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Patients having inferior turbinate hypertrophy causing intractable sneezing, rhinnorhoea which is non-responsive to conventional medication require alternative therapies. Aim of the study was to compare medical management vs chemical cautery with medical management in treatment of inferior turbinate hypertrophy since both these treatments are easily accessible, cost effective to the patients as well as not associated with major complications. The complaints sneezing, rhinorrhoea, nasal blockage, headache, eye irritation and redness of patients are reduced and quality of life of patients improved after chemical cautery with medical management as compared to medical management alone. 50 patients of age group 15-75 years with c/o Sneezing, rhinorrhoea, nasal blockage and headache were included in our study. Inferior turbinate hypertrophy was diagnosed on the basis of anterior rhinoscopy and diagnostic nasal endoscopy. Patients were divided randomly in 2 group-group A (medical management), group B (chemical cautery with medical management). The 22 question sino-nasal outcome test (SNOTT22) score and rhinomanometry was done before and after treatment to compare the efficacy and detect symptom free period in both groups. Percentage of relief was more among group B patients as compared to group A patients. Symptom free period was more in group B patients as compared to group A patients and both of them were analysed on the basis of SNOTT22 score and rhinomanometry. Chemical cautery with topical application of silver nitrate coupled with medical management is more effective in treatment of inferior turbinate hypertrophy as compared to medical management alone.

Central giant cell lesion is a non-neoplastic proliferation, usually asymptomatic, of unknown aetiology. This case report describes the diagnosis and treatment for a maxillary central giant cell lesion. We report a case of a 30-year-old lady with a central giant cell granuloma (CGCG) who presented with a history of right-side nasal blockage, swelling and pain in the right side of the cheek, proptosis of the right eye, occasional blurred vision for one month. Images and histopathology examinations confirmed the diagnosis. The patient underwent tumour resection through the endoscopic endonasal approach successfully without any postoperative complication, there was no recurrence within a year of follow up and its histopathological analysis was consistent with a CGCG. Histopathological examination of the mass confirmed as CGCG. Complete excision of right sinonasal mass achieved by right endoscopic sinus surgery through modified Denker’s approach. As CGCG is a non-neoplastic lesion of unknown aetiology, histopathology is necessary for definitive diagnosis. Treatment can vary depending on the extension of the tumour.

Amorphous solid dispersions (ASD) are a commonly used enabling formulation technology to drive oral absorption of poorly soluble drugs. To ensure adequate solid-state stability and dissolution characteristics, the ASD formulation design typically has ≤ 25% drug loading. Exposed to aqueous media, ASD formulations can produce drug-rich colloidal dispersion with particle size500 nm. This in situ formation of colloidal particles requires incorporation of excess excipients in the formulation. The concept of using engineered drug-rich particles having comparable size as those generated by ASDs in aqueous media is explored with the goal of increasing drug loading in the solid dosage form. Utilizing ABT-530 as model compound, a controlled solvent-antisolvent precipitation method resulted in a dilute suspension that contained drug-rich (90% (w/w)) amorphous nanoparticles (ANP). The precipitation process was optimized to yield a suspension containing300 nm ANP. A systematic evaluation of formulation properties and process variables resulted in the generation of dry powders composed of 1-8 µm agglomerates of nanoparticles which in contact with water regenerated the colloidal suspension having particle size comparable to primary particles. Thus, this work demonstrates an approach to designing a re-dispersible ANP based powder containing ≥90% w/w ABT-530 that could be used in preparation of a high drug load solid dosage form.

Transgender individuals represent 0.55% of the US population, equivalent to 1.4 million transgender adults. In transgender women, feminisation can include a number of medical and surgical interventions. The main goal is to deprive the phenotypically masculine body of androgens and simultaneously provide oestrogen therapy for feminisation. In gender-confirming surgery (GCS) for transgender females, the prostate is usually not removed. Due to limitations of existing cohort studies, the true incidence of prostate cancer in transgender females is unknown but is thought to be less than the incidence among cis-gender males. It is unclear how prostate cancer develops in androgen-deprived conditions in these patients. Six out of eleven case reports in the literature presented with metastatic disease. It is thought that androgen receptor-mediated mechanisms or tumour-promoting effects of oestrogen may be responsible. Due to the low incidence of prostate cancer identified in transgender women, there is little evidence to drive specific screening recommendations in this patient subpopulation. The treatment of early and locally advanced prostate cancer in these patients warrants an individualised thoughtful approach with input from patients' reconstructive surgeons. Both surgical and radiation treatment for prostate cancer in these patients can profoundly impact the patient's quality of life. In this review, we discuss the evidence surrounding screening and treatment of prostate cancer in transgender women and consider the current gaps in our knowledge in providing evidence-based guidance at the molecular, genomic and epidemiological level, for clinical decision-making in the management of these patients.

