LC phases and external configurations. The review presents a comprehensive summary of the material combinations and the techniques that have been considered in the development of LC-based concentrator films and concludes with a discussion about the future perspectives for these exciting optical concentrators.

Purpose: Dosimetric analysis and effect of different definitions of prescription point “A” to OAR in high dose rate brachytherapy for cervical cancer. Methods and Materials: This retrospective comparative dosimetric study is based on the data of 25 patients with histologically proven cervical carcinoma treated with HDR (high-dose-rate) brachytherapy. Patients received 21 Gy in three fractions (7.0 Gy X three fractions) to point A (AMAN, revised Manchester definition). Further, the patients were replanned with the new point A (AABS) as per the American Brachytherapy Society/ICRU 89 which is defined on CT images. The data compiled was then compared with the data observed from point A (AMAN). Results: When AMAN normalization method was used, the mean dose to the bladder at 0.1cc, 1cc, 2cc and 5cc obtained was 1121.2±54.5, 1058.7±44.1, 875.0±38.6, 780.5±35.9, and 641.2±29.5 cGy respectively. Likewise, using the ICRU-89 point A (ABS) normalization method, the mean dose to 0.1 cc, 0.2 cc, 1 cc, 2 cc, and 5cc bladder volumes was 1178±156.1,1110.0±130.8, 921.6±111.4, 826.6±101.32, and 673.3±80.9 cGy, respectively. For the rectum, point A (MAN) normalization plans, the mean dose of 0.1 cc, 0.2 cc,1 cc, 2 cc, and 5cc rectum volumes was 680±143.5, 652.53±129.8,574.25±131.1, 530±126.9, and 452.5±121.2cGy, respectively. Likewise, using the A (ABS) plan, the mean dose of 0.1 cc, 0.2cc, 1 cc, 2 cc, and 5cc rectum volume was 707.5±148.1, 678.7±128.7, 596.2±135.6, 551.25±127.44 and 471.25±122.64 cGy respectively. The statistical mean difference of Total Reference Air Kerma rate, V100 (cc), bladder, and rectum, was found significant. Conclusion: The present study attempts to analyze the differences in rectum and bladder dose, as well as the size of the volume enclosed for prescribed Isodose curve following ICRU 38 and ABS-ICRU 89 recommendations about intracavitary cervix cancer treated with brachytherapy. With Manchester system being more static, i.e., lesser variation with geometric changes, it is preferable in comparison to ABS system.

Abstract As survey costs continue to rise and response rates decline, researchers are seeking more cost-effective ways to collect, analyze and process social and public opinion data. These issues have created an opportunity and interest in expanding the fit-for-purpose paradigm to include alternate sources such as passively collected sensor data and social media data. However, methods for accessing, sourcing and sampling social media data are just now being developed. In fact, there has been a small but growing body of literature focusing on comparing different Twitter data access methods through either the elaborate firehose or the free Twitter search or streaming APIs. Missing from the literature is a good understanding of how to randomly sample Tweets to produce datasets that are representative of the daily discourse, especially within geographical regions of interest, without requiring a census of all Tweets. This understanding is necessary for producing quality estimates of public opinion from social media sources such as Twitter. To address this gap, we propose and test the Velocity-Based Estimation for Sampling Tweets (VBEST) algorithm for selecting a probability based sample of tweets. We compare the performance of VBEST sample estimates to other methods of accessing Twitter through the Search API on the distribution of total Tweets as well as COVID-19 keyword incidence and frequency and find that the VBEST samples produce consistent and relatively low levels of overall bias compared to common methods of access through the Search API across many experimental conditions.

In the current study, wear performance of pure magnesium (Mg) and composite fabricated with titanium carbide (TiC) reinforcement is investigated under various loading and sliding velocity conditions. The Mg-matrix composite is prepared by friction stir processing (FSP) carried out at optimized values of process parameters. Sliding wear tests on Mg and friction stir processed (FSPed) Mg+TiC surface composite were done on pin-on-disc configuration. The consequence of the normal load applied and sliding velocity on wear behaviour of the two materials is evaluated by performing the tests at two normal loads of 6 N and 12 N and three sliding speeds of 0.5 m/s, 1.5 m/s and 4.5 m/s. FSPed composite found to exhibit an enhanced wear resistance as compared to that of pure Mg. To get an insight into the possible types of mechanisms for wear of the composites sample under varying load and sliding speeds conditions, the worn test specimens are subjected to scanning electron microscopy (SEM). SEM/EDS analysis revealed that oxidation, ploughing, trailing edge and 3-body abrasive wear were the predominant mechanisms for the wear of samples at a different set of experimental conditions. The tensile strength of the FSPed surface composite was found to be 25% higher than pure Mg. Wear resistance was found to increase by about 33%.