A penile prosthesis can be successfully implanted after phalloplasty in transgender men to permit sexual intercourse. A prosthesis can be categorized as malleable or inflatable. The most common penile prosthesis implanted after masculinizing genital surgery is the inflatable prosthesis but this can be a challenging operation with high complication rates. Penile prosthesis in transgender patients differs from cis-patients in many respects but one critical difference is the absence of the tough, protective tunica of the corporal body to contain the prosthesis. This causes greater mobility of the prosthesis under the skin and increases the risk of migration and erosion of the device through the skin. In addition, to overcome the absence of a corpora cavernosa, the proximal portion of the prosthesis must be anchored to bone. Complications include injury to the urethra, vascular injury, skin breakdown, infection, device migration, device failure, extrusion, and erosion. There is no robust data on the use of penile prosthesis in transgender men with only multiple reports of small numbers of patients. While successful implantation can improve patients' quality of life, surgeons should counsel patients about the relatively high risk of the need for revision surgery.

This study aims to examine the role of fintech in financial inclusion and its implications for individuals, businesses, and society. The research uses a combination of quantitative and qualitative methods, including a survey of 98 respondents in the Mumbai Metropolitan Region and in-depth interviews with experts in the field. The results show that fintech has the potential to greatly increase financial inclusion by providing new and more accessible ways for individuals and businesses to access financial services. The most significant drivers for the adoption of fintech in promoting financial inclusion include technology, financial literacy, and innovation, while the most significant barriers include digital literacy, financial literacy, and data security. The study highlights the importance of addressing ethical and social issues, such as data privacy and consumer protection, to ensure that the benefits of fintech reach all members of society. The results provide insights into the current state of financial inclusion and the role of fintech in promoting it, as well as the challenges and opportunities for further development in this area.

High drug load amorphous solid dispersions (ASDs) have been a challenge to formulate partially because drug release is inhibited at high drug loads. The maximum drug load prior to inhibition of release has been termed the limit of congruency (LoC) and has been most widely studied for copovidone (PVPVA)-based ASDs. The terminology was derived from the observation that below LoC, the polymer controlled the kinetics and the drug and the polymer released congruently, while above LoC, the release rates diverged and were impaired. Recent studies show a correlation between the LoC value and drug-polymer interaction strength, where a lower LoC was observed for systems with stronger interactions. The aim of this study was to investigate the causality between drug-PVPVA interaction strength and LoC. Four chemical analogues with diverse abilities to interact with PVPVA were used as model drugs. The distribution of the polymer between the dilute aqueous phase and the insoluble nanoparticles containing drug was studied with solution nuclear magnetic resonance spectroscopy and traditional separation techniques to understand the thermodynamics of the systems in a dilute environment. Polymer diffusion to and from ASD particles suspended in aqueous solution was monitored for drug loads above the LoC to investigate the thermodynamic driving force for polymer release. The surface composition of ASD compacts before and after exposure to buffer was studied with Fourier transform infrared spectroscopy to capture potential kinetic barriers to release. It was found that ASD compacts with drug loads above the LoC formed an insoluble barrier on the surface that was in pseudo-equilibrium with the aqueous phase and prevented further release of drugs and polymers during dissolution. The insoluble barrier contained a substantial amount of the polymer for the strongly interacting drug-polymer systems. In contrast, a negligible amount was found for the weakly interacting systems. This observation provides an explanation for the ability of strongly interacting systems to form an insoluble barrier at lower drug loads. The study highlights the importance of thermodynamic and kinetic factors on the dissolution behavior of ASDs and provides a potential framework for maximizing the drug load in ASDs.

Runaway electrons (REs) are passively studied by hard x-ray (HX) emissions generated by REs. A LaBr3(Ce) detector-based HX spectroscopic diagnostic (operational within ∼75 keV to 3.5 MeV) has been set up on the ADITYA-U. The diagnostic acquisition software utility is upgraded to obtain the temporal evolution of the HX spectrum to understand the RE energy distribution in plasma during its various phases. The peak position moves to lower energy for Ohmically heated discharges (200–80 keV), indicating a relative increase in the thermal particle content in the plasma. The peak position of RE energy shows a decreasing tendency with increasing ne with Ne gas puffing and termination of the electron cyclotron resonance pulse.

Introduction: Almost 10 million patients suffer from tuberculosis all over the world. Miliary tuberculosis accounts for hardly 1-2 % of total tuberculosis cases but is usually fatal if left untreated. With global epidemic of human immunodeficiency virus (HIV) infection chances of developing tuberculosis disease has also increased. In last few decades MTB has shifted to young adults and elderly who are the most productive members of the society. Fifteen adults were diagnosed to have military tuberculosis during last one year and their data were analysed. Persons living with HIV(PLHIV) accounted for 46% of all cases of military TB. Twelve out of 15 were males. None had meningeal involvement. There was no mortality during hospital stay or follow up till date. High index of suspicion in classical clinical settings and early institution of anti-TB treatment can save lives of patients. Sputum for CBNAAT is very helpful in reaching the diagnosis.

A pediatric formulation workshop entitled "Pediatric Formulations: Challenges of Today and Strategies for Tomorrow" was held to advance pediatric drug product development efforts in both pre-competitive and competitive environments. The workshop had four main sessions discussing key considerations of Formulation, Analytical, Clinical and Regulatory. This paper focuses on the clinical session of the workshop. It provides an overview of the discussion on the interconnection of pediatric formulation design and development, clinical development strategy and pediatric clinical pharmacology. The success of pediatric drug product development requires collaboration of multi-disciplinary teams across the pharmaceutical industry, consortiums, foundations, academia and global regulatory agencies. Early strategic planning is essential to ensure alignment among major stakeholders of different functional teams. Such an alignment is particularly critical in the collaboration between formulators and clinical pharmacology teams.

Dissolution testing has long been used to monitor product quality. Its role in quality control of amorphous solid dispersion (ASD) formulations is relatively new. In the presence of the crystalline phase, the dissolution of ASDs is determined by the dynamics between the dissolution rate of the amorphous solids and the rate of crystal growth. The detection of crystalline phase by dissolution test has not been well understood in the context of drug properties, formulation characteristics and dissolution test variables. This study systematically evaluated the impact of key parameters such as intrinsic crystallization tendency of the API, drug loading, extent of dissolution sink conditions and level of crystallinity on the ASD dissolution behavior. The results indicated diverse dissolution behaviors due to the differences in the intrinsic crystallization propensity of the drug, the drug loading, the ASD polymers and the dissolution sink index. Each of the complex dissolution profiles were interpreted based on visual observations during dissolution, the appropriate sink index based on the amorphous solubility, and the competition between drug dissolution versus crystallization. The findings of this study provide insights towards the various considerations that should be taken into account towards rationally developing a discriminatory dissolution method.

Background Ventral hernias are commonly encountered problems in the field of general surgery. Incisional hernia is a common complication following abdominal surgery that requires reoperation. This study was conducted to understand the incidence of various types of ventral hernia in both sexes and various age groups, predisposing factors, clinical features, and complications. Methods This prospective observational study was conducted in the Department of Surgery, Dr. Hedgewar Hospital, Aurangabad, Maharashtra, India, on a total of 100 patients diagnosed with anterior abdominal wall hernia between September 2020 to February 2021. Data collection included thorough history taking and clinical examination along with relevant investigations. The data collected was entered in a proforma, tabulated, and analyzed with the IBM SPSS Statistics for Windows, Version 24.0 (Released 2016; IBM Corp., Armonk, New York, United States). Results Incisional hernia (43%) was the most common of all ventral hernias. Females were much more affected than males. Out of these types studied, epigastric hernia showed more incidence among males. The average age of presentation was 52 years. Obesity was the most common predisposing factor (34%) with female preponderance. Obese patients were also associated with a higher rate of postoperative complications like wound infection and seroma. In the cases of incisional hernia, 32.6% of the patients gave a history of previous surgery complicated by a wound infection. Incisional hernias were more common in lower midline incisions (34.9%) and after gynecological surgery (55.81%) like total abdominal hysterectomy, cesarean section, or tubal ligation. In the majority of the patients (62.8%), the incisional hernia occurred within three years of the previous surgery. Wound infection following ventral hernia repair occurred in 11% of the cases, wound dehiscence in 3%, and seroma in 2 % of the cases. Conclusions The most common ventral hernias in decreasing order of their frequency are incisional hernia, umbilical hernia, para-umbilical hernia, and epigastric hernia. Epigastric and umbilical hernias are more common in males whereas incisional hernia is more common in females. Obesity and constipation were found to be the major predisposing risk factors. Incisional hernia is more common in females after gynecological and obstetrics surgery. The lower midline segment is the most common site for developing an incisional hernia.