Background: Case reviews of severe cutaneous adverse drug reactions (ADRs) such as SJS/TEN provide useful insights for clinical characteristics, putative drugs, and management protocols. Patients and Methods: Medical charts of 62 (m:f- 20:42) patients with SJS/TEN hospitalized between 2010 and 2019 were analyzed retrospectively for clinical attributes, putative drugs and their indications, extracutaneous complications, and therapeutic outcome. The diagnosis was clinical based on established criteria. WHO-UMC scale for reporting ADR and ALDEN algorithm score were used for causality assessment. Therapies were customized based on in-house resources and affordability. Results: Cases included were SJS (41.9%), SJS/TEN overlap (33.9%), and TEN (24.2%) aged 4–85 years. Complications included transaminitis (69.4%), lymphadenopathy (15.5%), septicemia (11.3%), and wound infections (4.8%). Aromatic anticonvulsants (37.1%), disease-modifying antirheumatic drugs (25.8%), antiretroviral drugs (12.9%), non-steroidal anti-inflammatory drugs (8.1%), antimicrobials (4.8%), and trihexyphenidyl (3.2%) were major putative drugs. The mean latent period was 16.6 days. The observed 8% mortality was because of primary comorbidities or multiorgan failure. Addition of fresh blood transfusion (BT, n = 11) or IVIg (n = 7) to systemic corticosteroids showed early relief in skin tenderness, improvement in general condition, and re-epithelialization. Only 16% of patients developed sequelae. Conclusion: Aromatic anticonvulsants, allopurinol, nevirapine, cotrimoxazole, paracetamol, and diclofenac remain the most implicated drugs. Sulfasalazine, leflunomide, ethambutol, and trihexyphenidyl were uncommon additions. A short course of high-dose dexamethasone in the early stage was useful. Addition of BT or IVIg provided rapid relief. Preexisting HIV disease, kidney disease, and sepsis remain important for in-hospital deaths. Retrospective study design and small number of cases remain major limitations.

Background: The mandibular nerve exits the cranial cavity by traversing through the foramen ovale (FO) which is located in the greater wing of sphenoid, posterolateral to foramen rotundum. This foramen also provides an entry portal to the accessory middle meningeal artery and helps exit the lesser petrosal nerve apart from the emissary veins. Tumors and masses in infratemporal region require an accurate and precise morphometry of FO, before planning any surgical procedure. The aim of this study is to record and analyze the metric and nonmetric data and compares the morphometry of FO with gender and age. Methodology: Type of study – Retrospective observational study. The sample size was 200 computerized tomography head axial section scans without any disease which might alter the anatomy of foramen, from picture archiving and communication system. Bilateral foraminal parameters were obtained with the help of computer-assisted software. Results: The mean length, breadth, distance from mid-sagittal plane, and size of FO in males were 7.75 ± 1.16, 3.98 ± 0.91, 21.40 ± 1.75, and 30.94 ± 8.79, and in females, measurements were 6.90 ± 0.78, 3.57 ± 1.04, 20.36 ± 1.62, and 24.86 ± 9.08, respectively. Septation was observed in 2% of cases and the most common shape observed was oval (84%). Totally 26% of accessory foramina were observed. Conclusion: Significant gender differences were seen in the morphometry in all the four parameters. A significant difference with age was seen only with distance of foramen from midsagittal plane. Variations in morphometry and shapes of the FO may affect clinical and diagnostic procedures.