Formulating poorly soluble molecules as amorphous solid dispersions (ASDs) is an effective strategy to improve drug release. However, drug release rate and extent tend to rapidly diminish with increasing drug loading (DL). The poor release at high DLs has been postulated to be linked to the process of amorphous-amorphous phase separation (AAPS), although the exact connection between phase separation and release properties remains somewhat unclear. Herein, release profiles of ASDs formulated with ritonavir (RTV) and polyvinylpyrrolidone/vinyl acetate (PVPVA) at different DLs were determined using surface normalized dissolution. Surface morphologies of partially dissolved ASD compacts were evaluated with confocal fluorescence microscopy, using Nile red and Alexa Fluor 488 as fluorescence markers to track the hydrophobic and hydrophilic phases respectively. ASD phase behavior during hydration and release of components were also visualized in real time using a newly developed in situ confocal fluorescence microscopy method. RTV-PVPVA ASDs showed complete and rapid drug release below 30% DL, partial drug release at 30% DL and no drug release above 30% DL. It was observed that formation of discrete drug-rich droplets at lower DLs led to rapid and congruent release of both drug and polymer, whereas formation of continuous drug-rich phase at the ASD matrix-solution interface was the cause of poor release above certain DLs. Thus, the domain size and interconnectivity of phase separated drug-rich domains appear to be critical factors impacting drug release from RTV-PVPVPA ASDs.

Calcinosis cutis is an uncommon disorder identified by the deposition of calcium in the skin and subcutaneous tissue. Idiopathic variety of calcinosis cutis is the one with no underlying damage at the tissue level or an absence of systemic derangement in the calcium and phosphorus metabolism. Here, we report a case of a 65-year-old female diagnosed with idiopathic calcinosis cutis of the hip after her calcium and phosphorus levels were found to be normal and no connective tissue disorder could be identified.

COVID-19 has caused immense psychological and physical stress to almost everyone in the world. It has drastically changed the way people live and work. It has changed the way people communicate with each other and it has also changed the way people perceive different situations, relationships and things. Though a lot is talked about, discussed and researched upon the effects of COVID-19 on work-life balance, education sector, financial issues, issues arising from Work from Home for employees, health concerns about senior citizens and people with co-morbidities, the stress faced by homemakers due to online mode of education and work from home by family members during COVID-19 pandemic, is an area that remains relatively neglected. Family members being at home for most of the time of the day, is a new phenomenon for these homemakers. It is not very easy for them to deal with this new situation emotionally and physically. It means a lot of compromises are expected to be made by the homemaker in terms of time, energy and privacy, as she is most often taken for granted by our male dominated society. She has lost the only ME time that she used to get during the day while her family members were out attending their daily chores. Being at home for most of the time by family members has also increased her work at home as it is assumed by most of the family members that while they are busy attending to their professional and educational commitments, she is relatively free to take care of all their needs. This research paper tries to explore the stress faced by these homemakers due to such situations arising out of COVID-19.

Vinculin is a well-known cytoskeletal protein and is a component of the integrin-mediated cell-matrix adhesion system. Recently, vinculin is also being reported from the nuclei from a number of organisms. However, there is no report yet on purification of nuclear vinculin from the native source of any organism. In the present study, by using western blotting, we show nuclear localization of vinculin in chicken liver. The chicken liver nuclear vinculin was purified to homogeneity and subsequently, the identity of vinculin was confirmed by peptide mass fingerprinting. Further, actin was co-immunoprecipitated with vinculin from chicken liver nuclear extract. Interestingly, the above immunoprecipitate (IP) demonstrated histone specific protease activity. Thus, the present study suggests plausible interaction of vinculin with actin and histone specific proteases in the chicken liver nuclei.

A field experiment entitled, impact of organic nutrients on soil health and enzyme activity in soybean (Glycine max L.) on typic Heplustepts soils in Rajasthan was conducted at Instructional Farm, Rajasthan College of Agriculture, Udaipur during consecutive kharif season of the year 2016 and 2017. The experiment was evaluated in randomized block design (RBD) with three replications. Organic manures (FYM, compost, green leaf manure and vermicompost) were incorporated in treated plots before 15 days of sowing. Variety JS-9560 of soybean was sown as per recommended package of practices. Results showed that organic carbon, available N, P, K and micronutrients, viz. Fe, Zn, Cu and Mn in soil were found maximum at harvest stage of soybean with the application of 100% vermicompost treatment. Enzyme activity dehydrogenase and phosphate activity in soil were significantly influenced through organic nutrient fertilization of 100% vermicompost treatment. Maximum net return of ₹ 60785.07 with benefit cost ratio of 2.9 was obtained with the application of 100% RDF, followed by 100% vermicompost.

We report results from a phase 2, randomized, double-blind, 2-period trial (48 weeks each) of domagrozumab and its open-label extension in patients with Duchenne muscular dystrophy (DMD). Of 120 ambulatory boys (aged 6 to years) with DMD, 80 were treated with multiple ascending doses (5, 20, and 40 mg/kg) of domagrozumab and 40 treated with placebo. The primary endpoints were safety and mean change in 4-stair climb (4SC) time at week 49. Secondary endpoints included other functional tests, pharmacokinetics, and pharmacodynamics. Mean (SD) age was 8.4 (1.7) and 9.3 (2.3) years in domagrozumab- and placebo-treated patients, respectively. Difference in mean (95% CI) change from baseline in 4SC at week 49 for domagrozumab vs placebo was 0.27 (-7.4 to 7.9) seconds (p = 0.94). There were no significant between-group differences in any secondary clinical endpoints. Most patients had ≥1 adverse event in the first 48 weeks; most were mild and not treatment-related. Median serum concentrations of domagrozumab increased with administered dose within each dose level. Non-significant increases in muscle volume were observed in domagrozumab- vs placebo-treated patients. Domagrozumab was generally safe and well tolerated in patients with DMD. Efficacy measures did not support a significant treatment effect. Clinicaltrials.gov identifiers: NCT02310763 and NCT02907619.

Present paper deals with 28 species belonging to 6 genera of family Convolvulaceae collected from this sanctuary. Out of these, one species Ipomoea sagittifolia is reported first time and addition for flora of Rajasthan. Eleven species are reported first time and addition for flora of Aravalli range. Three genera i.e. Argyreia, Merremia and Rivea are first time report and generic addition for flora of Todgarh-Raoli wildlife sanctuary and 25 plant species are addition for flora of Todgarh-Raoli wildlife sanctuary.

Present paper deals with 16 species belonging to 9 genera of family Lamiaceae collected from this sanctuary. Out of these, two species Ocimum basilicum L. var. pilosum (Willd.) Bentham and Orthosiphon aristatus (Blume) Miq. are reported first time and addition for flora of Rajasthan. Five species are reported first time and addition for flora of Aravalli range. Seven genera Anisochilus, Anisomeles, Hyptis, Lavandula, Nepeta, Orthosiphon and Salvia are first time report and generic addition for flora of Todgarh-Raoli wildlife sanctuary and 14 plant species are addition for flora of Todgarh-Raoli wildlife sanctuary.

This paper deals with addition of three raptor birds species (Family: Accipitridae) from Todgarh-Raoli wildlife sanctuary; in which two species i.e. Crested serpent eagle and Crested Hawk eagle are addition to avian diversity of Rajasthan desert and one bird species (Short toed eagle) is first record from this sanctuary. Taxonomic description, distribution, vernacular name, present status, location map and photographs are provide here for their easy identification and updating of avian diversity of Todgarh-Raoli wildlife sanctuary.