Background: This retrospective study was to understand the clinico-epidemiologic and therapeutic aspects of pemphigus patients attending our clinic. Methods: We analyzed charts of 143 (M: F; 51:92) pemphigus patients having variable severity recorded between 2009 and 2019. Therapies were customized based on patient's age, disease severity, comorbidities, compliance prospects, and affordability. The patients were monitored monthly and as needed for therapeutic outcome in terms of disease control, reduced hospitalization, remission/relapse, and drug toxicity. Results: These patients were aged 15 to 86 years, the majority, 68 (47.5%), was 41 to 60 years of age. The pemphigus vulgaris in 83.9% patients was the commonest variant. Treatment regimens were; dexamethasone-cyclophosphamide-pulse (DCP) therapy in 51.2%, dexamethasone-azathioprine-pulse (DAP) therapy in 11%, dexamethasone-pulse (DP) therapy in 5.5%, rituximab in 24.4%, IVIg in 5.5% patients, and oral corticosteroids with or without adjuvant. Remission occurred after 2–17 (mean 5.8) DCP doses; 14 and 7 patients achieved remission for ≥2 y and ≥5 y, respectively. Rituximab was effective to treat both new and relapsed cases (n = 31). Additional treatment with another adjuvant prolonged remission in seven patients relapsed 12–16 months after treatment with rituximab alone. Overall, oral corticosteroids alone and DAP therapy showed unsatisfactory response. Adverse effects seen in 41.9% of patients were mainly corticosteroids related. Conclusion: The overall clinico-epidemiologic spectrum of pemphigus and therapeutic efficacy of DCP, DAP, or corticosteroids in this study was in sync with the literature. Combining rituximab and corticosteroids plus an immunomodulator initially (phase-1), followed by immunomodulator alone for one year (phase-2) will improve long-term (phase-3) therapeutic outcome. IVIg was effectively useful in patients with concurrent infections.

Background: Despite the fact that hypertension is increasing, merely 50% are aware of the disease. Being aware of hypertension is important to control it. Aim: The study's objective was to estimate the level of hypertension awareness in India and explore its associated sociodemographic factors. Materials and Methods: The data collected in National Family Health Survey 4 (2015–2016) among men aged 15–54 years and women aged 15–49 years were analyzed. Taking awareness of hypertension as an outcome variable, descriptive analysis, and multivariable logistic regression model were performed, by gender. Results: Of 1,41,215 hypertensive individuals analyzed, 34.7% of men and 53.6% of women were aware of being hypertensive. The control among those aware was 67.1% in men and 74.6% in women. The awareness varied among states ranging from 29.6% in Chhattisgarh to 75.6% in Tamil Nadu. The multivariable logistic regression model explained the awareness of hypertension in males increased with age (odds ratios [OR]: 0.226 for 95% confidence interval [CI]: 0.139–0.366 for 25–29 years of age increased to 0.599 for 95% CI: 0.48–0.74 for 40–44 years of age), education (OR of 0.66 for 95% CI: 0.51–0.85 for primary increased to 0.69 for 95% CI: 0.54–0.89 for secondary school level), and wealth status (OR of 0.407 for 95% CI: 0.309–0.535 for poor wealth quintile increased to 1.030 for 95% CI: 0.863–1.230 for the richest wealth quintile). For women, the awareness increased with age (OR of 0.306 for 95% CI: 0.119– 0.791 for the age of 20–24 years increased to 0.736 for 95% CI: 0.570–0.951 for the age of 45–49 years) and wealth status (OR of 0.28 for 95% CI: 0.18–0.44 for poor wealth quintile increased to 1.262 for 95% CI: 0.859–1.855 for the richest wealth quintile). Conclusion: Improving access to hypertension screening and awareness especially among men, with lower wealth and younger age is needed.

Introduction: In India, approximately 35,000 new cleft patients are born every year. Many patients receive suboptimum, improper, little, or no treatment. The cumulative burden of cleft care is up to 1 million cases. The spectrum of problems is varied, the caseload is enormous, and the logistics of treatment delivery are complicated. The Indian Council of Medical Research (ICMR) task force project was launched in 2012 to evaluate the status of cleft care in India and develop strategies to provide comprehensive cleft care through a dynamic multidisciplinary and multidimensional tool. ICMR task force project (2012–14) was conducted in Delhi, and the National Capital Region reported that at least 50% of studied cases had complex and multiple treatment needs. The needs identified were related to surgical, orthodontic, dental, ENT and Speech, rehabilitation of mutilated dentition, and various psychological disturbances among patients with Cleft anomalies. Aim: The aim of this study was to develop and test web-based application to create a system for national data of patients with cleft anomalies and digitize the patient records in a standardized preagreed format. Methods and Results: Corresponding to contemporary digital technologies and evolutionary improvements in data collection, web-based data collection instrument, including text, photographs, X-rays, and audio files, was considered the most appropriate. The experts from varied domains in consultation with ICMR and National Informatics Centre evolved a web-based data collection instrument which is named the “IndiCleft tool.” The tool has been tested and used over the years and is presently being upgraded to dynamic version for a national data and patient care registry. Conclusion: The present article describes the process of the development of a “dynamic” web-based data collection instrument. The IndiCleft tool is the national resource on cleft data in India.